Pediatric Anesthesia最新文献

{"title":"The power of POCUS in every pocket: Handheld ultrasound the new essential tool?","authors":"Elizabeth M O'Brien, Elaina E Lin","doi":"10.1111/pan.15016","DOIUrl":"https://doi.org/10.1111/pan.15016","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe knotting guidewire after central venous catheterization.","authors":"Xuejie Li, Lin Ma","doi":"10.1111/pan.15011","DOIUrl":"https://doi.org/10.1111/pan.15011","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ball valve gas trapping in pediatric one-lung ventilation: Not all ventilation is loss of isolation.","authors":"T Wesley Templeton, Cameron J Sutton, Christopher S McLaughlin, Vincent C Hsieh","doi":"10.1111/pan.15012","DOIUrl":"https://doi.org/10.1111/pan.15012","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Links between mutations in functionally separate arms of mitochondrial complex I and responses to volatile anesthetics.","authors":"Amanda R Scharenbrock, Luke A Borchardt, Zachariah P G Olufs, David A Wassarman, Misha Perouansky","doi":"10.1111/pan.14999","DOIUrl":"https://doi.org/10.1111/pan.14999","url":null,"abstract":"<p><strong>Background: </strong>Individuals with mitochondrial defects, especially those in Complex I of the electron transport chain, exhibit behavioral hypersensitivity and toxicity to volatile anesthetics. In Drosophila melanogaster, mutation of ND23 (NDUFS8 in mammals), which encodes a subunit of the matrix arm of Complex I, sensitizes flies to toxicity from isoflurane but not an equipotent dose of sevoflurane. Also, in ND23 flies, both anesthetics activate expression of stress response genes, but to different extents. Here, we investigated the generality of these findings by examining flies mutant for ND2 (ND2 in mammals), which encodes a subunit of the membrane arm of Complex I.</p><p><strong>Methods: </strong>The serial anesthesia array was used to expose ND2^del1 and ND23⁶⁰¹¹⁴ flies to precise doses of isoflurane, sevoflurane, and oxygen. Behavioral sensitivity was assessed by a climbing assay and toxicity by percent mortality within 24 h of exposure. Changes in expression were determined by qRT-PCR of RNA isolated from heads at 0.5 h after anesthetic exposure.</p><p><strong>Results: </strong>Unlike ND23⁶⁰¹¹⁴, ND2^del1 did not affect behavioral sensitivity to isoflurane or sevoflurane. Furthermore, sevoflurane in hyperoxia as well as anoxia caused mortality of ND2^del1 but not ND23⁶⁰¹¹⁴ flies. Finally, the mutations had different effects on induction of stress response gene expression by the anesthetics.</p><p><strong>Conclusion: </strong>Mutations in different arms of Complex I resulted in different behavioral sensitivities and toxicities to isoflurane and sevoflurane, indicating that (i) the anesthetics have mechanisms of action that involve arms of Complex I to different extents and (ii) the lack of behavioral hypersensitivity does not preclude susceptibility to anesthetic toxicity.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intraoperative methadone on postoperative opioid requirements in children undergoing orchiopexy: A randomized clinical trial.","authors":"Camilla G Uhrbrand, Karsten H Gadegaard, Asta Aliuskeviciene, Peter Ahlburg, Lone Nikolajsen","doi":"10.1111/pan.15009","DOIUrl":"https://doi.org/10.1111/pan.15009","url":null,"abstract":"<p><strong>Background: </strong>Children undergoing outpatient surgery are at risk of inadequate postoperative pain control. Methadone has a long duration of action and an intraoperative dose may provide stable analgesia throughout the postoperative period. Intraoperative methadone has been shown to improve pain control in adolescents but its use for postoperative pain in pediatric patients undergoing outpatient surgery has not been studied before. Therefore, we conducted a double-blind randomized placebo-controlled trial to investigate the effects of a single dose of intraoperative methadone in children aged less than 5 years undergoing orchiopexy for undescended testis.</p><p><strong>Methods: </strong>A total of 68 children were randomized to receive either methadone (0.1 mg/kg) or isotonic saline following induction of anesthesia. Exclusion criteria included preterm birth, previous scrotal surgery, and parents' inability to consent. Primary outcomes were opioid requirements (first primary outcome) and pain intensity in the post-anesthesia care unit. Secondary outcomes included episodes of desaturation and time until readiness to discharge from the post-anesthesia care unit, sleep on the first postoperative night, pain intensity, and opioid requirements at home until the evening on the first postoperative day. Follow-up was 4 days.</p><p><strong>Results: </strong>Sixty children completed the study (age, mean ± SD, 26.2 ± 13.9 months), 29 children received methadone, and 31 children received placebo. Eighteen children required opioids in the post-anesthesia care unit, five children in the methadone group (proportion = 0.17, 95% confidence interval (CI): 0.07, 0.36) compared to thirteen patients in the placebo group (0.42, 95% CI: 0.26, 0.60) (mean difference = -0.24 and 95% CI: -0.03, -0.47) (p = 0.037). Five children in the methadone group (0.17, 95% CI: 0.03, 0.31) versus ten in the placebo group (0.32, 95% CI: 0.16, 0.49) had a face, legs, activity, cry, consolability score of ≥5 in the post-anesthesia care unit (mean difference = -0.15, 95% CI: -0.36, 0.06) (p = .179). More children in the placebo group woke up due to pain the first night following surgery (seven children vs. one child). The methadone group had a longer stay in the post-anesthesia care unit. There were no differences between the two groups regarding the other secondary outcomes.</p><p><strong>Conclusion: </strong>A single dose of intraoperative methadone reduces short-term postoperative opioid requirements in children after orchiopexy for nondescended testes but prolongs the duration of their stay in the post-anesthesia care unit.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of bispectral index monitoring during pediatric critical care transport.","authors":"Adam Watson, Francesca Zanetti, Oliver Ross, John Pappachan, Michael J Griksaitis","doi":"10.1111/pan.15000","DOIUrl":"https://doi.org/10.1111/pan.15000","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In this issue November 2024.","authors":"","doi":"10.1111/pan.15010","DOIUrl":"https://doi.org/10.1111/pan.15010","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auricular laser acupuncture as an adjunct for parental anxiety management during children's surgery: A randomized‐controlled study","authors":"Wenrui Lin, Michelle A. Fortier, Haydee Cortes, Zeev N. Kain, Shu‐Ming Wang, Guann‐Pyng Li","doi":"10.1111/pan.14998","DOIUrl":"https://doi.org/10.1111/pan.14998","url":null,"abstract":"BackgroundPediatric surgery is associated with high levels of anxiety for both children and parents/caregivers. To mitigate anxiety, auricular acupuncture has shown its potential in the perioperative setting. Accordingly, our team developed a wearable prototype auricular laser acupuncture system, AcuHealth V1.0, as a portable acupuncture device and conducted a proof‐of‐concept evaluation with parents of children undergoing surgery.AimsThe primary aim of this study was to conduct feasibility testing of the AcuHealth V1.0 system in delivering auricular laser acupuncture.MethodsParents of children who were scheduled to undergo outpatient surgery were randomly assigned to one of three groups: authentic acupuncture (laser beams at known anxiolytic acupoints, <jats:italic>n</jats:italic> = 13), sham acupuncture (non‐anxiolytic acupoints, <jats:italic>n</jats:italic> = 14), or a placebo control group (inactive laser, <jats:italic>n</jats:italic> = 14). Parent self‐reported anxiety (0–10 numerical rating scale) was assessed at baseline, pre‐intervention (once child was taken to the OR), post‐intervention, and at 30 min after the intervention. Usability and acceptability data regarding the device were assessed after the intervention.ResultsBaseline data revealed no significant difference in anxiety between the three groups. Parent‐reported anxiety level at 30‐min post‐intervention as compared to baseline in the authentic group was significantly decreased (delta mean ± std = −3.58 ± 2.07) compared to both the sham acupuncture (−1.35 ± 2.65) and placebo control group (0.54 ± 1.13). Evaluation of changes in parent‐reported anxiety between groups over time using two‐way repeated‐measures analysis of variance (ANOVA) revealed a significant difference between the three groups (<jats:italic>p</jats:italic> = 0.001). Post hoc analysis with Scheffe test pairwise comparisons showed that at 30‐min post‐intervention compared to baseline, the authentic intervention group was significantly less anxious compared with both the sham group (<jats:italic>p</jats:italic> = 0.033) and the placebo control group (<jats:italic>p</jats:italic> = 0.001). Additionally, feedback regarding the usage of the device supported the acceptability and usability of the device with no adverse events.ConclusionsThis pilot study administering laser auricular acupuncture via the AcuHealth V1.0 system decreased parental anxiety after 30 min in parents who received treatment immediately after their children were taken to the operating room with no adverse effect.","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's picks for the pediatric anesthesia article of the day: June 2024","authors":"Melissa Brooks Peterson, Myron Yaster, Justin L. Lockman","doi":"10.1111/pan.15008","DOIUrl":"https://doi.org/10.1111/pan.15008","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can learning from military history help us improving neonatal intubation success rates?","authors":"Lukas P. Mileder","doi":"10.1111/pan.14996","DOIUrl":"https://doi.org/10.1111/pan.14996","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142203389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}