We present a case report of a 5-year-old boy who had severe agitation after PACU discharge after midazolam premedication for minor otologic surgery. He was treated over several hours in the emergency department with several doses of midazolam and phenobarbital, without resolution of the agitation. Finally, a single dose of flumazenil (0.2 mg) effectively reversed the child's agitation. The incidence and potential mechanisms for postoperative agitation are discussed, with a focus on the potential for midazolam-induced behavioral reactions. This information has nursing implications for postoperative discharge instructions and follow-up.
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http://dx.doi.org/10.1016/j.jopan.2007.07.003 | DOI Listing |
Neurosurg Rev
January 2025
Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.
Awake craniotomy (AC) facilitates real-time brain mapping, maximizing tumor resection while preserving critical neurological functions. This study systematically reviews the efficacy of several anesthetic protocols under Monitored Anesthesia Care (MAC) during AC, focusing on clinical outcomes. A systematic review and meta-analysis were conducted using data from observational studies and randomized trials involving AC under MAC.
View Article and Find Full Text PDFTurk Arch Otorhinolaryngol
January 2025
Shiraz University of Medical Sciences, Anesthesiology and Critical Care Research Center, Shiraz, Iran.
Objective: A pre-anesthetic medication that is ideal for pediatric patients undergoing tonsillectomy should alleviate pediatric anxiety, facilitate the smooth induction of anesthesia, and have an analgesic effect for postoperative care. This study compared the effectiveness of an oral combination of midazolam and ketamine (MK) with an oral combination of chloral hydrate and meperidine (CM) as premedication in pediatric patients undergoing tonsillectomy.
Methods: This double-blind clinical trial study was conducted with 68 pediatric patients scheduled to undergo tonsillectomy.
Crit Care Med
January 2025
Mass General Brigham (MGB) Health Design Lab, Boston, MA.
Objectives: The ICU built environment-including the presence of windows-has long been thought to play a role in delirium. This study investigated the association between the presence or absence of windows in patient rooms and ICU delirium.
Design: Retrospective single institution cohort study.
Cir Cir
January 2025
Department of Anesthesiology and Critical Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Objective: The agitation that can occur in patients undergoing vitreoretinal surgery on awakening from general anesthesia is a serious post-operative problem. In our study, we aimed to compare the effects of different anesthesia methods on emergence agitation in patients undergoing vitreoretinal surgery.
Method: Patients undergoing vitreoretinal surgery were divided into two groups: Total intravenous anesthesia (Group T) and inhalation anesthesia (Group D) according to the maintenance of anesthesia applied by consulting the records.
PLoS One
January 2025
Department of Anesthesiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Background: Literature regarding the advantages of HFNC in infants for ensuring oxygen supply after non-cardiac surgery is insufficient. The purpose of our study is to compare COT vs. HFNC on postoperative outcomes in infants undergoing non-cardiac surgery.
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