Paediatric anaesthesia
-
Paediatric anaesthesia · Nov 2019
Multicenter Study Observational StudyEpidemiology of Regional Anaesthesia in Children: Lessons learned from the European Multi-Institutional Study APRICOT.
Recently, the European prospective observational multicenter cohort study, APRICOT, reported anesthesia techniques and complications in more than 31 000 pediatric procedures. The main objective of this study was to analyze the current practice in regional anesthesia in the 33 countries that participated to APRICOT. ⋯ These data show a large predominance of central and truncal blocks in APRICOT study. Ultrasound guidance was mainly used for peripheral nerve blocks while central blocks were performed using landmark techniques.
-
Paediatric anaesthesia · Nov 2019
Observational StudyAgreement between frontal and occipital regional cerebral oxygen saturation in infants during surgery and general anesthesia an observational study.
Advances in perioperative pediatric care have resulted in an increased number of procedures requiring anesthesia. During anesthesia and surgery, the patient is subjected to factors that affect the circulatory homeostasis, which can influence oxygenation of the brain. Near-infrared spectroscopy (NIRS) is an easy applicable noninvasive method for monitoring of regional tissue oxygenation (rScO₂%). Alternate placements for NIRS have been investigated; however, no alternative cranial placements have been explored. ⋯ The agreement between frontal and occipital recordings of brain rScO₂% in infants using INVOSTM during surgery and general anesthesia was acceptable. In surgical procedures where the frontal region of the head is not available for monitoring, occipital recordings of rScO₂% could be an option for monitoring.
-
Paediatric anaesthesia · Nov 2019
Coagulative Function Assessed Preoperatively via the Clot Formation and Lysis Assay as a Prognostic Factor for Blood Loss in Adolescents Undergoing Posterior Spinal Fusion for Idiopathic Scoliosis.
Posterior spinal fusion for adolescent idiopathic scoliosis is a complex surgery often associated with clinically significant blood loss leading to perioperative blood transfusion. Knowledge of risk factors for blood loss and transfusion stems mostly from retrospective studies. ⋯ In adolescents undergoing posterior spinal fusion for idiopathic scoliosis, increased coagulative function measured preoperatively using the CloFAL assay is independently associated with decreased intraoperative blood loss. Future studies should expand upon these investigations of plasma coagulative and fibrinolytic capacities in combination with clinical factors, to guide precise preventive strategies against blood loss and blood transfusion in this patient population.