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High-Dose Remifentanil Anesthesia With Minimal Sedation in Neonates: A Single-Center Retrospective Study.
Cureus
August 2024
Department of Surgery, Jichi Medical University, Shimotsuke, JPN.
Article Synopsis
- Remifentanil is an opioid anesthetic known for its fast-acting effects, and this study investigates its use at high doses (0.5 mcg/kg/min or more) in neonatal surgeries to reduce sedation-related complications.
- The study reviewed 15 cases of neonatal abdominal surgeries conducted between January 2016 and February 2022, noting that while hypotension occurred in 13% of patients, no bradycardia or serious post-operative complications were reported.
- Although high-dose remifentanil maintained hemodynamic stability, concerns about respiratory depression remain, highlighting the need for further research into its long-term effects on neonates.
Clinical Case Report: Neonatal Mesenteric Traction Syndrome During Surgery for Congenital Duodenal Stenosis.
Cureus
July 2024
Department of Anesthesiology and Intensive Care Medicine, Akita University Graduate School of Medicine, Akita, JPN.
Mesenteric traction syndrome (MTS) is a common complication of major abdominal surgery, characterized by flushing, hypotension, and tachycardia. However, its occurrence in neonates has not yet been documented. This report details a neonatal case of MTS that emerged during surgery for congenital duodenal stenosis.
View Article and Find Full Text PDFDetermination of remifentanil in neonatal dried blood spots by liquid chromatography-tandem mass spectrometry.
Acta Pharm
June 2024
1University of Ljubljana, Faculty of Pharmacy 1000 Ljubljana, Slovenia.
Article Synopsis
- Remifentanil is an ultra-short-acting synthetic opioid potentially used off-label for pain management during labor, but poses risks like respiratory depression in mothers and infants due to placental transfer.
- The study aimed to develop a non-invasive method to monitor remifentanil levels in neonates using umbilical cord blood, supporting safety trials.
- A sensitive LC-MS method was validated, accurately measuring remifentanil in just 20 µL of blood, revealing arterial concentrations ranging from 0.2 to 0.3 ng/mL in neonates.
The effects of anaesthesia on cell death in a porcine model of neonatal hypoxic-ischaemic brain injury.
BJA Open
June 2024
Department of Physiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Background: Hypothermia is neuroprotective after neonatal hypoxic-ischaemic brain injury. However, systemic cooling to hypothermic temperatures is a stressor and may reduce neuroprotection in awake pigs. We compared two experiments of global hypoxic-ischaemic injury in newborn pigs, in which one group received propofol-remifentanil and the other remained awake during post-insult hypothermia treatment.
View Article and Find Full Text PDFWe conducted a prospective observational service evaluation across the United Kingdom on the use of total intravenous anaesthesia (TIVA) for obstetric surgery between November 2022 and June 2023. The primary aim was to describe the incidence of TIVA for obstetric surgery within participating units, with secondary aims to describe maternal and neonatal postoperative recovery indicators. Of 184 maternity units in the United Kingdom, 30 (16%) contributed data to the service evaluation.
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