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Neonatal anesthesia

Efrain Riveros-Perez, Amy C Hermesch, Linda A Barbour, Joy L Hawkins
Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem...
2018: International Journal of Women's Health
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
Jinglan Zhang, Jiakai Lu, Xiaorui Zhou, Xuefeng Xu, Qing Ye, Qitan Ou, Yanna Li, Jiapeng Huang
OBJECTIVES: The mortality of pregnant women with idiopathic pulmonary arterial hypertension (PAH) is very high. There are limited data on the management of idiopathic PAH during pregnancy. The authors aimed to examine systematically the characteristics of parturient women with idiopathic PAH, to explore the adverse effects of idiopathic PAH on pregnancy outcomes, and to report the multidisciplinary perioperative management strategy from the largest comprehensive cardiac hospital in China...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Nicole Rosskothen-Kuhl, Heika Hildebrandt, Ralf Birkenhäger, Robert-Benjamin Illing
Neuron-glia interactions contribute to tissue homeostasis and functional plasticity in the mammalian brain, but it remains unclear how this is achieved. The potential of central auditory brain tissue for stimulation-dependent cellular remodeling was studied in hearing-experienced and neonatally deafened rats. At adulthood, both groups received an intracochlear electrode into the left cochlea and were continuously stimulated for 1 or 7 days after waking up from anesthesia. Normal hearing and deafness were assessed by auditory brainstem responses (ABRs)...
2018: Frontiers in Cellular Neuroscience
Zhi-Peng Wang, Jue Ma, Sheng Wang, Li-Na Yu, Jin-Feng Wei, Jin-Dong Xu
OBJECTIVE: To compare the safety of sevoflurane anesthesia with laryngeal mask and tracheal intubation in cesarean section in women with heart disease. METHODS: Fifty-two pregnant women with heart diseases undergoing cesarean section were randomized into laryngeal mask (LAM) group and tracheal intubation group. In LAM group, 6% sevoflurane was given at the rate of 6 L/min for induction with a maintenance sevoflurane concentration of 3%. In the intubation group, 1...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Yang Li, Wei-Guang Li, Ze-Guo Feng, Cheng-Gang Zhang, Lian-Jun Huang, Xiao-Rui Yang, Ying-Qun Yu
OBJECTIVE: To investigate the effect of propofol and operative trauma on the neurodevelopment and cognitive function of the developing brain and its mechanism. METHODS: A total of 104 postnatal day 13 Sprague-Dawley rats were randomly divided into 4 groups: control group (treated by 7.5 mL/kg saline and sham surgery), propofol group (treated by 75 mg/kg propofol), surgery group (with abdominal surgery under local anesthesia) and propofol+surgery group (with abdominal surgery under local anesthesia plus 75 mg/kg propofol anesthesia)...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Carolyn F Weiniger, Anya Krichevsky, David Mankuta, Smadar Eventov Friedman
BACKGROUND: Early-term cesarean delivery (CD) increases neonatal respiratory morbidity; however planned later-term cesarean delivery (CD) may generate urgent CD related to spontaneous onset of labor. STUDY AIMS: We investigated maternal and neonatal morbidity for planned early (37/38 week) versus later-term (39/40 weeks) CD. Our primary study aim was to investigate severe maternal morbidity and general anesthesia rates according to early versus later-term CD. Our secondary study aims were to investigate the rate of urgent surgery and other measures of maternal morbidity, and neonatal morbidity, according to early versus later-term CD and according to urgent versus elective planned CD...
March 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
Roberta Rassi Mahamed, Carla Cristina Maganhin, Gisela Rodrigues Silva Sasso, Manuel de Jesus Simões, Maria Candida Pinheiro Baracat, Edmund Chada Baracat, José Maria Soares-
BACKGROUND: Metformin influences insulin receptor signaling, which might interfere with the proliferation of ovarian follicular structures and steroidogenesis. We hypothesize that reductions in glucose and insulin levels might interfere with CYP-17 expression and histomorphological changes in an androgenized rat model. The aim of this study was to analyze the effect of metformin on CYP-17 expression, follicular dynamics, and proliferative parameters in neonatally androgenized female rats...
March 1, 2018: Journal of Ovarian Research
Allan F Simpao, Jorge A Gálvez, Elicia C Wartman, W Randall England, Lezhou Wu, Mohamed A Rehman, Thienkim V Ngo
BACKGROUND: The migration of pediatric thoracic epidural catheters via a thoracic insertion site has been described. We assessed the migration of caudally threaded thoracic epidural catheters in neonates and infants at our institution. METHODS: The anesthesia records and diagnostic imaging studies of neonates and infants who had caudal epidural catheters placed during a 26-month period at our hospital were analyzed. Imaging studies were reviewed for changes in epidural catheter tip position...
February 23, 2018: Anesthesia and Analgesia
Hee Young Kim, Seung-Hoon Baek, Seong Wan Baik, Sun Sik Bae, Jung Min Ha, Minkyoung Kim, Gyeong-Jo Byeon, Hye Jin Kim, Hyun-Su Ri, So Hyun Kim
BACKGROUND: Sevoflurane is commonly used in general anesthesia for premature neonates. The main mechanism of retinopathy of prematurity (ROP) is increased levels of vascular endothelial growth factor (VEGF). For the investigation of sevoflurane's effect on angiogenesis, the angiogenesis and VEGF expression in the retina were measured after administering sevoflurane in an oxygen-induced retinopathy mice model. MATERIALS AND METHODS: The mice were divided into the normoxic group (Nc and Ns group; n = 6) and the ROP group (C, Rc, and Rs group; n = 6)...
February 20, 2018: Journal of Anesthesia
Mohamed Mohamed Tawfik, Amany Ismail Tarbay, Ahmed Mohamed Elaidy, Karim Ali Awad, Hanaa Mohamed Ezz, Mohamed Ahmed Tolba
BACKGROUND: The optimal strategy of fluid administration during spinal anesthesia for cesarean delivery is still unclear. Ultrasonography of the inferior vena cava (IVC) has been recently used to assess the volume status and predict fluid responsiveness. In this double-blind, randomized controlled study, we compared maternal hemodynamics using a combination of 500-mL colloid preload and 500-mL crystalloid coload versus 1000-mL crystalloid coload. We assessed the IVC at baseline and at subsequent time points after spinal anesthesia...
February 14, 2018: Anesthesia and Analgesia
H S Abdel-Ghaffar, S M Moeen
BACKGROUND: The serotonergic system is known to be involved in control of post-anesthetic shivering. Our hypothesis was that prophylactic granisetrone (serotonin antagonist) might reduce incidence of post- spinal anesthesia shivering in cesarean section. METHODS: Parturient scheduled for elective Caesarean delivery under spinal anesthesia were allocated to receive 0.9% saline (Group I, n = 71), 1 mg granisetron (Group II, n = 69), or 0.7 mg granisetron (Group III, n = 72) before the spinal block...
February 8, 2018: Acta Anaesthesiologica Scandinavica
Simin Atashkhoie, Hojat Pourfathi, Bahman Naghipour, Shahla Meshgi
Several techniques have been proposed to prevent hypotension in obstetric patients. Ephedrine and phenylephrine are individually used to prevent maternal hypotension; however, each has its own drawbacks. Some researchers have reported that the infusion of combined ephedrine and phenylephrine immediately after spinal anesthesia for cesarean delivery reduces the incidence of maternal hypotension. Other studies have indicated that the combination is not superior to the infusion of an individual agent. The present study aimed to evaluate the effect of prophylactic infusion of ephedrine and phenylephrine before the induction of spinal anesthesia for cesarean section on maternal hemodynamic...
January 2018: Iranian Journal of Medical Sciences
José M Vilar, M Batista, R Pérez, A Zagorskaia, E Jouanisson, L Díaz-Bertrana, S Rosales
This study assessed the influence of 3 different anesthetic protocols based on the quality of anesthesia induction and maintenance in four dog breeds (French Bulldog, n = 13; Yorkshire terrier, n = 12; Chihuahua, n = 10; Bull Terrier, n = 10) subjected to cesarean section. Neonatal mortality, birth defects and newborn viability were assessed. All females were pre-medicated with morphine (IM), and then were assigned to three different anesthetic protocols: group P (n = 17), anesthesia was induced with propofol (IV) and then also maintained with propofol until the complete delivery of puppies and then anesthesia was maintained afterwards with sevoflurane; group PS (n = 14), anesthesia was induced with IV propofol, and maintenance of the anesthesic plan was performed with sevoflurane; group PES (n = 14) the females were induced by propofol and an epidural anesthesia was then performed, anesthesia was then maintained with propofol until the complete extraction of all puppies and then anesthesia was maintained afterwards with sevoflurane...
March 2018: Animal Reproduction Science
Nicole S Carlson, Elizabeth J Corwin, Teri L Hernandez, Elizabeth Holt, Nancy K Lowe, K Joseph Hurt
BACKGROUND: Term nulliparous women have the greatest variation across hospitals and providers in cesarean rates and therefore present an opportunity to improve quality through optimal care. We evaluated associations between provider type and mode of birth, including examination of intrapartum management in healthy, laboring nulliparous women. METHODS: Retrospective cohort study using prospectively collected perinatal data from a United States academic medical center (2005-2012)...
January 31, 2018: Birth
Predrag Ilic, Mirjana Jankovic, Maja Milickovic, Slobodan Dzambasanovic, Vladimir Kojovic
PURPOSE: To compare the holmium-laser puncture and electrosurgery-incision in neonates with intravesical ureterocele. MATERIALS AND METHODS: We retrospectively analyzed the results of laser-puncture of ureterocele (LP group) in 12 patients (mean age 9.8 days, range 4-28) and electrosurgery-incision in 20 patients (ES group) (mean age 10.2 days, range 6-28), treated at our institution. Patients had their records reviewed for preoperative findings, endoscopic procedure description, and postoperative outcomes...
February 1, 2018: Urology Journal
Hongli Kan, Yang Wang, Dongxin Wang, Hong Sun, Shu Zhou, Huaiwu Wang, Jian Guan, Ming Li
Application of local anesthetic reagents, such as lidocaine (Lid), could cause significant neurotoxicity in spinal cord dorsal root ganglia neurons (DRGNs). In this study, we investigated the potential rescuing effect of cordycepin (CDC) in an in vitro explant model of lidocaine-induced apoptosis in DRGNs. Explant of rat neonatal DRGNs was prepared, and treated with Lid in vitro to induce neuronal apoptosis. Prior to Lid treatment, DRGN explant was pre-incubated with various concentrations of CDC to evaluate its rescuing effect on Lid-induced apoptosis...
January 27, 2018: European Journal of Pharmacology
Ulrich Schaudig, Matthias Keserü
BACKGROUND: Presentation of a congenital abnormality that is rare, but follows a distinct course and can be diagnosed and cured promptly if the pathognomonic presentation is recognized. A congenital tarsal kink leads to a malposition of the upper eyelid margin that must not be missed, as it will lead to ulcerative keratitis if it is not treated. CASE PRESENTATION: An otherwise healthy newborn was presented after delivery with forceps with marked unilateral purulent secretion and blepharospasm...
January 2018: Klinische Monatsblätter Für Augenheilkunde
Gustavo Henrique de Oliveira, Javier Svetliza, Denise Cristina Mós Vaz-Oliani, Humberto Liedtke Junior, Antonio Helio Oliani, Denise Araujo Lapa Pedreira
OBJECTIVE: To describe our initial experience with a novel approach to follow-up and treat gastroschisis in "zero minute" using the EXITlike procedure. METHODS: Eleven fetuses with prenatal diagnosis of gastroschisis were evaluated. The Svetliza Reductibility Index was used to prospectively evaluate five cases, and six cases were used as historical controls. The Svetliza Reductibility Index consisted in dividing the real abdominal wall defect diameter by the larger intestinal loop to be fitted in such space...
October 2017: Einstein
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