Background: Comprehensive data on pediatric anesthesia outcomes, particularly severe critical events (SCEs), are scarce in Asia. This highlights the need for standardized research to assess anesthesia safety and quality in the diverse settings.
Aims: The PEACH in Asia pilot study aimed to test the feasibility of a standardized protocol for investigating SCEs in anesthesia practices across Asia, evaluate the data acquisition processes, and determine the sample size for a main study.
Background: Airway management in children is challenging because of the smaller size, different proportions of anatomical structures compared to adults, and a higher risk of hypoxemia. Efforts to improve the efficiency of pediatric intubation can be made by manually twisting a spiral endotracheal tube (ETT) using a flexible stylet to manipulate its shape and angle.
Methods: This controlled trial randomized fifty children aged one month to six years who underwent elective surgery under general anesthesia into two groups (spiral ETT [sETT] and no-stylet ETT/standard ETT).
Sevoflurane has been shown to increase the incidence of emergence delirium in children; however, the mechanism remains unclear. Sevoflurane increases cytoplasmic calcium concentration which in turn may play a role in emergence delirium. This study aimed to investigate the level of intracellular calcium in rats experiencing hyperexcitatory behavior after exposure to sevoflurane, as well as the role of magnesium in preventing this phenomenon.
View Article and Find Full Text PDFPerioperative fluid management remains a challenging aspect of paediatric liver transplantation (LT) because of the risk of postoperative complications and haemodynamic instability. Limited research has specifically investigated the impact of fluid management and transfusion on mortality and morbidity in pediatric LT patients. This systematic review summarizes the evidence regarding perioperative fluid management and its clinical outcomes in paediatric LT patients.
View Article and Find Full Text PDFBackground: Airway emergency is the reason behind competency in mask ventilation and intubation skills for doctors. Procedural skills are taught through face-to-face training. However, the COVID-19 pandemic has had an impact on the education system, including medical education.
View Article and Find Full Text PDFBackground: Emergency separation of conjoined twins is performed when one twin is already dead or dying and threatens the survival of the other. The particular decision to perform an emergency separation of conjoined twins provides an ethical dilemma that needs special attention. Adding to the complexity of surgical and postsurgical management in emergency separation, ethical and sociocultural aspects further complicate decision-making.
View Article and Find Full Text PDFBackground: The first wave of COVID-19 in 2020 created massive challenges in providing safe surgery for pediatric patients with COVID-19. Inevitably, emergency surgery and the unknown nature of the disease place a burden on the heavily challenged surgical services for pediatrics in a developing country. Lessons from the pandemic are important for future disaster planning.
View Article and Find Full Text PDFBackground: Postoperative pain following lower abdominal surgery is one of the most common complications reported by patients. Gabapentin given two hours before surgery as pre-emptive analgesia has been reported to reduce postoperative pain and decrease postoperative analgesia requirements. The aim of this study was to determine the effectiveness of 600 mg oral gabapentin as a pre-emptive analgesia to reduce postoperative pain and morphine requirements following nonobstetric lower abdominal surgery.
View Article and Find Full Text PDFObjective: Emergence delirium (ED) is a condition that can occur when a child recovers from anaesthesia uncomfortably. ED can potentially injure children and indirectly discomforts parents. Various interventions were carried out to reduce ED, but there is no specific standard that has been established to prevent ED.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
June 2020
Background And Aims: Emergence agitation (EA) is a common transient behavioral disturbance after inhalational anesthesia and may cause harm to the patient. This study evaluated the efficacy of 0.5 mg/kg of propofol administered at the end of anesthesia to reduce the incidence of EA in children undergoing general inhalational anesthesia.
View Article and Find Full Text PDFObjectives: As an emerging country with the fourth largest population in the world, Indonesia's purchasing power has strengthened, leading to socioeconomic changes that affect its healthcare system. Additionally, there is a surge of healthcare utilisation after the implementation of a new national insurance scheme, particularly within emergency departments. Similar to other low- to middle-income countries, Indonesia has not prioritised the progress of emergency medicine despite existing evidence that suggests that the early intervention of many acute conditions lowers the rates of morbidity and mortality.
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