Age as a decisive factor in general anesthesia use in pediatric proton beam therapy.

2019 ◽  
Author(s):  
YUZO SHIMAZU ◽  
Rie Otsuki ◽  
Masao Murakani ◽  
Akio Konishi ◽  
Keiichi Kan ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Cancer Patients ◽  
Proton Therapy ◽  
Proton Beam Therapy ◽  
Background Information ◽  
Treatment Protocols ◽  
Logistic Regression Models ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Pediatric Cancer Patients

Abstract Background: Proton therapy for pediatric cancer patients is effective treatments. Young children have difficulties staying still during irradiation, so general anesthesia is often required. This study investigated the indication for general anesthesia in pediatric proton therapy.Methods: We focused on cancer patients under 15 years old who underwent proton therapy at Southern TOHOKU General Hospital, Fukushima, Japan from April 2016 to December 2018. Background information and anesthesia/treatment protocols were retrospectively extracted from the electronic medical record. The anesthesia and non-anesthesia group were compared to evaluate factors determining the need for general anesthesia .Results: We analyzed 32 patients who received 285 irradiations. The median age was 5 years old (range: 1–15), and 13 patients (40.6%) were female. Twelve (37.5%) patients were treated with general anesthesia. In the general anesthesia group, airway management using laryngeal mask was performed in 11 patients (91.6%). Age was significantly lower in the general anesthesia group than in the non-anesthetized group (p < 0.001). Considering all background factors, only age was strongly associated with anesthesia in the univariate logistic regression models: odds ratio 0.55 [95% confidence interval 0.35–0.86] (P < 0.01). Adverse events included nausea and vomiting during and after irradiation, and no fatal complications were observed.Conclusion: Age is one of the most important factors determining the need for general anesthesia for PBT in children. it will be necessary to determine the guidelines for accumulation and collection of data between institutions and the indication of general anesthesia/sedation for radiation therapy including PBT.

scholarly journals Age as a decisive factor in general anaesthesia use in paediatric proton beam therapy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yuzo Shimazu ◽  
Rie Otsuki ◽  
Masao Murakami ◽  
Akio Konishi ◽  
Keiichi Kan ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Cancer Patients ◽  
Proton Therapy ◽  
Medical Records ◽  
Odds Ratio ◽  
Proton Beam Therapy ◽  
Background Information ◽  
Paediatric Cancer ◽  
Treatment Protocols ◽  
General Anaesthesia Group

Abstract Proton therapy for paediatric cancer patients is an effective treatment; however, young children have may have difficulties staying still during irradiation. This study investigated the indication of general anaesthesia in paediatric proton therapy. Background information and anaesthesia/treatment protocols were retrospectively extracted from the medical records of cancer patients under 15 years who underwent proton therapy at Southern TOHOKU General Hospital, Fukushima, Japan between April 2016 and December 2018. The anaesthesia and non-anaesthesia groups were compared to evaluate factors determining the need for general anaesthesia. Thirty-two patients who received 285 irradiations were analysed. The median age was 5 years old (range: 1–15), and 13 patients (40.6%) were female. Twelve (37.5%) patients received general anaesthesia. In the general anaesthesia group, airway management using a laryngeal mask was performed in 11 patients (91.6%). Patient age was significantly lower in the general anaesthesia group than in the non-anaesthetised group (p < 0.001). Considering all background factors, only age was strongly associated with anaesthesia in the univariate logistic regression model (odds ratio 0.55 [95% confidence interval 0.35–0.86]; P < 0.01). Thus, age is one of the most important factors determining the need for general anaesthesia during proton therapy in children.

scholarly journals Evaluation Of Anxiety During Nasal Pack Removal In Patients Operated Under Local Versus General Anesthesia

2018 ◽  
Vol 08 (04) ◽  
pp. 226-230
Author(s):  
Amer Sabih Hydri ◽  
Muhammad Junaid Alam ◽  
Iqbal Hussain Udaipurwala ◽  
Furqan Mirza
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Rating Scale ◽  
Military Hospital ◽  
General Anesthesia Group ◽  
Nasal Pack ◽  
Assessment Scores ◽  
Anesthesia Group ◽  
Group B ◽  
Hamilton Anxiety

Objective: To evaluate the anxiety experienced before, during and after conventional paraffin gauze nasal pack removal in patients operated under local versus general anesthesia. Study design: Comparative study. Place and duration of study: Department of ENT, Combined Military Hospital Sialkot and PAF Hospital Shorkot from July 2017 to June 2018. Material and methods: A total of 120 patients planned for Septoplasty were enrolled and divided into two groups. Sixty patients were to be operated under local anesthesia (Group A) while the other 60 were undergoing the same procedure under general anesthesia (Group B). Conventional paraffin gauze nasal packing was done for 24 hours in all 120 patients. Hamilton Anxiety Rating Scale (HAM-A) was used to determine the patients’ anxiety in both groups, 1 hour pre-operatively, immediately before and 1 hour after nasal pack removal. Results: The mean Hamilton Anxiety Scale assessment scores in both groups were of ‘mild’ category. The highest scores in both groups were observed immediately before nasal pack removal, with a range of 15-18, while the lowest scores in both groups were documented one hour after pack removal with a range of 13-16. Anxiety level in patients operated under general anesthesia was slightly lower than patients administered local anesthesia mean score of 16.40 ± 0.763 vs 17.21 ± 0.666 (p<0.001). Conclusion: Anxiety during nasal pack removal is mainly associated with prior pain experienced during nasal pack insertion. It is recommended that proper analgesia, adequate topical anesthesia, gentle insertion would make this process less distressing and will subsequently result in less anxiety at its removal.

scholarly journals The Effect of Sevoflurane Anesthesia for Dental Procedure on Neurodevelopment in Children: A Prospective, Equivalence, Controlled Trial

2020 ◽  
Author(s):  
Pinping Zhou ◽  
Chao Zhang ◽  
Guijin Huang ◽  
Yuan Hu ◽  
Wenzhu Ma ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Age Groups ◽  
Outcome Data ◽  
Clinical Trial Registry ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Significant Difference

Abstract Background: Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment.Methods: In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin.Results: The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110 – 160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Only the mother's education could affect the primary outcome.Conclusions: In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018, http://www.chictr.org.cn/showproj.aspx?proj=24830.

scholarly journals Spinal block and delirium in oncologic patients after laparoscopic surgery in the Trendelenburg position: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0249808
Author(s):  
Jorge Kiyoshi Mitsunaga ◽  
Vinicius Fernando Calsavara ◽  
Elton Shinji Onari ◽  
Vinicius Monteiro Arantes ◽  
Carolina Paiva Akamine ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Spinal Block ◽  
Trendelenburg Position ◽  
General Anesthesia Group ◽  
Randomized Controlled ◽  
Anesthesia Group ◽  
Oncologic Patients

Delirium is the most common postsurgical neurological complication and has a variable incidence rate. Laparoscopic surgery, when associated with the Trendelenburg position, can cause innumerable physiological changes and increase the risk of neurocognitive changes. The association of general anesthesia with a spinal block allows the use of lower doses of anesthetic agents for anesthesia maintenance and facilitates better control over postoperative pain. Our primary outcome was to assess whether a spinal block influences the incidence of delirium in oncologic patients following laparoscopic surgery in the Trendelenburg position. Our secondary outcome was to analyze whether there were other associated factors. A total of 150 oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position were included in this randomized controlled trial. The patients were randomized into 2 groups: the general anesthesia group and the general anesthesia plus spinal block group. Patients were immediately evaluated during the postoperative period and monitored until they were discharged, to rule out the presence of delirium. Delirium occurred in 29 patients in total (22.3%) (general anesthesia group: 30.8%; general anesthesia plus spinal block: 13.8% p = 0.035). Patients who received general anesthesia had a higher risk of delirium than patients who received general anesthesia associated with a spinal block (odds ratio = 3.4; 95% confidence interval: 1.2–9.6; p = 0.020). Spinal block was associated with reduced delirium incidence in oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position.

Could spinal anesthesia be a choice for retrograde intrarenal surgery

2018 ◽  
Vol 85 (4) ◽  
pp. 169-173 ◽  
Author(s):  
Ibrahim Karabulut ◽  
Erdem Koc ◽  
Ali Haydar Yilmaz ◽  
Elif Oral Ahiskali ◽  
Ercument Keskin ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Analogue Scale ◽  
Complication Rates ◽  
Retrograde Intrarenal Surgery ◽  
General Anesthesia Group ◽  
Group I ◽  
Anesthesia Group ◽  
Spinal Anesthesia Group

Objective: In this study, we aimed to compare cases of retrograde intrarenal surgery performed under spinal or general anesthesia through investigating relevant parameters for the first time in the literature. Material and method: In total, 86 patients with diagnosis of kidney stone who were treated by retrograde intrarenal surgery were included in this randomized controlled prospective study. In total, 43 of these operations were performed under spinal anesthesia (group I) and 43 were performed under general anesthesia (group II). The groups were compared in terms of demographic features, American Society of Anesthesiologists score, duration of operation, complication rates, postoperative visual analogue scale, postoperative hospitalization period, stone-free rates, and cost value ratios. Results: There were no significant differences between the two groups in terms of demographic findings, preoperative stone loads, postoperative stone-free rates, complication rates and postoperative hospitalization periods (p > 0.05). Postoperative visual analogue scale scores and cost value ratios were found statistically significantly lower in the spinal anesthesia group (group I) when compared with the general anesthesia group (group II; p < 0.001). Conclusion: Performing retrograde intrarenal surgery in the presence of spinal anesthesia is equally effective with general anesthesia. Spinal anesthesia also appears to be a more advantageous method due to statistically significantly lower mean postoperative pain scores and treatment cost value ratios.

A Retrospective Evaluation of the Benefit of Referring Pediatric Cancer Patients to an External Proton Therapy Center

2015 ◽  
Vol 63 (2) ◽  
pp. 262-269 ◽  
Author(s):  
Per Munck af Rosenschold ◽  
Svend A. Engelholm ◽  
Patrik N. Brodin ◽  
Morten Jørgensen ◽  
David R. Grosshans ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Proton Therapy ◽  
Pediatric Cancer ◽  
Retrospective Evaluation ◽  
Pediatric Cancer Patients ◽  
Therapy Center

scholarly journals Association between General Anesthesia and the Occurrence of Cerebrovascular Accidents in Hip Fracture Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hu Wang ◽  
Lingyan Gao
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Risk Factor ◽  
Hip Fracture ◽  
General Anesthesia ◽  
Cerebrovascular Accidents ◽  
General Anesthesia Group ◽  
Anesthetic Drugs ◽  
Anesthesia Group

Background. General anesthesia is an important factor leading to postoperative complications, and cerebrovascular accidents take the first place in the causes of postoperative death. Therefore, it is extremely important to explore the correlation between general anesthesia and the occurrence of cerebrovascular accidents in hip fracture patients. Objective. To explore the association between general anesthesia and the occurrence of cerebrovascular accidents in hip fracture patients. Methods. The data of 240 hip fracture patients treated in our hospital from February 2017 to February 2021 were retrospectively analyzed, and the patients were divided into the general anesthesia group (n = 120) and nongeneral anesthesia group (n = 120) according to whether or not they received general anesthesia, so as to compare their incidence rate of cerebrovascular accidents between the two groups, record their hemodynamic changes, and analyze the association between various risk factors under general anesthesia and the occurrence of cerebrovascular accidents. Results. No statistical differences in patients’ general information such as age and gender between the two groups were observed ( P  > 0.05); compared with the nongeneral anesthesia group, the incidence rate of cerebrovascular accidents was significantly higher in the general anesthesia group ( P  < 0.001); between the two groups, the heart rates and mean arterial pressure (MAP) at 15 min after anesthesia, at the time of skin incision, and 15 min before the end of surgery were significantly different ( P  < 0.05); according to the multiple logistic regression analysis, general anesthesia was a risk factor affecting the occurrence of cerebrovascular accidents in hip fracture patients, and under general anesthesia, age ≥80 years, BMI ≥23 kg/m2, types of anesthetic drugs ≥4, intraoperative blood pressure ≥140 mmHg, and intraoperative heart rate ≥80 bpm were also regarded as the risk factors. Conclusion. General anesthesia is a risk factor affecting the occurrence of cerebrovascular accidents in hip fracture patients, and under general anesthesia, age ≥80 years, BMI ≥23 kg/m2, types of anesthetic drugs ≥4, intraoperative blood pressure ≥140 mmHg, and intraoperative heart rate ≥80 bpm will further increase the possibility of cerebrovascular accidents.

scholarly journals Effects of General Anesthesia Versus Spinal Anesthesia on Serum Cytokine Release after Cesarean Section: A Randomized Clinical Trial

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maryam Vosoughian ◽  
Mastaneh Dahi ◽  
Shideh Dabir ◽  
Mohammadreza Moshari ◽  
Soodeh Tabashi ◽  
...  
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Serum Levels ◽  
Major Surgery ◽  
Necrosis Factor Alpha ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Tnf Α ◽  
Significant Difference

Background: Tissue damage caused by major surgery, such as cesarean section, may lead to a poor host immune response and excessive release of cytokines. These responses may increase the risk of infection, cause postoperative pain, and exert damaging effects on various body organs. Objectives: Anesthesia methods may affect cytokine production after surgery. This study aimed to compare the serum levels of cytokines in general and spinal anesthesia among women undergoing cesarean section. Methods: Thirty parturients (ASA class I and II) undergoing cesarean section were randomly assigned into two equal groups of spinal anesthesia and general anesthesia. Blood samples were taken for measuring the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) before induction of anesthesia and 30 minutes after entering the recovery room. Results: In the general anesthesia group, the postoperative serum levels of IL-6 and TNF-α were significantly higher than the corresponding preoperative levels. Significant differences were found between the two groups in the preoperative and postoperative levels of TNF-α. Changes in the IL-6 and TNF-α concentrations were significantly higher in the general anesthesia group as compared to the spinal anesthesia group. However, there was no significant difference in the IL-6:IL-10 and TNF-α: IL-10 ratios between the two groups. Conclusions: General anesthesia, as compared to spinal anesthesia, significantly increased the IL-6 and TNF-α levels after cesarean section. Therefore, the spinal anesthesia technique may be a better option for patients undergoing cesarean section.

scholarly journals Artificial Bee Colony Algorithm-Based Ultrasound Image Features in the Analysis of the Influence of Different Anesthesia Methods on Lung Air Volume in Orthopedic Surgery Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Yufang Li ◽  
Manyun Bai ◽  
Xin Wang ◽  
Di Wu ◽  
Qian Zhao
Keyword(s):  
General Anesthesia ◽  
Orthopedic Surgery ◽  
Artificial Bee Colony Algorithm ◽  
Artificial Bee Colony ◽  
Ultrasound Image ◽  
Control Group ◽  
General Anesthesia Group ◽  
Bee Colony ◽  
Anesthesia Group ◽  
Fitness Value

This study aimed to provide a quantitative evaluation of the lung gas content in orthopedic surgery patients under different anesthesia using ultrasound images based on the artificial bee colony algorithm. The ultrasound image features based on an artificial bee colony algorithm were applied to analyze segmentation images to investigate the influence of different anesthesia methods on the lung air content of patients undergoing orthopedic surgery and the clinical features of such patients. They were also adopted for the anesthesia in orthopedic surgery to assist clinicians in the diagnosis of diseases. 160 orthopedic surgery patients who were hospitalized were treated with different anesthesia methods. The first group (traditional general anesthesia group) received general anesthesia and traditional ultrasound; the second group (ABC general anesthesia group) was used for ultrasound image analysis based on the artificial bee colony algorithm; the third group (traditional sclerosis group) was anesthetized with combined sclerosis block; ultrasound images of patients from the fourth group (ABC sclerosis group) were analyzed based on the artificial bee colony algorithm. Analysis was conducted at three time points. The LUS score of the traditional sclerosis group and ABC sclerosis group was hugely higher than the score of the traditional general anesthesia group and ABC general anesthesia group at T2 time, with statistical significance ( P < 0.005 ). At time point T3, the score of the traditional sclerosis group rose greatly compared with the general anesthesia group, and that of the ABC group was generally higher than that of the traditional ultrasound group ( P < 0.005 ). When the threshold value was 4, the fitness value of ABC algorithm was 2680.4461, and the fitness value of the control group was 1736.815. The difference between the two groups was 943.6311 ( P < 0.05 ). The operation time of ABC algorithm was 1.83, while that of the control group was 1.05, and the difference between the two groups was 0.78 ( P < 0.05 ). In conclusion, the feature analysis of ultrasonic images based on the artificial bee colony algorithm could effectively improve the accuracy of ultrasonic images and the accuracy of focus recognition. It can promote medical efficiency and accurately identify the lung air content of patients in future clinical case measurement and auxiliary treatment of fracture, which has great application potential in improving surgical anesthesia effect.

The Effect of Anesthesia Type During Delivery on Neonatal Otoacoustic Emission Hearing Test Results: A Tertiary Center Experience

2020 ◽  
Author(s):  
Betül Yakıştıran ◽  
Mehmet Karslı ◽  
Emre Canpolat ◽  
Yüksel Oğuz ◽  
Orhan Altınboğa ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Spinal Anesthesia ◽  
False Positive ◽  
Otoacoustic Emission ◽  
Test Results ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Hearing Test ◽  
Spinal Anesthesia Group ◽  
Positive Results

Abstract Background Hearing is essential for the healthy development of an infant as language is one of the main stimulants of intellectual capacity. We investigate the effect of anesthesia type during delivery on neonatal otoacoustic emission (OAE) hearing test results. Methods This retrospective cross-sectional study includes 1,493 healthy, full-term (39/0–40/6 gestational weeks) newborns of healthy women and who were delivered by cesarean section. Newborns were divided into 2 groups based on their anesthesia type during delivery: 1) general anesthesia group (n=160), and 2) spinal anesthesia group (n=1333). Maternal age, anesthesia type, birth weight, gestational age at birth, neonatal gender, 1st–5th minute APGAR scores, and OAE results were compared between the groups. Results 1287 (86.2%) newborns were reported to have passed the first step of OAE; 206 (13.8%) newborns were reported to have failed the first step and passed the second test. In the general anesthesia group, 133 (83.1%) of the newborns passed the first OAE test and 27 (16.9%) newborns had false-positive results. In the spinal anesthesia group, 1,154 (86.6%) of the newborns passed the first OAE test and 179 (13.4%) newborns had false-positive results. The difference between the 2 groups by false-positive values was found to be statistically significant (p<0.001). Conclusions Type of delivery anesthesia may have an effect on the false-positive rates of OAE test results.

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