Retinopathy of prematurity: systemic complications associated with different anaesthetic techniques at treatment
| Autor: | Paul M Haigh, Eamonn P O’Donoghue, Malcolm L Chiswick |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 1997 |
| Předmět: |
Artificial ventilation
medicine.medical_specialty medicine.medical_treatment Sedation Cryotherapy Cellular and Molecular Neuroscience Postoperative Complications medicine Intubation Humans Local anesthesia General anaesthesia Retinopathy of Prematurity Anesthetics Bronchopulmonary Dysplasia business.industry Infant Newborn Retinopathy of prematurity Pulmonary Surfactants medicine.disease Original articles - Clinical science Respiration Artificial Sensory Systems Surgery Ophthalmology Treatment Outcome Bronchopulmonary dysplasia Anesthesia Child Preschool Steroids medicine.symptom business |
| Popis: | BACKGROUND—Treatment of retinopathy of prematurity (ROP) in the UK is subject to considerable regional variation in terms of anaesthetic support. Change in practice at St Mary's neonatal medical unit from topical to general anaesthesia and, subsequently, to sedation/analgesia allowed comparison of the impact of these three modalities on infants' early postoperative course in a consecutive, non-randomised, observational study. METHODS—The study population consisted of 30 babies undergoing treatment of threshold ROP. Twelve were treated using topical anaesthesia alone (group A), six using general anaesthesia (group B), and 12 using sedation/analgesia combined with elective intubation and artificial ventilation (group C). Daily measurements of infant health were recorded starting 4 days preoperatively and continuing for 7 days postoperatively to facilitate the formulation of a cardiorespiratory stability index as follows: (0) improvement from baseline, (1) no change from baseline, (2) mild instability, (3) marked instability, and (4) life threatening event. RESULTS—Within the first 48 hours postoperatively in group A 5/12 showed mild instability and 4/12 showed marked instability (including three babies suffering life threatening events requiring emergency resuscitation). In group B within the first 48 hours postoperatively 1/6 showed mild and 1/6 showed marked instability, and in group C 5/12 babies showed mild instability alone. There was a significant difference for cardiorespiratory stability scores between the three groups overall for the 7 days postoperatively (repeated measures ANOVA, p = 0.018). CONCLUSIONS—Premature infants undergoing cryotherapy for ROP who were treated using topical anaesthesia alone had more severe and protracted cardiorespiratory complications. |
| Databáze: | OpenAIRE |
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