Anesthetic Hypersensitivity in a Case-Controlled Series of Patients With Mitochondrial Disease.

Background: Children with mitochondrial disease undergo anesthesia for a wide array of surgical procedures. However, multiple medications used for their perioperative care can affect mitochondrial function. Defects in function of the mitochondrial electron transport chain (ETC) can lead to a profound hypersensitivity to sevoflurane in children.

Anesthetic considerations in patients with mitochondrial defects.

Mitochondrial disease, once thought to be a rare clinical entity, is now recognized as an important cause of a wide range of neurologic, cardiac, muscle, and endocrine disorders . The incidence of disorders of the respiratory chain alone is estimated to be about 1 per 4-5000 live births, similar to that of more well-known neurologic diseases . High-energy requiring tissues are uniquely dependent on the energy delivered by mitochondria and therefore have the lowest threshold for displaying symptoms of mitochondrial disease.

Comparison of the Truview PCD™ and the GlideScope(®) video laryngoscopes with direct laryngoscopy in pediatric patients: a randomized trial.

Introduction: The GlideScope(®) video laryngoscope has a 60° angled blade and the blade of the Truview PCD™ video laryngoscope has an optical lens that provides a 46° refraction of the viewing angle. Despite successful results using the GlideScope in adults, few studies have been published regarding its use in pediatric patients. We therefore tested our joint primary hypothesis that the GlideScope and the Truview PCD video laryngoscopes provide superior visualization to direct laryngoscopy and are non-inferior regarding time to intubation.

Surgery for catastrophic epilepsy in infants 6 months of age and younger.

Object: Few data are available concerning efficacy and safety of surgery for catastrophic epilepsy in the first 6 months of life.

Methods: The authors retrospectively analyzed epilepsy surgeries in 15 infants ranging in age from 1.5 to 6 months (median 4 months) and weight from 4 to 10 kg (median 7 kg) who underwent anatomical (4 patients) or functional (7 patients) hemispherectomy, or frontal (1 patient), frontoparietal (2 patients), or parietooccipital (1 patient) resection for life-threatening catastrophic epilepsy due to malformation of cortical development.

Epidural analgesia for postoperative pain control after adolescent spinal fusion procedures which violated the epidural space.

Study Design: Retrospective chart review.

Objective: To determine the effectiveness of epidural analgesia in scoliosis patients with an opened (violated) spinal canal.

Background: Postoperative continuous epidural analgesia using local anesthetics and/or opioids has been described with good success after posterior scoliosis correction.

Dexmedetomidine for deep brain stimulator placement in a child with primary generalized dystonia: case report and literature review.

Dexmedetomidine, which is a relatively selective alpha2-adrenoceptor agonist, is used for sedation and analgesia in intensive care unit patients, during awake craniotomies in pediatric and adult patients, and during magnetic resonance imaging, with minimal depression of respiratory function. The successful use of dexmedetomidine in a pediatric patient undergoing bilateral deep brain stimulator placement for the treatment of generalized dystonia, is presented.

Shock-wave lithotripsy of renal stones situated adjacent to electronic nerve stimulators.

Shock-wave lithotripsy is commonly employed for the treatment of nephrolithiasis in the pediatric patient population. This report describes such treatment of a patient with electronic nerve stimulators that were located in close proximity to bilateral renal pelvic stones. Precautions and considerations of shock-wave lithotripsy in this context are discussed.

Anesthesia for minimally invasive cranial and spinal surgery.

The field of minimally invasive neurosurgery has evolved rapidly in its indications and applications over the last few years. New, less invasive techniques with low morbidity and virtually no mortality are replacing conventional neurosurgical procedures. Providing anesthesia for these procedures differs in many ways from conventional neurosurgical operations.

Unexpected ST segment changes in children--a case report.

In children, myocardial ischemic changes during anesthesia are a rare event unless there is underlying pathology. The patient in this case report was an apparently healthy child scheduled for adenoidectomy and bilateral tympanostomy. Occurrence of significant ST changes as well as intraoperative and postoperative hypoxemia required further diagnostic work-up.