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Intravenous fluids and neonatal anesthesia

Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
August 2017: Journal of Pediatric Urology
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...
January 2018: Anesthesia and Analgesia
Hakki Unlugenc, Mediha Turktan, Ismail Cuneyt Evruke, Murat Gunduz, Refik Burgut, Hacer Yapicioglu-Yildizdas, Geylan Isik
PURPOSE: Spinal anesthesia for caesarean delivery is often associated with hypotension. This study was conducted to evaluate the effects of rapid crystalloid (Lactated Ringer's solution; LRS) or colloid (hydroxyethyl starch; HES) cohydration with a second intravenous access line on the incidence of hypotension and ephedrine requirement during spinal anesthesia for cesarean section. METHODS: We studied 90 women with uncomplicated pregnancies undergoing elective cesarean section under spinal anesthesia...
October 2015: Middle East Journal of Anesthesiology
Javier Mata-Gómez, Rosana Guerrero-Domínguez, Marta García-Santigosa, Antonio Ontanilla
BACKGROUND AND OBJECTIVES: Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis...
July 2015: Brazilian Journal of Anesthesiology
Javier Mata-Gómez, Rosana Guerrero-Domínguez, Marta García-Santigosa, Antonio Ontanilla
BACKGROUND AND OBJECTIVES: Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis...
July 2015: Revista Brasileira de Anestesiologia
Chihebeddine Romdhani, Walid Trabelsi, Anis Lebbi, I Naas, Haythem Elaskri, Hedi Gharsallah, Radhouane Rachdi, Mustapha Ferjani
BACKGROUND: Hypotension is a common complication following spinal anesthesia for cesarean delivery. Techniques to prevent hypotension include preloading intravenous fluid. AIM: To compare the effect of two preloading regimens: 6% hydroxyethyl starch (HES) and 9‰ saline solution, to prevent hypotension after spinal anesthesia in cesarean delivery. METHODS: 105 patients undergoing intrathecal anesthesia for elective cesarean delivery were randomized and allocated to receive a preload of 500 ml HES 130/0...
June 2014: La Tunisie Médicale
Mahzad Alimian, Masood Mohseni, Reza Safaeian, Seyed Hamid Reza Faiz, Mohammad Azad Majedi
BACKGROUND: Although controversial, many studies have shown effectiveness of colloid loading as a substitute for crystalloids on reducing the incidence of hypotension in spinal anesthesia. This study was conducted to compare the effects of three intravenous fluid regimens on hemodynamic changes following spinal anesthesia in cesarean section. The regimens included 6% Hydroxyethylstarch 130/0.4 (HES) as a colloid and two crystalloids (lactated ringer's solution and sodium chloride 0.9%)...
August 2014: Medical Archives
M M Tawfik, S M Hayes, F Y Jacoub, B A Badran, F M Gohar, A M Shabana, M Abdelkhalek, M M Emara
BACKGROUND: Hypotension is a common problem during spinal anesthesia for cesarean delivery. Intravenous fluid loading is used to correct preoperative dehydration and reduce the incidence and severity of hypotension. Different fluid regimens have been studied but colloid preload and crystalloid co-load have not been compared. METHODS: In this randomized double-blind study, 210 patients scheduled for elective cesarean section under spinal anesthesia were randomly allocated to receive either 6% hydroxyethyl starch 130/0...
November 2014: International Journal of Obstetric Anesthesia
Judy Munday, Sonia Hines, Karen Wallace, Anne M Chang, Kristen Gibbons, Patsy Yates
BACKGROUND: Women undergoing cesarean section are vulnerable to adverse effects associated with inadvertent perioperative hypothermia, but there has been a lack of synthesized evidence for temperature management in this population. This systematic review aimed to synthesize the best available evidence in relation to preventing hypothermia in mothers undergoing cesarean section surgery. METHODS: Randomized controlled trials meeting the inclusion criteria (adult patients of any ethnic background, with or without comorbidities, undergoing any mode of anesthesia for any type of cesarean section) were eligible for consideration...
December 2014: Worldviews on Evidence-based Nursing
Suman Chattopadhyay, Ashok Das, Subrata Pahari
This prospective observational study compared the effects of general and spinal anesthesia in 173 severe preeclamptic women undergoing emergency cesarean section. 146 (84.5%) patients underwent spinal anesthesia (SA) and 27 (15.5%) patients had general anesthesia (GA). Most of the patients were primigravid and nulliparous. Intraoperatively SA group required more intravenous fluid and vasopressor support, while GA group required more preoperative labetalol injection for blood pressure control. Overall 13.3% of patients required critical care, particularly GA group (44...
2014: Journal of Pregnancy
Lauren D Martin, Gregory A Dissen, Matthew J McPike, Ansgar M Brambrink
Isoflurane, ketamine, and propofol are common anesthetics in human and nonhuman primate medicine. However, scant normative data exist regarding the response of neonatal macaques to these anesthetics. We compared the effects of isoflurane, ketamine, and propofol anesthesia on physiologic parameters in neonatal rhesus macaques. Neonatal rhesus macaques (age, 5 to 7 d) were exposed to isoflurane (n = 5), ketamine (n = 4), propofol (n = 4) or no anesthesia (n = 5) for 5 h. The anesthetics were titrated to achieve a moderate anesthetic plane, and heart rate, blood pressure, respiratory rate, end tidal carbon dioxide, oxygen saturation, and temperature were measured every 15 min...
May 2014: Journal of the American Association for Laboratory Animal Science: JAALAS
Vincent D Duron, Debra Watson-Smith, Scott E Benzuly, Christopher S Muratore, Barbara M O'Brien, Stephen R Carr, Francois I Luks
STUDY OBJECTIVE: To review our experience with general anesthesia in endoscopic fetal surgery for twin-to-twin transfusion syndrome (TTTS), and to compare fetomaternal outcome before and after protocol implementation. DESIGN: Retrospective impact study. SETTING: University-affiliated medical center. MEASUREMENTS: Data from 85 consecutive patients who underwent endoscopic laser ablation of placenta vessels for severe TTTS were studied...
May 2014: Journal of Clinical Anesthesia
Lavenia Carpenter, Curtis L Baysinger
Anesthesia and surgery interfere with normal thermoregulation, and nearly all patients will become hypothermic unless compensatory measures are used. Preoperative patient warming and intraoperative methods using forced air and warmed intravenous fluids are important methods for maintaining patient's core temperature during the perioperative period. The benefits of maintaining normothermia include reductions in postoperative wound infection, the risk of perioperative coagulopathy, and myocardial ischemia. These advantages, demonstrated in patients undergoing general surgery, would be expected in patients undergoing gynecological surgery but have not been specifically studied in that population...
July 2012: Obstetrical & Gynecological Survey
Suwannee Suraseranivongse, Anchalee Attachoo, Ruenreong Leelanukrom, Usa Chareonsawan, Duenpen Horatanaruang
OBJECTIVE: To assess current pediatric anesthesia practice for further education from Royal College of Anesthesiologists of Thailand. MATERIAL AND METHOD: A questionnaire was sent to 500 anesthetists in public hospitals in January 2010 to investigate preoperative data, intraoperative data, postoperative pain management, ambulatory anesthesia, and pediatric anesthesia training requirement. RESULTS: Response rate was 30.6%. Preoperative fasting and infective endocarditis (IE) prophylaxis were appropriate except that half the anesthesiologists preferred giving antibiotics in non-cyanotic heart diseases and ordering complete blood count as a routine investigation in healthy patients undergoing minor surgery...
April 2011: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
R Sümpelmann
No abstract text is available yet for this article.
January 2011: Der Anaesthesist
Haobo Ma, Mark A Lovich, Robert A Peterfreund
OBJECTIVE: Quantitative characterization of continuous pediatric drug infusions. BACKGROUND: The dynamics of drug delivery by continuous infusion to pediatric patients have not been systematically examined. This study extends previously described analytic models to propofol and remifentanil delivery, focusing on infants and toddlers. We postulated that infusion system dead volume, and drug and carrier flow rates, significantly influence drug delivery. METHODS: We studied effects of patient weight, infusion system dead volume, drug and carrier flow rates, along with drug stock concentration and dose, on propofol and remifentanil delivery to the circulation...
January 2011: Paediatric Anaesthesia
S Fyneface-Ogan, C N Mato, S E Anya
BACKGROUND: Pain during childbirth is a well known cause of dissatisfaction amongst women in labor. The use of epidural analgesia in labor is becoming widespread due to its benefit in terms of pain relief. METHOD: After approval of the local Ethics Committee on Research and obtaining informed written consent, 50 American Society of Anesthesiologists (ASA) class I-II consecutive multiparous women in labor requesting pain relief were enrolled in this prospective study...
October 2009: Annals of African Medicine
Iclal Ozdemir Kol, Kenan Kaygusuz, Sinan Gursoy, Ali Cetin, Zeki Kahramanoglu, Fikret Ozkan, Caner Mimaroglu
We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/kg lactated Ringer's solution was given. Shortly after the spinal injection, ephedrine 0.5 mg/kg or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0...
October 2009: Journal of Korean Medical Science
M Woolnough, J Allam, C Hemingway, M Cox, S M Yentis
BACKGROUND: We assessed the effect of warming intravenous fluids during elective caesarean section under combined spinal-epidural anaesthesia in a blinded, randomised controlled trial. METHOD: Seventy-five women having elective caesarean section were randomly assigned to receive all intravenous fluids at room temperature, or heated in a cabinet set at 45 degrees C or via a Hotline fluid warmer (Smiths Medical International Ltd, Watford, Herts, UK). After 10 mL/kg crystalloid preload, combined spinal-epidural anaesthesia was performed...
October 2009: International Journal of Obstetric Anesthesia
Walter Williamson, David Burks, Jessica Pipkin, Joseph F Burkard, Lisa A Osborne, Joseph E Pellegrini
Spinal-induced hypotension remains the most common complication associated with spinal anesthesia for cesarean delivery. Recent evidence indicates that a 20-mL/kg bolus via pressurized infusion system administered at the time of subarachnoid block (SAB) (coload) may provide better prophylaxis than the traditional administration of a 20-mL/kg crystalloid infusion (preload) approximately 20 minutes before SAB; however, this method raises some concerns. We hypothesized that administering half of the fluid bolus (10 mL/kg) before and half immediately following injection of the SAB would provide benefit...
April 2009: AANA Journal
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