Based on animal data, concern has been expressed regarding the potential deleterious neurocognitive effects of general anesthesia during infancy and early life. Although there are no definitive data to prove this effect, the neonatal period has been suggested to be the most vulnerable period. While various inhaled and intravenous anesthetic agents have been implicated, dexmedetomidine and the opioids may be devoid of such effects. However, there are limited data regarding the combination of these agents during neonatal surgery and anesthesia. We present the use of these agents in combination with epidural anesthesia for postoperative analgesia in a 1-day-old neonate during thoracotomy and excision of a congental cystic adenomatoid malformation. Previous reports of the use of this unique combination of agents are reviewed and their role in this scenario discussed.
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http://dx.doi.org/10.5863/1551-6776-23.3.215 | DOI Listing |
Paediatr Anaesth
January 2025
Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Background: In pediatric patients, the use of processed EEG monitoring may reduce the amount of anesthesia administered while maintaining adequate depth of anesthesia.
Aims: The primary aim of this study was to evaluate whether use of a BIS monitor to guide sevoflurane administration might reduce the average end tidal sevoflurane concentration used in children 4-18 years of age.
Methods: Participants in three age groups (4-8, 9-12, and 13-18 years) were randomized to either the BIS guided group or the control group.
Sci Rep
January 2025
The Second Affiliated Hospital of ZunYi Medical University, Zunyi, Guizhou, China.
It is crucial to determine the potential subgroups of sleep disturbances in patients undergoing elective surgery based on the importance of symptom clusters and individual characteristics in order to develop targeted symptom management plans. This study explored the potential categories of postoperative sleep disturbances in patients undergoing elective surgery through latent profile analysis, and explored the influencing factors of each category. A total of 400 eligible elective surgery patients were included in the analysis, and three potential subgroups were identified: mild sleep disturbance group (c1 = 140,35.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Background: The impact of noninvasive ventilation (NIV) managed outside the intensive care unit in patients with early acute respiratory failure remains unclear. We aimed to determine whether adding early NIV prevents the progression to severe respiratory failure.
Methods: In this multinational, randomised, open-label controlled trial, adults with mild acute respiratory failure (arterial oxygen partial pressure/fraction of inspiratory oxygen [Pao/FiO] ratio ≥200) were enrolled across 11 hospitals in Italy, Greece, and Kazakhstan.
Alzheimers Dement
December 2024
Anesthesia, Critical Care & Pain Medicine, Boston, MA, USA.
Background: Spouses of Alzheimer's disease (AD) patients are at a higher risk of developing incidental dementia. However, the causes and underlying mechanism of this clinical observation remain largely unknown. One possible explanation is linked to microbiota dysbiosis, a condition that has been associated with AD.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
January 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Background: Predictors of difficult fiberscopic intubation have not been fully elucidated. This study focused on identifying radiographic predictors of difficult fiberscopic intubation during general anesthesia in patients with a cervical collar.
Methods: This retrospective study included unconscious patients who underwent orotracheal intubation using a flexible fiberscope while wearing a cervical collar to simulate a difficult airway.
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