Intranasal dexmedetomidine in pediatrics: update of current knowledge.

Intranasal dexmedetomidine, although still off-label, recently boasted an increasing consensus for different uses, namely, in diagnostic non-painful procedures, in painful procedures and in surgical premedication. However, at present, there is no consensus regarding indications, dosage and timing for administration. This article aims to provide a comprehensive literature analysis and summarize the more recent evidence of research on pediatric intranasal dexmedetomidine, in the effort to better delineate usefulness and limits for each specific indication.

Incidence and risk factors of neurosurgical site infections: results of a prospective multicenter cohort study on 6359 surgeries.

Background: Neurosurgical surgical site infections (SSI) are life-threatening complications, requiring medical treatment and additional surgeries and remain a substantial cause of morbidity. In order to identify the incidence and the main risk factors for SSI, we developed the Prophylaxis with Antibiotic Protocol for Neurosurgical Site Infections Study (PASSIS), a prospective observational multicenter cohort study for examining a large number of neurosurgical procedures.

Methods: The study PASSIS involved four Italian departments of neurosurgery applying the same antibiotic prophylaxis (ABP) protocol on 6359 consecutive neurosurgical procedures.

Does the Maslach Burnout Inventory correlate with cognitive performance in anesthesia practitioners? A pilot study.

Background: Chronic stress is a common condition among health-care operators, anesthetists in particular. It is known to cause cognitive weakening and pathological outcomes, as the Burnout syndrome. Nevertheless, the impact of clinicians' health on their performance has received limited attention thus far.

Is a neutral head position safer than 45-degree neck rotation during ultrasound-guided internal jugular vein cannulation? Results of a randomized controlled clinical trial.

Background: The optimal degree of neck rotation during internal jugular vein (IJV) cannulation remains undetermined because previous studies suggested using sonography, but without puncturing the vein. We assessed whether a neutral position (NP) of the head (0 degrees) during ultrasound-guided cannulation of the IJV was safer than rotating the neck to 45 degrees head turned. The effect of these 2 positions during ultrasound-guided cannulation on major complications was the primary outcome.

Sedation of neurologically impaired children undergoing MRI: a sequential approach.

Background: The purpose of this retrospective study was to determine the efficacy of a sequential approach meant to rescue failed chloral hydrate sedation and to obtain a low rate of adverse events along with predictable timings in neurologically impaired children undergoing magnetic resonance imaging.

Methods: We retrospectively evaluated 1104 chloral hydrate sedations performed between 2002 and 2004 on 862 children weighing <26 kg. If the desired sedation score (3 on the Skeie Scale) was not reached within 30 min after oral administration of chloral hydrate, sedation was considered as potentially failed, and supplementation with sevoflurane, i.