Pediatric Anesthesia最新文献

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Predictors of Pain Concordance Among Caregiver-Child Dyads Undergoing Elective Surgery. 择期手术中照顾者-儿童对疼痛一致性的预测因素。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI: 10.1111/pan.15082
Paulina S Lim, Michelle A Fortier, Sherrie H Kaplan, Sergio Gago Masague, Zeev N Kain
{"title":"Predictors of Pain Concordance Among Caregiver-Child Dyads Undergoing Elective Surgery.","authors":"Paulina S Lim, Michelle A Fortier, Sherrie H Kaplan, Sergio Gago Masague, Zeev N Kain","doi":"10.1111/pan.15082","DOIUrl":"10.1111/pan.15082","url":null,"abstract":"<p><strong>Background: </strong>A total of 80% of children experience postoperative pain following discharge. Effective postoperative pain management involves reliable caregiver pain assessment and/or child self-report of pain. Unfortunately, caregiver and child ratings of postoperative pain are not always consistent (i.e., concordant). This study aimed to identify postoperative pain concordance among caregiver-child dyads and predictors for postoperative pain discordance.</p><p><strong>Methods: </strong>Children and their caregivers completed preoperative baseline demographic, anxiety, and distress measures. Postoperatively, children and caregivers completed pain severity ratings using the Child Health Rating Inventories (CHRIS 2.0). On the basis of postoperative pain scores, caregiver-child dyads were classified as overestimators (i.e., caregivers rated pain as higher than children), in agreement, or underestimators (i.e., caregivers rated pain as lower than children).</p><p><strong>Results: </strong>A large proportion of dyads disagreed on pain ratings (n = 104; 44%), with 64 (27%) caregivers classified as overestimators and 40 (17%) caregivers classified as underestimators. Caregivers were more likely to underestimate male children's pain, β = 1.238, OR = 3.35 (95% CI: 1.26, 9.43), p = 0.16, and Spanish-speaking Latinx caregivers were more likely to underestimate children's pain, β = 2.27, OR = 9.63 (95% CI: 2.35, 39.37), p = 0.002.</p><p><strong>Conclusion: </strong>Although most caregiver-child dyads agreed with pain ratings, 44% of the dyads disagreed. Among those who disagreed, males from Spanish-speaking Latinx households were at greatest risk of having their pain underestimated by their caregiver, which could be explained by the influence of intersecting social identities on pain beliefs, expression, and behaviors. Future studies should explore how pain discrepancies influence postoperative recovery outcomes for Latinx children.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"359-366"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441702","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}
引用次数: 0
Focused Review of Enhanced Recovery After Abdominal Trauma Surgery in the Pediatric Population and Development of a Pediatric Enhanced Recovery After Trauma Surgery Pathway. 儿童腹部创伤手术后增强恢复的重点综述和儿童创伤手术后增强恢复途径的发展。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-05-01 Epub Date: 2025-02-06 DOI: 10.1111/pan.15074
Robert P Moore, Niharika Singh, Madelyn Wang, Alexandra Tsivitis, Catherine Devitt, Zhaosheng Jin, Ehab Al Bizri, Sunitha M Singh, Helen Hsieh
{"title":"Focused Review of Enhanced Recovery After Abdominal Trauma Surgery in the Pediatric Population and Development of a Pediatric Enhanced Recovery After Trauma Surgery Pathway.","authors":"Robert P Moore, Niharika Singh, Madelyn Wang, Alexandra Tsivitis, Catherine Devitt, Zhaosheng Jin, Ehab Al Bizri, Sunitha M Singh, Helen Hsieh","doi":"10.1111/pan.15074","DOIUrl":"10.1111/pan.15074","url":null,"abstract":"<p><strong>Background: </strong>Traumatic injuries are the leading cause of morbidity and mortality amongst pediatric patients; improving outcomes after pediatric abdominal trauma surgery could be quite impactful. Although enhanced recovery after surgery (ERAS) pathways have been successfully employed in adult trauma patients, there are few studies on pediatric enhanced recovery after abdominal trauma surgery and no consensus post trauma surgery guidelines for children.</p><p><strong>Aims/methods: </strong>A systematic search of the existing literature for pediatric enhanced recovery after trauma surgery pathways was performed by two independent authors. However, no pediatric enhanced recovery after trauma surgery pathways were found. Therefore, we reviewed the pediatric and adult enhanced recovery after trauma surgery literature to identify potential impactful elements of care that could be part of a pediatric pathway.</p><p><strong>Results: </strong>The existing literature supports the incorporation of several elements into pediatric trauma ERAS pathway.</p><p><strong>Conclusion: </strong>We propose a pediatric enhanced recovery after trauma surgery pathway, which highlights several principles of ERAS pathways (multimodal analgesia, goal-directed fluid therapy, early initiation of nutrition, timely administration of antibiotics, avoidance of hypothermia, DVT prophylaxis, the early removal of drains and indwelling catheters, and patient education).</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"338-346"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255965","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}
引用次数: 0
Safety of Intrathecal Clonidine as an Adjuvant to Spinal Anesthesia in Infants and Children. 鞘内可乐定作为婴儿和儿童脊髓麻醉辅助剂的安全性。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-05-01 Epub Date: 2025-03-03 DOI: 10.1111/pan.15091
Grant Heydinger, Eden E Bayer, Catherine Roth, Sibelle Aurelie Yemele Kitio, V Rama Jayanthi, Arlyne Thung, Joseph D Tobias, Giorgio Veneziano
{"title":"Safety of Intrathecal Clonidine as an Adjuvant to Spinal Anesthesia in Infants and Children.","authors":"Grant Heydinger, Eden E Bayer, Catherine Roth, Sibelle Aurelie Yemele Kitio, V Rama Jayanthi, Arlyne Thung, Joseph D Tobias, Giorgio Veneziano","doi":"10.1111/pan.15091","DOIUrl":"10.1111/pan.15091","url":null,"abstract":"<p><strong>Introduction: </strong>Preliminary clinical studies have demonstrated that clonidine is an effective adjuvant to spinal anesthesia in neonates and infants. However, the studies conducted previously have had a limited cohort size of 80-100, potentially limiting an accurate measure of its safety.</p><p><strong>Methods: </strong>The current study retrospectively examines our 5-6-year experience with clonidine as an adjuvant to spinal anesthesia in a large cohort of neonates and infants.</p><p><strong>Results: </strong>The study cohort included 1420 patients ranging in age from newborn to 36 months (median age 7 months). Ninety-five percent of the patients tolerated spinal anesthesia without requiring conversion to general anesthesia, and over 73% of the patients did not require any additional intraoperative sedation. Hypotension (sBP ≤ 60 mmHg) was the most common intraoperative event (17%) with one patient requiring the administration of an anticholinergic agent for bradycardia. No serious intraoperative adverse events were noted. Post Anesthesia Care Unit (PACU) Phase I was bypassed in 75% of cases, and the postoperative admission rate was 7%, with the majority (85%) being planned admissions. Fifty-six patients (4%) returned to the hospital during the first seven postoperative days, primarily for surgical concerns.</p><p><strong>Conclusions: </strong>Based on this retrospective, observational study, clonidine appears to be a safe adjuvant to spinal anesthesia for ambulatory surgical procedures in infants and children. We observed a low incidence of intraoperative and postoperative complications.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"374-379"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cryoanalgesia for Pain Management After Pectus Excavatum Repair (COPPER) in Adolescents: A Randomized Controlled Trial. 低温镇痛在青少年漏斗胸修复(铜)后疼痛管理:一项随机对照试验。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-05-01 Epub Date: 2025-03-04 DOI: 10.1111/pan.15090
M Bastianello, M Torre, R Bonfiglio, M G Calevo, L Palomba, P Uva, A Kanapari, G Lorenzoni, N Disma
{"title":"Cryoanalgesia for Pain Management After Pectus Excavatum Repair (COPPER) in Adolescents: A Randomized Controlled Trial.","authors":"M Bastianello, M Torre, R Bonfiglio, M G Calevo, L Palomba, P Uva, A Kanapari, G Lorenzoni, N Disma","doi":"10.1111/pan.15090","DOIUrl":"10.1111/pan.15090","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing Pectus Excavatum repair with the minimally invasive approach frequently report severe postoperative pain. The goal of the study is to determine the superiority of cryoanalgesia compared to standard of care for return to normal quality of life.</p><p><strong>Methods: </strong>A randomized, active controlled, parallel groups trial (category IIb medical device) was designed for patients undergoing pectus excavatum repair. Participants were screened from the elective surgical lists at Istituto Gaslini, Genova, Italy, and they all were part of the academic practice setting. Once enrolled, patients were randomly assigned to one of the two study arms: cryoanalgesia vs. standard of care (epidural-based analgesia). The primary outcome was the Pediatric Quality of Life (PedsQL) and the subcomponents (psychosocial and physical health) 14 days after surgery.</p><p><strong>Results: </strong>Protocol was approved by the Ethics Committee (278/2021-DB id 11 421) and conducted between February 2022 and October 2023. Eighty-eight patients were enrolled in the study: forty-five to cryoanalgesia and forty-three in the epidural arm. The PedsQL median (IQR) at the 14th day was 59.8 (48.4, 71.2) vs. 67.9 (58.7, 73.9) (95% CI: 0.46-13; difference 6.5; p = 0.07) with ITT analysis, and 59.8 (48.37, 71.20) vs. 69.02 (58.70, 73.91) (95% CI: 0.82, 14; difference 7.4; p = 0.028) with PP analysis, in the cryoanalgesia and in the standard of care group, respectively. Irrespective of treatment, a significant decrease in both the PedsQL total score and its subcomponents was found. This effect persisted when stratified by treatment: physical health showed a decrease in both arms, while psychosocial health demonstrated a more marked decrease in the standard of care arm (q-value = 0.028), but not in the cryoanalgesia arm (q-value = 0.056).</p><p><strong>Conclusions: </strong>Cryoanalgesia did not improve return to baseline quality of life 2 weeks after surgery. However, it showed to be beneficial in the psychosocial component of the PedsQL scale.</p><p><strong>Trial registration: </strong>NCT05201820.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"347-358"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Educational Review and Cases of Delayed Gastric Emptying in Children With Short Bowel Syndrome. 儿童短肠综合征胃排空延迟的教育回顾和病例。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-04-24 DOI: 10.1111/pan.15117
Kelly Kathleen Everhart, Bukola Ojo, Danielle Wendel, Patrick J Javid, Vincent C Hsieh
{"title":"Educational Review and Cases of Delayed Gastric Emptying in Children With Short Bowel Syndrome.","authors":"Kelly Kathleen Everhart, Bukola Ojo, Danielle Wendel, Patrick J Javid, Vincent C Hsieh","doi":"10.1111/pan.15117","DOIUrl":"https://doi.org/10.1111/pan.15117","url":null,"abstract":"<p><strong>Background: </strong>Patients with short bowel syndrome (SBS) and intestinal failure (IF) often require repeated sedation and anesthesia throughout their lives. These patients may present for elective procedures well-appearing, with appropriate preoperative fasting and no clear signs of gastrointestinal (GI) obstruction. Despite appearing to be at normal risk for anesthesia-related aspiration, unique physiologic adaptations in this patient population are likely to increase the risk of gastrointestinal dysmotility and aspiration. Current guidelines do not specifically identify IF and SBS as conditions associated with high aspiration risk.</p><p><strong>Objectives: </strong>To highlight the elevated risk of pulmonary aspiration in patients with SBS and IF and propose mitigation strategies for anesthesia providers.</p><p><strong>Methods: </strong>We present two illustrative cases of patients with SBS who nearly experienced pulmonary aspiration under anesthesia. Both cases involved patients who exceeded standard fasting guidelines, lacked signs and symtoms of GI obstruction, and demonstrated normal to high stool output.</p><p><strong>Results: </strong>These cases reveal that intestinal adaptation, chronic physiologic changes, and prior medical and surgical interventions can significantly impair gastric emptying and intestinal motility, thereby increasing aspiration risk.</p><p><strong>Conclusions: </strong>Standard preoperative assessments may not adequately identify aspiration risk in patients with SBS and IF. Anesthesia providers should consider tailored strategies to mitigate aspiration risk in this unique patient population that include minimizing sedation or, when greater depth of anesthesia is required, avoiding natural airways and supglottic airway devices in favor of rapid sequence induction and endotracheal intubation.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015917","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}
引用次数: 0
In This Issue June 2025. 本刊2025年6月。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-04-23 DOI: 10.1111/pan.15115
{"title":"In This Issue June 2025.","authors":"","doi":"10.1111/pan.15115","DOIUrl":"https://doi.org/10.1111/pan.15115","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041021","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}
引用次数: 0
Metabolic Alkalosis in the Pediatric Cardiac Intensive Care Unit-A Prospective Observational Study. 儿童心脏重症监护病房的代谢性碱中毒——一项前瞻性观察研究。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-04-02 DOI: 10.1111/pan.15104
Diana Thomas, Suneel P Raman, Baiju S Dharan
{"title":"Metabolic Alkalosis in the Pediatric Cardiac Intensive Care Unit-A Prospective Observational Study.","authors":"Diana Thomas, Suneel P Raman, Baiju S Dharan","doi":"10.1111/pan.15104","DOIUrl":"https://doi.org/10.1111/pan.15104","url":null,"abstract":"<p><strong>Background: </strong>Metabolic alkalosis in pediatric patients following cardiac surgery warrants a comprehensive study. Newer methods of arterial blood gas (ABG) assessment can offer more insights into the mechanisms behind such derangement.</p><p><strong>Objective(s): </strong>To study the incidence of metabolic alkalosis in postsurgical infants admitted to the pediatric cardiac intensive care unit and analyze factors associated with its development and its effect on prognosis.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>Tertiary care teaching hospital in India during 2020-2021.</p><p><strong>Patients: </strong>One hundred four infants < 1 year of age undergoing elective cardiac surgery and who required more than 6 h of postoperative mechanical ventilation were included. Infants on preoperative mechanical ventilation or with metabolic alkalosis were excluded.</p><p><strong>Main outcome measures: </strong>Incidence of metabolic alkalosis and causative preoperative, intraoperative, and postoperative factors were studied along with their morbidity profile.</p><p><strong>Results: </strong>Metabolic alkalosis was detected in 23 (22.1%) subjects. In group MA (who developed metabolic alkalosis), 73.9% of infants belonged to risk adjustment for congenital heart surgery-1 (RACHS-1) category 3 and above (p = 0.009). They also had longer cardiopulmonary bypass time (200.04 ± 83.35 min vs. 144.59 ± 64.77; 95% confidence interval of the difference in means [23, 87.9]), longer cross-clamp time (119.78 ± 63.12 min vs. 84.95 ± 48.8; 95% CI [10.4, 59.3]), greater application of modified ultrafiltration (MUF) (91.3% vs. 60.5%, p = 0.005), and larger volume of MUF removed (60 (44.4, 70) ml kg<sup>-1</sup> vs. 44.44 (32.9, 54.3), p = 0.003). Partitioning of base excess showed similar standard base excess due to free water (SBE<sub>FW</sub>) (MA -0.18 ± 0.94 vs. No MA 0.25 ± 1.1; confidence interval of the difference in means [-0.95, 0.09]) and due to chloride (SBE<sub>Cl</sub>) (MA -5.7 ± 4.8 vs. No MA -5.18 ± 5.05; 95% CI [-2.9, 1.8]) in both groups. A longer period of ventilation, intensive care unit stay, and hospital stay were found in group MA.</p><p><strong>Conclusion: </strong>This prospective study on postcardiotomy infants revealed a much lower incidence of metabolic alkalosis than historical data. Physicochemical analysis of the blood samples for mechanisms underlying metabolic alkalosis found that its development is not entirely dependent on overt volume depletion or significant chloride loss. The administration of chloride-containing solutions appears to mitigate both the occurrence and severity of metabolic alkalosis.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764588","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}
引用次数: 0
Editor's Picks for the Pediatric Anesthesia Article of the Day: November 2024. 每日儿科麻醉文章编辑精选:2024年11月。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-04-02 DOI: 10.1111/pan.15107
Melissa Brooks Peterson, Justin L Lockman, Myron Yaster
{"title":"Editor's Picks for the Pediatric Anesthesia Article of the Day: November 2024.","authors":"Melissa Brooks Peterson, Justin L Lockman, Myron Yaster","doi":"10.1111/pan.15107","DOIUrl":"https://doi.org/10.1111/pan.15107","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764586","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}
引用次数: 0
Low-Dose Naltrexone for Pediatric Chronic Pain and Inflammatory States: Perioperative Considerations. 低剂量纳曲酮治疗儿童慢性疼痛和炎症:围手术期注意事项。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-04-01 Epub Date: 2025-02-04 DOI: 10.1111/pan.15070
Henry Huang, D Chiamaka Ijebuonwu, Rodney Whitney, Karla Wyatt-Thompson
{"title":"Low-Dose Naltrexone for Pediatric Chronic Pain and Inflammatory States: Perioperative Considerations.","authors":"Henry Huang, D Chiamaka Ijebuonwu, Rodney Whitney, Karla Wyatt-Thompson","doi":"10.1111/pan.15070","DOIUrl":"10.1111/pan.15070","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"329-330"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189988","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}
引用次数: 0
Electroencephalography and Anesthetic Depth in Children Under 2 Years of Age: A Prospective Observational Study. 2岁以下儿童的脑电图和麻醉深度:一项前瞻性观察研究。
IF 1.7 4区 医学
Pediatric Anesthesia Pub Date : 2025-04-01 Epub Date: 2024-12-26 DOI: 10.1111/pan.15058
Soo-Bin Yoon, Jung-Bin Park, Pyoyoon Kang, Young-Eun Jang, Eun-Hee Kim, Ji-Hyun Lee, Hyung-Chul Lee, Jin-Tae Kim, Hee-Soo Kim, Sang-Hwan Ji
{"title":"Electroencephalography and Anesthetic Depth in Children Under 2 Years of Age: A Prospective Observational Study.","authors":"Soo-Bin Yoon, Jung-Bin Park, Pyoyoon Kang, Young-Eun Jang, Eun-Hee Kim, Ji-Hyun Lee, Hyung-Chul Lee, Jin-Tae Kim, Hee-Soo Kim, Sang-Hwan Ji","doi":"10.1111/pan.15058","DOIUrl":"10.1111/pan.15058","url":null,"abstract":"<p><strong>Background: </strong>Processed electroencephalogram (EEG) indices are widely used to monitor anesthetic depth. However, their reliability in children under 2 years of age remains questionable. During anesthesia maintenance in this age group, processed EEG indices frequently exhibit unexpectedly elevated values that exceed the intended target range.</p><p><strong>Aim: </strong>This study aimed to identify EEG spectral parameters associated with false positive elevations in processed EEG indices and investigate their differences from true positive elevations during emergence.</p><p><strong>Methods: </strong>This prospective observational study included 50 children aged 4-24 months undergoing general anesthesia. Bispectral index (BIS), patient state index (PSi), and raw EEG were continuously recorded throughout anesthesia. False positive was defined as elevated processed EEG indices when end-tidal sevoflurane concentration was maintained at 0.7-1.3 minimum alveolar concentration, with heart rate and mean blood pressure between 80% and 120% of baseline values. We analyzed EEG power spectra and band power values during periods of false positives and compared them with those of true positives during emergence. Bonferroni-corrected p < 0.05 was considered significant.</p><p><strong>Results: </strong>False positives in processed EEG indices were observed in 35 (70%) of the children during anesthesia maintenance, occupying 28% of the maintenance phase. These false positives were associated with decreased power in delta (269-174 dB) and theta (115-97 dB) bands, but widespread increases in alpha and beta bands, resulting in elevated spectral edge frequency (19-22 Hz). Notably, EEG band power during false positives significantly differed from those observed during emergence (delta: 52 dB, theta: 38 dB) (all p < 0.001).</p><p><strong>Conclusions: </strong>Processed EEG indices may exhibit unexpectedly elevated values during anesthesia maintenance in children under 2 years of age. Quantitative assessments derived from raw EEG data may improve the evaluation of anesthetic depth in this population.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"294-301"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896502","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}
引用次数: 0
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