Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2018
ReviewAnesthesia and the developing brain: A way forward for laboratory and clinical research.
All commonly used general anesthetics have been shown to cause neurotoxicity in animal models, including nonhuman primates. Opinion, however, remains divided over how cumulative evidence from preclinical and human studies in this field should be interpreted and its translation to current practices in pediatric anesthesia and surgery. A group of international experts in laboratory and clinical sciences recently convened in Genoa, Italy, to evaluate the current state of both laboratory and clinical research and discuss future directions for basic, translational, and clinical studies in this field. ⋯ If anesthetics cause structural or functional adverse neurological effects in young children, alternative or mitigating strategies need to be considered. While protective or mitigating strategies have been repeatedly studied in animals, there are currently no human data to support alternative anesthetic strategies in clinical practice. Lastly, it was noted that there is still considerable debate over the clinical relevance of anesthesia neurotoxicity, and the need to evaluate the impact of other aspects of perioperative care on neurodevelopment must also be considered.
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Paediatric anaesthesia · Sep 2018
Association between children's emotional/behavioral problems before adenotonsillectomy and postoperative pain scores at home.
Children undergoing adenotonsillectomy are at risk of severe postoperative pain and sleep problems. Little is known about the specific child risk factors for these problems. ⋯ Following adenotonsillectomy, children often experienced moderate to severe pain and sleep problems during the first 3 days at home. Preoperative internalizing problems and parental need for information were independently associated with increased pain at home. Screening for these problems can help to identify vulnerable children and adapt the perioperative analgesic strategy accordingly (which includes preparation, information, and prescription of pain analgesics).
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Paediatric anaesthesia · Sep 2018
Biography Historical ArticleHow David Hatch became a professor of pediatric anesthesia.
This is an account of an interview with David John Hatch who was one of the first Professors of Pediatric Anesthesia in the world. He began his anesthesia career as a medical student administering chloroform and ended it 40 years later as a Consultant at Great Ormond Street Hospital where he developed and led a world renowned research team measuring and assessing lung function in infants and children. ⋯ Yet he does not think of himself as an academic. In his words "I wanted to be a hard working clinician with an interest in research, and not just academic".