Articles: general-anesthesia.
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J Clin Monit Comput · Dec 2020
The Peripheral Perfusion Index tracks systemic haemodynamics during general anaesthesia.
Stable intraoperative haemodynamics are associated with improved outcome and even short periods of instability are associated with an increased risk of complications. During anaesthesia intermittent non-invasive blood pressure and heart rate remains the cornerstone of haemodynamic monitoring. Continuous monitoring of systemic blood pressure or even -flow requires invasive or advanced modalities creating a barrier for obtaining important real-time haemodynamic insight. ⋯ After stabilizing a second HUT decreased PPI 59% (49-76), SV 33% (28-37), CO 31% (28-36), and MAP 34% (26-38). Restoration of preload with PE increased PPI by 607% (218-1078), SV by 96% (82-116), CO by 65% (56-99), and MAP by 114% (83-147). During general anaesthesia changes in PPI tracked changes in systemic haemodynamics.
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J Clin Monit Comput · Dec 2020
Randomized Controlled TrialShortening of the twitch stabilization period by tetanic stimulation in acceleromyography in infants, children and young adults (STSTS-Study): a prospective randomised, controlled trial.
Acceleromyography is characterised by an increase of the twitch response T1 (first twitch of the train-of-four [TOF]) during first 30 min of monitoring known as the staircase phenomenon. In adults the staircase phenomenon can be avoided by tetanic prestimulation. This study examined, if tetanic prestimulation eliminates the staircase phenomenon in children. ⋯ Tetanic prestimulation prevents the staircase phenomenon in these age groups. The stability of the TOFR reading confirms its value to monitor neuromuscular function over time. Registration: The study was registered as NCT02552875 on Clinical Trials.gov on July 29, 2014.
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J Clin Monit Comput · Dec 2020
Heart rate variability and surgical pleth index under anesthesia in poor and normal sleepers.
Poor sleep quality is associated with autonomic dysfunctions and altered pain perception and tolerance. To investigate whether autonomic dysregulations related to insomnia would still exist under general anesthesia, we adopt heart rate variability (HRV) analysis to evaluate ANS activity and surgical pleth index (SPI) to compare nociceptive/anti-nociceptive balance. We enrolled 61 adult females scheduled for gynecological surgeries under general anesthesia. ⋯ Patients with different sleep qualities did not exhibit different SPI levels in all four periods. Poor sleepers exhibited attenuated parasympathetic activities at the baseline but no differences after the induction. Nociceptive/anti-nociceptive balance seems not be altered by poor sleep condition under general anesthesia.
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Observational Study
"Incidence and Location of Atelectasis Developed During Bronchoscopy Under General Anesthesia" (I-LOCATE Trial).
Despite the many advances in peripheral bronchoscopy, its diagnostic yield remains suboptimal. With the use of cone-beam CT imaging we have found atelectasis mimicking lung tumors or obscuring them when using radial-probe endobronchial ultrasound (RP-EBUS), but its incidence remains unknown. ⋯ ClinicalTrials.gov; No.: NCT03523689; URL: www.clinicaltrials.gov.
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Anaesth Crit Care Pain Med · Dec 2020
Conditions requiring hospitalisations, more than general anaesthesia itself, are associated with diagnosis of learning disorders in children.
Anaesthesia is neurotoxic in developing primates. Retrospective clinical studies show a correlation between exposure to anaesthesia during infancy and the occurrence of learning disorders (LD). Prospective studies failed to detect any influence of a single exposure to anaesthesia on neurodevelopment. We hypothesised that some specific populations of children were electively sensitive to anaesthesia-related neurotoxicity. ⋯ One or more hospitalisation(s) may reflect a health status and/or have an iatrogenic effect disrupting the normal setting up of learning abilities. Anaesthesia may play a role, but a correlation between LD and anaesthesia is of a lower magnitude than between LD and hospitalisation.