Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2011
ReviewPostoperative maladaptive behavioral changes in children.
Induction of anesthesia can be a very stressful period for a child and his family and can be associated with increased risk of psychological disturbances. These disturbances are categorized as preoperative anxiety, emergence delirium and postoperative behavioral changes. ⋯ Several studies found a strong association between these postoperative behavioral changes, the distress of the child on induction and his individual personality characteristics, although a cause-effect relationship could not be determined. Understanding the risk factors for behavior changes helps us determine the best way for prevention and treatment of these changes in the perioperative period.
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Middle East J Anaesthesiol · Jun 2011
Ultrasound confirmation of laryngeal mask airway placement correlates with fiberoptic laryngoscope findings.
Correct placement of a laryngeal mask airway (LMA) requires confirmation to appreciate the adequacy of laryngeal seal and pulmonary ventilation. ⋯ Ultrasound examination can replace fiberoptic examination for confirmation of the correct placement of an LMA. Additionally, non-invasive ultrasound examination can further give insight into the cause of airway/ventilation events that may be interfering with the LMA placement and ventilation.
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Middle East J Anaesthesiol · Jun 2011
Clevidipine for controlled hypotension during spinal surgery in adolescents.
Clevidipine is an ultra-shorting acting, intravenous calcium channel antagonist of the dihydropyridine class. Metabolism by blood and tissue esterases results in a half-life of 1-2 minutes thereby allowing easy titration by i.v. administration. We present preliminary experience with this novel agent to provide controlled hypotension (CH) in a cohort of adolescents undergoing posterior spinal fusion. ⋯ Clevidipine effectively controlled MAP and provided CH. Mild tachycardia was noted in some patients with the occasional need for a beta-adrenergic antagonist. No episodes of excessive hypotension were noted. Given its short half-life, clevidipine can be rapidly titrated to provide CH when changing levels of sympathetic stimulation may occur. Should inadvertent hypotension occur, its short duration of action offers an additional advantage over several other i.v. antihypertensive agents.