Articles: anesthesia.
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To improve the management level of general anesthesia during bronchoscopy in the children with diffuse alveolar hemorrhage (DAH). A retrospective study was conducted in the children with DAH who had performed bronchoscopy under general anesthesia with spontaneous respiration by face mask ventilation initially from June 2021 to June 2022 in our hospital. (1) Thirty-four children who had underwent 38 bronchoscopy procedures were included. (2) General anesthesia induction was performed by bolus of propofol intravenous in all the procedures. For maintaining anesthesia, combination use of propofol and remifentanil intravenously infusion were given in 31 procedures (81.6%) and propofol intravenously infusion alone was given in the rest 7 procedures (18.4%). ⋯ Intraoperative hypercapnia also occurred in 16 procedures (42.1%). Two procedures (5.3%) were complicated by severe pulmonary hemorrhage. General anesthesia with spontaneous respiration by face mask ventilation is feasible and relatively safe for the children with DAH undergoing bronchoscopy, whereas the anesthetic protocol still needs to be improved.
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Total hip replacement surgery is performed to improve quality of life (QoL). We explored the association between multimorbidity and change in QoL after total hip replacement. ⋯ Hip replacement surgery improves QoL. However, patients with multimorbidity are less likely to experience these benefits. Poor QoL outcomes became more frequent as the number of comorbid diseases increased. These data should inform shared decision-making conversations around joint replacement surgery.
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Minerva anestesiologica · Nov 2024
Comparison of dexmedetomidine, ketamine, and magnesium sulfate for the prevention of emergence agitation following sevoflurane-based anesthesia in pediatric cardiac catheterization.
Emergence agitation (EA) is non-purposeful agitation that occurs during the early stages of general anesthesia recovery. This randomized, double-blinded trial aimed to compare the effect of dexmedetomidine, ketamine, and magnesium sulfate on the severity of EA following sevoflurane-based anesthesia in pediatric cardiac catheterization. We examined the fixed doses and assessed the severity of agitation using the Pediatric Anesthesia Emergence Delirium Scale (PAED) score. ⋯ Dexmedetomidine exhibited higher efficacy than ketamine and magnesium sulfate in reducing the severity of postoperative EA. However, ketamine and magnesium sulfate demonstrated comparable efficacy, exceeding that of the control group.