Articles: post-operative.
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Paediatric anaesthesia · Jun 2023
ReviewAnxiety in Children: A review on how to address it in the perioperative setting post pandemic.
In this paper, we review the psychological burden of SARS-CoV-2 on children and how health care workers can play a role in mitigating its mental health impact during anesthetic procedures. We evaluate the societal changes that have affected children over 2 years of the pandemic and the subsequent soaring rates of anxiety and depression reported. ⋯ Providers can utilize techniques based on developmental milestones, Certified Child Life Specialists, parental presence during induction, and medications to reduce anxiety. As health care workers, we need to recognize and address these concerns as untreated mental health issues can leave long-term consequences for children.
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Minerva anestesiologica · Jun 2023
Randomized Controlled TrialUltrasonographic assessment of metoclopramide effect on gastric volume in parturients females undergoing Caesarean section: a randomized double blind study.
The prokinetic effect of metoclopramide promotes gastric emptying and decreases stomach capacity. The aim of the present study was to assess the efficacy of metoclopramide in reducing gastric contents and volume using gastric point-of-care ultrasonography (PoCUS) in parturients females prepared for elective Cesarean section under general anesthesia. ⋯ Metoclopramide decreases gastric volume, reduces postoperative nausea and vomiting, and may lower the risk of aspiration when used as premedication before obstetric surgery. Preoperative gastric PoCUS has utility in objectively assessing stomach volume and contents.
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Curr Opin Anaesthesiol · Jun 2023
ReviewA new view on old problems in paediatric anaesthesia: premedication, postoperative agitation and dosing.
The aim of this review is to discuss recent developments in paediatric anaesthesia, which have evolved in an undulating fashion. ⋯ Midazolam and dexmedetomidine are not interchangeable; each compound has its pros and cons. As an anxiolytic drug, midazolam indisputably deserves its place, whereas dexmedetomidine is a better sedative and particularly beneficial in the postoperative period. New data will allow more precise age-adapted dosing of propofol.
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Minerva anestesiologica · Jun 2023
Randomized Controlled TrialComparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after laparoscopic nephrectomy: a randomized controlled non-inferiority clinical trial.
Thoracic paravertebral block offers effective analgesia after laparoscopic nephrectomy but has potential severe complication risks. Erector spinae plane block has been described for analgesia after abdominal surgery. However, there are no prospective randomized trials determining if ultrasound-guided erector spinae plane block is non-inferior to thoracic paravertebral block in terms of analgesia after abdominal surgeries including laparoscopic nephrectomy. ⋯ This study demonstrates that erector spinae plane block provides non-inferior analgesia for pain at rest within 24 postoperative hours in comparison to thoracic paravertebral block for laparoscopic nephrectomy.
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Observational Study
Near-infrared spectroscopy and processed electroencephalogram monitoring for predicting peri-operative stroke risk in cardiothoracic surgery: An observational cohort study.
Stroke is a feared complication after cardiothoracic surgery, with an incidence of around 2 to 3%. Anaesthesia and postoperative sedation may obscure clinical symptoms of stroke and thus delay diagnosis and timely intervention. ⋯ Cumulative intra-operative BIS values below 25 and longer duration of MAP below 60 mmHg were associated with the occurrence of peri-operative stroke within 3 days after cardiothoracic surgery. Prospective studies are warranted to evaluate a causal relationship between low BIS and stroke to establish whether avoiding intra-operative BIS values below 25 might reduce the incidence of peri-operative stroke.