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Chen DX, Tan ZM, Lin XM. General Anesthesia Exposure in Infancy and Childhood: A 10-year Bibliometric Analysis. J Perianesth Nurs 2024:S1089-9472(23)01072-9. [PMID: 38520467 DOI: 10.1016/j.jopan.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 03/25/2024]
Abstract
PURPOSE Heated discussions have divided health care providers and policymakers on the risks versus benefits of general anesthesia in pediatric populations. We conducted this study to provide a comprehensive bibliometric analysis of general anesthesia in this specific population over the past decade. DESIGN We summarized and quantitatively analyzed the studies related to general anesthesia in children and infants over the past decade. METHODS Using the Web of Science Core Collection as the data source, we analyzed the literature using CiteSpace software, focusing on authors, countries, institutions, keywords, and references to identify hotspots and predict research trends. FINDINGS A total of 2,364 publications on pediatric anesthesia were included in the analysis. The number of related publications and citations steadily increased from 2013 to 2022. The United States was the leading country in terms of output, and University of Toronto was the primary contributing institution. Co-citation analysis revealed that over the past decade research has mainly focused on the long-term adverse effects of general anesthesia on neurodevelopment and acute perioperative crisis events. Keyword analysis identified infant sedation and drug selection and compatibility as promising areas for development. In addition, improving the quality of perioperative anesthesia will be a major research focus in the future. CONCLUSIONS Recent research in pediatric anesthesia has focused on mitigating the adverse effects of general anesthesia in infants and young children and studying the pharmacological compatibility of anesthetics. Our study results would assist researchers and clinicians in understanding the current research status and optimizing clinical practice in this field.
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Affiliation(s)
- Dong X Chen
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Chengdu, Sichuan Province, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan Province, China
| | - Zhi M Tan
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Xue M Lin
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Chengdu, Sichuan Province, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan Province, China.
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AlKattan W, Sabbah BN, Alghafees MA, Sabbah AN, Alsaleem A, Alqahtani MA, Almadani A, Alrashid A, Alshabanat FB, Ali Omar MS, Ouban A, Aleem MU, Barbour A, Abuzubida A, Osman NA, Ali SS, Abbara Z, Alfuwais MA. Pediatric Anesthesia Exposure: Decoding Its Neurodevelopmental Implications and Navigating the Nuances. Cureus 2024; 16:e55952. [PMID: 38601369 PMCID: PMC11005881 DOI: 10.7759/cureus.55952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
General anesthesia is fundamental in pediatric medical interventions, but its potential neurodevelopmental impact on children has raised concerns, necessitating a thorough investigation. This systematic review aimed to assess the association between pediatric anesthesia exposure and neurodevelopmental outcomes, focusing on dosage effects and identifying high-risk groups. The study involved an extensive literature search across PubMed, Medline, and Google Scholar, selecting 40 relevant studies from an initial pool of 2,000, based on inclusion criteria that focused on children under 18 years exposed to anesthesia, excluding those with major comorbidities or perioperative physiological insults. It was observed that while a single exposure to anesthesia had minimal impact on general neurodevelopment, repeated or prolonged exposures posed greater concerns. Despite these findings, the study identified gaps in certain areas like adaptive behavior and sensory cognition due to limited data. The conclusion drawn is that although the evidence on anesthesia-induced neurotoxicity in children remains inconclusive, the implications of pediatric anesthesia exposure are significant enough to warrant careful consideration by healthcare professionals, who should balance the procedural benefits against the risks. This study also calls for future research to standardize methodologies and employ consistent, validated neurodevelopmental measurement tools.
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Affiliation(s)
- Wael AlKattan
- Surgery, Alfaisal University College of Medicine, Riyadh, SAU
| | - Belal N Sabbah
- College of Medicine, Alfaisal University College of Medicine, Riyadh, SAU
| | - Mohammad A Alghafees
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Ahmad N Sabbah
- College of Medicine, Alfaisal University College of Medicine, Riyadh, SAU
| | - Alanood Alsaleem
- Anesthesiology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Meshari A Alqahtani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Alshaima Almadani
- Anesthesiology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Aljazi Alrashid
- Anesthesiology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Faris B Alshabanat
- College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, SAU
| | | | | | | | - Aladeen Barbour
- College of Medicine, Alfaisal University College of Medicine, Riyadh, SAU
| | | | - Nadine A Osman
- College of Medicine, Alfaisal University College of Medicine, Riyadh, SAU
| | - Saad S Ali
- College of Medicine, Alfaisal University College of Medicine, Riyadh, SAU
| | - Zain Abbara
- College of Medicine, Alfaisal University College of Medicine, Riyadh, SAU
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Sjauw DJT, Dulfer K, van Hoorn CE, Buijs V, de Bruijn L, Reijtenbagh BWM, Tangel VE, de Graaff JC. The eXpectations of Parents regarding Anesthesiology Study (XPAS) from a parental perspective: a two-phase observational cross-sectional cohort study. Paediatr Anaesth 2023; 33:1034-1074. [PMID: 37650551 DOI: 10.1111/pan.14748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/21/2023] [Accepted: 08/12/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Uncertainty concerning anesthetic procedures and risks in children requiring anesthesia may cause concerns in parents and caregivers. AIMS To explore parental expectations and experiences regarding their child's anesthesia using questionnaires designed with parental input. METHODS This observational cross-sectional cohort study included parents (including caregivers) of children undergoing anesthesia in a tertiary pediatric referral university hospital. The study consisted of two phases. In Phase 1, we developed three questionnaires with parental involvement through a focus group discussion and individual interviews. The questionnaires focused on parental satisfaction, knowledge, concerns, and need for preparation regarding their child's anesthesia. In Phase 2, independent samples of parents completed the questionnaires at three time points: before the preanesthesia assessment (T1), 2 days after the preanesthesia assessment (T2), and 4 days after the anesthetic procedure (T3). RESULTS In Phase 1, 22 parents were involved in the development of the questionnaires. The three questionnaires contained 43 questions in total, of which 10 had been proposed by parents. In Phase 2, 78% (474 out of 934) parents participated at T1, 36% (610 out of 1705), at T2 and 34% (546 out of 1622) at T3. Parental satisfaction scores were rated on a visual analogue scale for the preanesthesia assessment with a median of 87/100, and with a median of 90/100 for the anesthetic procedure (0: not satisfied and 100: satisfied). Parental concerns were rated with a median of 50/100 (0: no concerns and 100: extremely concerned). Parental answers from the questionnaire at T2 revealed significant knowledge deficits, with only 73% reporting that the anesthesiologist was a physician. Parents preferred to receive more information about the procedure, especially regarding the intended effects and side effects of anesthesia. CONCLUSIONS Overall, parental satisfaction scores regarding the pediatric anesthesiology procedure were high, with a minority expressing concerns. Parents indicated a preference for their child's anesthesiologist to visit them both before and after the anesthetic procedure. Parental expectations regarding anesthesia did not completely correspond with the information provided; more information from the clinician about the intended effects and side effects of anesthesia was desired.
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Affiliation(s)
- Daphne J T Sjauw
- Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Karolijn Dulfer
- Department of Pediatrics and Pediatric Surgery, Intensive Care Unit, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Camille E van Hoorn
- Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vivi Buijs
- Department of Medical Care Management, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Liesbeth de Bruijn
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bente W M Reijtenbagh
- Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Virginia E Tangel
- Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA
| | - Jurgen C de Graaff
- Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Anesthesiology, Admiraal de Ruyter Ziekenhuis-Erasmus MC, Goes, The Netherlands
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Taverner F, Krishnan P, Baird R, von Ungern‐Sternberg BS. Perioperative management of infant inguinal hernia surgery; a review of the recent literature. Paediatr Anaesth 2023; 33:793-799. [PMID: 37449338 PMCID: PMC10947457 DOI: 10.1111/pan.14726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
Inguinal hernia surgery is one of the most common electively performed surgeries in infants. The common nature of inguinal hernia combined with the high-risk population involving a predominance of preterm infants makes this a particular area of interest for those concerned with their perioperative care. Despite a large volume of literature in the area of infant inguinal hernia surgery, there remains much debate amongst anesthetists, surgeons and neonatologists regarding the optimal perioperative management of these patients. The questions asked by clinicians include; when should the surgery occur, how should the surgery be performed (open or laparoscopic), how should the anesthesia be conducted, including regional versus general anesthesia and airway devices used, and what impact does anesthesia choice have on the developing brain? There is a paucity of evidence in the literature on the concerns, priorities or goals of the parents or caregivers but clearly their opinions do and should matter. In this article we review the current clinical surgical and anesthesia practice and evidence for infants undergoing inguinal hernia surgery to help clinicians answer these questions.
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Affiliation(s)
- Fiona Taverner
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
- Department of Anaesthesia and Pain ManagementFlinders Medical CentreAdelaideSouth AustraliaAustralia
| | - Prakash Krishnan
- Department of AnesthesiaBC Children's HospitalVancouverBritish ColumbiaCanada
- Department of Anesthesiology, Pharmacology and Therapeutics UBCVancouverBritish ColumbiaCanada
| | - Robert Baird
- Division of Pediatric SurgeryBC Children's HospitalVancouverBritish ColumbiaCanada
| | - Britta S. von Ungern‐Sternberg
- Department of Anaesthesia and Pain MedicinePerth Children's HospitalNedlandsWestern AustraliaAustralia
- Division of Emergency Medicine, Anaesthesia and Pain MedicineThe University of Western AustraliaPerthWestern AustraliaAustralia
- Perioperative Medicine Team, Perioperative Care ProgramTelethon Kids InstituteNedlandsWestern AustraliaAustralia
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Djalali Talab Y, Geibel MA. Comparison of parental and practitioner's acceptance for dental treatment under general anaesthesia in paediatric patients. BMC Pediatr 2023; 23:45. [PMID: 36707845 PMCID: PMC9883120 DOI: 10.1186/s12887-022-03805-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/15/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Practitioner's knowledge and parental perspectives on dental general anaesthesia (GA) have been surveyed separately in the past. But in daily routine both need to collaborate for the benefit of the child. The aim of this paper was to compare parental and practitioner's acceptance of GA with special focus on identifying factors which influence their differences in decision making. METHODS Questionnaires were conducted among 142 participants in a specialized paediatric dental clinic in Germany from February 2020 to February 2021. 51 German practitioners from private practices and clinics participated. Data collection included: age, gender, experience with GA, fear of GA, risk evaluation and indications for GA. RESULTS There were no gender related differences in decision making. Emotional factors are present in parents of younger children. Parents are more likely to express fear and uncertainty regarding GA than dentists. Prior experience with GA significantly decreases fears in GA for parents. Both agree that extent of the treatment and low compliance are a suitable indication for GA. Dentists are more likely to accept GA due to a mental disability than parents. Parents were more likely to accept GA than dentists when multiple extractions were needed (regardless of compliance) or acute pain was present. CONCLUSIONS A significant divergence in risk evaluation, acceptance and decision-making could be found in parents compared to dentists. Influencing factors are previous experience, younger age of the child, lack of knowledge and indication for GA.
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Affiliation(s)
- Yassamin Djalali Talab
- grid.465811.f0000 0004 4904 7440Danube Private University Krems, Krems an der Donau, Austria
| | - Margrit-Ann Geibel
- grid.465811.f0000 0004 4904 7440Department of Gender-Specific Dentistry, Danube Private University Krems, Krems an der Donau, Austria ,grid.6582.90000 0004 1936 9748Department of Oral and Maxillofacial Surgery, Medical University of Ulm, Ulm, Germany
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Rosenbloom JM, Deng H, Mueller AL, Alegria M, Houle TT. Race/Ethnicity and Duration of Anesthesia for Pediatric Patients in the US: a Retrospective Cohort Study. J Racial Ethn Health Disparities 2022; 10:1329-1338. [PMID: 35505152 DOI: 10.1007/s40615-022-01318-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous literature has demonstrated adverse patient outcomes associated with racial/ethnic disparities in health services. Because patients/parents and providers care about the duration of anesthesia, this study focuses on this outcome. OBJECTIVES To determine the association between race/ethnicity and duration under anesthesia. RESEARCH DESIGN In this retrospective cohort study of data from the Multicenter Perioperative Outcomes Group, White non-Latino was the reference and was compared with Black non-Latino children, Latino, Asian, Native American, Other, and "Unknown" race children. SUBJECTS Children aged 3 to 17 years. OUTCOMES Induction duration (primary outcome), procedure-end duration, and total duration under anesthesia (secondary outcomes). RESULTS Of 37,596 eligible cases, 9,610 cases with complete data were analyzed. The sample consisted of 6,894 White non-Latino patients, 1,021 Black non-Latino patients, 50 Latino patients, 287 Asian patients, 26 Native American patients, 57 "Other" race patients, and 1,275 patients of "Unknown" race. The mean induction time was 11.9 min (SD 5.6 min). In adjusted analysis, Black non-Latino patients had 5% longer induction and procedure-end durations than White non-Latino children (exponentiated beta coefficient [Exp (β)] 1.05, 95% CI: 1.02-1.08, p < 0.01 and Exp (β) 1.08, 95% CI 1.04-1.13, p < 0.01 respectively). CONCLUSIONS White non-Latino children had shorter induction and procedure-end durations than Black children. The differences in induction and procedure-end time were small but may be meaningful on a population-health level.
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Affiliation(s)
- Julia M Rosenbloom
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA.
| | - Hao Deng
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA
| | - Ariel L Mueller
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA
| | - Margarita Alegria
- Disparities Research Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Departments of Medicine and Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Timothy T Houle
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA
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Parental perspectives on pre-operative counseling regarding pediatric general anesthesia exposure. J Pediatr Surg 2021; 56:829-830. [PMID: 33451812 DOI: 10.1016/j.jpedsurg.2020.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/21/2022]
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Chan YY, Rosoklija I, Meade P, Cheon EC, Benzon HA, Chu DI. Parental perspectives on general anesthesia exposure in young children. Paediatr Anaesth 2020; 30:833-834. [PMID: 32333710 DOI: 10.1111/pan.13896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/21/2020] [Accepted: 04/19/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Yvonne Y Chan
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Ilina Rosoklija
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Patrick Meade
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Eric C Cheon
- Department of Pediatric Anesthesiology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Hubert A Benzon
- Department of Pediatric Anesthesiology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - David I Chu
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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