Abstract:
BACKGROUND:Children require anesthesia for MRI to maintain immobility and reduce discomfort; clear indications about the best anesthesiologic management are lacking and each center developed its own protocol. Moreover, children with neuropsychiatric disorders more likely require sedation and are described in literature as more prone to general and respiratory complications. Aim of this study was to analyze the applicability of a sevoflurane-based approach, to describe general and respiratory complications and to identify risk factors in a pediatric neuropsychiatric population. METHODS:Retrospective cohort study, university Hospital (January 2007-December 2016). All the 1469 anesthesiologic records of children addressed from Neuropsychiatric Unit to undergo MRI under general anesthesia were analyzed; 12 patients equal or older than 18-year-old were excluded. We identified post-hoc nine macro-categories: static encephalopathies, metabolic/evolutive encephalopathies, epileptic encephalopathies, neuromuscular diseases, autistic spectrum disorders, migraine, psychiatric disorders, intellectual disabilities, others. A logistic regression model for events with low frequency (Firth's penalized likelihood approach) was carried out to identify the mutually adjusted effect among endpoints (complications) and the independent variables chosen on the basis of statistical significance (univariate analysis, p ≤ 0.05) and clinical judgment. RESULTS:Of 1457 anesthesiologic records (age 4.0 (IQR 2.0 to 7.0) year-old, males 891 (61.2%), weight 17.0 (IQR 12.0 to 24.9) kg), 18 were cancelled for high anesthesiologic risk, 50 were cooperative, 1389 were anesthetized. A sevoflurane-based anesthesia was feasible in 92.3%; these patients required significantly less mechanical ventilation (8.6 vs. 16.2%; p = 0.012). Complications' rate was low (6.2%; 3.1% respiratory). The risk for general complications increases with ASA score > 1 (OR 2.22, 95 CI% 1.30 to 3.77, p = 0.003), male sex (OR 1.73, 95% CI 1.07 to 2.81, p = 0.025), multi-drug anesthesia (OR 2.98, 95 CI% 1.26 to 7.06, p = 0.013). For respiratory complications, it increases with ASA score > 1 (OR 2.34, 95 CI% 1.19 to 4.73, p = 0.017), autumn-winter (OR 2.01, 95 CI% 1.06 to 3.78, p = 0.030), neuromuscular disorders (OR 3.18, 95 CI% 1.20 to 8.41, p = 0.020). We had no major complications compromising patients' outcome or requiring admission to ICU. CONCLUSIONS:Sevoflurane anesthesia is feasible and safe for children affected by neuropsychiatric disorders undergoing MRI. Specific risk factors for general and respiratory complications should be considered.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Mongodi S,Ottonello G,Viggiano R,Borrelli P,Orcesi S,Pichiecchio A,Balottin U,Mojoli F,Iotti GAdoi
10.1186/s12871-019-0897-1subject
Has Abstractpub_date
2019-12-18 00:00:00pages
235issue
1issn
1471-2253pii
10.1186/s12871-019-0897-1journal_volume
19pub_type
杂志文章abstract:BACKGROUND:In the assessment of hypovolemia the value of functional hemodynamic monitoring during spontaneous breathing is debated. The aim of our study was to investigate in spontaneously breathing subjects the changes in hemodynamic parameters during graded central hypovolemia and to test whether slow patterned breat...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-40
更新日期:2013-11-05 00:00:00
abstract:BACKGROUND:No study has been conducted to demonstrate the feasibility of an opioid-free anesthesia (OFA) protocol in cardiac surgery to improve patient care. The aim of the present study was to evaluate the effect of OFA on post-operative morphine consumption and the post-operative course. METHODS:After retrospectivel...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0802-y
更新日期:2019-07-31 00:00:00
abstract:BACKGROUND:Embolic stroke is a common complication of atrial myxoma, whereas multiple cerebral aneurysms associated with atrial myxoma is rare. The pathogenesis of the cerebral vascular disease related to an atrial myxoma is still not well known, and there are no guidelines to guide treatment and anesthesia management ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01055-1
更新日期:2020-07-04 00:00:00
abstract:BACKGROUND:Continuous epidural infusion (CEI) is the standard application setting for epidural infusion. A new mode, the programmed intermittent epidural bolus (PIEB) technique, showed reduced local anesthetic (LA) consumption and improved analgesia in obstetric analgesia. Goal of this trial was to evaluate the effects...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0613-6
更新日期:2018-10-30 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short- and long- term morbidity and mortality. Evidence shows that hypoalbuminemia is associated with increased AKI risk in patients with infectious diseases and cancer and following cardiac surgery and transplant s...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0842-3
更新日期:2019-09-02 00:00:00
abstract:BACKGROUND:Mortality from anaesthesia and surgery in many countries in Sub-Saharan Africa remain at levels last seen in high-income countries 70 years ago. With many factors contributing to these poor outcomes, the World Health Organization (WHO) launched the "Safe Surgery Saves Lives" campaign in 2007. This program in...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0228-8
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:Hyperthermia is relatively rare during general anesthesia; however, a few studies have been conducted on hyperthermia and the neuromuscular blockade (NMB) induced by rocuronium, and the reversal of NMB by sugammadex. We investigated the effect of hyperthermia status on the NMB induced by rocuronium, and its ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01114-7
更新日期:2020-08-07 00:00:00
abstract:BACKGROUND:We sought to evaluate the effect of mild hypercapnia on brain tissue oxygen tension (Pbto2) and diffusion limitation (impaired ability of oxygen extraction) in a porcine post asphyxial cardiac arrest model. METHODS:In 16 Bama pigs, asphyxial cardiac arrest was induced by endotracheal tube clamping and remai...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01162-z
更新日期:2020-09-29 00:00:00
abstract:BACKGROUND:Gabapentin is an antiepileptic drug used in a variety of chronic pain conditions. Increasing numbers of randomized trials indicate that gabapentin is effective as a postoperative analgesic. This procedure-specific systematic review aims to analyse the 24-hour postoperative effect of gabapentin on acute pain ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-7-6
更新日期:2007-07-07 00:00:00
abstract:BACKGROUND:Abnormal acute pain after burn injury still torments patients severely. In this study, we investigated that one voltage gated sodium channel Nav1.7 plays a vital role in lowering heat pain threshold after burn injury, and the hypothesis that knockdown of Nav1.7 attenuates pain following burn injury. METHODS...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0215-0
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:It has been hypothesized that dexamethasone can inhibit persistent postoperative pain, but data on humans is lacking and results from animal studies are conflicting. We explored the effect of 16 mg dexamethasone IV administered preoperatively on persistent pain 1 year after lumbar discectomy. METHODS:This i...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0277-z
更新日期:2016-11-16 00:00:00
abstract:BACKGROUND:Sodium nitroprusside (SNP) is a potent vasodilator that has been used to induce deliberate hypotension in children during surgery involving significant blood loss, including craniofacial and spinal fusion procedures. SNP metabolism liberates cyanide, which may cause interference with cellular energy metaboli...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-9
更新日期:2013-04-30 00:00:00
abstract:BACKGROUND:Maintaining the cuff pressure of endotracheal tubes (ETTs) within 20-30 cmH2O is a standard practice. The aim of the study was to evaluate the effectiveness of standard practice in maintaining cuff pressure within the target range. METHODS:This was a prospective observational study conducted in a tertiary-c...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-015-0132-7
更新日期:2015-10-15 00:00:00
abstract:BACKGROUND:Despite international data indicating that Enhanced Recovery After Surgery (ERAS) programs, which combine evidence-based perioperative strategies, expedite recovery after surgery, few centers have successfully adopted this approach within the U.S. We describe the implementation and efficacy of an ERAS progra...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0223-0
更新日期:2016-08-03 00:00:00
abstract:BACKGROUND:Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01117-4
更新日期:2020-08-24 00:00:00
abstract:BACKGROUND:Increase of pulmonary vascular resistance (PVR) is an efficient method of modulating pulmonary and systemic blood flows (Qp/Qs) for patients with left-to-right (L-R) shunt, and is also closely associated with insufficient oxygen exchange for pulmonary hypoperfusion. So that it might be a preferred regime of ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0852-1
更新日期:2019-10-09 00:00:00
abstract:BACKGROUND:The present anonymous multicenter online survey was conducted to evaluate the application of regional anaesthesia techniques as well as the used local anaesthetics and adjuncts at German and Austrian university hospitals. METHODS:39 university hospitals were requested to fill in an online questionnaire, to ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-10-4
更新日期:2010-04-17 00:00:00
abstract:BACKGROUND:There is no defined gold standard for pain management after video-assisted thoracic surgery (VATS) for pneumothorax. In addition to systemic analgesia, various loco-regional analgesic techniques have been proposed but remain poorly evaluated in this context. We aimed to assess the analgesic efficacy of sever...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0797-4
更新日期:2019-07-06 00:00:00
abstract:BACKGROUND:Intracranial-pressure (ICP) monitoring is useful for patients with increased ICP following hemorrhagic stroke. In this study, the changes in pressure gradients between the two cerebral hemispheres were investigated after hemorrhagic stroke of one side, and after a craniotomy. METHODS:Twenty-four patients wi...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-112
更新日期:2014-12-03 00:00:00
abstract:BACKGROUND:Laryngeal mask airway is a supraglottic airway device which has led to a fundamental change in the management of modern general anesthesia. In the present study; we evaluated the laryngeal mask airway insertion conditions and hemodynamic changes comparing ketamine-propofol mixture (ketofol) with propofol. Th...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0711-0
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:The role of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) as a prognostic factor in patients admitted to the intensive care unit (ICU) is not yet fully established. We aimed to determine whether NT-pro-BNP is predictive of ICU mortality in a multicenter cohort of critically ill patients. METHODS:A ...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2253-14-16
更新日期:2014-03-10 00:00:00
abstract:BACKGROUND:Surgical stress index (SSI) is an established indicator for intraoperative nociception. Opioids are used to block stimulus of cranial pinning in neurosurgery. We investigated the effect of different infusion rates of sufentanil on SSI during cranial pinning in children under general anaesthesia. METHODS:For...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0448-6
更新日期:2017-12-08 00:00:00
abstract:BACKGROUND:The double lumen endotracheal tube (DLT) is the most widely-used device for single lung ventilation in current thoracic anesthesia practice. In recent years, the routine application of the videolaryngoscope for single lumen endotracheal intubation has increased; nevertheless there are few studies of the use ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01012-y
更新日期:2020-05-20 00:00:00
abstract:BACKGROUND:Many cases of coronary artery spasm (CAS) during general plus epidural anesthesia have been reported. But transversus abdominis plane(TAP) block in combination with general anesthesia has not been reported to be a cause of CAS, let alone a life-threatening CAS. CASE PRESENTATION:In this case report, we pres...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0616-3
更新日期:2018-10-20 00:00:00
abstract:BACKGROUND:The Zeus® (Dräger, Lübeck, Germany), an automated closed-circuit anesthesia machine, uses high fresh gas flows (FGF) to wash-in the circuit and the lungs, and intermittently flushes the system to remove unwanted N₂. We hypothesized this could increase desflurane consumption to such an extent that agent consu...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-8-4
更新日期:2008-07-17 00:00:00
abstract:BACKGROUND:The calcium sensitizer levosimendan is increasingly used to improve hemodynamics in patients with acutely decompensated heart failure. By binding to cardiac troponin C the conformation of the calcium-troponin C complex is stabilized, which leads to acceleration of actin-myosin crossbrigde formation and incre...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0644-z
更新日期:2018-12-03 00:00:00
abstract:BACKGROUND:Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus an...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0358-7
更新日期:2017-06-26 00:00:00
abstract:BACKGROUND:The effort to improve tracheal intubation process is clinically valuable. We hypothesized that a preoperative brief exercise therapy would increase mouth opening and neck extension, enhancing intubation conditions during general anesthesia. METHODS:Patients undergoing general anesthesia were randomized into...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12871-020-0939-8
更新日期:2020-01-29 00:00:00
abstract:BACKGROUND:To investigate the optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough (FIC) suppression. METHODS:Patients of 180 undergoing elective surgery with general anesthesia, aged 18-65 years, BMI 18.5-30 kg/m2, ASA I or II, were equally randomized into four groups (n = 45) to receive intravenous p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0765-z
更新日期:2019-06-01 00:00:00
abstract::We have developed a two-step procedure for preparing the skin before peripheral venous catheter (PVC) insertions. This procedure involves two successive swabbings with wipes soaked in alcoholic antiseptic. We investigated whether this two-step procedure was as effective and safe as the standard four-step procedure--wa...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-7-1
更新日期:2007-01-31 00:00:00