scholarly journals Comparison of laryngeal mask airway and endotracheal tube in preterm neonates receiving general anesthesia for inguinal hernia surgery: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miao-Pei Su ◽  
Ping-Yang Hu ◽  
Jao-Yu Lin ◽  
Shu-Ting Yang ◽  
Kuang-I Cheng ◽  
...  
Keyword(s):  
Body Weight ◽  
Inguinal Hernia ◽  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Preterm Neonates ◽  
Respiratory Complications ◽  
Delayed Extubation ◽  
History Of ◽  
Gestational Age At Birth ◽  
Age At Birth

Abstract Background Preterm neonates are at higher risk of developing inguinal hernia, and have an increased risk of perioperative adverse events. Laryngeal mask airway (LMA) is claimed to be associated to decreasing perioperative respiratory complications compared to endotracheal tube (ETT) in infants under one year of age receiving minor surgery; thus, we conducted a retrospective survey in former preterm neonates below 5000 g to compare the respiratory complications between LMA and ETT in general anesthesia for inguinal hernia surgeries. Methods The inclusion criteria were: gestational age at birth under 37 weeks, body weight at surgery below 5000 g, and receiving scheduled inguinal hernia repair under general anesthesia with LMA or ETT. Infants who were dependent on mechanical ventilation preoperatively were excluded. The postoperative respiratory complications including delayed extubation, re-intubation, and apnea within postoperative 24 h were compared between groups. Results From July 2014 to December 2017, 72 neonates were enrolled into final analysis. There were 57 neonates managed with LMA, and only 15 neonates intubated with ETT during the study period. The gestational age at birth and post-menstrual age at surgery showed no significant difference between groups, although in the ETT group, the body weight at birth and at surgery were lower, and more infants had history of severe respiratory distress syndrome and had received oxygen therapy within two weeks prior to surgery. Surprisingly, none one of the infants developed delayed extubation, re-intubation, or postoperative apnea in the LMA group. In the ETT group, 40 percent of the neonates could not be successfully extubated in the operation theater. Conclusion In preterm neonates, even in those younger than 52 weeks post-menstrual age who undergoing inguinal hernia repair in their early infancy, LMA appears feasible and safe as the airway device during general anesthesia in specific patient group. However, anesthesiologist might prefer ETT rather than LMA in some complex situation. In neonates with lower body weight at birth and at surgery, and with a history of severe RDS and oxygen-dependence, further prospective study is required.

Polymorphonuclear Leukocyte Function in the Preterm Neonate: Effect of Chronologic Age

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 675-679
Author(s):  
Shaista S. Usmani ◽  
Jerrold S. Schlessel ◽  
Concepcion G. Sia ◽  
Shahid Kamran ◽  
Shahnaz D. Orner
Keyword(s):  
Gestational Age ◽  
Polymorphonuclear Leukocyte ◽  
Preterm Neonate ◽  
Preterm Neonates ◽  
Term Neonates ◽  
Leukocyte Function ◽  
Pmn Functions ◽  
Gestational Age At Birth ◽  
Normal Adults ◽  
Age At Birth

In this study, effect of chronologic age on polymorphonuclear leukocyte (PMN) chemiluminescence and random and chemotactic motility was evaluated in 38 stable preterm neonates of less than 32 weeks' gestation during the first month of life. Chemiluminescence and random and chemotactic motility of PMNs from preterm neonates were first evaluated at mean postnatal age of 9.8 days and then weekly for an ensuing 21-day period. For comparison, one blood sample was obtained for PMN functions from 14 healthy term neonates younger than 72 hours of age and seven normal adults. On day 1 PMN chemiluminescence and random and chemotactic motility values in preterm neonates were significantly lower (P < .001) compared with those in term neonates and PMN function values of term neonates were significantly lower (P < .001) than those of adults. Although initial PMN chemiluminescence and random and chemotactic motility values in preterm neonates were depressed, subsequent values on days 7, 14, and 21 increased significantly (P < .002). On day 21 (mean postnatal age of 30.8 days) no differences existed in chemiluminescent activity and random motility between preterm and term neonates; chemotactic motility in preterm neonates, however, remained impaired. Mean cumulative age (gestational age at birth plus postnatal age) of preterm neonates on day 21 of study was 32.5 weeks, suggesting that chronologic age has more effect on maturational changes in PMN functions than gestational age.

scholarly journals Anesthetic Management by Laryngeal Mask Airway in a Patient With a History of Difficult Intubation Resulting in Dental Injuries

2015 ◽  
Vol 62 (1) ◽  
pp. 20-21 ◽  
Author(s):  
Yoshinao Asahi ◽  
Ryosuke Fujii ◽  
Naoko Usui ◽  
Hajime Kagamiuchi ◽  
Shiro Omichi ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Difficult Intubation ◽  
Dental Treatment ◽  
Anesthetic Management ◽  
Laryngeal Mask ◽  
Respiratory Problems ◽  
History Of ◽  
Disabled Patients ◽  
Dental Injuries

Abstract Disabled patients may face respiratory problems during general anesthesia because of head and neck anomalies. We describe a case of dental treatment under general anesthesia using a laryngeal mask airway in a disabled patient who faced difficulty in endotracheal intubation on several occasions, 5 of which resulted in dental injuries.

Assessment of renal functional maturation and injury in preterm neonates during the first month of life

2014 ◽  
Vol 307 (2) ◽  
pp. F149-F158 ◽  
Author(s):  
Lina Gubhaju ◽  
Megan R. Sutherland ◽  
Rosemary S. C. Horne ◽  
Alison Medhurst ◽  
Alison L. Kent ◽  
...  
Keyword(s):  
Renal Function ◽  
Gestational Age ◽  
Renal Injury ◽  
High Capacity ◽  
Tubular Function ◽  
Preterm Neonates ◽  
Urinary Ngal ◽  
Term Infants ◽  
Gestational Age At Birth ◽  
Age At Birth

Worldwide, approximately 10% of neonates are born preterm. The majority of preterm neonates are born when the kidneys are still developing; therefore, during the early postnatal period renal function is likely reflective of renal immaturity and/or injury. This study evaluated glomerular and tubular function and urinary neutrophil gelatinase-associated lipocalin (NGAL; a marker of renal injury) in preterm neonates during the first month of life. Preterm and term infants were recruited from Monash Newborn (neonatal intensive care unit at Monash Medical Centre) and Jesse McPherson Private Hospital, respectively. Infants were grouped according to gestational age at birth: ≤28 wk ( n = 33), 29–31 wk ( n = 44), 32–36 wk ( n = 32), and term (≥37 wk ( n = 22)). Measures of glomerular and tubular function were assessed on postnatal days 3–7, 14, 21, and 28. Glomerular and tubular function was significantly affected by gestational age at birth, as well as by postnatal age. By postnatal day 28, creatinine clearance remained significantly lower among preterm neonates compared with term infants; however, sodium excretion was not significantly different. Pathological proteinuria and high urinary NGAL levels were observed in a number of neonates, which may be indicative of renal injury; however, there was no correlation between the two markers. Findings suggest that neonatal renal function is predominantly influenced by renal maturity, and there was high capacity for postnatal tubular maturation among preterm neonates. There is insufficient evidence to suggest that urinary NGAL is a useful marker of renal injury in the preterm neonate.

scholarly journals Influence of anesthesia type on the wound healing after inguinal hernia surgeries

2013 ◽  
Vol 94 (3) ◽  
pp. 413-417
Author(s):  
L E Slavin ◽  
R R Aliullova ◽  
I U Borisova ◽  
A N Chugunov
Keyword(s):  
Inguinal Hernia ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Epidural Anesthesia ◽  
Two Phase ◽  
The Third ◽  
Duration Of Surgery ◽  
History Of ◽  
Group 2 ◽  
Surgery Duration

Aim. To estimate the influence of anesthesia type on the inguinal hernia rate surgery complication rate, considering the hernia type. Methods. 276 patients aged 35-65 years treated for inguinal hernia (history of hernia from 3 months to 3 years) from 2007 to 2011 were analyzed. The surgery was performed using local anesthesia in 146 patients (first group) and using epidural anesthesia in 102 patients (second group); 28 patients underwent surgery using general anesthesia (third group). A combination of 4 mL 10% lidocaine, 20 mL of 7.5 mg/mL ropivacaine solution and 60 mL 0.9% saline were used for local anesthesia in patients of the first group. 2% solutions of lidocaine and ropivacaine were used for epidural or spinal anesthesia in patients of the second group. Results. Mean surgery duration was shortest at the first group - 50.5±1.2 min. Mean surgery duration at the second group was 73.2±2.2 min, 61.8±5.0 min - at the third group (р1,2 0.001, р1,3=0.003, р2,3=0.017). Mean activation terms were 4.2±0,1 hours for the patients of the first group (local anesthesia), 20.3±0.2 hours - for the patients of the second group (epidural anesthesia), 10.5±0.2 hours - for the patients of the second group (general anesthesia). Postoperative pain measured by visual analogue scale occurred at significantly shorter terms after the surgery and was more intense for the first 3 days in patients of the first group. The pain intensity elevated gradually in patients of the first group starting from the second day after the surgery, pain lasted significantly in the second and third group patients compared to the first group. Complications were registered in 15 (10.3%) of the first group patients, in 12 (11.8%) of the second group patients and in 5 (17.9%) of the third group patients (р1,2=0.836; р1,3=0.237; р2,3=0.525). Conclusion. A combination of analgesics solutions based on their pharmacologic features and two-phase vasoactivity ability has shown good analgesic effect at local anesthesia. The type of anesthesia determines the duration of surgery and the rate of post-surgical complications as a consequence.

scholarly journals A clinical study of preterm labour

2019 ◽  
Vol 8 (11) ◽  
pp. 4503
Author(s):  
Prachi Patil ◽  
Richa Singh ◽  
Sriram Gopal
Keyword(s):  
Prospective Observational Study ◽  
Preterm Labour ◽  
Cervical Length ◽  
Preterm Neonates ◽  
P Value ◽  
High Risk Factors ◽  
Obstetrics And Gynaecology ◽  
Rising Incidence ◽  
Gestational Age At Birth ◽  
Age At Birth

Background: There has been a rising incidence of preterm labour in India. Preterm labour poses greater risks of morbidity and mortality of the preterm neonates. Various factors contribute towards risk of preterm labour and its outcome. Addressing these factors appropriately improves the outcome in pregnant women.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology from the period of July 2017 to July 2018.Results: The present study was in 98 patients admitted in our hospital with preterm labour. Clinical profile of those patients was studied. Statistically significant association was found between administration of antibiotics and tocolysis in prolongation of pregnancy (p value=0.00). There was an association found between gestational age at birth and immediate neonatal outcome (p value=0.00). Preterm labour was more common in multigravidae (62.4%) and women with cervical length less than 3 cm (85.17%).Conclusions: Preterm labour can be expected more commonly in multigravidae, pregnant women with cervical length less than 3 cm and in presence of high-risk factors. Anticipation of preterm labour, judicious use of antibiotics, tocolytics can improve the outcome of preterm labour.

Shunt failure clusters: an analysis of multiple, frequent shunt failures

2020 ◽  
pp. 1-7
Author(s):  
Brandon G. Rocque ◽  
Raymond P. Waldrop ◽  
Isaac Shamblin ◽  
Anastasia A. Arynchyna ◽  
Betsy Hopson ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Univariate Analysis ◽  
Shunt Infection ◽  
Third Ventriculostomy ◽  
Shunt Failure ◽  
Shunt Placement ◽  
History Of ◽  
Associated Risk Factors ◽  
Gestational Age At Birth ◽  
Age At Birth

OBJECTIVERepeated failure of ventriculoperitoneal shunts (VPSs) is a problem familiar to pediatric neurosurgeons and patients. While there have been many studies to determine what factors are associated with the first shunt failure, studies of subsequent failures are much less common. The purpose of this study was to identify the prevalence and associated risk factors of clustered shunt failures (defined as 3 or more VPS operations within 3 months).METHODSThe authors reviewed prospectively collected records from all patients who underwent VPS surgery from 2008 to 2017 at their institution and included only those children who had received all of their hydrocephalus care at that institution. Demographics, etiology of hydrocephalus, history of endoscopic third ventriculostomy or temporizing procedure, initial valve type, age at shunt placement, and other factors were analyzed. Logistic regression was used to test for the association of each variable with a history of shunt failure cluster.RESULTSOf the 465 included children, 28 (6.0%) had experienced at least one cluster of shunt failures. Among time-independent variables, etiology of hydrocephalus (OR 0.27 for non–intraventricular hemorrhage [IVH], nonmyelomeningocele, nonaqueductal stenosis etiology vs IVH, 95% CI 0.11–0.65; p = 0.003), younger gestational age at birth (OR 0.91, 95% CI 0.85–0.97; p = 0.003), history of a temporizing procedure (OR 2.77, 95% CI 1.12–6.85; p = 0.028), and smaller head circumference at time of initial shunt placement (OR 0.91, 95% CI 0.84–0.99; p = 0.044) showed significant association with shunt failure cluster on univariate analysis. None of these variables maintained significance in a multivariate model. Among children with a history of a shunt failure cluster, 21 (75%) had a shunt infection either prior to or during the shunt failure cluster. A comparison of the infecting organism between these children and 62 children with a history of infection but without a shunt failure cluster showed an association of cluster with gram-negative rod species.CONCLUSIONSSix percent of children in this institutional sample had at least one shunt failure cluster. These children accounted for 30% of the total shunt revisions in the sample. Shunt infection is an important factor associated with shunt failure cluster. Children with a history of prematurity and IVH may have a higher risk for failure cluster.

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