Paediatric anaesthesia
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The future of pediatric anesthesia can be thought of in terms of what will happen to the practice of anesthesia, or what will happen to the profession of pediatric anesthesia. The profession will change both under external forces, and by how pediatric anesthetists themselves decide to shape of the profession. The largest external force is likely to be cost. ⋯ New technologies will have an impact in monitoring and in the gathering and dissemination of information. Practice will also change with changes in surgery. Perhaps the biggest changes will come in areas with the greatest unknowns; neonatal anesthesia is an area with many unknowns and thus great potential for change and improvement.
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The accurate assessment of the depth of anesthesia, allowing a more accurate adaptation of the doses of hypnotics, is an important end point for the anesthesiologist. It is a particularly crucial issue in pediatric anesthesia, in the context of the recent controversies about the potential neurological consequences of the main anesthetic drugs on the developing brain. The electroencephalogram signal reflects the electrical activity of the neurons in the cerebral cortex. ⋯ However, the cortex is only one of several targets of anesthesia. Hypnotics and opiates, have also subcortical primary targets, and the EEG performances in the evaluation or prediction of nociception are poor. Monitoring subcortical structures in combination with the EEG might in the future allow a better evaluation and a more precise adaptation of balanced anesthesia.
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Paediatric anaesthesia · Jun 2012
Editorial Biography Historical ArticleEditorial: a special tribute to Isabelle Murat and Martin Jöhr.