Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2020
Exhaled Nitric Oxide Measurement before Pediatric Adenotonsillectomy: A Feasibility Study.
Exhaled nitric oxide (eNO) is a known biomarker for the diagnosis and monitoring of bronchial hyperreactivity in adults and children. ⋯ eNO testing on the day of surgery has limited feasibility in children younger than 7 years of age. The most common reason for failure was inadequate physical performance while interacting with the testing device. The role of this respiratory biomarker in the context of perioperative outcomes for pediatric adenotonsillectomy remains unknown and should be further studied with improved technologies.
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Paediatric anaesthesia · Sep 2020
Use of Dexmedetomidine and Opioids as the Primary Anesthetic in Infants and Young Children: A Retrospective Cohort Study.
Anesthetic regimens using dexmedetomidine and short-acting opioids have been suggested as potential alternatives to sevoflurane-based anesthesia in children. The primary aim of this study is to compare demographics, intraoperative characteristics, and complications of general anesthetics in which dexmedetomidine and opioids were used without sevoflurane, or in combination with a low sevoflurane concentration, in children 36 months old and younger. The secondary aim is to evaluate intraoperative bispectral index (BIS) values when available in these patients. ⋯ Dexmedetomidine and opioids can effectively be used in young children as an alternative total intravenous anesthesia technique with or without <1 minimum alveolar concentration of sevoflurane. Bispectral index monitoring reveals a likely sufficient depth of hypnosis.
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Children experience anesthetization as stressful, and many preoperative measures have been tested for reducing their anxiety. There is, however, little research about children's own experiences and thoughts about being anesthetized. ⋯ The reasons for children experiencing anxiety when being anesthetized are multifaceted, and this study highlights the importance of listening to each child's own voice and striving to create an individually adapted caring and safe environment with as much protection as possible.
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Paediatric anaesthesia · Sep 2020
Effects of hypothermia and hypothermia combined with hypocapnia on cerebral tissue oxygenation in piglets.
Hypothermia and its combination with hypocapnia are frequently associated with anesthesia. ⋯ The hypothermia-induced reduction in oxygen delivery was compensated by lowered metabolic demand. However, hypothermia was not able to compensate for an additional reduction in oxygen delivery caused by simultaneous hypocapnia. This resulted in a PtO2 drop, which was not reflected by a downshift in rSO2 .
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Paediatric anaesthesia · Sep 2020
Age-related cerebrovascular carbon dioxide reactivity in children with ventricular septal defect younger than 3 years.
Impaired cerebrovascular reactivity to carbon dioxide was proposed to contribute to neurological morbidity in children undergoing cardiac surgery. The objective of this study was to assess carbon dioxide reactivity and regional cerebral oxygen saturation in children younger than 3 years. ⋯ Abnormal carbon dioxide reactivity is prevalent in children younger than 3 years and the degree varies according to age.