Pediatric procedural sedation is a difficult exercise aiming to find the balance between optimal quality of a medical imaging or act, and maximal reduction of risks for the patient. Harmlessness of chloral hydrate has been recently questioned, thus promoting the use of the dexmedetomidine for these kinds of procedures. In this context we decided to develop a new protocol at the CHUV. We tested different combinations of molecules until we found the best association and dosage. We present here the analysis of our patient cohort, attesting the efficiency, reliability, and safety of combined dexmedetomidine and midazolam given intranasal for pediatric MRI.
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http://dx.doi.org/10.53738/REVMED.2024.20.864.507 | DOI Listing |
Anesthesiology
January 2025
Department of Anesthesiology and Critical Care Medicine B (DAR B), Saint-Eloi Hospital, University Teaching Hospital of Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier, France.
Background: Long-term controlled mechanical ventilation (CMV) in intensive care unit (ICU) induces ventilatory-induced-diaphragm-dysfunction (VIDD). The transition from CMV to assisted mechanical ventilation is a challenge that requires clinicians to balance over-assistance and under-assistance. While the effects of over-assistance on the diaphragm are well known, we aimed to assess the impact of under-assistance on diaphragm function and structure in piglet model with pre-existing VIDD (after long-term CMV) or without VIDD (short-term CMV).
View Article and Find Full Text PDFAnaesthesia
January 2025
Clinical Research Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Introduction: Data regarding the incidence of 12-month postoperative cognitive decline following regional or general anaesthesia in older patients undergoing hip fracture surgery remain observational. Compared with general anaesthesia, we hypothesised that regional anaesthesia would decrease the incidence of 12-month postoperative cognitive decline.
Methods: This is substudy of a multicentre randomised trial of regional anaesthesia with no sedation vs.
J Int Med Res
January 2025
Department of Anesthesiology and Pain Medicine, Saint Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea.
Objective: To evaluate the impact of adding epidural dexmedetomidine to low-concentration patient-controlled epidural analgesia (PCEA) on pain control and side effects in total knee arthroplasty (TKA).
Methods: In this double-blind study, American Society of Anesthesiologists I to II patients undergoing TKA were assigned to receive 0.125% bupivacaine + fentanyl 4 µg/mL (group R) or 0.
Diseases
December 2024
Department of Pulmonary and Critical Care, Mayo Clinic, Jacksonville, FL 32224, USA.
Background/objectives: Peri-intubation hypotension is a known complication of endotracheal intubation. In the hospital setting, peri-intubation hypotension has been shown to increase hospital mortality and length of stay. The use of prophylactic vasopressors at the time of sedation induction to prevent peri-intubation hypotension has been raised.
View Article and Find Full Text PDFAnn Card Anaesth
January 2025
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Background: Congenital heart diseases (CHDs) are not rare and often require an intervention at some point of time. Pediatric cardiac catheterization, a minimally invasive procedure, is performed to diagnose and to correct many cardiac abnormalities. Deep sedation with spontaneously breathing patients is the preferred technique for pediatric catheterization in the pediatric population.
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