Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2022
Multicenter Study Observational StudyPerioperative critical events and morbidity associated with anesthesia in early life: subgroup analysis of United Kingdom participation in the neonate and children audit of anesthesia practice in Europe (NECTARINE) prospective multicenter observational study.
The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective observational study reported critical events requiring intervention during 35.2% of 6542 anesthetic episodes in 5609 infants up to 60 weeks postmenstrual age. The United Kingdom (UK) was one of 31 participating countries. ⋯ Perioperative critical events and co-morbidities are common in neonates and young infants. Thirty-day morbidity and mortality data did not demonstrate national differences in outcome. Identifying factors associated with increased risk informs preoperative assessment, resource allocation, and discussions between clinicians and families.
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Paediatric anaesthesia · Jul 2022
Multicenter StudyModified fluid gelatin 4% for perioperative volume replacement in pediatric patients (GPS): results of a European prospective non-interventional multicenter study.
Modified fluid gelatin 4% is approved for use in children, but there is still a surprising lack of clinical studies including large numbers of pediatric patients. Therefore, we performed a European prospective noninterventional multicenter study to evaluate the use of a modified fluid gelatin 4% in saline (sal-GEL) or an acetate-containing balanced electrolyte solution (bal-GEL) in children undergoing major pediatric surgery. ⋯ Moderate doses up to 20 ml kg-1 of modified fluid gelatin were infused most frequently to improve hemodynamic stability in children undergoing major pediatric surgery. The acid-base balance was more stable when gelatin in a balanced electrolyte solution was used instead of saline. No serious adverse drug reactions associated with gelatin were observed.
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Paediatric anaesthesia · Jul 2022
Comprehensive Risk Assessments and Anesthetic Management for Children with Osteogenesis Imperfecta: A Retrospective Review of 252 Orthopedic Procedures Over 5 Years.
Major anesthetic risks arise in orthopedic surgeries for children with osteogenesis imperfecta, a rare genetically inherited condition presenting diverse skeletal issues. ⋯ Anesthesia for children with osteogenesis imperfecta undergoing complex orthopedic procedures was challenging. Proper anesthesia planning was essential for both intraoperative management and postoperative analgesia. Age, surgical duration, and use of sevoflurane for maintenance impacted the intraoperative temperature most, and massive blood loss was not uncommon. The risks for airway or regional anesthesia difficulties were low. Pain scores could be controlled to be ≤3 via multiple techniques.
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Paediatric anaesthesia · Jul 2022
Observational StudyComparison of the Newborn Infant Parasympathetic Evaluation (NIPETM ) index to changes in heart rate to detect intraoperative nociceptive stimuli in healthy and critically ill children below 2 years: An observational study.
The validity of current tools for intraoperative objective assessment of nociception/antinociception balance during anesthesia in young and very young surgery children is unknown. ⋯ The NIPE index was reliable for assessing intraoperative nociception in children aged <2 years and was more reproducible for detecting specific nociceptive stimuli during general anesthesia than heart rate. An effect on postoperative outcome is still elusive.