The effect of xenon‐augmented sevoflurane anesthesia on intraoperative hemodynamics and early postoperative neurocognitive function in children undergoing cardiac catheterization: A randomized controlled pilot trial

Devroe, Sarah; Lemiere, Jurgen; Hese, Laura Van; Gewillig, Marc; Boshoff, Derize; Poesen, Koen; Velde, Marc Van de; Rex, Steffen

doi:10.1111/pan.13444

Cited by 17 publications

(8 citation statements)

References 32 publications

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“…We previously demonstrated in children with CHD that the addition of 60% xenon to sevoflurane resulted in a 60% reduction of the mean expiratory sevoflurane concentration of sevoflurane to achieve a comparable depth of anesthesia [11,12]. Moreover, we did find a decreased incidence of ED when xenon was added to sevoflurane anesthesia [11].…”

Section: Introductionmentioning

confidence: 68%

“…The diagnosis of ED remains notoriously difficult in young children. For several reasons, we opted in this study (as we did in several previous ones) for the Watcha scale as an instrument to assess the incidence of ED in this young population [11,12,28]. In fact, the frequently used PAED scale was derived and validated in a cohort of children with a mean age of 3.7 years [23].…”

Section: Discussionmentioning

confidence: 99%

“…In neonates suffering from CHD, levels of S100β were described to be inversely related to cerebral blood flow and to mortality [38]. In children undergoing general anesthesia for cardiac catheterization, we recently reported early neurocognitive deficits that were paralleled by an increase in S100β blood levels [12]. In adult patients undergoing cardiac surgery, high levels of S100β were observed to be correlated with adverse neuropsychological and psychiatric outcomes [39] and to predict the occurrence of postoperative delirium [36].…”

Section: Discussionmentioning

confidence: 99%

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Effect of xenon and dexmedetomidine as adjuncts for general anesthesia on postoperative emergence delirium after elective cardiac catheterization in children: study protocol for a randomized, controlled, pilot trial

Devroe

Devriese

Debuck

et al. 2020

Trials

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Background: Emergence delirium, a manifestation of acute postoperative brain dysfunction, is frequently observed after pediatric anesthesia and has been associated with the use of sevoflurane. Both xenon and dexmedetomidine possess numerous desirable properties for the anesthesia of children with congenital heart disease, including hemodynamic stability, lack of neurotoxicity, and a reduced incidence of emergence delirium. Combining both drugs has never been studied as a balanced-anesthesia technique. This combination allows the provision of anesthesia without administering anesthetic drugs against which the Food and Drug Administration (FDA) issued a warning for the use in young children. Methods/Design: In this phase-II, mono-center, prospective, single-blinded, randomized, controlled pilot trial, we will include a total of 80 children aged 0-3 years suffering from congenital heart disease and undergoing general anesthesia for elective diagnostic and/or interventional cardiac catheterization. Patients are randomized into two study groups, receiving either a combination of xenon and dexmedetomidine or mono-anesthesia with sevoflurane for the maintenance of anesthesia. The purpose of this study is to estimate the effect size for xenon-dexmedetomidine versus sevoflurane anesthesia with respect to the incidence of emergence delirium in children. We will also describe group differences for a variety of secondary outcome parameters including peri-interventional hemodynamics, emergence characteristics, incidence of postoperative vomiting, and the feasibility of a combined xenon-dexmedetomidine anesthesia in

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Section: Introductionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of xenon and dexmedetomidine as adjuncts for general anesthesia on postoperative emergence delirium after elective cardiac catheterization in children: study protocol for a randomized, controlled, pilot trial

Devroe

Devriese

Debuck

et al. 2020

Trials

Self Cite

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“…Different drugs are being studied to mitigate the apoptosis response to ASAs. Xenon and Dexmedetomidine (DEX) are already used in clinical settings as neuroprotection and anaesthetic sparing-effect, but more research is still needed [48][49][50][51].…”

Section: Discussionmentioning

confidence: 99%

General anesthesia affecting on developing brain: evidence from animal to clinical research

Liu

Zhao

2020

J Anesth

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As the recent update of General anaesthesia compared to spinal anaesthesia (GAS) studies has been published in 2019, together with other clinical evidence, the human studies provided an overwhelming mixed evidence of an association between anaesthesia exposure in early childhood and later neurodevelopment changes in children. Pre-clinical studies in animals provided strong evidence on how anaesthetic and sedative agents (ASAs) causing neurotoxicity in developing brain and deficits in long-term cognitive functions. However pre-clinical results cannot translate to clinical practice directly. Three well designed large population-based human studies strongly indicated that a single brief exposure to general anesthesia (GAs) is not associated with any long-term neurodevelopment deficits in children’s brain. Multiple exposure might cause decrease in processing speed and motor skills of children. However, the association between GAs and neurodevelopment in children is still inconclusive. More clinical studies with larger scale observations, randomized trials with longer duration exposure of GAs and follow-ups, more sensitive outcome measurements, and strict confounder controls are needed in the future to provide more conclusive and informative data. New research area has been developed to contribute in finding solutions for clinical practice as attenuating the neurotoxic effect of ASAs. Xenon and Dexmedetomidine are already used in clinical setting as neuroprotection and anaesthetic sparing-effect, but more research is still needed.

show abstract

Section: Discussionmentioning

confidence: 99%

General Anesthesia Affecting on Developing Brain: Evidence from Animal to Clinical Research

Liu¹,

Ji²,

Zhao³

2020

Int J Anesthetic Anesthesiol

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As the recent update of General Anaesthesia compared to Spinal anaesthesia (GAS) studies has been published in 2019, together with other clinical evidence, the human studies provided an overwhelming mixed evidence of an association between anaesthesia exposure in early childhood and later neurodevelopment changes in children. Pre-clinical studies in animals provided strong evidence on how anaesthetic and sedative agents (ASAs) causing neurotoxicity in developing brain and deficits in long-term cognitive functions. However pre-clinical results cannot translate to clinical practice directly. Three well designed large population-based human studies strongly indicated that a single brief exposure to general anesthesia (GAs) is not associated with any long-term neurodevelopment deficits in children's brain. Multiple exposure might cause decrease in processing speed and motor skills of children. However, the association between GAs and neurodevelopment in children is still inconclusive. More clinical studies with larger scale observations, randomized trials with longer duration exposure of GAs and follow-ups, more sensitive outcome measurements, and strict confounder controls are needed in the future to provide more conclusive and informative data. New research area has been developed to contribute in finding solutions for clinical practice as attenuating the neurotoxic effect of ASAs. Xenon and Dexmedetomidine are already used in clinical setting as neuroprotection and anaesthetic sparing-effect, but more research is still needed.

show abstract

The effect of xenon‐augmented sevoflurane anesthesia on intraoperative hemodynamics and early postoperative neurocognitive function in children undergoing cardiac catheterization: A randomized controlled pilot trial

Cited by 17 publications

References 32 publications

Effect of xenon and dexmedetomidine as adjuncts for general anesthesia on postoperative emergence delirium after elective cardiac catheterization in children: study protocol for a randomized, controlled, pilot trial

Effect of xenon and dexmedetomidine as adjuncts for general anesthesia on postoperative emergence delirium after elective cardiac catheterization in children: study protocol for a randomized, controlled, pilot trial

General anesthesia affecting on developing brain: evidence from animal to clinical research

General Anesthesia Affecting on Developing Brain: Evidence from Animal to Clinical Research

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