Articles: general-anesthesia.
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J Neurosurg Anesthesiol · Oct 2023
Early Neurodevelopmental Outcomes Following Exposure to General Anesthesia in Infancy: EGAIN, a Prospective Cohort Study.
General anesthesia (GA) is known to worsen neural outcomes in animals, but human research assessing early-life GA exposure and neurodevelopment show inconsistent findings. We investigated the effects of a single GA exposure for minor surgery on the neurodevelopment of healthy children at multiple time-points, using clinical assessments along with behavioral and neurophysiological measures rarely used in human research. ⋯ GA-exposed children did not differ from unexposed children in cognitive, language or motor outcomes at 24 months, but exhibited poorer parent-reported behavior scores. Differences in infant behavior and neurophysiology were detected at 6 and 18 months. Neurophysiological assessments may complement clinically relevant assessments to provide greater insights into neurodevelopment following early GA exposure.
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Curr Opin Anaesthesiol · Oct 2023
ReviewSpine surgery under neuraxial vs. general anesthesia: the current state of comparative outcomes research.
The impact of primary anesthetic technique on outcomes after spine surgery is controversial. Given frequent calls for well designed prospective comparative studies of neuraxial anesthesia vs. general anesthesia and recent reports of 'awake spine surgery' successes in the surgical literature, an updated evidence review is indicated. ⋯ Our understanding of the risks, benefits and comparative outcomes between neuraxial anesthesia and general anesthesia for spine surgery is evolving. Although the results derived from this body of literature suggest specific benefits of neuraxial anesthesia, further research is required before widespread recommendations for either technique can be made. Until then, both neuraxial anesthesia and general anesthesia are reasonable choices for lumbar spine surgery of short duration, in appropriately selected patients.
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Patients with mastocytosis have an increased risk of anaphylaxis during surgical procedures with general anesthesia. Therefore, we reviewed the anesthesia course of a large cohort of patients with mastocytosis. ⋯ Intraoperative anaphylaxis can be the first presenting sign of mastocytosis. Patients with mastocytosis who received chronic antimediator therapy and/or preoperative prophylactic medications had an uneventful surgical course.
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Minerva anestesiologica · Oct 2023
Randomized Controlled TrialPupillary monitoring decreases remifentanil consumption during laparoscopic uterine surgery and improves postoperative recovery.
The aim of this paper was to explore pupillary monitoring for determining remifentanil consumption during general anesthesia and evaluating postoperative recovery quality. ⋯ Intraoperative pupil dilation reflex monitoring can reduce remifentanil consumption and improve postoperative recovery quality. Furthermore, postoperative pupil light reflex monitoring can help evaluate pain degree with high sensitivity.
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Randomized Controlled Trial
Effects of an open lung extubation strategy compared with a conventional extubation strategy on postoperative pulmonary complications after general anesthesia: a single-centre pilot randomized controlled trial.
Postoperative pulmonary complications (PPCs) are a common cause of morbidity. Postoperative atelectasis is thought to be a significant risk factor in their development. Recent imaging studies suggest that patients' extubation may result in similar postoperative atelectasis regardless of the intraoperative mechanical ventilation strategy used. In this pilot trial, we hypothesized that a study investigating the effects of an open lung extubation strategy compared with a conventional one on PPCs would be feasible. ⋯ ClinicalTrials.gov (NCT04993001); registered 6 August 2021.