Neuroblastoma and anaesthesia

The haemodynamic problems associated with anaesthesia and neuroblastoma were reviewed in 52 children who underwent 138 operations at The Hospital for Sick Children, London, UK. At diagnosis 42 patients (81%) had elevated urinary catecholamine metabolites; nine (17%) were hypertensive, of whom eight were treated with adrenergic blockade. The incidence of intra-operative hypertension due to excess catecholamine release was 9% (13/138), and was confined to the group undergoing tumour excision (29%; 13/45). Hypertension was observed more frequently in patients who had not received chemotherapy. It was effectively controlled by labetalol. Patients symptomatic of catecholamine secretion before surgery should be managed in a similar manner for those with a phaeochromocytoma. Surgical manipulation of the tumour predisposes to paroxysmal hypertension. Careful monitoring is advised.     

Larsen's syndrome: anaesthetic implications. Six case reports

Six cases were examined to review the important anaesthetic implications of Larsen's syndrome. Potential problems arising in these patients are highlighted and emphasis placed on cervical spine and airway/respiratory management.     

Postnatal Parental Concerns: The First Six Weeks of Life

The postnatal needs of parents from the infant's birth to the first physician visit remain largely unmet. This project explored these needs through the abstraction and coding of questions normally phoned to the health care provider during this period. The differential effects of infant sex, age, and parent parity on the contents of these questions were also explored. Findings suggest that parents of first or male infants have a much higher rate of questions. Several striking interactive effects were observed and are presented.     

Colitis Cystica Profunda

Colitis cystica profunda is a benign disease characterized by variably sized mucin-filled cysts beneath the muscularis mucosae. The clinicopathologic features of five patients are described. The accumulated evidence suggests that awareness of this entity both by clinicians and pathologists will help differentiate it from carcinoma and decrease the need for radical surgery.     

Halothane hepatitis in an 11–month-old child

Halothane hepatitis is extremely rare in childhood. However, this occurred in an 11-month-old infant, following multiple exposure to halothane. The diagnosis was confirmed by detection of specific antibodies to halothane-sensitised rabbit hepatocytes. The anaesthetic technique for a subsequent procedure with a halothane-free breathing system is also outlined.