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Anesthesia for young children

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https://www.readbyqxmd.com/read/27873010/regional-block-via-continuous-caudal-infusion-as-sole-anesthetic-for-inguinal-hernia-repair-in-conscious-neonates
#1
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
#2
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 11, 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
#3
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...
October 27, 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
#4
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
#5
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
https://www.readbyqxmd.com/read/27663301/laparoscopic-outcomes-of-adnexal-surgery-in-older-children-and-adolescents
#6
Ozlem Dural, Cenk Yasa, Ercan Bastu, Funda Gungor Ugurlucan, Gamze Yilmaz, Bahar Yuksel, Suleyman Engin Akhan, Faruk Buyru
AIM: To evaluate the outcomes of laparoscopic surgery for the treatment of adnexal pathology in older children and adolescents. METHODS: We retrospectively reviewed medical records of 69 pediatric and adolescent patients aged between 9 and 19 years who underwent laparoscopic surgery for adnexal pathology in a tertiary academic center in Istanbul, Turkey, from January 2005 through September 2015. Patients who were pregnant or had non-gynecology pathology detected during surgery were excluded from the study...
September 20, 2016: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/27617832/dexmedetomidine-injection-during-strabismus-surgery-reduces-emergence-agitation-without-increasing-the-oculocardiac-reflex-in-children-a-randomized-controlled-trial
#7
In-Ae Song, Kwang-Suk Seo, Ah-Young Oh, Ji-Seok Baik, Jin Hee Kim, Jung-Won Hwang, Young-Tae Jeon
OBJECTIVE: Dexmedetomidine is known to reduce the incidence of emergence agitation, which is a common complication after inhalational anesthesia like sevoflurane or desflurane in children. However, the dose of dexmedetomidine used for this purpose is reported variously and the most effective dose is not known. In this study, we tried to find the most effective dose of dexmedetomidine to reduce the incidence of emergence agitation in children undergoing strabismus surgery without the complications like oculocardiac reflex (OCR) or postoperative vomiting...
2016: PloS One
https://www.readbyqxmd.com/read/27614719/-facial-trauma-and-injury-in-children
#8
M-P Vazquez, N Kadlub, V Soupre, E Galliani, C Neiva-Vaz, I Pavlov, A Picard
Facial traumas are common in children but often unconsidered. Facial injury is responsible of impressive bleeding because of the rich vascularization of the face; this bleeding is often underestimated because of the immediate arterial vasoconstriction that is very strong for children. The blood volume is 80ml/kg for a newborn, with a total of 250ml, reaching 70ml/kg at one year of age. The evaluation must be rigorously performed due to the risk of a sudden decompensation. Regarding the wounds, the primary repair must be performed directly neat or optimal in case of damaged tissues...
October 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27564558/analysis-of-mri-utilization-in-pediatric-patients
#9
Yolanda Y Huang, Caleb Ing, Gouhua Li, Lena S Sun
INTRODUCTION: Although animal studies have consistently demonstrated long-term neurocognitive deficits following early anesthetic exposure under certain conditions, risk in human children remains unknown. Magnetic resonance imaging (MRI) in young patients often requires anesthesia to facilitate image acquisition. We studied MRI utilization in a pediatric population, and associated use of anesthesia for ambulatory MRI. MATERIALS AND METHODS: Data were obtained from the New York State Inpatient Database and State Ambulatory Surgery and Services Database on MRI performed in children under the age of 18 years from 2005 to 2011...
August 25, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27472253/ketosis-after-cardiopulmonary-bypass-in-children-is-associated-with-an-inadequate-balance-between-oxygen-transport-and-consumption
#10
Philippe Klee, Delphine Arni, Sonja Saudan, Valérie M Schwitzgebel, Ruchika Sharma, Oliver Karam, Peter C Rimensberger
OBJECTIVES: Hyperglycemia after cardiac surgery and cardiopulmonary bypass in children has been associated with worse outcome; however, causality has never been proven. Furthermore, the benefit of tight glycemic control is inconsistent. The purpose of this study was to describe the metabolic constellation of children before, during, and after cardiopulmonary bypass, in order to identify a subset of patients that might benefit from insulin treatment. DESIGN: Prospective observational study, in which insulin treatment was initiated when postoperative blood glucose levels were more than 12 mmol/L (216 mg/dL)...
September 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27397550/early-childhood-exposure-to-short-periods-of-sevoflurane-is-not-associated-with-later-lasting-cognitive-deficits
#11
Mahtab Poor Zamany Nejat Kermany, Fatemeh Roodneshin, Niloofar Ahmadi Dizgah, Ebrahim Gerami, Esmail Riahi
BACKGROUND: A detrimental effect of commonly used anesthetics on the neurodevelopmental and behavioral parameters has long been shown in young animals subjected to early childhood anesthesia. Epidemiologic studies suggest the possibility of a modestly elevated risk of adverse neurodevelopmental outcomes in children exposed to anesthesia during early childhood. However, these results are still preliminary and inconclusive. AIM: To further elucidate the probability of occurrence of such adverse outcomes, we evaluated cognitive performance of children who underwent general anesthesia early in their childhood...
October 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27301607/pediatric-tracheostomy
#12
Paolo Campisi, Vito Forte
Tracheotomy refers to a surgical incision made into a trachea. Tracheostomy, on the other hand, refers to a surgical procedure whereby the tracheal lumen is positioned in close proximity to the skin surface. Tracheostomy is an uncommon procedure in the pediatric population. When required tracheostomy is typically performed as an open surgical procedure under general anesthesia with the patient intubated. However, it may need to be performed under local anesthesia or over a rigid bronchoscope in the patient with a precarious airway...
June 2016: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/27290971/age-related-incidence-of-desaturation-events-and-the-cardiac-responses-on-stroke-index-cardiac-index-and-heart-rate-measured-by-continuous-bioimpedance-noninvasive-cardiac-output-monitoring-in-infants-and-children-undergoing-general-anesthesia
#13
Michael R King, T Anthony Anderson, Jinghu Sui, Guoluo He, Kwun Yee T Poon, Charles J Coté
STUDY OBJECTIVE: To assess the effects of desaturation on stroke index (SI), cardiac index (CI), and heart rate (HR) using the ICON continuous noninvasive cardiac output monitor in children undergoing general anesthesia. DESIGN: Retrospective analysis of a prospectively collected data set. SETTING: Pediatric operating rooms in a tertiary academic medical center. PATIENTS: Children younger than 20 years who experienced desaturation while undergoing general anesthesia...
August 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27281725/adverse-events-and-resource-utilization-after-spinal-and-general-anesthesia-in-infants-undergoing-pyloromyotomy
#14
Caleb Ing, Lena S Sun, Alexander F Friend, Arthur Roh, Susan Lei, Howard Andrews, Guohua Li, Robert K Williams
BACKGROUND AND OBJECTIVES: Interest in spinal anesthesia (SA) is increasing because of concern about the long-term effects of intravenous (IV) and inhaled anesthetics in young children. This study compared SA versus general anesthesia (GA) in infants undergoing pyloromyotomy. METHODS: Between 2000 to 2013, the University of Vermont Medical Center almost exclusively used SA for infant pyloromyotomy surgery, whereas Columbia University Medical Center relied on GA...
July 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27273110/-inhalation-and-intravenous-anesthesia-in-pediatric-patients
#15
M Jöhr
Inhalation as well as total intravenous anesthesia have both advantages and disadvantages. The pros of an inhalation technique are mask induction without the initial need for intravenous access and precise dosing; the pros of an intravenous technique are postoperative quiet recovery and a low incidence of vomiting. With both techniques the aim is to reach a certain, most often constant effect site concentration, which after a short latent period equals the blood concentration. Initially, with both techniques a higher dosing is required to wash in the compound...
June 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27252089/general-anesthetics-and-cytotoxicity-possible-implications-for-brain-health
#16
Ryden Armstrong, Fenglian Xu, Anish Arora, Nivez Rasic, Naweed I Syed
BACKGROUND: The search for agents that bring about faster induction and quicker recovery in the operating room have yielded numerous anesthetics whose mechanisms of action and potential toxic side effects remain unknown, especially in the young and aging brain. OBJECTIVE: Taking advantage of our clinical and basic science expertise, here we subject the reader to an interesting perspective vis-à-vis the current applications of general anesthetics, and present evidence for their neurotoxic effects on the developing and elderly brains...
June 2, 2016: Drug and Chemical Toxicology
https://www.readbyqxmd.com/read/27240510/threshold-changes-of-abr-results-in-toddlers-and-children
#17
Julia Louza, Daniel Polterauer, Natalie Wittlinger, Hanan Al Muzaini, Siiri Scheckinger, Martin Hempel, Maria Schuster
INTRODUCTION: Auditory brainstem response (ABR) is a clinically established method to identify the hearing threshold in young children and is regularly performed after hearing screening has failed. Some studies have shown that, after the first diagnosis of hearing impairment in ABR, further development takes place in a spectrum between progression of hearing loss and, surprisingly, hearing improvement. OBJECTIVE: The aim of this study is to evaluate changes over time of auditory thresholds measured by ABR among young children...
June 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27229508/strategies-to-minimize-sedation-in-pediatric-body-magnetic-resonance-imaging
#18
REVIEW
Camilo Jaimes, Michael S Gee
The high soft-tissue contrast of MRI and the absence of ionizing radiation make it a valuable tool for assessment of body pathology in children. Infants and young children are often unable to cooperate with awake MRI so sedation or general anesthesia might be required. However, given recent data on the costs and potential risks of anesthesia in young children, there is a need to try to decrease or avoid sedation in this population when possible. Child life specialists in radiology frequently use behavioral techniques and audiovisual support devices, and they practice with children and families using mock scanners to improve child compliance with MRI...
May 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27229504/current-role-of-body-mri-in-pediatric-oncology
#19
REVIEW
Ethan A Smith, Jonathan R Dillman
Magnetic resonance imaging (MRI) plays an important role in the imaging of children with non-central nervous system malignancies, and it is increasingly replacing or complementing CT in many cases. MRI has several advantages over CT, including superior contrast resolution as well as superior tissue characterization with the use of novel pulse sequences and functional or organ-specific contrast agents. In addition, the lack of ionizing radiation - an important consideration in children - allows for multiphase dynamic post-contrast imaging, which can be useful for lesion detection and characterization...
May 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27138592/analysis-of-components-of-total-astigmatism-in-infants-and-young-children
#20
Khulood Muhammad Sayed
The aim of this study is to examine and analyze the contribution of corneal and lenticular components of total astigmatism (TA) in infants and young children and to determine whether there is any compensation for astigmatism by the lenticular component or not. The study was conducted on 614 eyes of 307 infants and young children. Cycloplegic refraction and keratometric measures using the Hand-held Autokeratometer (Nidek Co. Ltd., Hiroishi, Japan) were done for the study group under general anesthesia in Paediatric Ophthalmology Center, Sohag City, Egypt...
April 30, 2016: International Ophthalmology
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