Expanding the use of volatile anesthetic agents beyond the operating room

Wąsowicz, Marcin; Jerath, Angela

doi:10.1007/s12630-014-0211-0

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…However, status asthmaticus is an intractable attack refractory to standard treatment that can lead to progressive respiratory failure [ 44 ]. Therefore, in refractory status asthmaticus, volatile anesthetics are also used for pediatric patients who do not respond well to conventional therapy [ 45 , 46 , 47 ]. The proposed mechanisms for volatile anesthetics include activating the β-adrenergic receptors, inhibiting acetylcholine and histamine release, and directly depressing airway reflexes and inducting bronchial smooth muscle relaxation that reverses the underlying airway bronchoconstriction [ 46 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

General Anesthesia in Early Childhood Significantly Reduces Asthma Incidence and Clinical Visits: A Nationwide Population-Based Cohort Study

Yang

Chang

et al. 2023

Children

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Few studies have focused on the consequence of exposure to general anesthesia (GA) in children’s early life with the risk of asthma and disease outcomes. The present study examines the correlation between exposure to GA under three years old and the subsequent course of asthma in a nationwide population-based cohort study. Our cases were acquired from Taiwan’s National Health Insurance Research Database (NHIRD). Children under three years old with either GA exposure or not during in-patient treatment from 1997 to 2008 were included. The study group was age- and sex-matched with a ratio of 1:2 to create the control group for comparison. The cohort included 2261 cases with GA and 4522 cases without GA as a control group. The incidence of asthma onset was significantly reduced in patients with GA exposure under 3 three years old (hazard ratio 0.64 (95% confidence interval 0.57~0.72), p < 0.001). In addition, regardless of whether the asthmatic clinical visits were before or after GA exposure, asthma onset patients before GA exposure have significantly fewer clinical visits than those without GA exposure (both p < 0.001, respectively). Using the Kaplan–Meier method, we also demonstrated that GA exposure was associated with favorable clinical visits in patients with asthma, whether their asthma was onset before GA (p = 0.0102) or after GA exposure (p = 0.0418) compared to non-GA-exposed controls. In the present study, we demonstrated that children with early GA exposure under three years old were at a reduced risk of developing asthma compared to the general population. Furthermore, we first reported that GA exposure significantly reduced clinical visits in patients with asthma regardless of whether their asthma onset was before or after GA exposure. It is indicated that GA exposure at a younger age could have potential clinical benefits for asthma than non-GA-exposed controls.

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Section: Discussionmentioning

confidence: 99%

General Anesthesia in Early Childhood Significantly Reduces Asthma Incidence and Clinical Visits: A Nationwide Population-Based Cohort Study

Yang

Chang

et al. 2023

Children

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“…[ 5 ] Nevertheless, volatile anesthetics have been used for refractory status asthmaticus in pediatric patients who do not respond to conventional therapy. [ 6 – 8 ] The proposed mechanisms for volatile anesthetics include activation of β-adrenergic receptor, direct bronchial smooth muscle relaxation by inhibition of acetylcholine and histamine release as well as addition of sedation that reverse the underlying bronchoconstriction. [ 7 , 9 ] Currently, the widespread and growing use of anesthesia in infants, defined as those less than 12 months of age, thus makes its safety an important health issue of interest to the public and government agencies.…”

Section: Introductionmentioning

confidence: 99%

General anesthesia exposure in early life reduces the risk of allergic diseases

Kuo

Yang

et al. 2016

Medicine

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General anesthesia (GA) has been used for second line treatment strategy for status asthmaticus in pediatric patients. The association between GA in children and risk of followed-up allergic diseases is unclear. This study aims to assess the risk of allergic diseases after GA in children.We did a nationwide retrospective cohort study by analyzing data from the National Health Insurance Research Database (NHIRD) in Taiwan. The subsequent risks for allergic diseases, including asthma (ICD-9: 493.X), allergic rhinitis (AR; ICD-9 CM code 477.X), and atopic dermatitis (AD; ICD-9-CM code 691.X), were compared between exposure to GA and none before 1 year of age throughout the follow-up period using the Cox proportional hazards model.Insurance claims data for 32,742 children younger than 1 year old from all insured children in the NHIRD. Of those, 2358 subjects were exposed to GA; 414 and 1944 children exposed to mask and intubation ventilation, respectively, served as the study cohort, whereas the remaining 30,384 children made up the comparison cohort. Children in the GA group were at a lower risk of developing asthma, AR and AD, with adjusted hazard ratios of 0.67 (0.62–0.72, 95%CI), 0.72 (0.68–0.77, 95%CI), 0.60 (0.56–0.64, 95%CI), respectively.Children who were exposed to GA in early life before 1 year of age had reduced risk of subsequently developing allergic diseases such as asthma, AD, and AR, when compared with general population.

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Sedation, Pain Relief and Weaning from Ventilation

Jarosz¹,

Wąsowicz

2022

Cardiac Anesthesia and Postoperative Care in the 21st Century

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Expanding the use of volatile anesthetic agents beyond the operating room

Cited by 6 publications

References 14 publications

General Anesthesia in Early Childhood Significantly Reduces Asthma Incidence and Clinical Visits: A Nationwide Population-Based Cohort Study

General Anesthesia in Early Childhood Significantly Reduces Asthma Incidence and Clinical Visits: A Nationwide Population-Based Cohort Study

General anesthesia exposure in early life reduces the risk of allergic diseases

Sedation, Pain Relief and Weaning from Ventilation

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