Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2017
Randomized Controlled TrialThe influence of parents' voice on the consumption of propofol for pediatric procedural sedation-a randomized controlled trial.
In pediatric patients, invasive procedures such as the insertion of a central venous catheter or gastroscopy require deep sedation. It is unknown whether listening to parental voice during deep sedation in children can reduce sedative doses. ⋯ Listening to parental voice during deep sedation does not result in a reduction of sedative dose in children undergoing short medical procedures.
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Paediatric anaesthesia · Apr 2017
Observational StudyOptimization of initial propofol bolus dose for EEG Narcotrend Index-guided transition from sevoflurane induction to intravenous anesthesia in children.
Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. ⋯ After sevoflurane induction, a reduced propofol bolus dose of 1 mg·kg-1 followed by TIVA according to McFarlan's regime resulted in a NI within the recommended range in children aged 1-8 years. During the course of TIVA, children younger than 2 years displayed higher NI values and more pronounced interindividual variation. Processed EEG monitoring is recommended to find adequate individual age-dependent doses.
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Paediatric anaesthesia · Apr 2017
Observational StudyDefining hypotension in anesthetized infants by individual awake blood pressure values: a prospective observational study.
Blood pressure (BP) is the most commonly applied clinical surrogate parameter for tissue perfusion and cerebral autoregulation. Hypotension during anesthesia may contribute to unfavorable outcome in young children. Hypotension in anesthetized infants can be defined using BP values relative to individual awake baseline or absolute BP values. ⋯ Awake BP values were unobtainable in 15% of our patients, resulting in the necessity to define hypotension under anesthesia using absolute BP values. Definitions of hypotension using either absolute MAP or values relative to awake baseline are not interchangeable.
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Paediatric anaesthesia · Apr 2017
Effects of partial sleep deprivation on reaction time in anesthesiologists.
Fatigue in anesthesiologists may have implications that extend beyond individual well-being. ⋯ Reaction time increased considerably in anesthesiologists after a night call duty. Greater subjective reliance on avoidance as a coping strategy was associated with greater deterioration in performance.
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Paediatric anaesthesia · Apr 2017
The effect of sevoflurane on electrocorticographic spike activity in pediatric patients with epilepsy.
Electrocorticogram (ECoG) spike activity is enhanced under general anesthesia with 1.5 minimum alveolar concentration (MAC) sevoflurane compared with lower concentrations in adult patients with epilepsy. However, the effect of concentration of sevoflurane on ECoG in children with epilepsy is less known. ⋯ Sevoflurane at 1.5 MAC significantly increased the extent and the number of spikes, prolonged the duration of suppression, and decreased median frequency of ECoG compared with those at 2.5% sevoflurane.