Safety profile of anesthetic modalities during laser treatment for retinopathy of prematurity: a systematic review

Gavriilidou, Ariadni; Seliniotaki, Aikaterini K; Arvanitaki, Zoi; Ziakas, Nikolaos; Haidich, Anna‐Bettina; Mataftsi, Asimina

doi:10.1038/s41372-023-01622-7

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…20 A recent review study pointed out that lately there is a shift from general anaesthesia towards other types of anaesthesia in preterm infants undergoing laser photocoagulation. 21 The main reason for this phenomenon was to decrease adverse events associated with extubation postoperatively. These findings suggest that the use of LMA instead of ETT can increase patient safety by reducing the chance of possible adverse events associated with ETT and eliminating the use of muscle relaxants for ETT insertion in VLBW infants.…”

Section: Discussionmentioning

confidence: 99%

Airway management may influence postoperative ventilation need in preterm infants after laser eye treatment

Trinh,

Tövisházi,

Kátai

et al. 2024

Pediatr Res

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Background Retinopathy of prematurity is treated with laser photocoagulation under general anaesthesia with intubation using endotracheal tube (ETT), which carries a risk for postoperative mechanical ventilation (MV). Laryngeal mask airway (LMA) may provide a safe alternative. We assessed the need for postoperative MV in preterm infants who received LMA versus ETT. Methods In this single-centre, retrospective cohort study, preterm infants who underwent laser photocoagulation between 2014–2021 were enroled. For airway management, patients received either LMA (n = 224) or ETT (n = 47). The outcome was the rate of postoperative MV. Results Patients’ age were 37 [35;39] weeks of postmenstrual age, median bodyweight of Group LMA was higher than Group ETT’s (2110 [1800;2780] g versus 1350 [1230;1610] g, respectively, p < 0.0001). After laser photocoagulation, 8% of Group LMA and 74% of Group ETT left the operating theatre requiring MV. Multiple logistic regression revealed that the use of LMA and every 100 g increase in bodyweight significantly decreased the odds of mechanical ventilation (OR 0.21 [95% CI 0.07–0.60], and 0.73 [95% CI 0.63–0.84], respectively). Propensity score matching confirmed that LMA decreased the odds of postoperative MV (OR 0.30 [95% CI 0.11–0.70]). Conclusion The use of LMA is associated with a reduced need for postoperative MV. Impact Using laryngeal mask airway instead of endotracheal tube for airway management in preterm infants undergoing general anaesthesia for laser photocoagulation for treating retinopathy of prematurity could significantly decrease the postoperative need for mechanical ventilation. According to our current understanding, this has been the largest study investigating the effect of laryngeal mask airway during general anaesthesia in preterm infants. Our study suggests that the use of laryngeal mask airway is a viable alternative to intubation in the vulnerable population of preterm infants in need of laser treatment.

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Section: Discussionmentioning

confidence: 99%

Airway management may influence postoperative ventilation need in preterm infants after laser eye treatment

Trinh,

Tövisházi,

Kátai

et al. 2024

Pediatr Res

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“…Classically, general anesthesia or sedation has been used for its treatment, but topical anesthesia has recently begun to be used (for example with propacaine). However, a recent review has shown its relationship with life-threatening events so more studies are required for its safe use [ 44 ].…”

Section: Management Of Painmentioning

confidence: 99%

Dexmedetomidine: An Alternative to Pain Treatment in Neonatology

et al. 2023

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Infants might be exposed to pain during their admissions in the neonatal intensive care unit [NICU], both from their underlying conditions and several invasive procedures required during their stay. Considering the particularities of this population, recognition and adequate management of pain continues to be a challenge for neonatologists and investigators. Diverse therapies are available for treatment, including non-pharmacological pain management measures and pharmacological agents (sucrose, opioids, midazolam, acetaminophen, topical agents…) and research continues. In recent years one of the most promising drugs for analgesia has been dexmedetomidine, an alpha-2 adrenergic receptor agonist. It has shown a promising efficacy and safety profile as it produces anxiolysis, sedation and analgesia without respiratory depression. Moreover, studies have shown a neuroprotective role in animal models which could be beneficial to neonatal population, especially in preterm newborns. Side effects of this therapy are mainly cardiovascular, but in most studies published, those were not severe and did not require specific therapeutic measures for their resolution. The main objective of this article is to summarize the existing literature on neonatal pain management strategies available and review the efficacy of dexmedetomidine as a new therapy with increasing use in the NICU.

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“…Together with the advanced precise control and digitalizable automation, typically the industrialization of robot and computer numerical control (CNC) systems, user-programmable automated lased-based process has been greatly developed in the past two decades. Some of these techniques [9], e.g., lasercladding (LC) [10][11][12][13][14], laser-treatment [15][16][17][18][19], and laser-shock peening (LSP) [20][21][22][23][24], have been entering industrial applications in recent years.…”

Section: Introductionmentioning

confidence: 99%

Laser-based Process Towards Advanced Manufacturing of Metal Alloys

Gong

Liu

2023

J. Phys.: Conf. Ser.

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Investigations on application of laser for manufacturing and remanufacturing have been extensively progressed since its advent in 1960. The rapid development of laser technologies in the past half-century has made many laser-based direct-energy processes possible and, nowadays, most of such laser-processing techniques are about entering industrial applications. An application of laser-cladding (LC) for remanufacturing turbine blades can save the cost by over 75%. Laser treatment, on the other hand, making use of direct laser-matter interactions, has been recognized as a green surface-cleaning technique for metal alloys, which may also introduce surface integrity enhancement for additively manufactured alloys. Here, we present and discuss recent progress in laser-based process through a few typical cases that have been recently developed in our group towards advanced remanufacturing of metallic alloys, typically including LC, laser treatment, and laser-shock peening.

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Safety profile of anesthetic modalities during laser treatment for retinopathy of prematurity: a systematic review

Cited by 5 publications

References 30 publications

Airway management may influence postoperative ventilation need in preterm infants after laser eye treatment

Airway management may influence postoperative ventilation need in preterm infants after laser eye treatment

Dexmedetomidine: An Alternative to Pain Treatment in Neonatology

Laser-based Process Towards Advanced Manufacturing of Metal Alloys

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