General Anesthesia-Related Neurotoxicity: Status of Pediatric Surgeries at an Academic Hospital in the North of Iran

Abstract

Background: Recently, general anesthesia (GA)-related neurotoxicity has turned into a big concern. However, it seems that inadequate attention has been paid to the issue in Iran. Objectives: The aim of this survey was to investigate the frequency of elective surgeries in children under the age of three at an academic hospital in the north of Iran. Methods: This retrospective study was conducted at Alzahra Hospital affiliated to the Guilan University of Medical Sciences (GUMS). The records of all children who had undergone surgeries during 2014-2017 were examined by a responsible physician. Then, the records of children under three receiving GA were sorted out. After that, questionnaires with items on gender, habitat, age of receiving GA, type and status (elective or urgency) of surgeries were filled out. Results: According to our results, 670 children underwent surgery under GA during the study period, while 50.4% were elective. The mean age of patients was 15.26 months; 9.9% of them were neonates, 42.4% were infants, 80.3% were boys, and 60.7% were from urban areas. The most affected children were urban boys and the most obviously avoidable surgery was circumcision. Conclusions: More attention should be paid to the issue of GA-related neurotoxicity at our hospital. Future studies are welcome to examine the issue and find practical interventions.

Knowledge, Attitude, and Performance of Pregnant Women Regarding General Anesthesia Neurotoxicity in Children under Three: A Report from an Academic Hospital

“…In a survey from northern Iran, the incidence and some related factors of elective pediatric surgeries were evaluated. It was reported that urban boys underdoing circumcision were the most cases of elective surgeries before the age of three (21). In another study, knowledge, and practice of physicians at Guilan academic hospitals regarding GA-related neurotoxicity was evaluated, and it was revealed that the current curriculum should be revised (22).…”

A Multidisciplinary Approach to Manage of a Recurrent Congenial Diaphragmatic Hernia; A Case Report

“…Sevoflurane 2% with oxygen were as anesthesia maintenance. In spite of being aware from the potential risks of general anesthetic agents neurotoxicity in infants exception α2 agonists and opioids, we could not avoid them due to the type of surgery requiring deep anesthesia with a proper muscle relaxation (10,11). After confirming the proper depth of anesthesia, he underwent a laparotomy through a transverse left upper quadrant incision (Figure 2).…”

Intraoperative Awareness During Cesarean Delivery Under General Anesthesia

“…Spinal anesthesia (SA) is considered the choice of anesthesia for CS. Preventing the fetus from being exposed to anesthetic agents, early onset, and ease of performance are some advantages of this method compared to GA [5][6][7]. The risk of pulmonary aspiration, failed intubation, increased blood loss, higher degrees of postoperative pain, chronic pain, increased risk of postpartum depression, and oxygen toxicity are GA-related risks in CS [8][9][10].…”