Paediatric anaesthesia
-
Paediatric anaesthesia · Feb 2024
It's time to stop using nitrous oxide for pediatric mask induction.
Mask induction of anesthesia for pediatric patients has included the use of nitrous oxide since the inception of pediatric anesthesia. However, the use of nitrous oxide precludes adequate preoxygenation. Additionally, pediatric physiology (less Functional Residual Capacity, higher oxygen consumption), increased risk of laryngospasm and lack of intravenous access increase the risk of a severe airway complication in the event of airway occlusion. Nitrous oxide does not facilitate tranquil mask placement on an unwilling child and does not meaningfully speed mask induction. Exposure to nitrous oxide has potential occupational health concerns and nitrous oxide has significant environmental detriment. ⋯ Utilizing other, evidence-based, techniques to facilitate tranquil mask placement will assure that patients have a pleasant induction experience and avoiding nitrous oxide will reduce the environmental impact, as well as improve the safety of, pediatric mask induction.
-
Paediatric anaesthesia · Feb 2024
ReviewThe effects of dexmedetomidine on intraoperative neurophysiologic monitoring modalities during corrective scoliosis surgery in pediatric patients: A systematic review.
During scoliosis surgery, motor evoked potentials (MEP), and somatosensory evoked potentials (SSEP) have been reported to be affected by the use of higher doses of anesthetic agents. Dexmedetomidine, a sympatholytic agent, an alpha-2 receptor agonist, has been used as an adjunctive agent to lower anesthetic dose. However, there is conflicting evidence regarding the effects of dexmedetomidine on the intraoperative neurophysiological monitoring of MEP and SSEP during surgery, particularly among pediatric patients. ⋯ Given the limitations of the studies available in the literature, it would be advisable to conduct rigorous randomized controlled trials with larger sample sizes to assess the effects of dexmedetomidine use of in scoliosis surgery in pediatric patients.
-
Paediatric anaesthesia · Feb 2024
The effect of intraoperative cerebral oxygen desaturations on postoperative cerebral oxygen metabolism in neonates and infants a pilot study.
Cerebral oxygen desaturation during pediatric surgery has been associated with adverse perioperative outcomes. The aim of this pilot study was to analyze the frequency and severity of intraoperative cerebral oxygen desaturations and their impact on postoperative cerebral oxygen metabolism in neonates and infants undergoing pediatric surgery. ⋯ Cerebral oxygen desaturation during major surgery in neonates and infants is associated with early postoperative increased cerebral oxygen extraction and possibly increased cerebral oxygen metabolism.
-
Paediatric anaesthesia · Feb 2024
Airway topicalization in pediatric anesthesia: An international cross-sectional study.
There is no national or international consensus or guideline on recommended dosing of lidocaine for airway topicalization in children. Doses quoted in the literature vary substantially. ⋯ The results support the need for further research and consensus in this area, in order to provide safe provision of lidocaine airway topicalization in children. It is hoped the results of this study can support future collaborative work in this area.