Growth and Development

Pediatric regional anesthesiology: a narrative review and update on outcome-based advances

“…Some of the most crucial differences between neonatal and adult physiology that impact the regional pharmacologic management of these young patients include reduced drug-protein binding and decreased hepatic drug metabolism due to organ immaturity. Other factors at play include delayed neurological myelination and development, as well as immature renal function leading to decreased drug clearance 9,15–19 . There are a plethora of additional physiological changes that occur during the first years of life; this list is not intended to be all-inclusive but rather meant to highlight those changes of particular consequence to pediatric RA. Reduced drug-protein binding in neonates directly impacts the free versus bound portion of amide local anesthetic (LA).…”

“…Higher doses of LA are required due to the relative increase in CSF volume compared with body size; CSF volumes have been shown to correlate linearly with current weight and post-conceptual age 143 . The duration of action of spinal anesthesia is shorter in neonates due to increased rates of CSF turnover; this is often cited as a limiting factor in its use 9 . Due to a predominantly parasympathetic nervous system and the underdevelopment of sympathetic pathways, neonates and infants do not display the same extent of sympathectomy with neuraxial anesthetics 9 .…”

“…The pediatric anesthesia subspecialty has made large leaps in understanding pediatric pain and stress responses during the same decades that the regional and acute pain subspecialty has benefitted from significant advances in technique and technology. Importantly, debate continues surrounding the possibility of anesthetic-induced neurotoxicity on the developing human brain, 4,6–14 making techniques that can help to minimize or reduce systemic sedation in pediatric patients appealing. Regional anesthesia (RA) has evolved from a field centered around intimate anatomic mastery requiring the correlation of surface landmarks to structures beneath to a practice in which we can use technology to literally see the structures that lie under the skin and provide tailored, precise regional analgesia and anesthesia.…”

Pertumbuhan dan Perkembangan Motorik Kasar Pada Kelas Rendah Sekolah Dasar

“…Pertumbuhan pada tubuh manusia dapat dilihat dari ukuran tulang yang semakin terbentuk atau semakin panjang. Menurut ahli, secara umum pertumbuhan tinggi badan pada masa anak-anak mengalami kenaikan per tahun 2 sampai 3 inchi (5-7 cm) (Marciniak, 2019;Nijhout & Callier, 2015). Sedangkan berat badan mengalami kenaikan yang bervariasi dari pada tinggi badan, berkisar antara sampai 5 pon (1,5 kg-2,5 kg).…”

Survei Pertumbuhan Dan Perkembangan Motorik Kasar Pada Kelas Rendah Usia 7-9 Tahun di SD Se-Gugus 01 Kecamatan Lowokwaru Kota Malang

“…Pertumbuhan manusia dilihat dari ukuran tulang yang semakin panjang atau terbentuk. Menurut pendapat ahli, umumnya pertumbuhan tinggi badan pada anak-anak akan mengalami peningkatan per tahun berkisar 2 sampai 3 inc (5-7 cm) (Marciniak, 2019;Nijhout & Callier, 2015). Sedangkan untuk berat badan berkisar 1,5kg-2,5kg.…”