Anesthesia for Procedures in the Intensive Care Unit and the Neonatal Intensive Care Unit

2011 ◽  
pp. 244-250
Author(s):  
John K. Stene ◽  
Carolyn A. Barbieri
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
General Anesthesia ◽  
Operating Room ◽  
Surgical Procedures ◽  
Neonatal Intensive Care ◽  
Percutaneous Tracheostomy ◽  
Critically Ill Patient ◽  
Anesthesia Practice ◽  
Endoscopic Gastrostomy

Anesthesiologists who are assigned to provide anesthesia for operations in the intensive care unit (ICU) must adapt principles of safe and effective anesthesia practice to this novel outside-of-the-operating-room environment. Among the reasons to perform surgical procedures at the bedside in the ICU is the avoidance of transporting an unstable, critically ill patient from the ICU to the operating room. Therefore, patients who need anesthesia care to undergo surgical procedures in the ICU can present a major challenge, The types of procedures performed in the ICU include those under local anesthesia (chest tubes, thoracentesis, diagnostic peritoneal lavage, diagnostic ultrasound; pericardiocentesis), and common procedures under general anesthesia (percutaneous tracheostomy, percutaneous endoscopic gastrostomy (PEG), esophagogastroduodenoscopy (EGD), and transesophageal echocardiogram (TEE)), as well as uncommon procedures under general anesthesia (thoracotomy, laparotomy, and amputation).

Procedures in the Adult and Neonatal Intensive Care Units

2018 ◽  
Author(s):  
Matthew Read ◽  
Christopher V. Maani
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Operating Room ◽  
Intensive Care Units ◽  
Surgical Procedures ◽  
Neonatal Intensive Care ◽  
Critical Care Medicine ◽  
Neonatal Intensive Care Units ◽  
Anesthesia Practice ◽  
Urgent Procedure

Bedside procedures in the ICU are an integral component of critical care medicine. Anesthesiologists who are assigned to the ICU must adapt principles of safe and effective anesthesia practice to this novel outside-of-the-operating-room environment. There are several reasons for surgical procedures to sometimes be performed at the bedside in the ICU, such as the avoidance of transporting unstable patients from the ICU to the OR, or the lack of adequate time to mobilize resources to perform an urgent procedure in the OR. Readiness of the entire ICU team is essential to avoid compromising care due to production pressure or lack of standards routine to the OR environment. This chapter discusses the types of procedures performed in the ICU and reviews the requirements of performing them successfully.

scholarly journals Operating Room Within the Neonatal Intensive Care Unit—Experience of a Medical Center in Taiwan

2015 ◽  
Vol 56 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Ya-Lei Wang ◽  
Suh-Fang Jeng ◽  
Po-Nien Tsao ◽  
Hung-Chieh Chou ◽  
Chien-Yi Chen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Operating Room ◽  
Neonatal Intensive Care ◽  
Medical Center

The Emotional Transition to the Neonatal Intensive Care Unit

1999 ◽  
Vol 18 (1) ◽  
pp. 5-5
Author(s):  
Denise deClaire
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Operating Room ◽  
Neonatal Intensive Care ◽  
Previous Experience ◽  
Emotional Transition

AFTER 20 YEARS AS AN OPERATING ROOM NURSE, I WAS ready for a change. The Neonatal Intensive Care Unit was an area of practice that I had always been interested in. The NICU at my hospital had expanded and was willing to train someone with no previous experience, and I was eager to learn. I was prepared to become a novice again, to wrestle with the frustrations and struggles of starting over in a new field. What I was not prepared for was the flood of emotions that I was to experience.

General Anesthesia with Endotracheal Intubation for Cryotherapy for Retinopathy of Prematurity

1995 ◽  
Vol 5 (3) ◽  
pp. 187-191 ◽  
Author(s):  
T.J. Sullivan ◽  
M.P. Clarke ◽  
R. Tuli ◽  
R. Devenyi ◽  
P. Harvey
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Minimal Risk ◽  
Systemic Complications ◽  
Mean Time

We present a technique for treating retinopathy of prematurity (ROP) with cryotherapy under general anesthesia, administered and monitored by a neonatologist, with endotracheal intubation in the neonatal intensive care unit that avoids the serious systemic complications associated with the administration of local anesthetics. Although no significant complications arose in this series, having the intubated infant monitored by trained neonatology staff allows appropriate management should complications arise. We have used this technique to treat 20 eyes with threshold ROP. The mean time to extubation was 40.2 hours. The systemic status and discharge from the neonatal intensive care unit were not influenced by the general anesthesia. This technique allows quick and accurate application of the cryotherapy in a stable and controlled setting. We recommend that physicians consider cryotherapy under general anesthesia with endotracheal intubation for infants with ROP. This technique allows ROP to be treated adequately with minimal risk to the infant.

Broviac catheter insertion: Operating room or neonatal intensive care unit

1987 ◽  
Vol 22 (9) ◽  
pp. 823-824 ◽  
Author(s):  
Kevin P. Lally ◽  
William D. Hardin ◽  
Millie Boettcher ◽  
Syed I. Shah ◽  
G. Hossein Mahour
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Operating Room ◽  
Neonatal Intensive Care ◽  
Catheter Insertion

scholarly journals Changes in the Bispectral Index in Response to Experimental Noxious Stimuli in Adults under General Anesthesia

ISRN Pain ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Robin Marie Coleman ◽  
Yannick Tousignant-Laflamme ◽  
Céline Gélinas ◽  
Manon Choinière ◽  
Maya Atallah ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
General Anesthesia ◽  
Operating Room ◽  
Bispectral Index ◽  
Pain Assessment ◽  
Deep Sedation ◽  
Moderate Increase ◽  
Thermal Probe ◽  
Noxious Stimuli

Objective. Pain assessment is a major challenge in nonverbal patients in the intensive care unit (ICU). Recent studies suggest a relationship between the Bispectral Index (BIS) and nociceptive stimuli. This study was designed to examine changes in BIS in response to experimental noxious stimuli. Methods. Thirty participants under general anesthesia were in this quasiexperimental, within subject, pre- and poststudy. In the operating room (OR), BIS was monitored during moderate and severe noxious stimuli, induced by a thermal probe on the participants’ forearm, after induction of general anesthesia, prior to surgery. Results. Significant increases in BIS occurred during moderate (increase from 35.00 to 40.00, ) and severe noxious stimuli (increase from 37.67 to 40.00, ). ROC showed a sensitivity (Se) of 40.0% and a specificity (Sp) of 73.3% at a BIS value > 45, in distinguishing a moderate from a severe noxious stimuli. Conclusion. BIS increased in response to moderate and severe noxious stimuli. The Se and Sp of the BIS did not support the use of the BIS for distinction of different pain intensities in the context of deep sedation in the OR. However, the results justify further studies in more lightly sedated patients such as those in the ICU.

scholarly journals Regional Anaesthesia for the Neonate

2017 ◽  
Vol 6 (4) ◽  
pp. 79
Author(s):  
Bharti Wadhwa ◽  
Neha Hasija ◽  
Kirti N Saxena
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Neonatal Intensive Care Unit ◽  
General Anesthesia ◽  
Local Anaesthesia ◽  
Regional Anaesthesia ◽  
Neonatal Intensive Care ◽  
Drug Requirement ◽  
Effective Analgesia

Numerous regional and local anaesthesia techniques are available for safe use in neonates and can be administered either in combination with general anesthesia or in the awake neonate. Regional anaesthesia provides effective analgesia with reduced drug requirement which is especially beneficial in view of the immature physiology and metabolism in the neonate. The reduced requirement of anaesthetic drugs facilitates stable hemodynamics, faster recovery and a decreased length of stay in the neonatal intensive care unit.

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