Stress indicators during general anesthesia with opioid analgesics in children

Drašković, Biljana; Stanic, Danica; Uram-Benka, Anna; Fabri, Izabella

doi:10.3906/sag-1305-36

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Corresponding to this finding, the blood glucose level increased the most in the fentanyl group from induction until awakening. The lowest increase of blood glucose was recorded in the remifentanil group [8].…”

Section: Discussionmentioning

confidence: 99%

Total Intravenous Anesthesia in GLUT1 Deficiency Syndrome Patient: A Case Report

et al. 2019

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Patient: Female, 2 Final Diagnosis: GLUT1 deficiency syndrome Symptoms: Mastoiditis Medication: — Clinical Procedure: General anesthesia Specialty: Anesthesiology Objective: Congenital defects/diseases Background: GLUT1-deficiency-syndrome (G1DS) is an autosomal dominant genetic disorder based on a mutation of the SLC2A1 gene. This mutation can lead to an encephalopathy due to abnormal glucose transport in the brain. G1DS is a rare disease, with an estimated incidence of 1: 90 000. Case Report: We report a case of a 10-year-old female who presented with recurrent fever, headaches, and vertigo for more than 3 days within 2 weeks following pneumonia. A bilateral mastoiditis was proven by a cerebral magnetic resonance imaging and a cranial computed tomography scan. The patient had to undergo mastoidectomy and thus, her first general anesthesia. Half a year previously she was diagnosed with G1DS. According to the standard of care, a ketogenic diet had been administered since the patient’s diagnosis 6 months earlier. Our patient received a total intravenous anesthesia (TIVA) using propofol, fentanyl, and rocuronium administered without any incidents. Conclusions: We recommend normoglycemia during the perioperative phase and avoidance of glucose-based medication to keep a patient’s ketotic state. Our case highlights that TIVA, with the outlined medication used in this case, was safe when the patient’s ketotic state and periprocedural blood glucose was monitored continuously. Nevertheless, we would suggest using remifentanil instead of fentanyl for future TIVAs due to a reduced increase in blood glucose level in our patient.

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Section: Discussionmentioning

confidence: 99%

Total Intravenous Anesthesia in GLUT1 Deficiency Syndrome Patient: A Case Report

et al. 2019

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“…Non-compliant children are very resistant to anesthesia induction; they scream loudly and they occasionally need to be restrained by staff during the induction [5]. Physiologically, the levels of blood cortisol heighten as a result of stress response that is associated with surgical anxiety [8]. This in turn might increase the risk of infection and delay healing postoperatively [8].…”

Section: Introductionmentioning

confidence: 99%

“…Physiologically, the levels of blood cortisol heighten as a result of stress response that is associated with surgical anxiety [8]. This in turn might increase the risk of infection and delay healing postoperatively [8].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Video Distraction on Children Preoperative Anxiety: An Integrative Literature Review

Dwairej¹,

Obeidat²,

Khalaf³

2018

OJN

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Background: Children who undergo a day case surgery experience high levels of preoperative anxiety. Preoperative anxiety interferes with anesthesia induction compliance and is associated with many short and long term postoperative complications. Recently, video distraction intervention has been evaluated for its anxiolytic effects in preoperative children. Aim: The aim of this integrative review was to demonstrate the varying methodological approaches utilized to evaluate the effectiveness of a video distraction intervention in reducing preoperative anxiety in children undergoing day case surgery. Methods: A total of 8 articles, meeting the inclusion criteria, were evaluated and included. Findings: The eight studies investigating the effect of video distraction on children preoperative anxiety concluded that video distraction was significant in controlling children preoperative anxiety. Four of the eight studies (50%), investigated video distraction effectiveness against pharmacological comparisons and demonstrated superior or equal anxiolytic effect of video distraction on different points along the surgical continuum. Three of the eight studies compared video distraction against parental presences and video distraction showed superior anxiolytic effect. Three of the eight studies evaluated the effect of video distraction on anesthesia induction compliance and emergence delirium. A significant effect on anesthesia induction was demonstrated while non-significant effect on emergence delirium was documented. Conclusion: Video distraction is a safe, time and cost effective non pharmacological anxiolytic intervention. It can be provided by nurses to control children high level of anxiety before surgery and during anesthesia induction.

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“…Intravenous morphine, fentanyl, and other opioids were used previously to reduce incidence of EA, but those drugs could not effectively ease the postoperative pain, as well as nausea, vomiting, delayed recovery, respiratory depression, and chest wall muscle rigidity. 6 Investigating safer and more efficient measures for prevention of EA has become the major challenge faced by clinical anesthesiologists.…”

Section: Introductionmentioning

confidence: 99%

Effect of ketamine combined with butorphanol on emergence agitation of postoperative patients with gastric cancer

Lin

Liu

Chen

et al. 2016

TCRM

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BackgroundThis study aimed to investigate the effect of ketamine combined with butorphanol on emergence agitation (EA) in postoperative gastric cancer patients.Materials and methodsA total of 150 patients with gastric cancer were included and divided into group B (1 mg butorphanol before anesthesia induction, n=50), group K (1 mg/kg ketamine, n=50), and group C (1 mg butorphanol combined with 1 mg/kg ketamine, n=50). Mean arterial pressure (MAP) and heart rate (HR) at the end of operation, just before extubation (T0) and at 0 minute (T1), 5 minutes (T2), and 30 minutes (T3) after extubation were compared. Statistical analysis of recovery time, extubation time, time in postanesthesia care unit, and EA incidence and adverse reactions were performed.ResultsThere were no differences among groups with respect to MAP and HR at T0 and T1 (P>0.05). Compared with patients in group C, significant reduction of MAP and HR were observed in groups K and B at T2 and T3 (P<0.05), while no differences were found between group K and group B (P>0.05). Recovery time, extubation time, time in postanesthesia care unit, and incidence of EA in group C were significantly less than those in groups K and B (P<0.05), but no differences were observed between group K and group B (P>0.05). Total incidence of adverse reactions were significantly increased in group K compared to those in groups C and B (P<0.05).ConclusionInjection of ketamine combined with butorphanol before anesthesia induction was more effective than injection of ketamine or butorphanol separately in the prevention of EA.

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Stress indicators during general anesthesia with opioid analgesics in children

Cited by 8 publications

References 19 publications

Total Intravenous Anesthesia in GLUT1 Deficiency Syndrome Patient: A Case Report

Total Intravenous Anesthesia in GLUT1 Deficiency Syndrome Patient: A Case Report

The Effectiveness of Video Distraction on Children Preoperative Anxiety: An Integrative Literature Review

Effect of ketamine combined with butorphanol on emergence agitation of postoperative patients with gastric cancer

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