Articles: general-anesthesia.
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Review Meta Analysis
Early exposure to general anesthesia may contribute to later attention-deficit/hyperactivity disorder (ADHD): A systematic review and meta-analysis of cohort studies.
The association between early childhood exposure to general anesthesia and subsequent risk of developing attention-deficit/hyperactivity disorder remains unknown. ⋯ Exposure to general anesthesia during early childhood increases the risk of developing attention-deficit/hyperactivity disorder. In particular, multiple general anesthesia exposures and exposures longer than 60 min significantly increase the risk of developing ADHD.
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Minerva anestesiologica · Nov 2024
ReviewMultimodal analgesic strategies in polytraumatized patients.
In recent years, the resuscitation of trauma patients has improved; however, pain related to trauma remains associated with systemic complications. In trauma patients, pain should be considered a vital sign, and its control is crucial for reducing complications, improving patient satisfaction, and enhancing the quality of life. ⋯ In this review, we offer the reader an updated general framework of the various approaches available for pain treatment in polytraumatized patients, with a focus on the opportunities presented by regional anesthesia. We will examine different types of locoregional anesthesia blocks and describe ultrasonographic execution techniques.
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Postoperative neurocognitive disorders (PNDs) frequently occur following orthopedic surgery and are closely associated with adverse prognosis. PNDs are an emerging concept that includes both postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). The prevention of combined use of peripheral nerve block (PNB) and general anesthesia (GA) on POCD and/or POD incidence following orthopedic surgery remains unknown. We aimed to investigate the effect of this combined anesthesia method on POCD/POD incidence after orthopedic surgery, compared with GA. ⋯ The combined use of PNB and GA decreases the incidence of POCD but not POD following orthopedic surgery.
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Journal of anesthesia · Oct 2024
ReviewRemimazolam for anesthesia and sedation in pediatric patients: a scoping review.
Anesthetic management of pediatric patients poses several challenges and the optimal anesthetic agent for use in this population is still a matter of debate. We systematically searched PubMed/MEDLINE and Google Scholar from their inception for studies that investigated the role and potential applications of remimazolam, a novel ultra-short-acting benzodiazepine, in pediatric patients. Furthermore, in March 2024, an update of the literature search along with an additional post-hoc search on the EMBASE database were performed. ⋯ Moreover, the current evidence suggested that remimazolam may contribute to reducing preoperative anxiety and postoperative delirium in children. Its favorable pharmacodynamic and pharmacokinetic profile demonstrated potential safety, effectiveness, and ease-of-use in various perioperative pediatric contexts, making it suitable for integration into specific protocols, such as intraoperative monitoring of evoked potentials and management of difficult intubation. Notwithstanding these promising findings, further research is essential to determine optimal dosages, establish conclusive evidence of its superiority over other benzodiazepines, and elucidate the impact of genetic factors on drug metabolism.
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Minerva anestesiologica · Oct 2024
Meta Analysis Comparative StudyComparison between hemodynamic effects of remimazolam and propofol during general anesthesia: a systematic review and meta-analysis.
The need for safe anesthetic agents with minimal side effects has led to the development of remimazolam, a new benzodiazepine designed to be an alternative to the commonly used drug propofol, which has significant hemodynamic effects. This study aims to compare the hemodynamic effects of remimazolam with propofol during general anesthesia. ⋯ This study provides evidence that remimazolam induces fewer cardiorespiratory depressant effects and has a more favorable side effect profile compared to propofol during general anaesthesia.