scholarly journals Recomendaciones ESRA/ASRA en anestésicos locales y adyuvantes empleados en la población pediátrica

2019 ◽  
Vol 11 (2) ◽  
pp. 5
Author(s):  
Marcos Salmerón Martín ◽  
Pedro Torres Mosquera
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
European Society ◽  
Local Anesthetics ◽  
Pediatric Population ◽  
American Society

Dada la preocupación creciente respecto al efecto de los anestésicos empleados en anestesia general en el neurodesarrollo de la población pediátrica; toma mayor importancia la Anestesia Locorregional en dicha población. Pero, ¿Qué sabemos sobre la dosificación en esta población de los anestésicos locales?. Debido a dicha incertidumbre y a lo poco publicado al respecto la ESRA (European Society of Regional Anesthesia) y la ASRA (American Society of Regional Anesthesia) han decido reunirse para establecer una serie de recomendaciones sobre la dosificación de anestésicos locales y adyuvantes en anestesia locorregional en la población pediátrica. Dicho documento lo hemos resumido, de forma esquemática y con ayuda de tablas, con el fin de facilitar su comprensión y tenerlo a la disposición de todo aquel interesado en este campo. ABSTRACT  ESRA/ASRA recommendations in local anesthetics and adjuvants in the pediatric population Growing concern regarding the effect of anesthetics used in general anesthesia in the neurodevelopment of the pediatric population; Loco-regional Anesthesia in this population takes greater importance. But, what do you know about the dosage of local anesthetics in this population? Due to this uncertainty and the little published about it, the ESRA (European Society of Regional Anesthesia) and the ASRA (American Society of Regional Anesthesia) have decided to meet to establish recommendations about the dosage of local anesthetics and adjuvants in loco-regional anesthesia in the pediatric population. This document has been summarized, in a schematic way with tables, to facilitate understanding. In this way, its content is available to all those interested.

Robert Emmett Farr (1875–1932): A pioneer of pediatric regional anesthesia

2016 ◽  
Vol 26 (3) ◽  
pp. 182-188
Author(s):  
MaryKate Driscoll ◽  
Hyun Kee Chung ◽  
Manisha S Desai
Keyword(s):  
Brachial Plexus ◽  
General Anesthesia ◽  
Regional Anesthesia ◽  
Surgical Procedures ◽  
Local Anesthetics ◽  
Clinical Care ◽  
The Other ◽  
Local Infiltration ◽  
Surgical Practice ◽  
The Future

Surgeons influence the introduction and development of anesthesia in many ways. Robert Emmett Farr is frequently cited as the first to describe the use of brachial plexus anesthesia in children. A surgeon based in Minneapolis, Minnesota, he passionately believed that regional anesthesia was superior to general anesthesia for many surgical procedures. He wrote extensively promoting other regional techniques, including local infiltration of local anesthetics for pyloromyotomy and harelip repairs, as well as caudal blocks for lower abdominal procedures. Anesthesia texts from the early 1900’s suggest that regional anesthesia was not popular as a reliable alternative to general anesthesia. Undeterred, Farr continued promoting his view that regional anesthesia was the future of surgery. We examine how Farr promoted regional anesthesia in children and adults, in a way changing surgical practice and improving clinical care. We also hope to highlight the other contributions to medicine made by this pioneer.

scholarly journals Impact of anesttesia method on foetus condition

2021 ◽  
Author(s):  
A. M. Morozov ◽  
A. N. Pichugova ◽  
E. M. Askerov ◽  
S. V. Zhukov ◽  
Yu. E. Minakova ◽  
...  
Keyword(s):  
Pain Relief ◽  
General Anesthesia ◽  
Regional Anesthesia ◽  
Negative Impact ◽  
Contractile Activity ◽  
Obstetric Practice ◽  
Literary Sources ◽  
Wide Range ◽  
Negative Effect ◽  
American Society

Topicality. Currently, intrapartum fetal health care is aimed at an adequate choice of anesthetic aid used during delivery to minimize the negative impact. Despite the wide range of currently existing anesthetics, the choice of anesthetic drug is limited by its negative effect not only on the fetus, but also on the contractile activity of the uterus, which significantly reduces the number of anesthetics used in obstetric practice.The purpose of this study is to analyze domestic and foreign literature in order to study the effect of anesthesia on the condition of the fetus. Material and methods. In the course of this study, an analysis of modern Russian and foreign literary sources, as well as the latest scientific works in the field of methods of general and regional anesthesia in the field of obstetrics and gynecology, was carried out.Results. Almost all drugs used for general anesthesia in obstetric practice can have a negative effect on the fetus. Neuroaxial pain relief methods are leading in obstetric practice, but their use is associated with complications that can lead to an adverse outcome not only from the mother, but also from the fetus. One such complication is the risk of arterial hypotension. It is interesting that comparative studies of general and regional anesthesia methods during operative delivery differ in the results obtained. Regarding the issue of anesthesia of natural births, the information of the Congress of the American Society of Anesthesiologists (lecture C.A. Wong (Chicago) “Neuroaxial Labor Analgesia and Prognancy Outcome: Factand Fiction”) remains relevant, according to which neuroaxial anesthesia methods do not affect the condition of the fetus, provided that the mother has stable hemodynamics.Conclusion. Due to the appearance and release of neuroaxial pain relief methods, completely unreasonably little attention is paid to the issues of general anesthesia of pregnant women, while according to the results of a study of scientific literary sources, it was revealed that this method of pain relief in obstetric practice is accompanied by the most direct and mediated effects on the fetus. Neuroaxial pain relief methods have practically no effect on the condition of the fetus, provided that the mother has stable hemodynamics.

scholarly journals Anesthesia in Pediatric Eye Surgery (Review)

2018 ◽  
Vol 14 (6) ◽  
pp. 114-125
Author(s):  
Lyudmila S. Korobova ◽  
Vladimir V. Lazarev
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Local Anesthetics ◽  
Anesthetic Techniques ◽  
Eye Surgery

The review dwells on the analysis of anesthetic techniques for pediatric eye surgery, including the use of drugs used and methods of anesthesia. While preparing the paper, Cyberleninka (www.cyberleninka.ru), PubMed, Medline databases were used with the targeted search using the following keywords: propofol, sevoflurane, paracetamol, regional anesthesia, ophthalmology, children. The search was not restricted by the date of paper publishing; the focus was made on papers published within the last 10 years. The purpose of the review was to assess the scope of various anesthetic techniques (general anesthesia and regional blockades), anesthetics (sevoflurane, propofol, paracetamol, local anesthetics) in pediatric eye surgery.

Injury and Liability Associated with Monitored Anesthesia Care

2006 ◽  
Vol 104 (2) ◽  
pp. 228-234 ◽  
Author(s):  
Sanjay M. Bhananker ◽  
Karen L. Posner ◽  
Frederick W. Cheney ◽  
Robert A. Caplan ◽  
Lorri A. Lee ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Respiratory Depression ◽  
Brain Damage ◽  
Regional Anesthesia ◽  
Supplemental Oxygen ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Malpractice Claims ◽  
American Society ◽  
Permanent Brain Damage

Background To assess the patterns of injury and liability associated with monitored anesthesia care (MAC) compared with general and regional anesthesia, the authors reviewed closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1990. Methods All surgical anesthesia claims associated with MAC (n = 121) were compared with those associated with general (n = 1,519) and regional (n = 312) anesthesia. A detailed analysis of MAC claims was performed to identify causative mechanisms and liability patterns. Results MAC claims involved older and sicker patients compared with general anesthesia claims (P < 0.025), often undergoing elective eye surgery (21%) or facial plastic surgery (26%). More than 40% of claims associated with MAC involved death or permanent brain damage, similar to general anesthesia claims. In contrast, the proportion of regional anesthesia claims with death or permanent brain damage was less (P < 0.01). Respiratory depression, after absolute or relative overdose of sedative or opioid drugs, was the most common (21%, n = 25) specific damaging mechanism in MAC claims. Nearly half of these claims were judged as preventable by better monitoring, including capnography, improved vigilance, or audible alarms. On-the-patient operating room fires, from the use of electrocautery, in the presence of supplemental oxygen during facial surgery, resulted in burn injuries in 20 MAC claims (17%). Conclusion Oversedation leading to respiratory depression was an important mechanism of patient injuries during MAC. Appropriate use of monitoring, vigilance, and early resuscitation could have prevented many of these injuries. Awareness and avoidance of the fire triad (oxidizer, fuel, and ignition source) is essential to prevent on-the-patient fires.

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