International anesthesiology clinics
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The association between perioperative myocardial ischemia and infarction has clearly been established. In patients undergoing CABG, myocardial ischemia that occurs during the intraoperative period has the strongest correlation with perioperative MI. ⋯ Much of the descriptive phase of this research is complete. It is important next to determine the etiology of perioperative myocardial ischemia and to design treatment regimens that will tell us whether MI is merely associated with perioperative ischemia or is also the cause of cardiac morbidity.
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Both the etiology of Robin sequence and the mechanisms of upper airway obstruction are heterogeneous. As a result, generalizations about the care of newborns with the combination of micrognathia, cleft palate, and airway obstruction cannot be made. ⋯ It should not be assumed that "catch-up growth" of the mandible will occur and lead to spontaneous resolution of either the airway obstruction or the micrognathia. The presentation of the child with Pierre Robin sequence should not be the end of the diagnostic search, but rather the beginning.
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Parents of soon-to-be-anesthetized children frequently express concern about their child's safety because they have heard that "anesthesia is the most dangerous part of the operation." Although I don't believe that statement was ever true, it is even less true today. With the development of reliable capnography and volatile agent measurement in infants and children, we have significantly reduced the risks associated with anesthesia. I think we can, and should, confidently reassure parents that the "anesthesia part of the operation" has been made much safer and that the child's breathing (as well as heart beat, temperature, oxygenation, etc.) will be vigilantly monitored by the anesthesiologist using both human senses and the latest in monitoring equipment.