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Neonatal anesthesia

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https://www.readbyqxmd.com/read/29160002/a-randomized-double-blind-trial-of-needle-free-injected-lidocaine-versus-topical-anesthesia-for-infant-lumbar-puncture
#1
Ryan Caltagirone, Vidya R Raghavan, Kathleen Adelgais, Genie E Roosevelt
OBJECTIVES: Lumbar punctures (LPs) are commonly performed in febrile infants to evaluate for meningitis, and local anesthesia increases the likelihood of LP success. Traditional methods of local anesthesia require injection which may be painful or topical application which is not effective immediately. Recent advances in needle-free jet injection may offer a rapid alternative to these modalities. We compared a needle-free jet-injection system (J-Tip(™) ) with 1% buffered lidocaine to topical anesthetic (TA) cream for local anesthesia in infant LPs...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#2
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#3
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29133659/congenital-capillary-hemangioma-arising-from-palpebral-conjunctiva-of-a-neonate
#4
S Padmanaban, P Sumathi, Prayagi Kandoth, R P Dharmendra
Capillary hemangioma is the most common benign vascular eyelid tumor in childhood. The periocular lesion appears within the first few weeks after birth and usually has superficial or deep components. Primary conjunctival capillary hemangiomas are rarely reported. We present the case of a 2-day-old child with a pedunculated capillary hemangioma arising from superior palpebral conjunctiva. A complete surgical excision was performed under general anesthesia, and the child was asymptomatic at follow-up of two months...
November 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29115488/repeated-inhalation-of-sevoflurane-inhibits-the-information-transmission-of-purkinje-cells-and-delays-motor-development-via-the-gabaa-receptor-%C3%AE%C2%B5-subunit-in-neonatal-mice
#5
Hong Fang, Ze-Hua Wang, Ying-Jiang Bu, Zhi-Jun Yuan, Guo-Qiang Wang, Yan Guo, Xiao-Yun Cheng, Wen-Jie Qiu
General anesthesia is widely used in pediatric surgery, although the influence of general anesthesia on cerebellar information transmission and motor function is unclear. In the present study, neonatal mice received repeated inhalation of sevoflurane, and electrophysiological alterations in Purkinje cells (PCs) and the development of motor functions were detected. In addition, γ‑aminobutyric acidA receptor ε (GABAA‑R ε) subunit knockout mice were used to investigate the mechanism of action of sevoflurane on cerebellar function...
November 3, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29061366/long-duration-sevoflurane-exposure-with-the-normoxic-carrier-gas-increase-the-neural-apoptosis-and-impair-the-long-term-cognitive-function-in-neonatal-rats
#6
Toru Goyagi
The effects of short-term versus long-term anesthesia and the carrier gas used to deliver anesthesia on neuroapoptosis and cognitive impairments in the developing brain are not fully understood. This study shows that long-duration sevoflurane anesthesia with or without additional oxygen induces neuroapoptosis and long-term cognitive dysfunction in neonatal rats. Seven-day-old rats were exposed to sevoflurane anesthesia for 2, 4, and 6 h with 21% or 30% oxygen. The control group received 21% oxygen alone for 6 h...
October 20, 2017: Brain Research
https://www.readbyqxmd.com/read/29044830/optimal-management-of-apparatus-dead-space-in-the-anesthetized-infant
#7
REVIEW
Michael R King, Jeffrey M Feldman
Mechanical ventilation of the anesthetized infant requires careful attention to equipment and ventilator settings to assure optimal gas exchange and minimize the potential for lung injury. Apparatus dead space, defined as dead space resulting from devices placed between the endotracheal tube and the Y-piece of the breathing circuit, is the primary source of dead space controlled by the clinician. Due to the small tidal volumes required by infants and neonates, it is easy to create excessive apparatus dead space resulting in unintended hypercarbia or increased minute ventilation in an effort to achieve a desirable PCO2 ...
October 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29034653/successful-delivery-in-a-woman-with-achondroplasia-a-case-report
#8
Mahbooheh Shirazi, Fateme Golshahi, Nastaran Teimoory
Achondroplasia is an autosomal dominant disease which is characterized by limb shortening and narrow trunk, and macrocephaly. Women with achondroplasia suffer from infertility, menorrhagia, dysmenorrhoea, leiomyomata and early menopause. Our case was a 26-year-old woman with achondroplasia who had scoliosis and osteoporosis. She referred to our clinic at 9 weeks of gestation and had all screenings completely. She had a single female fetus with no abnormalities. She had an emergent due to rupture of membranes at 37 weeks and 3 days under general anesthesia...
August 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29033728/anesthesia-in-pregnancy-with-heart-disease
#9
REVIEW
Ankur Luthra, Ritika Bajaj, Anudeep Jafra, Kiran Jangra, V K Arya
Management of pregnant women with heart disease remains challenging due to the advancement of innovations in cardiac surgery and correction of complex cardiac anomalies, and more recently, with the successful performance of heart transplants, cardiac diseases are not only likely to coexist with pregnancy, but will also increase in frequency over the years to come. In developing countries with a higher prevalence of rheumatic fever, cardiac disease may complicate as many as 5.9% of pregnancies with a high incidence of maternal death...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29020780/-selective-feticide-in-monochorionic-twin-pregnancies-with%C3%A2-discordant-fetal-anomalies-management-and-outcome
#10
J Vojtěch, L Hašlík, R Pock, K Běhávková, K Macková, P Hanulíková, H Heřman, L Krofta
OBJECTIVE: To analyze results and outcome after selective feticide for discordant anomalies in monochorionic twins. DESIGN: Prospective cohort study. SETTING: Fetal medicine center, Institute for the Care of Mother and Child, Praha. METHODS: Analysis of outcome of monochorionic pregnancies after intrauterine surgery for structural abnormalities between January 2013 and June 2016. RESULTS: We performed 13 intrauterine operations in monochorionic twins with structural anomalies during the period...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/29019815/an-international-multicenter-observational-study-of-cerebral-oxygenation-during-infant-and-neonatal-anesthesia
#11
Vanessa A Olbrecht, Justin Skowno, Vanessa Marchesini, Lili Ding, Yifei Jiang, Christopher G Ward, Gaofeng Yu, Huacheng Liu, Bernadette Schurink, Laszlo Vutskits, Jurgen C de Graaff, Francis X McGowan, Britta S von Ungern-Sternberg, Charles Dean Kurth, Andrew Davidson
BACKGROUND: General anesthesia during infancy is associated with neurocognitive abnormalities. Potential mechanisms include anesthetic neurotoxicity, surgical disease, and cerebral hypoxia-ischemia. This study aimed to determine the incidence of low cerebral oxygenation and associated factors during general anesthesia in infants. METHODS: This multicenter study enrolled 453 infants aged less than 6 months having general anesthesia for 30 min or more. Regional cerebral oxygenation was measured by near-infrared spectroscopy...
October 11, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28990517/anesthetic-agents-and-neuronal-autophagy-what-we-know-and-what-we-don-t
#12
Lili Xu, Jianjun Shen, Patrick M McQuillan, Zhiyong Hu
Numerous experimental data have demonstrated that neonatal animal exposure to commonly used anesthetic agents may cause neuronal death resulting in cognitive impairment. The underlying mechanism(s) remain elusive. Depending on the circumstances, autophagy may produce an effect that can be either protective or deleterious. Recent evidence demonstrates that this process can reduce the development of ethanol induced neurotoxicity and, as we know, ethanol has γ-Aminobutyric acid (GABA) agonist and N-methyl-D-aspartate (NMDA) antagonist characteristics similar to commonly used volatile anesthetic agents...
October 9, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28982596/subsequent-maternal-separation-exacerbates-neurobehavioral-abnormalities-in-rats-neonatally-exposed-to-sevoflurane-anesthesia
#13
Jiaojiao Yang, Lingsha Ju, Min Jia, Hui Zhang, Xiaoru Sun, Muhuo Ji, Jianjun Yang, Anatoly E Martynyuk
Several recent studies suggest that in the human population, a routine, short anesthetic in otherwise healthy infants is void of neurodevelopmental insult. On the other hand, many human retrospective epidemiological studies report evidence of cognitive abnormalities in children after testing those who had different anesthesia-requiring procedures in early childhood. We tested in a rat model whether post-anesthesia stressful environmental factors can contribute to developmental abnormalities that were initiated by a relatively short exposure to sevoflurane, the most widely used anesthetic in pediatric anesthesia, whose polyvalent actions include enhancement of gamma-aminobutyric acid type A receptor (GABAAR) activity...
November 20, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28979702/chikusetsu-saponin-iva-attenuates-isoflurane-induced-neurotoxicity-and-cognitive-deficits-via-sirt1-erk1-2-in-developmental-rats
#14
Xi Fang, Qiang Han, Shiyong Li, Yilin Zhao, Ailin Luo
Inhalation anesthetics isoflurane may increase the risk of neurotoxicity and cognitive deficiency at postnatal and childhood. Chikusetsu saponin IVa (chIV) is a plant extract compound, which could possessed extensive pharmacological actions of central nervous system, cardia-cerebrovascular system, immunologic system and treatment and prevention of tumor. In our study, we investigated the neuroprotective effect of chIV on isoflurane-induced hippocampal neurotoxicity and cognitive function impairment in neonatal rats...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28974135/propofol-and-fentanyl-sedation-for-laser-treatment-of-retinopathy-of-prematurity-to-avoid-intubation
#15
Fiammetta Piersigilli, Alessandra Di Pede, Gino Catena, Simona Lozzi, Cinzia Auriti, Iliana Bersani, Irma Capolupo, Anna Lipreri, Vincenzo Di Ciommo, Andrea Dotta, Stefania Sgrò
BACKGROUND: Despite the optimization of neonatal assistance, severe retinopathy of prematurity (ROP, stage III-IV) remains a common condition among preterm infants. Laser photocoagulation usually requires general anesthesia and intubation, but extubation can be difficult and these infants often affected by chronic lung disease. We retrospectively evaluated the clinical charts of 13 neonates that were sedated with propofol in association with fentanyl for the laser treatment of ROP. This protocol was introduced in our unit to avoid intubation and minimize side effects of anesthesia and ventilation...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28953494/the-effect-of-prophylactic-phenylephrine-and-ephedrine-infusions-on-umbilical-artery-blood-ph-in-women-with-preeclampsia-undergoing-cesarean-delivery-with-spinal-anesthesia-a-randomized-double-blind-trial
#16
Nicole Higgins, Paul C Fitzgerald, Dominique van Dyk, Robert A Dyer, Natalie Rodriguez, Robert J McCarthy, Cynthia A Wong
BACKGROUND: Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. METHODS: This study was a randomized double-blind clinical trial...
September 25, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28944872/isoflurane-exposure-regulates-the-cell-viability-and-bdnf-expression-of-astrocytes-via-upregulation-of-trek%C3%A2-1
#17
Cui-Hong Zhou, Ya-Hong Zhang, Fen Xue, Shan-Shan Xue, Yun-Chun Chen, Ting Gu, Zheng-Wu Peng, Hua-Ning Wang
Neonatal isoflurane exposure in rodents disrupts hippocampal cognitive functions, including learning and memory, and astrocytes may have an important role in this process. However, the molecular mechanisms underlying this disruption are not fully understood. The present study investigated the role of TWIK‑related K+ channel (TREK‑1) in isoflurane‑induced cognitive impairment. Lentiviruses were used to overexpress or knockdown TREK‑1 in astrocytes exposed to increasing concentrations of isoflurane or O2 for 2 h...
November 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28937537/comparison-of-biological-screening-and-diagnostic-indicators-to-detect-in-utero-opiate-and-cocaine-exposure-among-mother-infant-dyads
#18
Meagan Stabler, Peter Giacobbi, Ilana Chertok, Leann Long, Lesley Cottrell, Panitan Yossuck
BACKGROUND: Opioid and cocaine antenatal substance use can result in significant obstetric and pediatric health implications. Accurate detection of in utero-exposed neonates can improve patient care and health outcomes. Therefore, the effectiveness of mother-infant biological and diagnostic indicators collected at labor and delivery to provide accurate detection of in utero opiate and cocaine exposure was assessed. METHODS: A retrospective medical chart review included 335 mother-infant dyads exposed to antenatal substances who were delivered between January 2009 and March 2014...
December 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28937235/heart-rate-variability-in-newborns
#19
K Javorka, Z Lehotska, M Kozar, Z Uhrikova, B Kolarovszki, M Javorka, M Zibolen
Heart rate (HR) and heart rate variability (HRV) in newborns is influenced by genetic determinants, gestational and postnatal age, and other variables. Premature infants have a reduced HRV. In neonatal HRV evaluated by spectral analysis, a dominant activity can be found in low frequency (LF) band (combined parasympathetic and sympathetic component). During the first postnatal days the activity in the high frequency (HF) band (parasympathetic component) rises, together with an increase in LF band and total HRV...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28928561/periprocedural-management-of-vein-of-galen-aneurysmal-malformation-patients-an-11-year-experience
#20
Ajay Prasad Hrishi, Karen Ruby Lionel
CONTEXT: The vein of Galen aneurysmal malformation (VGAM) is a rare arteriovenous malformation where a dilated median prosencephalic vein provides a low-resistance conduit for intracerebral blood flow resulting in high-output cardiac failure, severe pulmonary hypertension, with or without central nervous system symptoms secondary to hydrocephalus, in the neonatal and pediatric population. AIM: This study aims to analysis of the anesthetic management of this unique subset of patients with VGAM...
July 2017: Anesthesia, Essays and Researches
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