Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2017
Single and multiple sevoflurane exposures during pregnancy and offspring behavior in mice.
The second trimester is a period of neurogenesis and neuronal migration, which can be affected by exposure to anesthetics. Studies also suggest that multiple exposures may have a greater impact on neurodevelopment. ⋯ Our study suggests that neither single nor multiple exposures of mice to sevoflurane during the fetal developmental period induces long-term behavioral dysfunctions or affects long-term synaptic plasticity. Additional studies focusing on early stages of neurodevelopment are necessary to confirm the effects of sevoflurane exposure during pregnancy.
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Paediatric anaesthesia · Jul 2017
Randomized Controlled TrialHemodynamic responses and plasma phenylephrine concentrations associated with intranasal phenylephrine in children.
Intranasal phenylephrine, an alpha-1 adrenergic agonist, causes vasoconstriction of the nasal mucosa and is used to reduce bleeding associated with nasotracheal intubation or endoscopic sinus surgery. The purpose of this study was to describe the hemodynamic effects associated with plasma phenylephrine concentrations following topical intranasal administration of 0.25% and 0.5% phenylephrine in children. ⋯ Administration of intranasal phenylephrine, 0.25% and 0.50%, results in rapid but highly variable systemic absorption that is associated with mild increases of blood pressure that are clinically insignificant. Bleeding associated with nasotracheal intubation was less following administration of 0.5% intranasal phenylephrine than following intranasal saline.
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Paediatric anaesthesia · Jul 2017
Multicenter Study Comparative StudyDifferences in intraoperative hemodynamics between spinal and general anesthesia in infants undergoing pyloromyotomy.
Hypotension and bradycardia are known side effects of spinal anesthesia in pregnant women undergoing cesarean section and adults undergoing other surgical procedures. Whether children experience similar hemodynamic changes is unclear. ⋯ Our findings show that spinal anesthesia performed in healthy infants undergoing pyloromyotomy results in reduced intraoperative blood pressure changes from baseline, significantly higher blood pressure readings, and no increased bradycardia compared to general anesthesia. Further research is needed to assess whether any clinical impact of these hemodynamic differences between spinal and general anesthesia exists.
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Paediatric anaesthesia · Jul 2017
Risk factors for perioperative mortality and transfusion in sacrococcygeal teratoma resections.
Sacrococcygeal teratomas are a common congenital tumor. Surgical resection can occur in utero, in the neonatal period, or in the postneonatal period. ⋯ Prematurity is associated with increased intraoperative and 30-day mortality. Noncystic tumor morphology was the only significant factor associated with transfusion volume and all six patients who died had transfusion volumes of 240 ml·kg-1 or greater. In these patients at high risk of mortality due to blood loss, the anesthesia team should be prepared to manage massive transfusion and coagulopathy with blood components and pharmacologic measures.