{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T05:10:24Z","timestamp":1779426624633,"version":"3.53.1"},"reference-count":19,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951125109487_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Single ventricle patients undergoing bidirectional Glenn palliation subjectively experience increased post-operative agitation and discomfort. This is presumed to be secondary to increased intracranial pressure due to physiologic changes. This state of discomfort has been dubbed the \u201cGlenn headache.\u201d The purpose of this study was to determine whether sedation and analgesia requirements were higher in post-operative bidirectional Glenn patients than those of similar age who undergo tetralogy of Fallot or ventricular septal defect repairs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125109487_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective chart review was performed. Medication use, demographic, and haemodynamic data were collected. Comparisons between all groups were performed using the chi-squared test, Fisher\u2019s exact test, Kruskal\u2013Wallis test, and Dunn test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125109487_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 96 patients met inclusion criteria. Thirty-nine patients (40.3%) underwent bidirectional Glenn, 36 patients (37.5%) tetralogy of Fallot repair, and 21 patients (21.9%) ventricular septal defect closure. When comparing as needed (PRN) morphine, lorazepam, and oxycodone boluses between the three groups, patients who underwent bidirectional Glenn received significantly more doses in comparison with the other two groups (all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). The total dose of morphine (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001) and dexmedetomidine infusions (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) were also higher in the bidirectional Glenn group than in ventricular septal defect patients, but equivalent to tetralogy of Fallot patients. There was no significant difference in post-operative intubation status or total hours of mechanical ventilation when comparing bidirectional Glenn patients to those who underwent both tetralogy of Fallot and ventricular septal defect repairs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125109487_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Study demonstrates that patients who undergo bidirectional Glenn have higher analgesic and sedation requirements than similar aged patients who undergo tetralogy of Fallot or ventricular septal defect repairs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951125109487","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T08:03:36Z","timestamp":1758269016000},"page":"2011-2015","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Increased utilisation of analgesia and sedation in patients following bidirectional Glenn: evidence for the \u201cGlenn Headache\u201d?"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3356-2619","authenticated-orcid":false,"given":"Laura","family":"Hermann","sequence":"first","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3962-5115","authenticated-orcid":false,"given":"Matthew","family":"Coghill","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6554-8881","authenticated-orcid":false,"given":"Lindsey","family":"Justice","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Cooper","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan Thomas","family":"Homanick","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Diller","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria H. Santos","family":"de Oliveria","sequence":"additional","affiliation":[{"name":"State University of Maring\u00e1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Henry","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7417-727X","authenticated-orcid":false,"given":"David","family":"Lehenbauer","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Ryan","family":"Florez","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"S1047951125109487_ref12","first-page":"584","article-title":"Assessment of phenobarbital administration to reduce opioid and benzodiazepine use in the immediate postoperative period following Stage 2 single-ventricle palliation","volume":"26","author":"Tripathi","year":"2021","journal-title":"J Pediatr Pharmacol Ther"},{"key":"S1047951125109487_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951120004394"},{"key":"S1047951125109487_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-018-3973-9"},{"key":"S1047951125109487_ref8","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2014.06.001"},{"key":"S1047951125109487_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.06.061"},{"key":"S1047951125109487_ref2","first-page":"742","volume-title":"Critical Heart Disease in Infants and Children","author":"Ungerleider","year":"2019"},{"key":"S1047951125109487_ref16","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001870"},{"key":"S1047951125109487_ref18","unstructured":"18. Seligson, MT , Surowiec, SM. Superior Vena Cava Syndrome. Stat Pearls. 2022. Accessed September 29, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441981\/?report=printable."},{"key":"S1047951125109487_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(03)00582-8"},{"key":"S1047951125109487_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02527-4"},{"key":"S1047951125109487_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002016"},{"key":"S1047951125109487_ref9","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2018.31"},{"key":"S1047951125109487_ref13","doi-asserted-by":"publisher","DOI":"10.32604\/CHD.2021.015257"},{"key":"S1047951125109487_ref14","unstructured":"14. Children\u2019s Wisconsin. Herma Heart Institute. Heart Conditions. Hypoplastic left heart syndrome. What is Glenn procedure ? Glenn procedure | Glenn surgery & outcomes | Children\u2019s Wisconsin (https:\/\/childrenswi.org\/medical-care\/herma-heart\/conditions\/hypoplastic-heart-syndrome\/glenn-procedure). Accessed June 15, 2025."},{"key":"S1047951125109487_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.08.038"},{"key":"S1047951125109487_ref1","first-page":"272","volume-title":"Pediatric Cardiology for Practitioners","author":"Park","year":"2008"},{"key":"S1047951125109487_ref15","doi-asserted-by":"crossref","first-page":"168","DOI":"10.7326\/0003-4819-148-2-200801150-00020","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"148","author":"von Elm","year":"2008","journal-title":"Ann Intern Med"},{"key":"S1047951125109487_ref4","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2018.31"},{"key":"S1047951125109487_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000162665.08685.E2"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951125109487","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:59:11Z","timestamp":1779425951000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951125109487\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,19]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["S1047951125109487"],"URL":"https:\/\/doi.org\/10.1017\/s1047951125109487","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,19]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}