keyword
https://read.qxmd.com/read/37954765/intranasal-dexmedetomidine-with-intravenous-midazolam-a-safe-and-effective-alternative-in-the-paediatric-mri-sedation
#21
JOURNAL ARTICLE
Kavya Kg, Pooja N
Background and aims MRI sedation in paediatrics includes challenges like respiratory depression, maintaining haemodynamic stability and use of neuroprotective drugs, since MRI is performed in remote places outside the operating room with a lack of support staff and nonavailability of choice of medications and equipments. The primary aim was to use a combination of the drugs to encounter the above challenges and look for its efficacy. The secondary aim of the study was to determine the rate of successful completion of MRI in children using a combination of intranasal dexmedetomidine and intravenous midazolam - without the need for rescue sedatives...
October 2023: Curēus
https://read.qxmd.com/read/37927199/the-effects-of-dexmedetomidine-on-intraoperative-neurophysiologic-monitoring-modalities-during-corrective-scoliosis-surgery-in-pediatric-patients-a-systematic-review
#22
REVIEW
Ahmed Abdelaal Ahmed Mahmoud Metwally Alkhatip, Kerry Elizabeth Mills, Olivia Hogue, Amr Sallam, Mohamed Khaled Hamza, Ehab Farag, Hany Mahmoud Yassin, Mohamed Wagih, Ahmed Mohamed Ibrahim Ahmed, Mohamed Hussein Helmy, Mohamed Elayashy
BACKGROUND: During scoliosis surgery, motor evoked potentials (MEP), and somatosensory evoked potentials (SSEP) have been reported to be affected by the use of higher doses of anesthetic agents. Dexmedetomidine, a sympatholytic agent, an alpha-2 receptor agonist, has been used as an adjunctive agent to lower anesthetic dose. However, there is conflicting evidence regarding the effects of dexmedetomidine on the intraoperative neurophysiological monitoring of MEP and SSEP during surgery, particularly among pediatric patients...
February 2024: Paediatric Anaesthesia
https://read.qxmd.com/read/37885235/exposure-to-sedation-and-analgesia-medications-short-term-cognitive-outcomes-in-pediatric-critical-care-survivors-with-acquired-brain-injury
#23
JOURNAL ARTICLE
Kurt M Drury, Trevor A Hall, Benjamin Orwoll, Sweta Adhikary, Aileen Kirby, Cydni N Williams
Background/Objective: Pediatric intensive care unit (PICU) survivors risk significant cognitive morbidity, particularly those with acquired brain injury (ABI) diagnoses. Studies show sedative and analgesic medication may potentiate neurologic injury, but few studies evaluate impact on survivor outcomes. This study aimed to evaluate whether exposures to analgesic and sedative medications are associated with worse neurocognitive outcome. Methods: A retrospective cohort study was conducted of 91 patients aged 8 to 18 years, undergoing clinical neurocognitive evaluation approximately 1 to 3 months after PICU discharge...
April 2024: Journal of Intensive Care Medicine
https://read.qxmd.com/read/37882809/intensive-care-unit-analgosedation-after-cardiac-surgery-in-children-with-williams-syndrome-a-matched-case-control-study
#24
JOURNAL ARTICLE
Marcos Mills, Claudia Algaze, Chloe Journel, Geovanna Suarez, Kirstie Lechich, M David Kwiatkowski, Alexander R Schmidt, R Thomas Collins
OBJECTIVE: Cardiovascular abnormalities are common in patients with Williams syndrome and frequently require surgical intervention necessitating analgesia and sedation in a population with a unique neuropsychiatric profile, potentially increasing the risk of adverse cardiac events during the perioperative period. Despite this risk, the overall postoperative analgosedative requirements in patients with WS in the cardiac intensive care unit have not yet been investigated. Our primary aim was to examine the analgosedative requirement in patients with WS after cardiac surgery compared to a control group...
January 2024: Pediatric Cardiology
https://read.qxmd.com/read/37880385/higher-cumulative-dose-of-opioids-and-other-sedatives-are-associated-with-extubation-failure-in-norwood-patients
#25
JOURNAL ARTICLE
Sebastian Acosta, Adel M Hassan, Zbigniew Gugala, Zena Karagoli, Jessica Hochstetler, Amy L Kiskaddon, Paul Checchia, David Faraoni, Feng Zheng, Fabio Savorgnan
BACKGROUND: The primary purpose of this study is to evaluate the relationship between sedation usage and extubation failure, and to control for the effects of hemodynamic, oximetric indices, clinical characteristics, ventilatory settings pre- and post-extubation, and echocardiographic (echo) findings in neonates with hypoplastic left heart syndrome (HLHS) post-Norwood procedure. METHODS: Single-center, retrospective analysis of Norwood patients during their first extubation post-surgery from January 2015 to July 2021...
October 25, 2023: Pediatric Cardiology
https://read.qxmd.com/read/37855676/dexmedetomidine-withdrawal-syndrome-in-children-in-the-picu-systematic-review-and-meta-analysis
#26
JOURNAL ARTICLE
Thomas Knapp, Olivia DiLeonardo, Tim Maul, Alexander Hochwald, Zhuo Li, Jobayer Hossain, Adam Lowry, Jason Parker, Kimberly Baker, Peter Wearden, Jennifer Nelson
OBJECTIVES: To systematically review literature describing the clinical presentation, risk factors, and treatment for dexmedetomidine withdrawal in the PICU (PROSPERO: CRD42022307178). DATA SOURCES: MEDLINE/PubMed, Cochrane, Web of Science, and Scopus databases were searched. STUDY SELECTION: Eligible studies were published from January 2000 to January 2022 and reported clinical data for patients younger than 21 years old following discontinuation of dexmedetomidine after greater than or equal to 24 hours of infusion...
January 1, 2024: Pediatric Critical Care Medicine
https://read.qxmd.com/read/37811026/dexmedetomidine-as-a-myocardial-protector-in-pediatric-heart-surgery-using-cardiopulmonary-bypass-a-systematic-review
#27
Dian Kesumarini, Yunita Widyastuti, Cindy E Boom, Lucia K Dinarti
BACKGROUND: In recent years, dexmedetomidine has been studied as a cardioprotective agent. However, studies on its application in pediatric heart surgery using cardiopulmonary bypass (CPB) remain limited. This systematic review aimed to provide information on the cardioprotective effect of dexmedetomidine in children undergoing heart surgery using CPB. METHODS: The authors searched several databases (MEDLINE, Embase, Cochrane Library, etc.) to identify all trials comparing the levels of myocardial injury via biomarkers, including pediatric patients undergoing heart surgery using CPB who received dexmedetomidine versus placebo or other anesthetic agents...
October 2023: Annals of Medicine and Surgery
https://read.qxmd.com/read/37564019/local-vasoconstriction-following-ropivacaine-dexmedetomidine-parasternal-block-in-a-neonate
#28
JOURNAL ARTICLE
Dominik P Guensch, Sandra Terbeck, Daniel Gerber, Gabor Erdoes
No abstract text is available yet for this article.
December 2023: Paediatric Anaesthesia
https://read.qxmd.com/read/37550522/impact-of-dexmedetomidine-infusion-on-opioid-and-benzodiazepine-doses-in-ventilated-pediatric-patients-in-the-cardiac-intensive-care-unit
#29
JOURNAL ARTICLE
Reuth Nir, Francesca Sperotto, Manasee Godsay, Minmin Lu, John N Kheir
INTRODUCTION: Dexmedetomidine (DEX) is frequently used as an adjunct agent for prolonged sedation in the intensive care unit (ICU), though its effect on concomitant opioids or benzodiazepines infusions is unclear. We explored the impact of DEX on concomitant analgosedation in a cohort of ventilated pediatric patients in a cardiac ICU, with stratification of patients according to duration of ventilation (< 5 versus ≥ 5 days) following DEX initiation. METHODS: We conducted a retrospective analysis on ventilated patients receiving a DEX infusion ≥ 24 h and at least one other sedative/analgesic infusion (January 2011-June 2021)...
August 7, 2023: Paediatric Drugs
https://read.qxmd.com/read/37528645/postoperative-recovery-in-preschool-aged-children-a-secondary-analysis-of-a-randomized-controlled-trial-comparing-premedication-with-midazolam-clonidine-and-dexmedetomidine
#30
JOURNAL ARTICLE
Åsa Bromfalk, Magnus Hultin, Tomi Myrberg, Åsa Engström, Jakob Walldén
BACKGROUND: Preoperative anxiety in pediatric patients can worsen postoperative outcomes and delay discharge. Drugs aimed at reducing preoperative anxiety and facilitating postoperative recovery are available; however, their effects on postoperative recovery from propofol-remifentanil anesthesia have not been studied in preschool-aged children. Thus, we aimed to investigate the effects of three sedative premedications on postoperative recovery from total intravenous anesthesia in children aged 2-6 years...
August 1, 2023: Paediatric Anaesthesia
https://read.qxmd.com/read/37438578/anesthetic-management-of-a-pediatric-patient-with-freeman-sheldon-syndrome-undergoing-atrial-septal-defect-closure-a-case-report
#31
JOURNAL ARTICLE
Kyosuke Takahashi, Kotaro Sakurai, Izumi Hamaya
BACKGROUND: Freeman-Sheldon syndrome (FSS) is a rare disorder characterized by specific deformities of the extremities and face. There have been no reports of open-heart surgery in pediatric patients with FSS. CASE PRESENTATION: We present the case of an 8-year-old girl with FSS who underwent atrial septal defect closure. Tracheal intubation was uncomplicated, although the patient had microstomia. Inhalational anesthetics and dopamine antagonists were avoided intraoperatively and perioperatively...
July 13, 2023: JA Clinical Reports
https://read.qxmd.com/read/37410631/awake-craniotomies-in-the-pediatric-population-a-systematic-review
#32
JOURNAL ARTICLE
Debarati Bhanja, Bao Y Sciscent, Lekhaj C Daggubati, Casey A Ryan, Natalie K Pahapill, Sprague W Hazard, Elias B Rizk
OBJECTIVE: Awake craniotomy (AC) is employed to maximize tumor resection while preserving neurological function in eloquent brain tissue. This technique is used frequently in adults but remains poorly established in children. Its use has been limited due to concern for children's neuropsychological differences compared with adults and how these differences may interfere with the safety and feasibility of the procedure. Among studies that have reported pediatric ACs, complication rates and anesthetic management vary...
June 30, 2023: Journal of Neurosurgery. Pediatrics
https://read.qxmd.com/read/37409901/sedation-weaning-initiative-targeting-methadone-exposure-single-center-improvements-in-withdrawal-symptoms-and-hospital-length-of-stay-for-pediatric-cardiac-critical-care
#33
JOURNAL ARTICLE
Caitlin E King, Danielle N Wood, Jeannie Koo, Austin B Cutler, Travis P Vesel
OBJECTIVES: Sedation and pain medications are necessary in the management of postoperative pediatric cardiac patients. Prolonged exposure to these medications can lead to negative side effects including withdrawal. We hypothesized that standardized weaning guidelines would decrease exposure to sedation medications and decrease withdrawal symptoms. The primary aim was to decrease average days of methadone exposure to within goal for moderate- and high-risk patients within 6 months. DESIGN: Quality improvement methods were used to standardize sedation medication weaning in a pediatric cardiac ICU...
July 1, 2023: Pediatric Critical Care Medicine
https://read.qxmd.com/read/37409840/comparison-of%C3%A2-intranasal-dexmedetomidine-midazolam-dexmedetomidine-ketamine-and-midazolam-ketamine-for-premedication-in-paediatric-patients-a%C3%A2-double-blinded-randomized-trial
#34
RANDOMIZED CONTROLLED TRIAL
Vaishnavi Bd, Shilpa Goyal, Ankur Sharma, Nikhil Kothari, Narendra Kaloria, Priyanka Sethi, Pradeep Bhatia
BACKGROUND: Paediatric patients are a population with a high level of anxiety. The prevention of perioperative stress in a frightened child is important to render the child calm and cooperative for smoother induction. Intranasal premedication is easy and safe, and the drug is rapidly absorbed into the systemic circulation, ensuring early onset of sedation in children and good effectiveness. METHODS: 150 patients in the age group 2-4 years, ASA class I, undergoing elective surgical procedures were enrolled...
2023: Anaesthesiology Intensive Therapy
https://read.qxmd.com/read/37409838/prospective-randomised-comparison-of%C3%A2-two-intravenous-sedation-methods-for-magnetic-resonance-imaging-in-children
#35
RANDOMIZED CONTROLLED TRIAL
Viktor Mark Brzózka, Andrzej Jerzy Piotrowski
BACKGROUND: Children usually need sedation or even anaesthesia for magnetic resonance imaging (MRI) studies. As there is no universally accepted method for this purpose we undertook a prospective, randomised comparison of propofol and dexmedetomidine in children aged 1 to 10 years. METHODS: After Institutional Board approval and parents' informed consent 64 ASA status I or II children scheduled for MRI scan were enrolled. Patients were premedicated with intravenous (IV) midazolam (0...
2023: Anaesthesiology Intensive Therapy
https://read.qxmd.com/read/37371178/the-effects-of-dexmedetomidine-on-children-undergoing-magnetic-resonance-imaging-a-systematic-review-and-meta-analysis
#36
REVIEW
Valentina-Anastasia Angelopoulou, Abraham Pouliakis, Nikolaos Alexiou, Parthena Ioannidi, Dimitra Vagiona, Konstantinos Ekmektzoglou, Theodoros Xanthos, Theodora Boutsikou, Zoi Iliodromiti, Nikoletta Iacovidou
BACKGROUND: Magnetic Resonance Imaging (MRI) is a valuable diagnostic tool but often requires sedation to complete, especially in children. Dexmedetomidine (DEX) is an a2 agonist, for which there are experimental findings that support its potential neuroprotective effects. Given the potential risks of anesthetic drugs, we ran this study to examine DEX's effectiveness and cardiopulmonary safety as a sedative drug for children undergoing MRI. MATERIAL AND METHODS: Systematic research was conducted in PubMed, Google Scholar, Scopus and Cochrane databases for randomized controlled trials published between 2010 and 6th/2022 and involving children undergoing MRI who received DEX as sedative medication...
May 26, 2023: Children
https://read.qxmd.com/read/37287843/randomized-controlled-trial-to-evaluate-the-effect-of-prophylactic-amiodarone-versus-dexmedetomidine-on-reducing-the-incidence-of-postoperative-junctional-ectopic-tachycardia-after-pediatric-open-heart-surgery
#37
JOURNAL ARTICLE
Santosh Wadile, Kothandam Sivakumar, Udaya Charan Murmu, Selvakumar Ganesan, Giridhar Gopal Dhandayuthapani, Ravi Agarwal, Ejaz Ahamed Sheriff, Roy Varghese
BACKGROUND: Junctional ectopic tachycardia (JET) is the most common arrhythmia after pediatric open-heart surgeries (OHS), causing high morbidity and mortality. As diagnosis is often missed in patients with minimal hemodynamic instability, its incidence depends on active surveillance. A prospective randomized trial evaluated the efficacy and safety of prophylactic amiodarone and dexmedetomidine to prevent and control postoperative JET. METHODS: Consecutive patients aged under 12 years were randomized into amiodarone, dexmedetomidine (initiated during anesthetic induction) and control groups...
2023: Annals of Pediatric Cardiology
https://read.qxmd.com/read/37128675/the-effect-of-intranasal-dexmedetomidine-administration-on-emergence-agitation-or-delirium-in-pediatric-patients-after-general-anesthesia-a-meta-analysis-of-randomized-controlled-trials
#38
JOURNAL ARTICLE
Hyo-Seok Na, Su Yeon Kim, Ji In Park, Sohyun Lee, Jung-Won Hwang, Hyun-Jung Shin
BACKGROUND: Emergence agitation or delirium can occur in pediatric patients after anesthesia. Dexmedetomidine is known to reduce the impairment of postoperative cognitive function. AIMS: This study aimed to identify the role of intranasal administration of dexmedetomidine in lowering the development of emergence agitation or emergence delirium in pediatric patients after general anesthesia. METHODS: Electronic databases, including PubMed, EMBASE, CENTRAL, Scopus, and Web of Science, were searched to identify studies...
August 2023: Paediatric Anaesthesia
https://read.qxmd.com/read/37023406/another-option-for-aggression-and-self-injury-alternative-benzodiazepines-for-catatonia-in-profound-autism
#39
JOURNAL ARTICLE
Joshua Ryan Smith, Tasia York, Samuel Warn, Darara Borodge, Donald L Pierce, D Catherine Fuchs
Introduction: Individuals with profound autism often present for inpatient care due to aggression. Diagnostic and treatment options are limited. Agitated catatonia is a treatable comorbidity in autism, which should be considered in cases of aggression. Preliminary data report high clinical response rates of catatonia in autism when treated with electroconvulsive therapy (ECT), with poor response to lorazepam. However, access to ECT is often limited, especially in pediatric populations. Methods: We conducted a retrospective chart review to identify cases of hyperactive catatonia with partial response to lorazepam in profoundly autistic children presenting to the pediatric medical hospital...
April 2023: Journal of Child and Adolescent Psychopharmacology
https://read.qxmd.com/read/37010953/perioperative-management-and-outcomes-in-patients-with-autism-spectrum-disorder-a-retrospective-cohort-study
#40
JOURNAL ARTICLE
Elizabeth M O'Brien, Paul A Stricker, Kathleen A Harris, Hongyan Liu, Heather Griffis, Wallis T Muhly
BACKGROUND: Autism spectrum disorder (ASD) is a neurocognitive disorder characterized by impairments in communication and socialization. There are little data comparing the differences in perioperative outcomes in children with and without ASD. We hypothesized that children with ASD would have higher postoperative pain scores than those without ASD. METHODS: Pediatric patients undergoing ambulatory tonsillectomy/adenoidectomy, ophthalmological surgery, general surgery, and urologic procedures between 2016 and 2021 were included in this retrospective cohort study...
April 3, 2023: Anesthesia and Analgesia
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