RESUMO
La dexmedetomidina (DEX) es un agente anestésico que mimetiza el sueño profundo natural y produce una mínima depresión cardiorrespiratoria, convirtiéndose en una opción muy valiosa en el manejo de un paciente tan exigente como es el pediátrico. El objetivo principal de esta mini revisión fue centrarse en el papel de la DEX como analgésico en el período perioperatorio de niños sometidos a anestesia. Se realizó una búsqueda bibliográfica, entre 2010 y 2021, en Google, Pubmed, Embase y Cochrane Library. Se repasaron diferentes aspectos como su farmacología, efectividad, seguridad y la evidencia más reciente sobre su uso clínico como analgésico en anestesia pediátrica. Igualmente se incluyó una estimación de coste del tratamiento analgésico perioperatorio con DEX.(AU)
Dexmedetomidine (DEX) is an anaesthetic agent that mimics natural deep sleep and produces minimal cardiorespiratory depression. As such, it is a very valuable option in the management of such a challenging population as paediatric patients. The main objective of this mini review was to evaluate the role of DEX as a perioperative analgesic in children receiving anaesthesia. We searched Google, Pubmed, Embase and the Cochrane Library for articles published between 2010 and 2021, and reviewed various of aspects of DEX, such as pharmacology, effectiveness, safety, and the most recent evidence on its clinical use as an analgesic in paediatric anaesthesia. We also include a cost estimate of perioperative analgesia with DEX.(AU)
Assuntos
Humanos , Lactente , Criança , Adolescente , Dexmedetomidina , Analgesia , Período Perioperatório , Anestesia , Pediatria , Analgésicos , Manejo da Dor , Farmacocinética , Bases de Dados Bibliográficas , PubMed , Reanimação Cardiopulmonar , AnestesiologiaAssuntos
Humanos , Masculino , Criança , Cateteres , Pediatria , Analgesia , Cirurgia Torácica , Radiografia Torácica , Pacientes Internados , Exame Físico , Simpatectomia , Toracoscopia , Reanimação Cardiopulmonar , Anestesiologia , AnestesiaRESUMO
Dexmedetomidine (DEX) is an anaesthetic agent that mimics natural deep sleep and produces minimal cardiorespiratory depression. As such, it is a very valuable option in the management of such a challenging population as paediatric patients. The main objective of this mini review was to evaluate the role of DEX as a perioperative analgesic in children receiving anaesthesia. We searched Google, Pubmed, Embase and the Cochrane Library for articles published between 2010 and 2021, and reviewed various of aspects of DEX, such as pharmacology, effectiveness, safety, and the most recent evidence on its clinical use as an analgesic in paediatric anaesthesia. We also include a cost estimate of perioperative analgesia with DEX.
Assuntos
Analgesia , Anestesia , Dexmedetomidina , Analgésicos , Criança , Dexmedetomidina/farmacologia , Dexmedetomidina/uso terapêutico , HumanosRESUMO
Dexmedetomidine (DEX) is an anaesthetic agent that mimics natural deep sleep and produces minimal cardiorespiratory depression. As such, it is a very valuable option in the management of such a challenging population as paediatric patients. The main objective of this mini review was to evaluate the role of DEX as a perioperative analgesic in children receiving anaesthesia. We searched Google, Pubmed, Embase and the Cochrane Library for articles published between 2010 and 2021, and reviewed various of aspects of DEX, such as pharmacology, effectiveness, safety, and the most recent evidence on its clinical use as an analgesic in paediatric anaesthesia. We also include a cost estimate of perioperative analgesia with DEX.
RESUMO
Introducción: La mejora de la calidad en el cuidado de la salud conlleva el diseño de procesos fiables, que prevengan y mitiguen los errores médicos. Los listados de verificación (checklists) son herramientas cognitivas que reducen dichos errores. El objetivo de este trabajo fue diseñar un checklist anestésico en Pediatría para su posterior implementación en nuestro hospital. Metodología: Se aplicó el método Delphi con 3 rondas de cuestionarios: uno genérico para aportar dimensiones e ítems y 2 específicos para puntuar individualmente los ítems y globalmente el checklist (mediana), y para medir el nivel de consenso intraítem (rango intercuartil relativo) y la fiabilidad (prueba de rangos con signo de Wilcoxon). Resultados: La versión final del checklist obtuvo una elevada puntuación global (Med 9) con un nivel de consenso muy alto (RIR 5%). Se alcanzó el consenso interno en todos los ítems (RIR ≤ 30%). El test de Wilcoxon no encontró diferencias estadísticamente significativas y evidenció la fiabilidad o estabilidad de la respuesta entre rondas consecutivas. Conclusión: El Checklist anestésico en Pediatría ha sido diseñado metódicamente para su implementación y uso en nuestro hospital
Introduction: Quality improvement in health care entails the design of reliable processes which prevent and mitigate medical errors. Checklists are cognitive tools which reduce such errors. The primary objective of this study was to design an anesthetic checklist in Pediatrics to be implemented in our hospital. Methods: Delphi technique was used, with 3 rounds of questionnaire surveys: a generic questionnaire to obtain dimensions and items; and 2 specific ones to score individual items and obtain an overall rating for the checklist (median), and to measure the level of consensus (relative interquartile range) and internal reliability (Wilcoxon signed-rank test). Results: Final version of the checklist obtained a high overall score (Med 9) with a very high consensus (RIR 5%). Internal consensus was reached on all items (RIR ≤ 30%). Wilcoxon signed-rank test found no statistically significant differences, demonstrating reliability or consistency of responses between consecutive rounds. Conclusion: The Anesthetic checklist in Pediatrics has been methodically designed for implementation and use in our hospital
Assuntos
Humanos , Criança , Anestesia/métodos , Anestésicos/administração & dosagem , Lista de Checagem/métodos , Erros Médicos/prevenção & controle , Segurança do Paciente , Melhoria de Qualidade/tendências , Anestesia/efeitos adversos , Fatores de Risco , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Projetos de PesquisaRESUMO
INTRODUCTION: Quality improvement in health care entails the design of reliable processes which prevent and mitigate medical errors. Checklists are cognitive tools which reduce such errors. The primary objective of this study was to design an anesthetic checklist in Pediatrics to be implemented in our hospital. METHODS: Delphi technique was used, with 3 rounds of questionnaire surveys: a generic questionnaire to obtain dimensions and items; and 2 specific ones to score individual items and obtain an overall rating for the checklist (median), and to measure the level of consensus (relative interquartile range) and internal reliability (Wilcoxon signed-rank test). RESULTS: Final version of the checklist obtained a high overall score (Med 9) with a very high consensus (RIR 5%). Internal consensus was reached on all items (RIR ≤ 30%). Wilcoxon signed-rank test found no statistically significant differences, demonstrating reliability or consistency of responses between consecutive rounds. CONCLUSION: The Anesthetic checklist in Pediatrics has been methodically designed for implementation and use in our hospital.
Assuntos
Anestesia/normas , Lista de Checagem/normas , Erros Médicos/prevenção & controle , Pediatria/normas , Melhoria de Qualidade , Lista de Checagem/métodos , Consenso , Técnica Delfos , Retroalimentação , Pesquisas sobre Atenção à Saúde/normas , Humanos , Segurança do Paciente , Qualidade da Assistência à Saúde , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Inquéritos e Questionários/normasRESUMO
No disponible
Assuntos
Humanos , Dispositivos de Acesso Vascular/efeitos adversos , Falha de Equipamento , Dor de Ombro/etiologia , Antineoplásicos/administração & dosagem , Resistência ao CisalhamentoRESUMO
No disponible
Assuntos
Humanos , Criança , Anestésicos/farmacologia , Neurotoxinas/análise , Composição de Medicamentos , Duração da Cirurgia , Segurança do PacienteRESUMO
No disponible
Assuntos
Humanos , Masculino , Pré-Escolar , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Fissura Palatina/complicações , Fissura Palatina/cirurgia , Midazolam/uso terapêutico , Taquicardia/complicações , Ecocardiografia/métodos , Broncoscopia/métodos , Atropina/uso terapêutico , Propofol/uso terapêutico , Fentanila/uso terapêutico , Doença das Coronárias/congênito , Doença das Coronárias/complicações , Doença das Coronárias/cirurgiaRESUMO
La anestesia neuroaxial pediátrica es una herramienta efectiva que puede ser usada como complemento o alternativa a la anestesia general. Sin embargo, siempre ha generado dudas en cuanto a su utilidad y relación riesgo-beneficio. El propósito de esta revisión es describir el papel actual de los bloqueos centrales en la población pediátrica, actualizar aspectos prácticos y de seguridad, así como repasar los últimos avances tecnológicos aplicados a este procedimiento (AU)
Pediatric neuraxial anesthesia is an effective tool that can be used as a supplement or alternative to general anesthesia. However, there have always been doubts about its usefulness and risk-benefit ratio. The purpose of this review is to describe the current role of central blockades in pediatric patients, upgrade practical and safety aspects, and review the latest technological advances applied to this procedure (AU)
Assuntos
Humanos , Masculino , Feminino , Pediatria/educação , Anestesia por Condução/métodos , Ultrassonografia/métodos , Anestesia Caudal/métodos , Cateteres/provisão & distribuição , Estudos Multicêntricos como Assunto/instrumentação , Hipovolemia/sangue , Sistema Nervoso Central/patologia , Pediatria/métodos , Anestesia por Condução , Ultrassonografia/instrumentação , Anestesia Caudal , Cateteres/normas , Estudos Multicêntricos como Assunto , Hipovolemia/complicações , Sistema Nervoso Central/metabolismoRESUMO
Pediatric neuraxial anesthesia is an effective tool that can be used as a supplement or alternative to general anesthesia. However, there have always been doubts about its usefulness and risk-benefit ratio. The purpose of this review is to describe the current role of central blockades in pediatric patients, upgrade practical and safety aspects, and review the latest technological advances applied to this procedure.
Assuntos
Anestesia Geral , Anestesia por Condução , Criança , Humanos , Medição de RiscoRESUMO
No disponible
