Pediatric Anesthesia

Gregory, George

doi:10.1007/978-1-4614-8441-7_65

Cited by 3 publications

(10 citation statements)

References 62 publications

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“…Diazepam's sedative and anxiolytic effects are caused by its interaction with the γ‐aminobutyric acid (GABA) receptor complex and subsequent depression of the limbic amygdala and spinal afferent pathways (47,52). It is hepatically metabolized by hydroxylation and demethylation in the liver, both of which are reduced in the neonate, accounting for the longer half‐life (approximately 30 hours) in premature and term infants compared with that in children (18 hours) (46). Because diazepam exhibits some degree of enterohepatic circulation, a second peak of the drug can occur 4 to 6 hours after administration, leading to re‐sedation (40).…”

Section: Benzodiazepinesmentioning

confidence: 99%

“…Midazolam is a short‐acting benzodiazepine that is three to four times as potent as diazepam (46). It is very widely used because of its more rapid onset of action and shorter duration of effect compared with diazepam (9).…”

Section: Benzodiazepinesmentioning

confidence: 99%

“…Meperidine is a synthetic narcotic analgesic that is hepatically metabolized by N ‐demethylation. Because this process is less efficient in neonates, the half‐life is longer than in older children and adults (46). With an IV dose of 1.0 to 1.5 mg/kg, meperidine demonstrates onset of action in 15 to 30 minutes, peak effect at 45 to 60 minutes, and a duration of action of 3 to 4 hours (47).…”

Section: Narcotic Analgesicsmentioning

confidence: 99%

“…Plasma fentanyl concentrations are lower in infants and children than in adults when administered in similar gram per kilogram dosages. Yet, variation in pharmacokinetics with age, type of surgery, or underlying medical conditions (e.g., cyanotic congenital heart disease) make this agent's effects less predictable in pediatric patients (46,52). Fentanyl's high lipid solubility allows for quick penetration of the blood–brain barrier, resulting in a very rapid onset of action (<1 minute) and short duration of action (30–45 minutes) (51,53).…”

Section: Narcotic Analgesicsmentioning

confidence: 99%

“…It is very widely used because of its more rapid onset of action and shorter duration of effect compared with diazepam (9). Because it is in aqueous solution, no local irritation is usually seen after IV injection (46). At physiologic pH, the drug's ringed structure closes, increasing its lipophilic activity and allowing midazolam to readily cross the blood–brain barrier (46,52).…”

Section: Benzodiazepinesmentioning

confidence: 99%

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Sedation for Pediatric Endoscopic Procedures

Tolia,

Peters,

Gilger

2000

J. pediatr. gastroenterol. nutr.

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Section: Benzodiazepinesmentioning

confidence: 99%

Section: Benzodiazepinesmentioning

confidence: 99%

Section: Narcotic Analgesicsmentioning

confidence: 99%

Section: Narcotic Analgesicsmentioning

confidence: 99%

Section: Benzodiazepinesmentioning

confidence: 99%

See 3 more Smart Citations

Sedation for Pediatric Endoscopic Procedures

Tolia,

Peters,

Gilger

2000

J. pediatr. gastroenterol. nutr.

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The evolution of pediatric sedation and anesthesia patient safety: An interview with Dr Charles J. “Charlie” Coté

Firth

Christine

2020

Pediatric Anesthesia

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The career of Dr Charles J. Coté covered a period of major advances in pediatric anesthesia patient safety. Dr Coté (1946-), Professor Emeritus in Anaesthesia at Harvard Medical School, helped develop pediatric sedation guidelines, conducted influential clinical research, edited a major textbook, and promoted pediatric anesthesia training fellowships in low-and middle-income countries. Based on a series of interviews with Dr Coté, this article reviews the career of this Robert M. Smith Award winner through the lens of improvements in pediatric sedation and anesthesia patient safety.

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Comparison of weight-based and pinna size method for ProSeal laryngeal mask airway size selection in children receiving general anesthesia: A randomized clinical study

Mishra,

Kaur,

Suri

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Several methods are in use for LMA ProSeal™ size selection in pediatric patients. Weight-based method is most commonly used. Pinna size–based method is a promising new technique for accurate size selection. Material and Methods: A total of 146 children aged between 6 months and 12 years undergoing surgery under general surgery were included. They were randomized into either pinna-based group (group X) or weight-based group (group Y). Both groups were compared for accurate placement of ProSeal™ laryngeal mask airway (PLMA), ease of insertion, number of attempts needed, and peak airway pressures. Results: A Comparable number of patients had a Brimacombe score of 3 and above, indicating correct placement in both groups (P = 0.407). PLMA was easily inserted in 79.5% and 87.7% of patients of groups X and Y, respectively (P = 0.180). Insertion was found to be difficult in 20.5% of patients in group X, whereas it was difficult in only 12.3% of patients of group Y (P = 0.180). The two groups were comparable as per the number of attempts needed for insertion (P = 0.161). Mean peak airway pressures too were comparable between both groups. Ease of insertion too, was statistically insignificant between both groups. Conclusions: Pinna size–based estimation of LMA size is an effective alternative method to weight-based selection.

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Pediatric Anesthesia

Cited by 3 publications

References 62 publications

Sedation for Pediatric Endoscopic Procedures

Sedation for Pediatric Endoscopic Procedures

The evolution of pediatric sedation and anesthesia patient safety: An interview with Dr Charles J. “Charlie” Coté

Comparison of weight-based and pinna size method for ProSeal laryngeal mask airway size selection in children receiving general anesthesia: A randomized clinical study

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