Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2020
Use of Dexmedetomidine and Opioids as the Primary Anesthetic in Infants and Young Children: A Retrospective Cohort Study.
Anesthetic regimens using dexmedetomidine and short-acting opioids have been suggested as potential alternatives to sevoflurane-based anesthesia in children. The primary aim of this study is to compare demographics, intraoperative characteristics, and complications of general anesthetics in which dexmedetomidine and opioids were used without sevoflurane, or in combination with a low sevoflurane concentration, in children 36 months old and younger. The secondary aim is to evaluate intraoperative bispectral index (BIS) values when available in these patients. ⋯ Dexmedetomidine and opioids can effectively be used in young children as an alternative total intravenous anesthesia technique with or without <1 minimum alveolar concentration of sevoflurane. Bispectral index monitoring reveals a likely sufficient depth of hypnosis.
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Paediatric anaesthesia · Sep 2020
Effects of hypothermia and hypothermia combined with hypocapnia on cerebral tissue oxygenation in piglets.
Hypothermia and its combination with hypocapnia are frequently associated with anesthesia. ⋯ The hypothermia-induced reduction in oxygen delivery was compensated by lowered metabolic demand. However, hypothermia was not able to compensate for an additional reduction in oxygen delivery caused by simultaneous hypocapnia. This resulted in a PtO2 drop, which was not reflected by a downshift in rSO2 .
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Paediatric anaesthesia · Sep 2020
Exhaled Nitric Oxide Measurement before Pediatric Adenotonsillectomy: A Feasibility Study.
Exhaled nitric oxide (eNO) is a known biomarker for the diagnosis and monitoring of bronchial hyperreactivity in adults and children. ⋯ eNO testing on the day of surgery has limited feasibility in children younger than 7 years of age. The most common reason for failure was inadequate physical performance while interacting with the testing device. The role of this respiratory biomarker in the context of perioperative outcomes for pediatric adenotonsillectomy remains unknown and should be further studied with improved technologies.
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Paediatric anaesthesia · Sep 2020
Observational StudyEffect of etomidate on systemic and regional cerebral perfusion in neonates and infants with congenital heart disease: A prospective observational study.
Neonates and infants with congenital heart disease undergoing general anesthesia have an increased risk for critical cardiovascular events. Etomidate produces very minimal changes in hemodynamic parameters in older children with congenital heart disease. There is a lack of studies evaluating the effect of etomidate on systemic and regional cerebral perfusion in neonates and infants with congenital heart disease. ⋯ Etomidate 0.4mg kg-1 does not impair systemic or regional cerebral perfusion in neonates or infants with congenital heart disease.