Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2014
Exposure to general anesthesia in early life and the risk of attention deficit/hyperactivity disorder development: a nationwide, retrospective matched-cohort study.
Postnatal exposure to anesthetics can cause neural apoptosis and degeneration in animals, but results from studies conducted on humans were discordant. Previous studies contained no information on the relationship between neurobehavioural disorders and anesthesia exposure in Asian children. We conducted a retrospective matched-cohort study in Taiwan to investigate the association of early life anesthesia exposure with risk of attention deficit/hyperactivity disorder (ADHD). ⋯ Exposure to general anesthesia before 3 years of age was not associated with ADHD.
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Paediatric anaesthesia · Jul 2014
ReviewIntraoperative neurophysiological monitoring in pediatric neurosurgery.
The use of intraoperative neurophysiological monitoring (IONM) in pediatric neurosurgery is not new; however, its application to a wider range of procedures is a relatively new development. The purpose of this article is to review the physiology underlying the commonly employed IONM modalities and to describe their application to a subset of pediatric neurosurgical procedures.
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Paediatric anaesthesia · Jul 2014
Randomized Controlled TrialSevoflurane-induced changes in infants' quantifiable electroencephalogram parameters.
Electroencephalogram (EEG) based depth of anesthesia algorithms developed in the adult population have not demonstrated the same reliability when applied to infants. This may be due to frequency changes occurring in the EEG during development. Amplitude-integrated EEG (aEEG) is based primarily in the time domain and hence may have greater utility in infants. ⋯ The aEEG is unlikely to be a useful measure of anesthesia depth in young children.
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Paediatric anaesthesia · Jul 2014
ReviewEndoscopic pediatric neurosurgery: implications for anesthesia.
Endoscopic surgery is increasingly utilized in neurosurgery for all pediatric age groups. Endoscopic intraventricular neurosurgery represents a unique approach to intracranial pathology but may cause a unique set of limitations and potential complications. Important endoscopic neurosurgical techniques and their indications, perioperative anesthesia management, complications, and success rates are reviewed with special emphasis on endoscopic third ventriculostomy and endoscopic-assisted strip craniectomy in early infancy. Despite encouraging short- and long-term results of early pediatric endoscopic neurosurgery, multicenter randomized studies will be needed to further determine safety and the effect on cognitive development and quality of life.
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Paediatric anaesthesia · Jul 2014
Comparative StudyEvaluation of the auditory evoked potentials derived aepEX(™) as a measure of hypnotic depth in pediatric patients receiving sevoflurane-remifentanil anesthesia.
The aepEX is a measure of depth of hypnosis (DoH), derived from processed mid-latency auditory evoked potentials. ⋯ In this study with children receiving sevoflurane anesthesia, the aepEX outperformed the BIS in distinguishing unconsciousness from consciousness. Both indices performed equally bad in differentiating different levels of DoH.