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Anaesthesia for young children

Joe Hulin, Sarah R Baker, Zoe Marshman, Sondos Albadri, Helen D Rodd
BACKGROUND: Decision aids are tools used to help individuals faced with difficult healthcare decisions. They help patients further understand the treatment options available and encourage the sharing of information between patients and clinicians. AIM: To develop a decision aid for young patients faced with the decision to undergo dental treatment with inhalation sedation, intravenous sedation, or general anaesthesia (GA). DESIGN: Qualitative interviews with dental patients (aged 10-16 years), and their parents/guardians were used to inform the content of a draft decision aid...
September 29, 2016: International Journal of Paediatric Dentistry
E Pesonen, J Keski-Nisula, S Andersson, R Palo, J Salminen, P K Suominen
BACKGROUND: Corticosteroids are used in paediatric heart surgery to attenuate systemic inflammatory response. Glycocalyx regulates vascular permeability, shear stress and cell adhesion on the endothelium. Syndecan-1 serves as a biomarker of glycocalyx degradation. Hydrocortisone decreased endothelial glycocalyx degradation in an experimental model. Our hypothesis was that high-dose methylprednisolone decreases glycocalyx degradation as measured by plasma sydecan-1 concentration in children undergoing cardiac surgery...
November 2016: Acta Anaesthesiologica Scandinavica
R L Marsh, M Kaestli, A B Chang, M J Binks, C E Pope, L R Hoffman, H C Smith-Vaughan
BACKGROUND: Invasive methods requiring general anaesthesia are needed to sample the lung microbiota in young children who do not expectorate. This poses substantial challenges to longitudinal study of paediatric airway microbiota. Non-invasive upper airway sampling is an alternative method for monitoring airway microbiota; however, there are limited data describing the relationship of such results with lung microbiota in young children. In this study, we compared the upper and lower airway microbiota in young children to determine whether non-invasive upper airway sampling procedures provide a reliable measure of either lung microbiota or clinically defined differences...
2016: Microbiome
K Bücher, K Rothmaier, R Hickel, R Heinrich-Weltzien, J Kühnisch
AIM: Though the use of advanced behaviour management may facilitate dental treatment in children, some patients still require comprehensive care under general anaesthesia (GA). This is especially true for young children and/or medically compromised children. Thus, this study aimed to provide information about children undergoing GA with regard to age, sex and medical conditions (ICD-10), repeated treatments, dental procedures and recall. MATERIALS AND METHODS: A total of 464 medically compromised children treated under GA in a dental university clinic between 2004 and 2012 were included...
June 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
M A E-M Oomens, L H D Booij, J A Baart
General anaesthesia in children younger than 4 years of age can cause brain damage with cognitive and behavioral problems as a result. The chance of these side effects is small, but increases with prolonged duration of the anaesthesia or when the general anaesthesia is provided more frequently. It goes without saying that the indication for anaesthesia should be very strictly set. In order to reduce the chance of damage, the anaesthesia itself should be performed in consultation between the anaesthesiologist and care provider, according to a set protocol...
May 2016: Nederlands Tijdschrift Voor Tandheelkunde
Nicola Disma, Tom G Hansen
Many studies have demonstrated a neurodegenerative effect of anesthetic drugs in cubs and young animals, raising the concern that similar effects can happen in children, and that the administration of anesthesia in young children undergoing surgical or diagnostic procedures may cause long-term neurocognitive impairment. Thus, several epidemiological studies have been performed with the aim to find a possible association between early anesthesia exposure and poor long-term outcome, like learning disabilities or worse school grading and two prospective trials are currently running, the GAS and the PANDA study...
July 2016: Minerva Anestesiologica
Bonnie C Swan, Susan J Robertson, Alana Tuxen, Ellen Ma, Leona Yip, Lena Ly, Linda Bingham, Andrew Davidson, Philip Bekhor
Capillary malformations (CM) cause significant psychosocial complications. Pulsed dye laser (PDL) treatment at 6-12-weekly intervals under general anaesthesia (GA) commencing in infants at 6 months of age remains the standard of care in order to achieve maximal improvement prior to school age. The safety of repeated GA in children is controversial. Shortening the time between treatments increases the number that can be delivered prior to 6 months of age, thus reducing the number of subsequent treatments needed under GA...
February 23, 2016: Australasian Journal of Dermatology
Joanne Guay, Santhanam Suresh, Sandra Kopp
BACKGROUND: The use of ultrasound guidance for regional anaesthesia has become popular over the past two decades. However, it is not recognized by all experts as an essential tool. The cost of an ultrasound machine is substantially higher than the cost of other tools such as a nerve stimulator. OBJECTIVES: To determine whether ultrasound guidance offers any clinical advantage when neuraxial and peripheral nerve blocks are performed in children in terms of increasing the success rate or decreasing the rate of complications...
2016: Cochrane Database of Systematic Reviews
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
M Weiss, T G Hansen, T Engelhardt
No abstract text is available yet for this article.
July 2016: Archives of Disease in Childhood
Michelle C de Souza, Mike Harrison, Zoe Marshman
OBJECTIVE: To assess parental reports of changes in oral health-related quality of life (OHRQoL) of young children in the UK with early childhood caries (ECC) following dental treatment under general anaesthesia (DGA). To compare the impact of oral rehabilitation (OR) and extraction-only (Exo) treatment approaches on this. METHODS: Data were collected using the proxy reported components of the Child Oral Health-Related Quality of Life (COHRQoL(®) ) questionnaire: the Parent-Caregivers Perceptions questionnaire (P-CPQ) and Family Impact Scale (FIS), from a convenience sample of parents of children receiving DGA at a UK Paediatric Dental Department...
January 17, 2016: International Journal of Paediatric Dentistry
O Gall, B Champigneulle, B Schweitzer, T Deram, O Maupain, J Montmayeur Verchere, G Orliaguet
BACKGROUND: The ability to perform objective pain assessment is very important in paediatric patients. The goal of this study was to investigate the relationship between the analgesia nociception index (ANI), which is based on the heart rate variability, and objective measurements of pain intensity in young or cognitively impaired children, after surgical or imaging procedures (control group) under general anaesthesia. METHODS: On arrival in the recovery room and subsequently at 5-10 min intervals, the level of pain was rated using the FLACC pain scale (0-10)...
December 2015: British Journal of Anaesthesia
Cynthia Pine, Pauline Adair, Girvan Burnside, Louise Robinson, Rhiannon Tudor Edwards, Sondos Albadri, Morag Curnow, Marjan Ghahreman, Mary Henderson, Clare Malies, Ferranti Wong, Vanessa Muirhead, Sally Weston-Price, Hilary Whitehead
BACKGROUND: In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions...
2015: Trials
Andrew J Davidson, Nicola Disma, Jurgen C de Graaff, Davinia E Withington, Liam Dorris, Graham Bell, Robyn Stargatt, David C Bellinger, Tibor Schuster, Sarah J Arnup, Pollyanna Hardy, Rodney W Hunt, Michael J Takagi, Gaia Giribaldi, Penelope L Hartmann, Ida Salvo, Neil S Morton, Britta S von Ungern Sternberg, Bruno Guido Locatelli, Niall Wilton, Anne Lynn, Joss J Thomas, David Polaner, Oliver Bagshaw, Peter Szmuk, Anthony R Absalom, Geoff Frawley, Charles Berde, Gillian D Ormond, Jacki Marmor, Mary Ellen McCann
BACKGROUND: Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy has any effect on neurodevelopmental outcome. Here we report the secondary outcome of neurodevelopmental outcome at 2 years of age in the General Anaesthesia compared to Spinal anaesthesia (GAS) trial...
January 16, 2016: Lancet
V Mixa, B Nedomova, I Berka
The popularity of continuous caudal epidural block in post-operative analgesia in very young children has been growing. This method of analgesia is used in major abdominal and urological surgeries. A local anaesthetic, usually levobupivacaine, is administered through an epidural catheter introduced via hiatus canalis sacralis. The usual type of the catheter is Arrow G20 armed with a metal spiral, which can be used for children of up to approximately 2000 g of body weight. We want to introduce a modification of the method which uses the thin silicone catheter Premicath G28...
2015: Bratislavské Lekárske Listy
Frank Weber, Stefan Van Beek, Gail Scoones
BACKGROUND: Potential neurotoxicity of anesthetic drugs is currently one of the most intensely discussed issues in pediatric anesthesia. Prospective human data are sorely lacking and there is an on-going debate among experts in the field whether one should (or can) extrapolate animal data to humans. Data regarding the thoughts of practicing anesthetists regarding this topic have not been published. METHODS: A web-based survey to assess the thoughts of practicing (European) anesthetists regarding neurotoxicity and how it may have influenced their daily practice of pediatric anesthesia...
March 2016: Minerva Anestesiologica
D Bakhos, H Vitaux, A Villeneuve, S Kim, E Lescanne, V Pigeon, J M Aoustin, P Bordure, J Galvin
The objective of this study was to investigate the usefulness of auditory steady-state responses (ASSRs) for estimating hearing thresholds in young children, compared with behavioural thresholds. The second objective was to investigate ASSR thresholds obtained with insert earphones versus supra-aural headphones to determine which transducer produces ASSR thresholds most similar to behavioural thresholds measured with supra-aural headphones. This retrospective study included 29 participants (58 ears): 12 children (24 ears) in the insert group and 17 children (34 ears) in the supra-aural group...
August 2016: European Archives of Oto-rhino-laryngology
E Widström, J Linden, H Tiira, T T Seppälä, M Ekqvist
OBJECTIVES: To analyse treatment measures provided in the Public Dental Service (PDS) and to discuss the therapy given against treatment needs as expressed in the national clinical epidemiological studies. METHODS: In 2009, the Chief Dentists of the PDS units collected data from their local registers on patients and treatment provided. Data were obtained from 166 PDS units (86%). Treatment patterns were compared between age groups, provider groups and geographical areas using chi-square tests...
March 2015: Community Dental Health
Ida Louise Heiberg, Lars Nebrich, Pernille Pedersen
We present two cases in which two boys of four weeks and four and a half months, respectively, experienced seizures and respiratory insufficiency as complications to the local anaesthesia administered for ritual circumcision. They both needed intubation and anticonvulsive therapy and acquired an aspiration pneumonia, which was treated with antibiotics. Both recovered without sequelae. Surgeons should be careful with calculating the maximum safe dose of local anaesthesia for young children and should be prepared to treat complications...
June 29, 2015: Ugeskrift for Laeger
L H D J Booij, R C W Burgersdijk
Many histological studies, animal experiments and also human studies during the past 30 years have proven that the use of general anaesthesia in young children under the age of four can have a permanent effect on the brain, which is still developing, and can therefore cause learning and/or behaviour problems later in life. This knowledge has to be taken seriously into account in the discussion with parents whether general anaesthesia is really necessary for the treatment of Early Childhood Caries in very young children...
January 2015: Nederlands Tijdschrift Voor Tandheelkunde
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