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Neonates and Anaesthetics

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https://www.readbyqxmd.com/read/28294340/neuroprotective-effects-of-artemisinin-against-isoflurane-induced-cognitive-impairments-and-neuronal-cell-death-involve-jnk-erk1-2-signalling-and-improved-hippocampal-histone-acetylation-in-neonatal-rats
#1
Guang Xu, Yun-Li Huang, Ping-le Li, Hai-Ming Guo, Xue-Ping Han
OBJECTIVE: This study was performed to assess the effect of artemisinin against isoflurane-induced neuronal apoptosis and cognitive impairment in neonatal rats. METHODS: Artemisinin (50, 100 or 200 mg/kg b.wt/day; oral gavage) was administered to separate groups of neonatal rats starting from postnatal day 3 (P3) to postnatal day 21 (P21). On postnatal day 7 (P7), animals were exposed to inhalation anaesthetic isoflurane (0.75%) for 6 h. KEY FINDINGS: Neuronal apoptosis following anaesthetic exposure was significantly reduced by artemisinin...
March 12, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28283552/anaesthetic-considerations-for-surgery-in-newborns
#2
Constance S Houck, Amy E Vinson
Almost 30 years ago, the American Academy of Pediatrics Committee on Fetus and Newborn coauthored a policy statement strongly advocating for the use of anaesthesia in all neonates stating 'local or systemic pharmacologic agents now available permit relatively safe administration of anesthesia or analgesia to neonates undergoing surgical procedures and that such administration is indicated according to the usual guidelines for the administration of anesthesia to high-risk, potentially unstable patients'. With current techniques and advanced monitoring, preterm and full-term infants routinely undergo surgical procedures under general anaesthesia to repair congenital defects that were lethal in years past...
March 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28160271/topical-anaesthesia-for-needle-related-pain-in-newborn-infants
#3
REVIEW
Jann P Foster, Christine Taylor, Kaye Spence
BACKGROUND: Hospitalised newborn neonates frequently undergo painful invasive procedures that involve penetration of the skin and other tissues by a needle. One intervention that can be used prior to a needle insertion procedure is application of a topical local anaesthetic. OBJECTIVES: To evaluate the efficacy and safety of topical anaesthetics such as amethocaine and EMLA in newborn term or preterm infants requiring an invasive procedure involving puncture of skin and other tissues with a needle...
February 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141842/dopamine-therapy-does-not-affect-cerebral-autoregulation-during-hypotension-in-newborn-piglets
#4
Vibeke Ramsgaard Eriksen, Martin Bo Rasmussen, Gitte Holst Hahn, Gorm Greisen
BACKGROUND: Hypotensive neonates who have been treated with dopamine have poorer neurodevelopmental outcome than those who have not been treated with dopamine. We speculate that dopamine stimulates adrenoceptors on cerebral arteries causing cerebral vasoconstriction. This vasoconstriction might lead to a rightward shift of the cerebral autoregulatory curve; consequently, infants treated with dopamine would have a higher risk of low cerebral blood flow at a blood pressure that is otherwise considered "safe"...
2017: PloS One
https://www.readbyqxmd.com/read/27861919/consequences-of-maternal-omega-3-polyunsaturated-fatty-acid-supplementation-on-respiratory-function-in-rat-pups
#5
Luana Tenorio-Lopes, Cécile Baldy, Alexandra Jochmans-Lemoine, Océane Mercier, Olivier Pothier-Piccinin, Tommy Seaborn, Vincent Joseph, Isabelle Marc, Richard Kinkead
KEY POINTS: Incomplete development of the neural circuits that control breathing contributes to respiratory disorders in pre-term infants. Manifestations include respiratory instability, prolonged apnoeas and poor ventilatory responses to stimuli. Based on evidence suggesting that omega-3 polyunsaturated fatty acids (n-3 PUFA) improves brain development, we determined whether n-3 PUFA supplementation (via the maternal diet) improves respiratory function in 10-11-day-old rat pups. n-3 PUFA treatment prolonged apnoea duration but augmented the relative pulmonary surface area and the ventilatory response to hypoxia...
November 11, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27792244/breastfeeding-for-procedural-pain-in-infants-beyond-the-neonatal-period
#6
REVIEW
Denise Harrison, Jessica Reszel, Mariana Bueno, Margaret Sampson, Vibhuti S Shah, Anna Taddio, Catherine Larocque, Lucy Turner
BACKGROUND: Randomised controlled trials (RCTs) show that breastfeeding newborn infants during painful procedures reduces pain. Mechanisms are considered to be multifactorial and include sucking, skin-to-skin contact, warmth, rocking, sound and smell of the mother, and possibly endogenous opiates present in the breast milk. OBJECTIVES: To determine the effect of breastfeeding on procedural pain in infants beyond the neonatal period (first 28 days of life) up to one year of age compared to no intervention, placebo, parental holding, skin-to-skin contact, expressed breast milk, formula milk, bottle feeding, sweet-tasting solutions (e...
October 28, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27637278/sublingual-dermoid-causing-stertor-in-an-infant
#7
P Naina, Kamran Asif Syed, Lisa Koshy, Suma Susan Mathews
Sublingual dermoids are uncommon lesions in the floor of mouth. The most common age of presentation is early adulthood, but presentation in infancy has also been reported. This report highlights the clinical presentation and treatment challenges in infants. An 8-month-old infant presented with inability to close mouth, intermittent stertor and snoring. MRI suggested a sublingual dermoid which was confirmed on histopathology of the surgically enucleated specimen. Sublingual dermoids are uncommon lesions of the floor of mouth...
September 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27630748/engagement-with-and-outcomes-of-a-midwifery-led-intervention-group-for-pregnant-women-of-high-body-mass-index
#8
Sarah R Chwah, Amanda Reilly, Beverley Hall, Anthony J O'Sullivan, Amanda Henry
AIMS: To compare pregnancy care, maternal and neonatal outcomes of women with Body Mass Index (BMI) >30 enrolled in a Weight Intervention Group versus other models of antenatal care. METHODS: Retrospective, case-control study of mothers with BMI >30 managed with a specialised programme versus age-matched women enrolled in standard models of care. RESULTS: One thousand, one hundred and fifteen of 9954 pregnant women with singleton pregnancies, had a BMI >30, of whom 9...
September 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27604839/the-effect-of-a-multidisciplinary-obstetric-emergency-team-training-program-the-in-time-course-on-diagnosis-to-delivery-interval-following-umbilical-cord-prolapse-a-retrospective-cohort-study
#9
Sean Copson, Katrina Calvert, Puvaneswary Raman, Elizabeth Nathan, Mathias Epee
BACKGROUND: Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. AIMS: This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval...
September 7, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27572468/naringenin-pre-treatment-inhibits-neuroapoptosis-and-ameliorates-cognitive-impairment-in-rats-exposed-to-isoflurane-anesthesia-by-regulating-the-pi3-akt-pten-signalling-pathway-and-suppressing-nf-%C3%AE%C2%BAb-mediated-inflammation
#10
Fu-Zhou Hua, Jun Ying, Jing Zhang, Xi-Feng Wang, Yan-Hui Hu, Ying-Ping Liang, Qin Liu, Guo-Hai Xu
The volatile anaesthetic isoflurane is one of the most frequently employed general anaesthetics in neonates, children and adults. Accumulating evidence demonstrated that exposure to anaesthetics is associated with widespread neurodegeneration and cognitive impairment. Thus, the identification and development of compounds capable of preventing or reducing these adverse effects is of great clinical importance. For this purpose, the present study aimed to assess the effects of a flavonoid, naringenin, on isoflurane-induced neuroapoptosis and cognitive impairment...
October 2016: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/27504386/anaesthetic-management-of-caesarean-section-in-a-term-pregnancy-with-ventricular-septal-defect-and-pulmonary-hypertension-with-severe-pulmonary-stenosis
#11
Rohan Bhatia, Nidhi Kaeley, Ruby Bhatia
Pregnancy with pulmonary hypertension - WHO risk class IV cardiac disease is associated with significant haemodynamic burden due to cardiocirculatory changes which is a significant indirect cause of maternal mortality. We report a very rare case - primigravida term pregnancy with pulmonary hypertension, large ventricular septal defect (2.4 cm(2)), bidirectional shunt mainly left to right with severe pulmonary stenosis with peak gradient of 144mmHg. Caesarean section was done under general anaesthesia with successful maternal and neonatal outcome...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27420164/sucrose-for-analgesia-in-newborn-infants-undergoing-painful-procedures
#12
REVIEW
Bonnie Stevens, Janet Yamada, Arne Ohlsson, Sarah Haliburton, Allyson Shorkey
BACKGROUND: Administration of oral sucrose with and without non-nutritive sucking is the most frequently studied non-pharmacological intervention for procedural pain relief in neonates. OBJECTIVES: To determine the efficacy, effect of dose, method of administration and safety of sucrose for relieving procedural pain in neonates as assessed by validated composite pain scores, physiological pain indicators (heart rate, respiratory rate, saturation of peripheral oxygen in the blood, transcutaneous oxygen and carbon dioxide (gas exchange measured across the skin - TcpO2, TcpCO2), near infrared spectroscopy (NIRS), electroencephalogram (EEG), or behavioural pain indicators (cry duration, proportion of time crying, proportion of time facial actions (e...
July 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27388793/adjunct-analgesic-drugs-to-local-anaesthetics-for-neuroaxial-blocks-in-children
#13
Märit Lundblad, Per-Arne Lönnqvist
PURPOSE OF REVIEW: This article reviews various adjunct drugs used in the context of neuroaxial blocks in children and to provide a literature and evidence-based suggestion for the rational use of such adjuncts. RECENT FINDINGS: Contrary to plain local anaesthetics, preservative-free morphine and clonidine, ketamine in neonatal rodents has been found to enhance apoptosis in the spinal cord. Dexmedetomidine has been shown to be equally effective as clonidine as an adjunct to caudal blocks...
October 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27366533/retrospective-evaluation-of-anaesthetic-techniques-for-caesarean
#14
Melek Aksoy Sarı, Semih Küçükgüçlü, Şule Özbilgin, Ferim Sakize Günenç, Sümeyye Mercan, Ayşenur Esen, Büşra Yetim
OBJECTIVE: This study aimed to evaluate the maternal, foetal and neonatal effects of anaesthetic techniques used in caesarean sections (C/S) retrospectively over 6 years at the Hospital of Medical School of Dokuz Eylül University and to compare the results with the literature from Turkey and developed countries. METHODS: After obtaining approval from the ethics committee, anaesthetic and gestational data from all caesarean operations performed over a 6-year period between 2005 and 2010 was retrospectively obtained from hospital archives...
December 2015: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27335360/congenital-lobar-emphysema-diagnostic-and-therapeutic-challenges
#15
James Jackson Mulvany, Andrew Weatherall, Amanda Charlton, Hiran Selvadurai
Congenital lobar emphysema (CLE), a rare condition that usually presents in the neonatal period, can be a diagnostic and therapeutic challenge for the treating clinician. If unrecognised, it is a significant risk at the time of anaesthetic induction. We describe a case of CLE in a 3-month-old boy who was initially treated for suspected aspiration pneumonia at the referring hospital. We highlight the importance of careful consideration of common childhood respiratory illness as well as pneumothorax in the differential diagnosis, and the significance of appropriate preoperative anaesthetic management...
June 22, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27230409/animal-facility-videoendoscopic-intubation-station-tips-and-tricks-from-mice-to-rabbits
#16
Alice Miranda, José M Pêgo, Jorge Correia-Pinto
Endotracheal intubation of laboratory animals is a common procedure shared by several research fields for different purposes, such as mechanical ventilation of anaesthetized animals, instillation of cytotoxic nanoparticles, infectious agents or tumour cells for induction of disease models, and even for diagnostic and therapeutic purposes. These different research purposes, achieved in different animal models, require technical expertise and equipment that suits every research need from animal facilities. In this short report we propose a videoendoscopic intubation station that could be shared among the most common laboratory animals, namely the mouse, rat, guinea pig and rabbit, from neonates to adult animals...
April 2017: Laboratory Animals
https://www.readbyqxmd.com/read/27147542/inhibiting-nadph-oxidase-protects-against-long-term-memory-impairment-induced-by-neonatal-sevoflurane-exposure-in-mice
#17
Z Sun, M Satomoto, Y U Adachi, H Kinoshita, K Makita
BACKGROUND: Neonatal exposure to anaesthetics such as sevoflurane has been reported to result in behavioural deficits in rodents. However, while oxidative injury is thought to play an underlying pathological role, the mechanisms of neurotoxicity remain unclear. In the present study, we investigated whether the NADPH oxidase inhibitor apocynin protects against long-term memory impairment produced by neonatal sevoflurane exposure in mice. METHODS: Postnatal day six mice were divided into four groups; (1) non-anaesthesia, (2) intraperitoneal apocynin (50 mg kg(-1)) treatment, (3) 3% sevoflurane exposure for 6 h, and (4) apocynin treatment combined with sevoflurane exposure...
July 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27100952/circulatory-collapse-following-epidural-bolus-for-caesarean-section-a-profound-vasovagal-reaction-a-case-report
#18
Eva Oddby, Anette Hein, Jan G Jakobsson
INTRODUCTION: Reduced blood pressure is commonly seen associated to spinal anaesthesia for Caesarean section and efforts to reduce its occurrence and its magnitude is common practice. Cardiovascular collapse requiring cardio-pulmonary resuscitation after putting the spinal/epidural block for Caesarean section is however a rare but most dramatic event. PRESENTATION OF CASE: We describe a case with sudden short loss of circulation, circulatory collapse, short after start of emergency Caesarean section in top up epidural anaesthesia (3+12ml ropivaciane 7...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27013750/maternal-and-foetal-outcome-after-epidural-labour-analgesia-in-high-risk-pregnancies
#19
Sukhen Samanta, Kajal Jain, Neerja Bhardwaj, Vanita Jain, Sujay Samanta, Rini Saha
BACKGROUND AND AIMS: Low concentration local anaesthetic improves uteroplacental blood flow in antenatal period and during labour in preeclampsia. We compared neonatal outcome after epidural ropivacaine plus fentanyl with intramuscular tramadol analgesia during labour in high-risk parturients with intrauterine growth restriction of mixed aetiology. METHODS: Forty-eight parturients with sonographic evidence of foetal weight <1.5 kg were enrolled in this non-randomized, double-blinded prospective study...
February 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26958696/why-is-neonatal-anaesthesia-such-a-challenge
#20
REVIEW
Bogumiła Wołoszczuk-Gebicka
Approximately 1.5 million neonates receive general anaesthesia each year for surgical procedures. Providing anaesthesia to neonates is not easy. Surgical procedures are often difficult and extensive, and the physiology of neonates makes respiratory and cardiovascular problems more frequent and life-threatening. The paper covers the changing concepts in neonatal anaesthesia, including recent studies that indicate that anaesthetic exposure could cause neuronal apoptosis in the developing brain. This could potentially influence the long-term developmental outcome, especially in infants requiring multiple surgical procedures...
July 2015: Developmental Period Medicine
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