Articles: general-anesthesia.
-
Paediatric anaesthesia · May 2023
Standardized Anesthesia InductioN Tool (SAINT) - the development and international adoption of an integrated electronic tool for documenting the induction of anesthesia in children.
The induction of anesthesia in children poses a challenge for the anesthesiologist, the parent and child. Anxiety and negative behaviours and strategies that effectively mitigate should be documented accurately and be available for future patient encounters. To address the need for a structured and standardized electronic documentation tool. ⋯ We show that collaborative development and rapid adoption of the comprehensive induction tool SAINT has led to its rapid adoption in the routine practice of pediatric anesthesiology across several countries. Further studies on how the SAINT is being used for quality improvement or research are warranted.
-
Randomized Controlled Trial
Lung-protective ventilation during Trendelenburg pneumoperitoneum surgery: A randomized clinical trial.
Study objective To assess the effects of a protective ventilation strategy during Trendelenburg pneumoperitoneum surgery on postoperative oxygenation. ⋯ In obese patients undergoing Trendelenburg pneumoperitoneum surgery, PV did not improve postoperative oxygenation nor day-2 respiratory function. PV was associated with intraoperative respiratory mechanics indicating less injurious ventilation. The high prevalence of complete airway closure may have affected study results.
-
'Depth of anaesthesia' monitors claim to measure hypnotic depth during general anaesthesia from the EEG, and clinicians could reasonably expect agreement between monitors if presented with the same EEG signal. We took 52 EEG signals showing intraoperative patterns of diminished anaesthesia, similar to those that occur during emergence (after surgery) and subjected them to analysis by five commercially available monitors. ⋯ Many clinical providers still rely on index values and manufacturer's recommended ranges for titration decision making. That two-thirds of cases showed discordant recommendations given identical EEG data, and that one-third signified excessive hypnotic depth where the EEG would suggest a lighter hypnotic state, emphasizes the importance of personalised EEG interpretation as an essential clinical skill.
-
Anesthesia and analgesia · May 2023
The Impact of Inflammation and General Anesthesia on Memory and Executive Function in Mice.
Perioperative neurocognitive disorders (PNDs) are complex, multifactorial conditions that are associated with poor long-term outcomes. Inflammation and exposure to general anesthetic drugs are likely contributing factors; however, the relative impact of each factor alone versus the combination of these factors remains poorly understood. The goal of this study was to compare the relative impact of inflammation, general anesthesia, and the combination of both factors on memory and executive function. ⋯ Impairments in recognition memory were driven by inflammation. Deficits in executive function were only observed in mice cotreated with LPS and etomidate. Thus, an interplay between inflammation and etomidate anesthesia led to cognitive deficits that were not observed with either factor alone. These findings suggest that inflammation and anesthetic drugs may interact synergistically, or their combination may unmask covert or latent deficits induced by each factor alone, leading to PNDs.