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Neonatal anesthesia

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https://www.readbyqxmd.com/read/28514320/preoperative-warming-versus-no-preoperative-warming-for-maintenance-of-normothermia-in-women-receiving-intrathecal-morphine-for-cesarean-delivery-a-single-blinded-randomized-controlled-trial
#1
Judy Munday, Sonya Osborne, Patsy Yates, David Sturgess, Lee Jones, Edward Gosden
BACKGROUND: Rates of hypothermia for women undergoing spinal anesthesia for cesarean delivery are high and prevention is desirable. This trial compared the effectiveness of preoperative warming versus usual care among women receiving intrathecal morphine, which is thought to exacerbate perioperative heat loss. METHODS: A prospective, single-blinded, randomized controlled trial compared 20 minutes of forced air warming (plus intravenous fluid warming) versus no active preoperative warming (plus intravenous fluid warming) in 50 healthy American Society of Anesthesiologists graded II women receiving intrathecal morphine as part of spinal anesthesia for elective cesarean delivery...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28511794/application-of-end-tidal-carbon-dioxide-monitoring-via-distal-gas-samples-in-ventilated-neonates
#2
Ziying Jin, Maoying Yang, Ru Lin, Wenfang Huang, Jiangmei Wang, Zhiyong Hu, Qiang Shu
BACKGROUND: Previous research has suggested correlations between the end-tidal partial pressure of carbon dioxide (PETCO2) and the partial pressure of arterial carbon dioxide (PaCO2) in mechanically ventilated patients, but both the relationship between PETCO2 and PaCO2 and whether PETCO2 accurately reflects PaCO2 in neonates and infants are still controversial. This study evaluated remote sampling of PETCO2 via an epidural catheter within an endotracheal tube to determine the procedure's clinical safety and efficacy in the perioperative management of neonates...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28496360/epidural-anesthesia-for-labor-and-delivery-in-a-patient-with-may-hegglin-anomaly-a-case-report
#3
Annas Muhammad Muzannar, Mohammed Al Harbi, Raza Rathore, Nasser Tawfeeq, Freddie Wambi, Nasir Mahmood, Sonia Albrechtova, Vassilios Dimitriou
We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28485776/isoflurane-and-sevoflurane-affects-wnt-%C3%AE-catenin-signaling-pathways-in-hippocampal-formation-of-neonatal-rats
#4
J-F Ma, C-G Li, M-Y Sun, G-F Shao, K-Z Li
OBJECTIVE: General anesthesia impairs spatial learning and memory in neonatal rats. The aim of this study was to investigate whether the Wnt pathway was involved in neonatal isoflurane and sevoflurane exposure-induced neurocognitive impairment. MATERIALS AND METHODS: Sprague-Dawley rats were randomly assigned to administration isoflurane or sevoflurane for 6 hours at postnatal 7 days. Wnt inhibitor XAV 939 was administrated 30 min before anesthesia. Morris water maze was used to test the learning and memory at 5-week and 10-week...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28465226/repeated-propofol-anesthesia-induced-downregulation-of-hippocampal-mir-132-and-learning-and-memory-impairment-of-rats
#5
Shuo Zhang, Zuodi Liang, Wenchong Sun, Ling Pei
Several studies have reported that neonatal exposure to propofol may cause neurotoxicity in the hippocampus, involving long-term neurodevelopmental impairments. We aimed to detect real-time changes of miR-132 of neonatal rats exposed to propofol anesthesia and to characterize subsequent changes in learning and memory. Seven-day-old Sprague-Dawley rats were injected intraperitoneally with 40 mg/kg propofol at 0, 120, and 240 minutes or with isotonic fat emulsion as controls. Expression levels of miR-132 were assessed, and the mRNA and protein expression levels of p250GAP, a prominent target for miR-132, were evaluated at different time points during development...
April 29, 2017: Brain Research
https://www.readbyqxmd.com/read/28451389/effect-of-ephedrine-combined-with-bupivacaine-on-maternal-hemodynamic-and-spinal-nerve-block-in-cesarean-delivery
#6
Mingyue Ge, Sheng Wang, Zhigang Dai, Yan Li, Liping Xie, Xuejao Liu, Jiangwen Yin
The aim of the study was to investigate the effects of ephedrine intrathecal injection on maternal thermodynamics and spinal nerve block in cesarean section. A total of 107 patients undergoing elective cesarean section under combined spinal epidural anesthesia were randomly divided into two groups: group E: Bupivacaine (6 mg) combined with ephedrine (15 mg) and group C: Bupivacaine (6 mg). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), the incidence of hypotension, hypertension, tachycardia, nausea and vomiting were all recorded...
March 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28447275/risk-factors-for-shoulder-dystocia-the-impact-of-mother-s-race-and-ethnicity
#7
Jennifer Gaudet Hefele, Palmira Santos, Grant Ritter, Neha Varma, Ann Hendrich
Shoulder dystocia is a rare but severe birth trauma where the neonate's shoulders fail to deliver after delivery of the head. Failure to deliver the shoulders quickly can lead to severe, long-term injury to the infant, including nerve injury, skeletal fractures, and potentially death. This observational study examined shoulder dystocia risk factors by race and ethnicity using a sample of 19,236 pregnant women who presented for labor and delivery from July 1, 2010 until June 30, 2013 at five locations. Multivariate analyses were used to identify risk factors associated with shoulder dystocia occurrence in racial/ethnic groups with high incidence rates...
April 26, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28435999/neonatal-propofol-anesthesia-changes-expression-of-synaptic-plasticity-proteins-and-increases-stereotypic-and-anxyolitic-behavior-in-adult-rats
#8
Desanka Milanovic, Vesna Pesic, Natasa Loncarevic-Vasiljkovic, Vladimir Avramovic, Vesna Tesic, Vesna Jevtovic-Todorovic, Selma Kanazir, Sabera Ruzdijic
Propofol is a general anesthetic commonly used in pediatric clinical practices. Experimental findings demonstrate that anesthetics induce widespread apoptosis and cognitive decline in a developing brain. Although anesthesia-mediated neurotoxicity is the most prominent during intense period of synaptogenesis, the effects of an early anesthesia exposure on the synapses are not well understood. The aim of this study was to examine the effects of neonatal propofol anesthesia on the expression of key proteins that participate in synaptogenesis and synaptic plasticity and to evaluate long-term neurobehavioral abnormalities in the mature adult brain...
April 24, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28433802/role-of-environmental-stressors-in-determining-the-developmental-outcome-of-neonatal-anesthesia
#9
Ling-Sha Ju, Jiao-Jiao Yang, Nikolaus Gravenstein, Christoph N Seubert, Timothy E Morey, Colin Sumners, Terrie Vasilopoulos, Jian-Jun Yang, Anatoly E Martynyuk
BACKGROUND: The majority of studies evaluating neurocognition in humans who had procedures under anesthesia early in life found long-term deficits even though the typical anesthesia duration normalized to the human life span is much shorter than that shown to induce developmental abnormalities in rodents. Therefore, we studied whether subsequent environmental stressors contribute to deficiencies programmed by a brief neonatal etomidate exposure. METHODS: Postnatal days (P) 4, 5, or 6, Sprague-Dawley rats, pretreated with vehicle or the Na(+)-K(+)-2Cl(-) (NKCC1) inhibitor, bumetanide, received two injections of etomidate resulting in anesthesia for 2h...
April 7, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28431256/neurodevelopmental-outcomes-of-neonates-undergoing-surgery-under-general-anesthesia-for-malrotation-of-intestines
#10
Suresh Birajdar, Shripada Rao, Judy McMichael
BACKGROUND: It is difficult to differentiate between the potential adverse effects of general anesthesia (GA) on the developing brain and the role of associated co-morbidities and syndromes that can adversely affect neurodevelopmental outcomes in neonates undergoing GA. Neonates with malrotation of the intestines without volvulus usually do not have co-morbidities or syndromes. In addition, majority of them recover very well after surgery and are discharged home within a few days. Neonates with malrotation are a clean cohort of babies to study the role of a single episode of GA on the developing brain...
April 18, 2017: Early Human Development
https://www.readbyqxmd.com/read/28425250/retrospective-analysis-of-maternal-fetal-and-neonatal-outcomesof-intrahepatic-cholestasis-of-pregnancy-at-gazi-university
#11
Berrin Günaydin, Merih Bayram, Melis Altuğ, Semra Cevher, Nuray Bozkurt
BACKGROUND/AIM: Maternal, fetal, and neonatal outcomes in parturients with intrahepatic cholestasis of pregnancy (ICP) have been retrospectively documented. We aimed to present pregnancy outcomes of parturients with ICP who underwent delivery. The study was conducted during a 1-year period. MATERIALS AND METHODS: After ethics committee approval, data from 1 January to 31 December 2015 were collected to identify parturients with ICP. RESULTS: Ten out of 37 patients underwent normal spontaneous vaginal delivery (NSVD), and the remaining 27 parturients underwent cesarean section (CS)...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28416843/-influences-of-repeated-propofol-anesthesia-on-hippocampal-apoptosis-and-long-term-learning-and-memory-abilities-of-neonatal-rats
#12
Y J Wang, X Y Guo, J Wang
OBJECTIVE: To investigate the influences of repeated propofol anesthesia on the hippocampal apoptosis and the long-term learning and memory abilities of neonatal rats. METHODS: In the study, 45 male Sprague-Dawley rats, aged 7 days, were randomly divided into 3 group (n=15 each): control group (C group) that received intralipid 7.5 mL/kg intraperitioneal (IP) once a day×7 days; group propofol 1 (P1) that received propofol 75 mg/kg IP once a day×7 days; group propofol 2 (P2) that received intralipid 7...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28413274/evaluation-of-decision-to-delivery-interval-in-emergency-cesarean-section-a-1-year-prospective-audit-in-a-tertiary-care-hospital
#13
Sunanda Gupta, Udita Naithani, C Madhanmohan, Ajay Singh, Pradeep Reddy, Apoorva Gupta
BACKGROUND AND AIMS: The American College of Obstetricians and Gynecologists (ACOG) committee on professional standards and the National Institute of Clinical Excellence (NICE) guidelines suggest that decision-to-delivery interval (DDI) and emergency cesarean section (CS) should not be more than 30 min, and a delay of more than75 min in the presence of maternal or fetal compromise can lead to poor outcome. This prospective 1-year study was conducted on emergency CS in a tertiary care hospital to evaluate the DDI, factors affecting it and to analyze their effects on maternal and neonatal outcome...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28410092/tidal-volume-delivery-during-the-anesthetic-management-of-neonates-is-variable
#14
Thanaa Abouzeid, Elizabeth J Perkins, Prue M Pereira-Fantini, Anushi Rajapaksa, Asha Suka, David G Tingay
OBJECTIVES: To describe expiratory tidal volume (VT) during routine anesthetic management of neonates at a single tertiary neonatal surgical center, as well as the proportion of VT values within the range of 4.0-8.0 mL/kg. STUDY DESIGN: A total of 26 neonates needing surgery under general anesthesia were studied, of whom 18 were intubated postoperatively. VT was measured continuously during normal clinical care using a dedicated neonatal respiratory function monitor (RFM), with clinicians blinded to values...
May 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28393462/current-use-of-factor-concentrates-in-pediatric-cardiac-anesthesia
#15
REVIEW
Nina A Guzzetta, Glyn D Williams
Excessive bleeding following pediatric cardiopulmonary bypass is associated with increased morbidity and mortality, both from the effects of hemorrhage and the therapies employed to achieve hemostasis. Neonates and infants are especially at risk because their coagulation systems are immature, surgeries are often complex, and cardiopulmonary bypass technologies are inappropriately matched to patient size and physiology. Consequently, these young children receive substantial amounts of adult-derived blood products to restore adequate hemostasis...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28391017/pretreatment-with-minocycline-restores-neurogenesis-in-the-subventricular-zone-and-subgranular-zone-of-the-hippocampus-after-ketamine-exposure-in-neonatal-rats
#16
Yang Lu, P K Giri, Shan Lei, Juan Zheng, Weisong Li, Ning Wang, Xinlin Chen, Haixia Lu, Zhiyi Zuo, Yong Liu, Pengbo Zhang
Ketamine is commonly used for anesthesia in pediatric patients. Recent studies indicated that ketamine exposure in the developing brain can induce neuroapoptosis and disturb normal neurogenesis, which will result in long-lasting cognitive impairment. Minocycline exerts neuroprotection against a wide range of toxic insults in neurodegenerative disease models. In the present study, we investigated whether the disturbed neurogenesis and behavioral deficits after ketamine neonatal exposure could be alleviated by minocycline...
June 3, 2017: Neuroscience
https://www.readbyqxmd.com/read/28385380/outcomes-of-bedside-sutureless-umbilical-closure-without-endotracheal-intubation-for-gastroschisis-repair-in-surgical-infants
#17
Gillian E Pet, Rebecca A Stark, John J Meehan, Patrick J Javid
INTRODUCTION: Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. METHODS: A retrospective review was performed of neonates with gastroschisis who underwent sutureless umbilical closure from 2011 to 2015. Clinical characteristics and outcomes between groups were compared...
March 24, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28372649/can-we-reduce-anesthesia-exposure-neonatal-brain-mri-swaddling-vs-sedation-a-national-survey
#18
Benjamin J Heller, Francine S Yudkowitz, Scott Lipson
STUDY OBJECTIVE: Neonatal magnetic resonance imaging (MRI) is a diagnostic modality that requires minimal motion to acquire quality images. Sedation or even general anesthesia may be necessary to achieve acceptable scans. There is a growing body of literature, especially in animal studies, that links neurotoxicity with anesthetic exposure to the developing brain. There is no study outlining strategies used by neonatal intensive care units (NICU) to achieve quality MRI images with limited exposure to medications identified as possibly harmful to the developing brain...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28368936/closed-loop-feedback-computer-controlled-phenylephrine-for-maintenance-of-blood-pressure-during-spinal-anesthesia-for-cesarean-delivery-a-randomized-trial-comparing-automated-boluses-versus-infusion
#19
Warwick D Ngan Kee, Yuk-Ho Tam, Kim S Khaw, Floria F Ng, Shara W Y Lee
BACKGROUND: We previously described the use of closed-loop feedback computer-controlled infusion of phenylephrine for maintaining blood pressure (BP) during spinal anesthesia for cesarean delivery. In this study, we report a modified system in which phenylephrine is delivered by intermittent boluses rather than infusion. We hypothesized that the use of computer-controlled boluses would result in more precise control of BP compared with infusions. METHODS: Two hundred fourteen healthy patients having spinal anesthesia for elective cesarean delivery were randomized to have their systolic BP maintained by phenylephrine administered by computer-controlled continuous infusion or computer-controlled intermittent boluses...
March 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28364969/-gastroschisis-repair-under-caudal-anesthesia-a-series-of-three-cases
#20
Neha Kasat, Nandini Dave, Harick Shah, Swapnil Mahajan
Gastroschisis is a congenital anomaly characterized by a defect in the anterior abdominal wall with protrusion of abdominal viscera. Perioperative mortality is very high in these patients. Traditionally gastroschisis repair has been performed under general anesthesia with endotracheal intubation, requiring postoperative intensive care admission and mechanical ventilation. Caudal block is an attractive alternative to general anesthesia. We present a series of three neonates with gastroschisis, repaired solely under caudal anesthesia...
March 29, 2017: Revista Brasileira de Anestesiologia
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