Clinical meeting Wednesday 19th July

(Posted on behalf of Peter McLaren.)

  • Date: Wednesday 19th July
  • Time: 5.30 for 6.00pm
  • Topic: Myasthenia gravis and anaesthesia – is it all now just a non-event?
  • Presenter: Peter McLaren
  • Venue: Pindara Boardroom.

The topic is a case presentation and review of the literature by me on ‘myasthenia gravis and anaesthesia – is it all now just a non-event?’ I would hope that others might also have contributions to the discussion. The venue is the boardroom, Pindara Hospital. Note that this is located in the main hospital at the end of the corridor leading from the main entrance in Allchurch St. 5.30 for 6. Food and drink supplied. Sponsored by Stephen Shields from MSD, the distributers of sugammadex, who will give a short presentation from 5.45. Surgeons interested in the topic are welcome to attend.

SPANZA Advisory on Tramadol

Recommendations Following FDA Warnings about Tramadol Use in Children
  1. Tramadol can have a useful role as part of a multimodal analgesic regimen for managing acute pain in children.
  2. Tramadol dose should be limited for acute pain after tonsillectomy (e.g., maximum dose 1 mg/kg 6-8 h, max 400 mg/day). We suggest starting with a lower dose of 2 mg/kg daily in divided doses (e.g., 0.5 mg/kg 6-8 h). Tramadol overdose is a greater danger than CYP variants.
  3. Children with obstructive sleep apnoea who have undergone tonsillectomy should continue to be monitored in hospital overnight to assess both response and sensitivity to opioids before discharge. While evidence is lacking, it may be prudent to observe any child given opioids during a period of sleep before discharge.
  4. The use of any opioid in children after day-stay surgery should be done so with caution.

The full document can be downloaded here.