International Journal of Pediatrics

Reliability of Visually Estimated Blood Loss with Hemoglobin Measurement: 200 Cases of Craniosynostosis Surgery

Afsaneh Sadeghi Sadeghi; Bita Malekianzadeh; Narges Ahmadizadeh; Alireza Mahdavi

Volume 6, Issue 9 , September 2018, , Pages 8207-8213

https://doi.org/10.22038/ijp.2018.29258.2562

Abstract

Background Bleeding is one of the most common complications of craniosynostosis surgery, which its appropriate management is associated with better post-operative outcomes. The aim ... Read More

The Effect of Inhalation Anesthesia with Hyperventilation and Total Intravenous Anesthesia on Intracranial Pressure Control in Pediatrics with Craniosynostosis Surgery: A Randomized Clinical Trial

Alireza Mahdavi; Bita Malekianzadeh; Afsaneh Sadeghi Sadeghi

Volume 6, Issue 2 , February 2018, , Pages 7201-7209

https://doi.org/10.22038/ijp.2018.28956.2529

Abstract

Background: Intracranial pressure (ICP) control is one of the anesthesiologist challenges in craniosynostosis repair surgery, especially in multiple sutures involvement. The aim of ... Read More Background: Intracranial pressure (ICP) control is one of the anesthesiologist challenges in craniosynostosis repair surgery, especially in multiple sutures involvement. The aim of this study was comparing the effect of two anesthesia methods including inhalation with hyperventilation and total intravenous anesthesia (TIVA) on ICP control and surgeon satisfaction in pediatrics with craniosynostosis surgery.Materials and Methods: In this randomized clinical trial study, 40 pediatric patients with American society of anesthesiologists (ASA) І-ІІ, 6 months to 2 years old were included. All of the patients were scheduled for craniosynostosis repair at Mofid Children Hospital, Tehran, Iran, in May 2016 to January 2017. The patients were randomly divided into two groups. In hyperventilation group, patients received isoflurane for maintenance of anesthesia and hyperventilation (Paco2=25-30 mmHg) established during surgery. The total intravenous anesthesia (TIVA) group received propofol infusion for anesthesia maintenance and Paco2 was maintained 35 mmHg. Intra cranial pressure (ICP) was assessed by surgeon using a 4-point scale. Hemodynamic (mean arterial pressure and heart rate) changes and blood loss were compared between hyperventilation and TIVA groups. Results: The mean age of patients in hyperventilation group was 10.9±3.25 months and in TIVA group was 8.7 ± 2063 months (p=0.11). Fourteen (70%) patients in hyperventilation group and 6 (30%) patients in TIVA group were male (p=0.74). A significant difference was seen in ICP control and surgical condition between hyperventilation and TIVA groups (p=0.032). ICP was controlled better in hyperventilation group. There was no difference in hemodynamic parameters and blood loss between hyperventilation and TIVA groups (p>0.05). Conclusion: This study showed inhalation anesthesia with hyperventilation was more effective than TIVA on ICP control in craniosynostosis surgery.

International Journal of Pediatrics

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Author = Bita Malekianzadeh

Reliability of Visually Estimated Blood Loss with Hemoglobin Measurement: 200 Cases of Craniosynostosis Surgery

Abstract

The Effect of Inhalation Anesthesia with Hyperventilation and Total Intravenous Anesthesia on Intracranial Pressure Control in Pediatrics with Craniosynostosis Surgery: A Randomized Clinical Trial

Abstract