Three 13-year-olds with burns on 30%, 70%, and 75% of their body surface areas and with related respiratory tract lesions underwent multiple surgical interventions for debridement, graft placement, and topical treatments. Balanced general anesthesia was provided with sevoflurane and an infusion of remifentanil and cisatracurium. Each patient underwent 41 procedures over a period of 6 months. All interventions were carried out without complications other than the difficulty of establishing an access to veins and monitoring because of the scarcity of intact surfaces. Remifentanil is an effective analgesic for meeting the needs of patients with severe burns. The combination of remifentanil, sevoflurane, and cisatracurium provides good hemodynamic stability and is very appropriate for patients who must undergo a large number of surgical interventions.
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Cureus
January 2025
Anesthesiology and Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, NLD.
When a difficult airway is anticipated, awake tracheal intubation can be considered. Usually, low doses of sedatives are administered during this procedure for minimal sedation and anxiolysis, such as midazolam and remifentanil. The newly developed ultra-short-acting benzodiazepine remimazolam has a pharmacokinetic profile that is more suitable for titration during awake tracheal intubation than the long-acting midazolam.
View Article and Find Full Text PDFAnesthesiology
January 2025
Takeda Development Center Americas, Inc., Lexington, MA, USA.
Background: Orexin neuropeptides help regulate sleep/wake states, respiration, and pain. However, their potential role in regulating breathing, particularly in perioperative settings, is not well understood. TAK-925 (danavorexton), a novel, orexin receptor 2-selective agonist, directly activates neurons associated with respiratory control in the brain and improves respiratory parameters in rodents undergoing fentanyl-induced sedation.
View Article and Find Full Text PDFMedicina (Kaunas)
November 2024
Department of Anaesthesia and Intensive care, Odense university hospital, 5000 Odense, Denmark.
Breast cancer surgeries offer challenges in perioperative pain management, especially in the presence of inherent risk of postoperative nausea and vomiting (PONV) and postmastectomy pain syndrome (PMPS). Inappropriate opioid consumption was speculated as one of the reasons. Through this study, the influence of objective pain monitoring through a nociception level monitor (NOL) on perioperative course in breast surgeries was investigated.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Anesthesiology and Reanimation, Ankara Bilkent City Hospital, Ankara 06800, Turkey.
Postoperative delirium is a frequent complication in children undergoing general anesthesia. It has been suggested that inflammation and oxidative stress contribute to the pathophysiology of delirium. The aim of our study was to investigate the relationship between inflammatory markers and delirium.
View Article and Find Full Text PDFAnesth Analg
January 2025
Department of Anesthesiology, Cincinnati Children's Hospital, Cincinnati, Ohio.
Background: Posterior spinal fusion (PSF) surgery for correction of idiopathic scoliosis is associated with chronic postsurgical pain (CPSP). In this multicenter study, we describe perioperative multimodal analgesic (MMA) management and characterize postoperative pain, disability, and quality of life over 12 months after PSF in adolescents and young adults.
Methods: Subjects (8-25 years) undergoing PSF were recruited at 6 sites in the United States between 2016 and 2023.
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