Providing Diabetes Care in General Practice

1......Page 1
Neonatal anaesthesia......Page 2
Practical pain management in the neonate......Page 4
Pain assessment......Page 6
Minor surgery......Page 7
Circumcision......Page 8
Herniotomy/pyloromyotomy......Page 9
Major neonatal surgery......Page 10
Procedural pain in neonates......Page 12
Lumbar puncture......Page 13
Future challenges......Page 14
Conclusions......Page 15
References......Page 16
4......Page 21
Tracheo-oesophageal fistula (TOF) and oesophageal atresia (OA)......Page 97
Pulse oximetry......Page 22
Caudal blockade......Page 23
Intraosseous access......Page 113
Use of test dosing......Page 24
Ultrasound-guided epidural technique......Page 25
Intra-operative fluid management......Page 26
Dosage recommendations......Page 28
The evidence base for neonatal regional anaesthesia......Page 29
References......Page 31
Apnoea of prematurity......Page 34
Pressure-controlled ventilation......Page 64
Physiology of control of breathing......Page 36
The change from foetus to neonate......Page 37
Physiological features......Page 38
Associated conditions causing apnoea......Page 39
Preoperative assessment and management......Page 40
Methylxanthines......Page 41
Carnitine......Page 42
Anaesthesia......Page 43
Practical management options......Page 45
References......Page 46
Use of pharmaceuticals `Off-Label\' in the neonate......Page 48
The ex-premie......Page 49
Anatomy......Page 50
Drugs and doses......Page 51
Methylxanthines......Page 52
Duration of action......Page 53
Changing surgical management of hernias and hydrocoeles......Page 54
Spinal anaesthesia for procedures other than herniorrhaphy......Page 55
Complications......Page 57
Conclusion......Page 58
References......Page 59
7......Page 63
Ultrasound for vascular access in the neonate......Page 112
Volume-targeted ventilation......Page 65
Implications for paediatric medicine......Page 147
Peripheral arterial access......Page 66
Extracorporal membrane oxygenation (ECMO)......Page 67
Application of ventilation modes in the operating theatre......Page 68
‘Open lung’ and ‘protective’ ventilation strategy in the operating theatre......Page 70
Medications route and dosage......Page 173
Conclusion......Page 71
References......Page 72
Body composition......Page 75
Plasma proteins......Page 76
Putative mechanisms of anaesthesia-induced neurotoxicity......Page 144
Consciousness......Page 183
Complications......Page 77
Cardiovascular effects of pulmonary hypertension......Page 88
Quantity of intra-operative fluids......Page 78
Glucose: necessary or harmful?......Page 79
Conclusion......Page 152
Volume replacement during infancy: indications and choice of crystalloids and colloids......Page 80
Conclusion......Page 81
References......Page 82
Pulmonary hypertension of the newborn......Page 85
The approval process......Page 159
Pathophysiology......Page 86
Medical management of PPHN......Page 89
Anaesthetic agents......Page 91
Anaesthetic management......Page 92
Conflict of interest statement......Page 93
Clinical presentation......Page 98
Clinical management of neonates with TOF/OA......Page 99
Thoracoscopic surgery......Page 101
Apnoeic intubation......Page 102
Environmental factors......Page 103
Ventilation......Page 104
Analgesic management......Page 105
Postoperative management......Page 106
Laryngeal mask airways......Page 107
Summary......Page 108
References......Page 109
Blood–brain barrier......Page 130
Suction......Page 170
Equipment......Page 114
Landmark approach......Page 115
Landmark approach......Page 116
Landmark approach......Page 117
Technique......Page 118
Immediate or late......Page 119
Complications of access to IVC......Page 120
Maintenance of the catheter......Page 121
Umbilical access......Page 122
Complications of umbilical access......Page 123
End tidal CO2 monitoring (capnography)......Page 172
Supplementary data......Page 124
The pharmacology of anaesthetics in the neonate......Page 128
Body composition......Page 129
Hepatic metabolic clearance......Page 131
Extrahepatic routes of metabolic clearance......Page 133
Renal elimination......Page 134
Neonatal PD differences......Page 135
Consciousness and memory formation in neonates......Page 184
Pharmacodynamic measures......Page 136
References......Page 138
The impact of the perioperative period on neurocognitive development, with a focus on pharmacological concerns......Page 141
Historical perspective......Page 142
GABAA agonists......Page 143
Interspecies comparison......Page 145
Pain and stress......Page 148
Hypoxia and hypoxia–ischaemia......Page 149
Recent human epidemiological studies......Page 150
References......Page 153
14......Page 158
Neonatal-specific approvals and ‘off-label’ uses......Page 161
Non-anaesthetic medications......Page 162
Recently approved agents with potential for use in newborns......Page 163
Off-label route of administration......Page 164
Conclusion......Page 165
References......Page 166
Neonatal resuscitation......Page 168
Oxygen......Page 169
Cuffed endotracheal tubes......Page 171
Post-resuscitation care......Page 174
Induced hypothermia......Page 175
Conclusion......Page 176
Conflict of interest statement......Page 177
Evidence for the need for anaesthesia in the neonate......Page 182
Do neonates experience pain?......Page 185
The stress response and clinical outcome in neonates......Page 186
The risks of anaesthesia in neonates......Page 187
Conclusions......Page 188
References......Page 189