Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2013
Pupillary reflex dilatation and analgesia nociception index monitoring to assess the effectiveness of regional anesthesia in children anesthetised with sevoflurane.
Pupillary diameter (PD) monitoring and Analgesia Nociception Index (ANI) (Metrodoloris, Lille, France), an online wavelet transform-based heart rate variability index, have been used in the assessment of pain. ⋯ Both PD and ANI rapidly change after skin incision in case of RA failure. These indices may provide a useful tool alone, or in combination with heart rate changes in the assessment of RA efficacy in children anesthetised with sevoflurane.
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Paediatric anaesthesia · Dec 2013
Effects of sevoflurane on the expression of tau protein mRNA and Ser396/404 site in the hippocampus of developing rat brain.
General anesthesia induces a transient hyperphosphorylation of tau protein that is associated with neurotoxicity in neonatal rats, but the mechanism remains unknown. The current study sought to investigate the effects of sevoflurane on the levels of tau phosphorylation at phosphor-Ser396/404 and total tau mRNA in the hippocampus of neonatal rats. ⋯ In rat hippocampus, sevoflurane was associated with microtubular disarray as well as increased levels of tau mRNA and excessive phosphorylation of tau protein at Ser396 and Ser404. This implicates that sevoflurane may induce neurotoxicity.
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Paediatric anaesthesia · Nov 2013
Clinical TrialAccuracy of the CNAP™ monitor, a noninvasive continuous blood pressure device, in providing beat-to-beat blood pressure readings in pediatric patients weighing 20-40 kilograms.
During perioperative care, the continuous measurement of blood pressure (BP) provides superior physiologic monitoring to intermittent techniques. However, such monitoring requires placement of an intraarterial catheter, which may be time-consuming or associated with adverse events and technical difficulty. A noninvasive, continuous BP monitoring device has been studied in the adult population. This study prospectively assesses its accuracy in pediatric patients, weighing 20-40 kg. ⋯ Although some variation in its accuracy was noted, the CNAP™ device provides a noninvasive and continuous blood pressure reading which appears to be within clinically useful limits. It may be that modification of the finger cuffs is needed to improve its absolute accuracy as our clinical experience demonstrated that achieving an effective fit with the cuffs was at times difficult.