Update on Complications in Pediatric Anesthesia

Francisci, G. De; Papasidero, Angela Elisa; Spinazzola, Giorgia; Galante, Dario; Caruselli, Marco; Pedrotti, Dino; Caso, Antonio; Lambo, Massimo; Melchionda, Matteo; Faticato, Maria Grazia

doi:10.4081/pr.2013.e2

Cited by 25 publications

(29 citation statements)

References 23 publications

(30 reference statements)

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“…Additionally, paediatric anaesthesia and burn surgery are challenging. Children are prone to hypothermia and fluid loss due to the large surface to volume ratio and the need to expose large surface areas during surgery, vascular access is often difficult, and hypovolemia and anaemia are a threat due to the reduced blood volume 8‐10 …”

Section: Introductionmentioning

confidence: 99%

Rapid enzymatic burn debridement: A review of the paediatric clinical trial experience

Shoham

Krieger

Rubin

et al. 2020

International Wound Journal

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NexoBrid (NXB) has been proven to be an effective selective enzymatic debridement agent in adults. This manuscript presents the combined clinical trial experience with NXB in children. Hundred and ten children aged 0.5 to 18 years suffering from deep thermal burns of up to 67% total body surface area were treated with NXB in three clinical trials. Seventy‐seven children were treated with NXB in a phase I/II study, where 92.7% of the areas treated achieved complete eschar removal within 0.9 days from admission. Thirty‐three children (17 NXB, 16 standard of care [SOC]) participated in a phase III randomized controlled trial. All wounds treated with NXB achieved complete eschar removal. Time to complete eschar removal (from informed consent) was 0.9 days for NXB vs 6.5 days for SOC (P < .001). The incidence of surgical excision was 7.9% for NXB vs 73.3% for SOC (P < .001). Seventeen of these children participated in a phase III‐b follow‐up study (9 NXB and 8 SOC). The average long‐term modified Vancouver Scar Scale scores were 3.4 for NXB‐treated wounds vs 4.4 for SOC‐treated wounds (NS). There were no significant treatment‐related adverse events. Additional studies are needed to strengthen these results.

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Section: Introductionmentioning

confidence: 99%

Rapid enzymatic burn debridement: A review of the paediatric clinical trial experience

Shoham

Krieger

Rubin

et al. 2020

International Wound Journal

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“…The most common of the AEs related to this drug class are he-DOI: 10.4236/pp.2019.1010033 408 Pharmacology & Pharmacy modynamic (a significant drop in blood pressure) or endocrinologic related (inhibition of synthesis of steroids) [4]. These AEs are usually adequately avoided or handled by the anesthesiologist, but vulnerable populations, such as the very young or the frail elderly, are more at-risk [5] [6] [7] [8].…”

Section: Introductionmentioning

confidence: 99%

Designing General Anesthetics That Have a Better Safety Profile

Raffa¹,

Pergolizzi²,

Taylor³

2019

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General anesthetics constitute some of the most important and widely-used therapeutic drugs in the pharmacotherapeutic armamentarium. They are routinely used effectively and with adequate precaution-safety throughout the world for a multitude of clinical applications, predominantly as adjunctive agents for surgical procedures. Nevertheless, they have potential adverse effects (such as a drop in blood pressure and the inhibition of steroid production), particularly in vulnerable populations such as the very young and the frail elderly. It would be desirable therefore to have alternative agents that are just as efficacious, but have a better safety profile in a broader spectrum of patients. Toward this end, an anesthetic based on a unique chemical core (viz., an N-arylpyrrole derivative) has been reported in preclinical models to produce anesthetic effects without hemodynamic suppression. This lead could pave the way for new general anesthetics that are safer and easier to use.

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“…The widespread and growing use of anesthesia in infants and young children has made the safety and adverse effects of anesthesia a major concern of anesthesiologists. Pediatric anesthesiologists are increasingly questioned by parents about the risks of anesthetic agents for their children [ 1 – 3 ]. Currently, no clinical trials have provided clear evidence as to the suitable minimum age for the first anesthetic application, importance of anesthesia duration, number of anesthetic applications or the appropriate interval between two consecutive anesthesia applications.…”

Section: Introductionmentioning

confidence: 99%

A case report of multiple anesthesia for pediatric surgery: 80 anesthesia applications in a period of 6 years

Oba

Türk

2018

BMC Anesthesiol

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BackgroundThe side and adverse effects of anesthesia and its neurotoxicity to children have become major concerns of anesthesiologists in recent years.Currently, no clinical trials have provided clear evidence indicating the suitable minimum age for a patient’s first anesthetic application, importance of anesthesia duration, number of anesthetic applications or interval between two consecutive anesthesia applications.A very rare case concerning the side, adverse and neurotoxic effects of multiple anesthesia in a child is presented.Case presentationA case of a 9-year-old child who received 80 applications of anesthesia in 6 years because of corrosive esophagitis is presented. The commonly used anesthetic agents were propofol, fentanyl, rocuronium and sevoflurane.ConclusionIn our case, there were no permanent side or adverse effects due to multiple anesthesia. The minimal psychological and scholastic problems of our case were tied to frequent hospitalization by the pediatric psychiatry consultation.

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Update on Complications in Pediatric Anesthesia

Cited by 25 publications

References 23 publications

Rapid enzymatic burn debridement: A review of the paediatric clinical trial experience

Rapid enzymatic burn debridement: A review of the paediatric clinical trial experience

Designing General Anesthetics That Have a Better Safety Profile

A case report of multiple anesthesia for pediatric surgery: 80 anesthesia applications in a period of 6 years

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