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We received a slurry of responses to the PAADs on Cricoid Pressure and Right to Left shunt and speed of induction.
Traumatic brain injury and ketamine: Another bubbe meisa?
Vanessa Mazandi, MD and Justin L. Lockman, MD, MSEd
Original Article
Jeffcote T, Weir T, Anstey J, McNamara R, Bellomo R, Udy A. The Impact of Sedative Choice on Intracranial and Systemic Physiology in Moderate to Severe Traumatic Brain Injury: A Scoping Review. J Neurosurg Anesthesiol. Feb 10 2022. PMID 35142704
Turns out that ketamine is not only safe in patients with TBI and at risk of developing increased ICP, it may be the best induction to use.
Sugammadex
Debra J. Faulk MD and Myron Yaster MD
Original Article
Voss T, Wang A, DeAngelis M, Speek M, Saldien V, Hammer GB, Wrishko R, Herring WJ. Sugammadex for reversal of neuromuscular blockade in pediatric patients: Results from a phase IV randomized study. Paediatr Anaesth. 2022 Mar;32(3):436-445. doi: 10.1111/pan.14370. Epub 2021 Dec 17. PMID: 34878707.
Although most pediatric anesthesiologists have been using sugammadex “off label” the results of this article was used by FDA to extend the labeling to children >2.
Anesthesia and the developing brain
Myron Yaster MD and Lynne G. Maxwell MD
Review Article
Caleb Ing, David O Warner, Lena S Sun, Randall P Flick, Andrew J Davidson, Laszlo Vutskits, Mary Ellen McCann, James O’Leary, David C Bellinger, Virginia Rauh, Beverley A Orser, Santhanam Suresh, Dean B Andropoulos. Anesthesia and Developing Brains: Unanswered Questions and Proposed Paths Forward. Anesthesiology. 2022 Mar 1;136(3):500-512. PMID: 3501580
Are general anesthetics safe in the developing brain? Our take: whatever the negative effects of general anesthetics may be they pale in comparison to the failure to provide anesthesia and pain relief for children undergoing surgery.
