Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2023
Consequences of General Anesthesia in Infancy on Behavior and Brain Structure.
One in 7 children will need general anesthesia (GA) before the age of 3. Brain toxicity of anesthetics is controversial. Our objective was to clarify whether exposure of GA to the developing brain could lead to lasting behavioral and structural brain changes. ⋯ The preclinical and clinical findings of these independent studies suggest lasting effects of early life exposure to anesthetics on later emotional control behaviors and brain structures.
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Anesthesia and analgesia · Feb 2023
Meta AnalysisAssociation Between the FRAIL Scale and Postoperative Complications in Older Surgical Patients: A Systematic Review and Meta-Analysis.
Several frailty screening tools have been shown to predict mortality and complications after surgery. However, these tools were developed for in-person evaluation and cannot be used during virtual assessments before surgery. The FRAIL (fatigue, resistance, ambulation, illness, and loss of weight) scale is a brief assessment that can potentially be conducted virtually or self-administered, but its association with postoperative outcomes in older surgical patients is unknown. The objective of this systematic review and meta-analysis (SRMA) was to determine whether the FRAIL scale is associated with mortality and postoperative outcomes in older surgical patients. ⋯ As measured by the FRAIL scale, frailty was associated with 30-day mortality, 6-month mortality, postoperative complications, and postoperative delirium.
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Anesthesia and analgesia · Feb 2023
Always Assess the Raw Electroencephalogram: Why Automated Burst Suppression Detection May Not Detect All Episodes.
Electroencephalogram (EEG)-based monitors of anesthesia are used to assess patients' level of sedation and hypnosis as well as to detect burst suppression during surgery. One of these monitors, the Entropy module, uses an algorithm to calculate the burst suppression ratio (BSR) that reflects the percentage of suppressed EEG. Automated burst suppression detection monitors may not reliably detect this EEG pattern. Hence, we evaluated the detection accuracy of BSR and investigated the EEG features leading to errors in the identification of burst suppression. ⋯ Our results complement previous results regarding the underestimation of burst suppression by other automated detection modules and highlight the importance of not relying solely on the processed index, but to assess the native EEG during anesthesia.