British journal of anaesthesia
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Randomized Controlled Trial
Visual preconditioning reduces emergence delirium in children undergoing ophthalmic surgery: a randomised controlled trial.
Emergence delirium is a common complication in children, especially in preschool children undergoing ophthalmic surgery. The aim of the study was to investigate the effects of visual preconditioning (application of an eyepatch over the eye to be operated for ≥3 h the day before surgery) on emergence delirium after ophthalmic surgery under sevoflurane anaesthesia. ⋯ NCT02590744.
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Observational Study
Evaluation of the analgesia nociception index for monitoring intraoperative analgesia in children.
Intraoperative analgesia is still administered without guidance. Anaesthetists decide upon dosing on the basis of mean population opioid pharmacological studies and in response to variations in haemodynamic status. However, those techniques have been shown to be imprecise. We assessed the diagnostic value of monitoring the analgesia nociception index (ANI) to detect surgical stimulation in children. ⋯ ANI has diagnostic value for detecting surgical stimuli in children.
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Observational Study
Management of rocuronium neuromuscular block using a protocol for qualitative monitoring and reversal with neostigmine.
Neuromuscular block using subjective monitoring and neostigmine reversal is commonly associated with postoperative residual neuromuscular block. We tested whether a protocol for the management of neuromuscular block that specified appropriate dosing and optimal neostigmine reversal was associated with a reduction in postoperative residual neuromuscular block. ⋯ NCT02660398.
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Transversus abdominis plane block is increasingly used for post-Caesarean section analgesia. Cases of toxicity and the limited pharmacokinetic information during pregnancy motivated this study. The objective of the study was to characterise and compare the pharmacokinetics of levobupivacaine with epinephrine in tranversus abdominis plane block, in post-Caesarean section patients and healthy volunteers. ⋯ NCT02852720.
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Clinical studies report learning disabilities and attention-deficit/hyperactivity disorders in those exposed to general anaesthesia early in life. Rats, primarily males, exposed to GABAergic anaesthetics as neonates exhibit behavioural abnormalities, exacerbated responses to stress, and reduced expression of hypothalamic K+-2Cl- Cl- exporter (Kcc2). The latter is implicated in development of psychiatric disorders, including male predominant autism spectrum disorders. We tested whether parental early life exposure to sevoflurane, the most frequently used anaesthetic in paediatrics, affects the next generation of unexposed rats. ⋯ Neonatal exposure to sevoflurane can affect the next generation of males through epigenetic modification of Kcc2 expression, while F1 females are at diminished risk.