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'Emergence delirium'

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https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#1
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27871601/effects-of-low-dose-propofol-vs-ketamine-on-emergence-cough-in-children-undergoing-flexible-bronchoscopy-with-sevoflurane-remifentanil-anesthesia-a-randomized-double-blind-placebo-controlled-trial
#2
Tulun Ozturk, Arzu Acıkel, Ozge Yılmaz, Ismet Topçu, Eralp Çevıkkalp, Hasan Yuksel
STUDY OBJECTIVE: To determine the effects of low-dose ketamine and propofol on cough during emergence and the recovery period when administered at emergence in children undergoing fiberoptic bronchoscopy for bronchoalveolar lavage (FOBL) with sevoflurane-remifentanil anesthesia. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Operating room, postoperative recovery area. PATIENTS: Sixty-eight children aged 1 to 8 years old undergoing elective diagnostic FOBL...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27830713/efficacy-and-acceptability-of-different-auxiliary-drugs-in-pediatric-sevoflurane-anesthesia-a-network-meta-analysis-of-mixed-treatment-comparisons
#3
Wuchao Wang, Panchuan Huang, Weiwei Gao, Fangli Cao, Mingling Yi, Liyong Chen, Xiaoli Guo
Emergence agitation preventive medicine should be combined with pediatric anesthesia because of the high frequency of emergence agitation. However, it is challenging to determine the most appropriate medication that can be introduced into pediatric anesthesia for the sake of emergence agitation prevention. We reviewed and retrieved the data from PubMed and Embase. Various medications were assessed based on several endpoints including Emergence agitation outcomes (EA), postoperative nausea and vomiting (PONV), the number of patients who required analgesic (RA), pediatric anesthesia emergence delirium (PAED), the extubation time, the emergency time and the duration of post-anesthesia care unit (PACU) stay...
November 10, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27798810/emergence-delirium-in-pediatric-anesthesia
#4
REVIEW
Arthura D Moore, Doralina L Anghelescu
Emergence delirium (ED) is a complex of perceptual disturbances and psychomotor agitation that occurs most commonly in preschool-aged children in the early postanesthetic period. The incidence of ED varies between 10 and 80% in children and is perceived as a troublesome clinical situation by 42% of pediatric anesthesiologists. Although these events are often short lived, they increase the risk of self-injury and delayed discharge, require additional nursing staff and can increase medical care costs, all of which are causes for concern...
October 31, 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27687337/postanesthesia-emergence-in-patients-with-post-traumatic-stress-disorder
#5
Matthew Umholtz, John Cilnyk, Christopher K Wang, Jahan Porhomayon, Leili Pourafkari, Nader D Nader
STUDY OBJECTIVE: Recovery from anesthesia may be complicated with development of severe panic symptoms and anxiety. Preexisting anxiety disorder has been reported as a risk factor for development of these symptoms. We aimed to examine the frequency of emergence delirium (EDL) among veterans diagnosed with posttraumatic stress disorders (PTSDs). DESIGN: Retrospective cohort. SETTING: Postoperative recovery area. PATIENTS: Perioperative information of 1763 consecutive patients who underwent a surgical procedure requiring general anesthesia were collected...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27635747/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-pediatric-patients-undergoing-general-anesthesia-a-systematic-review-protocol
#6
Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux, James J FitzSimons
This review aims to identify the effectiveness of preoperative intranasal dexmedetomidine compared with oral midazolam for the prevention of emergence delirium in pediatric patients undergoing general anesthesia.
August 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27555179/efficacy-of-premedication-with-intranasal-dexmedetomidine-on-inhalational-induction-and-postoperative-emergence-agitation-in-pediatric-undergoing-cataract-surgery-with-sevoflurane
#7
Yiquan Lin, Ying Chen, Jingxia Huang, Hongbin Chen, Weihua Shen, Wenjun Guo, Qianru Chen, Hongfeng Ling, Xiaoliang Gan
STUDY OBJECTIVES: This study aimed to test the hypothesis that premedication with a single dose of intranasal dexmedetomidine (DEX) could not only reduce preoperative anxiety but also minimize the emergence agitation in children undergoing cataract surgery with sevoflurane anesthesia. DESIGN: Single-blinded, randomized, placebo-controlled clinical comparison study. SETTING: Academic medical center. PATIENTS: Ninety American Society of Anesthesiologists physical status 1 and 2 children scheduled for cataract surgery...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27479259/-emergence-delirium-in-children-prophylaxis-and-treatment
#8
Julius Z Wermelt, Richard K Ellerkmann
Emergence Delirium in children after general anesthesia is a common and self limitating event. Although it might be seen as being harmless it can cause other serious complications and might leave both parents and other caregivers with a negative impression behind. Although the cause may still not be clear, potential predictors can be named: preschool age, the use of fast acting volatile anesthestics, higher preoperative anxiety levels and postoperative pain.A child-focused approach to reduce preoperative anxiety focusing on distraction methods rather than pharmacological sedation may be the key as well as sufficient postoperative pain control and the use of total intravenous anesthesia...
July 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27328618/a-review-of-ketamine-abuse-and-diversion
#9
REVIEW
Sean Sassano-Higgins, Dave Baron, Grace Juarez, Neevon Esmaili, Mark Gold
Ketamine was discovered in the 1960s and released for public use in 1970. Originally developed as a safer alternative to phencyclidine, ketamine is primarily used in clinical settings for analgesia and sedation. In recent years, other uses have been developed, including pain management and treatment of asthma and depression. Clinical use of ketamine causes dissociation and emergence delirium. These effects have led to recreational abuse. Although death from direct pharmacologic effects appears rare, the disinhibition and altered sensory perceptions caused by ketamine puts users at risk of environmental harm...
August 2016: Depression and Anxiety
https://www.readbyqxmd.com/read/27276343/validity-of-different-delirium-assessment-tools-for-critically-ill-children-covariates-matter
#10
Alawi Luetz, Dennis Gensel, Judith Müller, Bjoern Weiss, Viktoria Martiny, Andreas Heinz, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVES: To evaluate test validity of the Pediatric Confusion Assessment Method for the ICU, the Pediatric Anesthesia Emergence Delirium scale, and the newly developed severity scale for the Pediatric Confusion Assessment Method for the ICU; to prospectively assess covariates and their influence on test validity of the scores. DESIGN: Prospective observational cohort study. SETTING: PICU of a tertiary care medical center. PATIENTS: Critically ill patients 5 years old or older ventilated or nonventilated with an ICU length of stay of at least 24 hours...
June 7, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27022817/anesthesia-for-off-floor-dental-and-oral-surgery
#11
Joseph A Giovannitti
PURPOSE OF REVIEW: Anesthesia for dentistry is commonly performed outside the operating room. The combination of a shared airway between surgeon and anesthetist, the variety of open airway techniques, and the out-of-operating room setting often results in anxiety and avoidance of dental cases among anesthesia personnel. This review attempts to demystify dental treatment and facilitate the anesthesia provider in providing effective sedation of dental procedures performed in the nonoperating room setting...
August 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26991753/physostigmine-and-methylphenidate-induce-distinct-arousal-states-during-isoflurane-general-anesthesia-in-rats
#12
Jonathan D Kenny, Jessica J Chemali, Joseph F Cotten, Christa J Van Dort, Seong-Eun Kim, Demba Ba, Norman E Taylor, Emery N Brown, Ken Solt
BACKGROUND: Although emergence from general anesthesia is clinically treated as a passive process driven by the pharmacokinetics of drug clearance, agents that hasten recovery from general anesthesia may be useful for treating delayed emergence, emergence delirium, and postoperative cognitive dysfunction. Activation of central monoaminergic neurotransmission with methylphenidate has been shown to induce reanimation (active emergence) from general anesthesia. Cholinergic neurons in the brainstem and basal forebrain are also known to promote arousal...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26968337/post-anaesthetic-emergence-delirium-in-adults-incidence-predictors-and-consequences
#13
L Munk, G Andersen, A M Møller
BACKGROUND: Emergence delirium (ED) after general anaesthesia (GA) is a well-known phenomenon, yet the risk factors are still unclear. The aims of this study were to determine the incidence and independent predictors of ED and secondly to determine to which degree ED has any relevant, clinical consequences to medical staff as well as to patients. METHOD: This prospective, observational cohort study assessed adult patients emerging from GA in the operating room, using the Richmond Agitation-Sedation Scale (RASS)...
September 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26890267/randomized-controlled-trial-on-preemptive-analgesia-for-acute-postoperative-pain-management-in-children
#14
In-Kyung Song, Yong-Hee Park, Ji-Hyun Lee, Jin-Tae Kim, In Ho Choi, Hee-Soo Kim
BACKGROUND: Preemptive analgesia is an anti-nociceptive treatment that starts before surgery and prevents the establishment of central sensitization. Whether preemptive analgesia is more effective than conventional regimens for managing postoperative pain remains controversial. This study evaluated the efficacy of intravenous preemptive analgesia for acute postoperative pain control in pediatric patients. METHODS: In this prospective randomized controlled trial, 51 children aged 3-7 years, scheduled for corrective osteotomy were randomized into control (group C) or preemptive (group P) group...
April 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26865130/emergence-delirium-or-pain-after-anaesthesia-how-to-distinguish-between-the-two-in-young-children-a-retrospective-analysis-of-observational-studies
#15
M Somaini, T Engelhardt, R Fumagalli, P M Ingelmo
BACKGROUND: Early postoperative negative behaviour in preschool children after general anaesthesia is a common problem. The distinction between emergence delirium (ED) and pain is difficult, but management differs between the two. The aim of the current analysis was to identify individual observational variables that can be used to diagnose ED and allow distinction from postoperative pain. METHODS: This retrospective analysis of data from three previous prospective observational studies included children undergoing general anaesthesia for elective adeno-tonsillectomy, sub-umbilical surgery, and MRI scanning...
March 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26771265/a-randomized-controlled-trial-to-determine-the-effect-of-depth-of-anesthesia-on-emergence-agitation-in-children
#16
RANDOMIZED CONTROLLED TRIAL
Heather J Frederick, Kenneth Wofford, Guy de Lisle Dear, Scott R Schulman
BACKGROUND: The cause of emergence agitation (EA) in children is unknown. Rapid emergence from inhaled anesthesia has been implicated because EA is more common with sevoflurane than with halothane. A dose-dependent effect of sevoflurane, which increases seizure-like electroencephalogram activity, has also been proposed. METHODS: To determine whether depth of anesthesia as measured by bispectral index (BIS) affects EA, 40 ASA physical status I to II children aged 2 to 8 years undergoing ophthalmic surgery were enrolled in a blinded randomized controlled trial of low-normal (40-45, deep) versus high-normal (55-60, light) anesthesia...
April 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26629139/consequence-of-dexmedetomidine-on-emergence-delirium-following-sevoflurane-anesthesia-in-children-with-cerebral-palsy
#17
Yang Liu, Dao-Lin Kang, He-Yi Na, Bi-Lian Li, Ying-Yi Xu, Jin Ni, Jun-Zheng Wu
Children with cerebral palsy can demonstrate irritability following emergence from general anaesthesia. As well, an elevated rate of emergence delirium (ED) in children has been associated with the application of sevoflurane. The current study's intent is to administer dexmedetomidine, in a single dosage administration, at the initial phase of sevoflurane based anesthesia with regard to the occurrence and severity of ED in children afflicted with cerebral palsy. Participating in the study (American Society of Anesthesiologists I-II) are eighty children ranging in ages two through twelve years...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26627917/electrical-stimulation-of-the-heart-7-acupuncture-site-for-preventing-emergence-agitation-in-children-a-randomised-controlled-trial
#18
Toshiyuki Hijikata, Takahiro Mihara, Nobuhito Nakamura, Takaaki Miwa, Koui Ka, Takahisa Goto
BACKGROUND: Emergence agitation is common in children recovering from general anaesthesia. The prevention of emergence agitation remains an important challenge in the field of paediatric anaesthesia. OBJECTIVE: We aimed to examine the effectiveness of electrically stimulating the heart 7 (HT7) acupuncture site with a peripheral nerve stimulator (PNS) during surgery, for preventing emergence agitation in paediatric patients recovering from general anaesthesia. DESIGN: A double-blind, randomised, controlled, parallel-group trial...
July 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/26582315/ultrasound-guided-ilioinguinal-iliohypogastric-block-did-not-reduce-emergence-delirium-after-ambulatory-pediatric-inguinal-hernia-repair-a-prospective-randomized-double-blind-study
#19
Nobuko Ohashi, Sadahei Denda, Kenta Furutani, Takayuki Yoshida, Yoshinori Kamiya, Reiko Komura, Hironobu Nishimaki, Yasushi Iinuma, Yutaka Hirayama, Shinichi Naitou, Koju Nitta, Hiroshi Baba
PURPOSE: Emergence delirium (ED) is a common postoperative complication of ambulatory pediatric surgery done under general anesthesia with sevoflurane. However, perioperative analgesic techniques have been shown to reduce sevoflurane-induced ED. The primary objective of this investigation was to examine whether an ultrasound-guided ilioinguinal/iliohypogastric (II/IH) nerve block for ambulatory pediatric inguinal hernia repair could reduce the incidence of sevoflurane-induced ED. METHODS: The subjects of this prospective randomized double-blind study were 40 boys ranging in age from 1 to 6 years, who were scheduled to undergo ambulatory inguinal hernia repair...
August 2016: Surgery Today
https://www.readbyqxmd.com/read/26559766/pediatric-emergence-delirium-canadian-pediatric-anesthesiologists-experience
#20
H David Rosen, Deborah Mervitz, Joseph P Cravero
INTRODUCTION: Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED...
February 2016: Paediatric Anaesthesia
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