Articles: anesthesia.
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Case Reports
Electroencephalogram-Guided General Anesthesia in a Pediatric Patient With Alexander's Disease: A Case Report.
In this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%. This highlights the potential impact of astrocyte dysfunction on anesthetic sensitivity and robustness of EEG as a biomarker of anesthetic effect, including for pediatric patients with rare neurodevelopmental diseases.
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Review Meta Analysis Comparative Study
The impact of spinal versus general anesthesia on the variability of surgical times: a systematic review and meta-analysis.
With spinal anesthesia, when cases are taking longer than usual, there may be behavioural tendencies for surgical teams to work more quickly. We conducted a systematic review with meta-analysis to examine standard deviations of surgical times for single-dose spinal anesthetics versus general anesthesia. We compared ratios of mean surgical times as a secondary endpoint. ⋯ PROSPERO ( CRD42023461952 ); first submitted 8 September 2023.
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Review Meta Analysis Comparative Study
Comparison of different monitors for measurement of nociception during general anaesthesia: a network meta-analysis of randomised controlled trials.
To avoid underdosing or overdosing of analgesic medications, a variety of nociception monitors that use distinct techniques have been developed to quantify nociception during general anaesthesia. Although prior meta-analyses have examined the behaviour of nociception monitors vs standard care protocols, they did not include the potentially valuable data for monitor-to-monitor comparisons. In order to capture these data fully and compare the behaviour of these monitors, we conducted a systematic search and network meta-analysis. ⋯ Apart from pupillometry, no monitors demonstrated a significant effect on intraoperative opioid consumption. Secondary outcomes indicate limited clinical benefit for patients when using these monitors.