Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2017
Observational StudyElectroencephalographic discontinuity during sevoflurane anesthesia in infants and children.
Deep anesthesia in adults may be associated with electroencephalographic (EEG) suppression and higher rates of postoperative complications. Little is known about the impact of anesthetic depth on short- or long-term outcomes in pediatrics. Brain activity monitoring may complement clinical signs of anesthetic depth. This prospective observational study aimed to assess the frequency and degree of profound EEG suppression using multichannel EEG in children during sevoflurane general anesthesia. ⋯ Electroencephalographic monitoring may complement clinical signs in providing information about brain homeostasis during general anesthesia. The impact of discontinuity events on immediate and long-term outcomes merits further study.
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Paediatric anaesthesia · Mar 2017
Review Meta AnalysisThe use of methadone to facilitate opioid weaning in pediatric critical care patients: a systematic review of the literature and meta-analysis.
Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. ⋯ We did not identify sufficient evidence to recommend any particular methadone weaning strategy, or to recommend methadone over other medications or prescribed infusion weaning, for successful weaning of continuous opioid infusions in the pediatric intensive care setting.
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Paediatric anaesthesia · Mar 2017
Comment LetterReply to Greenstein, Alan; Morton, Neil; Patil, Vinodkumar, regarding their comment on "Optimized preoperative fasting times decrease ketone body concentration and stabilize mean arterial blood pressure during induction of anesthesia in children younger than 36 months: a prospective observational cohort study".