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Anesthesia for young children

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https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#1
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306195/influence-of-caudal-block-on-postoperative-oliguria-in-infants-undergoing-bilateral-ureteroneocystostomy-a-retrospective-analysis
#2
Hyun Jeong Lee, Yong Seon Choi, Bon-Nyeo Koo, Sang Won Han, Young Eun Cho, Young Jae Im, Jae Hoon Lee
BACKGROUND: Caudal block has been widely used in children undergoing genitourinary surgery. However, the influence of caudal block on postoperative oliguria is unclear. AIM: The aim of this study was to assess the effect of caudal block on urinary flow through the reimplanted ureter after ureteroneocystostomy and the incidence of postoperative oliguria in infants. METHODS: This retrospective study analyzed the medical records of 121 infants aged less than 12 months who underwent bilateral ureteroneocystostomy for vesicoureteral reflux at a tertiary medical center...
March 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28276857/safety-considerations-of-anesthetic-drugs-in-children
#3
Raeford E Brown
Great strides have been made in the last twenty years in providing safe anesthesia care for infants and children. Despite a historical record of safety, recent findings have called to question the toxicities of many anesthetic agents. Observations concerning the inherent safety of these agents, their appropriate management in infants, and new findings which suggest overlooked toxicities will be discussed. Areas covered: A literature search using Pub Med identified journal articles relating to the safety of anesthetic agents in infants and children...
March 1, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28256096/dexmedetomidine-sedation-combined-with-caudal-anesthesia-for-lower-abdominal-and-extremity-surgery-in-ex-preterm-and-full-term-infants
#4
Katrin Waurick, Cristina Sauerland, Christiane Goeters
BACKGROUND: Awake caudal anesthesia is a potentially attractive option, because the administration of general anesthesia is associated with a high rate of respiratory complications and hemodynamic disturbances and potential neurotoxic effects. To facilitate the caudal puncture and subsequent surgical intervention, additional sedatives are commonly administered. AIM: We aimed to establish a new, safe, and effective anesthetic procedure for very young children with comorbidities...
March 2, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28244242/defining-hypotension-in-anesthetized-infants-by-individual-awake-blood-pressure-values-a-prospective-observational-study
#5
Frank Weber, Laurens Koning, Gail P Scoones
BACKGROUND: Blood pressure (BP) is the most commonly applied clinical surrogate parameter for tissue perfusion and cerebral autoregulation. Hypotension during anesthesia may contribute to unfavorable outcome in young children. Hypotension in anesthetized infants can be defined using BP values relative to individual awake baseline or absolute BP values. AIM: The aim of this study was to investigate the applicability of the two definitions and to compare the incidences of hypotension...
February 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28243884/role-of-ct-in-congenital-heart-disease
#6
REVIEW
Prabhakar Rajiah, Sachin S Saboo, Suhny Abbara
Congenital heart diseases (CHD) are being increasingly encountered in cardiac imaging due to improved outcomes from surgical and interventional techniques. Imaging plays an important role in the evaluation of CHD, both prior to and after surgeries and interventions. Computed tomography (CT) has several advantages in the evaluation of these disorders, particularly its high spatial resolution, multi-planar reconstruction capabilities at sub-millimeter isotropic resolution, good temporal resolution, wide field of view, and rapid turnaround time, which minimizes the need for sedation and anesthesia in young children or children with disabilities...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28224632/scoping-review-awareness-of-neurotoxicity-from-anesthesia-in-children-in-otolaryngology-literature
#7
REVIEW
Marisa A Earley, Liem T Pham, Max M April
OBJECTIVE: Review otolaryngology literature for awareness of neurotoxicity from general anesthesia in children. Recently, there has been increasing focus in anesthesia literature on the long-term effects of general anesthesia on neurodevelopment. Multiple animal models have demonstrated evidence of neurotoxicity from both inhalational and intravenous anesthetics. Cohort studies also have revealed modestly increased risk of adverse neurodevelopmental outcomes in children exposed to a single episode of general anesthesia prior to 3 to 4 years of age, with stronger evidence for multiple exposures in this age range...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28211134/effect-of-age-on-the-performance-of-bispectral-and-entropy-indices-during-sevoflurane-pediatric-anesthesia-a-pharmacometric-study
#8
Alberto Sciusco, Joseph F Standing, Yucheng Sheng, Pasquale Raimondo, Gilda Cinnella, Michele Dambrosio
BACKGROUND: Bispectral index (BIS) and entropy monitors have been proposed for use in children, but research has not supported their validity for infants. However, effective monitoring of young children may be even more important than for adults, to aid appropriate anesthetic dosing and reduce the chance of adverse consequences. This prospective study aimed to investigate the relationships between age and the predictive performance of BIS and entropy monitors in measuring the anesthetic drug effects within a pediatric surgery setting...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28209547/pregnancy-after-urinary-diversion-at-young-ages-risks-and-outcome
#9
Nina Huck, S Schweizerhof, P Honeck, A Neisius, J W Thüroff, R Stein
OBJECTIVE: To assess the urologic and obstetric outcomes during and after pregnancy following urinary diversion (UD) performed during childhood or adolescence. MATERIALS AND METHODS: From our UD database, we identified 25 women who became pregnant between 1981 and 2013. Reasons for UD were neurogenic bladder, exstrophy, trauma, sinus urogenitalis, and interstitial cystitis. Seventeen had continent cutaneous diversion, 4 had continent anal diversion, and 4 had colonic conduit...
February 14, 2017: Urology
https://www.readbyqxmd.com/read/28193114/the-relationship-of-exposure-to-anesthesia-on-outcomes-in-children-with-isolated-oral-clefts
#10
Amy L Conrad, Jon W Goodwin, James Choi, Robert I Block, Peg Nopoulos
This study evaluated the relationship between exposure to anesthesia and previously identified differences in cognitive functioning, growth, and volumetric brain measures among a sample of children, adolescents, and young adults with isolated oral clefts. Data from a cross-sectional study were combined with a retrospective chart review. Data were obtained for 87 participants with isolated cleft lip and/or palate (55% male), ranging from 7.5 to 27 years old (mean = 15.78, standard deviation = 4.58). Measures of interest included cognitive functioning, growth measures, and brain volumes...
March 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28184267/prediction-of-endotracheal-tube-size-for-pediatric-patients-from-the-epiphysis-diameter-of-radius
#11
Hee Young Kim, Ji Hyun Cheon, Seung Hoon Baek, Kyung Hoon Kim, Tae Kyun Kim
BACKGROUND: Using a too big or a too small size of an endotracheal tube in pediatric patients would result in tracheal injury or insufficient ventilation. Determining the appropriate endotracheal tube size is important because using an inappropriate size can cause complications. This study was performed to predict the appropriate endotracheal tube size by measuring the transverse diameter of the epiphysis of the distal radius under the assumption that the growth rates of cartilages in the entire body are close to each other...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183568/the-effect-of-play-distraction-on-anxiety-before-premedication-administration-a-randomized-trial
#12
Gözde Bumin Aydın, Serhat Yüksel, Jülide Ergil, Reyhan Polat, Fatma Kavak Akelma, Musa Ekici, Murat Sayın, Öner Odabaş
STUDY OBJECTIVE: The majority of children scheduled to undergo surgery experience substantial anxiety in the preoperative holding area before induction of anesthesia. Pharmacological interventions aimed at reducing perioperative anxiety are paradoxically a source of stress for children themselves. Midazolam is frequently used as premedication, and the formula of this drug in Turkey is bitter. We aimed to assess the role of distraction in the form of playing with play dough (Play-Doh) on reducing premedication anxiety in children...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181351/sedation-methods-for-transthoracic-echocardiography-in-children-with-trisomy-21-a-retrospective-study
#13
Jeff Miller, Lili Ding, James Spaeth, Jennifer Lam, Joanna Paquin, Erica Lin, Allison Divanovic, Bi Lian Li, Shankar Baskar, Andreas W Loepke
BACKGROUND: Many children with Trisomy 21 have neurologic or behavioral problems that make it difficult for them to remain still during noninvasive imaging studies, such as transthoracic echocardiograms (TTEcho). Recently, intranasal dexmedetomidine sedation has been introduced for this purpose. However, dexmedetomidine has been associated with bradycardia. Children with Trisomy 21 have been reported to have a higher risk of bradycardia and airway obstruction with sedation or anesthesia compared to children without Trisomy 21...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28079825/the-utility-of-bispectral-index-monitoring-for-prevention-of-rocuronium-induced-withdrawal-movement-in-children-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Byung Gun Lim, Il Ok Lee, Young Sung Kim, Young Ju Won, Heezoo Kim, Myoung Hoon Kong
BACKGROUND: This study was designed to determine whether a deep hypnotic state with a bispectral index (BIS) value less than 40 could alleviate withdrawal movement (WM) upon rocuronium injection during anesthesia induction in children. METHODS: Finally, 135 healthy children (3-12 years) scheduled for minor elective surgery were studied. Without premedication, anesthesia was induced with thiopental sodium 5 mg/kg. Patients were randomized into 2 groups (control vs experimental) and then by virtue of rocuronium injection time, patients in the experimental group were allocated into 2 groups, as follows: in the control group (group C; n = 45), rocuronium 0...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28017292/bullosis-diabeticorum-in-a-young-child-case-report-of-a-very-rare-entity-and-a-literature-review
#15
Anca Chiriac, Irina Costache, Cristian Podoleanu, Adrian Naznean, Simona Stolnicu
Bullosis diabeticorum (BD), or diabetic bulla, is 1 of the cutaneous manifestations of diabetes mellitus, reported in 0.5% of people with diabeties in the United States, mostly in adult men who have had long-lasting and uncontrolled diabetes associated with diabetic peripheral neuropathy. However, BD in young children is a mostly unrecognized entity. We present a case of BD in a 3-year-old girl with type 1 diabetes mellitus who had been treated with insulin for 7 months prior to hospitalization. Dermatologic examination revealed a large, tense bulla filled with clear fluid and not associated with pain or pruritus, localized on the lateral margin of the right hand...
December 21, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27873010/regional-block-via-continuous-caudal-infusion-as-sole-anesthetic-for-inguinal-hernia-repair-in-conscious-neonates
#16
Claudia M Mueller, Tiffany J Sinclair, Megan Stevens, Micaela Esquivel, Noah Gordon
PURPOSE: The use of general anesthesia in young children has come under increasing scrutiny due to its potential long-term neurotoxic effects. Meanwhile, regional anesthesia for surgical procedures in neonates has many advantages, including preservation of respiratory status and faster return to feeding. We describe the successful use of 3% 2-chloroprocaine administered via continuous caudal infusion as the sole anesthetic agent during elective surgical procedures in infants. METHODS: A retrospective chart review of all patients who underwent elective surgical procedures under continuous caudal regional anesthetic at a single institution was performed...
November 21, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27842864/-use-of-hypnosis-in-radiotherapy-as-an-alternative-to-general-anesthesia-in-pediatric-radiation-oncology
#17
Line Claude, Magali Morelle, Sandrine Mancini, Anita Duncan, Henri Sebban, Christian Carrie, Perrine Marec-Berard
BACKGROUND: General anesthesia (GA) is often needed for radiotherapy (RT) in young children. This study aimed to evaluate the place of the rituals and/or hypnosis in pediatric in a reference center in pediatric radiation oncology in Rhône-Alpes Auvergne. METHODS: This observational study retrospectively collected data on AG in children<5 years treated by RT in Leon-Berard regional center, Lyon, France between 2003 and 2014. Two-time periods, before and after 2008 have been compared, the second one introducing accompaniment methods such as hypnosis systematically...
November 2016: Bulletin du Cancer
https://www.readbyqxmd.com/read/27787571/-anesthesia-for-medical-students-a-brief-guide-to-practical-anesthesia-in-adults-with-a-web-based-video-illustration
#18
REVIEW
S Mathis, O Schlafer, J Abram, J Kreutziger, P Paal, V Wenzel
In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career...
December 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27711024/reference-intervals-of-thromboelastometric-evaluation-of-coagulation-in-pediatric-patients-with-congenital-heart-diseases-a-retrospective-investigation
#19
Ji Young Kim, Yu Rim Shin, Hae Keum Kil, Mi Ran Park, Jong Wha Lee
BACKGROUND Rotational thromboelastometry (ROTEM®) is a point-of-care test for coagulation, enabling physicians to make a swift decision. The aim of this investigation was to establish reference intervals of thromboelastometric evaluation for coagulation in pediatric patients with congenital heart diseases (CHD). MATERIAL AND METHODS As baseline data, 3 assays of ROTEM® (INTEM, EXTEM, and FIBTEM) were measured after anesthesia induction. ROTEM® parameters were clotting time (CT), amplitude at 10 min (A10), clot formation time (CFT), a angle, maximal clot firmness (MCF), clot lysis index at 60 min (LI60), and maximal clot elasticity (MCE)...
October 6, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27672305/successful-conjunctival-socket-expansion-in-anophthalmic-patients-until-the-age-of-2-years-an-outpatient-procedure
#20
Rania Assem El Essawy, Sameh Hassan Abdelbaky
PURPOSE: To report the results of a simple outpatient method for soft tissue socket expansion in young children with congenital anophthalmos. METHODS: Seventeen congenital anophthalmic sockets of 15 infants of a mean age of 4.2±4.4 months were fitted with specially designed serial solid acrylic shapes or hydrogel expanders using cyanoacrylate for eyelids closure when using the latter. RESULTS: At the age of 2 years, the mean horizontal eyelid length increased from a mean of 11...
2016: Clinical Ophthalmology
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