Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2022
Randomized Controlled TrialThe effect of end-tidal carbon dioxide level on the optic nerve sheath diameter measured by transorbital ultrasonography in anesthetized pediatric patients: a randomized trial.
Intraoperative hypercapnia and hypocapnia are common during pediatric anesthesia, and the cerebral blood flow and intracranial pressure may be affected by the partial pressure of arterial carbon dioxide. Transorbital ultrasound measurement of the optic nerve sheath diameter is a simple and non-invasive method for intracranial pressure assessment. The objective of this study was to evaluate the effect of end-tidal carbon dioxide (ET CO2 ) on optic nerve sheath diameter in a healthy anesthetized pediatric population. ⋯ The optic nerve sheath diameter measured by transorbital ultrasound showed rapid reactivity from ET CO2 35 to 45 mmHg in healthy pediatric patients under inhalation general anesthesia.
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Paediatric anaesthesia · Jun 2022
ReviewThe role of sugammadex in the treatment of anaphylaxis due to rocuronium in children: extrapolation from adult and animal reports.
Allergic reactions are generalized hypersensitivity processes triggered by different antigenic stimuli, resulting in the end effect of mast cell degranulation and adverse physiologic effects. During the perioperative period, the most commonly identified agents include antibiotics, neuromuscular blocking agents (rocuronium and succinylcholine), chlorhexidine, and iodinated dyes for radiologic imaging. ⋯ Its unique mechanism of action, whereby it encapsulates and forms a one-to-one complex with rocuronium, has led to its anecdotal use as an adjunct in the treatment of anaphylactic and anaphylactoid reactions following rocuronium. The current manuscript discusses the potential use of sugammadex in the treatment of allergic reactions following the administration of rocuronium, reviews previous anecdotal reports of its use in these scenarios, and provides recommendations for future care.
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Paediatric anaesthesia · Jun 2022
Outcomes Following Formation of a Dedicated Pediatric Liver Transplant Anesthesia Team.
Given the complex nature of liver transplant surgery, adult centers typically use a dedicated liver transplant anesthesia team, which has improved patient outcomes. ⋯ The liver group was associated with increased early extubations, decreased ventilator days, and decreased fresh frozen plasma use.