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Anestesia Pediatrica

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14 papers 0 to 25 followers
Shan-Shan Wang, Ma-Zhong Zhang, Ying Sun, Chi Wu, Wen-Yin Xu, Jie Bai, Mei-Hua Cai, Lin Lin
OBJECTIVE: Premedication with intranasal dexmedetomidine (DEX) has shown to be an effective sedative in pediatric patients. This prospective, randomized, and controlled investigation was designed to evaluate whether the difference in intranasal DEX dosing would produce different beneficial effects on the attenuation of cardiovascular and arousal responses during anesthesia induction and intubation. METHODS: Forty children, aged from 3 to 6 years, of American Society of Anesthesiologists physical status I or II and scheduled for elective adenotonsillectomy randomly received intranasal DEX 1 μg·kg(-1) (group D1) or 2 μg·kg(-1) (group D2) 30 min before anesthesia induction...
March 2014: Paediatric Anaesthesia
Li Jiang, Sheng Ding, Hongtao Yan, Yunming Li, Liping Zhang, Xue Chen, Xiumei Yin, Shunbi Liu, Xiuying Tang, Jinbao Zhang
We hypothesized that postoperative sedation with dexmedetomidine/fentanyl would be effective in infants and neonates with congenital heart disease and pulmonary arterial hypertension (PAH). Children who were <36 months of age, had congenital heart disease with PAH, and had been treated at our hospital between October 2011 and April 2013 (n = 187) were included in this retrospective study. Either dexmedetomidine/fentanyl (Group Dex) or midazolam/fentanyl (Group Mid) was used for postoperative sedation. The main outcome variables included delirium scores, supplemental sedative/analgesic drugs, ventilator use, and sedation time...
June 2015: Pediatric Cardiology
Christopher G Ward, Scott J Hines, Lynne G Maxwell, Francis X McGowan, Lena S Sun
BACKGROUND: Recent articles in both scholarly journals and the lay press about the topic of anesthetic related neurotoxicity have increased the awareness and discussion of this topic with parents and other pediatric medical specialties (i.e., surgeons, radiologists, and pediatricians). AIM: The purpose of the present study was to survey how a subset of pediatric anesthesia departments in the US have responded to the issue of anesthetic related neurotoxicity in terms of clinical practice, training and communication with other medical specialties, and the frequency and timing of discussions with families...
January 2016: Paediatric Anaesthesia
Diego Neuhaus
PURPOSE OF REVIEW: Difficulties to establish a venous access may also occur in routine pediatric anesthesia and lead to hazardous situations. Intraosseous infusion is a well tolerated and reliable but rarely used alternative technique in this setting. RECENT FINDINGS: According to recent surveys, severe complications of intraosseous infusion stay a rare event. Minor complications and problems in getting an intraosseous infusion started on the other side seem to be more common than generally announced...
June 2014: Current Opinion in Anaesthesiology
Jianrong Guo, Xiaoju Jin, Huan Wang, Jun Yu, Xiaofang Zhou, Yong Cheng, Qiang Tao, Li Liu, Jianping Zhang
Desflurane, halothane, isoflurane, propofol, and sevoflurane are widely used anesthetics in pediatric anesthesia. Adverse effect including emergence agitation, postoperative nausea and vomiting, and postoperative pain are common. Prolonged extubation time and emergency time are also troubling anesthesiologists. Previous studies have noted the characteristics of various anesthetics in pediatric anesthesia, while the results were inconclusive and conflicting. In this study, we aimed at performing a comprehensive network meta-analysis concerning the emergence and recovery characteristics of pediatric anesthetics...
August 2017: Molecular Neurobiology
Jeffrey A Feinstein, D Woodrow Benson, Anne M Dubin, Meryl S Cohen, Dawn M Maxey, William T Mahle, Elfriede Pahl, Juan Villafañe, Ami B Bhatt, Lynn F Peng, Beth Ann Johnson, Alison L Marsden, Curt J Daniels, Nancy A Rudd, Christopher A Caldarone, Kathleen A Mussatto, David L Morales, D Dunbar Ivy, J William Gaynor, James S Tweddell, Barbara J Deal, Anke K Furck, Geoffrey L Rosenthal, Richard G Ohye, Nancy S Ghanayem, John P Cheatham, Wayne Tworetzky, Gerard R Martin
In the recent era, no congenital heart defect has undergone a more dramatic change in diagnostic approach, management, and outcomes than hypoplastic left heart syndrome (HLHS). During this time, survival to the age of 5 years (including Fontan) has ranged from 50% to 69%, but current expectations are that 70% of newborns born today with HLHS may reach adulthood. Although the 3-stage treatment approach to HLHS is now well founded, there is significant variation among centers. In this white paper, we present the current state of the art in our understanding and treatment of HLHS during the stages of care: 1) pre-Stage I: fetal and neonatal assessment and management; 2) Stage I: perioperative care, interstage monitoring, and management strategies; 3) Stage II: surgeries; 4) Stage III: Fontan surgery; and 5) long-term follow-up...
January 3, 2012: Journal of the American College of Cardiology
Maya Keplinger, Peter Marhofer, Wolfgang Klug, Birgit Reiter, Thomas Stimpfl, Stephan C Kettner, Lena Korf, Markus Zeitlinger, Daniela Marhofer, Lydia Triffterer
BACKGROUND: Caudal blockade, although an important technique of pediatric regional anesthesia, is rarely used in children heavier than 30 kg. This reservation is due to anatomical concerns and lack of pharmacokinetic data. We therefore set out to evaluate, in pediatric patients weighing 30-50 kg, the feasibility of ultrasound-guided caudal blockade and the pharmacokinetics of caudally administered ropivacaine. METHODS: Twenty consecutive children were included. General anesthesia was used to ensure a secured airway...
November 2016: Paediatric Anaesthesia
Justin B Long, Anita S Joselyn, Tarun Bhalla, Joseph D Tobias, Gildasio S De Oliveira, Santhanam Suresh
BACKGROUND: Currently, there is limited evidence to support the safety of neuraxial catheters in neonates. Safety concerns have been cited as a major barrier to performing large randomized trials in this population. The main objective of this study is to examine the safety of neuraxial catheters in neonates across multiple institutions. Specifically, we sought to determine the incidence of overall and individual complications encountered when neuraxial catheters were used for postoperative analgesia in neonates...
June 2016: Anesthesia and Analgesia
Olivier Brissaud, Astrid Botte, Gilles Cambonie, Stéphane Dauger, Laure de Saint Blanquat, Philippe Durand, Véronique Gournay, Elodie Guillet, Daniela Laux, Francis Leclerc, Philippe Mauriat, Thierry Boulain, Khaldoun Kuteifan
Cardiogenic shock which corresponds to an acute state of circulatory failure due to impairment of myocardial contractility is a very rare disease in children, even more than in adults. To date, no international recommendations regarding its management in critically ill children are available. An experts' recommendations in adult population have recently been made (Levy et al. Ann Intensive Care 5(1):52, 2015; Levy et al. Ann Intensive Care 5(1):26, 2015). We present herein recommendations for the management of cardiogenic shock in children, developed with the grading of recommendations' assessment, development, and evaluation system by an expert group of the Groupe Francophone de Réanimation et Urgences Pédiatriques (French Group for Pediatric Intensive Care and Emergencies)...
December 2016: Annals of Intensive Care
Lisa Hartling, Andrea Milne, Michelle Foisy, Eddy S Lang, Douglas Sinclair, Terry P Klassen, Lisa Evered
BACKGROUND: Sedation is increasingly used to facilitate procedures on children in emergency departments (EDs). This overview of systematic reviews (SRs) examines the safety and efficacy of sedative agents commonly used for procedural sedation in children in the ED or similar settings. METHODS: We followed standard SR methods: comprehensive search; dual study selection, quality assessment, data extraction. We included SRs of children (1 month to 18 years) where the indication for sedation was procedure-related and performed in the ED...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jacqueline A Hannam, Brian J Anderson
Pharmacokinetic (PK) and pharmacodynamic (PD) models are important tools for summarizing drug dose, concentration, and effect relationships. Co-administration of drugs may alter PK and PD relationships. Traditional methods of evaluating PD interactions include using isoboles, shifts in dose-response curves, or interaction indices based on parameters of potency derived from separate monotherapy and combination therapy analyses. These methods provide an estimation of the magnitude of effect for dose or concentration combinations, but they do not inform us on the time course of that effect, or its associated variability...
October 2015: Paediatric Anaesthesia
Jue T Wang, Thomas J Mancuso
No abstract text is available yet for this article.
July 2015: Paediatric Anaesthesia
Michael R King, Paul G Firth, Myron Yaster, Zulfiqar Ahmed, Christine L Mai
Dr. John F. Ryan (1935 - ), Associate Professor of Anaesthesia at the Harvard Medical School, influenced the careers of hundreds of residents and fellows-in-training while instilling in them his core values of resilience, hard work, and integrity. His authoritative textbook, A Practice of Anesthesia for Infants and Children, remains as influential today as it did when first published decades ago. Although he had had many accomplishments, he identified his experiences caring for patients with malignant hyperthermia and characterizing the early discovery of this condition as his defining contribution to medicine...
September 2015: Paediatric Anaesthesia
C Dean Kurth, Charles J Coté
No abstract text is available yet for this article.
July 2015: Anesthesiology
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