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Complications of Equine Anesthesia
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Some anesthesiologists may elect to transition a horse to injectable anesthetic if a difficult recovery is predicted. Others may use a recovery pool or some other method of assisting recovery. Nonetheless, sedation may be necessary to help control emergence delirium.
Special considerations: Alzheimer’s disease
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Christopher G. Sinon, Sona Shah Arora, Amy D. Rodriguez, Paul S. García
Delirium can be further classified by its clinical setting, such as intensive care unit (ICU) delirium (62) or PACU delirium (63). In contrast, the term emergence delirium has been used to describe an agitated state upon emergence from anesthesia (64). This is less likely to occur in patients with AD as opposed to younger patients. Many researchers are beginning to describe this as emergence agitation, because consciousness (impaired or unimpaired) was not yet restored before the hyperactivity began. Encouraging the use of assistive devices such as eyeglasses, hearing aids, and dentures would be expected to decrease delirium. No pharmacologic intervention has been proven to be effective in prevention or treatment of PPND, but risk awareness, brain monitoring for titration of anesthetic medications, and post-procedural assessments may decrease the incidence and severity.
Anesthesia
Published in Prem Puri, Newborn Surgery, 2017
Sevoflurane has replaced halothane for the induction of anesthesia in neonates and children. It lacks the airway irritation associated with other newer inhalation agents and provides cardiovascular stability. Induction time is similar to halothane.20 Infants undergoing inguinal herniotomy with sevoflurane have a slower recovery than those with desflurane but no difference in postoperative respiratory events.21 Higher concentrations of sevoflurane, commonly used for induction of anesthesia, can be associated with epileptiform electroencephalogram (EEG) changes.22 In older children, the agent is associated with emergence delirium.23
Parental active participation during induction of general anesthesia to decrease children anxiety and pain
Published in Egyptian Journal of Anaesthesia, 2022
Tarek I Ismail, Rabab S. S. Mahrous
However, in this review, the included studies didn’t evaluate prepared parents to be present in the operating room. Eijler et al. [49] also found that distraction therapy for children in day case surgery through provision of virtual reality exposure had no valuable effect on pain and anxiety. In our trial, relatively small proportion of our patients in both groups experienced substantial levels of pain and needed less rescue analgesia. These results are because of adequate pain management. These results are in line with low incidence of emergence delirium in both groups. As it is well known that it is difficult to differentiate between pain from emergence delirium, we included valid scale that may also reflect pain [50]. FLACC scale includes consolability items [15]. It is concluded that low incidence of emergence delirium in both groups could be related to the efficacy of the observer. The well-trained observer in our trial was adequately able to differentiate between agitation due to delirium from other causes such as pain or anxiety [51].
Comparative Effectiveness of Analgesics to Reduce Acute Pain in the Prehospital Setting
Published in Prehospital Emergency Care, 2020
Diana M. Sobieraj, Brandon K. Martinez, Benjamin Miao, Mark X. Cicero, Richard A. Kamin, Adrian V. Hernandez, Craig I. Coleman, William L. Baker
The major limitation of this review is the indirectness of evidence, which led to our downgrading of conclusions. We believe the single most important future research need is addressing this evidence gap with pain management studies set in the prehospital environment. In addition, research is needed to explore subgroups further, including patient and drug regimen characteristics and EMS personnel training and how these characteristics may modify comparative effectiveness and harms of analgesics. Use of ED data was associated with addition challenges. Pain, and usually cardiorespiratory monitoring parameters, were measured multiple times throughout the study period. We chose to evaluate these outcomes at 15, 30, and 60 minutes to balance clinical applicability and multiple hypothesis testing. Assessment of mental status changes was challenging because this outcome can be described in many ways. While we were quite liberal in what we allowed as a mental status change, we separately analyzed each distinct “symptom” since within a study these outcomes may not have been mutually exclusive. Similarly, the assessment of emergence delirium posed a challenge since several signs or symptoms may be associated with this phenomenon. We were strict in collecting data explicitly reported by the authors as emergence reactions, delirium or phenomenon rather than assuming a vaguely reported symptom may have been emergence delirium.
Dexmedetomidine versus propofol for prevention of emergence delirium in pediatric cataract surgery: Double blinded randomized study
Published in Egyptian Journal of Anaesthesia, 2022
Ghada F. Amer, Maha Younis Abdallah
Emergence delirium (ED) is a common postoperative neurological complication that could be encountered in up to 80% of pediatrics after general anesthesia. It is defined as involuntary agitation associated with crying, shouting, kicking, uncooperability, inconsolability, lack of awareness of the surroundings, and absent eye contact with parents or healthcare staff [1,2]. The etiology of this problem is multifactorial, as multiple patients, anesthetic, surgical, and medication-related factors play a role in its development [3,4].