WorldWideScience

Sample records for anaesthetics

  1. Scoliosis and anaesthetic considerations

    OpenAIRE

    Kulkarni, Anand H; M Ambareesha

    2007-01-01

    Scoliosis may be of varied etiology and tends to cause a restrictive ventilatory defect, along with ventilation-perfusion mismatch and hypoxemia. There is also cardiovascular involvement in the form of raised right heart pressures, mitral valve prolapse or congenital heart disease. Thus a careful pre-anaesthetic evaluation and optimization should be done. Intraoperatively temperature and fluid balance, positioning, spinal cord integrity testing and blood conservation techniques are to be kept...

  2. How do general anaesthetics work?

    Science.gov (United States)

    Antkowiak, Bernd

    2001-05-01

    Almost a century ago, Meyer and Overton discovered a linear relationship between the potency of anaesthetic agents to induce general anaesthesia and their ability to accumulate in olive oil. Similar correlations between anaesthetic potency and lipid solubility were later reported from investigations on various experimental model systems. However, exceptions to the Meyer-Overton correlation exist in all these systems, indicating that lipid solubility is an important, but not the sole determinant of anaesthetic action. In the mammalian central nervous system, most general anaesthetics act at multiple molecular sites. It seems likely that not all of these effects are involved in anaesthesia. GABAA- and NMDA-receptor/ion channels have already been identified as relevant targets. However, further mechanisms, such as a blockade of Na+ channels and an activation of K+ channels, also come into play. A comparison of different anaesthetics seems to show that each compound has its own spectrum of molecular actions and thus shows specific, fingerprint-like effects on different levels of neuronal activity. This may explain why there is no known compound that specifically antagonises general anaesthesia. General anaesthesia is a multidimensional phenomenon. Unconsciousness, amnesia, analgesia, loss of sensory processing and the depression of spinal motor reflexes are important components. It was not realised until very recently that different molecular mechanisms might underlie these different components. These findings challenge traditional views, such as the assumption that one anaesthetic can be freely replaced by another.

  3. Inhalation anaesthetics and climate change

    DEFF Research Database (Denmark)

    Andersen, Mads Peter Sulbæk; Sander, S P; Nielsen, O J;

    2010-01-01

    Although the increasing abundance of CO(2) in our atmosphere is the main driver of the observed climate change, it is the cumulative effect of all forcing agents that dictate the direction and magnitude of the change, and many smaller contributors are also at play. Isoflurane, desflurane, and...... sevoflurane are widely used inhalation anaesthetics. Emissions of these compounds contribute to radiative forcing of climate change. To quantitatively assess the impact of the anaesthetics on the forcing of climate, detailed information on their properties of heat (infrared, IR) absorption and atmospheric...

  4. Rural anaesthetic audit 2006 to 2010.

    Science.gov (United States)

    Mills, P D; Newbury, J

    2012-03-01

    In order to review anaesthetic morbidity in our remote rural hospital, a retrospective audit of all anaesthetic records was undertaken for a five-year period between 2006 and 2010. Eight hundred and eighty-nine anaesthetic records were reviewed. The patients were all American Society of Anaesthesiologists physical status I to III. Ninety-eight percent of the anaesthetics were performed by general practitioner (non-specialist) anaesthetists. There were no anaesthetic deaths or serious adverse outcomes reported over this period. Sixteen intraoperative and seven postoperative problems were documented, but all were resolved uneventfully. The most common problems documented were difficult intubation (n=9) and respiratory depression (n=3). Within the limitations of this retrospective audit, these findings indicate that general practitioner anaesthetists provided safe anaesthesia in a remote rural hospital. It is our opinion that the case selection, prior experience of anaesthetic and theatre staff, stable nursing workforce and the use of protocols were important factors in determining the low rate of adverse events. However, we caution against over-interpretation of the data, given its retrospective nature, relatively small sample size, reliance on case records and the absence of agreed definitions for adverse events. We would also like to encourage all anaesthetic services, however remote, to audit their results as part of ongoing quality assurance. PMID:22417029

  5. Anaemia and pregnancy: Anaesthetic implications

    Directory of Open Access Journals (Sweden)

    Anju Grewal

    2010-01-01

    Full Text Available Anaemia in pregnancy defined as haemoglobin (Hb level of < 10 gm/dL, is a qualitative or quantitative deficiency of Hb or red blood cells in circulation resulting in reduced oxygen (O 2 -carrying capacity of the blood. Compensatory mechanisms in the form of increase in cardiac output (CO, PaO 2 , 2,3 diphosphoglycerate levels, rightward shift in the oxygen dissociation curve (ODC, decrease in blood viscosity and release of renal erythropoietin, get activated to variable degrees to maintain tissue oxygenation and offset the decreases in arterial O 2 content. Parturients with concomitant medical diseases or those with acute ongoing blood losses may get decompensated, leading to serious consequences like right heart failure, angina or tissue hypoxemia in severe anaemia. Preoperative evaluation is aimed at assessing the severity and cause of anaemia. The concept of an acceptable Hb level varies with the underlying medical condition, extent of physiological compensation, the threat of bleeding and ongoing blood losses. The main anaesthetic considerations are to minimize factors interfering with O 2 delivery, prevent any increase in oxygen consumption and to optimize the partial pressure of O 2 in the arterial blood. Both general anaesthesia and regional anaesthesia can be employed judiciously. Monitoring should focus mainly on the adequacy of perfusion and oxygenation of vital organs. Hypoxia, hyperventilation, hypothermia, acidosis and other conditions that shift the ODC to left should be avoided. Any decrease in CO should be averted and aggressively treated.

  6. Anaesthetic Management of Conjoined Twins′ Separation Surgery

    Directory of Open Access Journals (Sweden)

    Kolli S Chalam

    2009-01-01

    Full Text Available Anaesthesia for conjoined twins, either for separation surgery, or for MRI or other evaluation procedures is an enormous challenge to the paediatric anaesthesiologist. This is an extra challenging surgery because we the anaesthesiologists need to care for two patients at the same time instead of just one. Anaesthesia for conjoined twins ′separation surgery mainly centered on the following concerns: 1.Conjoined Twins′ physiology like crossed circulation. distribution of blood volume and organ sharing with their anaesthetic implications. 2.Long marathon surgery with massive fluid shifts and loss of blood & blood components and their rapid replenishment. 3.Meticulous planning for organized management of long hours of anaesthetic administration in two paediatric subjects simultaneously with multi surgical specialties involvement and their unique requirements.We report the anaesthetic and intensive care management of one pair of Pygopagus separation surgery and also the review of literature and world statistics.

  7. Local anaesthetics and chondrotoxicty: What is the evidence?

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2012-11-01

    Recent reports have suggested that local anaesthetic agents have a toxic effect on articular chondrocytes. This is despite the widespread intra-articular use of local anaesthetic agents following arthroscopic procedures for a number of years.

  8. Periodic Classification of Local Anaesthetics (Procaine Analogues

    Directory of Open Access Journals (Sweden)

    Gloria Castellano

    2006-01-01

    Full Text Available Algorithms for classification are proposed based on criteria (information entropyand its production. The feasibility of replacing a given anaesthetic by similar ones in thecomposition of a complex drug is studied. Some local anaesthetics currently in use areclassified using characteristic chemical properties of different portions of their molecules.Many classification algorithms are based on information entropy. When applying theseprocedures to sets of moderate size, an excessive number of results appear compatible withdata, and this number suffers a combinatorial explosion. However, after the equipartitionconjecture, one has a selection criterion between different variants resulting fromclassification between hierarchical trees. According to this conjecture, for a given charge orduty, the best configuration of a flowsheet is the one in which the entropy production is mostuniformly distributed. Information entropy and principal component analyses agree. Theperiodic law of anaesthetics has not the rank of the laws of physics: (1 the properties ofanaesthetics are not repeated; (2 the order relationships are repeated with exceptions. Theproposed statement is: The relationships that any anaesthetic p has with its neighbour p 1are approximately repeated for each period.

  9. Anaesthetic management of a morbidly obese patient.

    Directory of Open Access Journals (Sweden)

    Tuteja L

    1996-10-01

    Full Text Available Morbid Obesity (MO is associated with various pathophysiological changes which affect the outcome of anaesthesia and surgery. We report here anaesthetic management of a fit morbidly obese patient for transcervical resection of endometrium (TCRE under spinal subarachnoid block. The preoperative preparation, intraoperative and postoperative management is described and the various problems in morbidly obese patients are discussed.

  10. Release of opioid peptides in anaesthetized cats?

    OpenAIRE

    Dashwood, M. R.; Feldberg, W.

    1980-01-01

    1 The effect on arterial blood pressure of intravenous injections of naloxone (200 μg) was examined in cats anaesthetized with chloralose. Usually these injections have no effect on blood pressure unless morphine or opioid peptides have been injected, when they produce a pressor response with tachycardia.

  11. Anaesthetic Considerations in Paediatric Myasthenia Gravis

    OpenAIRE

    Oliver William Masters; Oliver N. Bagshaw

    2011-01-01

    Myasthenia gravis is of particular interest to anaesthetists because of the muscle groups affected, the pharmacology of the neuromuscular junction, and interaction of both the disease and treatment with many anaesthetic drugs. Anaesthetists may encounter children with myasthenia either to facilitate treatment options or to institute mechanical ventilation in the face of a crisis. This paper reviews the literature pertaining to the pathophysiology and applied pharmacology of the disease and ex...

  12. Tachyphylaxis to local anaesthetics. What is the clinical evidence?

    DEFF Research Database (Denmark)

    Kongsgaard, U E; Werner, M U

    2016-01-01

    : We performed a systematic review of the literature utilising the databases PubMed and Embase employing the search terms [Tachyphylaxis AND Local Anaesthetics AND Human] AND [Tolerance AND Local Anaesthetics AND Human]. RESULTS: A total of 66 records were identified. Thirty-four articles were assessed...

  13. Codifications of anaesthetic information for computer processing.

    Science.gov (United States)

    Harrison, M J; Johnson, F

    1981-07-01

    In order for any decision-making process to be computer-assisted it is necessary for the information to be encodable in some way so that the computer can manipulate the data using logical operations. In this paper the information used to generate an anaesthetic regiment is examined. A method is presented for obtaining a suitable set of statements to describe the patient's history and surgical requirements. These statements are then sorted by an algorithm which uses standard Boolean operators to produce a protocol for six phases of anaesthetic procedure. An example is given of the system in operation. The system incorporate knowledge at the level of a consultant anaesthetist. The program used 428 statements to encode patient data, and drew upon a list of 163 possible prescriptions. The program ran on an LSI-11/2 computer using one disc drive. The scheme has direct application in training of junior anaesthetist, as well as producing guidelines to application in other areas of medicine where the possibility of a similar codification may exist. PMID:7306370

  14. Influence of pre-anaesthetic thoracic radiographs on ASA physical status classification and anaesthetic protocols in traumatized dogs and cats

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate if pre-anaesthetic thoracic radiographs contribute to the anaesthetic management of trauma patients by comparing American Society of Anesthesiologists Physical Status Classification (ASA grade) with and without information from thoracic radiography findings. Case records of 157 dogs and cats being anaesthetized with or without post-traumatic, pre-anaesthetic chest radiographs were retrospectively evaluated for clinical parameters, radiographic abnormalities and anaesthetic protocol. Animals were retrospectively assigned an ASA grade. ASA grades, clinical signs of respiratory abnormalities and anaesthesia protocols were compared between animals with and without chest radiographs. The group of animals without pre-anaesthetic radiographs was anaesthetized earlier after trauma and showed less respiratory abnormalities at presentation. The retrospectively evaluated ASA grade significantly increased with the information from thoracic radiography. Animals with a higher ASA grade were less frequently mechanically ventilated. Pre-anaesthetic radiographs may provide important information to assess the ASA grade in traumatized patients and may therefore influence the anesthesia protocol

  15. NAPROS: a semiautomatic user-friendly anaesthetic record system.

    Science.gov (United States)

    Osswald, P M; Winter, D; Hartung, H J; Gasteiger, P

    1987-01-01

    NAPROS is a semiautomatic, inexpensive, and easy-to-use anaesthetic record system. It is based on an ACORN (BBC-Model B) microcomputer that is linked to a non-invasive arterial pressure monitor (DIN-AMAP 845a) and an inhalation anaesthetic monitor (Engstroem EMMA) for automatic collection of measured data. The following functions have been implemented: Automatic registration of cardiovascular data and concentration of anaesthetic inhalation agents. Graphical or numerical representation of fluid-balances. Possibility to recall dosage information for drugs and drops. Printing of a final anaesthetic report at the end of anaesthesia. Definite advantages of NAPROS are: The number of hours saved by the computer record over manual data entry is 8 hours. - Better acceptance by users. PMID:3681106

  16. Effect of Fentanyl Addition to Local Anaesthetic in Peribulbar Block

    OpenAIRE

    Mostafa Abdel Hamid Abo El Enin; Ismail Ewis Amin; Ahmed Sayed Abd El Aziz; Mostafa Mohamed Mahdy; Mohamed Abdel Hamid Abo El Enin; Mostafa Mahmoud Mostafa

    2009-01-01

    Summary Forty patients ASA I, II undergoing vitrectomy due to vitreous hemorrhage not associated with retinal detachment were divided into two groups randomly, each of them with 20 patients. In Control group patients received local anaesthetic only, while Fentanyl group receive 20 mcg fentanyl added to local anaesthetic, the onset and duration of lid and globe akinesia were assessed at 1,3,5 and 10 min. Postoperative VAS was recorded each hour up to 6th hour. The results show statistically si...

  17. Cleaning and sterilisation of anaesthetic equipment

    Directory of Open Access Journals (Sweden)

    Chitra Sanjeev Juwarkar

    2013-01-01

    Full Text Available The main purpose of this review article is to bring up what has been known (practiced about decontamination, disinfection, and sterilisation of anaesthetic equipment. It also discusses how this evidence-based information on infection prevention and control impacts care of patient in routine anaesthesia practice. This review underscores the role played by us, anaesthetists in formulating guidelines, implementing the same, monitoring the outcome and training post-graduate trainees and coworkers in this regard. The article re-emphasises that certain guidelines when followed strictly will go a long way in reducing transmission of hospital acquired infection between patient and anaesthetist or between patients. Anaesthetists do not restrict their work to operating room but are involved in disaster management, interventional radiological procedures and in trauma care. They should ensure that the patients are cared for in clean and safe environment so as to reduce healthcare associated infections (HCAIs simultaneously taking preventive measures against the various health hazards associated with clinical practice. They should ensure that the coworkers too adopt all the preventive measures while delivering their duties. For this review, we conducted literature searches in Medline (PubMed and also searched for relevant abstracts and full texts of related articles that we came across. There is much to be learned from the western world where, health care organisations now have legal responsibility to implement changes in accordance with the newer technology to reduce health care associated infection. There is a need to develop evidence-based infection prevention and control programs and set national guidelines for disinfection and sterilisation of anaesthesia equipment which all the institutions should comply with.

  18. The Lack, Magill and Bain anaesthetic breathing systems: a direct comparison in spontaneously-breathing anaesthetized adults.

    OpenAIRE

    Humphrey, D.

    1982-01-01

    The performances of the Lack (Mapleson A), Magill (Mapleson A) and Bain (Mapleson D) anaesthetic breathing systems were compared in each of 20 anaesthetized adult patients breathing spontaneously with fresh gas flows of 70 ml kg-1 min-1. In every patient the Lack system caused the least rebreathing, as seen by the lowest inspired and end-expired CO2 tensions using capnography. The Magill caused more rebreathing than the Lack though less than the Bain. Comparative fresh gas flows for each syst...

  19. Evaluation of the Draeger Anaesthetic Equipment Washing Machine (ANDA 9002).

    Science.gov (United States)

    Miles, R S; Wolfe, R; Malcolm-Smith, N; Bowick, G

    1989-05-01

    An evaluation was made of an anaesthetic equipment washing machine. Our results largely substantiated the manufacturers claims. A clean, dry, disinfected load could be produced within 75 min. After minor modifications were made to the machine by the manufacturers, potential users were satisfied with its performance. We recommend consideration of this type of equipment for use in hospitals. PMID:2567771

  20. Iatrogenic greenhouse gases: the role of anaesthetic agents.

    Science.gov (United States)

    Uzoigwe, Chika E; Sanchez Franco, Luis C; Forrest, Michael D

    2016-01-01

    The contribution of health-care activity to climate change is not negligible and is increasing. Anaesthetic greenhouse gases, in particular the fluranes, have a much more potent global warming capacity, volume for volume, than carbon dioxide, but their emissions remain completely unregulated. PMID:26903451

  1. Anaesthetic management of bilateral alveolar proteinosis for bronchopulmonary lavage.

    OpenAIRE

    Dixit R; Chaudhari L; Mahashur A

    1998-01-01

    The most hazardous manifestation of pulmonary alveolar proteinosis is progressive hypoxia for which bronchopulmonary lavage (BPL) is the single most effective treatment. Unfortunately this procedure under general anesthesia itself increases the risk of hypoxia due to the need for one lung ventilation. It was therefore considered interesting to report the successful anaesthetic management of a patient with pulmonary alveolar proteinosis for Bronchopulmonary lavage.

  2. Osler-Weber-Rendu syndrome: an anaesthetic challenge?

    Science.gov (United States)

    Chieira, Diana; Conceição, Luis; Semedo, Edgar; Almeida, Valentina

    2016-01-01

    Osler-Weber-Rendu syndrome, or hereditary haemorrhagic telangiectasia (HHT), is an autosomal dominant vascular dysplasia characterised by mucocutaneous telangiectases and arteriovenous malformations (AVMs). Diagnosis is clinical and treatment is supportive. The authors demonstrate a safe anaesthetic approach for a patient with HHT. A 53-year-old woman with a left trochanteric fracture was scheduled for urgent orthopaedic surgery. She was diagnosed as having HHT and presented with recurrent epistaxis, telangiectases and gastrointestinal AVMs. She had undergone a nasal dermoseptoplasty 4 weeks earlier, with total nasal occlusion. Surgery was undertaken with a lumbar and sacral plexus block performed with neurostimulation. She was sedated and spontaneous ventilation was maintained. The procedure was completed without complications. Anaesthetic management of patients with HHT is a challenge. The patients should be carefully studied before surgery, to reduce perioperative morbidity and mortality. Regional anaesthesia may be a good alternative to general anaesthesia, but the use of neuroaxial techniques is still controversial. PMID:27126092

  3. Chronic fluorosis: The disease and its anaesthetic implications

    Directory of Open Access Journals (Sweden)

    Madhuri S Kurdi

    2016-01-01

    Full Text Available Chronic fluorosis is a widespread disease-related to the ingestion of high levels of fluoride through water and food. Prolonged ingestion of fluoride adversely affects the teeth, bones and other organs and alters their anatomy and physiology. Fluoride excess is a risk factor in cardiovascular disease and other major diseases, including hypothyroidism, diabetes and obesity. Although anaesthesiologists may be aware of its skeletal and dental manifestations, other systemic manifestations, some of which may impact anaesthetic management are relatively unknown. Keeping this in mind, the topic of chronic fluorosis was hand searched from textbooks, scientific journals and electronically through Google, PubMed and other scientific databases. This article concentrates on the effect of chronic fluorosis on various organ systems, its clinical features, diagnosis and the anaesthetic implications of the disease.

  4. Chronic fluorosis: The disease and its anaesthetic implications.

    Science.gov (United States)

    Kurdi, Madhuri S

    2016-03-01

    Chronic fluorosis is a widespread disease-related to the ingestion of high levels of fluoride through water and food. Prolonged ingestion of fluoride adversely affects the teeth, bones and other organs and alters their anatomy and physiology. Fluoride excess is a risk factor in cardiovascular disease and other major diseases, including hypothyroidism, diabetes and obesity. Although anaesthesiologists may be aware of its skeletal and dental manifestations, other systemic manifestations, some of which may impact anaesthetic management are relatively unknown. Keeping this in mind, the topic of chronic fluorosis was hand searched from textbooks, scientific journals and electronically through Google, PubMed and other scientific databases. This article concentrates on the effect of chronic fluorosis on various organ systems, its clinical features, diagnosis and the anaesthetic implications of the disease. PMID:27053777

  5. Anaesthetic management of bilateral alveolar proteinosis for bronchopulmonary lavage.

    Directory of Open Access Journals (Sweden)

    Dixit R

    1998-01-01

    Full Text Available The most hazardous manifestation of pulmonary alveolar proteinosis is progressive hypoxia for which bronchopulmonary lavage (BPL is the single most effective treatment. Unfortunately this procedure under general anesthesia itself increases the risk of hypoxia due to the need for one lung ventilation. It was therefore considered interesting to report the successful anaesthetic management of a patient with pulmonary alveolar proteinosis for Bronchopulmonary lavage.

  6. Anaesthetic management of neonate with giant occipital meningoencephalocele: Case report

    OpenAIRE

    H.D. Pahuja; S.R. Deshmukh; S.A. Lande; S.R. Palsodkar; A.R. Bhure

    2015-01-01

    Meningoencephalocele is herniation of cerebrospinal fluid, brain tissue and meninges through the skull defect. The anaesthetic management of occipital meningoencephalocele is challenging because of the difficulty in securing airway, prone position, blood loss and, perioperative care. The two major aims of the anaesthesiologists while caring for children with occipital encephalocoele intraoperatively are to avoid premature rupture of the encephalocoele and to manage a possible difficult airway...

  7. Positive inotropic effects of histamine in anaesthetized dogs.

    OpenAIRE

    Einstein, R.; Mihailidou, A. S.; Richardson, D. P.

    1987-01-01

    1 The cardiovascular effects of histamine were examined in dogs anaesthetized with pentobarbitone 2 The effect of histamine on heart rate, blood pressure, left ventricular pressure, dP/dtmax and dP/dt: IIT (integrated isometric tension) was compared in the presence and absence of autonomic reflexes and blood pressure control. 3 In innervated animals with no attempt to control blood pressure, histamine produced dose-dependent decreases in blood pressure and heart rate and either positive or ne...

  8. Interaction of inhalational anaesthetics with CO2 absorbents.

    Science.gov (United States)

    Baum, Jan A; Woehlck, Harvey J

    2003-03-01

    We review the currently available carbon dioxide absorbents: sodium hydroxide lime (=soda lime), barium hydroxide lime, potassium-hydroxide-free soda lime, calcium hydroxide lime and non-caustic lime. In general, all of these carbon dioxide absorbents are liable to react with inhalational anaesthetics. However, there is a decreasing reactivity of the different absorbents with inhalational anaesthetics: barium hydroxide lime > soda lime > potassium-hydroxide-free soda lime > calcium hydroxide lime and non-caustic lime. Gaseous compounds generated by the reaction of the anaesthetics with desiccated absorbents are those that threaten patients. All measures are comprehensively described to--as far as possible--prevent any accidental drying out of the absorbent. Whether or not compound A, a gaseous compound formed by the reaction of sevoflurane with normally hydrated absorbents, is still a matter of concern is discussed. Even after very high loading with this compound, during long-lasting low-flow sevoflurane anaesthesias, no clinical or laboratory signs of renal impairment were observed in any of the surgical patients. Finally, guidelines for the judicious use of different absorbents are given. PMID:12751549

  9. Role of anaesthetic equipment in transmitting nosocomial infection.

    Science.gov (United States)

    Richard, V S; Mathai, E; Cherian, T

    2001-04-01

    There is a potential risk of bacterial and viral infection being transmitted through anaesthesia circuits. Several studies have shown contamination of parts of anaesthetic equipment with bacteria that colonise the mouth and upper airway. A definite relationship between such contaminated anaesthetic equipment and subsequent lung infection remains to be established. Various factors contribute to the transmission and pathogenesis. Among the recommendations for preventing transmission of infection through anaesthetic circuits are using a bacterial/viral filter for every patient or using disposable circuits. Owing to financial constraints, all these recommendations may not be practical in India. Possible guidelines for India may include discarding endotracheal tubes after single use and rigorous cleaning and disinfection of masks and laryngoscopes. Corrugated tubings used in the expiratory limb of the circuit may be washed with soap and water after each patient and dried before use. It is advisable to disinfect all such tubings in 2% glutaraldehyde, and then to wash in water and to dry before use at least once a day or when they are visibly contaminated. PMID:11762619

  10. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis?

    LENUS (Irish Health Repository)

    Heaney, A

    2012-12-01

    Summary Cancer is a leading cause of morbidity and mortality worldwide and the ratio of incidence is increasing. Mortality usually results from recurrence or metastases. Surgical removal of the primary tumour is the mainstay of treatment, but this is associated with inadvertent dispersal of neoplastic cells into the blood and lymphatic systems. The fate of the dispersed cells depends on the balance of perioperative factors promoting tumour survival and growth (including surgery per se, many anaesthetics per se, acute postoperative pain, and opioid analgesics) together with the perioperative immune status of the patient. Available evidence from experimental cell culture and live animal data on these factors are summarized, together with clinical evidence from retrospective studies. Taken together, current data are sufficient only to generate a hypothesis that an anaesthetic technique during primary cancer surgery could affect recurrence or metastases, but a causal link can only be proved by prospective, randomized, clinical trials. Many are ongoing, but definitive results might not emerge for a further 5 yr or longer. Meanwhile, there is no hard evidence to support altering anaesthetic technique in cancer patients, pending the outcome of the ongoing clinical trials.

  11. Local anaesthetic activity of the essential oil of Lavandula angustifolia.

    Science.gov (United States)

    Ghelardini, C; Galeotti, N; Salvatore, G; Mazzanti, G

    1999-12-01

    In this work we studied the local anaesthetic activity of the essential oil obtained from Lavandula angustifolia Mill., a medicinal plant traditionally used as an antispasmodic. We compared its activity to the essential oils obtained from two citrus fruits, Citrus reticulata Blanco and Citrus limon (L.) Burm. f., which have no medical uses. Biological tests were also performed on the major pure components of L. angustifolia Mill. essential oil: linalol and linalyl acetate as determined by GC and confirmed by GC-MS. Anaesthetic activity was evaluated in vivo in the rabbit conjunctival reflex test, and in vitro in a rat phrenic nerve-hemidiaphragm preparation. The essential oil of L. angustifolia, linalyl acetate and linanol (0.01-10 micrograms/ml) but not the oils of Citrus reticulata and Citrus limon were able to drastically reduce, in a dose-dependent manner, the electrically evoked contractions of rat phrenic-hemidiaphragm. In the rabbit conjunctival reflex test treatment with a solution of essential oil of L. angustifolia, as well as linalyl acetate and linalol (30-2500 micrograms/ml administered in the conjunctival sac) allow a dose-dependent increase in the number of stimuli necessary to provoke the reflex, thus confirming in vivo the local anaesthetic activity observed in vitro. PMID:10630108

  12. Comparative efficacy of four anaesthetic agents in the yellow seahorse, Hippocampus kuda (Bleeker, 1852)

    Digital Repository Service at National Institute of Oceanography (India)

    Pawar, H.B.; Sanaye, S.V.; Sreepada, R.A.; Harish, V.; Suryavanshi, U.; Tanu; Ansari, Z.A.

    and Bull, 2005; Castro et al., 2008; Mattle and Wilson, 2009; Otero-Ferrer et al., 2010), however practical details on their efficacy were seldom outlined. Before recommending the use of a particular anaesthetic, a range of induction and recovery times...) and clove oil (Sigma Aldrich Co. USA) were used. Doses of the anaesthetic agents were prepared a few minutes prior to anaesthetic induction experiments. Since clove oil does not readily dissolve in water (Woody et al., 2002), it was initially diluted...

  13. Anaesthetic management of a child with massive extracranial arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Faisal Shamim

    2012-01-01

    Full Text Available Vascular tumors affect the head and neck commonly but arteriovenous malformations are rare. Vascular malformations are often present at birth and grow with the patient, usually only becoming significant later in childhood. Embolization has been the mainstay of treatment in massive and complex arteriovenous malformations. We present a case of massive extracranial arteriovenous malformation in a 7-year-old boy causing significant workload on right heart and respiratory distress. The management of angioembolization under general anaesthesia and anaesthetic concerns are presented.

  14. IgE-mediated reaction to local anaesthetics

    International Nuclear Information System (INIS)

    Local anaesthetics (LAs) are essential agents in daily practices of dentistry, minor surgery and dermatology. Although they have an impressive history of safety and efficacy, LAs also have the potential to produce adverse events, which are mainly of non-immune nature. The true IgE-mediated allergies are quite rare, but are more considerable in terms of ability to cause life-threatening outcomes. In this report, we present a case of IgE-mediated systemic reaction to LAs occurring during epidural anaesthesia for Cesarean section. (author)

  15. Anaesthetic management and implications of a case of chronic inflammatory demyelinating polyneuropathy

    OpenAIRE

    Babita Gupta; Pramendra Agrawal; Nita D′souza; Chhavi Sawhney

    2011-01-01

    A 60-year-old man with chronic inflammatory demyelinating polyneuropathy (CIDP) was posted for surgery of the neck femur fracture and was successfully managed. We discuss the anaesthetic considerations during regional and general anaesthesia of this patient with CIDP. A brief review of the available literature reveals no consensus on the choice of anaesthetic management.

  16. Anaesthetic management and implications of a case of chronic inflammatory demyelinating polyneuropathy

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2011-01-01

    Full Text Available A 60-year-old man with chronic inflammatory demyelinating polyneuropathy (CIDP was posted for surgery of the neck femur fracture and was successfully managed. We discuss the anaesthetic considerations during regional and general anaesthesia of this patient with CIDP. A brief review of the available literature reveals no consensus on the choice of anaesthetic management.

  17. A possible mechanism for pressure reversal of general anaesthetics from molecular simulations

    Science.gov (United States)

    Chau, P.-L.; Hoang, Paul N. M.; Picaud, Sylvain; Jedlovszky, Pál

    2007-04-01

    The effect of general anaesthetics is pressure-dependent. We have simulated a fully hydrated dimyristoylphosphatidylcholine bilayer with halothane (a general anaesthetic) embedded, at pressures of 1, 200 and 400 atm, respectively. We find that at higher pressures, halothane molecules tend to cluster together. Based on these results, we propose a possible mechanisms for pressure reversal of anaesthesia.

  18. Anaesthetic management of a patient with familial normokalaemic periodic paralysis.

    LENUS (Irish Health Repository)

    Walsh, F

    2012-02-03

    PURPOSE: We describe the anaesthetic management of a patient with the autosomal dominant inherited disease, normokalaemic periodic paralysis. The disease results in intermittent bouts of limb and respiratory muscular weakness in association with hypothermia, stress, prolonged fasting or exercise. Unlike hypokalaemic and hyperkalaemic periodic paralysis, the more common variants of the disease, normokalaemic periodic paralysis is not accompanied by alterations in the plasma potassium concentration. CLINICAL FEATURES: A five-year-old boy presented for emergency scrotal exploration. He had a family history of periodic paralysis and had experienced previous episodes of weakness, two of which had required hospitalization for respiratory distress. On admission there was no evidence of weakness and serum potassium concentration was 4.2 mMol.L-1. A spinal anaesthetic was performed and the procedure was uncomplicated by muscle paralysis above the level of the spinal block. CONCLUSION: Avoidance of known precipitating factors and judicious use of neuromuscular blocking drugs has been advocated in patients with this disorder presenting for surgery. In appropriate circumstances, spinal anaesthesia represents a useful option in patients with normokalaemic periodic paralysis.

  19. 2D3 Pilotstudy: Accelerated learning in anaesthetic training

    DEFF Research Database (Denmark)

    Bisgaard, Claus Hedebo; Holdgaard, Hans Ole; Rubak, Sune Leisgaard Mørck; Charles, Peder

    2011-01-01

    6 and insertion of a epidural catheter from week 20 to 10. Following the simulation based course in airway management, general anaesthesia and spinal anaesthesia the residents seemed more confident with the procedures in clinical practice. It is still too early to get a clear impression about......Background: With the purpose to elucidate the possibility for accelerated learning, four residents, in their first year of anaesthetic training, followed a revised curriculum. Summary of work: The curriculum consisted of skills training for airway management, spinal anaesthesia and insertion of an...... one year curriculum. The skills training were assessed with OSATS and global rating scales for each procedure. Summary of results: As assessed with an OSCE the residents accelerated their competencies in airway management and general anaesthesia from week 10-12 to 4, spinal anaesthesia from week 10 to...

  20. Optimal volume of local anaesthetic for the adductor canal block

    DEFF Research Database (Denmark)

    Jæger, P.; Jenstrup, M. T.; Lund, J.;

    2015-01-01

    Background: Theoretically, the ideal volume of local anaesthetic for adductor canal block (ACB) would ensure sufficient filling ofthe canal and avoid proximal spread to the femoral triangle. In this dose-finding study, we aimed to investigate the minimaleffective volume for an ACB needed to fill...... the adductor canal distally in at least 95% of patients (ED95). Methods: We performed a blinded trial, enrolling 40 healthy men. All subjects received an ACB with lidocaine 1%. Volumes wereassigned sequentially to the subjects using the continual reassessment method followed by Bayesian analysis to...... baseline) and sensory block. Results: The ED95 was 20 ml, with an estimated probability of sufficiently filling the canal of 95.1% (95% credibility interval: 0.91–0.98). Proximal spread to the femoral triangle was seen in 0/4 (0%), 7/12 (58%), 4/8 (50%), and 8/16 (50%) subjects with the 5, 10, 15,and 20 ml...

  1. Anaesthetic Management of Caesarean Section in an Achondroplastic Dwarf

    Directory of Open Access Journals (Sweden)

    Kirti N Saxena

    2008-01-01

    A twenty year old parturient with short stature presented to the hospital in early labour. An elective lower segment caesarean section(LSCS was planned in view of cephalopelvic disproportion. She had papers which suggested that she had been diagnosed as a case of achondroplasia though details were not available. Combined spinal epidural(CSE anaesthesia was planned in the patient in view of the death of her first baby following caesarean section under general anaesthesia. Repeatedly dry taps were achieved on attempting dural puncture. Dural puncture was abandoned and an 18 G epidural catheter was threaded via the Tuohy needle. Sensory block till T 6 was achieved with 6ml of local anaesthetic solution. The patient was stable during the intraoperative and postoperative period.

  2. Interference of anaesthetics with radioligand binding in neuroreceptor studies

    Energy Technology Data Exchange (ETDEWEB)

    Elfving, Betina; Knudsen, Gitte Moos [Neurobiology Research Unit N9201, University hospital Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen (Denmark); Bjoernholm, Berith [Department of Computational Chemistry, H. Lundbeck A/S, Copenhagen-Valby (Denmark)

    2003-06-01

    Evaluations of new emission tomography ligands are usually carried out in animals. In order to keep the animals in a restricted position during the scan session, anaesthesia is almost inevitable. In ex vivo rat studies we investigated the interference of ketamine/xylazine, zoletile mixture, isoflurane and halothane with the serotonin re-uptake site, the serotonin{sub 2A} receptor and the dopamine re-uptake site by use of [{sup 3}H]-(S)-citalopram, [{sup 18}F]altanserin and [{sup 125}I]PE2I, respectively. Ketamine/xylazine decreased the target-to-background ratio (mean {+-} SD) of [{sup 3}H]-(S)-citalopram from 1.5{+-}0.19 to 0.81{+-}0.19 (P<0.05), whereas isoflurane and halothane increased the ratio from 1.5{+-}0.19 to 1.9{+-}0.24 and 2.1{+-}0.13 (P<0.05), respectively. Only with the zoletile mixture did the ratio remain unaltered. None of the tested anaesthetics affected the target-to-background ratio of [{sup 18}F]altanserin. The [{sup 125}I]PE2I target-to-background ratio decreased with both ketamine/xylazine (from 12.4{+-}0.81 to 10.1{+-}1.4, P<0.05) and isoflurane (from 12.4{+-}0.81 to 9.5{+-}1.1, P<0.05) treated rats, whereas treatment with zoletile mixture and halothane left the ratio unaltered. It is concluded that prior to performance of neuroreceptor radioligand studies, the possible interaction between radioligands and anaesthetics should be carefully evaluated. (orig.)

  3. Pain Levels after Local Anaesthetic with or without Hyaluronidase in Carpal Tunnel Release: A Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    G. Yeo

    2015-01-01

    Full Text Available Purpose. Hyaluronidase is an enzyme that temporarily liquefies the interstitial barrier, allowing easy dispersal of local anaesthetic through cleavage of tissue planes. This prospective, blinded, randomised controlled study investigates the utility of adding hyaluronidase to local anaesthetic in the setting of carpal tunnel release. Methods. 70 consecutive carpal tunnel release patients were recruited and randomised into a control group only receiving local anaesthetic and a hyaluronidase group receiving both hyaluronidase and local anaesthetic. Pain scores were rated using the visual analogue scale (VAS by patients immediately after local anaesthetic injection and again immediately after the carpal tunnel release. Results. Preoperative VAS scores, taken after local anaesthetic injection, were greater than postoperative VAS scores. Postoperative VAS scores were significantly lower in the hyaluronidase group and tourniquet times were significantly shorter in the hyaluronidase group. Conclusion. Hyaluronidase addition to local anaesthetic in carpal tunnel release resulted in significant reductions in operative time and pain immediately after operation.

  4. ANAESTHETIC MANAGEMENT OF A CASE OF HEREDITARY SPHEROCYTOSIS FOR SPLENECTOMY AND CHOLECYSTECTOMY.

    Directory of Open Access Journals (Sweden)

    Jyotsna

    2012-11-01

    Full Text Available ABSTRACT: We report successful anaesthetic management of a pat ient with hereditary spherocytosis who underwent laproscopic splenectomy, ch olecystectomy and appendioectomy. Hereditary spherocytosis is a familial hemolytic di sorder with marked heterogeneity of clinical features, ranging from asymptomatic condition to a f ulminant hemolytic anaemia. Commonly recommended perioperative management in these patien ts includes preemptive erythrocyte transfusion, aggressive hydration and avoidance of hypoxia, aplastic crisis, hypothermia and acidosis. The management of such a case is challeng ing from anaesthetic point of view because of sickling oriented anaesthetic approach. Key words: Hereditary spherocytosis, splenectomy, cholecystectomy, perioperative management.

  5. Anaesthetic training programmes in the UK: the role of the programme director.

    Science.gov (United States)

    Barker, I

    1998-02-01

    Schools of anaesthesia provide anaesthetic training in the UK. Each school has at least one programme director undertaking some or all of the management duties. Most programme directors appears to be unresourced volunteers whose roles have developed in response to local requirements. A postal questionnaire was sent to all anaesthetic training programme directors in the UK, asking about their role. Respondents had a wide variation in duties and responsibilities towards anaesthetic training schemes. Few had terms of reference, clear lines of responsibility, remuneration or resources to undertake the role. PMID:9797894

  6. Anaesthetic management of an adult patient with DOOR syndrome: a case report.

    Science.gov (United States)

    Michalek, Pavel; Donaldson, William; Abraham, Alexander

    2009-01-01

    We report the anaesthetic management of a 48-year-old male patient with Deafness, Onycho-Osteodystrophy and mental Retardation syndrome, epilepsy and cerebral palsy who had two dental procedures under anaesthetic care. For the first short examination sedoanalgesia was employed and the second, longer, procedure was performed under general anaesthesia. His airway management was moderately difficult and the postoperative period was complicated by partial seizures involving the upper extremity and a short period of decreased oxygen saturation. The potential anaesthetic implications of Deafness, Onycho-Osteodystrophy and mental Retardation syndrome are highlighted. PMID:19830001

  7. Antibacterial and immunity enhancement properties of anaesthetic doses of thyme (Thymus vulgaris oil and three other anaesthetics in Sparidentax hasta and Acanthopagrus latus

    Directory of Open Access Journals (Sweden)

    I.S. Azad

    2014-04-01

    Full Text Available An effective alternative was discovered in the form of thyme oil for use as a fish anaesthetic (patent pending approval. The thyme oil along with a common aquaculture-grade commercial anaesthetic (AQUI-S, clove oil and quinaldine were investigated for their antimicrobial properties and its effect on the immune parameters of two important maricultured fish species, bluefin bream (Sparidentax hasta and yellowfin bream (Acanthopagrus latus. In vivo studies indicated that both the fish species had highly reduced bacterial load after the treatments and the in vitro antibacterial activity of the of the thyme oil was superior to that of the other treatments. The effects of anaesthetic dose of thyme oil, clove oil, quinaldine and AQUI-S were evaluated and compared. The reduction in the total viable vibrio counts in the anesthetized fish indicated that the vibrio were sensitive to the thyme oil. Also thyme oil produced higher non-specific immune enhancements.

  8. The analgesic effect of wound infiltration with local anaesthetics after breast surgery

    DEFF Research Database (Denmark)

    Byager, N; Hansen, Mads; Mathiesen, Ole; Dahl, J B

    2014-01-01

    -operative pain after breast surgery. METHODS: A systematic review was performed by searching PubMed, Google Scholar, the Cochrane database and Embase for randomised, blinded, controlled trials of wound infiltration with local anaesthetics for post-operative pain relief in female adults undergoing breast surgery......BACKGROUND: Wound infiltration with local anaesthetics is commonly used during breast surgery in an attempt to reduce post-operative pain and opioid consumption. The aim of this review was to evaluate the effect of wound infiltration with local anaesthetics compared with a control group on post...... statistically significant reduction in post-operative, supplemental opioid consumption that was, however, of limited clinical relevance. CONCLUSION: Wound infiltration with local anaesthetics may have a modest analgesic effect in the first few hours after surgery. Pain after breast surgery is, however...

  9. Efficacy and safety of local anaesthetics for premature ejaculation: a systematic review and meta-analysis

    OpenAIRE

    Xia, Jia-Dong; Han, You-Feng; Zhou, Liu-Hua; Chen, Yun; Dai, Yu-Tian

    2013-01-01

    To assess the efficacy and safety of local anaesthetics for premature ejaculation (PE), a systematic review of the literature was performed using the Cochrane Library, PUBMED and EMBASE. We screened and retrieved the randomized controlled trials on the treatment of PE with local anaesthetics. End points included intravaginal ejaculation latency time (IELT), patient-reported outcome assessments and adverse events. Meta-analyses were conducted with Stata 11.0. In total, seven publications invol...

  10. TOPICAL APPLICATION OF LOCAL ANAESTHETIC GEL VS ICE IN PEDIATRIC PATIENTS FOR INFILTRATION ANAESTHESIA

    OpenAIRE

    Iqra; Jyothsna V .; Ila; Junaid Ahmed

    2015-01-01

    BACKGROUND: Local anaesthetic injections are one of the most feared or anxiety - inducing stimuli in dental operatory. Due to the fear of pain attributed to injection of anaesthetic agents providing appropriate dental care in children is difficult. Various methods have been investigated to decrease pain perception during injection. Hence, the present study was directed towards reducing pain perception in pediatric patients by comparing the effect of cooling the injecti...

  11. Anaesthetic management of an adult patient with DOOR syndrome: a case report

    OpenAIRE

    Michalek, Pavel; Donaldson, William; Abraham, Alexander

    2009-01-01

    We report the anaesthetic management of a 48-year-old male patient with Deafness, Onycho-Osteodystrophy and mental Retardation syndrome, epilepsy and cerebral palsy who had two dental procedures under anaesthetic care. For the first short examination sedoanalgesia was employed and the second, longer, procedure was performed under general anaesthesia. His airway management was moderately difficult and the postoperative period was complicated by partial seizures involving the upper extremity an...

  12. Comparative efficacy and patient preference of topical anaesthetics in dermatological laser treatments and skin microneedling

    OpenAIRE

    Yi Zhen Chiang; Firas Al-Niaimi; Vishal Madan

    2015-01-01

    Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA ® ), 4% tetracaine gel (Ametop TM ) and 4% liposomal lidocaine gel (LMX4 ® )) in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients under...

  13. Comparative Efficacy and Patient Preference of Topical Anaesthetics in Dermatological Laser Treatments and Skin Microneedling

    OpenAIRE

    Chiang, Yi Zhen; Al-Niaimi, Firas; Madan, Vishal

    2015-01-01

    Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA®), 4% tetracaine gel (Ametop™) and 4% liposomal lidocaine gel (LMX4®)) in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing l...

  14. Cost analysis of two anaesthetic machines: "Primus®" and "Zeus®"

    OpenAIRE

    Hinz Jose; Rieske Nadine; Schwien Bernd; Popov Aron F; Mohite Prashant N; Radke Oliver; Bartsch Armin; Quintel Michael; Züchner Klaus

    2012-01-01

    Abstract Background Two anaesthetic machines, the "Primus®" and the "Zeus®" (Draeger AG, Lübeck, Germany), were subjected to a cost analysis by evaluating the various expenses that go into using each machine. Methods These expenses included the acquisition, maintenance, training and device-specific accessory costs. In addition, oxygen, medical air and volatile anaesthetic consumption were determined for each machine. Results Anaesthesia duration was 278 ± 140 and 208 ± 112 minutes in the Prim...

  15. Carbon dioxide rebreathing with the anaesthetic conserving device, AnaConDa

    OpenAIRE

    Walther Sturesson, Louise; Malmkvist, Gunnar; Bodelsson, Mikael; Niklason, Lisbet; Jonson, Björn

    2012-01-01

    The anaesthetic conserving device (ACD) AnaConDa was developed to allow the reduced use of inhaled agents by conserving exhaled agent and allowing rebreathing. Elevated has been observed in patients when using this ACD, despite tidal volume compensation for the larger apparatus dead space. The aim of the present study was to determine whether CO2, like inhaled anaesthetics, adsorbs to the ACD during expiration and returns to a test lung during the following inspiration. The ACD was attached t...

  16. Intraoperative esmolol infusion reduces postoperative analgesic consumption and anaesthetic use during septorhinoplasty: a randomized trial

    OpenAIRE

    Nalan Celebi; Elif A. Cizmeci; Ozgur Canbay

    2014-01-01

    Background and objectives: Esmolol is known to have no analgesic activity and no anaesthetic properties; however, it could potentiate the reduction in anaesthetic requirements and reduce postoperative analgesic use. The objective of this study is to evaluate the effect of intravenous esmolol infusion on intraoperative and postoperative analgesic consumptions as well as its effect on depth of anaesthesia. Methods: This randomized-controlled double blind study was conducted in a tertiary care ...

  17. ANAESTHETIC MANAGEMENT OF TETRALOGY OF FALLOT COMING FOR NON - CARDIAC SURGERY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Dilesh

    2015-03-01

    Full Text Available Tetralogy of Fallot is a cyanotic congenital heart disorder and includes ventricular septal defect , right ventricular outflow tract obstruction (pulmonic stenosis , right ventricular hypertrophy and overriding of aorta . Anaesthetic goals in these patients is to maintain or increase the systemic vascular resistance minimize pulmonary vascular resistance and provide mild cardiac depression . Here we present a report of anaesthetic management of a 5 year old boy with t etralogy of fallot coming for cleft lip and cleft palate repair .

  18. Local Anaesthetic Infusion with Elastomeric Pump After Arthroscopic Subacromial Decompression

    Science.gov (United States)

    Little, Kevin; Pillai, Anand; Fazzi, Umberto; Storey, Neil

    2007-01-01

    INTRODUCTION The use of extended local anaesthesia for postoperative pain has previously been reported, and has several advantages over other methods, including ease of placement, safety, reliability, lower cost and effective analgesia. We present our experience with a portable elastomeric infusion device in patients undergoing arthroscopic subacromial decompression, and make a case for its potential to allow same-day discharge. PATIENTS AND METHODS Forty patients undergoing arthroscopic subacromial decompression were followed-up. At the end of the procedure, an epidural catheter connected to a portable elastomeric local anaesthetic infusion system was inserted into the subacromial space. All patients were electively admitted for overnight stay postoperatively and assessed using a visual analogue scale (VAS) to evaluate their level of pain. RESULTS No patient reported severe pain at any stage. None of the patients required any parenteral opiate analgesia with the pump in situ. CONCLUSIONS These findings suggest that the use of this elastomeric infusion device following shoulder surgery allows safe and early discharge of patients with decreased need for parenteral opiate analgesia. PMID:17535622

  19. Routine veterinary anaesthetic management practices in South Africa

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2000-07-01

    Full Text Available A survey of the routine anaesthetic management of dogs and cats during sterilisation by veterinarians in South Africa was conducted. This report describes the premedication, induction and maintenance agents most commonly used in dogs and cats. Information about monitoring of patients during the procedure and who is responsible for induction of anaesthesia and monitoring was obtained. Questionnaires were analysed with regard to demographic data, practice size, continuing education, the number of surgical procedures and sterilisations performed per week and an estimate of yearly mortality. Acetylpromazine is the most commonly used premedication in dogs and xylazine in cats. Thiopentone in dogs and alphaxalone/alphadolone in cats were the induction agents most commonly used. Alphaxalone/alphadolone in cats and halothane in dogs are the most commonly used maintenance agents. Records of anaesthesia are poorly kept and monitoring of patients is poorly performed. Respiratory rate is the parameter most commonly monitored (90.7 %, and in most cases is the sole parameter. On average 10.34 ± 8.25 cats were operated per week, of which 5.45 ±5.60 were sterilised; 17.79 ±11.61 dogs were operated per week, of which 8.65 ±7.10 were sterilised. In total, 190 patients died under anaesthesia, a mortality rate of 1:1243. Just over 50 % of practitioners had attended continuing education courses during their careers.

  20. Pain Levels after Local Anaesthetic with or without Hyaluronidase in Carpal Tunnel Release: A Randomised Controlled Trial

    OpenAIRE

    Yeo, G.; Gupta, A; Ding, G.; Skerman, H.; Khatun, M.; Melsom, D.

    2015-01-01

    Purpose. Hyaluronidase is an enzyme that temporarily liquefies the interstitial barrier, allowing easy dispersal of local anaesthetic through cleavage of tissue planes. This prospective, blinded, randomised controlled study investigates the utility of adding hyaluronidase to local anaesthetic in the setting of carpal tunnel release. Methods. 70 consecutive carpal tunnel release patients were recruited and randomised into a control group only receiving local anaesthetic and a hyaluronidase gro...

  1. Comparative efficacy and patient preference of topical anaesthetics in dermatological laser treatments and skin microneedling

    Directory of Open Access Journals (Sweden)

    Yi Zhen Chiang

    2015-01-01

    Full Text Available Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA ® , 4% tetracaine gel (Ametop TM and 4% liposomal lidocaine gel (LMX4 ® in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval pain score of 5 (±2.58; 3.66-6.46 with Ametop TM , 4.38 (±2.53; 2.64-4.89 with EMLA ® and 3.91 (±1.95; 2.65-4.76 with LMX4 ® . There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4 ® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures.

  2. Efficacy and safety of local anaesthetics for premature ejaculation: a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Jia-Dong Xia; You-Feng Han; Liu-Hua Zhou; Yun Chen; Yu-Tian Dai

    2013-01-01

    To assess the efficacy and safety of local anaesthetics for premature ejaculation (PE),a systematic review of the literature was performed using the Cochrane Library,PUBMED and EMBASE.We screened and retrieved the randomized controlled trials on the treatment of PE with local anaesthetics.End points included intravaginal ejaculation latency time (IELT),patient-reported outcome assessments and adverse events.Meta-analyses were conducted with Stata 11.0.In total,seven publications involving 566 patients with local anaesthetics and 388 with placebos strictly met our eligibility criteria.Meta-analyses showed that after the patients were treated with the local anaesthetics,the value of the standardized mean difference of the changes in IELT was 5.02 (95% CI:3.03-7.00).A higher rate of adverse events occurred compared with placebos (odds ratio:3.30,95% CI:1.71-6.36),but these events were restricted to local side effects.In addition,significantly greater improvement was observed in patient-reported outcomes.In summary,local anaesthetics can prolong IELT and improve ejaculatory control and sexual satisfaction.

  3. Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis.

    Science.gov (United States)

    Martyn-St James, Marrissa; Cooper, Katy; Ren, Kate; Kaltenthaler, Eva; Dickinson, Kath; Cantrell, Anna; Wylie, Kevan; Frodsham, Leila; Hood, Catherine

    2016-04-01

    Eutectic Mixture of Local Anaesthetics (EMLA) is recommended for use off-label as a treatment for premature ejaculation (PE). Other topical anaesthetics are available, some of which have been evaluated against oral treatments. The purpose of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) for topical anaesthetics in the management of PE. Bibliographic databases including MEDLINE were searched to August 2014. The primary outcome was intra-vaginal ejaculatory latency time (IELT). Methodological quality of RCTs was assessed. IELT and other outcomes were pooled across RCTs in a meta-analysis. Between-trial heterogeneity was assessed. Nine RCTs were included. Seven were of unclear methodological quality. Pooled evidence (two RCTs, 43 participants) suggests that EMLA is significantly more effective than placebo at increasing IELT (Pparoxetine (P=0.01; P=0.0001). TEMPE spray is associated with significantly more adverse events than placebo (P=0.003). More systemic adverse events are reported with tramadol, sildenafil and paroxetine than with lidocaine gel. Diverse methods of assessing sexual satisfaction and ejaculatory control with topical anaesthetics are reported and evidence is conflicting. Topical anaesthetics appear more effective than placebo, paroxetine and sildenafil at increasing IELT in men with PE. However, the methodological quality of the existing RCT evidence base is uncertain. PMID:26599522

  4. Evaluation of genotoxicity induced by repetitive administration of local anaesthetics: an experimental study in rats

    Directory of Open Access Journals (Sweden)

    Gisele Alborghetti Nai

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVE: Previous studies regarding the effects of some local anaesthetics have suggested that these agents can cause genetic damage. However, they have not been tested for genotoxicity related to repetitive administration. The aim of this study was to evaluate the genotoxic potential of local anaesthetics upon repetitive administration. METHODS: 80 male Wistar rats were divided into: group A - 16 rats intraperitoneally injected with lidocaine hydrochloride 2%; group B - 16 rats IP injected with mepivacaine 2%; group C - 16 rats intraperitoneally injected with articaine 4%; group D - 16 rats IP injected with prilocaine 3% (6.0 mg/kg; group E - 8 rats subcutaneously injected with a single dose of cyclophosphamide; and group F - 8 rats intraperitoneally injected with saline. Eight rats from groups A to D received a single dose of anaesthetic on Day 1 of the experiment; the remaining rats were dosed once a day for 5 days. RESULTS: The median number of micronuclei in the local anaesthetics groups exposed for 1 or 5 days ranged from 0.00 to 1.00, in the cyclophosphamide-exposed group was 10.00, and the negative control group for 1 and 5 days was 1.00 and 0.00, respectively (p 0.05. CONCLUSION: No genotoxicity effect was observed upon repetitive exposure to any of the local anaesthetics evaluated.

  5. Inhibition of astrocyte metabolism is not the primary mechanism for anaesthetic hypnosis.

    Science.gov (United States)

    Voss, Logan J; Harvey, Martyn G; Sleigh, James W

    2016-01-01

    Astrocytes have been promoted as a possible mechanistic target for anaesthetic hypnosis. The aim of this study was to explore this using the neocortical brain slice preparation. The methods were in two parts. Firstly, multiple general anaesthetic compounds demonstrating varying in vivo hypnotic potency were analysed for their effect on "zero-magnesium" seizure-like event (SLE) activity in mouse neocortical slices. Subsequently, the effect of astrocyte metabolic inhibition was investigated in neocortical slices, and compared with that of the anaesthetic drugs. The rationale was that, if suppression of astrocytes was both necessary and sufficient to cause hypnosis in vivo, then inhibition of astrocytic metabolism in slices should mimic the anaesthetic effect. In vivo anaesthetic potency correlated strongly with the magnitude of reduction in SLE frequency in neocortical slices (R(2) 37.7 %, p = 0.002). Conversely, SLE frequency and length were significantly enhanced during exposure to both fluoroacetate (23 and 20 % increase, respectively, p hypnosis. PMID:27462489

  6. Challenges in Anaesthetic management of a child for thoracoscopic assisted oesophageal replacement.

    Science.gov (United States)

    Chandrakala, K R; Nagaraj, Bindu; Bhagya, D V; Chandrika, Y R

    2016-02-01

    The loss of oesophageal length or obliteration of oesophageal lumen due to stricture acquired by accidental caustic ingestion is more common in children that may require major operative reconstruction. A number of procedures have been developed for anatomic replacement of oesophagus of which thoracoscopic assisted gastric transposition has shown the best outcome in children. This demands an extensive pre-operative evaluation, preparation and anaesthetic management since this is challenging and prolonged procedure done under one lung ventilation (OLV). Though it is a minimally invasive procedure, providing OLV and management of complications associated with it are the anaesthetic challenges among these children. We report anaesthetic management of an 8-year-old boy with oesophageal stricture following corrosive injury posted for thoracoscopic assisted gastric transposition. PMID:27013752

  7. Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics

    DEFF Research Database (Denmark)

    Zaric, Dusanka; Pace, Nathan Leon

    complications after spinal anaesthesia with lidocaine compared to other local anaesthetics. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials Register (CENTRAL) (The Cochrane Library, Issue 4, 2008); MEDLINE (1966 to August 2008); EMBASE (1980 to week 35, 2008); LILACS (August 2008......); and handsearched the reference lists of trials and review articles. SELECTION CRITERIA: We included all randomized and quasi-randomized studies comparing the frequency of TNS and neurologic complications after spinal anaesthesia with lidocaine as compared to other local anaesthetics. DATA COLLECTION...... local anaesthetics (bupivacaine, prilocaine, procaine, levobupivacaine, ropivacaine, and 2-chloroprocaine) was 7.31 (95% confidence interval (CI) 4.16 to 12.86). Mepivacaine was found to give similar results as lidocaine and was therefor omitted from the overall comparison to diminish the heterogeneity...

  8. Preparation of the Drager Fabius CE and Drager Zeus anaesthetic machines for patients susceptible to malignant hyperthermia.

    LENUS (Irish Health Repository)

    Shanahan, Hiliary

    2012-05-01

    Malignant hyperthermia may follow exposure to trace quantities of inhalational anaesthetics. In susceptible patients, the complete avoidance of these triggers is advised when possible; however, failing this, it is essential to washout or purge the anaesthesia machine of residual inhalational anaesthetics.

  9. Anaesthetic management for caesarean section in a case of previously operated with residual pituitary tumour

    Directory of Open Access Journals (Sweden)

    Prerana N Shah

    2011-01-01

    Full Text Available Successful anaesthetic management for caesarean section in a case with previous pituitary tumour resection, with residual tumour, is reported. The pituitary gland undergoes global hyperplasia during pregnancy. Functional pituitary tumours may exhibit symptomatic enlargement during pregnancy. Growth hormone secreting tumour is associated with acromegaly which has associated anaesthetic implications of difficult airway, systemic hypertension, and diabetes and electrolyte imbalance. Intracranial space occupying lesions can increase intra cranial pressure and compromise cerebral perfusion or cause herniation. We report management of this case.

  10. Concomitant Takayasu arteritis and Cushing syndrome in a child undergoing open adrenalectomy: An anaesthetic challenge

    Directory of Open Access Journals (Sweden)

    Hemlata

    2014-01-01

    Full Text Available Takayasu′s arteritis (TA is a rare, chronic progressive panendarteritis involving the aorta and its main branches. Anaesthesia for patients with TA is complicated by their severe uncontrolled hypertension, end-organ dysfunction, stenosis of major blood vessels, and difficulties encountered in monitoring arterial blood pressure. In a patient with Cushing′s syndrome (CS, the anaesthesiologist needs to deal with volume overload, hyperglycaemia, hypokalaemia, difficult airway and ventilation. Anaesthetic management of a patient with concomitant TA and CS undergoing adrenalectomy has hardly ever been reported. We present the successful anaesthetic management of a 15-year-old child with coexisting TA and CS undergoing open adrenalectomy.

  11. Anaesthetic challenges in carotid body tumour resection: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Anuradha Malliwal

    2015-12-01

    Full Text Available Carotid body tumour (CBT is an extremely rare, non-chromaffin paraganglioma arising from chemoreceptor cells at the carotid bifurcation. Reported incidence is 1-2 per 100,000. Surgical excision of the tumour, the definitive treatment, poses several anaesthetic challenges and a high incidence of perioperative morbidity and mortality (20-40%. Very few cases have been reported so far. We report the anaesthetic management of a case of CBT excision with a review of recent literature on the same. [Int J Res Med Sci 2015; 3(12.000: 3897-3900

  12. Local anaesthetic toxicity in a pregnant patient undergoing lignocaine-induced intravenous regional anaesthesia.

    LENUS (Irish Health Repository)

    Coleman, M

    2012-02-03

    A pregnant patient at 38 weeks\\' gestation developed symptoms of local anaesthetic toxicity following intravenous regional anaesthesia (IVRA) for hand surgery, using a standard dose of lignocaine. Reports suggest that a number of factors, both physiological and pharmacological, combine to increase the likelihood of local anaesthetic (LA) toxicity in pregnancy despite employment of a conventional "safe" IVRA technique. It is suggested that for IVRA, pregnant patients are premedicated with a benzodiazepine, the tourniquet time is increased and the concentration of LA is decreased to reduce the risks of LA toxicity.

  13. Anaesthetic management for emergency caesarean section in a patient with an untreated recently diagnosed phaeochromocytoma

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2011-01-01

    Full Text Available Phaeochromocytoma is a rare cause of hypertension during pregnancy with potentially fatal consequences. If not detected and treated early in pregnancy, it is catastrophic for both the mother and the baby. Management requires close co-ordination between the obstetrician, anaesthesiologist, paediatrician and the endocrinologist. Perioperative management for an emergency caesarean section in a parturient with untreated phaeochromocytoma is an anaesthetic challenge and no standard recommendations have been reported till date. In this case report, we present anaesthetic management in such a case with successful maternal and foetal outcome.

  14. Anaesthetic, cardiovascular and respiratory effects of a new steroidal agent CT 1341: a comparison with other intravenous anaesthetic drugs in the unrestrained cat.

    Science.gov (United States)

    Child, K J; Davis, B; Dodds, M G; Twissell, D J

    1972-10-01

    1. The anaesthetic, cardiovascular, respiratory and adverse effects produced by the intravenous injection of CT 1341, thiopentone, methohexitone, pentobarbitone, propanidid and ketamine have been compared in unrestrained cats prepared with chronically implanted venous and arterial cannulae. Aortic blood pressure and heart rates were monitored before, during and after loss of consciousness.2. CT 1341 produced rapid induction of anaesthesia followed by moderately rapid recovery, was active over a wide range of doses and caused minimal respiratory depression and few adverse effects. It caused an initial short-lasting tachycardia and fall in aortic blood pressure succeeded by a secondary depressor response.3. The safety margin was narrower with the barbiturate drugs than with CT 1341, and large doses induced apnoea and respiratory depression. Small doses of methohexitone elicited excitatory effects and large doses caused severe respiratory and circulatory depression, and recovery from anaesthesia was protracted.4. Propanidid induced short-lasting light anaesthesia. The safety margin was narrowest with this drug and induction was associated with adverse circulatory, respiratory and other effects.5. Ketamine was active over a wide range of doses but exhibited qualitatively different properties from the other anaesthetics. Induction was slower after small doses and these produced circulatory stimulation, catatonia and bizarre behavioural effects. Large doses caused respiratory and circulatory depression and recovery was protracted.6. It is concluded that CT 1341 has a wider therapeutic latitude, produces less respiratory depression and has other advantages over the currently used intravenous anaesthetics. PMID:4651769

  15. Anaesthetic Management of Two Patients with Pompe Disease for Caesarean Section

    Directory of Open Access Journals (Sweden)

    I. J. J. Dons-Sinke

    2014-01-01

    Full Text Available The introduction of enzyme replacement therapy and the resultant stabilisation or improvement in mobility and respiratory muscle function afforded to patients with late-onset Pompe may lead to an increased number of Pompe patients prepared to accept the challenges of parenthood. In this case report, we describe our anaesthetic management of two patients with Pompe disease for a caesarean section.

  16. Effects of chronic occupational exposure to anaesthetic gases on the rate of neutrophil apoptosis among anaesthetists.

    LENUS (Irish Health Repository)

    Tyther, R

    2012-02-03

    BACKGROUND AND OBJECTIVE: Volatile anaesthetic agents are known to influence neutrophil function. The aim was to determine the effect of chronic occupational exposure to volatile anaesthetic agents on the rate of neutrophil apoptosis among anaesthetists. To test this hypothesis, we compared the rate of neutrophil apoptosis in anaesthetists who had been chronically exposed to volatile anaesthetic agents with that in unexposed volunteers. METHODS: Venous blood (20 mL) was withdrawn from 24 ASA I-II volunteers, from which neutrophils were isolated, and maintained in culture. At 1, 12 and 24 h in culture, the percentage of neutrophil apoptosis was assessed by dual staining with annexin V-FITC and propidium iodide. RESULTS: At 1 h (but not at 12 and 24 h) in culture, the rate of neutrophil apoptosis was significantly less in the anaesthetists--13.8 (12.9%) versus 34.4 (12.1%) (P = 0.001). CONCLUSIONS: Chronic occupational exposure to volatile anaesthetic agents may inhibit neutrophil apoptosis. This may have implications for anaesthetists and similarly exposed healthcare workers in terms of the adequacy of their inflammatory response.

  17. Bacterial contamination and the effect of filters in anaesthetic circuits in a simulated patient model.

    Science.gov (United States)

    Leijten, D T; Rejger, V S; Mouton, R P

    1992-05-01

    In order to investigate bacterial contamination of anaesthetic breathing circuits and means of prevention of this, six different laboratory experiments were performed. These experiments involved the bacterial contamination of Dräger Narkose Spiromat 650 and Dräger AV-1 circle system circuits and of an isolated soda lime carbon dioxide absorber. The effects of anaesthetic gas, gas flow rate and the incorporation of a hydrophobic membrane heat and moisture exchanging bacterial/viral filter (HMEF) at the patient end of these circuits were investigated. It was found that without a HMEF the whole interior of the anaesthetic circuits became contaminated with bacteria. Components closest to the simulated patient showed the highest levels of contamination. Higher gas flows were associated with decreased levels of circuit contamination, presumably because more bacteria were expelled from the system. Halothane (1 volume %) and soda lime were not found to have any demonstrable bactericidal action. The presence of a HMEF between the simulated patient and the Y-piece prevented any detectable contamination from reaching the circuit. Consequently, the presence of a HMEF provides protection of the anaesthetic circuit as well as other patients, healthcare workers and the environment. PMID:1351496

  18. Anaesthetic implications of laparoscopic splenectomy in patients with sickle cell anaemia.

    LENUS (Irish Health Repository)

    Doodnath, R.

    2010-04-01

    With the increasing immigrant population in the Republic of Ireland, the number of patients with sickle cell disease (SCD) seen in the paediatric hospitals is climbing. In this case report, we review the anaesthetic implications and outcome of the first two paediatric patients with SCD to have a laparoscopic splenectomy due to repeated splenic infarcts in the Republic of Ireland.

  19. Anaesthetic implications of laparoscopic splenectomy in patients with sickle cell anaemia.

    LENUS (Irish Health Repository)

    Doodnath, R

    2012-02-01

    With the increasing immigrant population in the Republic of Ireland, the number of patients with sickle cell disease (SCD) seen in the paediatric hospitals is climbing. In this case report, we review the anaesthetic implications and outcome of the first two paediatric patients with SCD to have a laparoscopic splenectomy due to repeated splenic infarcts in the Republic of Ireland.

  20. Assessment of anaesthetic depth by clustering analysis and autoregressive modelling of electroencephalograms

    DEFF Research Database (Denmark)

    Thomsen, C E; Rosenfalck, A; Nørregaard Christensen, K

    The brain activity electroencephalogram (EEG) was recorded from 30 healthy women scheduled for hysterectomy. The patients were anaesthetized with isoflurane, halothane or etomidate/fentanyl. A multiparametric method was used for extraction of amplitude and frequency information from the EEG. The...

  1. Anaesthetic Management of a Child with Neurofibromatosis Type 2 for Multiple Tumour Decompressions

    OpenAIRE

    Lakshiminarasimhaiah, Geetha; Jagannatha, Aniruddha Thekkatte; Pai, Kulyadi Raghavendra; Varma, Ravi Gopal; Hegde, Alangar Satyaranjandas

    2013-01-01

    Neurofibromatosis type 2 is a genetic disorder with autosomal dominant pattern. It can manifest as intracranial, spinal, ocular and cutaneous lesions. The lesions can extend to all the systems. We present an anaesthetic management of a paediatric patient with neurofibromatosis 2 for multiple spinal and thoracic tumour decompression.

  2. The insulinotropic effect of exogenous GLP-1 is not affected by acute vagotomy in anaesthetized pigs

    DEFF Research Database (Denmark)

    Veedfald, Simon; Hansen, Marie; Christensen, Louise Wulff;

    2016-01-01

    by dipeptidyl peptidase-4 (DPP-4), a signalling pathway involving activation of intestinal vagal afferents has been proposed. We conducted two series of experiments in α-chloralose-anaesthetized pigs. Protocol I: pigs (n = 14) were allocated for either intravenous(iv) or intra-arterial(mesenteric) GLP-1...

  3. Prepubertal gonadectomy in cats: different injectable anaesthetic combinations and comparison with gonadectomy at traditional age.

    Science.gov (United States)

    Porters, Nathalie; de Rooster, Hilde; Moons, Christel P H; Duchateau, Luc; Goethals, Klara; Bosmans, Tim; Polis, Ingeborgh

    2015-06-01

    Anaesthetic and analgesic effects of three different injectable anaesthetic combinations for prepubertal gonadectomy (PPG) in cats were studied. One anaesthetic protocol was compared with a similar one for gonadectomy at traditional age (TAG). Kittens were randomly assigned to PPG or TAG. For PPG, three different protocols were compared: (1) intramuscular (IM) administration of 60 μg/kg dexmedetomidine plus 20 μg/kg buprenorphine followed by an IM injection of the anaesthetic agent (20 mg/kg ketamine) (DB-IM protocol); (2) oral transmucosal (OTM) administration of 80 μg/kg dexmedetomidine plus 20 μg/kg buprenorphine followed by an IM injection of 20 mg/kg ketamine combined with 20 µg/kg dexmedetomidine (DB-OTM protocol); (3) IM injection of a 40 μg/kg medetomidine-20 μg/kg buprenorphine-20 mg/kg ketamine combination (MBK-IM protocol). For TAG, a DB-IM protocol was used, but with different doses for dexmedetomidine (40 μg/kg) and ketamine (5 mg/kg). All cats (PPG and TAG) received a non-steroidal anti-inflammatory before surgery. Anaesthetic and analgesic effects were assessed pre- and postoperatively (until 6 h). Cumulative logit, linear and logistic regression models were used for statistical analysis. Compared with the DB-OTM protocol, the DB-IM and MBK-IM protocols provided better anaesthesia with fewer adverse effects in PPG cats. Postoperative pain was not significantly different between anaesthetic protocols. PPG and TAG cats anaesthetised with the two DB-IM protocols differed significantly only for sedation and pain scores, but sedation and pain scores were generally low. Although there were no anaesthesia-related mortalities in the present study and all anaesthetic protocols for PPG in cats provided a surgical plane of anaesthesia and analgesia up to 6 h postoperatively, our findings were in favour of the intramuscular (DB-IM and MBK-IM) protocols. PMID:25170033

  4. Model of anaesthetic induction by unilateral intracerebral microinjection of GABAergic agonists.

    Science.gov (United States)

    Devor, Marshall; Zalkind, Vladimir; Fishman, Yelena; Minert, Anne

    2016-03-01

    General anaesthetic agents induce loss of consciousness coupled with suppression of movement, analgesia and amnesia. Although these diverse functions are mediated by neural structures located in wide-ranging parts of the neuraxis, anaesthesia can be induced rapidly and reversibly by bilateral microinjection of minute quantities of γ-aminobutyric acid (GABA)A -R agonists at a small, focal locus in the mesopontine tegmentum (MPTA). State switching under these circumstances is presumably executed by dedicated neural pathways and does not require widespread distribution of the anaesthetic agent itself, the classical assumption regarding anaesthetic induction. Here it was asked whether these pathways serve each hemisphere independently, or whether there is bilateral redundancy such that the MPTA on each side is capable of anaesthetizing the entire brain. Either of two GABAA -R ligands were microinjected unilaterally into the MPTA in awake rats, the barbiturate modulator pentobarbital and the direct receptor agonist muscimol. Both agents, microinjected on either side, induced clinical anaesthesia, including bilateral atonia, bilateral analgesia and bilateral changes in cortical activity. The latter was monitored using c-fos expression and electroencephalography. This action, however, was not simply a consequence of suppressing spike activity in MPTA neurons, as unilateral (or bilateral) microinjection of the local anaesthetic lidocaine at the same locus failed to induce anaesthesia. A model of the state-switching circuitry that accounts for the bilateral action of unilateral microinjection and also for the observation that inactivation with lidocaine is not equivalent to inhibition with GABAA -R agonists was proposed. This is a step in defining the overall switching circuitry that underlies anaesthesia. PMID:26804488

  5. TOPICAL APPLICATION OF LOCAL ANAESTHETIC GEL VS ICE IN PEDIATRIC PATIENTS FOR INFILTRATION ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Iqra

    2015-09-01

    Full Text Available BACKGROUND: Local anaesthetic injections are one of the most feared or anxiety - inducing stimuli in dental operatory. Due to the fear of pain attributed to injection of anaesthetic agents providing appropriate dental care in children is difficult. Various methods have been investigated to decrease pain perception during injection. Hence, the present study was directed towards reducing pain perception in pediatric patients by comparing the effect of cooling the injection site and use of local anaesthetic gel. AIMS AND OBJECTIVES: To comp are the effect of topical cooling and the use of local anesthetic gel before infiltration anesthesia in reducing pain in pediatric patients undergoing dental extractions in the maxillary anterior region. MATERIALS AND METHODS: A clinical trial was used to investigate pain perception in 100 healthy pediatric patients in the age group of 8 to 12 years who required infiltration anaesthesia for bilateral maxillary primary anterior teeth extraction. Before infiltration anaesthesia precooling was done on right si de, whereas on the left side local anaesthetic gel was applied. The patients were asked to individually rate their pain experience on each side using the visual analogue scale. Scores were tabulated and subjected to statistical analysis using Student’s t t est. Statistical significance was defined at P < 0.001. RESULTS: The results of the present study, showed a statistically significant differences between the two groups ( P < 0.001, with greater pain reduction in the ice group. CONCLUSION: Pre cooling injectio n site before infiltration anaesthesia significantly reduced the pain perception in pediatric patients when compared to local anaesthetic gel. Pre cooling of the injection site before infiltration anesthesia is an easy, reliable, and effective technique wi th no additional cost and can be beneficial to apply to all pediatric patients to reduce discomfort and facilitate clinical management.

  6. The dissociative anaesthetics, ketamine and phencyclidine, selectively reduce excitation of central mammalian neurones by N-methyl-aspartate.

    OpenAIRE

    Anis, N. A.; Berry, S. C.; Burton, N. R.; Lodge, D.

    1983-01-01

    The interaction of two dissociative anaesthetics, ketamine and phencyclidine, with the responses of spinal neurones to the electrophoretic administration of amino acids and acetylcholine was studied in decerebrate or pentobarbitone-anaesthetized cats and rats. Both ketamine and phencyclidine selectively blocked excitation by N-methyl-aspartate (NMA) with little effect on excitation by quisqualate and kainate. Ketamine reduced responses to L-aspartate somewhat more than those of L-glutamate; t...

  7. Anaesthetic management of patients with congenital heart disease presenting for non-cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Mohindra R

    2002-01-01

    Full Text Available The incidence of congenital heart disease is about one percent of all live births in the United States. Treatment is being performed at a younger age and these children are showing improved survival. It is not unusual for children with congenital heart disease to present for non-cardiac surgery. Their management depends on their age, type of lesion, extent of corrective procedure, the presence of complications and other congenital anomalies. Each patient needs a detailed pre-operative evaluation to understand the abnormal anatomy and physiology, and related anaesthetic implications. No anaesthetic agent is an absolute contraindication, although drugs beneficial for one lesion may be detrimental for another. Regional anaesthesia has also been safely used in children with congenital heart disease. However the anaesthesiologist must have a detailed understanding of the pathophysiology of the lesion and the pharmacology of drugs being used to be able to provide safe anaesthesia for children with congenital heart disease.

  8. Diagnosis and pathogenesis of the anaphylactic and anaphylactoid reactions to anaesthetics.

    Science.gov (United States)

    Gueant, J L; Aimone-Gastin, I; Namour, F; Laroche, D; Bellou, A; Laxenaire, M C

    1998-09-01

    Immediate adverse reactions to anaesthetics have an immune mechanism in more than 50% of the cases. They are mainly due to muscle relaxant drugs. A prospective evaluation of tryptase, histamine and serotonin for diagnosing anaphylaxis to anaesthetics was performed over 2 years. The sensitivity of each marker was at 60-70% and it reached 80% when combining tryptase and histamine. Specific IgE have been already observed in serum from patients allergic to muscle relaxant, thiopentone, morphine, phenoperidine, propofol and radio-contrast media. However, the recent progress in the identification of drug epitopes by Sepharose-solid drug phase IgE radioimmunoassay has to be reconsidered as non-specific binding of hydrophobic drugs such as propofol to hydrophobic serum IgE has been observed recently in patients with drug allergy. In addition, association of drugs such as propofol and muscle relaxant may potentiate the mediator release by a non-elucidated mechanism. PMID:9761037

  9. Emergency Surgery in a Patient with Scleroderma - Anaesthetic Challenges: A Case Report

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2013-06-01

    Full Text Available Scleroderma (progressive systemic sclerosis is a multisystem disease involving the skin, airway, musculoskeletal, gastrointestinal, pulmonary, renal and cardiac systems that can pose a significant challenge for the anaesthetist. The multisystem involvement of scleroderma can impact on every aspect of anaesthetic care especially airway management. There are no specific contraindications to the use of any type of anaesthesia, although the selection must be guided by identification of organ dysfunction. The anaesthetist must be aware of the organs involved, the severity of the disease and the associated anaesthetic considerations and potential risks in order to safely & skilfully manage the patient with scleroderma. We hereby present a case report of a patient with scleroderma for emergency orbital decompression because of orbital cellulitis.

  10. Effects of an anaesthetic on plasma levels of histamine and tele-methylhistamine in the cat.

    Science.gov (United States)

    Irman-Florjanc, T

    1996-01-01

    The effects of intravenous injection of ketamine on plasma levels of histamine (Hi) and its metabolite, tele-methylhistamine (MeHi) were studied in the cat. The results showed that the anaesthetic, given in doses which prolonged anaesthesia in the cat (2.5-7.5 mg/kg) caused Hi release, which raised the concentrations of Hi in plasma up to 1600%. It was followed by a slower and also significant increase of plasma MeHi levels (up to 1200%). When urethane was used as an anaesthetic no changes of plasma levels were noticed. However, about 50% of i.v. injections of Ringer-Locke solution were followed by a transient increase of plasma Hi and MeHi concentrations. PMID:8739344

  11. Anaesthetic Management of Caesarean Section in a Patient with Large Mediastinal Mass

    International Nuclear Information System (INIS)

    Pregnancy is associated with both anatomical and physiological changes in the body, especially in cardiovascular and respiratory systems. Patients with anterior and middle mediastinal masses are recognized to be at risk for cardiorespiratory compromise. Likewise, pregnancy has a widely known constellation of potential complications that confront the anaesthesiologist. The combination of both (pregnancy and mediastinal mass) in a single patient presents an unusual anaesthetic challenge. Caesarean sections are usually the mode of delivery, therefore, the cardio-respiratory stability is very important. The following is the report of a 31 weeks pregnant patient with a large, symptomatic anterior and middle mediastinal mass, who required anaesthesia for emergency caesarean section. The anaesthetic management entailed Combined Spinal and Epidural (CSE) technique with safe feto-maternal outcome. (author)

  12. Anaesthetic management of caesarean section in a patient with large mediastinal mass.

    Science.gov (United States)

    Kashif, Sanum; Saleem, Jodat

    2015-02-01

    Pregnancy is associated with both anatomical and physiological changes in the body, especially in cardiovascular and respiratory systems. Patients with anterior and middle mediastinal masses are recognized to be at risk for cardiorespiratory compromise. Likewise, pregnancy has a widely known constellation of potential complications that confront the anaesthesiologist. The combination of both (pregnancy and mediastinal mass) in a single patient presents an unusual anaesthetic challenge. Caesarean sections are usually the mode of delivery, therefore, the cardio-respiratory stability is very important. The following is the report of a 31 weeks pregnant patient with a large, symptomatic anterior and middle mediastinal mass, who required anaesthesia for emergency caesarean section. The anaesthetic management entailed Combined Spinal and Epidural (CSE) technique with safe feto-maternal outcome. PMID:25703761

  13. Modulation of reflexly evoked vagal bradycardias by central 5-HT1A receptors in anaesthetized rabbits

    OpenAIRE

    Skinner, Matthew R; Ramage, Andrew G; Jordan, David

    2002-01-01

    The role of central 5-HT1A receptors in the control of the bradycardia and changes in central respiratory drive, renal nerve activity and blood pressure evoked by stimulating cardiopulmonary afferents with phenylbiguanide, baroreceptors by electrical stimulation of the aortic nerve and chemoreceptors by injections of sodium cyanide (NaCN) in atenolol-pretreated anaesthetized rabbits were studied.Buspirone (100 μg kg−1; i.c.) potentiated the bradycardia (increase in R-R interval) and the chang...

  14. Efficacy of sodium bicarbonate as anaesthetic for yellow seahorse, Hippocampus kuda (Bleeker, 1852)

    Digital Repository Service at National Institute of Oceanography (India)

    Pawar, H.B; Ingole, B; Sreepada, R.A.

    rapid recovery is better (Marking & Meyer, 1985; Stoskopf, 1993). An ideal anaesthetic should possess several attributes such Available online at http://www.urpjournals.com International Journal of Research in Fisheries and Aquaculture Universal... carp (Cyprinus carpio L., 1758) juveniles. Turk J Fish Aquat Sc. 9, 29-31. 2. Booke, H. E., Hollender, B. and Lutterbie, G. 1978. 3. Sodium bicarbonate, an inexpensive fish anesthetic for field use. Progressive Fish Culturist., 40, 11...

  15. ANAESTHETIC MANAGEMENT FOR A RARE CASE OF LOEYS-DIETZ SYNDROME FOR LAPAROTOMY

    Directory of Open Access Journals (Sweden)

    Premalatha

    2014-12-01

    Full Text Available Loeys-Dietz syndrome (LDS is an autosomally dominant connective tissue disorder characterised by vascular and skeletal manifestations. It is caused by mutations in the TGFBR1, TGFBR2, TGFB2 or SMAD3 genes. There are four types of which type I is the most common accounting for more than 75% of the cases. Here we report the anaesthetic management of a case of LDS type I who presented with abdominal pain with suspected twisted ovarian cyst for laparotomy.

  16. Anaesthetic Management of A Patient with Hypokalemic Periodic Paralysis- A Case Report

    OpenAIRE

    Chitra, S; Grace Korula

    2009-01-01

    Summary We report the anaesthetic management of a patient with hypokalemic periodic paralysis who underwent hepaticojejunostomy for stricture of the common bile duct. Patients with this disorder, who are apparently normal, can develop sudden paralysis as they are exposed to many of the predisposing factors, perioperatively. The complications due to this rare genetic disorder, the factors that can precipitate these problems and preventive measures are discussed.

  17. Anaesthetic Management of A Patient with Hypokalemic Periodic Paralysis- A Case Report

    Directory of Open Access Journals (Sweden)

    S Chitra

    2009-01-01

    Full Text Available We report the anaesthetic management of a patient with hypokalemic periodic paralysis who underwent hepaticojejunostomy for stricture of the common bile duct. Patients with this disorder, who are apparently normal, can develop sudden paralysis as they are exposed to many of the predisposing factors, perioperatively. The complications due to this rare genetic disorder, the factors that can precipitate these problems and preventive measures are dis-cussed.

  18. Emergency anaesthetic management of a severely anaemic, chronic schizophrenic patient with history of neuroleptic malignant syndrome

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2011-01-01

    Full Text Available Administering anaesthesia to a patient with chronic schizophrenia is a challenge due to the increased risk of various perioperative complications. Neuroleptic agents are highly effective drugs used for the treatment of psychiatric disorders, but are rarely associated with neuroleptic malignant syndrome (NMS. Here, we describe the successful anaesthetic management of a patient of chronic schizophrenia with past history of NMS who presented in emergency with active bleeding per rectum and haemoglobin of 3 gm%.

  19. Spinal anaesthesia at low and moderately high altitudes: a comparison of anaesthetic parameters and hemodynamic changes

    OpenAIRE

    Aksoy, Mehmet; Ince, Ilker; Ahıskalıoglu, Ali; Karaca, Omer; Bayar, Fikret; Erdem, Ali Fuat

    2015-01-01

    Background Hypoxemia caused high altitude leads to an increase and variability in CSF volume. The purpose of this prospective study was to detect the differences, if any, between moderately highlanders and lowlanders in terms of anaesthetic parameters under neuroaxial anaesthesia. Methods Consecutive patients living at moderately high altitude (Erzurum, 1890 m above the sea level) and sea level (Sakarya, 31 m above the sea level) scheduled for elective lower extremity surgery with spinal anae...

  20. Effect of Metal Ions on Melanin – Local Anaesthetic Drug Complexes

    OpenAIRE

    Ewa Buszman; Bożena Betlej; Dorota Wrześniok; Bożena Radwańska-Wala

    2003-01-01

    The affinity of melanin biopolymers for metal ions, drugs and other organic compounds is an important factor in the etiology of toxic retinopathy, hiperpigmentation, otic lesions and irreversible extrapyramidal disorders. The aim of the presented work was to examine the interaction of local anaesthetic drugs used in ophthalmology with model DOPA-melanin in the presence of metal ions. It has been demonstrated that the analyzed drugs form complexes with melanin biopolymer. Based on the .values ...

  1. Recannulation of a stenosed old tracheostomy wound in vocal-cord palsy: Anaesthetic management

    OpenAIRE

    Rashmi Pal; Arora, K. K.; Pandey, S.

    2011-01-01

    Tracheostomy still remains a life-saving procedure to secure a patent airway in emergency situations. Anaesthetic management of tracheostomy in paediatric patients with bilateral vocal cord immobility and acute respiratory distress in emergency has always been a great challenge to the anaesthesiologists. Administering general anaesthesia in a child for recannulation of tracheostomy in emergency is far more challenging. We report a case of a 4-year-old male child in whom tracheostomy tube was ...

  2. Anaesthetic Management of Cataract Surgery in a Patient with Sturge-Weber Syndrome

    Directory of Open Access Journals (Sweden)

    Vasantha Kumar

    2015-05-01

    Full Text Available Sturge-Weber Syndrome (SWS, also called as encephalo trigeminal angiomatosis, is a rare congenital syndrome, characterized by lepto meningeal haemangioma, a facial port-wine stains distributed over the trigeminal nerve area, (usually involving one side and glaucoma. During cataract surgery, there may be rupture of choroid haemangioma, leading to excessive bleeding, or of haemangioma involving the airway, leading to difficult mask ventilation, laryngoscopy and intubation. We discuss the anaesthetic management of the patient with SWS for cataract surgery.

  3. Prophylactic lignocaine and early post-coronary artery occlusion dysrhythmias in anaesthetized greyhounds.

    OpenAIRE

    Marshall, R J; Parratt, J R

    1980-01-01

    1. Lignocaine (1 mg kg-1 min-1 infused intravenously for 30 min) greatly reduced the incidence of ventricular ectopic beats that resulted from acute coronary artery ligation in anaesthetized greyhound dogs. However, the incidence of ventricular fibrillation was only slightly reduced by this treatment which caused significant myocardial depression. 2. There is no good evidence from this study that lignocaine is a particularly effective prophylactic in acute myocardial infarction.

  4. The effect of local anaesthesia on anaesthetic requirements for feline ovariectomy.

    Science.gov (United States)

    Zilberstein, Luca F; Moens, Yves P; Leterrier, Eléonore

    2008-11-01

    A dose of supplementary ketamine was used to evaluate the anaesthetic sparing effect of adding local anaesthesia to general anaesthesia in cats undergoing ovariectomy. Fifty-six healthy cats were randomly assigned to receive lidocaine 2% (group L) as skin infiltration (1 mg kg(-1)), topical application (splash block) on both the ovaries (2 mg kg(-1), each) and on abdominal muscular layers (1 mg kg(-1)), or an equal volume of NaCl 0.9% at the same sites (group S). Anaesthesia was induced with a mixture of 20 microg kg(-1) medetomidine and 5 mg kg(-1) ketamine administered intramuscularly. Rectal temperature, ECG, heart rate and respiratory rate were measured continuously. Ketamine supplemental boli (1 mg kg(-1), intravenously) were administered in response to movements during surgery. Local lidocaine significantly reduced the need for supplementary ketamine. All animals were returned to their owners without complications. With this protocol, local anaesthetics reduced the need for injectable anaesthetic during feline ovariectomy. PMID:18036858

  5. THE USE OF SELECTED ANAESTHETIC DRUGS IN SEARCH OF A METHOD FOR IMPROVING EARTHWORMS’ WELFARE

    Directory of Open Access Journals (Sweden)

    Agnieszka Podolak-Machowska

    2013-07-01

    Full Text Available This paper describes selected effects of body contact of earthworms Dendrobaena veneta Rosa with local anaesthetic (LA drugs used for human anesthesia (lidocaine and prilocaine and anaesthetics for aquatic animals (MS-222. The findings showed safe and effective immobilization of earthworms with prilocaine at a concentration of 0.25-1%. At the applied concentrations lidocaine was safe, but less effective. On the other hand, MS-222, at the applied concentrations had a strongly irritating effect for earthworms and induced convulsive body movements connected with a discharge of coelomic fluid. The results may be relevant both for improving the welfare of earthworms during experiments and for the organization of research involving testing drugs on invertebrates. In this case, by using earthworms as an experimental model and by applying the method for measuring their mobility after contact with anaesthetics, which has been described in this article, it might be possible to replace experiments on guinea pigs, rabbits, rats and mice, which are expensive and require an approval of an ethics committee, with laboratory tests on earthworms.

  6. Anaesthetic impairment of immune function is mediated via GABA(A receptors.

    Directory of Open Access Journals (Sweden)

    Daniel W Wheeler

    Full Text Available GABA(A receptors are members of the Cys-loop family of neurotransmitter receptors, proteins which are responsible for fast synaptic transmission, and are the site of action of wide range of drugs. Recent work has shown that Cys-loop receptors are present on immune cells, but their physiological roles and the effects of drugs that modify their function in the innate immune system are currently unclear. We are interested in how and why anaesthetics increase infections in intensive care patients; a serious problem as more than 50% of patients with severe sepsis will die. As many anaesthetics act via GABA(A receptors, the aim of this study was to determine if these receptors are present on immune cells, and could play a role in immunocompromising patients.We demonstrate, using RT-PCR, that monocytes express GABA(A receptors constructed of α1, α4, β2, γ1 and/or δ subunits. Whole cell patch clamp electrophysiological studies show that GABA can activate these receptors, resulting in the opening of a chloride-selective channel; activation is inhibited by the GABA(A receptor antagonists bicuculline and picrotoxin, but not enhanced by the positive modulator diazepam. The anaesthetic drugs propofol and thiopental, which can act via GABA(A receptors, impaired monocyte function in classic immunological chemotaxis and phagocytosis assays, an effect reversed by bicuculline and picrotoxin.Our results show that functional GABA(A receptors are present on monocytes with properties similar to CNS GABA(A receptors. The functional data provide a possible explanation as to why chronic propofol and thiopental administration can increase the risk of infection in critically ill patients: their action on GABA(A receptors inhibits normal monocyte behaviour. The data also suggest a potential solution: monocyte GABA(A receptors are insensitive to diazepam, thus the use of benzodiazepines as an alternative anesthetising agent may be advantageous where infection is a life

  7. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2012-02-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  8. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2011-04-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  9. Anaesthetic management of a patient with deep brain stimulation implant for radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Monica Khetarpal

    2014-01-01

    Full Text Available A 63-year-old man with severe Parkinson′s disease (PD who had been implanted with deep brain stimulators into both sides underwent radical nephrectomy under general anaesthesia with standard monitoring. Deep brain stimulation (DBS is an alternative and effective treatment option for severe and refractory PD and other illnesses such as essential tremor and intractable epilepsy. Anaesthesia in the patients with implanted neurostimulator requires special consideration because of the interaction between neurostimulator and the diathermy. The diathermy can damage the brain tissue at the site of electrode. There are no standard guidelines for the anaesthetic management of a patient with DBS electrode in situ posted for surgery.

  10. Simultaneous pancreas-kidney transplant for type I diabetes with renal failure: Anaesthetic considerations.

    Science.gov (United States)

    Kumar, Lakshmi; Surendran, Sudhindran; Kesavan, Rajesh; Menon, Ramachandran Narayana

    2016-02-01

    Pancreatic grafts have been successfully used in patients with diabetes and are combined with kidney transplantation in patients with renal failure. The propagation of awareness in organ donation in India has increased the donor pool of transplantable organs in the last few years making multi visceral transplants feasible in our country. We present the anaesthetic management of a 32-year-old male with diabetes mellitus and end-stage renal failure who was successfully managed with a combined pancreas and kidney transplantation. PMID:27013753

  11. Hypersensitivity to local anaesthetics--update and proposal of evaluation algorithm

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Menné, Torkil; Elberling, Jesper;

    2008-01-01

    Local anaesthetics (LA) are widely used drugs. Adverse reactions are rare but may be caused by delayed-type hypersensitivity reactions and probably also immediate-type reactions. As it is not always easy to clinically differ between these subtypes, allergy skin testing should be considered....... Although numerous test protocols have been published, how patients with hypersensitivity reactions to LA are ideally evaluated remains a topic of discussion. This review attempts to generate a comprehensive update on allergic reactions to LA and to present an algorithm that can be used for the evaluation...

  12. Anaesthetic Implications in Primary Hyperparathyroidism with Severe Hypercalcaemia; a Case Report

    Directory of Open Access Journals (Sweden)

    Pranav Bansal

    2013-07-01

    Full Text Available Primary hyperparathyroidism is a rare endocrinal disorder of excess production of parathormone. A wide array of presenting symptoms may occur from parathormone induced hypercalcaemia leading to nephrolithiasis, osteoporosis, muscle weakness and cardiac arrhythmias. We present a case of young female who presented with non union of an operated fracture femur and generalized bony pains and frequent complaints of vomiting, polyuria and polydipsia. She was diagnosed to have primary hyperparathyroidism with hypercalcaemia and underwent parathyroidectomy. The potential perioperative problems and anaesthetic concerns require a focused management and are discussed.

  13. On the local anaesthetic action of propolis and some of its constituents.

    Science.gov (United States)

    Paintz, M; Metzner, J

    1979-12-01

    An ethanolic propolis extract and some constituents isolated from propolis were tested on the cornea of the rabbit and of the mouse for local anaesthetic activity. Total anaesthesia was obtained with the total extract as well as with the compounds 5,7-dihydroxyflavanone (pinocembrin), 5-hydroxy-7-methoxyflavanone (pinostrobin) and with a mixture of caffeic acid esters. Each of these compounds was nearly thrice as potent as the total extract. Propoxypiperocaine which was tested for the purpose of comparison was still efficient in an almost 10-fold lower concentration. When applied subcutaneously, pinocembrin and the mixture of caffeic acid esters produced nearly the same anaesthesia as lidocaine. PMID:545354

  14. Morbidly obese patient with obstructive sleep apnoea for major spine surgery: An anaesthetic challenge

    Directory of Open Access Journals (Sweden)

    Shruti Redhu

    2016-01-01

    Full Text Available Morbidly obese patients with clinical features of obstructive sleep apnoea can present a myriad of challenges to the anaesthesiologists which must be addressed to minimise the perioperative risks. Initiation of continuous positive airway pressure (CPAP therapy early in the pre- and post-operative period along with appropriate anaesthetic planning is of paramount importance in such patients. This case report emphasises the usefulness of CPAP therapy, even for a short duration, to minimise morbidity, improve recovery and hasten early discharge from the hospital after major surgery.

  15. The value of decision tree analysis in planning anaesthetic care in obstetrics.

    Science.gov (United States)

    Bamber, J H; Evans, S A

    2016-08-01

    The use of decision tree analysis is discussed in the context of the anaesthetic and obstetric management of a young pregnant woman with joint hypermobility syndrome with a history of insensitivity to local anaesthesia and a previous difficult intubation due to a tongue tumour. The multidisciplinary clinical decision process resulted in the woman being delivered without complication by elective caesarean section under general anaesthesia after an awake fibreoptic intubation. The decision process used is reviewed and compared retrospectively to a decision tree analytical approach. The benefits and limitations of using decision tree analysis are reviewed and its application in obstetric anaesthesia is discussed. PMID:27026589

  16. Indomethacin enhances the effect of histamine on airways resistance in the anaesthetized guinea-pig.

    OpenAIRE

    Mitchell, H.W.

    1983-01-01

    In anaesthetized guinea-pigs intravenous histamine caused an increase in airways resistance (RA) and a fall in dynamic compliance (CDyn). Indomethacin (1 mg kg-1, i.v.) significantly enhanced the effect of histamine on RA. Indomethacin also increased the basal RA and the RA response to a histamine infusion. The effect of indomethacin on CDyn was less consistent but here also there was a trend for an increased response to histamine. Sodium carbonate (the vehicle for indomethacin, 0.05 ml 100 m...

  17. Anaesthetic management of a patient with Cushing′s syndrome and non-compaction cardiomyopathy for adrenal tumour resection

    Directory of Open Access Journals (Sweden)

    Akilandeswari Manickam

    2012-01-01

    Full Text Available We describe the anaesthetic management of adrenalectomy in a patient with Cushing′s syndrome due to adrenal mass with coexisting non-compaction cardiomyopathy. The problems due to hypersecretion of cortisol in Cushing′s syndrome were compounded by the association of a rare form of genetic cardiomyopathy with very few guidelines regarding the perioperative management. The knowledge about the pathophysiological changes, clinical presentation and complications in non-compaction cardiomyopathy is essential for planning the anaesthetic care, and the aim of this presentation is to highlight the issues crucial for management of such challenging patients.

  18. Anaesthetic Management of a patient with Myasthenia Gravis and Small Bowel Intussusception for Jejuno-Ileal Anastomoses

    Directory of Open Access Journals (Sweden)

    Pawan Kumar Jain

    2016-01-01

    Full Text Available Myasthenia gravis is a chronic autoimmune disease affecting voluntary skeletal muscles. The altered sensitivity of acetylcholine receptors to muscle relaxants and concomitant treatment with anticholinesterase in these patients affect their anaesthetic management. Patients who have undergone bowel anastomosis and are on regular anticholinesterase treatment are susceptible to anastomotic leaks. We report successful anaesthetic management of class I myasthenic patient with coexisting small bowel intussusception operated for jejuno-ileal anastomoses using regional, inhalational and intravenous (i.v anaesthesia based on train of four responses, and avoiding the use of reversal (anticholinesterase.

  19. Distribution of Methylene Blue after Injection into the Epidural Space of Anaesthetized Pregnant and Non-Pregnant Sheep

    OpenAIRE

    Moll Sánchez, Xavier; García Arnas, Félix; Ferrer, Rosa Isabel; Santos Benito, Laura; Aguilar Catalán, Adrià

    2014-01-01

    The aim of the study was to determine the distribution of different volumes of methylene blue solution injected into the epidural space in anaesthetized pregnant and non-pregnant sheep, to evaluate its cranial distribution and to compare between them. Fifteen pregnant and fifteen non-pregnant sheep were included in the study. Sheep were anaesthetized and received 0.05, 0.1, or 0.2 mL/kg of a lumbosacral epidural solution containing 0.12% methylene blue in 0.9% saline. Thirty minutes after the...

  20. Comparison of three different formulations of local anaesthetics for cervical epidural anaesthesia during thyroid surgery

    Directory of Open Access Journals (Sweden)

    Gaurav Jain

    2012-01-01

    Full Text Available Background: To compare the efficacy and safety of local anaesthetics under cervical epidural anaesthesia (CEA using lignocaine (1%, bupivacaine (0.25% and ropivacaine (0.5% for thyroid surgery. Methods: In a prospective, randomized fashion, 81 patients were selected for thyroid surgery under CEA. They were assigned to one of three groups: Group L, B and R to receive 10 mL of 1% lignocaine, 0.25% bupivacaine and 0.5% ropivacaine, respectively. We compared their efficacy in terms of pulmonary and haemodynamic parameters, blockade quality and complications. Results: Of the total, 74 patients completed the study successfully. Sensory block attained the median dermatomal range of C2-T4/T5 in all the groups. Motor block was more pronounced in the ropivacaine group. Cardiorespiratory parameters decreased significantly in all the groups; however, none of the patients had any major complications except for bradycardia in two patients. Among the measured variables, the decrease in heart rate and peak expiratory force was more in the lignocaine group while forced vital capacity and forced expiratory volume at 1 sec declined to a greater extent in the ropivacaine group. The lignocaine group required significantly more epidural top-ups compared with the other two groups. Conclusion: We conclude that cervical epidural route can be safely used for surgery on thyroid gland in patients with normal cardiorespiratory reserve, using either of local anaesthetics chosen for our study. Under the selected dose and concentrations, the decrease in cardiorespiratory parameters was lesser with bupivacaine.

  1. Regional and systemic haemodynamic changes evoked by 5-hydroxytryptamine in awake and anaesthetized rabbits

    International Nuclear Information System (INIS)

    The radioactive microsphere method has been used to study the effects of the infusions of 5-hydroxytryptamine (5-HT) on cardiac output and its distribution in both pentobarbital-anaesthetized and conscious rabbits. Doses of 5 and 10 μg kg-1 min-1 caused progressive decreases in diastolic pressure and total peripheral resistance in the anaesthetized rabbits but not in conscious ones. There was no significant effect on systolic pressure, cardiac output or heart rate. However, in spite of minimal systematic changes, in both groups 5-HT evoked increases in blood flow to the brain, heart and stomach at the expense of the kidneys, skin, liver (hepatic artery) and lungs (bronchial artery plus aerteriovenous anastomotic flow). The 10 μg kg-1 min-1 dose of 5-HT also increased blood flow and decreased resistance in the extracerebral tissues of the head. The significance of these findings in relation to the possible role of 5-HT in the migraine syndrome has been discussed. (Auth.)

  2. Drug distribution in spinal cord during administration with spinal loop dialysis probes in anaesthetized rats

    DEFF Research Database (Denmark)

    Uustalu, Maria; Abelson, Klas S P

    2007-01-01

    The present investigation aimed to study two methodological concerns of an experimental model, where a spinal loop dialysis probe is used for administration of substances to the spinal cord and sampling of neurotransmitters by microdialysis from the same area of anaesthetized rats. [(3)H]Epibatid......The present investigation aimed to study two methodological concerns of an experimental model, where a spinal loop dialysis probe is used for administration of substances to the spinal cord and sampling of neurotransmitters by microdialysis from the same area of anaesthetized rats. [(3)H......]Epibatidine in concentrations of 1, 10 and 100 nM was dissolved in Ringer's solution and administered through the dialysis membrane into the dorsal region of the cervical spinal cord. First, the outflow of [(3)H]epibatidine from the probe into the spinal cord was examined with respect to different concentrations and changes....... The administered [(3)H]epibatidine was found to be distributed to the area closest to the dialysis probe and not dispersed along the spinal cord, and the distribution was equal for all concentrations. The data presented in this investigation provide information, which is important for interpretation of data from...

  3. Influence of anaesthetic drugs on the epididymal sperm quality in domestic cats.

    Science.gov (United States)

    Jiménez, E; Pérez-Marín, C C; Millán, Y; Agüera, E

    2011-02-01

    The present study investigated the effect of different anaesthetic agents commonly used in cats on the fresh and frozen-thawed epididymal sperm. Seventeen male domestic cats were castrated using pentobarbital, ketamine HCl or isoflurane. Sperm samples were recovered from epididymides and evaluated before and after freezing, determining the vigor, motility, morphology, acrosome status, sperm viability and functional membrane integrity. Fresh epididymal sperm was influenced by the drugs used, noting that motility features, i.e. vigor (p≤0.05) and progressive motility (p≤0.05), were higher for the inhalation anaesthetic while the others did not showed statistical differences. In frozen-thawed sperm samples, cats treated with barbiturics showed lower values for acrosome status (p≤0.05) and integrity and functionality of membrane (p≤0.05 and p≤0.01, respectively) than in the others groups. Results suggested that drugs used for castration in cats could affect the sperm quality and this should be considered when implementing sperm cryopreservation in the feline. PMID:21288668

  4. Accident analysis of large-scale technological disasters applied to an anaesthetic complication.

    Science.gov (United States)

    Eagle, C J; Davies, J M; Reason, J

    1992-02-01

    The occurrence of serious accidents in complex industrial systems such as at Three Mile Island and Bhopal has prompted development of new models of causation and investigation of disasters. These analytical models have potential relevance in anaesthesia. We therefore applied one of the previously described systems to the investigation of an anaesthetic accident. The model chosen describes two kinds of failures, both of which must be sought. The first group, active failures, consists of mistakes made by practitioners in the provision of care. The second group, latent failures, represents flaws in the administrative and productive system. The model emphasizes the search for latent failures and shows that prevention of active failures alone is insufficient to avoid further accidents if latent failures persist unchanged. These key features and the utility of this model are illustrated by application to a case of aspiration of gastric contents. While four active failures were recognized, an equal number of latent failures also became apparent. The identification of both types of failures permitted the formulation of recommendations to avoid further occurrences. Thus this model of accident causation can provide a useful mechanism to investigate and possibly prevent anaesthetic accidents. PMID:1544192

  5. Cyclohexanol analogues are positive modulators of GABA(A) receptor currents and act as general anaesthetics in vivo.

    Science.gov (United States)

    Hall, Adam C; Griffith, Theanne N; Tsikolia, Maia; Kotey, Francesca O; Gill, Nikhila; Humbert, Danielle J; Watt, Erin E; Yermolina, Yuliya A; Goel, Shikha; El-Ghendy, Bahaa; Hall, C Dennis

    2011-09-30

    GABA(A) receptors meet all the pharmacological criteria required to be considered important general anaesthetic targets. In the following study, the modulatory effects of various commercially available and novel cyclohexanols were investigated on recombinant human γ-aminobutyric acid (GABA(A), α(1)β(2)γ(2s)) receptors expressed in Xenopus oocytes, and compared to the modulatory effects on GABA currents observed with exposures to the intravenous anaesthetic agent, propofol. Submaximal EC(20) GABA currents were typically enhanced by co-applications of 3-300 μM cyclohexanols. For instance, at 30 μM 2,6-diisopropylcyclohexanol (a novel compound) GABA responses were increased ~3-fold (although similar enhancements were achieved at 3 μM propofol). As regards rank order for modulation by the cyclohexanol analogues at 30 μM, the % enhancements for 2,6-dimethylcyclohexanol~2,6-diethylcyclohexanol~2,6-diisopropylcyclohexanol~2,6-di-sec-butylcyclohexanol ≫2,6-di-tert-butylcyclohexanol~4-tert-butylcyclohexanol>cyclohexanol~cyclopentanol~2-methylcyclohexanol. We further tested the potencies of the cyclohexanol analogues as general anaesthetics using a tadpole in vivo assay. Both 2,6-diisopropylcyclohexanol and 2,6-dimethylcyclohexanol were effective as anaesthetics with EC(50)s of 14.0 μM and 13.1 μM respectively, while other cyclohexanols with bulkier side chains were less potent. In conclusion, our data indicate that cyclohexanols are both positive modulators of GABA(A) receptors currents and anaesthetics. The positioning and size of the alkyl groups at the 2 and 6 positions on the cyclohexanol ring were critical determinants of activity. PMID:21658385

  6. Effect of anaesthetics MS-222 and clove oil on blood biochemical parameters of juvenile Siberian sturgeon (Acipenser baerii)

    Science.gov (United States)

    Feng, G.; Zhuang, P.; Zhang, L.; Kynard, B.; Shi, X.; Duan, M.; Liu, J.; Huang, X.

    2011-01-01

    The effects of MS-222 and clove oil on blood biochemical parameters of juvenile Siberian sturgeon (Acipenser baerii) were studied. MS-222 caused higher glucose (GLU) concentrations in anaesthetic test groups than for the control group. Triglyceride (TGL) concentrations of fish in the 140 and 160mgL-1 groups were also significantly higher than those of other groups. Alanine aminotransferase (ALT) activity in the 140mgL-1 group was significantly higher than the level in 80, 100 and 120mgL-1 groups. Aspartate aminotransferase (AST) activity in the 140mgL-1 group was significantly higher than those in the 100 and 120mgL-1 groups. Levels of total protein (TP), cholesterol (CHOL) and alkaline phosphatase (ALP) in anaesthetic test groups were not significantly influenced by MS-222. Clove oil did not have significant effects on levels of GLU, TP, CHOL, ALT and ALP. TGL concentration of fish exposed to 180mgL-1 clove oil was significantly higher than those of the rest anaesthetic groups. AST activities of fish exposed to 120, 150 and 180mgL-1 were significantly higher than those of 60 and 90mgL-1. Overall, TGL and AST could be potentially used as indicators of anaesthetic stress for juvenile Siberian sturgeon. Based on blood biochemical parameters, the appropriate anaesthetic concentrations of MS-222 and clove oil were 80-120mgL-1 and 60-90mgL-1, respectively. Clove oil was a promising alternative to MS-222. ?? 2011 Blackwell Verlag, Berlin.

  7. Clove oil as an anaesthetic for adult sockeye salmon: Field trials

    Science.gov (United States)

    Woody, C.A.; Nelson, Jack L.; Ramstad, K.

    2002-01-01

    Wild migrating sockeye salmon Oncorhynchus nerka exposed to 20, 50 and 80 mg 1-1 of clove oil could be handled within 3 min, recovered within 10 min, and survived 15 min exposure trials. Fish tested at 110 mg 1-1 did not recover from 15 min exposure trials. Response curves developed for induction and recovery time considered the following predictors: clove oil concentration, sex, fish length and depth. A significant positive dependence was observed between induction time and fish length for 20, 50 and 80 mg 1-1 test concentrations; no dependence was observed between induction time and length at 110 and 140 mg 1-1. Recovery time differed as a function of clove oil concentration, but not fish size. A concentration of 50 mg 1-1 is recommended for anaesthetizing sockeye salmon ranging in length from 400 to 550 mm at water temperatures averaging 9-10??C.

  8. Conjugates of methylated cyclodextrin derivatives and hydroxyethyl starch (HES: Synthesis, cytotoxicity and inclusion of anaesthetic actives

    Directory of Open Access Journals (Sweden)

    Lisa Markenstein

    2014-12-01

    Full Text Available The mono-6-deoxy-6-azides of 2,6-di-O-methyl-β-cyclodextrin (DIMEB and randomly methylated-β-cyclodextrin (RAMEB were conjugated to propargylated hydroxyethyl starch (HES by Cu+-catalysed [2 + 3] cycloaddition. The resulting water soluble polymers showed lower critical solution temperatures (LCST at 52.5 °C (DIMEB-HES and 84.5 °C (RAMEB-HES, respectively. LCST phase separations could be completely avoided by the introduction of a small amount of carboxylate groups at the HES backbone. The methylated CDs conjugated to the HES backbone exhibited significantly lower cytotoxicities than the corresponding monomeric CD derivatives. Since the binding potentials of these CD conjugates were very high, they are promising candidates for new oral dosage forms of anaesthetic actives.

  9. Infusion thrombophlebitis: a prospective comparison of 645 Vialon and Teflon cannulae in anaesthetic and postoperative use.

    Science.gov (United States)

    Gaukroger, P B; Roberts, J G; Manners, T A

    1988-08-01

    A prospective study of the incidence and severity of infusion thrombophlebitis in peripheral intravenous infusions used for anaesthetic and postoperative purposes in 645 patients was conducted over a four-month period. Conditions of insertion were carefully controlled while ward management was according to standard practice. A total of 330 polyurethane Vialon and 315 FEP-A Teflon cannulae were used. The results show that the nature of the cannula was the single most important factor in the incidence and severity of infusion thrombophlebitis, Vialon cannulae being associated with a 46% lower incidence than the Teflon type. Less important but significant factors included intravenous antibiotics, duration of infusion, cannula tip damage and caesarean section. Factors not associated with infusion thrombophlebitis included potassium therapy, blood transfusion or site of insertion in the upper limb. Heparinisation increased duration of infusion without affecting the incidence of infusion thrombophlebitis. PMID:3189736

  10. Anaesthetic management of craniotomy for intracranial lesion in a child with uncorrected Tetrology of Fallot

    International Nuclear Information System (INIS)

    The case of a 16 years old female with uncorrected Tetrology of Fallot, who operated for intracranial lesion in parieto frontal area with midline shift is presented. She had right ventricular hypertrophy, clubbing, central and peripheral cyanosis. Patient was anaesthetized keeping all measures required to avoid haemodynamic swings, tachycardia, desaturation, acidosis and dehydration. Pre-operative antibiotic cover was given to prevent bacterial endocarditis. Neurosurgeon, Paediatric cardiologist, Anaesthesiologist and Intensivist were involved in the preoperative planning and management of the patient. Haemodynamics were maintained and managed by monitoring continuous arterial line secured pre-induction and central line after induction. During surgery pain was controlled with fentanyl boluses intra-operatively and post operatively by tramadol infusion. Patient was extubated post operatively in the recovery room fulfilling the extubation criteria. She remained haemodynamically stable throughout the course. She was discharged on 5th post operative day from the hospital on SpO/sub 2/ of 70-80% at room air. (author)

  11. Anaesthetic management of two Bengal tiger (Panthera tigris tigris cubs for fracture repair

    Directory of Open Access Journals (Sweden)

    Gareth E. Zeiler

    2013-02-01

    Full Text Available This case series describes the anaesthetic management of two sibling Bengal tiger (Panthera tigris tigris cubs that were found to have spontaneous femur fractures due to severe nutritional secondary hyperparathyroidism. Both cubs received a combination of medetomidine (25 µg/kg and ketamine (4 mg/kg intramuscularly and were maintained with isoflurane in oxygen. An epidural injection of morphine (0.1 mg/kg and ropivacaine (1.6 mg/kg was administered to both tigers, which allowed a low end-tidal isoflurane concentration to be maintained throughout the femur fracture reduction operations. Both cubs experienced profound bradycardia and hypotension during general anaesthesia, and were unresponsive to anticholinergic treatment. Possible causes for these cardiovascular complications included: drug pharmacodynamics (medetomidine, morphine, isoflurane, decreased sympathetic tone due to the epidural (ropivacaine and hypothermia. These possible causes are discussed in detail.

  12. Anaesthetic management of shoulder arthroscopic repair in Parkinson′s disease with deep brain stimulator

    Directory of Open Access Journals (Sweden)

    Ranju Gandhi

    2014-01-01

    Full Text Available We describe the anaesthetic management of arthroscopic repair for complete rotator cuff tear of shoulder in a 59-year-old female with Parkinson′s disease (PD with deep brain stimulator (DBS using a combination of general anaesthesia with interscalene approach to brachial plexus block. The DBS consists of implanted electrodes in the brain connected to the implantable pulse generator (IPG normally placed in the anterior chest wall subcutaneously. It can be programmed externally from a hand-held device placed directly over the battery stimulator unit. In our patient, IPG with its leads was located in close vicinity of the operative site with potential for DBS malfunction. Implications of DBS in a patient with PD for shoulder arthroscopy for anaesthesiologist are discussed along with a brief review of DBS.

  13. ANAESTHETIC MANAGEMENT OF PREGNANT PATIENT WITH UNCONTROLLED HYPERTHYROIDISM FOR EMERGENCY CAESARIAN SECTION

    Directory of Open Access Journals (Sweden)

    Bala Subramanya

    2014-09-01

    Full Text Available The anaesthetic management of patient with uncontrolled hyperthyroidism requiring emergency cesarean section is presented here. Elevated free T3 and T4 and severely suppressed TSH levels confirmed the diagnosis. Propyl thio uracil was started preoperatively. IV Metoprolol was used to control the pre-operative heart rate. After adequate preloading with crystalloids, spinal anaesthesia was administered. There were three episodes of hypotension and tachycardia which were successfully managed with small dose of IV Phenylephrine. Post-operative anaelgesia was administered through epidural catheter. Patient was observed in intensive care unit for congestive cardiac failure and thyroid storm. Anti-thyroid drugs, Propranolol and Dexamethasone were given in the post-operative period.

  14. Quantification of anaesthetic effects on atrial fibrillation rate by partial least-squares

    International Nuclear Information System (INIS)

    The mechanism underlying atrial fibrillation (AF) remains poorly understood. Multiple wandering propagation wavelets drifting through both atria under hierarchical models are not understood. Some pharmacological drugs, known as antiarrhythmics, modify the cardiac ionic currents supporting the fibrillation process within the atria and may modify the AF propagation dynamics terminating the fibrillation process. Other medications, theoretically non-antiarrhythmic, may slightly affect the fibrillation process in non-defined mechanisms. We evaluated whether the most commonly used anaesthetic agent, propofol, affects AF patterns. Partial least-squares (PLS) analysis was performed to reduce significant noise into the main latent variables to find the differences between groups. The final results showed an excellent discrimination between groups with slow atrial activity during the propofol infusion. (paper)

  15. Anaesthetic specialist registrars in Ireland: current teaching practices and perceptions of their role as undergraduate teachers.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    BACKGROUND AND OBJECTIVES: Teaching is an important responsibility of non-consultant hospital doctors. In Ireland, specialist registrars (SpRs) in anaesthesia are contractually obliged to teach medical students, other doctors and nurses. Both medical students and fellow non-consultant hospital doctors attribute between 30 and 40% of their knowledge gain to non-consultant hospital doctors. METHODS: We carried out a confidential telephone survey of anaesthetic SpRs in Ireland regarding their current teaching practices and the perceptions of their role as undergraduate teachers. All the SpRs currently working in clinical practice in Ireland were eligible. RESULTS: Fifty-five of the 79 (70%) SpRs responded to the questionnaire. Only 7 (12.7%) of the respondents said they had been well trained as a teacher. The majority of the respondents stated that they would attend a learning-to-teach course\\/workshop if one was available, and felt that such a course would improve their ability as a teacher. Only 8 (14.5%) agreed that adequate emphasis is placed on commitment to teaching in the assessment of SpRs, both by individual departments and by the College of Anaesthetists. Anaesthetic SpRs in Ireland spend a considerable amount of time each day teaching undergraduate medical students, the majority (68.9%) stated that they had inadequate time to prepare for teaching. CONCLUSION: The majority of the respondents stated that they enjoy teaching, feel that they play an important role in undergraduate teaching but have inadequate time to prepare for teaching. An adequate emphasis is not placed on their commitment to teaching.

  16. Intraoperative esmolol infusion reduces postoperative analgesic consumption and anaesthetic use during septorhinoplasty: a randomized trial

    Directory of Open Access Journals (Sweden)

    Nalan Celebi

    2014-09-01

    Full Text Available Background and objectives: Esmolol is known to have no analgesic activity and no anaesthetic properties; however, it could potentiate the reduction in anaesthetic requirements and reduce postoperative analgesic use. The objective of this study is to evaluate the effect of intravenous esmolol infusion on intraoperative and postoperative analgesic consumptions as well as its effect on depth of anaesthesia. Methods: This randomized-controlled double blind study was conducted in a tertiary care hospital between March and June 2010. Sixty patients undergoing septorhinoplasty were randomized into two groups. History of allergy to drugs used in the study, ischaemic heart disease, heart block, bronchial asthma, hepatic or renal dysfunction, obesity and a history of chronic use of analgesic or β-blockers were considered cause for exclusion from the study. Thirty patients received esmolol and remifentanil (esmolol group and 30 patients received normal saline and remifentanil (control group as an intravenous infusion during the procedure. Mean arterial pressure, heart rate, and bispectral index values were recorded every 10min. Total remifentanil consumption, visual analogue scale scores, time to first analgesia and total postoperative morphine consumption were recorded. Results: The total remifentanil consumption, visual analogue scale scores at 0, 20 and 60 min, total morphine consumption, time to first analgesia and the number of patients who needed an intravenous morphine were lower in the esmolol group. Conclusions: Intravenous infusion of esmolol reduced the intraoperative and postoperative analgesic consumption, reduced visual analogue scale scores in the early postoperative period and prolonged the time to first analgesia; however it did not influence the depth of anaesthesia.

  17. GOAL ORIENTED ANAESTHETIC MANAGEMENT FOR CAESAREAN SECTION IN A PARTURIENT WITH PITUITARY TUMOUR

    Directory of Open Access Journals (Sweden)

    Sushma

    2015-03-01

    Full Text Available BACKGROUND AND OBJECTIVE: Anesthesia for Pregnancy with pituitary tumours is a challenge to an Anesthesiologist , requires careful preoperative assessment and meticulous perioperative management to achieve optimal safety of mother and fetus. There are very limited studies in literature to guide the anaesthetic management of such patients. Here we report the successful Anaesthetic management of a parturient with pituitary tumour with epilepsy posted for emergency caesarean section. PRESENTATION, DIAGNOSIS, MANAGEMENT: A 25 year young woman, G2P1L1, a known epileptic, diagnosed with pituitary macroadenoma presented at 40 weeks of gestation with severe Oligohydramnios (AFI - 4cm was posted for an emergency caesarean section. Following consultation with the obstetrician, neonato logist and the neurosurgeon the decision was made to proceed with caesarean section under general anesthesia. Rapid sequence induction and intubation was performed with inj Thiopentone sodium and inj Rocuronium and was maintained with Isoflurane, titrated to maintain the stability of mean arterial pressure until extraction. A live 4. 25kgs male child was born with Apgar scores of 8 and 9 at 1 and 5 mins respectively. Following extraction 10U run as infusion in Ringers lactate. Intraoperative analgesia was a dministered after extraction. Dexmedetomedine infusion was used. Postoperative period was uneventful. DISCUSSION & CONCLUSION: Management of obstetric patients with pituitary tumour is complex, requiring knowledge of the physiological effects of pregnancy on tumour size and labour on intracranial pressure. General anesthesia combined with multimodal balanced analgesia is associated with a favorable outcome. General anaesthesia using Thiopentone, Fentanyl, Dexmedetomedine and titrated dose of Isoflurane was used in our case were found to be safe with adequate hemodynamic stability and postoperative pain control. A team approach involving the Anaesthethesiologist

  18. Anaesthetic induction and recovery characteristics of a diazepam-ketamine combination compared with propofol in dogs

    Directory of Open Access Journals (Sweden)

    Jacques P. Ferreira

    2015-03-01

    Full Text Available Induction of anaesthesia occasionally has been associated with undesirable behaviour in dogs. High quality of induction of anaesthesia with propofol has been well described while in contrast variable induction and recovery quality has been associated with diazepam-ketamine. In this study, anaesthetic induction and recovery characteristics of diazepam-ketamine combination with propofol alone were compared in dogs undergoing elective orchidectomy. Thirty-six healthy adult male dogs were used. After habitus scoring (simple descriptive scale [SDS], the dogs were sedated with morphine and acepromazine. Forty minutes later a premedication score (SDS was allocated and general anaesthesia was induced using a combination of diazepam-ketamine (Group D/K or propofol (Group P and maintained with isoflurane. Scores for the quality of induction, intubation and degree of myoclonus were allocated (SDS. Orchidectomy was performed after which recovery from anaesthesia was scored (SDS and times to extubation and standing were recorded. Data were analysed using descriptive statistics and Kappa Reliability and Kendall Tau B tests. Both groups were associated with acceptable quality of induction and recovery from anaesthesia. Group P, however, was associated with a poorer quality of induction (p = 0.014, prolonged induction period (p = 0.0018 and more pronounced myoclonus (p = 0.003, but had better quality of recovery (p = 0.000002 and shorter recovery times (p = 0.035 compared with Group D/K. Diazepam-ketamine and propofol are associated with acceptable induction and recovery from anaesthesia. Propofol had inferior anaesthetic induction characteristics, but superior and quicker recovery from anaesthesia compared with diazepam-ketamine.

  19. AB192. Efficacy and safety of local anaesthetics in the treatment of premature ejaculation: a systematic review and meta-analysis

    OpenAIRE

    Xia, Jiadong; Dai, Yutian

    2015-01-01

    Objective To assess the efficacy and safety of local anaesthetics for premature ejaculation (PE), a systematic review of the literature was performed using the Cochrane Library, PubMed and EMBASE. Methods We screened and retrieved the randomised controlled trials on the treatment of PE with local anaesthetics. End points included intravaginal ejaculation latency time (IELT), patient-reported outcome assessments and adverse events. Meta-analyses were conducted with STATA 11.0. Results In total...

  20. Efficacy of sub-Tenon's block using an equal volume of local anaesthetic administered either as a single or as divided doses. A randomised clinical trial.

    LENUS (Irish Health Repository)

    Khan, Ehtesham I

    2009-01-01

    Sub-Tenon\\'s anaesthetic is effective and reliable in producing both akinesia and anaesthesia for cataract surgery. Our clinical experience indicates that it is sometimes necessary when absolute akinesia is required during surgery to augment the block with 1-2 ml of local anaesthetic. Hypothesis was that after first injection some of the volume injected may spill out and before second injection the effect of hyaluronidase has taken place and second volume injectate will have desired effect.

  1. The actions of ether, alcohol and alkane general anaesthetics on GABAA and glycine receptors and the effects of TM2 and TM3 mutations

    OpenAIRE

    Matthew D Krasowski; Harrison, Neil L.

    2000-01-01

    The actions of 13 general anaesthetics (diethyl ether, enflurane, isoflurane, methoxyflurane, sevoflurane, chloral hydrate, trifluoroethanol, tribromoethanol, tert-butanol, chloretone, brometone, trichloroethylene, and α-chloralose) were studied on agonist-activated Cl− currents at human GABAA α2β1, glycine α1, and GABAC ρ1 receptors expressed in human embryonic kidney 293 cells.All 13 anaesthetics enhanced responses to submaximal (EC20) concentrations of agonist at GABAA and glycine receptor...

  2. An investigation into how the European Working Time Directive has affected anaesthetic training

    Directory of Open Access Journals (Sweden)

    Bowhay Andrew R

    2008-08-01

    Full Text Available Abstract Background The European Working Time Directive (EWTD became law in 1993 but only applied to doctors in training in the United Kingdom in 2004. The trainees have in consequence had a reduction in their working hours but also a change to a shift pattern of working. For craft specialities, such as anaesthesia, there are concerns that a reduction in working hours has also led to a reduction in the time available for learning and that ultimately this may affect patient care. However, there is scant research on the perceptions of trainees concerning the impact of the EWTD on their training and working lives. This study investigated what the anaesthetic Specialist Registrars (SpRs on the Mersey Deanery SpR rotation perceived to be training and also what effect the EWTD has had on that training and their quality of life, both within and outside work. Methods The project was a cross sectional survey, using a quantitative questionnaire with qualitative free text comments which were aggregated into overarching themes and sub themes. Results 117 SpRs were sent questionnaires in April 2005; 73 completed questionnaires were returned (response rate 62.4%. Hierarchies of training opportunities emerged with training by consultants being most valued. 71.8% (95% CI 60.7 – 81.3 of trainees believed the EWTD has had a deleterious effect on their training and experience and 74.3% (95% CI 63.2 – 83.4 thought that they will be less prepared for a consultant post. 69.9% (95% CI 58.7 – 79.5 considered that their quality of life outside work had deteriorated, with only 15% (95% CI 8.3 – 24.6 finding improvement. 38.6% (95% CI 27.8 – 50.3 felt that they were not functioning as well as doctors, only 14.3% (95% CI 7.6 – 23.9 noting improvement. The trainees were still positive about anaesthesia and 73.2% (95% CI 62.2 – 82.5 would recommend this specialty to a student. Conclusion The majority of anaesthetic SpRs in the Mersey Deanery have not welcomed

  3. Haemodynamic and anaesthetic management of patients undergoing endovascular therapy for cerebral vasospasm

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    Audrey Tan

    2014-01-01

    Full Text Available Background: Cerebral vasospasm is a common and devastating complication after a subarachnoid haemorrhage (SAH. Current guidelines for treatment recommend hypertension with euvolaemia. Endovascular therapy with cerebral angioplasty and possible administration of intra-arterial vasodilators is indicated in patients who fail medical treatment. The objective of our study was to review the haemodynamic management and anaesthetic care of patients undergoing endovascular therapy for cerebral vasospasm in our institution. Materials and Methods: The medical records of all patients who underwent endovascular therapy for cerebral vasospasm between, April 2006 and September 2012, were reviewed retrospectively. Patients with clinical vasospasm were treated initially by inducing hypertension to systolic pressures of 140 to 170 mmHg; Endovascular treatment was performed, if there was no clinical improvement. Data was collected on blood pressure measurements, anaesthetic management, duration and complications of hypertensive therapy and outcome. The differences in the pre- and post-angioplasty systolic blood pressure were statistically analysed. Results : A total of 45 patients had 47 endovascular interventions, with balloon angioplasty for proximal vessel spasm and 16 (34% patients had additional intra-arterial injection of a vasodilator agent. Onset of vasospasm was 7 days (range 2-15 days after SAH. Vasospasm was usually seen in multiple vessels in the same patient regardless of the site of ruptured aneurysm and was present unilaterally in 80% of the patients. All patients had a general anaesthesia for the procedure. Prior to endovascular treatment 68.9% patients required vasopressors, but post angioplasty 93.3% required them. Norepinephrine was the most commonly used (66.2%. Angioplasty was successful in reversing the cerebral vasospasm as assessed by angiography in all patients with no intra-procedure complications. Overall 80% of patients were discharged

  4. N-nitro L-arginine causes coronary vasoconstriction and inhibits endothelium-dependent vasodilatation in anaesthetized greyhounds.

    OpenAIRE

    Woodman, O. L.; Dusting, G J

    1991-01-01

    1. The effect of N-nitro-L-arginine (L-NNA), an inhibitor of nitric oxide biosynthesis, on large coronary artery diameter and coronary blood flow was examined in anaesthetized greyhounds. The effects of L-NNA on the coronary vascular responses to acetylcholine (ACh), glyceryl trinitrate (GTN) and 5-hydroxytryptamine (5-HT) were also assessed. 2. L-NNA (5 mg kg-1), infused into the left circumflex coronary artery, increased systemic mean arterial pressure and decreased the external diameter of...

  5. An anaesthetic pre-operative assessment clinic reduces pre-operative inpatient stay in patients requiring major vascular surgery.

    LENUS (Irish Health Repository)

    O'Connor, D B

    2012-02-01

    BACKGROUND: Patients undergoing major vascular surgery (MVS) require extensive anaesthetic assessment. This can require extended pre-operative stays. AIMS: We investigated whether a newly established anaesthetic pre-operative assessment clinic (PAC) would reduce the pre-operative inpatient stay, avoid unnecessary investigations and facilitate day before surgery (DBS) admissions for patients undergoing MVS. PATIENT AND METHODS: One year following and preceding the establishment of the PAC the records of patients undergoing open or endovascular aortic aneurysm repair, carotid endarterectomy and infra-inguinal bypass were reviewed to measure pre-operative length of stay (LoS). RESULTS: Pre-operative LoS was significantly reduced in the study period (1.85 vs. 4.2 days, respectively, P < 0.0001). Only 12 out of 61 patients in 2007 were admitted on the DBS and this increased to 33 out of 63 patients (P = 0.0002). No procedure was cancelled for medical reasons. CONCLUSION: The PAC has facilitated accurate outpatient anaesthetic assessment for patients requiring MVS. The pre-operative in-patient stay has been significantly reduced.

  6. Episodic hypoxia induces long-term facilitation of upper airway muscle activity in spontaneously breathing anaesthetized rats.

    Science.gov (United States)

    Ryan, Stephen; Nolan, Philip

    2009-07-01

    We performed these experiments to determine if repeated exposure to episodic hypoxia induces long term facilitation (LTF) in anaesthetized spontaneously breathing rats. A previous study in spontaneously breathing rats was unable to demonstrate evidence of LTF with repeated hypoxia, but this may have been due to the low number of hypoxic episodes used. We hypothesized that with sufficient exposure, episodic hypoxia LTF of genioglossus (GG), hyoglossus (HG) and diaphragm (Dia) activities would be elicited. Experiments were performed in 24 anaesthetized spontaneously breathing rats with intact vagi. Peak and tonic GG, HG and Dia EMG activities were recorded before, during and for 1 h following exposure to eight (n = 8) or three (n = 8) episodes of isocapnic hypoxia ( = 0.1) each of 3 min duration. A third time control series was also performed with exposure to normoxia alone ( = 0.28, n = 8). Short-term potentiation of GG and HG muscle activity developed during the early period after repeated exposure to eight and three hypoxic episodes. LTF, however, occurred only after eight hypoxic episodes. This manifested as an increase in peak GG and Dia inspiratory muscle activity and tonic HG activity. LTF of respiratory breathing frequency was also induced, reflected by a reduction in inspiratory and expiratory time. These findings support our initial hypothesis that LTF in the anaesthetized, spontaneously breathing rat is dependent on the number of exposures to hypoxia and show that the responses to repetitive hypoxia are composed of both short and long-term facilitatory changes. PMID:19332489

  7. Effects of some analgesic anaesthetic drugs on human erythrocyte glutathione reductase: an in vitro study.

    Science.gov (United States)

    Senturk, Murat; Irfan Kufrevioglu, O; Ciftci, Mehmet

    2009-04-01

    Inhibitory effects of some analgesic and anaesthetic drugs on human erythrocyte glutathione reductase were investigated. For this purpose, human erythrocyte glutathione reductase was initially purified 2139-fold in a yield of 29% by using 2', 5'-ADP Sepharose 4B affinity gel and Sephadex G-200 gel filtration chromatography. SDS polyacrylamide gel electrophoresis confirmed the purity of the enzyme by sharing a single band. A constant temperature (+4 degrees C) was maintained during the purification process. Diclofenac sodium, ketoprofen, lornoxicam, tenoxicam, etomidate, morphine and propofol exhibited inhibitory effects on the enzyme in vitro using the Beutler assay method. K(i) constants and IC(50) values for drugs were determined from Lineweaver-Burk graphs and plotting activity % versus [I] graphs, respectively. The IC(50) values of diclofenac sodium, ketoprofen, lornoxicam, propofol, tenoxicam, etomidate and morphine were 7.265, 6.278, 0.3, 0.242, 0.082, 0.0523 and 0.0128 mM and the K(i) constants were 23.97 +/- 2.1, 22.14 +/- 7.6, 0.42 +/- 0.18, 0.418 +/- 0.056, 0.13 +/- 0.025, 0.0725 +/- 0.0029 and 0.0165 +/- 0.0013 mM, respectively. While diclofenac sodium, ketoprofen, lornoxicam, tenoxicam etomidate and morphine showed competitive inhibition, propofol displayed noncompetitive inhibition. PMID:18608753

  8. Mechanisms of cardiovascular activity of Andrographis paniculata in the anaesthetized rat.

    Science.gov (United States)

    Zhang, C Y; Tan, B K

    1997-04-01

    The cardiovascular activities of crude water extract (WE) of Andrographis paniculata (Burm. f.) Nees (Acanthaceae), its three semi-purified ethyl acetate (FA), n-butanol (FB) and aqueous (FC) fractions, as well as andrographolide, a major plant constituent, were elucidated in anaesthetized Sprague-Dawley (SD) rats for the very first time. FA and andrographolide, which possesses multiple pharmacological activities, elicited no drop in mean arterial blood pressure (MAP), while WE, FB and FC produced a significant fall in MAP in a dose-dependent manner without significant decrease in heart rate. The ED50 values for WE, FB and FC were 11.4, 5.0 and 8.6 mg/kg-respectively. These suggested that the hypotensive substance(s) of the crude water extract was concentrated in FB. Pharmacological antagonist studies were consequently only tested in FB (5 mg/kg). The hypotensive action of FB was not mediated through effects on the beta-adrenoceptor, muscarinic cholinergic receptor and angiotensin-converting enzyme, for it was not affected by propranolol, atropine and captapril, respectively. However, it seems to work via alpha-adrenoceptors, autonomic ganglion and histaminergic receptors, since the hypotensive effect of FB was negated or attenuated in the presence of phentolamine, hexamethonium as well as pyrilamine and cimetidine. PMID:9174969

  9. Subcutaneous versus subcutaneous and intraperitoneal local anaesthetic in the management of post appendicectomy pain

    International Nuclear Information System (INIS)

    To compare the efficacy of subcutaneous only and combined subcutaneous and peritoneal infiltration of 0.5% bupivacaine during appendicectomy for the management of early post operative pain. Study Design: Randomized controlled study. Place and Duration of Study: Department of Surgery, CMH Kohat from 13th December 2007 to 20th December 2008. Patients and Methods: Sixty patients of a cute appendicitis, divided into two groups of 30 each, were included in the study. Group A was given 0.5% bupivacaine subcutaneously, whereas group B was given the anaesthetic subcutaneously as well as intraperitoneally during appendectomy. Results: In group A, 24 (80%) were VAS (visual analoguescoring) 3 (uncomfortable) and 6 (20%) were VAS 2 (mild pain) whereas in study group B, 11 (36.6%) were VAS 3, 19 (63.3%) were VAS 2 and 19 (63.3%) were VAS 2 during 1st 12 hrs postoperatively (p=0.001). In 12-24 hrs post operatively, 15 (50%) patients were VAS 3 in group A and same number was VAS 2 and in group B, only 3 (10%) were in VAS 3 and 27 (90%) were VAS 2 (p=0.001). Conclusion: A combination of subcutaneous and peritoneal infiltration with bupivacaine is superior in relieving post appendectomy pain so patients require less dosage of analgesics in early post operative period along with early mobilization. (author)

  10. Modified PADSS (Post Anaesthetic Discharge Scoring System) for monitoring outpatients discharge.

    Science.gov (United States)

    Palumbo, Piergaspare; Tellan, Guglielmo; Perotti, Bruno; Pacilè, Maria Antonietta; Vietri, Francesco; Illuminati, Giulio

    2013-01-01

    The decision to discharge a patient undergoing day surgery is a major step in the hospitalization pathway, because it must be achieved without compromising the quality of care, thus ensuring the same assistance and wellbeing as for a long-term stay. Therefore, the use of an objective assessment for the management of a fair and safe discharge is essential. The authors propose the Post Anaesthetic Discharge Scoring System (PADSS), which considers six criteria: vital signs, ambulation, nausea/vomiting, pain, bleeding and voiding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a score of 9 or more are considered ready for discharge. Furthermore, PADSS has been modified to ensure a higher level of safety, thus the "vital signs" criteria must never score lower than 2, and none of the other five criteria must ever be equal to 0, even if the total score reaches 9. The effectiveness of PADSS was analyzed on 2432 patients, by recording the incidence of postoperative complications and the readmission to hospital. So far PADDS has proved to be an efficient system that guarantees safe discharge. PMID:23165318

  11. The effect of the anaesthetic agent isoflurane on the rate of neutrophil apoptosis in vitro.

    LENUS (Irish Health Repository)

    Tyther, R

    2012-02-03

    BACKGROUND: Volatile anaesthetic agents influence neutrophil function, and potentially, the inflammatory response to surgery. AIM: The objective of this study was to determine the effect of isoflurane (1-4%) on human polymorphonuclear neutrophil apoptosis in vitro. METHODS: Venous blood from 12 healthy volunteers was exposed to 0, 1, and 4% isoflurane delivered via a 14G Wallace flexihub internal jugular cannula, at a fresh gas flow of 0.51\\/min for 5 minutes. Isolated neutrophils were assessed for apoptosis at 1, 12, and 24 hours in culture using dual staining with annexin V-FITC and propidium iodide (Annexin-V FITC assay). Data were analysed using paired, one-tailed Student\\'s t-tests. p<0.05 was considered significant. RESULTS: At 1 hour apoptosis was inhibited in the 1% (5.1 [6.8]%; p=0.017) and 4% (4.8 [4.5]%; p=0.008) isoflurane groups compared to control (11.3 [6.9]%). At 12 and 24 hours, a dose-dependent inhibition of apoptosis was demonstrated, i.e. 4% > 1% > 0%. CONCLUSION: Human neutrophil apoptosis is inhibited in a concentration-dependent manner in vitro by isoflurane in clinical concentrations.

  12. Detrimental effect of hypothermia during acute normovolaemic haemodilution in anaesthetized cats

    Science.gov (United States)

    Talwar, A.; Fahim, Mohammad

    Haemodynamic responses to hypothermia were studied at normal haematocrit and following the induction of acute normovolaemic haemodilution. Experiments were performed on 20 cats anaesthetized with a mixture of chloralose and urethane in two groups. In one group (n=10) the effects of hypothermia on various haemodynamic variables were studied at normal haematocrit (41.0+/-1.7%) and in the second group of cats (n=10) the effects of hypothermia on various haemodynamic variables were studied after the induction of acute normovolaemic haemodilution (14.0+/-1.0%). The haemodynamic variables left ventricular pressure, left ventricular contractility, arterial blood pressure, heart rate and right atrial pressure were recorded on a polygraph. Cardiac output was measured using a cardiac output computer. In both groups hypothermia was induced by surface cooling with the help of ice. Cardiovascular variables were recorded at each 1° C fall in body temperature. Hypothermia produced a significant (P<0.05) drop in heart rate, cardiac output, arterial blood pressure and left ventricular contractility in both groups. However, the percentage decrease in these variables in response to hypothermia was significantly (P<0.05) higher in cats with low haematocrit than in those with normal haematocrit. The severity of hypothermia - induced cardiovascular effects is evident from the drastic decrease in heart rate, cardiac output, arterial blood pressure and myocardial contractility in cats with low haematocrit, indicating a higher risk of circulatory failure under anaemic conditions at low temperatures.

  13. Species of Compassion: Aesthetics, Anaesthetics, and Pain in the Physiological Laboratory

    Directory of Open Access Journals (Sweden)

    Rob Boddice

    2012-12-01

    Full Text Available This essay explores the interplay of different species of compassion with regard to physiological practices in the final decades of the nineteenth century. Drawing on the lexicon from which ideals of late-Victorian compassion were formed, it illustrates their contested nature, demonstrating how physiologists developed their own concepts of compassion based on the theories of Darwin and Spencer. Within this purview, the essay examines the historical specificity of antivivisectionist compassion as well as ways in which pain in the laboratory was conceptualized, experienced, and managed ethically. This article explores the interplay of different species of compassion with regard to physiological practices in the last quarter of the nineteenth century in Britain. The lexicographical web of late-Victorian compassion included ‘humanity’, ‘pity’, ‘commiseration’, ‘tenderness’ (or ‘tender sympathy’, and ‘sympathetic pain’, all of which projected contested ideals of both individual character and moral conduct. As well as showing the historical specificity of antivivisectionist compassion – a complex aesthetic of pain closely linked to disgust – the article will principally demonstrate that physiologists (and the community of evolutionary scientists in general were applying their own newly, but no less highly, developed form of compassion that emerged straight from the pages of Darwin and Spencer. There is a story here of pain awareness and pain imagination within physiology, specifically connected to feelings of ‘humanity’. In practice, this story centres on anaesthesia and its role in allowing physiologists to live up to an ideal of ‘imperturbability’. It includes an investigation into what physiologists thought about causing pain in animals, as well as analysis of what changed after the use of anaesthetics became widespread. The article inquires anew about the ways in which pain in the laboratory was conceptualized

  14. Abdominal vascular responses to changes in carbon dioxide tension in the cephalic circulation of anaesthetized dogs.

    Science.gov (United States)

    Ford, R; Hainsworth, R; Rankin, A J; Soladoye, A O

    1985-01-01

    Dogs were anaesthetized with chloralose, the regions of both carotid sinuses were vascularly isolated and perfused with arterial blood and both cervical vagosympathetic trunks were cut above the nodose ganglia. The cephalic circulation was perfused through the brachiocephalic and left subclavian arteries with blood which was equilibrated with various levels of CO2. The abdomen was vascularly isolated, perfused through the aorta at constant flow and drained through the inferior vena cava at constant pressure. Changes in vascular resistance were determined from changes in abdominal aortic perfusion pressure and changes in capacitance from the integral of the changes in venous outflow. An increase in PCO2 in the cephalic perfusate resulted in an increase in abdominal vascular resistance and a decrease in capacitance. However, when carotid sinus pressure was high, the response of resistance to an increase in cephalic PCO2 was abolished and that of capacitance was significantly reduced. The reflex responses of both vascular resistance and capacitance to a change in carotid sinus pressure were enhanced when the cephalic PCO2 was raised. However, the effect on the reflex capacitance response from stimulation of baroreceptors was obtained only when PCO2 was changed below 5 kPa whereas the effect on resistance occurred at higher values of PCO2. The interaction between the effects of changes in cephalic PCO2 and the carotid sinus reflex and the differential effect on resistance and capacitance vessels have been explained in terms of the known difference in the sensitivities of these vessels to sympathetic nerve activity. PMID:3920388

  15. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available Background and Aims: Alpha-2 agonists are being increasingly used as adjuncts in general anaesthesia, and the present study was carried out to investigate the ability of intravenous dexmedetomidine in decreasing the dose of opioids and anaesthetics for attenuation of haemodynamic responses during laryngoscopy and tracheal intubation. Methods: One hundred patients scheduled for elective general surgery were randomized into two groups: D and F (n=50 in each group. Group D were administered 1 μg/kg each of dexmedetomidine and fentanyl while group F received 2 μg/kg of fentanyl pre-operatively. Thiopental was given until eyelash reflex disappeared. Anaesthesia was maintained with 33:66 oxygen: nitrous oxide. Isoflurane concentration was adjusted to maintain systolic blood pressure within 20% of the pre-operative values. Haemodynamic parameters were recorded at regular intervals during induction, intubation, surgery and extubation. Statistical analysis was carried out using analysis of variance, chi-square test, Student′s t test and Mann-Whitney U test. Results: The demographic profile was comparable. The pressor response to laryngoscopy, intubation, surgery and extubation were effectively decreased by dexmedetomidine, and were highly significant on comparison (P50% by the administration of dexmedetomidine. The mean recovery time was also shorter in group D as compared with group F (P=0.014. Conclusions: Dexmedetomidine is an excellent drug as it not only decreased the magnitude of haemodynamic response to intubation, surgery and extubation but also decreased the dose of opioids and isoflurane in achieving adequate analgesia and anaesthesia, respectively.

  16. Systemic and coronary haemodynamic effects of ketamine in intact anaesthetized and unanaesthetized dogs.

    Science.gov (United States)

    Folts, J D; Afonso, S; Rowe, G G

    1975-06-01

    Ten intact anaesthetized dogs breathing room air spontaneously (Group A) were compared with ten artificially ventilated dogs (Group B). All were given a bolus of ketamine 2 mg/kg followed by a 20-min infusion of ketamine 0.1 mg/kg/min. In Group A, coronary sinus blood flow, measured with a thermodilution flowmeter, increased by 90% while coronary vascular resistance decreased by 28% and coronary sinus oxygen content decreased by 27%. Heart rate increased by 47%, and arterial pressure by 9%. Cardiac output, calculated by the dye dilution method, increased by 29%, while the left ventricular work index decreased by 50%. Minute ventilation rate decreased by 55%. The Group B dogs were studied as described above, except that they were artificially ventilated. The haemodynamic ahanges were less in Group B, possibly because of improved arterial oxygenation. Heart rate increased by 24%, cardiac output by 21% and arterial pressure by 2%. The coronary sinus blood flow increased by 12% while coronary vascular resistance decreased by 11%. Coronary sinus oxygen concentration decreased by 15%. Five unanaesthetized dogs with electromagnetic flowmeter probes chronically implanted on the aorta and circumflex coronary artery, and an indwelling arterial catheter were studied before, during and after the intravenous administration of ketamine 2, 4, and 8 mg/kg. A dose of 8 mg/kg produced increases in cardiac output, heart rate and arterial pressure of 21%, 44% and 24%, respectively, while coronary blood flow increased 47%. We conclude that, in healthy dogs, ketamine produces an increase in heart rate and cardiac work. A significant increase in coronary blood flow appears to be insufficient to meet the metabolic demands of the myocardium, as the coronary sinus oxygen content decreased. PMID:1148088

  17. KETAMINE AS A SOLE ANAESTHETIC AGENT IN SHORT SURGI CAL PROCEDURES – A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Shilpashri

    2013-02-01

    Full Text Available ABSTRACT: BACKGROUND AND OBJECTIVES: Present clinical study was conducted to evaluate the features of Ketamine hydrochloride suc h as rapid induction, profound analgesia and minimal cardiovascular and respiratory depression with good airway maintenance. METHODS: Study was conducted on one hundred patients of eithe r sex of different age group for various short surgical procedures. All patients w ere premedicated with Inj. Atropine 0.02 mg/kg IV and Inj. Diazepam 0.2 mg/kg IV. Following t his Inj. Ketamine 2 mg/kg was given intravenously. During the course of anaesthesia pati ent was observed for the time of onset, duration of action, haemodynamic parameters, respirat ion, recovery from anaesthesia and certain side effects. RESULTS: The onset of anaesthesia after intravenous injectio n of ketamine was within 20-54 sec (Mean 34.3 ± 8.7. Duration of effect of initial dose was betwe en 9 – 20 min. (Mean 16.9 ± 2.9. There was 14.5 ± 4.7 beats / min rise in pulse rate with 6 to 30 mm of Hg (Mean 15.6 ± 6.2 rise in systolic blood pressure and 0 to 30 mm Hg (12.1 ± 8.8 rise in diastolic blood pressure. There was transient apnea in 5% of pat ients and airway was well maintained. Recovery was complete with in 9-30 minutes (Mean 19. 8 ± 5.2. Vomiting was seen in 11%, hallucinations in 8%, dreams in 9% and involuntary movements in 40%. CONCLUSION: Ketamine can be used as a sole anaesthetic agent fo r short surgical procedure, with minimum adverse effects and maximum safety.

  18. The effect of four anaesthetic protocols for maintenance of anaesthesia on trans-diaphragmatic pressure in dogs.

    Directory of Open Access Journals (Sweden)

    Kiriaki Pavlidou

    Full Text Available The diaphragm is the main inspiratory muscle and the main indicator of diaphragmatic contractility is the trans-diaphragmatic pressure (Pdi. The aim of this clinical study was to determine the effect of four different anaesthetic protocols on Pdi in anaesthetized healthy dogs. Eighty client-owned dogs were recruited in this clinical study. All the animals received dexmedetomidine and morphine as premedication and propofol for induction. Anaesthesia was maintained with one of four protocols: isoflurane (I, isoflurane with CRI of propofol (IP, isoflurane with CRI of fentanyl (IF, and isoflurane with CRI of ketamine (IK. When the surgical plane of anaesthesia was achieved, two balloon catheters were inserted, one into the stomach and one into the mid-third of the oesophagus for Pdi measurement. Pdi value was the highest in groups I (14.9±4.7 mmHg and IK (15.2±3.5 mmHg and the lowest in groups IP (12.2±3.2 mmHg and IF (12.0±5.9 mmHg. There was a statistically significant difference (p = 0.029 between groups IK and IF. PE'CO2 was statistically significantly higher (p<0.0005 in group IF (7.7±0.8 kPa than in group IK (6.5±0.7 kPa. Isoflurane alone or isoflurane with ketamine for the maintenance of anaesthesia seem to better preserve the respiratory function and the diaphragmatic contractility than isoflurane with either propofol or fentanyl in dogs. Therefore, the use of isoflurane or isoflurane with ketamine may be of benefit when animals with respiratory problems have to be anaesthetized.

  19. Perioperative Anaesthetic Management of a Patient of Gilbert’s Syndrome with Adult Congenital Heart Disease - A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Sambhunath Das

    2014-11-01

    Full Text Available Gilbert's syndrome is a hereditary condition with the genetic mutation of the enzyme uridine diphosphate glucuronosyltransferase, characterized by intermittent jaundice in the absence of hemolysis or underlying liver disease. These patients develop jaundice when subjected to fasting, stress and exercise. Majority of anaesthetics are metabolized by liver. Anaesthesia, surgery and cardiopulmonary bypass (CPB can act as triggers to hepatic injury. The successful perioperative management of an adult congenital heart disease patient for atrial septal defect closure under cardiopulmonary bypass was discussed in this report.

  20. Electroencephalographic Changes Associated with Antinociceptive Actions of Lidocaine, Ketamine, Meloxicam, and Morphine Administration in Minimally Anaesthetized Dogs

    OpenAIRE

    Ubedullah Kaka; Chen Hui Cheng; Goh Yong Meng; Sharida Fakurazi; Asmatullah Kaka; Atique Ahmed Behan; Mahdi Ebrahimi

    2015-01-01

    Effects of ketamine and lidocaine on electroencephalographic (EEG) changes were evaluated in minimally anaesthetized dogs, subjected to electric stimulus. Six dogs were subjected to six treatments in a crossover design with a washout period of one week. Dogs were subjected to intravenous boluses of lidocaine 2 mg/kg, ketamine 3 mg/kg, meloxicam 0.2 mg/kg, morphine 0.2 mg/kg and loading doses of lidocaine 2 mg/kg followed by continuous rate infusion (CRI) of 50 and 100 mcg/kg/min, and ketamine...

  1. Serotonin in the solitary tract nucleus shortens the laryngeal chemoreflex in anaesthetized neonatal rats.

    Science.gov (United States)

    Donnelly, William T; Bartlett, Donald; Leiter, J C

    2016-07-01

    What is the central question of this study? Failure to terminate apnoea and arouse is likely to contribute to sudden infant death syndrome (SIDS). Serotonin is deficient in the brainstems of babies who died of SIDS. Therefore, we tested the hypothesis that serotonin in the nucleus of the solitary tract (NTS) would shorten reflex apnoea. What is the main finding and its importance? Serotonin microinjected into the NTS shortened the apnoea and respiratory inhibition associated with the laryngeal chemoreflex. Moreover, this effect was achieved through a 5-HT3 receptor. This is a new insight that is likely to be relevant to the pathogenesis of SIDS. The laryngeal chemoreflex (LCR), an airway-protective reflex that causes apnoea and bradycardia, has long been suspected as an initiating event in the sudden infant death syndrome. Serotonin (5-HT) and 5-HT receptors may be deficient in the brainstems of babies who die of sudden infant death syndrome, and 5-HT seems to be important in terminating apnoeas directly or in causing arousals or as part of the process of autoresuscitation. We hypothesized that 5-HT in the brainstem would limit the duration of the LCR. We studied anaesthetized rat pups between 7 and 21 days of age and made microinjections into the cisterna magna or into the nucleus of the solitary tract (NTS). Focal, bilateral microinjections of 5-HT into the caudal NTS significantly shortened the LCR. The 5-HT1a receptor antagonist, WAY 100635, did not affect the LCR consistently, nor did a 5-HT2 receptor antagonist, ketanserin, alter the duration of the LCR. The 5-HT3 specific agonist, 1-(3-chlorophenyl)-biguanide, microinjected bilaterally into the caudal NTS significantly shortened the LCR. Thus, endogenous 5-HT released within the NTS may curtail the respiratory depression that is part of the LCR, and serotonergic shortening of the LCR may be attributed to activation of 5-HT3 receptors within the NTS. 5-HT3 receptors are expressed presynaptically on C

  2. Modelling of interactions between volatile anaesthetics (halothane, enflurane) and aromatic compounds, ab initio study

    International Nuclear Information System (INIS)

    Graphical abstract: Halothane and enflurane form the blue-shifting hydrogen bonded C-H...complexes with benzene. The CCSD(T)/CBS calculated stabilization energies are about -10 kcal mol-1. - Abstract: For many years halothane and enflurane have been used clinically as volatile anaesthetics, however, their mechanism of action is still not fully understood. Recently, it has been suggested that they can act by a direct bonding to neuroreceptors containing the aromatic groups. In this work, the halothane...benzene and enflurane...benzene complexes were studied by the ab initio MP2 and CCSD(T) methods. All possible structures of the complexes were calculated by means of the counterpoise CP-corrected gradient optimization technique. It has been found that among these species, the C-H...π hydrogen bonded complexes are the most stable. The CCSD(T)/CBS calculated stabilization energies for halothane and enflurane complexes are: -10.56 and -9.72 kcal mol-1, respectively. The interaction energy is mainly dominated by the dispersion attraction. In the case of enflurane, the C-H bond shows a very small contraction (by -0.0008 A) upon complexation. This change is accompanied by the blue-shift (20 cm-1) of the C-H stretching frequency and an increase of the infrared intensity of the corresponding mode by 7 km mol-1. Similar results were obtained for the halothane complex: a small contraction of the C-H bond; an increase of the C-H stretching frequency by 11 cm-1 (blue-shift); and an increase of the infrared intensity by 37 km mol-1. In order to explain the nature of these effects, the halothane and enflurane molecules were studied in the electric field generated by benzene atoms, and Natural Bond Orbital (NBO) analyses were performed. The molecular dipole moments of these molecules were calculated with respect to the C-H bond changes. The positive dipole moment derivative obtained for halothane is in agreement with the literature data, while, in the case of enflurane, an unusual

  3. Quantitative structure-activity relationships and toxicity studies of mixtures of chemicals with anaesthetic potency: Acute lethal and sublethal toxicity to Daphnia magna

    NARCIS (Netherlands)

    Hermens, J.L.M.; Canton, H.; Janssen, P.; Jong, R. de

    1984-01-01

    In this study quantitative structure-activity relationships (QSARs) were calculated between hydrophobicity of a group of organic chemicals with anaesthetic potency and toxicity (immobilization, mortality and inhibition of reproduction) to Daphnia magna. Differences in slopes of the high quality QSAR

  4. Selected Ion Flow Tube Studies of the Reactions of H3O+, NO+ and O2+ with the Anaesthetic Gases Halothane, Isoflurane and Sevoflurane

    Czech Academy of Sciences Publication Activity Database

    Wang, T.; Smith, D.; Španěl, Patrik

    2002-01-01

    Roč. 16, - (2002), s. 1860-1870. ISSN 0951-4198 R&D Projects: GA ČR GA203/00/0632; GA ČR GA203/02/0737 Institutional research plan: CEZ:AV0Z4040901 Keywords : ion-molecule reactions * SIFT * anaesthetics Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.372, year: 2002

  5. Effect of topical anaesthetics on interstitial colloid osmotic pressure in human subcutaneous tissue sampled by wick technique.

    Directory of Open Access Journals (Sweden)

    Hans Jørgen Timm Guthe

    Full Text Available OBJECTIVES: To measure colloid osmotic pressure in interstitial fluid (COP(i from human subcutaneous tissue with the modified wick technique in order to determine influence of topical application of anaesthetics, dry vs. wet wick and implantation time on COP(i. MATERIAL AND METHODS: In 50 healthy volunteers interstitial fluid (IF was collected by subcutaneous implantation of multi-filamentous nylon wicks. Study subjects were allocated to two groups; one for comparing COP(i obtained from dry and saline soaked wicks, and one for comparing COP(i from unanaesthetized skin, and skin after application of a eutectic mixture of local anaesthetic (EMLA®, Astra Zeneca cream. IF was sampled from the skin of the shoulders, and implantation time was 30, 60, 75, 90 and 120 min. Colloid osmotic pressure was measured with a colloid osmometer. Pain assessment during the procedure was compared for EMLA cream and no topical anaesthesia using a visual analogue scale (VAS in a subgroup of 10 subjects. RESULTS: There were no significant differences between COP(i obtained from dry compared to wet wicks, except that the values after 75 and 90 min. were somewhat higher for the dry wicks. Topical anaesthesia with EMLA cream did not affect COP(i values. COP(i decreased from 30 to 75 min. of implantation (23.2 ± 4.4 mmHg to 19.6 ± 2.9 mmHg, p = 0.008 and subsequently tended to increase until 120 min. EMLA cream resulted in significant lower VAS score for the procedure. CONCLUSION: COP(i from subcutaneous tissue was easily obtained and fluid harvesting was well tolerated when topical anaesthetic was used. The difference in COP(i assessed by dry and wet wicks between 75 min. and 90 min. of implantation was in accordance with previous reports. The use of topical analgesia did not influence COP(i and topical analgesia may make the wick technique more acceptable for subjects who dislike technical procedures, including children. TRIAL REGISTRATION: ClinicalTrials.gov NCT

  6. Intravenous anaesthetics inhibit nicotinic acetylcholine receptor-mediated currents and Ca2+ transients in rat intracardiac ganglion neurons.

    Science.gov (United States)

    Weber, Martin; Motin, Leonid; Gaul, Simon; Beker, Friederike; Fink, Rainer H A; Adams, David J

    2005-01-01

    The effects of intravenous (i.v.) anaesthetics on nicotinic acetylcholine receptor (nAChR)-induced transients in intracellular free Ca(2+) concentration ([Ca(2+)](i)) and membrane currents were investigated in neonatal rat intracardiac neurons. In fura-2-loaded neurons, nAChR activation evoked a transient increase in [Ca(2+)](I), which was inhibited reversibly and selectively by clinically relevant concentrations of thiopental. The half-maximal concentration for thiopental inhibition of nAChR-induced [Ca(2+)](i) transients was 28 microM, close to the estimated clinical EC(50) (clinically relevant (half-maximal) effective concentration) of thiopental. In fura-2-loaded neurons, voltage clamped at -60 mV to eliminate any contribution of voltage-gated Ca(2+) channels, thiopental (25 microM) simultaneously inhibited nAChR-induced increases in [Ca(2+)](i) and peak current amplitudes. Thiopental inhibited nAChR-induced peak current amplitudes in dialysed whole-cell recordings by approximately 40% at -120, -80 and -40 mV holding potential, indicating that the inhibition is voltage independent. The barbiturate, pentobarbital and the dissociative anaesthetic, ketamine, used at clinical EC(50) were also shown to inhibit nAChR-induced increases in [Ca(2+)](i) by approximately 40%. Thiopental (25 muM) did not inhibit caffeine-, muscarine- or ATP-evoked increases in [Ca(2+)](i), indicating that inhibition of Ca(2+) release from internal stores via either ryanodine receptor or inositol-1,4,5-trisphosphate receptor channels is unlikely. Depolarization-activated Ca(2+) channel currents were unaffected in the presence of thiopental (25 microM), pentobarbital (50 microM) and ketamine (10 microM). In conclusion, i.v. anaesthetics inhibit nAChR-induced currents and [Ca(2+)](i) transients in intracardiac neurons by binding to nAChRs and thereby may contribute to changes in heart rate and cardiac output under clinical conditions. PMID:15644873

  7. Investigation into the characteristics, triggers and mechanism of apnoea and bradycardia in the anaesthetized platypus (Ornithorhynchus anatinus).

    Science.gov (United States)

    Macgregor, J W; Holyoake, C; Fleming, P A; Robertson, I D; Connolly, J H; Warren, K S

    2014-01-01

    Health and conservation research on platypuses (Ornithorhynchus anatinus) may require anaesthesia to reduce stress and the risk of injury to both the animal and the researcher, as well as to facilitate examination and sample collection. Platypus anaesthesia can be difficult to manage, with reports of periods of apnoea and bradycardia described. This study investigated the conditions around sudden-onset apnoea and bradycardia in 163 field-anaesthetized platypuses as part of a health study. Anaesthesia was induced and maintained using isoflurane delivered in oxygen by face mask. Sudden-onset apnoea and bradycardia was observed in 19% of platypuses, occurring either at induction of anaesthesia, during recovery, or both. At induction, occurrence was more often recorded for adults (P = 0.19) and was correlated with low body temperature (P < 0.001), season (P = 0.06; greater incidence in summer) and longer pre-anaesthetic holding time (P = 0.16). At recovery, sudden-onset apnoea and bradycardia occurred only in platypuses that had been placed in dorsal recumbency as part of their examination, and correlated with poor body condition (P = 0.002), time in dorsal recumbency (P = 0.005), adults (P = 0.06), number of fieldworkers (P = 0.06) and females (P = 0.11). The sudden-onset apnoea and bradycardia we observed is likely to result from the irritant nature of isoflurane (stimulating the trigeminal nerve via nasal chemoreceptors). We propose that this mechanism is analogous to that of submersion of the face/nasal cavity in cold water during a natural dive response, but that the term 'nasopharyngeal response' would more appropriately describe the changes observed under isoflurane anaesthesia. Although we did not record any long-term adverse effects on platypuses that had undergone this response, the nasopharyngeal response could complicate the diagnosis of anaesthetic dose-dependent apnoea and bradycardia. Therefore, we suggest that these

  8. Efficacy of sub-Tenon's block using an equal volume of local anaesthetic administered either as a single or as divided doses. A randomised clinical trial

    Directory of Open Access Journals (Sweden)

    McAdoo John

    2009-03-01

    Full Text Available Abstract Background Sub-Tenon's anaesthetic is effective and reliable in producing both akinesia and anaesthesia for cataract surgery. Our clinical experience indicates that it is sometimes necessary when absolute akinesia is required during surgery to augment the block with 1–2 ml of local anaesthetic. Hypothesis was that after first injection some of the volume injected may spill out and before second injection the effect of hyaluronidase has taken place and second volume injectate will have desired effect. Methods A prospective, randomised, control trial in which patients were randomly allocated to one of two groups. In group 1, single injection of 5 ml of local anaesthetic was injected. In group 2, 3 ml of the same anaesthetic solution was injected followed by application of gentle orbital pressure for 2 minutes. A further 2 ml of the same anaesthetic solution was injected through the same conjunctival incision. Measurement of movement in four quadrants of eye was done by the surgeon at 3 and 6 minutes. Intraocular pressure, chemosis, and subconjuctival haemorrhage were also measured. Results Significant differences at 3 minutes between groups for overall movement, medial, superior, and lateral quadrants occurred. At 6 minutes no significant group differences emerged for the overall movement or for any of four quadrants. Conclusion Single injection of local anaesthesia for sub-Tenon's block with mixture of lignocaine with adrenaline, bupivacaine and hyaluronidase was found to be superior to provide akinesia of ocular muscles compared to divided dose given by two injections. No difference in groups in terms of haemorrhage, chemosis, patient's satisfaction and intraocular pressure was found. Trial registration Trial registration no-ISRCTN73431052

  9. Anaesthesia with sevoflurane in pigeons: minimal anaesthetic concentration (MAC) determination and investigation of cardiorespiratory variables at 1 MAC.

    Science.gov (United States)

    Botman, J; Gabriel, F; Dugdale, A H A; Vandeweerd, J-M

    2016-05-28

    The objective of the study was to determine the minimal anaesthetic concentration (MAC) of sevoflurane (SEVO) in pigeons and investigate the effects of 1 MAC SEVO anaesthesia on cardiovascular and respiratory variables compared with the awake state. This is a prospective, experimental study. Animals were seven healthy adult pigeons. After acclimatisation to handling, heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (PE'CO2), inspired CO2 tension, indirect systolic arterial blood pressure (SAP) and cloacal temperature were measured to determine baseline, 'awake' values. Pigeons were then anaesthetised with SEVO and MAC was determined by the 'bracketing' method. The same variables were monitored during a 40 minute period at 1.0 MAC SEVO for each bird. Mean MAC was 3.0±0.6 per cent for SEVO. During maintenance of anaesthesia at 1.0 MAC, SAP decreased significantly (Ppigeons. PMID:27083873

  10. Comparative study of intrathecal pethidine versus lignocaine as an anaesthetic and a postoperative analgesic for perianal surgery.

    Directory of Open Access Journals (Sweden)

    Chaudhari L

    1996-04-01

    Full Text Available 100 patients with ASA risk I & II and undergoing perianal surgery were studied for anaesthetic effects and postoperative analgesia following either intrathecal pethidine or lignocaine. Saddle block was performed either with intrathecal pethidine 5% (50 mg/ml 0.5 mg/kg or 1 ml of 5% lignocaine. Sensory and motor block postoperative analgesia, need for additional analgesia were studied. The onset of sensory and motor blockade with lignocaine was faster than pethidine. However the sensory and motor blockade lasted longer with pethidine. The duration of postoperative analgesia was 15.39 +/- 5.14 hours as against duration of postoperative analgesia with lignocaine which was 1.3 +/- 0.53 hours. Only 10% of patients in the pethidine group required intramuscular analgesic supplementation whereas 30% of patients in the lignocaine group required intramuscular analgesic supplementation.

  11. Evaluation of the anaesthetic depth during piglet castration under an automated isoflurane-anaesthesia at farm level.

    Science.gov (United States)

    Schwennen, Cornelia; Kolbaum, Nina; Waldmann, Karl-Heinz; Höltig, Doris

    2016-01-01

    Piglet castration under isoflurane-anaesthesia could represent an alternative to the practice of castration without anaesthesia. The objective of this study was to evaluate practicality and effectiveness of an automated isoflurane-anaesthesia for castration. A field study on three different farms in Germany (farm A, B: 200 sows; C: 540 sows) was performed. In total, 1429 (1166 anaesthetised and 263 conventionally castrated) male piglets (age: 1-8 days; bodyweight: 0.7-3.7 kg) were monitored. All piglets were treated with nonsteroidal anti-inflammatory drugs directly before castration. Castration and anaesthesia were performed by the farm-manager in presence of a veterinarian. All farmers used the PIGNAP Pro® (Agrosystems GmbH, CH) anaesthetic device (5 vol.% isoflurane, 30% oxygen; flow rate: 2 l/min). Vocalisation and defensive movements of 1166 anaesthetised piglets was rated using a scoring system. Presence or absence of the palpebral- and flexor-reflex was noted. Approximately every second piglet was weighed and oxygen-saturation and pulse- frequency of 231 animals were measured during treatment. Rectal temperatures before and after castration of 264 anaesthetised and 263 conventionally castrated piglets were compared. Only 77% of the anaesthetised piglets showed a sufficient anaesthetic depth based on the assessment of reflexes as well as vocalisations and defensive movements. It was found that the probability for a sufficient depth of anaesthesia decreases with increasing age and weight. The measurements of the pulse-frequency and oxygen-saturation showed an average oxygen-saturation of 98% and an average heart rate of 270/min during anaesthesia. The conventionally castrated piglets had significantly higher rectal temperatures in comparison to the anaesthetised (p < 0.0001). The result of 77% sufficiently anaesthetised piglets is not adequate for commercial application of this technology. PMID:26904895

  12. Effect of sodium nitrite on ischaemia and reperfusion-induced arrhythmias in anaesthetized dogs: is protein S-nitrosylation involved?

    Directory of Open Access Journals (Sweden)

    Mária Kovács

    Full Text Available To provide evidence for the protective role of inorganic nitrite against acute ischaemia and reperfusion-induced ventricular arrhythmias in a large animal model.Dogs, anaesthetized with chloralose and urethane, were administered intravenously with sodium nitrite (0.2 µmol kg(-1 min(-1 in two protocols. In protocol 1 nitrite was infused 10 min prior to and during a 25 min occlusion of the left anterior descending (LAD coronary artery (NaNO2-PO; n = 14, whereas in protocol 2 the infusion was started 10 min prior to reperfusion of the occluded vessel (NaNO2-PR; n = 12. Control dogs (n = 15 were infused with saline and subjected to the same period of ischaemia and reperfusion. Severities of ischaemia and ventricular arrhythmias, as well as changes in plasma nitrate/nitrite (NOx levels in the coronary sinus blood, were assessed throughout the experiment. Myocardial superoxide and nitrotyrosine (NT levels were determined during reperfusion. Changes in protein S-nitrosylation (SNO and S-glutathionylation were also examined.Compared with controls, sodium nitrite administered either pre-occlusion or pre-reperfusion markedly suppressed the number and severity of ventricular arrhythmias during occlusion and increased survival (0% vs. 50 and 92% upon reperfusion. There were also significant decreases in superoxide and NT levels in the nitrite treated dogs. Compared with controls, increased SNO was found only in NaNO2-PR dogs, whereas S-glutathionylation occurred primarily in NaNO2-PO dogs.Intravenous infusion of nitrite profoundly reduced the severity of ventricular arrhythmias resulting from acute ischaemia and reperfusion in anaesthetized dogs. This effect, among several others, may result from an NO-mediated reduction in oxidative stress, perhaps through protein SNO and/or S-glutathionylation.

  13. Exposure to volatile anaesthetics is not followed by a massive induction of single-strand DNA breaks in operation theatre personnel.

    Science.gov (United States)

    Szyfter, Krzysztof; Stachecki, Ireneusz; Kostrzewska-Poczekaj, Magdalena; Szaumkessel, Marcin; Szyfter-Harris, Joanna; Sobczyński, Paweł

    2016-08-01

    Volatile anaesthetics such as halothane, isoflurane and others were expected to produce a health challenge for operation room personnel because of prolonged occupational exposure to anaesthetic gases. To estimate a molecular background of adverse health effects, a cohort of 100 exposed individuals was studied by the single-cell gene electrophoresis (comet assay) test. DNA lesions in lymphocytes of the exposed group did not differ significantly compared with non-exposed blood donors. Then, the exposed group was further divided according to job position. A highest level of DNA lesions was established in nurses but without significant difference compared with other groups. When a time period of exposure was taken into account, a tendency to cumulate DNA lesions was found only in the group of anaesthesiologists. A very weak genotoxic effect established in this study is discussed in relation to DNA repair, adaptative response and potential self-elimination of sensitive individuals. PMID:26685861

  14. SUCCESSFUL ANAESTHETIC MANAGEMENT OF A PATIENT WITH PARADOXICAL VENTRICULAR SEPTAL MOTION (PVSM POSTED FOR MODIFIED RADICAL NECK DISSECTION WITH RADIAL FREE FLAP

    Directory of Open Access Journals (Sweden)

    Amruta

    2015-04-01

    Full Text Available BACKGROUND : Patients with paradoxical ventricular septal motion are a challenge to anaesthesiologist due to risk of perioperative myocardial ischaemia and sudden cardiac arrest. CASE DESCRIPTION : We present anaesthetic management of a 45year old lady with a diagnosed case of carcinoma left buccal mucosa with paradoxical ventricular septal motion posted for modified radical neck disse ction with radial free flap. CONCLUSION : Although clinical manifestations of this cardiac condition may be mild, there is certainly associated pathology of direct relevance, which carries importance in the anaesthetic management in the peri - operative perio d. Patients with paradoxical ventricular septal motion of any etiology are more prone for perioperative myocardial ischaemia and sudden cardiac arrest, because if cardiac conduction is not maintained properly then it may result in further increase in the p aradoxical ventricular septal motion

  15. Determination of the exposure parameters that maximise the concentrations of the anaesthetic/sedative eugenol in rainbow trout (Oncorhynchus mykiss) skin-on fillet tissue

    Science.gov (United States)

    Meinertz, Jeffery R.; Porcher, Scott T.; Smerud, Justin R.

    2014-01-01

    Studies were conducted to determine the anaesthetic/sedative concentrations and durations that would maximize anaesthetic/sedative residue concentrations in rainbow trout (Oncorhynchus mykiss) skin-on fillet tissue. Rainbow trout (167–404 g) were exposed to 50 mg l−1 AQUI-S® 20E (10% active ingredient, eugenol) in 17°C freshwater for durations up to 1440 min, 100 and 250 mg l−1 AQUI-S® 20E for durations up to 240 min, and 500 and 1000 mg l−1 AQUI-S® 20E for durations up to 90 min. Fish exposed to 100 mg l−1 AQUI-S® 20E for durations of 30, 60, 120 and 240 min had the greatest eugenol concentrations in the fillet tissue, 50, 58, 54 and 62 µg g−1, respectively. All other exposure concentrations and durations resulted in significantly lower eugenol concentrations, i.e. all −1.

  16. Effects of administration of a local anaesthetic and/or an NSAID and of docking length on the behaviour of piglets during 5 h after tail docking

    DEFF Research Database (Denmark)

    Herskin, Mette S.; Di Giminiani, Pierpaolo; Thodberg, Karen

    2016-01-01

    In many countries, piglets are tail docked to prevent tail biting. The aim of this study was 1) to evaluate the efficacy of a local anaesthetic and/or NSAID to reduce pain caused by tail docking; and 2) to examine interactions with docking length. This was examined in 295 piglets docked by hot iron...... cautery 2–4 days after birth and based on behaviour during docking as well as the following 5 h. The study involved three main factors: local anaesthetic (Lidocain), NSAID (Meloxicam) and docking length. Either 100%, 75%, 50% or 25% of the tails were left on the body of the piglets. Irrespective of the...... tail length, tail docking led to signs of procedural pain, which could be reduced by administration of Lidocain. Preemptive use of Meloxicam did not affect the signs of procedural pain. The results show that tail docking led to behavioural changes throughout the 5 h observation period indicating that...

  17. The anaesthetic propofol shifts the frequency of maximum spectral power in EEG during general anaesthesia: analytical insights from a linear model

    Directory of Open Access Journals (Sweden)

    Axel Hutt

    2013-02-01

    Full Text Available The work introduces a linear neural population model that allows to derive analytically the power spectrum subjected to the concentration of the anaesthetic propofol. The analytical study of the power spectrum of the systems activity gives conditions on how the frequency of maximum power in experimental EEG changes dependent on the propofol concentration. In this context, we explain the anaesthetic-induced power increase in neural activity by an oscillatory instability and derive conditions under which the power peak shifts to larger frequencies as observed experimentally in EEG. Moreover the work predicts that the power increase only occurs while the frequency of maximum power increases. Numerically simulations of the systems activity complement the analytical results.

  18. COMPARISON OF EFFICACY OF INTRAPERITONEALLY ADMIN I STERED LOCAL ANAESTHETICS WITH ADJUVANTS FOR POST - OPERATIVE ANALGESIA AFTER LAPAROSCOPIC CHOLECYSTECTOMY

    Directory of Open Access Journals (Sweden)

    Subbalakshmi

    2015-10-01

    Full Text Available CONTEXT : Post - operative pain after laparoscopic cholecystectomy is less than open cholecystectomy, but many patients require strong analgesia postoperatively. Intraperitoneal administration of local anaesthetics alone or in combination with various adjuvan ts can control post - operative pain. AIM : To compare the analgesic effect of the intraperitoneal administration of Bupivacaine, Bupivacaine plus Tramadol and Bupivacaine plus Dexmedetomidine. SETTINGS AND DESIGN: 80 patients undergoing laparoscopic cholecys tectomy were randomly allocated to one of four groups: Group C; Group B, Group T and Group D. METHODS AND MATERIAL : 80 patients undergoing laparoscopic cholecystectomy were randomly allocated to one of four groups: Group C received 20 ml of saline; Group B received 20 ml of 0.25% Bupivacaine. Group T received 20 ml of 0.25% Bupivacaine with 100 mg Tramadol and patients allocated to Group D received 20 ml of 0.25% Bupivacaine with 1μg/kg of Dexmedetomidine intraperitoneally post - operatively. Faces pain scale was recorded at 0.5, 1, 2, 4, 6 and 24 hours postoperatively. Time of requirement of rescue analgesia was calculated. Level of sedation postoperatively was assessed. Incidence of postoperative nausea and vomiting (PONV was also recorded. STATISTICAL ANAL YSIS : Data was analyzed by two - way analysis of variance, Student’s t - test, Kruscal - Walis and Mann - Whitney U - test. RESULTS : Pain intensity, time of requirement of rescue analgesia, sedation score, as well as PONV were significantly lower in Group D, Group T and Group B than in Group C. Duration of post - operative analgesia was highest with Bupivacaine plus Dexmedetomidine. Ther e were no differences between the three groups receiving Bupivacaine and Bupivacaine with Tramadol and Bupivacaine with Dexmedetomidine in FPS score, incidence of PONV and postoperative analgesic and antiemetic consumption. CONCLUSIONS : Bupivacaine with or without adjuvants provides

  19. Local anaesthetic eye drops for prevention of pain in preterm infants undergoing screening for retinopathy of prematurity.

    LENUS (Irish Health Repository)

    Dempsey, Eugene

    2012-01-31

    BACKGROUND: Screening examinations for retinopathy of prematurity (ROP) are performed routinely in the neonatal intensive care unit and are a recognised cause of pain in the newborn. OBJECTIVES: To determine the effect of instillation of topical anaesthetic eye drops compared with placebo or no treatment on pain in infants undergoing ROP screening. SEARCH STRATEGY: We used the standard search strategy of the Cochrane Neonatal Review Group. This included a search of the Cochrane Neonatal Group register and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 10, 2010). We identified relevant studies by searching the following: (1) computerised bibliographic databases: MEDLINE (1966 to October 2010), EMBASE (1988 to October 2010) and Web of Science (1975 to March 2010; (2) the Oxford Database of Perinatal Trials. We searched electronically abstracts from PAS from 2000 to 2010 and handsearched abstracts from ESPR from 2000 to 2009. SELECTION CRITERIA: All randomised, or quasi-randomised controlled trials, or randomised cross-over trials. DATA COLLECTION AND ANALYSIS: We used the standard methods of the Cochrane Neonatal Review Group. MAIN RESULTS: We identified two studies for inclusion. Both studies were randomised cross-over trials performed in single centres. Both studies used the Premature Infant Pain Profile (PIPP) score as a measure of pain response. Different methods of evaluating PIPP scores are presented including the absolute PIPP score, a PIPP score > 10 or > 12 and an increase in PIPP >\\/= 4 from the baseline value. There is a nonsignificant reduction in pain scores at one minute and a nonsignificant increase at five minutes post insertion of the speculum. PIPP score > 12 at one minute resulted in a statistically significant reduction in the number of patients who experienced pain (typical risk ratio (RR) 0.56, 95% CI 0.36 to 0.89; typical risk difference (RD) -0.23, 95% CI -0.39 to -0.86; number needed to treat to

  20. The effects of prostaglandins E2, F2 alpha, prostacyclin, flurbiprofen and aspirin on arrhythmias resulting from coronary artery ligation in anaesthetized rats.

    OpenAIRE

    Coker, S. J.; Parratt, J R

    1981-01-01

    1 Various prostaglandins and inhibitors of prostaglandin synthesis were administered prior to acute coronary artery ligation in anaesthetized rats and their effects were assessed on the number and severity of the resulting early arrhythmias (ventricular ectopic activity; incidence and duration of ventricular tachycardia and of ventricular fibrillation). 2 Prostaglandin E2 (PGE2), PGF2 alpha and prostacyclin all showed antiarrhythmic activity; in contrast flurbiprofen increased the incidence o...

  1. On-demand use of tramadol, sildenafil, paroxetine and local anaesthetics for the management of premature ejaculation: A randomised placebo-controlled clinical trial

    OpenAIRE

    Gameel, Tarek A.; Tawfik, Ahmad M.; Abou-Farha, Mohamed O.; Bastawisy, Mohamed G.; El-Bendary, Mohamed A.; El-Gamasy, Abd El-Naser

    2013-01-01

    Objectives To compare the clinical efficacy of the on-demand use of four drugs in the management of patients with premature ejaculation (PE), as the off-label use of selective serotonin-reuptake inhibitors and topical penile anaesthetics is frequently indicated for the management of patients with PE, and tramadol HCl and sildenafil citrate were also tried for managing this disorder, but with recommendations based on weak evidence. Patients and methods This was a single-centre, single-blind, p...

  2. Application of a topical vapocoolant spray decreases pain at the site of initial intradermal anaesthetic injection during ultrasound-guided breast needle biopsy

    International Nuclear Information System (INIS)

    Aim: To assess whether the application of a topical vapocoolant spray immediately prior to initial intradermal anaesthetic injection during ultrasound-guided breast biopsy decreases pain at the site of the initial injection. Materials and methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant study, 50 women aged 49.1 ± 1.6 years (mean ± standard error) were recruited and provided written informed consent. Participants served as their own controls and were blinded as to whether a topical vapocoolant spray or a placebo was used immediately prior to the initial local anaesthetic injection at two separate biopsy sites. With the exception of the application of vapocoolant or placebo, the entire ultrasound-guided procedure was performed according to a routine protocol. Participants recorded pain at initial injection site on a visual analogue scale. General linear mixed models for repeated measures analysis of variance and a 0.05 significance level were used. Results: Application of topical vapocoolant spray was shown to significantly decrease pain at the site of initial intradermal anaesthetic injection as compared to placebo (p<0.001). Treatment effect was independent of age of the subject, race/ethnicity, operator, type of biopsy device, and histopathology result. No complications from vapocoolant spray use were reported. Conclusion: Application of a topical vapocoolant spray immediately prior to initial intradermal anaesthetic injection during ultrasound-guided breast biopsy significantly decreases pain at the site of the initial injection and could contribute to improve the patient's overall procedural experience. -- Highlights: •Topical vapocoolant spray decreased pain at site of initial anesthetic injection (

  3. Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries

    OpenAIRE

    Watanabe Orie; Kobayashi Rie; Stener-Victorin Elisabet; Lundeberg Thomas; Kurosawa Mieko

    2004-01-01

    Abstract Background Maintenance of ovarian blood flow (OBF) is suggested to be important for regular ovulation in women with polycystic ovaries (PCO). The purpose of the present study was to investigate whether electro-acupuncture (EA) of different frequencies and intensities can improve the OBF of anaesthetized rat in the animal model of PCO. Methods PCO was experimentally induced by a single intramuscular (i.m.) injection of estradiol valerate (EV) in rats. Control rats were given i.m. inje...

  4. Autonomic Nervous System Mediates the Hypotensive Effects of Aqueous and Residual Methanolic Extracts of Syzygium polyanthum (Wight) Walp. var. polyanthum Leaves in Anaesthetized Rats

    OpenAIRE

    Ismail, A.; Mohamed, M.; Sulaiman, S. A.; Wan Ahmad, W. A. N.

    2013-01-01

    Syzygium polyanthum (Wight) Walp. var. polyanthum leaves are consumed as a traditional Malay treatment of hypertension. This study investigates hypotensive potential of aqueous (AESP) and residual methanolic (met-AESP) extracts of S. polyanthum leaves and possible involvement of autonomic receptors. AESP and met-AESP (20 to 100 mg/kg) were intravenously administered into anaesthetized Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. Blood pressure and heart were monitored for 20 ...

  5. Nitric oxide impacts on angiotensin AT2 receptor modulation of high-pressure baroreflex control of renal sympathetic nerve activity in anaesthetized rats

    OpenAIRE

    Abdulla, M H; Johns, E. J.

    2013-01-01

    Aim Nitric oxide (NO) interacts with the local brain renin-angiotensin system to modulate sympathetic outflow and cardiovascular homoeostasis. This study investigated whether NO influenced the ability of angiotensin AT2 receptor activation to modify the high-pressure baroreceptor regulation of renal sympathetic nerve activity (RSNA) and heart rate (HR). Methods Anaesthetized (chloralose/urethane) rats were prepared to allow generation of baroreflex gain curves for RSNA or HR following intrace...

  6. Pharmacokinetics and bio-distribution of novel super paramagnetic iron oxide nanoparticles (SPIONs) in the anaesthetized pig.

    Science.gov (United States)

    Edge, Deirdre; Shortt, Christine M; Gobbo, Oliviero L; Teughels, Stephanie; Prina-Mello, Adriele; Volkov, Yuri; MacEneaney, Peter; Radomski, Marek W; Markos, Farouk

    2016-03-01

    Manufactured nanomaterials have a variety of medical applications, including diagnosis and targeted treatment of cancer. A series of experiments were conducted to determine the pharmacokinetic, biodistribution and biocompatibility of two novel magnetic nanoparticles (MNPs) in the anaesthetized pig. Dimercaptosuccinic acid (DMSA) coated superparamagnetic iron oxide nanoparticles (MF66-labelled 12 nm, core nominal diameter and OD15 15 nm); at 0.5, or 2.0 mg/kg) were injected intravenously. Particles induced a dose-dependent decrease in blood pressure following administration which recovered to control levels several minutes after injection. Blood samples were collected for a 5-h period and stored for determination of particle concentration using particle electron paramagnetic resonance (pEPR). Organs were harvested post-mortem for magnetic resonance imaging (MRI at 1.5 T field strength) and histology. OD15 (2.0 mg/kg) MNP had a plasma half-life of approximately 15 min. Both doses of the MF66 (0.5 and 2.0 mg/kg) MNP were below detection limits. MNP accumulation was observed primarily in the liver and spleen with MRI scans which was confirmed by histology. MRI also showed that both MNPs were present in the lungs. The results show that further modifications may be required to improve the biocompatibility of these particles for use as diagnostic and therapeutic agents. PMID:26707795

  7. Electroencephalographic Changes Associated with Antinociceptive Actions of Lidocaine, Ketamine, Meloxicam, and Morphine Administration in Minimally Anaesthetized Dogs

    Directory of Open Access Journals (Sweden)

    Ubedullah Kaka

    2015-01-01

    Full Text Available Effects of ketamine and lidocaine on electroencephalographic (EEG changes were evaluated in minimally anaesthetized dogs, subjected to electric stimulus. Six dogs were subjected to six treatments in a crossover design with a washout period of one week. Dogs were subjected to intravenous boluses of lidocaine 2 mg/kg, ketamine 3 mg/kg, meloxicam 0.2 mg/kg, morphine 0.2 mg/kg and loading doses of lidocaine 2 mg/kg followed by continuous rate infusion (CRI of 50 and 100 mcg/kg/min, and ketamine 3 mg/kg followed by CRI of 10 and 50 mcg/kg/min. Electroencephalogram was recorded during electrical stimulation prior to any drug treatment (before treatment and during electrical stimulation following treatment with the drugs (after treatment under anaesthesia. Anaesthesia was induced with propofol and maintained with halothane at a stable concentration between 0.85 and 0.95%. Pretreatment median frequency was evidently increased (P<0.05 for all treatment groups. Lidocaine, ketamine, and morphine depressed the median frequency resulting from the posttreatment stimulation. The depression of median frequency suggested evident antinociceptive effects of these treatments in dogs. It is therefore concluded that lidocaine and ketamine can be used in the analgesic protocol for the postoperative pain management in dogs.

  8. Electroencephalographic changes associated with antinociceptive actions of lidocaine, ketamine, meloxicam, and morphine administration in minimally anaesthetized dogs.

    Science.gov (United States)

    Kaka, Ubedullah; Hui Cheng, Chen; Meng, Goh Yong; Fakurazi, Sharida; Kaka, Asmatullah; Behan, Atique Ahmed; Ebrahimi, Mahdi

    2015-01-01

    Effects of ketamine and lidocaine on electroencephalographic (EEG) changes were evaluated in minimally anaesthetized dogs, subjected to electric stimulus. Six dogs were subjected to six treatments in a crossover design with a washout period of one week. Dogs were subjected to intravenous boluses of lidocaine 2 mg/kg, ketamine 3 mg/kg, meloxicam 0.2 mg/kg, morphine 0.2 mg/kg and loading doses of lidocaine 2 mg/kg followed by continuous rate infusion (CRI) of 50 and 100 mcg/kg/min, and ketamine 3 mg/kg followed by CRI of 10 and 50 mcg/kg/min. Electroencephalogram was recorded during electrical stimulation prior to any drug treatment (before treatment) and during electrical stimulation following treatment with the drugs (after treatment) under anaesthesia. Anaesthesia was induced with propofol and maintained with halothane at a stable concentration between 0.85 and 0.95%. Pretreatment median frequency was evidently increased (P ketamine, and morphine depressed the median frequency resulting from the posttreatment stimulation. The depression of median frequency suggested evident antinociceptive effects of these treatments in dogs. It is therefore concluded that lidocaine and ketamine can be used in the analgesic protocol for the postoperative pain management in dogs. PMID:25695060

  9. Anaesthetic management of a child with "cor-triatriatum" and multiple ventricular septal defects - A rare congenital anomaly

    Directory of Open Access Journals (Sweden)

    Sriram Sabade

    2010-01-01

    Full Text Available Cor-triatriatum is a rare congenital cardiac anomaly. It accounts for 0.1% of congenital heart diseases. Its association with multiple ventricular septal defects (VSD is even rarer. A five-month-old baby was admitted with respiratory distress and failure to thrive. Clinical examination revealed diastolic murmur over mitral area. Chest X-ray showed cardiomegaly. Haematological and biochemical investigations were within normal limits. Electrocardiogram showed left atrial enlargement. 2D echo showed double-chambered left atrium (cor-triatriatum, atrial septal defect (ASD and muscular VSD with moderate pulmonary arterial hypertension. The child was treated with 100% oxygen, diuretics and digoxin and was stabilized medically. We used balanced anaesthetic technique using oxygen, air, isoflurane, fentanyl, midazolam and vecuronium. Patient was operated under cardiopulmonary bypass (CPB with moderate hypothermia. Through right atriotomy abnormal membrane in the left atrium was excised to make one chamber. VSD were closed with Dacron patches and ASD was closed with autologous pericardial patch. Patient tolerated the whole procedure well and was ventilated electively for 12h in the intensive care unit. He was discharged on the 10 th postoperative day.

  10. The bite of the honeybee: 2-heptanone secreted from honeybee mandibles during a bite acts as a local anaesthetic in insects and mammals.

    Directory of Open Access Journals (Sweden)

    Alexandros Papachristoforou

    Full Text Available Honeybees secrete 2-heptanone (2-H from their mandibular glands when they bite. Researchers have identified several possible functions: 2-H could act as an alarm pheromone to recruit guards and soldiers, it could act as a chemical marker, or it could have some other function. The actual role of 2-H in honeybee behaviour remains unresolved. In this study, we show that 2-H acts as an anaesthetic in small arthropods, such as wax moth larva (WML and Varroa mites, which are paralysed after a honeybee bite. We demonstrated that honeybee mandibles can penetrate the cuticle of WML, introducing less than one nanolitre of 2-H into the WML open circulatory system and causing instantaneous anaesthetization that lasts for a few minutes. The first indication that 2-H acts as a local anaesthetic was that its effect on larval response, inhibition and recovery is very similar to that of lidocaine. We compared the inhibitory effects of 2-H and lidocaine on voltage-gated sodium channels. Although both compounds blocked the hNav1.6 and hNav1.2 channels, lidocaine was slightly more effective, 2.82 times, on hNav.6. In contrast, when the two compounds were tested using an ex vivo preparation-the isolated rat sciatic nerve-the function of the two compounds was so similar that we were able to definitively classify 2-H as a local anaesthetic. Using the same method, we showed that 2-H has the fastest inhibitory effect of all alkyl-ketones tested, including the isomers 3- and 4-heptanone. This suggests that natural selection may have favoured 2-H over other, similar compounds because of the associated fitness advantages it confers. Our results reveal a previously unknown role of 2-H in honeybee defensive behaviour and due to its minor neurotoxicity show potential for developing a new local anaesthetic from a natural product, which could be used in human and veterinary medicine.

  11. Effect of acid secretion blockade on acute gastric mucosal lesions induced by Tityus serrulatus scorpion toxin in anaesthetized rats.

    Science.gov (United States)

    Melo, Júnio Rios; de Araújo, Gnana Keith Marques; da Luz, Magda Maria Profeta; da Conceição, Sérgio Alexandre; Lisboa, Felipe Assis; Moraes-Santos, Tasso; Cunha-Melo, José Renan

    2006-10-01

    Scorpion venom (TX) promotes gastric acid and pepsin secretion leading to acute gastric mucosal lesions (AGML), when injected in animals. The goal of the present study was to observe the effects of acid gastric secretion blockers over the incidence of TX-induced AGML in vivo. To verify this model, we used male albino rats, fasted 18-20 h (n=122) and anaesthetized with urethane (1.4 g/kg, i.p.). Their trachea and left femoral vein were both cannulated; the first to avoid airway obstructions during scorpion intoxication and the second for administration of saline, TX and acid blockers. Following the surgical procedure, the animals were divided in 10 groups of at least 10 animals each. Control groups were injected with NaCl 0.9% 1 ml/kg (n=10) or TX 375 microg/kg (n=32). Test groups (n=10, each) received atropine 5 mg/kg, cimetidine 10mg/kg, ranitidine 2.5mg/kg, ranitidine 5mg/kg, omeprazol 1 mg/kg, omeprazol 4 mg/kg, octreotide 80 and octreotide 100 microg/kg 10 min before the TX was injected. After 1h of intoxication, the stomach was resected for macroscopic study and the gastric secretion was collected for volume, pH and acid output assessment. We observed that all blockers were able to completely or partially prevent the TX-induced acid secretion as well as the AGML (p<0.05). Our data suggest the TX-induced AGML can be prevented by different class of acid blockers injected before the intoxication. PMID:16926041

  12. Comparison between lignocaine hydrochloride and ropivacaine hydrochloride as lumbosacral epidural anaesthetic agents in goats undergoing laparoscopy assisted embryo transfer

    Directory of Open Access Journals (Sweden)

    Anubhav Khajuria

    2014-10-01

    Full Text Available Goats (n=12 undergoing laparoscopy assisted embryo transfer were randomly allotted to two groups (I and II and injected lignocaine hydrochloride (4mg/kg or ropivacaine hydrochloride (1mg/kg at the lumbosacral epidural space. The animals were held with raised hind quarters for first three minutes following injection. Immediately after induction of regional anaesthesia, they were restrained in dorsal recumbency in Trendelenburg position in a cradle. Laparoscopy was performed after creating pneumoperitoneum using filtered room air. The mean (± S.E induction time in animals of group I was significantly shorter (5.33 ± 0.61 min than those belonging to group II (12.66 ±1.99 min. Complete analgesia developed throughout the hind quarters and abdomen for 30 min and 60 min in group I and II animal’s respectively. Unlike animals of group I, group II goats continued to show moderate analgesia for 180 minutes. The motor activity returned after a lapse of 130.00 ± 12.64 min and 405.00 ± 46.31 min respectively. Occasional vocalization and struggling was noticed in two goats one from each group irrespective of the surgical manipulations during laparoscopy. The rectal temperature and respiration rates showed only non-significant increase, but the heart rate values were significantly higher (P < 0.5 up to 150 min in animals of both the groups when compared to their baseline values. From this study, it was concluded that both anaesthetic agents produced satisfactory regional anaesthesia in goats undergoing laparoscopy. However, considering the very long delay in regaining the hind limb motor activity, the use of ropivacaine may not be recommended for this purpose. Supplementation of sedative/tranquilizer with lumbosacral epidural anaesthesia needs evaluation.

  13. Tracheal epithelial damage alters the effects of luminal histamine on blood flow and tracer flux in anaesthetized sheep

    International Nuclear Information System (INIS)

    Epithelial damage greatly increases the flux of a now molecular weight tracer 99mtechnetium-diethylenetriamine penta-acetic acid (99mTc-DTPA) from tracheal lumen to venous-blood in anaesthetized sheep. We have now investigated whether epithelial damage induced by the detergent, Triton X-100, alter the effects of luminal histamine on blood flow and 99mTc-DTPA flux. The cervical trachea was filled with Krebs-Henseleit solution containing 99mTc-DTPA. Tracheal arterial flow was measured and tracheal venous blood collected. The lumen was exposed to 100 μM histamine on two occasions (Hist 1 and Hist 2) for 15 min. In six out of 11 sheep, the lumen was also exposed to 0.2% Triton X-100 between Hist 1 and Hist 2. Triton X-100 increased the baseline 99mTc-DTPA permeability coefficient from -5.3x10-7 to -400±130x10-7 cmxs-1. After epithelial damage, Hist 2 produced significantly greater changes in arterial and venous flows than Hist 1 (n=5) (0-5 min: Hist 1 Q'a=+6.4±0.8%, Q'v=+6.2±6.2%; Hist 2 Q'a=+36.7±12.2%, Q'v=+35.4±8.8%). Similar changes did not occur in the controls. Venous 99mTc-DTPA concentration during Hist 2 after epithelial damage (0-5 min -37.7±6.9%) was significantly different from Hist 1 (+5.2±7.0%). Thus, after epithelial damage, luminal histamine produces more rapid and larger changes in blood flow and a greater reduction in venous 99mTc-DTPA concentration. (au) 34 refs

  14. Acute effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate, on cardiovascular parameters in anaesthetized, artificially ventilated rats

    International Nuclear Information System (INIS)

    The organophosphorus compound sarin irreversibly inhibits acetylcholinesterase. We examined the acute cardiovascular effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate (BIMP), in anaesthetized, artificially ventilated rats. Intravenous administration of BIMP (0.8 mg/kg; the LD50 value) induced a long-lasting increase in blood pressure and tended to increase heart rate. In rats pretreated with the non-selective muscarinic-receptor antagonist atropine, BIMP significantly increased both heart rate and blood pressure. In atropine-treated rats, hexamethonium (antagonist of ganglionic nicotinic receptors) greatly attenuated the BIMP-induced increase in blood pressure without changing the BIMP-induced increase in heart rate. In rats treated with atropine plus hexamethonium, intravenous phentolamine (non-selective α-adrenergic receptor antagonist) plus propranolol (non-selective β-adrenergic receptor antagonist) completely blocked the BIMP-induced increases in blood pressure and heart rate. In atropine-treated rats, the reversible acetylcholinesterase inhibitor neostigmine (1 mg/kg) induced a transient increase in blood pressure, but had no effect on heart rate. These results suggest that in anaesthetized rats, BIMP induces powerful stimulation of sympathetic as well as parasympathetic nerves and thereby modulates heart rate and blood pressure. They may also indicate that an action independent of acetylcholinesterase inhibition contributes to the acute cardiovascular responses induced by BIMP. - Highlights: • A sarin-like agent BIMP markedly increased blood pressure in anaesthetized rats. • Muscarinic receptor blockade enhanced the BIMP-induced increase in blood pressure. • Ganglionic nicotinic receptor blockade attenuated the BIMP-induced response. • Blockade of α- as well as β-receptors attenuated the BIMP-induced response

  15. Acute effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate, on cardiovascular parameters in anaesthetized, artificially ventilated rats

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Yoshimasa [Department of Pharmacology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Itoh, Takeo, E-mail: titoh@med.nagoya-cu.ac.jp [Department of Pharmacology, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Shiraishi, Hiroaki [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Maeno, Yoshitaka [Department of Forensic Medical Science, Graduate School of Medical Sciences, Nagoya City University, Nagoya (Japan); Arima, Yosuke; Torikoshi, Aiko; Namera, Akira [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Makita, Ryosuke [Department of Nursing, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima (Japan); Yoshizumi, Masao [Department of Cardiovascular Physiology and Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan); Nagao, Masataka [Department of Forensic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima (Japan)

    2013-10-01

    The organophosphorus compound sarin irreversibly inhibits acetylcholinesterase. We examined the acute cardiovascular effects of a sarin-like organophosphorus agent, bis(isopropyl methyl)phosphonate (BIMP), in anaesthetized, artificially ventilated rats. Intravenous administration of BIMP (0.8 mg/kg; the LD50 value) induced a long-lasting increase in blood pressure and tended to increase heart rate. In rats pretreated with the non-selective muscarinic-receptor antagonist atropine, BIMP significantly increased both heart rate and blood pressure. In atropine-treated rats, hexamethonium (antagonist of ganglionic nicotinic receptors) greatly attenuated the BIMP-induced increase in blood pressure without changing the BIMP-induced increase in heart rate. In rats treated with atropine plus hexamethonium, intravenous phentolamine (non-selective α-adrenergic receptor antagonist) plus propranolol (non-selective β-adrenergic receptor antagonist) completely blocked the BIMP-induced increases in blood pressure and heart rate. In atropine-treated rats, the reversible acetylcholinesterase inhibitor neostigmine (1 mg/kg) induced a transient increase in blood pressure, but had no effect on heart rate. These results suggest that in anaesthetized rats, BIMP induces powerful stimulation of sympathetic as well as parasympathetic nerves and thereby modulates heart rate and blood pressure. They may also indicate that an action independent of acetylcholinesterase inhibition contributes to the acute cardiovascular responses induced by BIMP. - Highlights: • A sarin-like agent BIMP markedly increased blood pressure in anaesthetized rats. • Muscarinic receptor blockade enhanced the BIMP-induced increase in blood pressure. • Ganglionic nicotinic receptor blockade attenuated the BIMP-induced response. • Blockade of α- as well as β-receptors attenuated the BIMP-induced response.

  16. Comparison of efficacy of spinal anaesthesia and sub-fascial local anaesthetic inguinal field block for open inguinal hernia repair-a single institutional experience

    International Nuclear Information System (INIS)

    The use of local anaesthetic for open inguinal hernia surgery has long been restricted to specialist centres. This study aimed to compare the efficacy of spinal anaesthesia and sub-fascial local anaesthetic (LA) for performing open hernia repair and at the same time provide better post op pain relief and early mobilization. Methods: In this randomized clinical trial, 62 male patients aged 16-72 were randomly allocated to two groups. Group A received mixture of 20ml 0.5% bupivacain, 20ml 2% lignocaine with adrenaline, 20ml normal saline (N/S), 3 ml NaHCO/sub 3/ sub-fascially for Local anaesthetic (LA) inguinal field block, while Group B received Spinal Anaesthesia (SA) with 0.5% Bupivacaine. Comparison was made in terms of Visual Analogue Score (VAS) recorded intra-operatively at 0 and 30 minutes and post operatively at 2, 4 and 12 hours at rest and on movement. Need for rescue analgesia and total analgesic consumption in both groups were calculated. Interval to pain free ambulation as well as procedural and anaesthesia related complications were compared. Results: Mean VAS in the intraoperative period were significantly high in Group A (p-value 0.011) at the start of operation and at 30 minutes (p-value <0.001). However, it did not correlate with patient satisfaction as 90% of patients in Group A successfully underwent the procedure without need for supplemental analgesia. VAS scores at rest and on movement/cough were comparable in the post op period at 2, 4 and 12 hours in both groups. Interval to pain free ambulation was significantly low in Group A (p-value 0.0012). Conclusion: Sub facial LA inguinal field block provides effective anaesthesia with optimum post op analgesia, prompt recovery and fewer systemic side effects compared to SA and can safely be used for routine open inguinal hernia surgery. (author)

  17. Increasing ketamine dose enhances the anaesthetic properties of ketamine-xylazine-midazolam combinations in growing pigs : short communication

    Directory of Open Access Journals (Sweden)

    R.A. Ajadi

    2008-05-01

    Full Text Available The influence of increasing the dosage of ketamine on anaesthesia induced by a combination of ketamine, xylazine and midazolam in pigs was determined by assessing the onset of action (OAN, duration of analgesia (DAN, anaesthesia time (ANT, and recovery time (RCT in 10 growing pigs (Mean weight: 18.2 ± 1.65 kg receiving either 10 mg / kg intramuscular (i.m injection of 10 % ketamine, 2 mg / kg i.m injection of 2 % xylazine and 0.25 mg / kg i.m injection of 0.1%midazolam (K10XM or 20 mg / kg i.m injection of ketamine and 2 mg / kg i.m injection of xylazine and 0.25 mg / kg i.m injection of 0.1 % midazolam (K20XM. In addition, the heart rates (HR, respiratory rates (RR and rectal temperatures (RT were determined immediately after drug administration and at 10 minute intervals over a period of 60 minutes. Analgesia was assessed by the response of the pigs to artery forceps applied at the interdigital space. Recovery was determined as pigs' ability to stand without ataxia. Data were expressed as mean ± SEM while anaesthetic indices were compared using Student's t-tests. AP value of 0.05 was accepted as significant in all cases. In this study, both the OAN and RCT were significantly (P < 0.05 shorter in K10XM (1.4 ± 0.2 min; 7.8 ± 2.2 min than in K20XM (2.2 ± 0.2; 18.6 ± 1.4 min respectively. Similarly, the duration of anaesthesia was significantly (P < 0.05 shorter in K10XM (55.4 ± 8.4 min than in K20XM (92.0 ± 13.6 min. The pigs that received K20XM combination had analgesia of duration of 41.4±12.6 min while those that received K10XM combination had no analgesia. However, the HR, RR, and RT were not significantly (P > 0.05 different between K10XM and K20XM. It was therefore concluded that the lower dose ketamine combination is better for the induction of anaesthesia, while the higher dose ketamine combination is preferable for surgery of short duration in pigs.

  18. 在无痛分娩中局麻药最低有效感觉及运动阻滞浓度的研究和应用%Research and application of the minimum local-anaesthetic concentration and motor-block minimum local-anaesthetic concentration for labour pain relief

    Institute of Scientific and Technical Information of China (English)

    李梅娜; 孙来保; 雷亚红; 黄文起

    2011-01-01

    Background Since the walking epidural technique in labour analgisa was first published in 1992, how to ascertain the concentration of local anesthetics has became a new challenge to all anesthesia providers. Purpose Knowing the minimum local -anaesthetic concentration (MLAC) and motor-block minimum local -anaesthetic concentration (MMLAC) of local anaesthetics not only can provide complete analgesia and retain the motor function for puerpera, but also can provide some clinical evidences to guide the walking epidural technique in labour analgisa. Content This article introduces the definition and experiment methodology of MLAC and MMLAC, and summarizes some of the related research results. Trend The minimal effective concentration is a sensitive index to determine the potency of local anesthetics. Although its clinical application can be affected by several factors, it may play the advantages of precision and quantification in intrathecal anesthesia and analgesia.%背景 随着1992年可行走式分娩镇痛服务首次公布,学者们关于局麻药浓度如何确定面临新的挑战.目的 寻找出局麻药引起感觉和运动阻滞的最低有效浓度,才能在镇痛完善的同时保留产妇运动功能,为可行走式分娩镇痛提供循证医学依据.内容 介绍局麻药最低有效感觉阻滞浓度(minimum local-anaesthetic concentration,MLAC)和最低有效运动阻滞浓度(motor-block minimum local-anaesthetic concentration,MMLAC)的定义及其测定方法学,并对国内外部分相关研究结果进行总结分析.趋向 局麻药最低有效浓度是比较其效价强度的灵敏指标,虽然临床应用受一定因素的影响,但在阻滞麻醉和镇痛治疗中有可能发挥其既精确、又量化的重要作用.

  19. Assessment of Common Anaesthetic and Clinical Indices of Multimodal Therapy of Propofol, Xylazine, and Ketamine in Total Intravenous Anaesthesia in West African Dwarf Goat

    Directory of Open Access Journals (Sweden)

    Ukwueze Celestine Okwudili

    2014-01-01

    Full Text Available The assessment of anaesthetic and clinical indices of multimodal therapy of propofol, xylazine, and ketamine was done in West African Dwarf (WAD goat. Sixteen healthy male WAD goats were assigned into four treatment groups, namely, control (group A (ketamine 5 mg/kg + xylazine 0.05 mg/kg, group B (propofol 5 mg/kg + xylazine 0.05 mg/kg, group C (propofol 5 mg/kg + ketamine 5 mg/kg, and group D (propofol 2.5 mg/kg + ketamine 2.5 mg/kg + xylazine 0.05 mg/kg. All drugs were administered intravenously. The multimodal therapy decreased significantly (P<0.05 the heart rate in groups A, B, and D. Also respiratory rate significantly (P<0.05 decreased in groups A, B, and D but significantly (P<0.05 increased at 20 min after induction in group C. However, temperature significantly (P<0.05 decreased in groups A, B, and C. The induction was good and smooth in groups B and D. Surgical anaesthetic time was longer in groups B and D and shorter in group C. The quality of recovery was good in groups B and D. Side effects such as salivation and apnoea were observed in all groups. In conclusion, the multimodal therapy could be used successfully. However, group D could be the best combination considering the parameters measured.

  20. Pre-surgical regional blocks in orthognathic surgery: prospective study evaluating their influence on the intraoperative use of anaesthetics and blood pressure control.

    Science.gov (United States)

    Chen, Y A; Rivera-Serrano, C M; Chen, C; Chen, Y R

    2016-06-01

    In orthognathic surgery, maxillary (CNV2) and mandibular (CNV3) divisions of the trigeminal nerve can be blocked successfully prior to surgery. In this study, it was hypothesized that regional blocks (nerve block over a particular region: bilateral CNV2 and CNV3 divisions of the trigeminal nerve) would decrease the total requirement for intraoperative anaesthetic agents and facilitate the process of hypotensive anaesthesia. Local anaesthesia containing 1/100,000 epinephrine and 10ml 0.5% levobupivacaine was injected into the planned incisions in 50 patients. Twenty-five patients (group A) underwent orthognathic surgery without regional blocks and another 25 patients (group B) underwent surgery with regional blocks. The anaesthetic protocol was the same in both groups and administered by a single anaesthesiologist. The mean arterial pressure was recorded at several points throughout the operation, as well as all the medications used. The blood loss and the amounts of medications administered were lower in group B than in group A. In patients receiving regional blocks, the amounts of fentanyl and nicardipine required were significantly lower. The use of pre-emptive anaesthesia in orthognathic surgery may reduce the overall amounts of medications required for hypotensive anaesthesia, facilitate the intraoperative control of blood pressure, and decrease intraoperative blood loss. PMID:26811189

  1. General anaesthetics do not impair developmental expression of the KCC2 potassium-chloride cotransporter in neonatal rats during the brain growth spurt

    KAUST Repository

    Lacoh, Claudia Marvine

    2013-03-26

    BackgroundThe developmental transition from depolarizing to hyperpolarizing γ-aminobutyric acid-mediated neurotransmission is primarily mediated by an increase in the amount of the potassium-chloride cotransporter KCC2 during early postnatal life. However, it is not known whether early neuronal activity plays a modulatory role in the expression of total KCC2 mRNA and protein in the immature brain. As general anaesthetics are powerful modulators of neuronal activity, the purpose of this study was to explore how these drugs affect KCC2 expression during the brain growth spurt.MethodsWistar rat pups were exposed to either a single dose or 6 h of midazolam, propofol, or ketamine anaesthesia at postnatal days 0, 5, 10, or 15. KCC2 expression was assessed using immunoblotting, immunohistochemistry, or quantitative polymerase chain reaction analysis up to 3 days post-exposure in the medial prefrontal cortex.ResultsThere was a progressive and steep increase in the expression of KCC2 between birth and 2 weeks of age. Exposure to midazolam, propofol, or ketamine up to 6 h at any investigated stages of the brain growth spurt did not influence the expression of this cotransporter protein.ConclusionI.V. general anaesthetics do not seem to influence developmental expression of KCC2 during the brain growth spurt. © 2013 © The Author [2013].

  2. Developmental paediatric anaesthetic pharmacology

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing

    2015-01-01

    Safe and effective drug therapy in neonates, infants and children require detailed knowledge about the ontogeny of drug disposition and action as well how these interact with genetics and co-morbidity of children. Recent advances in developmental pharmacology in children follow the increased...

  3. Diabetic parturient - Anaesthetic implications

    Directory of Open Access Journals (Sweden)

    Nibedita Pani

    2010-01-01

    Full Text Available Pregnancy induces progressive changes in maternal carbohydrate metabolism. As pregnancy advances insulin resistance and diabetogenic stress due to placental hormones necessitate compensatory increase in insulin secretion. When this compensation is inadequate gestational diabetes develops. ′Gestational diabetes mellitus′ (GDM is defined as carbohydrate intolerance with onset or recognition during pregnancy. Women diagnosed to have GDM are at increased risk of future diabetes predominantly type 2 DM as are their children. Thus GDM offers an important opportunity for the development, testing and implementation of clinical strategies for diabetes prevention. Timely action taken now in screening all pregnant women for glucose intolerance, achieving euglycaemia in them and ensuring adequate nutrition may prevent in all probability, the vicious cycle of transmitting glucose intolerance from one generation to another. Given that diabetic mothers have proportionately larger babies it is likely that vaginal delivery will be more difficult than in the normal population, with a higher rate of instrumentally assisted delivery, episiotomy and conversion to urgent caesarean section. So an indwelling epidural catheter is a better choice for labour analgesia as well to use, should a caesarean delivery become necessary. Diabetes in pregnancy has potential serious adverse effects for both the mother and the neonate. Standardized multidisciplinary care including anaesthetists should be carried out obsessively throughout pregnancy. Diabetes is the most common endocrine disorder of pregnancy. In pregnancy, it has considerable cost and care demands and is associated with increased risks to the health of the mother and the outcome of the pregnancy. However, with careful and appropriate screening, multidisciplinary management and a motivated patient these risks can be minimized.

  4. Diabetic parturient - Anaesthetic implications

    OpenAIRE

    Nibedita Pani; Shakti Bedanta Mishra; Shovan Kumar Rath

    2010-01-01

    Pregnancy induces progressive changes in maternal carbohydrate metabolism. As pregnancy advances insulin resistance and diabetogenic stress due to placental hormones necessitate compensatory increase in insulin secretion. When this compensation is inadequate gestational diabetes develops. ‘Gestational diabetes mellitus’ (GDM) is defined as carbohydrate intolerance with onset or recognition during pregnancy. Women diagnosed to have GDM are at increased risk of future diabetes predominantly typ...

  5. The insulinotropic effect of exogenous glucagon-like peptide-1 is not affected by acute vagotomy in anaesthetized pigs.

    Science.gov (United States)

    Veedfald, Simon; Hansen, Marie; Christensen, Louise Wulff; Larsen, Sara Agnete Hjort; Hjøllund, Karina Rahr; Plamboeck, Astrid; Hartmann, Bolette; Deacon, Carolyn Fiona; Holst, Jens Juul

    2016-07-01

    What is the central question of this study? We investigated whether intestinal vagal afferents are necessary for the insulinotropic effect of glucagon-like peptide-1 (GLP-1) infused into a mesenteric artery or a peripheral vein before and after acute truncal vagotomy. What is the main finding and its importance? We found no effect of truncal vagotomy on the insulinotropic effect of exogenous GLP-1 and speculate that high circulating concentrations of GLP-1 after i.v. and i.a. infusion might have overshadowed any neural signalling component. We propose that further investigations into the possible vagal afferent signalling of GLP-1 would best be pursued using enteral stimuli to provide high subepithelial levels of endogenous GLP-1. Glucagon-like peptide 1 (GLP-1) is secreted from the gut in response to luminal stimuli and stimulates insulin secretion in a glucose-dependent manner. As a result of rapid enzymatic degradation of GLP-1 by dipeptidyl peptidase-4, a signalling pathway involving activation of intestinal vagal afferents has been proposed. We conducted two series of experiments in α-chloralose-anaesthetized pigs. In protocol I, pigs (n = 14) were allocated for either i.v. or i.a. (mesenteric) GLP-1 infusions (1 and 2 pmol kg(-1)  min(-1) , 30 min) while maintaining permissive glucose concentrations at 6 mmol l(-1) by i.v. glucose infusion. The GLP-1 infusions were repeated after acute truncal vagotomy. In protocol II, pigs (n = 27) were allocated into six groups. Glucagon-like peptide 1 was infused i.v. or i.a. (mesenteric) for 1 h at 3 or 30 pmol kg(-1)  min(-1) . During the steady state (21 min into the GLP-1 infusion), glucose (0.2 g kg(-1) , i.v.) was administered over 9 min to stimulate β-cell secretion. Thirty minutes after the glucose infusion, GLP-1 infusions were discontinued. Following a washout period, the vagal trunks were severed in four of six groups (vagal trunks were left intact in two of six groups), whereupon all

  6. 局部麻醉剂引起的眼压改变%Changes in intraocular pressure after topical anaesthetic instillation

    Institute of Scientific and Technical Information of China (English)

    Javier A Montero; Jose M Ruiz-Moreno; Marta Fernandez-Munoz; M.Isabel Rodriguez-Palacios

    2006-01-01

    · AIM: To determine the influence of topical anaesthetic drops, age and central corneal thickness (CCT) in the determination of intraocular pressure (IOP) by non contact tonometry (NCT). · METHODS: Ninety-three eyes from 47 patients were examined for CCT and lOP by NCT before and after the instillation of topical anaesthetic drops.· RESULTS: Average age was 66.4 (SD 16, range 34 to 88years-of-age). Thirty one patients were female and 16 were male. Average basal IOP was 16.0 mmHg (SD 4.0, range 8.5to 26.1). IOP pressure one minute after topical anesthesia instillation was 15.0 mmHg (SD 3.8, range 7.7 to 26.7), and 14.9 mm Hg (SD 3.9, range 7.6 to 26.3) five minutes after the instillation. The differences were statistically significant for the 0 to 1 minute lapse (P=0.0007) and for the 0 to 5minute lapse (P=0.0003), but not for the 1 to 5 minute lapse (P=0.27) (Student's t test for paired data). Average CCT before topical anaesthetic drops was 565.4 microns. Simple linear regression analysis demonstrated absence of significant variation between age and IOP changes and between CCT and IOP changes,· CONCLUSION: Our study confirms that the instillation of topical anaesthetics causes a reduction in IOP, which is progressive during the first 5 minutes after instillation. This IOP reduction does not seem to be associated with basal CCT or age.%目的:确定局麻药,年龄和角膜中央厚度对非接触眼压计眼压测量值的影响.方法:记录47例93眼滴局麻药前后角膜中央厚度和非接触眼压计眼压测量值.结果:在47例中女31例,男16例;平均年龄66.4岁(标准差16,范围34~88岁);平均基础眼压16.0 mmHg(标准差4.0,范围8.5~26.1 mmHg).滴局麻药后1 min平均眼压16.0 mmHg(标准差3.8,范围7.7~26.7 mmHg),5 min平均眼压14.9 mmHg(标准差3.9,范围7.6~26.3).0~1 min(P=0.0007)和0~5 min(P=0.0003)的数值差异有统计学意义,1~5 min(P=0.27)的数值差异无统计学意义(配对资料t检验).滴局麻

  7. The effect of local anaesthetic wound infiltration on chronic pain after lower limb joint replacement: A protocol for a double-blind randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Smith Alison J

    2011-02-01

    Full Text Available Abstract Background For the majority of patients with osteoarthritis (OA, joint replacement is a successful intervention for relieving chronic joint pain. However, between 10-30% of patients continue to experience chronic pain after joint replacement. Evidence suggests that a risk factor for chronic pain after joint replacement is the severity of acute post-operative pain. The aim of this randomised controlled trial (RCT is to determine if intra-operative local anaesthethic wound infiltration additional to a standard anaethesia regimen can reduce the severity of joint pain at 12-months after total knee replacement (TKR and total hip replacement (THR for OA. Methods 300 TKR patients and 300 THR patients are being recruited into this single-centre double-blind RCT. Participants are recruited before surgery and randomised to either the standard care group or the intervention group. Participants and outcome assessors are blind to treatment allocation throughout the study. The intervention consists of an intra-operative local anaesthetic wound infiltration, consisting of 60 mls of 0.25% bupivacaine with 1 in 200,000 adrenaline. Participants are assessed on the first 5 days post-operative, and then at 3-months, 6-months and 12-months. The primary outcome is the WOMAC Pain Scale, a validated measure of joint pain at 12-months. Secondary outcomes include pain severity during the in-patient stay, post-operative nausea and vomiting, satisfaction with pain relief, length of hospital stay, joint pain and disability, pain sensitivity, complications and cost-effectiveness. A nested qualitative study within the RCT will examine the acceptability and feasibility of the intervention for both patients and healthcare professionals. Discussion Large-scale RCTs assessing the effectiveness of a surgical intervention are uncommon, particulary in orthopaedics. The results from this trial will inform evidence-based recommendations for both short-term and long-term pain

  8. Effectiveness of the anaesthetic MS-222 in gilthead seabream, Sparus aurata: effect of feeding time and day-night variations in plasma MS-222 concentration and GST activity.

    Science.gov (United States)

    Vera, L M; Montoya, A; Sánchez-Vázquez, F J

    2013-02-17

    Feeding time is a potent zeitgeber capable of synchronising behavioural and physiological daily rhythms in fish. However, the effect of feeding time on the daily rhythm of drugs toxicity and/or effectiveness remains unexplored to date. In this paper we investigated the day/night variations in the effectiveness of an anaesthetic commonly used in fish (Tricaine, MS-222) in a teleost of great chronobiological and aquaculture interest (gilthead seabream). To this end, fish were kept under LD 12:12 and fed at mid-light (ML), mid-darkness (MD) or random times (RD). The time needed to induce anaesthesia (reduction of locomotor activity) during MS-222 exposure (65 mg/L) as well as the recovery period were investigated at ML and MD in the three experimental groups using specialised video tracking software. In addition, daily rhythms of GST activity in the liver (as an indicator of detoxification processes) and plasma MS-222 concentration (related to uptake) were determined. The results revealed that MS-222 effectiveness in the ML group was higher during the day than at night (significant reduction of activity after 3 min vs. 5 min) whereas in the MD group, the daily variation of MS-222 effectiveness was inverted (significant reduction of activity after 7 min at ML vs. 2 min at MD), suggesting that feeding time can shift the day-night variations in the effectiveness of MS-222. Hepatic GST also seemed to be affected by feeding time: in fish fed at MD or RD this enzyme activity showed significant differences during the day, and the highest levels were found at different times of the day in each group. Plasma MS-222 concentrations were higher at ML (142.4±12.8 ng/ml) than at MD (96.3±10.9 ng/ml) (t-Student, peffectiveness of this anaesthetic. Furthermore, manipulation of the feeding schedule can be used to modify the daily variations in MS-222 effectiveness, which has basic as well applied implications for optimising anaesthesia protocols in fish aquaculture. PMID:23291569

  9. Effects of Light Stimulation on the Hippocampal Rhythm of Anaesthetized Rats%光照对麻醉大鼠海马节律的影响

    Institute of Scientific and Technical Information of China (English)

    谢康宁; 刘娟; 罗二平; 申广浩; 田越; 郑丽娟; 汤池; 闫一力; 吴小明; 孙涛

    2012-01-01

    Objective: To investigate the effects of light stimulation on hippocampal rhythm of anaesthetized rats. Methods: The rats were anaesthetized with urcthane and implanted with eleclrodes in the hippocampus, from which neural local field potentials (LFPs) were recorded. Light stimulation were applied to the rats repetitively with 10s duration and additional 20s delay for recovery, which was compared with the classical tail-pinch experiment. Results: The tail-pinch of urethane-anesthetize rat could change the LFPs in hippocampus from large irregular activity (LIA) into theta wave, which indicated that a sensory input could cause the animal being 'active'. The transition of LIA to theta wave is within Is, and that theta wave back to LIA is approximately 3s after pinch's removal. We found that light can eliminate LIA but not elicit theta wave, with much longer delay, 5-9s for LIA disappearing after light onset and 4-6s for LIA'S back. Conclusions: This may suggest that under urethane-ancsthetized condition visual input is less sensitive and with lower priority comparing with tactility.%目的:研究光照刺激对麻醉大鼠海马节律的影响.方法:对乌拉坦麻醉大鼠,在海马中植入电极,通过神经信号放大器记录场电位.重复对大鼠进行视觉刺激,刺激10s,并给予20s的恢复期.与经典掐尾实验进行对比.结果:乌拉坦麻醉大鼠的掐尾实验能够将海马场电位从“大不规则波”(LIA)变成theta波.LIA到theta的转变通常只需1s,掐尾结束后3s后theta返回LIA.光刺激造成了在5-8s后LIA消失,光刺激撤离后4-6sLIA返回,并没有引发theta.结论:本文结果提示视觉通路与触觉通路有不同的优先级和行为特性.

  10. Cost-effectiveness of steroid (methylprednisolone) injections versus anaesthetic alone for the treatment of Morton’s neuroma: economic evaluation alongside a randomised controlled trial (MortISE trial)

    OpenAIRE

    Edwards, Rhiannon Tudor; Yeo, Seow Tien; Russell, Daphne; Thomson, Colin E; Beggs, Ian; Gibson, J N Alastair; McMillan, Diane; Martin, Denis J; Ian T. Russell

    2015-01-01

    Background Morton’s neuroma is a common foot condition affecting health-related quality of life. Though its management frequently includes steroid injections, evidence of cost-effectiveness is sparse. So, we aimed to evaluate whether steroid injection is cost-effective in treating Morton’s neuroma compared with anaesthetic injection alone. Methods We undertook incremental cost-effectiveness and cost-utility analyses from the perspective of the National Health Service, alongside a patient-blin...

  11. Time-frequency analysis of laser Doppler flowmetry signals recorded in response to a progressive pressure applied locally on anaesthetized healthy rats

    Energy Technology Data Exchange (ETDEWEB)

    Humeau, Anne [Groupe ISAIP-ESAIP, 18 rue du 8 mai 1945, BP 80022, 49180 Saint Barthelemy d' Anjou Cedex (France); Koitka, Audrey [Laboratoire de Physiologie et d' Explorations Vasculaires, Centre Hospitalier Universitaire d' Angers, 49033 Angers Cedex 01 (France); Abraham, Pierre [Laboratoire de Physiologie et d' Explorations Vasculaires, Centre Hospitalier Universitaire d' Angers, 49033 Angers Cedex 01 (France); Saumet, Jean-Louis [Laboratoire de Physiologie et d' Explorations Vasculaires, Centre Hospitalier Universitaire d' Angers, 49033 Angers Cedex 01 (France); L' Huillier, Jean-Pierre [Ecole Nationale Superieure d' Arts et Metiers (ENSAM), Laboratoire Procedes-Materiaux-Instrumentation (LPMI), 2 boulevard du Ronceray, BP 3525, 49035 Angers Cedex (France)

    2004-03-07

    The laser Doppler flowmetry technique has recently been used to report a significant transient increase of the cutaneous blood flow signal, in response to a local non-noxious pressure applied progressively on the skin of both healthy humans and rats. This phenomenon is not entirely understood yet. In the present work, a time-frequency analysis is applied to signals recorded on anaesthetized healthy rats, at rest and during a cutaneous pressure-induced vasodilation (PIV). The comparison, at rest and during PIV, of the scalogram relative energies and scalogram relative amplitudes in five bands, corresponding to five characteristic frequencies, shows an increased contribution for the endothelial related metabolic activity in PIV signals, till 400 s after the beginning of the progressive pressure application. The other subsystems (heart, respiration, myogenic and neurogenic activities) contribute relatively less during PIV than at rest. The differences are statistically significant for all the relative activities in the interval 0-200 s following the beginning of the pressure. These results and others obtained on patients, such as diabetics, could increase the understanding of some cutaneous pathologies involved in various neurological diseases and in the pathophysiology of decubitus ulcers.

  12. Association of nausea and vomiting in between anaesthetic or patients factors in Monitored Anaesthesia Care (MAC after gastrointestinal endoscopies in tertiary care hospital: An Audit

    Directory of Open Access Journals (Sweden)

    Khalid Maudood Siddiqui

    2012-09-01

    Full Text Available Introduction: Esophagogastroduodenoscopy (EGD is used for both diagnostic and therapeutic procedures. EGD under Monitored Anesthesia Care (MAC is gaining wide acceptance, but nausea and vomiting remains one of the most common and distressing complications, which require additional resources and may delay in the discharge of patient from hospital. The aim of this audit was to determine the association of nausea and vomiting in between anaesthetic technique or patients factors after gastrointestinal endoscopic procedures under MAC. Methods: After finishing 3 hours of endoscopic procedure one of the investigators evaluated and collects the patient’s data in the ward and filled the predesigned assessment form and ticked the different variables which may have effect on nausea and vomiting. Results: 130 patients were enrolled over the period of 1 year. During the all procedure we observed mild to severe nausea vomiting in those patients who have diabetes mellitus and 10 patients were need antiemetic to control vomiting. Conclusion: Incidence of PONV (Postoperative nausea and vomiting is high after endoscopy under MAC especially in those patients who has high risk factors for PONV as well as in known diabetic patients. So prophylactic antiemetic therapy should be commenced in those patients and further randomized controlled trial should be recommended to establish this relationship.

  13. Time-frequency analysis of laser Doppler flowmetry signals recorded in response to a progressive pressure applied locally on anaesthetized healthy rats

    International Nuclear Information System (INIS)

    The laser Doppler flowmetry technique has recently been used to report a significant transient increase of the cutaneous blood flow signal, in response to a local non-noxious pressure applied progressively on the skin of both healthy humans and rats. This phenomenon is not entirely understood yet. In the present work, a time-frequency analysis is applied to signals recorded on anaesthetized healthy rats, at rest and during a cutaneous pressure-induced vasodilation (PIV). The comparison, at rest and during PIV, of the scalogram relative energies and scalogram relative amplitudes in five bands, corresponding to five characteristic frequencies, shows an increased contribution for the endothelial related metabolic activity in PIV signals, till 400 s after the beginning of the progressive pressure application. The other subsystems (heart, respiration, myogenic and neurogenic activities) contribute relatively less during PIV than at rest. The differences are statistically significant for all the relative activities in the interval 0-200 s following the beginning of the pressure. These results and others obtained on patients, such as diabetics, could increase the understanding of some cutaneous pathologies involved in various neurological diseases and in the pathophysiology of decubitus ulcers

  14. 近日节律对麻醉药物作用的影响%Effect of circadian rhythms on the action of anaesthetic agents

    Institute of Scientific and Technical Information of China (English)

    曾海波; 尚游; 袁世荧

    2010-01-01

    多数麻醉医生认为,人体是一个非常稳定的有机体.事实上,机体的许多方面因为受到生物节律的影响而会表现出周期性的变化.近日节律是一种重要的生物节律,对动植物乃至人都有诸多重要的影响,这其中也包括对麻醉药物作用的影响.因此,在从事科学研究和临床工作时,近日节律对麻醉药物作用的这种影响不容忽视.%Many anaesthetists assume that humans are homeostatic organisms but in reality we show periodic variations in nearly all facets of our physiology and behaviour, influenced by biologic rhythms. Circadian rhythms is an important biologic rhythm which can affect animals, plants and human beings. Also it make effects on anesthetics, The effects of circadian rhythms should be considered in scientific research of anaesthetic drugs and works of clinical practice of anaesthesia.

  15. Autonomic Nervous System Mediates the Hypotensive Effects of Aqueous and Residual Methanolic Extracts of Syzygium polyanthum (Wight) Walp. var. polyanthum Leaves in Anaesthetized Rats.

    Science.gov (United States)

    Ismail, A; Mohamed, M; Sulaiman, S A; Wan Ahmad, W A N

    2013-01-01

    Syzygium polyanthum (Wight) Walp. var. polyanthum leaves are consumed as a traditional Malay treatment of hypertension. This study investigates hypotensive potential of aqueous (AESP) and residual methanolic (met-AESP) extracts of S. polyanthum leaves and possible involvement of autonomic receptors. AESP and met-AESP (20 to 100 mg/kg) were intravenously administered into anaesthetized Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. Blood pressure and heart were monitored for 20 min. AESP and met-AESP induced significant dose-dependent hypotension, but only 100 mg/kg AESP caused mild bradycardia (n = 5). AESP-induced hypotension was more potent than that of met-AESP in WKY. AESP has a faster onset time than that of met-AESP in both WKY and SHR. However, met-AESP-induced hypotension was more sustained than that of AESP in SHR. Blockages of autonomic ganglion and α -adrenergic receptors using hexamethonium and phentolamine (n = 5 for each group) partially attenuated AESP-induced hypotension, suggesting involvement of α -adrenergic receptors. Blockages of autonomic ganglion, β -adrenergic, cholinergic receptors, and nitric oxide production using hexamethonium, propranolol, atropine, and N- ω -nitro-l arginine methyl ester (L-NAME) (n = 5 for each group) partially attenuated met-AESP-induced hypotension, suggesting involvement of β -adrenergic and cholinergic receptors via nitric oxide production. PMID:24454508

  16. Autonomic Nervous System Mediates the Hypotensive Effects of Aqueous and Residual Methanolic Extracts of Syzygium polyanthum (Wight Walp. var. polyanthum Leaves in Anaesthetized Rats

    Directory of Open Access Journals (Sweden)

    A. Ismail

    2013-01-01

    Full Text Available Syzygium polyanthum (Wight Walp. var. polyanthum leaves are consumed as a traditional Malay treatment of hypertension. This study investigates hypotensive potential of aqueous (AESP and residual methanolic (met-AESP extracts of S. polyanthum leaves and possible involvement of autonomic receptors. AESP and met-AESP (20 to 100 mg/kg were intravenously administered into anaesthetized Wistar-Kyoto (WKY and spontaneously hypertensive (SHR rats. Blood pressure and heart were monitored for 20 min. AESP and met-AESP induced significant dose-dependent hypotension, but only 100 mg/kg AESP caused mild bradycardia (n=5. AESP-induced hypotension was more potent than that of met-AESP in WKY. AESP has a faster onset time than that of met-AESP in both WKY and SHR. However, met-AESP-induced hypotension was more sustained than that of AESP in SHR. Blockages of autonomic ganglion and α-adrenergic receptors using hexamethonium and phentolamine (n=5 for each group partially attenuated AESP-induced hypotension, suggesting involvement of α-adrenergic receptors. Blockages of autonomic ganglion, β-adrenergic, cholinergic receptors, and nitric oxide production using hexamethonium, propranolol, atropine, and N-ω-nitro-l arginine methyl ester (L-NAME (n=5 for each group partially attenuated met-AESP-induced hypotension, suggesting involvement of β-adrenergic and cholinergic receptors via nitric oxide production.

  17. Clove oil as anaesthetic for juveniles of matrinxã Brycon cephalus (Gunther, 1869 Óleo de cravo como anestésico para juvenis de matrinxã Brycon cephalus (Gunther, 1869

    Directory of Open Access Journals (Sweden)

    Luis Antônio Kioshi Aoki Inoue

    2003-10-01

    Full Text Available Many chemicals have been used as anaesthetics in fish farms and fish biology laboratories to keep the fish immobilized during handling procedures and to prevent accidents and animal stress. In Brazil, tricaine methane sulfonate (MS 222, quinaldine sulfate, benzocaine, and phenoxyethanol are the most common fish anaesthetics used to prevent fish stress during handling, but many side effects such as body and gill irritations, corneal damage and general risks of intoxication have been reported. Clove oil is a natural product proposed as an alternative fish anaesthetic by many researchers and it has been used in many countries with great economic advantages and no apparent toxic properties. In this work, we assessed the suitability of clove oil to anaesthetize matrinxã. Sixty-three juveniles of matrinxã were exposed to seven anaesthetic batches of clove oil (pharmaceutical grade namely 18, 20, 30, 40, 50, 60, and 70 mg/L. The times to reach total loss of equilibrium and to recover the upright position were measured. Clove oil concentration about 40 mg/L was enough to anaesthetize the fish in approximately one minute and the recovery time was independent in regard to anaesthetic concentration.Diversos produtos químicos têm sido empregados como anestésicos para peixes nas estações de piscicultura e laboratórios de biologia de peixes para a devida imobilização dos organismos, afim de se prevenir acidentes e ferimentos na superfície do corpo dos próprios peixes, que podem ficar susceptíveis a patógenos e taxas altas de mortalidade. A tricaina metano sulfonato (MS 222, a quinaldina, a benzocaina e o phenoxyethanol têm sido amplamente utilizados no Brasil, mas alguns efeitos colaterais são observados como perda de muco, irritação nas brânquias e olhos, e também alguns incômodos aos trabalhadores como a necessidade do uso de luvas. Dessa forma, o óleo de cravo é proposto como um anestésico alternativo por ser um produto natural de

  18. Behavioural Responses of Heterobranchus longifilis Juveniles. Val (Pisces: 1840 Exposed to Freeze–dried Bark Extract of Tephrosia vogelii as an Anaesthetic

    Directory of Open Access Journals (Sweden)

    S.G. Solomon

    2014-03-01

    Full Text Available This study evaluates the anaesthetic properties of freeze-dried leaf extract of Tephrosia vogelii on the African catfish Heterobranchus longifilis juveniles. Experimental fish of Mean weight 115.00 were obtained from River Benue at Makurdi, Nigeria and acclimatized at the hatchery of University of Agriculture Makurdi for two weeks. Four H. longifilis were selected randomly for both control and treatment groups. Each treatment fish was weighed and injected intramuscularly 0.05ml of the extract at concentrations of 0.01, 0.02, 0.03, 0.04, 0.05 and 0.06g/l using a 2ml heparinized syringe. The result showed that H. longifilis in treatment group passed sequentially through the first three stages of anaesthesia but could not attain total loss of equilibrium (stage 4 of anaesthesia. The result showed that treatment group of fishes passed sequentially through the first three stages of anaesthesia but could not attain total loss of equilibrium (stage 4 of anaesthsia. Behavioural responses included mucus secretion, slow and erratic swimming, excrement discharge, increase in opercular beat rate, strong retention of reflex action, partial loss of equilibrium and colour change. The induction time showed a declining pattern with increasing concentration of the extract in the treatment levels with significant differences (P0.05. The most effective concentration was 0.06g/l with an induction time of 32.00±1.76 seconds and a recovery time of 182.00±3.46 minutes. The result of this study revealed that the freeze-dried bark extract of T. vogelii can be used as a tranquilizer for transporting fish over average distances, biopsy and morphological evaluation.

  19. Anaesthetic management of emergency pacemaker implantation in a case of neonatal lupus erythematosus with complete congenital heart block & severe respiratory distress

    Directory of Open Access Journals (Sweden)

    Usha Kiran

    2007-01-01

    Full Text Available An 8-week old 3-kilogram male baby was brought to this tertiary care hospital with respiratory distress, marked tracheal tug, poor feeding and a heart rate of 46/minute. The child had been referred from a peripheral hospital as a case of neonatal lupus with complete congenital heart block. The mother was seropositive for systemic lupus erythematosus with a history of two abortions. Evaluation on admission revealed a heart rate between 40-60/ minute, respiratory rate 40-50/ minute, inspiratory stridor, bilateral crepitations, chest retrac-tion and a marked tracheal tug that improved with prone positioning. Electrocardiography and echocardiography confirmed complete congenital heart block with cardiomegaly and mild left ventricular dysfunction. Keeping in view the impending congestive heart failure, possible early cardiomyopathy and the bad obstetric history ur-gent pacemaker implantation was planned to allow early recovery of the child. The anaesthetic risk was high due to the heart block, ventricular dysfunction, laryngomalacia, severe tracheal tug and anticipated difficult weaning from controlled ventilation. General anaesthesia was administered with endotracheal tube and con-trolled ventilation using ketamine, rocuronium and sufentanil. For patient safety invasive monitoring was pro-vided and external pacing was kept standby. Epicardial pacemaker leads were implanted onto the left ventricu-lar wall through a left anterior 6th intercostal space thoracotomy. The child was electively ventilated for two post operative days. The tracheal tug and secretions gradually subsided over 2 weeks with oxygen, antibiotics, steroids, bronchodilators and physiotherapy. At the time of discharge from hospital 2 weeks after the implant the child was feeding well, tracheal tug was minimal and the lungs were clear.

  20. Effect of lidocaine-prilocaine eutectic mixture of local anaesthetic cream compared with oral sucrose or both in alleviating pain in neonatal circumcision procedure

    Directory of Open Access Journals (Sweden)

    Reem Al Qahtani

    2014-01-01

    Full Text Available Background: Neonatal circumcision is one of the oldest and most frequently performed surgical procedures on males. Newborns demonstrate strong endogenous reaction to pain and therefore modalities are being explored for optimum pain relief during circumcision. Pediatric nurses have a vital role for the use of these modalities and minimising the pain response during the neonatal minor procedures. Aim: The aim of this study was to assess the effectiveness of eutectic mixture of local anaesthetic (EMLA cream compared with oral sucrose and both in alleviating pain in neonatal circumcision. Materials and Methods: This study was conducted in the Day Care Surgery Department of Maternity and Children Hospital, Dammam City, KSA. 90 full-term newborn males who underwent circumcision were divided randomly into three groups (30 each. Each group was assigned to receive a different type of analgesics such as EMLA cream (Group A, oral sucrose (Group B or combination of EMLA cream and oral sucrose (Group C. Neonatal pain agitation and sedation scale (N-PASS was used 5 min before, during and 5 min after the circumcision procedure to assess the neonatal response to pain. Results: N-PASS scores were significantly lower in Group C (median Group C = 5.2, Group A = 5.8, Group B = 8.5; P< 0.001. The endogenous response to pain in terms of escalation of heart rate and reduction in O 2 saturation were minimal among Group C (P < 0.0001. Duration of crying was comparable among all the groups. Conclusion: The combination of sucrose and EMLA cream revealed a higher analgesic effect and minimal adverse response to pain than either EMLA cream or sucrose alone during neonatal circumcision.

  1. Involvement of spinal α2 -adrenoceptors in prolonged modulation of hind limb withdrawal reflexes following acute noxious stimulation in the anaesthetized rabbit.

    Science.gov (United States)

    Harris, John

    2016-03-01

    The role of spinal α2 -adrenoceptors in mediating long-lasting modulation of hind limb withdrawal reflexes following acute noxious chemical stimulation of distant heterotopic and local homotopic locations has been investigated in pentobarbitone-anaesthetized rabbits. Reflexes evoked in the ankle extensor muscle medial gastrocnemius (MG) by electrical stimulation of the ipsilateral heel, and reflexes elicited in the ankle flexor tibialis anterior and the knee flexor semitendinosus by stimulation at the base of the ipsilateral toes, could be inhibited for over 1 h after mustard oil (20%) was applied to either the snout or into the contralateral MG. The heel-MG response was also inhibited after applying mustard oil across the plantar metatarsophalangeal joints of the ipsilateral foot, whereas this homotopic stimulus facilitated both flexor responses. Mustard oil also caused a significant pressor effect when applied to any of the three test sites. The selective α2 -adrenoceptor antagonist, RX 821002 (100-300 μg, intrathecally), had no effect on reflexes per se, but did cause a decrease in mean arterial blood pressure. In the presence of the α2 -blocker, inhibitory and facilitatory effects of mustard oil on reflexes were completely abolished. These data imply that long-lasting inhibition of spinal reflexes following acute noxious stimulation of distant locations involves activation of supraspinal noradrenergic pathways, the effects of which are dependent on an intact α2 -adrenoceptor system at the spinal level. These pathways and receptors also appear to be involved in facilitation (sensitization) as well as inhibition of reflexes following a noxious stimulus applied to the same limb. PMID:26804327

  2. Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries

    Directory of Open Access Journals (Sweden)

    Watanabe Orie

    2004-03-01

    Full Text Available Abstract Background Maintenance of ovarian blood flow (OBF is suggested to be important for regular ovulation in women with polycystic ovaries (PCO. The purpose of the present study was to investigate whether electro-acupuncture (EA of different frequencies and intensities can improve the OBF of anaesthetized rat in the animal model of PCO. Methods PCO was experimentally induced by a single intramuscular (i.m. injection of estradiol valerate (EV in rats. Control rats were given i.m. injection of oil. The involvement of the two ovarian sympathetic nerves; superior ovarian nerve (SON and plexus ovarian nerve (OPN, in OBF responses was elucidated by severance of SON and OPN in both control and PCO rats. How systemic circulatory changes affect OBF was evaluated by continuous recording of the blood pressure. OBF was measured on the surface of the ovary-using laser Doppler flowmetry. Acupuncture needles were inserted bilaterally into the abdominal and hind limb muscles and connected to an electrical stimulator. Two frequencies – 2 Hz (low and 80 Hz (high – with three different intensities – 1.5, 3, and 6 mA – were applied for 35 s. Results Low-frequency EA at intensities of 3 and 6 mA elicited significant increases in OBF in the Control group compared to baseline. In the PCO group the increases in OBF were significant only when stimulating with low-frequency EA at 6 mA. After severance of the ovarian sympathetic nerves, the increased response of OBF that had been induced by low-frequency EA in both the Control and PCO group was abolished, indicating that the OBF response is mediated via the ovarian sympathetic nerves. High-frequency EA at 6 mA significantly decreased OBF and mean arterial blood pressure (MAP in the Control group compared to baseline. In the PCO group, the same stimulation produced similar decreases in MAP, but not in OBF. Conclusion Low-frequency EA stimulation with a strong intensity (6 mA increases OBF in rats with steroid

  3. Anaesthetic complications in plastic surgery

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    Soumya Sankar Nath

    2013-01-01

    Full Text Available Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

  4. Anaesthetic management of giant encephalocele

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2015-12-01

    Full Text Available One of the several challenges to the anaesthesiologists, is management of child with difficult airway. Management of even normal airway in a neonate is different and complex as compared to airway of two year old child and that of adult. Definition of the difficult airway is related solely to tracheal intubation or problems with mask ventilation1.Among the different causes of difficult airway cranio facial and neoplastic anomalies are very common. We present a case report of difficult airway management in encephalocele patient. [Int J Res Med Sci 2015; 3(12.000: 3889-3892

  5. Anaesthetic complications in plastic surgery

    OpenAIRE

    Soumya Sankar Nath; Debashis Roy; Farrukh Ansari; Pawar, Sundeep T.

    2013-01-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issue...

  6. Mucopolysaccharidoses -An Adventurous Anaesthetic Encounter

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    Madhuri S Kurdi

    2008-01-01

    Full Text Available Cases of Mucopolysaccharidoses (MPS, though rare, may pose many challenges for the anaesthesiologist. Maintaining the airway may be extremely difficult even in the most experienced hands. We present here, two breath taking airway securing experiences-one emergency and the other elective- in a 10 year old child of Mucopolysaccharidoses (MPS who presented to us for repair of an irreducible umbilical hernia.

  7. Utilização do eugenol como anestésico para o manejo de juvenis de Pintado (Pseudoplatystoma corruscans = The use of eugenol as an anaesthetic for the handling of Pintado juveniles (Pseudoplatystoma corruscans

    Directory of Open Access Journals (Sweden)

    Luiz Vítor Oliveira Vidal

    2006-07-01

    Full Text Available Neste trabalho, foi avaliada a eficiência do eugenol como anestésico em juvenis de pintado (Pseudoplatystoma corruscans através de ensaios. No primeiro, os peixes (n=6 foram individualmente expostos a concentrações de 25, 50, 75, 100 mg L-1 de eugenol durante 10 minutos e os parâmetros de observação estabelecidos foram: perda de equilíbrio, efeito calmante e redução do movimento opercular. No segundo ensaio, foram utilizadas as concentrações de 50, 75, 100 mg L-1 de eugenol, em que os animais foram mantidos na água com anestésico até atingirem o estágio IV de anestesia: perda total de equilíbrio, do tônus muscular e redução dos movimentos operculares. A recuperação foi conduzida em um aquário, contendo 10 litros de água livre de anestésico, com aeração constante. Após os dois ensaios, foi constatada a eficiência do eugenol como substância anestésica em juvenis de pintado, sendo a concentração de 50 mg L-1 considerada a mais adequada para procedimentos usuais no manejo desses animais em piscicultura.In this work the efficacy of eugenol as an anaesthetic in Pintado juveniles (Pseudoplatystoma corruscans was evaluated by two experimental assays. In the first one, the animals (n=6 were exposed for 10 minutes to four concentrations of eugenol (25; 50; 75; 100 mg L-1. The observed behavioral patterns were: loss of equilibrium, sedative effect and reduction of opercular movement. In the secondassay, the concentrations of 50; 75; 100 mg L-1 of eugenol were tested. The animals were maintained in the anaesthetic bath until they reached the stage of anaesthesia IV: total loss of equilibrium, muscle tonus and reduction of opercular movement. The recovery wasconducted in an aquarium containing 10 liters of anaesthetic free water, with constant aeration. The efficacy of clove oil as an anaestetics for Pintado juveniles were demonstrated after the assays and the 50 mg L-1 concentration was defined as the most adequate to usual

  8. Estudio comparativo del efecto de las asociaciones anestésicas atropina-tiletamina/zolazepam y atropina-ketamina/diazepam en emúes (Dromaius novaehollandiae adultos Effects of the anaesthetic associations atropine-tiletamine/zolazepam and atropine-ketamine/diazepam on adult emus (Dromaius novaehollandiae

    Directory of Open Access Journals (Sweden)

    R Pulgar

    2009-01-01

    Full Text Available En el presente estudio se determinó el efecto de las asociaciones anestésicas atropina IM (0,05 mg/kg-tiletamina/zolazepam EV (4 mg/kg total y atropina IM (0,05 mg/kg-ketamina EV (5 mg/kg total/diazepam (0,5 mg/kg sobre la respuesta fisiológica, anestésica y bioquímica de emúes adultos. Los ejemplares (n = 7 por grupo fueron asignados al azar a dos tratamientos anestésicos. La frecuencia cardiaca y la temperatura corporal de los emúes mostraron un incremento al inicio del tratamiento experimental (entre 5-10 min, P = 0,001. Sin embargo, la frecuencia respiratoria y pulso disminuyeron (entre 5-15 min, P = 0,003. Estos patrones fueron detectados para ambas asociaciones anestésicas. Por otra parte, la inducción anestésica y el tiempo de recuperación anestésica no fueron afectados por los tratamientos (P = 0,12 y P = 0,13 respectivamente. Los emúes tratados con tiletamina mostraron un mayor tiempo de anestesia quirúrgica, comparados con los emúes tratados con ketamina (P = 0,012. En el caso de A.S.T. y glucosa, ambas variables presentaron un incremento a las 24 h de la aplicación del tratamiento anestésico, resultando los niveles de glucosa más altos en emúes tratados con ketamina (P = 0,006 y P = 0,008 respectivamente. Finalmente, la hemoglobina, proteínas totales y ácido úrico no presentaron diferencias significativas entre tratamientos (P = 0,99, P = 0,97 y P = 0,81 respectivamente. En conclusión, los dos protocolos anestésicos resultaron seguros y eficientes para la manipulación de los animales; sin embargo, el mayor tiempo de anestesia observado en animales tratados con tiletamina podría determinar la preferencia por esta asociación anestésica.In this study, the effects of the anaesthetic associations atropine IM (0.05 mg/kg-tiletamine/zolazepam IV (4 mg/kg total and atropine IM (0.05 mg/kg-ketamine IV (5 mg/kg total/diazepam (0.5 mg/kg on physiological, anaesthetic and biochemical responses were determined on adult

  9. Anaesthetic management of nesidioblastosis in a newborn.

    OpenAIRE

    Soares A.; Karapurkar S; Suresh S.

    1996-01-01

    This report details the management of a newborn with nesidioblastosis who underwent a 95% pancreatectomy under general anaesthesia. The baby presented with hypoglycemic convulsions, due to hyperinsulinism, and was treated with 12.5% dextrose infusions, glucagon and anticonvulsants. Intraoperatively and postoperatively the baby remained hyperglycemic. A postoperative osmotic diuresis necessitated the use of insulin for brief period. The infant remained euglycemic and convulsion f...

  10. Anaesthetic Management of Conjoined Twins' Separation Surgery

    OpenAIRE

    Chalam, Kolli S

    2009-01-01

    Summary Anaesthesia for conjoined twins, either for separation surgery, or for MRI or other evaluation procedures is an enormous challenge to the paediatric anaesthesiologist. This is an extra challenging surgery because we the anaesthesiologists need to care for two patients at the same time instead of just one. Anaesthesia for conjoined twins ‘separation surgery mainly centered on the following concerns: 1.Conjoined Twins’ physiology like crossed circulation, distribution of blood volume an...

  11. ANAESTHETIC CONSIDERATIONS FOR THE HIV POSITIVE PARTURIENT

    OpenAIRE

    Oluwabukola, Adesina; Adesina, Oladokun

    2009-01-01

    The HIV epidemic in children parallels that among women on account of perinatal transmission. A combination of antiretroviral therapy and elective caesarean section reduces the rate of vertical transmission to

  12. The anaesthetic management of conjoined twins.

    Science.gov (United States)

    Stuart, Grant M; Black, Ann E; Howard, Richard F

    2015-10-01

    The management of anaesthesia for conjoined twins poses unique anatomical, physiological and logistic challenges. Although many possible configurations of union exist and each is unique, we describe the principles of anaesthesia for conjoined twins drawing on our institutional experience of managing 26 sets for a variety of procedures including separation. PMID:26382261

  13. An/Aesthetics : A Lecture-Performance

    NARCIS (Netherlands)

    Garcia, Luis-Manuel; LaBelle, Brandon

    2014-01-01

    What is an experience? Seemingly numb due to the overload of information, stimuli, and sensory possibilities that characterize our contemporary world, where experiences are packaged, sold, and consumed, the question of “aesthetics” emerges with ever greater urgency today. What is good and beautiful,

  14. Cataract extraction without retrobulbar anaesthetic injection.

    OpenAIRE

    Smith, R

    1990-01-01

    Extracapsular cataract extraction with lens implant under local anaesthesia consisting of amethocaine drops followed by a simple subconjunctival injection in the upper part of the globe but without a retrobulbar injection was carried out in 175 eyes of 165 patients. The purpose of the study was to establish the feasibility of this type of anaesthesia in cataract surgery with the principal object of avoiding the possibility of retrobulbar haemorrhage and the other, rarer, complications of retr...

  15. Utilização do eugenol como anestésico para o manejo de juvenis de Pintado (Pseudoplatystoma corruscans - DOI: 10.4025/actascibiolsci.v28i3.400 The use of eugenol as an anaesthetic for the handling of Pintado juveniles (Pseudoplatystoma corruscans - DOI: 10.4025/actascibiolsci.v28i3.400

    Directory of Open Access Journals (Sweden)

    Gustavo Rodamilans de Mecêdo

    2007-11-01

    Full Text Available Neste trabalho, foi avaliada a eficiência do eugenol como anestésico em juvenis de pintado (Pseudoplatystoma corruscans através de ensaios. No primeiro, os peixes (n=6 foram individualmente expostos a concentrações de 25, 50, 75, 100 mg L-1 de eugenol durante 10 minutos e os parâmetros de observação estabelecidos foram: perda de equilíbrio, efeito calmante e redução do movimento opercular. No segundo ensaio, foram utilizadas as concentrações de 50, 75, 100 mg L-1 de eugenol, em que os animais foram mantidos na água com anestésico até atingirem o estágio IV de anestesia: perda total de equilíbrio, do tônus muscular e redução dos movimentos operculares. A recuperação foi conduzida em um aquário, contendo 10 litros de água livre de anestésico, com aeração constante. Após os dois ensaios, foi constatada a eficiência do eugenol como substância anestésica em juvenis de pintado, sendo a concentração de 50 mg L-1 considerada a mais adequada para procedimentos usuais no manejo desses animais em piscicultura.In this work the efficacy of eugenol as an anaesthetic in Pintado juveniles (Pseudoplatystoma corruscans was evaluated by two experimental assays. In the first one, the animals (n=6 were exposed for 10 minutes to four concentrations of eugenol (25; 50; 75; 100 mg L-1. The observed behavioral patterns were: loss of equilibrium, sedative effect and reduction of opercular movement. In the second assay, the concentrations of 50; 75; 100 mg L-1 of eugenol were tested. The animals were maintained in the anaesthetic bath until they reached the stage of anaesthesia IV: total loss of equilibrium, muscle tonus and reduction of opercular movement. The recovery was conducted in an aquarium containing 10 liters of anaesthetic free water, with constant aeration. The efficacy of clove oil as an anaestetics for Pintado juveniles were demonstrated after the assays and the 50 mg L-1 concentration was defined as the most adequate to

  16. Manejo del dolor postoperatorio en artroplastia/artroscopia de rodilla en nuestro medio: Déficit de concurso del Servicio de Anestesiología Management of postoperative pain in knee arthroplasty/arthroscopy in Spain: Lack of anaesthetic department support

    Directory of Open Access Journals (Sweden)

    R. Bajo Pesini

    2010-03-01

    management of acute postoperative pain is becoming increasingly important for the progression of the patient during their hospital stay. Taking advantage of a change in the infrastructure of our complex, and being aware of the regular analgesic control required by certain patients, in this study we attempt to highlight the importance of this analgesic management being directed by the Anaesthetic Department. Material and methods: This study was performed in the Orthopaedic Surgical Unit of the Badajoz (Spain University Hospital Complex, lasted 2 months, and included two working groups consisting of Group A (arthroplasty with 33 patients and Group B (arthroscopy with 15 patients. We collected the relevant data for subsequent analysis (descriptive observational study, as well a survey carried out on the physicians of the Traumatology Unit and nursing staff, which collected a series of items to establish an opinion on the concepts to study. Results: Two fundamental deficiencies were found. Firstly, the levels of pain perceived by the patients were higher than those desired, and secondly, the analgesic techniques that were being practiced were not the most adequate and were not multimodal. Conclusions: According to the results we consider the support of the Anaesthetic Department as fundamental in the management of postoperative pain, since the final satisfaction of the patient would improve greatly. Although they were not objectives of the study, the days in hospital and the appearance of morbidity associated with the surgery would surely be reduced based on the existing literature. Furthermore, the surveys carried out showed a lack of protocols, clinical attitudes and training that the physicians and nurses demand.

  17. Risk factors for peri-anaesthetic dental injury.

    Science.gov (United States)

    Ham, S Y; Kim, J; Oh, Y J; Lee, B; Shin, Y-S; Na, S

    2016-09-01

    In this retrospective case-control study, we evaluated peri-operative dental injury risk factors following tracheal intubation. Ninety-four of 290,415 patients experienced dental injury following tracheal intubation over a 10-y period. A control group was matched for surgery type and intubating anaesthetist. The incidence of dental injury was 0.03%. Univariate analysis revealed that previous and current difficult intubation, male gender, hepatitis, neurological disease, anticonvulsant use, pre-existing poor dentition and the use of airway devices (other than a laryngoscope) were associated with dental injury. Multivariate analysis revealed that predictors of dental injury were: history of hepatitis, odds ratio (95% CI) 10.1 (1.02-100.3); poor dentition, 8.8 (3.9-20.0); alternative airway device use, 3.1 (1.2-8.0); and intubation difficulty, 3.7 (1.0-13.3). As well as confirming previously reported risk factors for dental injury during tracheal intubation, this study also suggests hepatitis and the use of alternative airway devices as additional risk factors. PMID:27440234

  18. Public Health Aspects of Paediatric Dental Treatment under General Anaesthetic

    OpenAIRE

    William Murray Thomson

    2016-01-01

    Early childhood caries (ECC) has negative psychosocial effects on children, with chronic pain, changed eating habits, disrupted sleep and altered growth very common, and it disrupts the day-to-day lives of their families. The treatment of young children with ECC places a considerable burden on health systems, with a considerable amount having to be provided under general anaesthesia (GA), which is resource-intensive. Justifying its use requires evidence of the efficacy of treatment in improvi...

  19. Administering an eye anaesthetic: principles, techniques, and complications

    Directory of Open Access Journals (Sweden)

    Ahmed Fahmi

    2008-03-01

    Full Text Available The trigeminal nerve carries the sensory innervation of the eye and adnexa in three divisions: ophthalmic, maxillary, and mandibular. The sensory fibres of the eye and adnexa are found in the ophthalmic division – with the exception of a portion of the sensory input from the lower lid, which is carried by the maxillary division. Blocking the sensory fibres provides anaesthesia so that no pain is felt.The motor supply of the extraocular muscles and levator palpebrae superioris is carried by the oculomotor (III, trochlear (IV, and abducens (VI nerves. Paralysing these muscles by blocking their motor supply provides akinesia so that the eye does not move during surgery.The motor supply of the orbicularis oculi, which is responsible for the gentle and forcible closure of the eye, is carried by the facial nerve (VII. Blocking these fibres will provide better surgical exposure. It also reduces the risk of forcing out the ocular contents if the patient tries to close his eyelids forcibly after the surgeon opens the globe.

  20. Congenital Cervical Teratoma: Anaesthetic Management (The EXIT Procedure

    Directory of Open Access Journals (Sweden)

    Ferruh Bilgin

    2009-01-01

    Full Text Available Ex utero intrapartum treatment (EXIT is a procedure performed during caesarean section with preservation of fetal-placental circulation, which allows the safe handling of fetal airways with risk of airways obstruction. This report aimed at describing a case of anaesthesia for EXIT in a fetus with cervical teratoma. A 30-year-old woman, 70 kg, 160 cm, gravida 2, para 1, was followed because of polyhydramniosis diagnosed at 24 weeks′ gestation. During a routine ultrasonographic examination at 35 weeks′ gestation, it was noticed that the fetus had a tumoral mass on the anterior neck, the mass had cystic and calcified components and with a size of was 10 x 6 x5 cm. The patient with physical status ASA I, was submitted to caesarean section under general anaesthesia with mechanically controlled ventilation for exutero intrapartum treatment (EXIT. Anaesthesia was induced in rapid sequence with fentanyl, propofol and rocuronium and was maintained with isoflurane in 2.5 at 3 % in O 2 and N 2 O (50%. After hysterotomy, fetus was partially released assuring uterus-placental circulation, followed by fetal laryngoscopy and tracheal intuba-tion. The infant was intubated with an uncuffed, size 2.5 endotracheal tube. Excision of the mass was performed under general anaesthesia. After surgical intervention, on the fourth postoperative day, the infant was extubated and the newborn was discharged to the pediatric neonatal unit and on the seventh day postoperatively to home without complications. Major recommendations for EXIT are maternal-fetal safety, uterine relaxation to maintain uterine volume and uterus-placental circulation, and fetal immobility to help airway handling. We report one case of cervical teratoma managed successfully with EXIT procedure.

  1. Maffucci syndrome: Anaesthetic management and review of literature

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    Gyaninder P Singh

    2015-01-01

    Full Text Available Maffucci syndrome is a rare, nonhereditary disorder manifesting early in life. The syndrome is characterized by presence of multiple hemangiomas and enchondromas mostly affecting the extremities. Haemangiomas are usually cutaneous, but may sometimes be visceral as well. Enchondromas commonly affect the long bones of the extremities. However, other areas including skull, ribs, vertebrae, larynx and trachea may also be involved. The presence of these lesions in the trachea and/or oropharynx may compromise the airway and cause difficulty during tracheal intubation. Complete airway examination and investigation is important to rule out any such lesion in a patient of Maffucci syndrome before planning for general anaesthesia with tracheal intubation.

  2. Secrets of safe laparoscopic surgery: Anaesthetic and surgical considerations

    Directory of Open Access Journals (Sweden)

    Srivastava Arati

    2010-01-01

    Full Text Available In recent years, laparoscopic surgery has gained popularity in clinical practice. The key element in laparoscopic surgery is creation of pneumoperitoneum and carbon dioxide is commonly used for insufflation. This pneumoperitoneum perils the normal cardiopulmonary system to a considerable extent. Every laparoscopic surgeon should understand the consequences of pneumoperitoneum; so that its untoward effects can be averted. Pneumoperitoneum increases pressure on diaphragm, leading to its cephalic displacement and thereby decreasing venous return, which can be aggravated by the position of patient during surgery. There is no absolute contraindication of laparoscopic surgery, though we can anticipate some problems in conditions like obesity, pregnancy and previous abdominal surgery. This review discusses some aspects of the pathophysiology of carbon dioxide induced pneumoperitoneum, its consequences as well as strategies to counteract them. Also, we propose certain guidelines for safe laparoscopic surgery.

  3. Pharmacogenetics and anaesthetic drugs: Implications for perioperative practice

    OpenAIRE

    Arash Behrooz

    2015-01-01

    Pharmacogenetics seeks to elucidate the variations in individual's genetic sequences in order to better understand the differences seen in pharmacokinetics, drug metabolism, and efficacy between patients. This area of research is rapidly accelerating, aided by the use of novel and more economical molecular technologies. A substantial evidence base is being generated with the hopes that in the future it may be used to generate personalised treatment regimens in order to improve patient comfort...

  4. Alstrom syndrome: A rare genetic disorder and its anaesthetic significance

    Directory of Open Access Journals (Sweden)

    Akhilesh Tiwari

    2010-01-01

    Full Text Available Alstrom syndrome is a rare autosomal recessive disorder that was first described in 1959, by Carl Henry Alstrom, characterised by multiorgan system involvement ranging from ocular, aural, endocrinal, hepatorenal, gastrointestinal, respiratory and cardiac to the musculoskeletal system, among many others. It exposes the patient to various risks ranging from pulmonary aspiration and increased cardiac morbidity to separational anxiety, and may necessitate postoperative elective ventilation. We hereby present the successful management of one such diagnosed case in a 12-year-old boy, who presented to us for incision and drainage of an abscess present over the nape of his neck, along with foreign body removal from his right ear.

  5. Defining an anaesthetic curriculum for medical undergraduates. A Delphi study.

    LENUS (Irish Health Repository)

    Rohan, Denise

    2009-01-01

    Anaesthesia is commonly taught to medical students. The duration and content of such teaching varies however and no consensus exists as to what constitutes an optimal curriculum. Anaesthetists possess the necessary knowledge and skills and operate in clinical settings suitable to provide training for medical undergraduates, especially in areas where deficiencies have been identified. This Delphi study was directed towards developing a consensus on an optimal anaesthesia, intensive care and pain medicine curriculum for medical undergraduates.

  6. Mitral stenosis and pregnancy: Current concepts in anaesthetic practice

    Directory of Open Access Journals (Sweden)

    M Kannan

    2010-01-01

    Full Text Available The incidence of rheumatic mitral stenosis is grossly reduced in India. Still, among heart disease complicating pregnancy, rheumatic mitral stenosis occupies a greater segment. The unique physiological changes in pregnancy and the pathological impact of mitral stenosis over pregnancy and labour are discussed in detail. A multidisciplinary approach in the diagnosis and management reduces the mortality and morbidity during peripartum. The labour analgesia technique and the evidence-based regional and general anaesthesia techniques are discussed at length in this article.

  7. Mitral stenosis and pregnancy: Current concepts in anaesthetic practice

    OpenAIRE

    Kannan, M.; Vijayanand, G

    2010-01-01

    The incidence of rheumatic mitral stenosis is grossly reduced in India. Still, among heart disease complicating pregnancy, rheumatic mitral stenosis occupies a greater segment. The unique physiological changes in pregnancy and the pathological impact of mitral stenosis over pregnancy and labour are discussed in detail. A multidisciplinary approach in the diagnosis and management reduces the mortality and morbidity during peripartum. The labour analgesia technique and the evidence-based region...

  8. ANAESTHETIC MANAGEMENT OF A HUGE ORAL LYMPHANGIOMA IN A NEONATE

    Directory of Open Access Journals (Sweden)

    Laxmi Narayana

    2015-11-01

    Full Text Available Lymphangiomas are commonly located in head and neck. They are congenital benign haemartomas of the lymphatic system. The most common location of intra oral lymphangiomas is the dorsum of the tongue. The lymphangiomas are amicable to surgical excision. Large oral lymphangiomas can decrease the already small mouth opening in the neonates and cause difficulty in mask ventilation, laryngoscopy and intubation. The postoperative challenges include laryngospasm and airway obstruction compounded by the large tongue and the airway odema caused by the surgical manipulations. Providing a safe anesthesia in such challenging cases necessitate awareness of the anesthetic complications and necessary steps to prevent them. In this case report we present a case of large oral lymphangioma in a newborn and discuss the peri operative and anesthetic management.

  9. Anaesthetic management of a patient with hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Nergis Ataol

    2015-12-01

    Full Text Available Hereditary angioedema is a rare autosomal dominant disorder caused by reduced activity of the C1 esterase inhibitor. Patients with hereditary angioedema are clinically characterized by recurrent episodes of swelling of the extremities, face, trunk, airways and abdominal organs. Attacks may occur either spontaneously or following trauma, stress, surgery, infections and hormonal fluctuations. The most common cause of death is asphyxia related to laryngeal edema. Giving C1 esterase inhibitor is the most effective method of treatment. Also fresh frozen plasma, androgen steroids, quinine pathway inhibitors, antifibrinolytics and bradykinin receptor antagonists can be used as treatment. In this paper, the anesthetic management of a patient with hereditary angioedema undergoing inguinal hernia repair surgery is reported.

  10. Ruptured intrathoracic cyst during induction of anaesthesia: Anaesthetic challenges

    Directory of Open Access Journals (Sweden)

    Bharat Paliwal

    2015-01-01

    Full Text Available Congenital benign cysts are among the rare types of mediastinal masses. When symptomatic, complete surgical excision through thoracotomy is the definitive treatment. Rarely they may present with symptoms due to complications like rupture. However, rupture following the induction of general anaesthesia poses unique challenges for anaesthesiologist. We report our experience of a rare variant of intraparenchymal cyst (lung, which was subsequently found to be a bronchogenic cyst.

  11. Ventricular rhythm in atrial fibrillation under anaesthetic infusion with propofol

    International Nuclear Information System (INIS)

    Changes in patients' autonomic tone and specific pharmacologic interventions may modify the ventricular response (actual heart rate) during atrial fibrillation (AF). Hypnotic agents such as propofol may modify autonomic balance as they promote a sedative state. It has been shown that propofol slightly slows atrial fibrillatory activity, but the net global effect on the ventricular response remains unknown. We aimed to evaluate in patients in AF the effect of a propofol bolus on the ventricular rate and regularity at ECG. We analysed the possible relation with local atrial fibrillatory activities, as ratios between atrial and ventricular rates (AVRs), analysing atrial activity from intracardiac electrograms at the free wall of the right and left atria and at the interatrial septum. We compared data at the baseline and after complete hypnosis. Propofol was associated with a more homogeneous ventricular response and lower AVR values at the interatrial septum

  12. Comparación del efecto anestésico del aceite de clavo, solución salina y solución coloidal en juveniles de Chirostoma jordani (Woolman, 1894 Comparison of anaesthetic effect of clove oil, saline solution and colloidal solution in juvenile Chirostoma jordani (Woolman, 1894

    Directory of Open Access Journals (Sweden)

    G Vázquez

    2013-01-01

    disease and high mortality rates. The objective of this study was to compare the anaesthetic effects of clove oil, saline solution and colloidal solution (Pentabiocare on juvenile Chirostoma jordani. 18 C. jordani specimens aged two months old were used for each treatment. Treatments consisted on clove oil at four concentrations (5, 8, 13 and 25 µL/L, saline solution at 7 g/L and colloidal solution at 5 mL/L. The anaesthesia stages and recovery time of fish were recorded during a six hour period. High concentrations of clove oil and prolonged exposure to it were associated with deep stages of anaesthesia. Clove oil in a concentration of 25 µL/L induced fish to stage three and after three hours of being exposed they entered stage five, while those sedated with saline and colloidal solutions were induced to stage one and showed the longest sedation times (six hours. Recovery time in juveniles when using 25 µL/L clove oil concentration was extended to 3,006.0 ± 5.3 seconds, while fish exposed to saline and colloidal solution showed a recovery of opercular rhythm, responsiveness to external stimuli and active swimming within 60 to 180 seconds. The results indicated that colloidal and saline solution kept the C. jordani juveniles in a state of light sedation during a six hours period with brief intervals of recovery. The use of clove oil at 5 and 13 µL/L doses induced juveniles to light and deep anaesthesia stages, respectively, with a recovery time under 420 seconds.

  13. Anaesthetic management of a child with congenital afibrinogenemia - A rare inherited coagulation disorder

    Directory of Open Access Journals (Sweden)

    Sham Sunder Goyal

    2011-01-01

    Full Text Available Congenital afibrinogenemia is a very rare autosomal recessive disorder, results from mutation that affects plasma fibrinogen concentration. It is frequently associated with bleeding diathesis of varying severity. We describe the case of a 10-year-old child diagnosed of congenital afibrinogenemia who presented to hospital with subperiosteal haematoma and was posted for incision and drainage. Replacement therapy is the mainstay of treatment of bleeding episodes in this patient and plasma-derived fibrinogen concentrate is the agent of choice. Cryoprecipitate and fresh frozen plasma are alternative treatments. Appropriate amount of cryoprecipitate were transfused pre-operatively to the child. Individuals with congenital afibrinogenemia should be managed by a comprehensive bleeding disorder care team experienced in diagnosing and managing inherited bleeding disorders. Anaesthesiologist, surgeons and haematologist should work like a unit to manage the surgical emergencies.

  14. Species of Compassion: Aesthetics, Anaesthetics, and Pain in the Physiological Laboratory

    OpenAIRE

    Rob Boddice

    2012-01-01

    This essay explores the interplay of different species of compassion with regard to physiological practices in the final decades of the nineteenth century. Drawing on the lexicon from which ideals of late-Victorian compassion were formed, it illustrates their contested nature, demonstrating how physiologists developed their own concepts of compassion based on the theories of Darwin and Spencer. Within this purview, the essay examines the historical specificity of antivivisectionist compassi...

  15. Anaesthetic management of patients with congenital heart disease presenting for non-cardiac surgery.

    OpenAIRE

    Mohindra R; Beebe David; Belani Kumar

    2002-01-01

    The incidence of congenital heart disease is about one percent of all live births in the United States. Treatment is being performed at a younger age and these children are showing improved survival. It is not unusual for children with congenital heart disease to present for non-cardiac surgery. Their management depends on their age, type of lesion, extent of corrective procedure, the presence of complications and other congenital anomalies. Each patient needs a detailed pre-operative evaluat...

  16. Protective effect of crocin against reperfusion-induced cardiac arrhythmias in anaesthetized rats

    OpenAIRE

    Aghai, Hasan; Esmailidehaj, Mansour; Jafari, Mahvash; Jahanbakhsh, Zahra; Khoshbaten, Ali; Mohammadi, Mohammad Taghi; Rasoulian, Bahram; Salehi, Maryam; Shekarforoush, Shahnaz

    2012-01-01

    The aim of the present study was to investigate the effects of crocin - a natural antioxidant derived from saffron - on cardiac reperfusion-induced arrhythmia and antioxidant systems such as catalase and superoxide dismutase (SOD) enzyme activities, glutathione (GSH) and malondialdehyde (MDA, as a marker of lipid peroxidation) levels. Rats in 4 experimental groups were administered crocin (20 mg/kg/day) or vehicle (i.p.) for 21 days with or without cardiac ischemia-reperfusion (IR). At the...

  17. ANAESTHETIC MANAGEMENT OF A TWO YEAR OLD CHILD WITH RETROPHARYNGEAL ABSCESS

    Directory of Open Access Journals (Sweden)

    Vanajakshi C

    2014-10-01

    Full Text Available A two year old boy weighing 10kg presented with history of fever, neck swelling, difficulty in swallowing and breathing. On examination of the child and neck X-ray (lateral view confirmed it as retropharyngeal abscess. Child was posted for incision and drainage on an emergency basis. We present this case as it poses great challenge to the anesthesiologist due to difficult intubation and in techniques managing difficult airway particularly in the pediatric patients.

  18. Ear acupuncture or local anaesthetics as pain relief during postpartum surgical repair: a randomised controlled trial

    DEFF Research Database (Denmark)

    Kindberg, S; Klünder, L; Strøm, J;

    2009-01-01

    with approximately 1600 annual deliveries. Population Primiparous women with a vaginal delivery at term who needed surgical repair of lacerations to the labia or the vagina, perineal lacerations of first or second degree or mediolateral episiotomies. Methods The trial was set up to evaluate the effect of a brief 2...

  19. Spinal 5-HT2 receptor-mediated facilitation of pudendal nerve reflexes in the anaesthetized cat.

    OpenAIRE

    Danuser, H.; Thor, K. B.

    1996-01-01

    1. 5-Hydroxytryptamine (5-HT) is intimately associated with central sympathetic and somatic control of the lower urinary tract. The sympathetic and somatic innervation of the lower urinary tract is conveyed through efferent axons of the hypogastric and pudendal nerves, respectively. 2. The present study examined the effects of 2,5-dimethoxy-4-iodophenylisopropylamine (DOI), a 5-HT2 receptor subtype-selective agonist, on evoked potentials recorded from the central ends of the hypogastric and p...

  20. The effect of transversus abdominis plane block or local anaesthetic infiltration in inguinal hernia repair

    DEFF Research Database (Denmark)

    Petersen, Pernille Lykke; Mathiesen, Ole; Stjernholm, Pia;

    2013-01-01

    primary outcome measure was pain scores while coughing between group TAP and group placebo calculated as area under the curve for the first 24 h (AUC24 h). Secondary outcomes were pain scores while coughing and at rest, opioid consumption and side effects in groups TAP, infiltration and placebo. RESULTS......: Visual analogue pain scores while coughing and at rest demonstrated no difference between groups. Pain scores in groups infiltration, TAP and placebo were 19 versus 22 versus 15 mm at rest (P = 1.00) and 37 versus 41 versus 37 mm while coughing (P = 1.00). Pain scores at 6 h (AUC6 h) were significantly...

  1. Field anaesthetic and surgical techniques for implantation of intraperitoneal radio transmitters in Eurasian beavers Castor fiber

    OpenAIRE

    Ranheim, Birgit; Rosell, Frank; Haga, Henning Andreas; Arnemo, Jon Martin

    2004-01-01

    Radio transmitters were implanted intraperitoneally in 22 (nine females, 13 males) adult, territorial Eurasian beavers Castor fiber under field conditions. Two different injectable anaesthestic drug combinations were tested. Access to the peritoneal cavity was made through a ventral midline incision. The animals in group # 1 (N = 10) were initially injected with medetomidine (0.05 mg/kg), ketamine (5 mg/kg) and butorphanol (0.1 mg/kg). Three animals needed additional injections of the drug co...

  2. Electrocardiogram assessment in non-anaesthetized clinically healthy agouti (Dasyprocta primnolopha, Wagler 1831

    Directory of Open Access Journals (Sweden)

    Anaemilia das N. Diniz

    2013-12-01

    Full Text Available The agouti is one of the most intensely hunted species throughout the Amazon and the semiarid regions of north-eastern Brazil. Considering the current tendency of wild animal management in captivity, the objective of this study was to determine heart reference values for agouti raised in captivity, based on electrocardiographic assessments (ECG. Adult agouti were selected without clinical signs of heart disease (n=30. The animals were restrained physically and then the ECG was performed. Standardized measurements were taken to establish the statistical analysis of the data. Analysis of the QRS complex showed values compatible with previous reports in peer animals and the limited data available for other wild and exotic species, except for the T wave that showed similar amplitude to the R wave in all the animals studied. The data obtained provided the first reference values for ECG tracings in agouti, contributing to a better understanding of heart electrophysiology in identifying myocardial pathology in these animals.

  3. Recovery at the post anaesthetic care unit after breast cancer surgery

    DEFF Research Database (Denmark)

    Gärtner, Rune; Callesen, Torben; Kroman, Niels Thorndahl;

    2010-01-01

    Extant literature shows that women having undergone breast cancer surgery have substantial problems at the post-anaesthesia care unit (PACU). Based on nursing reports and elements of the discharge scoring system recommended by The Danish Society of Anaesthesiology and Intensive Care Medicine, the...

  4. Exploratory clinical development of ropivacaine, a local anaesthetic, in ulcerative colitis

    OpenAIRE

    Arlander, Eva

    2003-01-01

    The aims of this thesis were to explore the clinical pharmacology of ropivacaine gel as a potential new rectal therapy for ulcerative colitis (UC). The studies included pharmacokinetics, tolerability, preliminary efficacy in patients, formulation factors and drug-drug interactions. These results paved the way for the start of a larger scale dose finding study in patients. UC is an idiopathic inflammation involving part of or the entire colon, and characterised by early o...

  5. Effect of warming anaesthetic solutions on pain during dental injection. A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Pedro Aravena

    2015-10-01

    Full Text Available Aim: To determine the effectiveness of anesthesia warming control pain feeling during the administration of anesthesia in maxillary infiltration technique nerve block. Methods: A double-blind clinical trial study was designed. Fifty-six volunteers students (mean age 23.1±2.71 years of Universidad Austral de Chile Dental School (Valdivia, Chile were participated. They were given 0.9 ml of 2% lidocaine with 1: 100,000 epinephrine (Alphacaine®; Nova DFL - Brazil by two punctions at buccal vestibule of lateral incisor. In a hemi-arch a warm anesthesia of 42ºC (107.6°F was administered; and after one week in to contralateral side a room temperature (21ºC; 69.8°F was administered. In both times with a standard speed. The level of intensity pain perceived during injection was registered and compared by visual analog scale (VAS of 100mm (Wilcoxon test p

  6. Analgesic, Anxiolytic and Anaesthetic Effects of Melatonin: New Potential Uses in Pediatrics

    Directory of Open Access Journals (Sweden)

    Lucia Marseglia

    2015-01-01

    Full Text Available Exogenous melatonin is used in a number of situations, first and foremost in the treatment of sleep disorders and jet leg. However, the hypnotic, antinociceptive, and anticonvulsant properties of melatonin endow this neurohormone with the profile of a drug that modulates effects of anesthetic agents, supporting its potential use at different stages during anesthetic procedures, in both adults and children. In light of these properties, melatonin has been administered to children undergoing diagnostic procedures requiring sedation or general anesthesia, such as magnetic resonance imaging, auditory brainstem response tests and electroencephalogram. Controversial data support the use of melatonin as anxiolytic and antinociceptive agents in pediatric patients undergoing surgery. The aim of this review was to evaluate available evidence relating to efficacy and safety of melatonin as an analgesic and as a sedative agent in children. Melatonin and its analogs may have a role in antinociceptive therapies and as an alternative to midazolam in premedication of adults and children, although its effectiveness is still controversial and available data are clearly incomplete.

  7. Formulation and Evaluation of Topical Hydrogel Patch Containing Amide Type Local Anaesthetic Agent

    Directory of Open Access Journals (Sweden)

    Jayrajsinh Sarvaiya

    2012-09-01

    Full Text Available Hydrogel based drug delivery systems provides significant effect in designing sustained release topical dosage forms. Topical patch containing drug in hydrogel type polymer matrix provides not only targeted drug flux through the skin but also provides cooling effect on application site. Topical hydrogel patch containing lidocaine was prepared by using sodium poly acrylate as bioadhesive polymer. Effect of brij 30 and transcutol was also evaluated on topical flux of lidocaine base from hydrogel patch. Transcutol (10% w/w provides sufficient drug release in contrast to brij 30(4%w/w in prepared hydrogel patches. Maintenance of uniformity of weight is one of the critical task in preparation of hydrogel patch as polymers used are highly water absorbent. Excess amount of penetration enhancers leads to alter adhesive property of bioadhesive patch so formulation was optimized with Sodium polyacrylate (7%w/w as the desired concentration for necessary bioadhesiveness and zinc oxide as cross linking agent.

  8. A retrospective study of anaesthetic management of foreign bodies in airway- a two & half years experience

    Directory of Open Access Journals (Sweden)

    Jyoti V Kulkarni

    2007-01-01

    In 17 % patients foreign body was located in subglottic region, in 59 % patients FB was in right main bronchus and in 24% patients it was in left main bronchus. In 33 % patients bronchoscopy was done within 72 hours of appearance of symptoms while in 51% patients bronchoscopy was done after 72 hours to one week of appearance of symptoms. In 16% patients bronchoscopy was done after one week. Twenty percent patients required tracheostomy and 3% patients required bronchodilators, nebuliza-tion and ventilatory support in immediate post operative period. All patients were managed under general anaesthesia using ketamine, suxamethonium, oxygen and halothane. All patients were ventilated through side arm of ventilating bronchoscope.All patients were discharged from hospital & no death was reported.

  9. Postoperative recovery profile after elective abdominal hysterectomy: a prospective, observational study of a multimodal anaesthetic regime

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Kehlet, Henrik; Lund, Claus M

    2009-01-01

    insufficiency and time of discharge readiness. RESULTS: The structured regime consisting of total intravenous anaesthesia (propofol-remifentanil), well defined fluid administration, prophylactic antiemetics (dexamethasone, ondansetron, droperidol), weak analgesics (celecoxib, paracetamol) and intraoperative...

  10. Intraincisional vs intraperitoneal infiltration of local anaesthetic for controlling early post-laparoscopic cholecystectomy pain

    Directory of Open Access Journals (Sweden)

    Gouda M El-labban

    2011-01-01

    Full Text Available Background: The study was designed to compare the effect of intraincisional vs intraperitoneal infiltration of levobupivacaine 0.25% on post-operative pain in laparoscopic cholecystectomy. Materials and Methods: This randomised controlled study was carried out on 189 patients who underwent laparoscopic cholecystectomy. Group 1 was the control group and did not receive either intraperitoneal or intraincisional levobupivacaine. Group 2 was assigned to receive local infiltration (intraincisional of 20 ml solution of levobupivacaine 0.25%, while Group 3 received 20 ml solution of levobupivacaine 0.25% intraperitoneally. Post-operative pain was recorded for 24 hours post-operatively. Results: Post-operative abdominal pain was significantly lower with intraincisional infiltration of levobupivacaine 0.25% in group 2. This difference was reported from 30 minutes till 24 hours post-operatively. Right shoulder pain showed significantly lower incidence in group 2 and group 3 compared to control group. Although statistically insignificant, shoulder pain was less in group 3 than group 2. Conclusion: Intraincisional infiltration of levobupivacaine is more effective than intraperitoneal route in controlling post-operative abdominal pain. It decreases the need for rescue analgesia.

  11. Presence of protein deposits on 'cleaned' re-usable anaesthetic equipment.

    Science.gov (United States)

    Miller, D M; Youkhana, I; Karunaratne, W U; Pearce, A

    2001-11-01

    Twenty previously used and supposedly clean, sterilised laryngeal mask airways, five bougies and five Magill forceps from the operating theatre, and 61 laryngoscope blades from different sites within a single hospital were randomly collected and stained with erythrosin B dye, which stains proteins if present on surfaces. All 20 laryngeal mask airways had been used before and were stained: four (20%) showed heavy staining, five (25%) moderate staining and 11 (55%) mild staining. Two unused laryngeal mask airways used as controls were without staining. Thirty-four of 44 (77%) laryngoscope blades taken from the operating theatres, six of seven (86%) from the overnight intensive recovery room and all 10 (100%) from the wards were stained. None of the other items was totally clean. These findings suggest that current cleaning methods do not remove all proteinaceous material. PMID:11703239

  12. Vocalizations during electroejaculation in anaesthetized adult and young pampas deer (Ozotoceros bezoarticus) males.

    Science.gov (United States)

    Fumagalli, F; Damián, J P; Ungerfeld, R

    2015-04-01

    The aim of this study was to characterize the vocalizations produced during electroejaculation under general anaesthesia in pampas deer males and to determine whether the characteristics of those vocalizations differ in adult and young pampas deer males. Electroejaculation was applied to 13 adults (AM) and 13 young (YM) males under general anaesthesia. Vocalizations were digitally recorded, and the number and duration of vocalizations, the latency in relation to each voltage, the total time vocalizing, and the structure of the fundamental frequency (F0) [initial frequency (F(start)), maximal frequency (F(max)), minimal frequency (F(min)) and final frequency (F(end))] were analysed. No male vocalized with 0 V; the number of animals that vocalized increased at 2 and 3 V and increased again at 4, 5 and 6 V (p electroejaculation in pampas deer under general anaesthesia are related to the voltage applied during the process. Young males vocalize more time, probably due to a greater sensibility to the electric stimulation. The differences in the characteristics of the vocalizations between adult and young males may be related to the anatomic differences in the neck of adult or young males. PMID:25683788

  13. Direct measurement of free radicals in the tail of anaesthetized rats by using the EPR method

    Czech Academy of Sciences Publication Activity Database

    Fricová, J.; Stopka, Pavel; Křížová, Jana; Rokyta, R.

    2006-01-01

    Roč. 10, č. 1 (2006), s. 563. ISSN 1090-3801 Institutional research plan: CEZ:AV0Z40320502 Keywords : free radicals * melatonin Subject RIV: CA - Inorganic Chemistry Impact factor: 3.333, year: 2006

  14. A CASE OF CONGENITAL LOBAR EMPHYSEMA: CHALLENGES IN DIAGNOSIS AND IN ANAESTHETIC MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Swati Bisht

    2015-01-01

    Full Text Available Congenital lobar emphysema (CLE is a rare clinical entity presenting as acute respiratory distress in infants. Its diagnosis is difficult as clinically and radio logically it mimics pneumonia or pneumothorax. Its early recognition and management with thoracotomy is lifesa ving. Inhalation induction is preferred and spontaneous ventilation should be maintained until either the chest is opened or one lung ventilation of the contralateral lung is achieved. In this case report, we describe the challenges faced in the anaestheti c management of this condition

  15. The ultrasound guided psoas-compartment-block fundamentals and technique for a new regional anaesthetic procedure

    CERN Document Server

    Kirchmair, L P M

    2001-01-01

    Ultrasound (US) has proven to be an useful adjunct during the performance of peripheral nerve blocks. This study is the first dealing with the application of US guidance for the psoas-compartment-block which is used to achieve lumbar plexus blockades. A pilot study was carried out to establish the US anatomy of the lumbar paravertebral region and its blood vessels. Moreover, suitable transducers and US frequencies were assessed. The feasibility of US imaging of the psoas-compartment was studied on healthy volunteers (N=21) of varying body types (normal weight: N= 13; overweight: N=5; obese: N=3) in a first volunteer study. Additionally, the skin-plexus distances were measured. A second volunteer study (N=21) was carried out to investigate the US anatomy of the paravertebral blood vessels by means of power Doppler sonography. The technique of an US guided approach to the psoas-compartment was tested on embalmed cadavers (N=10) at the levels L2/L3, L3/L4 and L4/L5. Accuracy and safety of this technique were ver...

  16. Pulmonary Alveolar Proteinosis with Respiratory Failure-Anaesthetic Management of Whole Lung Lavage

    Directory of Open Access Journals (Sweden)

    Sunita Nandkumar

    2009-01-01

    A 43-year-old man suffering from PAP presented to casualty with NYHA grade IV dyspnoea with oxygen saturation (SaO 2 on pulseoximetry 67% on room air and 78% with O 2 6 L/min. He underwent whole lung lavage under general anaesthesia using one lung ventilation with 37 F left end bronchial double lumen tube. The lung lavage was initially performed for the left lung and for the right lung 4 days later. The patient was discharged home with oxygen saturation of 96 % on room air.

  17. Pulmonary Alveolar Proteinosis with Respiratory Failure-Anaesthetic Management of Whole Lung Lavage

    OpenAIRE

    Sunita Nandkumar; Madhavi Desai; Manju Butani; Udwadia, Z

    2009-01-01

    Summary Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by accumulation of amorphous acellular phospholipid material in the lungs. Whole lung lavage is the standard therapy which gives dramatic clinical improvement and offers a long term survival to these patients. A 43-year-old man suffering from PAP presented to casualty with NYHA grade IV dyspnoea with oxygen saturation (SaO2) on pulseoximetry 67% on room air and 78% with O2 6 L/min. He underwent whole lung lavage und...

  18. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

    Science.gov (United States)

    Abysique, Anne; Tardivel, Catherine; Troadec, Jean-Denis; Félix, Bernadette

    2015-01-01

    Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation. PMID:26192767

  19. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats.

    Directory of Open Access Journals (Sweden)

    Anne Abysique

    Full Text Available Deoxynivalenol (DON, one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the esophagus. To better understand DON effects on ingestive behaviour, we have studied its effects on rhythmic swallowing in the rat, after intravenous and central administration. Repetitive electrical stimulation of the superior laryngeal nerve or of the tractus solitarius, induces rhythmic swallowing that can be recorded using electromyographic electrodes inserted in sublingual muscles. Here we provide the first demonstration that, after intravenous and central administration, DON strongly inhibits the swallowing reflex with a short latency and in a dose dependent manner. Moreover, using c-Fos staining, a strong neuronal activation was observed in the solitary tract nucleus which contains the central pattern generator of swallowing and in the area postrema after DON intravenous injection. Our data show that DON modifies swallowing and interferes with central neuronal networks dedicated to food intake regulation.

  20. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats

    OpenAIRE

    Anne Abysique; Catherine Tardivel; Jean-Denis Troadec; Bernadette Félix

    2015-01-01

    International audience Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bo...

  1. ANAESTHETIC CHALLENGES IN A PEDIATRIC PATIENT WITH KLIPPEL FEIL SYNDROME UNDERGOING SURGERY IN PRONE POSITION

    Directory of Open Access Journals (Sweden)

    Vishak

    2014-07-01

    Full Text Available Seven years old male child with Klippel Feil syndrome and Sprengel shoulder was posted for Woodwards procedure in prone position. Patients with this syndrome are vulnerable to cervical spinal cord injury and are at high risk for neurological injury not only during laryngoscopy and intubation but thereafter. Paediatric patients with cervical spine instability and limited range of motion are challenge to anaesthesiologists

  2. ANAESTHETIC MANAGEMENT OF A CASE OF CONGENITAL LOBAR EMPHYSEMA IN A NEONATE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Yerramsetti Atchyutha

    2014-11-01

    Full Text Available Congenital lobar emphysema (CLE is a congenital anomaly of the lower respiratory tract characterized by over inflation of alveoli of the one or more lobes of the lung. CLE is potentially reversible, though possibly life threatening cause of respiratory distress in the neonate. We are presenting a 2 week old baby who presented with sudden onset of respiratory distress related to CLE affecting the upper lobe of left lung. Lobectomy was performed under general anesthesia with one lung ventilation. The anesthetic challenges and management of this case are discussed here.

  3. Labour analgesia and anaesthetic management of a primigravida with uncorrected Pentology of Fallot

    OpenAIRE

    Sandhya, K; Shivakumar Shivanna; Tejesh, C. A.; Rathna, N

    2012-01-01

    Tetraology of Fallot is the most common congenital heart disease causing intracardiac right-left shunts. It is characterized by presence of ventricular septal defect, aortic overriding, pulmonary artery outflow obstruction and right ventricular hypertrophy. When these features are associated with atrial septal defect, it is often referred to as Pentology of Fallot (POF). If the lesions remain uncorrected, they can cause significant morbidity and mortality to the patient. Pregnancy and labour ...

  4. Fractured Tracheostomy Tube in Left Main Bronchus with No Mouth Opening: An Anaesthetic Challenge

    Directory of Open Access Journals (Sweden)

    Arghya Mukherjee

    2014-10-01

    Full Text Available Foreign body aspiration is a serious medical condition that demands prompt diagnosis and treatment to prevent fatal complications. This is a case report of a 42 year male with history of surgery for carcinoma tongue, hemiglossectomy and tracheostomy. He presented with dislodged fractured metallic tracheostomy tube in left main bronchus. Patient was breathing through stenosed tracheostomy stoma with bilateral normal air entry in chest. He was haemodynamically stable. Rigid bronchoscopic removal was impossible due to no mouth opening. After securing airway, general anaesthesia was induced and thoracotomy was performed to remove dislodged tube. Proper planning and coordinated team work resulted in good outcome.

  5. ANAESTHETIC MANAGEME NT OF A POST BURN CONTRACTURE PATIENT : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Anupam

    2015-08-01

    Full Text Available Airway management in a post - burn contracture patient is unique challenge due to scar contracture head and neck region. A female with 70 % burn along with history of post burn scar tissue over the neck region , MP - 3, reduced thyromental distance & mouth opening undergone release of nostril bl ockade with the help of difficult airway kit under general anaesthesia

  6. Inflammatory response and cardioprotection during open-heart surgery: the importance of anaesthetics

    OpenAIRE

    Suleiman, M-S; Zacharowski, K; Angelini, G. D.

    2007-01-01

    Open-heart surgery triggers an inflammatory response that is largely the result of surgical trauma, cardiopulmonary bypass, and organ reperfusion injury (e.g. heart). The heart sustains injury triggered by ischaemia and reperfusion and also as a result of the effects of systemic inflammatory mediators. In addition, the heart itself is a source of inflammatory mediators and reactive oxygen species that are likely to contribute to the impairment of cardiac pump function. Formulating strategies ...

  7. [Legal characteristics of expert opinions of anaesthetic cases of the North German Arbitration Board].

    Science.gov (United States)

    Schaffartzik, Walter; Hachenberg, Thomas; Kols, Kerstin; Neu, Johann

    2016-05-01

    The Arbitration Board for Medical Liability Issues of the State Medical Councils of Northern Germany in Hannover (North German Arbitration Board, NGAB) settles about 100 cases in the area of anaesthesiology per year. In these proceedings the patient carries the burden of proof. I. e. the patient has to prove that its health damage was caused by a medical error. Nevertheless, for individual cases the NGAB examines also whether facilitation of the burden of proof can be granted to the patient. This article exemplifies cases, for which the NGAB recognized such facilitation of the burden of proof. In each of these cases, the NGAB asserted the damage claim. PMID:27213605

  8. The ultrasound guided psoas-compartment-block: fundamentals and technique for a new regional anaesthetic procedure

    International Nuclear Information System (INIS)

    Ultrasound (US) has proven to be an useful adjunct during the performance of peripheral nerve blocks. This study is the first dealing with the application of US guidance for the psoas-compartment-block which is used to achieve lumbar plexus blockades. A pilot study was carried out to establish the US anatomy of the lumbar paravertebral region and its blood vessels. Moreover, suitable transducers and US frequencies were assessed. The feasibility of US imaging of the psoas-compartment was studied on healthy volunteers (N=21) of varying body types (normal weight: N= 13; overweight: N=5; obese: N=3) in a first volunteer study. Additionally, the skin-plexus distances were measured. A second volunteer study (N=21) was carried out to investigate the US anatomy of the paravertebral blood vessels by means of power Doppler sonography. The technique of an US guided approach to the psoas-compartment was tested on embalmed cadavers (N=10) at the levels L2/L3, L3/L4 and L4/L5. Accuracy and safety of this technique were verified by means of computed tomography (CT). Two coordinates (A and B) were established to assess the position of the needle tips by means of US and CT. In 112/126 investigations the psoas-compartment, except the lumbar plexus, could be delineated clearly. In 14/126 investigations a visualization of the psoas-compartment was unfeasible. The mean skin-plexus distances were 5,8±1,3 cm at L2/L3, 6±1,4 cm at L3/L4 and 6,1±1,3 cm at L4/L5. Spearman's coefficient showed a correlation of 0,87 (P<0,001) between body mass index (BMI) and skin-plexus distance. A linear regression analysis revealed the relationship between BMI and skin-plexus distances. In 126 US examinations of the paravertebral blood vessels the lumbar arteries (N=21), their ventral (N=57) and dorsal branches (N=34) and the ascending lumbar veins (N=52) could be depicted most frequently. In some cases the ascending lumbar veins showed diameters above 1 cm and a close proximity to the psoas-compartment. In 47/48 US guided approaches the needles were advanced into the psoas-compartment correctly. In 1/48 approaches the needle tip was located posterior to the psoas muscle. The mean differences between US and CT-measurements of the needle tips' positions were 0,04±0,03 cm for A and 0,03±0,03 cm for B. Kendall's coefficient W showed a concordance of 0,88 for A (P<0,001) and 0,92 for B (P<0,001) between US and CT-measurements. In conclusion, US imaging of the lumbar paravertebral region - except the lumbar plexus - as a basis for an US guided psoas-compartment block proved to be feasible and accurate. Due to its possible size and topographical position the ascending lumbar vein must be considered as a reason for intravascular injections which are well-known complications of the psoas-compartment block. The use of US needle guidance, which proved to be safe and accurate, might help to prevent complications that occurred during 'blind' procedures. (author)

  9. ANAESTHETIC MANAGEMENT IN A PATIENT WITH ARNOLD-CHI ARI MALFORMATION TYPE I AND SYRINGOMYELIA

    Directory of Open Access Journals (Sweden)

    Kartika

    2013-04-01

    Full Text Available ABSTRACT: Syringomyelia is an unusual neurological condition characterised by the the presence of cystic cavity in the spinal cord resultin g in neurological manifestations. Here, we report a safe anesthetic management of patient with Arnold-Ch iari malformation type I and syringomyelia posted for foramen magnum decompression . INTRODUCTION: Arnold-Chiari malformation (ACM is a developmental malformation characterised by downward displacement of cerebellar tonsils into spinal canal due to reduced capacity of the posterior fossa. ACM may be complicate d by other malformations like Platybasia, basilar invagination and occipitalization although S yringomyelia (SM is most commonly seen. [1] There are four types of ACM; types I – IV. Type I ACM manifests with headaches, neck pain, and mild co-ordination problems mostly asymptomatic a nd discovered on brain or cervical spine MRI scans. It has adult onset characterised by downward displacement of cerebellar tonsils and medulla through the foramen magnum. [2] Syringomyelia is an unusual neurological condition characterised by the presence of fluid filled cystic cavity or syrinx within the spin al cord. Ollivies d’ Angers (1827 coined the term syringomyelia from two greek words meaning “ch annel” and “marroin”. [3] It has a prevalence of 8.4 per 100,000 and occurs more frequen tly in men than in women in the third or fourth decade of life. Rarely, it may develop in chi ldhood or late adulthood. [4

  10. Anaesthetic Management of Myasthenia Gravis with Thymic Mass in Facial Trauma

    OpenAIRE

    Deepak Sharma; Dheer Singh

    2010-01-01

    Myasthenia gravis is an immunologic disorder characterised by polyclonal antibodies directed against nicotinic acetylcholine receptors at postneuromuscular junction. This case describes perioperative management of a patient suffering facial trauma with underlying myasthenia gravis with thymic mass

  11. Microdialysis as a tool for drug quantification in the bronchioles of anaesthetized pigs

    DEFF Research Database (Denmark)

    Rottbøll, Lisa Amanda Holm; Friis, Christian

    2014-01-01

    guided through a tracheostomy into the distal bronchioles using an insertion tube. Intravenously administered inulin served as a marker of extracellular fluid contamination of PELF. Concentrations of free drug in MD fractions were compared to total and non-protein-bound drug concentrations in plasma...

  12. Anaesthetic and cardiopulmonary effects of intramuscular morphine, medetomidine and ketamine administered to telemetered cats.

    Science.gov (United States)

    Wiese, Ashley J; Muir, William W

    2007-04-01

    The quality and duration of anaesthesia, cardiorespiratory effects and recovery characteristics of a morphine, medetomidine, ketamine (MMK) drug combination were determined in cats. Six healthy, adult female cats were administered 0.2 mg/kg morphine sulphate, 60 microg/kg medetomidine hydrochloride, and 5 mg/kg ketamine hydrochloride intramuscularly. Atipamezole was administered intramuscularly at 120 min after MMK administration. Time to lateral recumbency, intubation, extubation and sternal recumbency were recorded. Cardiorespiratory variables and response to a noxious stimulus were recorded before and at 3 min and 10 min increments after drug administration until sternal recumbency. The time to lateral recumbency and intubation were 1.9+/-1.2 and 4.3+/-1.2 min, respectively. Body temperature and haemoglobin saturation with oxygen remained unchanged compared to baseline values throughout anaesthesia. Respiratory rate, tidal volume, minute volume, heart rate, and blood pressure were significantly decreased during anaesthesia compared to baseline values. One cat met criteria for hypotension (systolic blood pressure cat remained non-responsive to noxious stimuli from 3 to 120 min. Time to extubation and sternal recumbency following atipamezole were 2.9+/-1.1 and 4.7+/-1.0 min, respectively. MMK drug combination produced excellent short-term anaesthesia and analgesia with minimal cardiopulmonary depression. Anaesthesia lasted for at least 120 min in all but one cat and was effectively reversed by atipamezole. PMID:17198759

  13. A comparative evaluation of epidural and general anaesthetic technique for renal surgeries: A randomised prospective study

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2014-01-01

    Full Text Available Background and Aims: Neuraxial anaesthesia has become popular for the renal surgeries during the last few years. This study was aimed at comparing general anaesthesia (GA with epidural anaesthesia in patients undergoing renal surgeries. Methods: One hundred American Society of Anaesthesiologists (ASA physical status-I and II adult consenting patients of both gender in the age group of 25-55 years undergoing renal surgeries were randomly assigned to two groups of 50 patients each: Group G and Group E. Group G patients were administered conventional GA while Group E received epidural anaesthesia (EA with 3 mg/kg of ropivacaine and 1 μg/kg of dexmedetomidine. Besides cardio-respiratory parameters, surgeon′s satisfaction, patient′s satisfaction and side effects were observed. Parametric data were analysed by ANOVA while non-parametric data were compared with Mann-Whitney U-test and Wilcoxon test. Value of P < 0.05 was considered statistically significant. Results: The demographic profile, total anaesthesia time, surgical time and haemodynamic parameters and surgeon′s satisfaction scores were comparable in both groups. Patient′s satisfaction scores were better in Group E during the post-operative period. Incidence of side-effects such as nausea and vomiting and shivering were higher in Group G (P < 0.001 while the incidence of dry mouth was higher in Group E (P < 0.001. Conclusion: Epidural anaesthesia with ropivacaine and dexmedetomidine can be safely and effectively used in patients undergoing renal surgeries.

  14. Ketamine as a part of anaesthetic management in a dog with twiddler's syndrome.

    Science.gov (United States)

    De Monte, V; Staffieri, F; Birettoni, F; Bufalari, A

    2014-02-01

    An 11-year-old male German shepherd dog was referred for possible pacemaker implantation. A routine 6-lead electrocardiogram revealed a third-degree atrio-ventricular block with a heart rate of 40 to 45 beats/minute. A transvenous pacemaker implantation procedure was scheduled. The dog was premedicated with 10 µg/kg acepromazine and 5 mg/kg pethidine. A dose of 5 mg/kg ketamine and 0·2 mg/kg diazepam were used for induction and isoflurane in O2 and a constant rate infusion of ketamine (20 to 30 µg/kg/minute) were administered for maintenance of general anaesthesia. Due to a twiddler's syndrome, the pacemaker had to be repositioned. For the second procedure, the same protocol was employed except for a lower dose of ketamine both for induction (3 mg/kg) and constant rate infusion (10 to 15 µg/kg/minute). Ketamine appeared to be useful for both management of anaesthesia and cardiac pacemaker implantation in the absence of a temporary pacemaker. PMID:24117717

  15. Anaesthetic Considerations in the Perioperative Management of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.

    Science.gov (United States)

    Sheshadri, Deepak B; Chakravarthy, Murali R

    2016-06-01

    Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy has emerged as one of the primary modalities of treatment of diffuse peritoneal malignancies. It is a complex surgical procedure with the patients facing major and potentially life threatening alterations of haemodynamic, respiratory, metabolic and thermal balance with significant fluid losses and the perioperative management is challenging for anaesthesiologists and intensive care physicians. Though the alterations are short lived, these patients require advanced organ function monitoring and support perioperatively. The anaesthesiologist is involved in the management of haemodynamics, respiratory function, coagulation, haematologic parameters, fluid balance, thermal variations, and metabolic and nutritional support perioperatively. The chemotherapy instillate used are known to cause nephrotoxicity, cardiotoxicity, dyselectrolytemia and lactic acidosis. The preoperative polypharmacy for pain control, previous surgery and/or chemotherapy, malnourished status secondary to feeding problems and tumour wasting syndrome make the task all the more challenging. The anaesthesiologist also needs to consider the perioperative care from a quality of life perspective and proper preoperative counselling is important. The present overview summarizes the challenges faced by the anaesthesiologist regarding the pathophysiological alterations during the Cytoreductive surgery and Hyperthermic intraperitoneal chemotherapy in the preoperative, intraoperative and postoperative periods. PMID:27065715

  16. Contrast-enhanced ultrasound of both kidneys in healthy, non-anaesthetized cats

    OpenAIRE

    Schweiger, Hanna; Ohlerth, Stefanie; Gerber, Bernhard

    2015-01-01

    BACKGROUND: Changes in perfusion are considered to play a key role in the pathophysiology of renal disease. Contrast-enhanced ultrasound (CEUS) has shown a promising diagnostic imaging technique to non-invasively and repetitively quantify tissue perfusion. Examination protocols have varied between studies regarding US equipment, quantification software, the use of sedation or anaesthesia, and animals. The purpose of the present study was, to assess the feasibility of a standardized CEUS proto...

  17. Autonomic nervous control of myoepithelial cells and secretion in submandibular gland of anaesthetized dogs

    OpenAIRE

    Lung, MA

    2003-01-01

    In dog submandibular gland, the activity of myoepithelial cells was assessed by simultaneous measurement of intraductal pressure (Pdu) and subcapsular pressure (Pca) using catheter-tip pressure transducers; their resting values were 2.5 ± 0.21 and 3.0 ± 0.19 mmHg, respectively (n = 40). Retrograde infusion of saliva (collected from preceding parasympathetic nerve stimulation) increased Pdu (coefficient of 50 mmHg ml-1 for rates < 1 ml min-1 and 85 mmHg ml-1 for higher rates) and Pca (coeffici...

  18. A Novel Anaesthetical Approach to Patients with Brugada Syndrome in Neurosurgery

    Directory of Open Access Journals (Sweden)

    Pietro Paolo Martorano

    2013-01-01

    Full Text Available Brugada syndrome (BrS is one of the most common causes of sudden death in young people. It usually presents with life-threatening arrhythmias in subjects without remarkable medical history. The need for surgical treatment may unmask BrS in otherwise asymptomatic patients. The best anaesthesiological treatment in such cases is matter of debate. We report a case of neurosurgical treatment of cerebello pontine angle (CPA tumor in a BrS patient, performed under total intravenous anesthesia (TIVA with target controlled infusion (TCI modalities, using midazolam plus remifentanil and rocuronium, without recordings of intraoperative ECG alterations in the intraoperative period and postoperative complications.

  19. Pharmacokinetics and pharmacodynamics of eltanolone (pregnanolone), a new steroid intravenous anaesthetic, in humans

    DEFF Research Database (Denmark)

    Carl, Peder; Høgskilde, S; Lang-Jensen, T;

    1994-01-01

    -linear regression programme, showing data consistent with a three-compartment model with initial distribution half-life t1/2 lambda 1 between 0.3 and 2 min, intermediate distribution half-life t1/2 lambda 2 between 12 and 29 min and terminal half-life t1/2 lambda z between 72 and 212 min. The total body clearance...... depression, a small transient increase in heart rate, and a maximum reduction in arterial blood pressure of 23%, as compared with the resting level. Pain on injection and venous sequelae were not seen. Involuntary movements were seen in one subject. We conclude that eltanolone has a favourable...... pharmacokinetic profile with relatively rapid half-lives, large distribution volumes and rapid total body clearance.(ABSTRACT TRUNCATED AT 250 WORDS)...

  20. Anaesthetic Management of Parturient with Acute Atrial Fibrillation for Emergency Caesarean Section

    OpenAIRE

    Madhu Gupta; Shalini Subramanian; Preeti Adlakha

    2013-01-01

    A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate th...

  1. Anaesthetic Management of Parturient with Acute Atrial Fibrillation for Emergency Caesarean Section

    Directory of Open Access Journals (Sweden)

    Madhu Gupta

    2013-01-01

    Full Text Available A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed.

  2. Formulation and Evaluation of Topical Hydrogel Patch Containing Amide Type Local Anaesthetic Agent

    OpenAIRE

    Jayrajsinh Sarvaiya; Chintan Tank; Kosanam Divakar; Jay Upadhyay; G.K.Kapse

    2012-01-01

    Hydrogel based drug delivery systems provides significant effect in designing sustained release topical dosage forms. Topical patch containing drug in hydrogel type polymer matrix provides not only targeted drug flux through the skin but also provides cooling effect on application site. Topical hydrogel patch containing lidocaine was prepared by using sodium poly acrylate as bioadhesive polymer. Effect of brij 30 and transcutol was also evaluated on topical flux of lidocaine base from hydroge...

  3. Anaesthetic Considerations in A Child with Bilateral Hydatid Cysts of Lung

    Directory of Open Access Journals (Sweden)

    Harsimran Singh

    2008-01-01

    Full Text Available Bilateral hydatid cyst of lung in a child is a challenge to anaesthesiologist. The benefits of one lung versus two lung ventilation is still a question. A 9-yr-old male child presented with respiratory distress. The chest X-ray showed the presence of two cysts bilaterally in the lung fields. A possibility of bilateral hydatid cyst in lung was considered. The child was taken up for emergency single stage bilateral thoracotomy under general anaesthesia. Two lung ventilation technique was used. Postoperatively the child was kept on controlled ventilation in the paediatric intensive care unit. The child was weaned off from ventilatory support and extubated 48 hours after the surgery.

  4. Anaesthetic Considerations in A Child with Bilateral Hydatid Cysts of Lung

    OpenAIRE

    Harsimran Singh; Harjinder Kohli; Anju Grewal; Sushil Budhiraja

    2008-01-01

    Bilateral hydatid cyst of lung in a child is a challenge to anaesthesiologist. The benefits of one lung versus two lung ventilation is still a question. A 9-yr-old male child presented with respiratory distress. The chest X-ray showed the presence of two cysts bilaterally in the lung fields. A possibility of bilateral hydatid cyst in lung was considered. The child was taken up for emergency single stage bilateral thoracotomy under general anaesthesia. Two lung ventilation technique was used. ...

  5. CONGENITAL DIAPHRAGMATIC HERNIA IN A TWO-DAY-OLD NEONATE: ANAESTHETIC MANAGEMENT AND CHALLENGES

    Directory of Open Access Journals (Sweden)

    Tridip Jyoti

    2016-04-01

    Full Text Available INTRODUCTION Congenital diaphragmatic hernia in a neonate is a challenging task to any anaesthesiologist. CDH occurs due to an early developmental defect that results in the extrusion of intra-abdominal organs (i.e. stomach, small intestines, spleen, liver into the thoracic cavity. In 85% of the cases it is left sided. This leads to lung hypoplasia, pulmonary hypertension, and pulmonary arteriolar dysregulation/reactivity. Historically, CDH was considered to be a surgical emergency and aggressive hyperventilatory strategies with high peak inspiratory pressures were employed to improve survival. But recent multicentre studies have shown the beneficial effect of conservative low volume ventilation with low inflation pressures and permissive hypercapnia. We present to you the successful management of a two day old neonate with this ventilation strategy.

  6. The Food Contaminant Mycotoxin Deoxynivalenol Inhibits the Swallowing Reflex in Anaesthetized Rats

    OpenAIRE

    Abysique, Anne; Tardivel, Catherine

    2015-01-01

    Deoxynivalenol (DON), one of the most abundant mycotoxins found on cereals, is known to be implicated in acute and chronic illnesses in both humans and animals. Among the symptoms, anorexia, reduction of weight gain and decreased nutrition efficiency were described, but the mechanisms underlying these effects on feeding behavior are not yet totally understood. Swallowing is a major motor component of ingestive behavior which allows the propulsion of the alimentary bolus from the mouth to the ...

  7. Application of colour magnification technique for revealing skin microcirculation changes under regional anaesthetic input

    Science.gov (United States)

    Rubins, Uldis; Spigulis, Janis; Miscuks, Aleksejs

    2013-11-01

    In this work the colour magnification technique was applied for monitoring of palm skin microcirculation changes under peripheral (Plexus Brachialis with axiliary access) Regional Anaesthesia (RA). During the RA procedure 20 minute video of patient's forearm was taken at steady light conditions. Video content was processed offline by custom developed Matlab software with build-in colour magnification algorithm that performs temporal filtering of video sequence near-heartbeat frequency, spatial decomposition of video and amplification of pulsatile signal in every pixel of skin image. Using this method, we are able to visualize the subcutaneous microcirculation changes in high spatial resolution. The results showed different blood pulse amplitude dynamics over the skin regions of palm and forearm during the RA. The colour magnification technique could be used for real-time monitoring of RA effect.

  8. Deep vein thrombosis and pulmonary embolism - Prevention, management, and anaesthetic considerations

    Directory of Open Access Journals (Sweden)

    Krishan Kumar Narani

    2010-01-01

    Full Text Available There is high incidence of venous thromboembolism, comprising of deep vein thrombosis and pulmonary embolism, in hospitalized patients. The need for systemic thromboprophylaxis is essential, especially in patients with inherited or acquired patient-specific risk factors or in patients undergoing surgeries associated with high incidence of postoperative deep vein thrombosis and pulmonary embolism. These patients, on prophylactic or therapeutic doses of anticoagulants, may present for surgery. General or regional anaesthesia may be considered depending on the type and urgency of surgery and degree of anticoagulation as judged by investigations. The dilemma regarding the type of anaesthesia can be solved if the anaesthesiologist is aware of the pharmacokinetics of drugs affecting haemostasis. The anaesthesiologist must keep abreast with the latest developments of methods and drugs used in the prevention and management of venous thromboembolism and their implications in the conduct of anaesthesia.

  9. Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations

    OpenAIRE

    Krishan Kumar Narani

    2010-01-01

    There is high incidence of venous thromboembolism, comprising of deep vein thrombosis and pulmonary embolism, in hospitalized patients. The need for systemic thromboprophylaxis is essential, especially in patients with inherited or acquired patient-specific risk factors or in patients undergoing surgeries associated with high incidence of postoperative deep vein thrombosis and pulmonary embolism. These patients, on prophylactic or therapeutic doses of anticoagulants, may present for surgery. ...

  10. Recovery at the post anaesthetic care unit after breast cancer surgery

    DEFF Research Database (Denmark)

    Gärtner, Rune; Callesen, Torben; Kroman, Niels Thorndahl; Kehlet, Henrik

    2010-01-01

    Extant literature shows that women having undergone breast cancer surgery have substantial problems at the post-anaesthesia care unit (PACU). Based on nursing reports and elements of the discharge scoring system recommended by The Danish Society of Anaesthesiology and Intensive Care Medicine, the...... present prospective, observational study aims to determine why these patients stayed at PACU....

  11. Conjugates of methylated cyclodextrin derivatives and hydroxyethyl starch (HES): Synthesis, cytotoxicity and inclusion of anaesthetic actives

    OpenAIRE

    Lisa Markenstein; Antje Appelt-Menzel; Marco Metzger; Gerhard Wenz

    2014-01-01

    The mono-6-deoxy-6-azides of 2,6-di-O-methyl-beta-cyclodextrin (DIMEB) and randomly methylated-beta-cyclodextrin (RAMEB) were conjugated to propargylated hydroxyethyl starch (HES) by Cu+-catalysed [2 + 3] cycloaddition. The resulting water soluble polymers showed lower critical solution temperatures (LCST) at 52.5 degrees C (DIMEB-HES) and 84.5 degrees C (RAMEB-HES), respectively. LCST phase separations could be completely avoided by the introduction of a small amount of carboxylate groups at...

  12. ANAESTHETIC MANAGEMENT OF A GERIATRIC PATIENT WITH PARKINSON`S DISEASE AND DIABETES MELLITUS POSTED FOR EMERGENCY LAPAROTOMY

    Directory of Open Access Journals (Sweden)

    Prajwal Patel

    2014-10-01

    Full Text Available Parkinson's disease (PD, one of the most common disabling neurological diseases, affects about 1% of the population over 60 years of age. It is a degenerative disease of the central nervous system caused by the loss of dopaminergic fibers in basal ganglia of the brain. PD is an important cause of perioperative morbidity and with an increasingly elderly population; it is being encountered with greater frequency in surgical patients. Here we report a case of 79year old male with Parkinsonism and diabetes mellitus posted for emergency laparotomy, which we managed successfully with general anesthesia.

  13. ANAESTHETIC MANAGEMENT OF A PATIENT WITH WILSON’S DISEASE POSTED FOR EMERGENCY LSCS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kousalya

    2015-06-01

    Full Text Available Wilson’s disease (WD, or hepatolenticular degeneration, is a rare autosomal recessive disorder with a prevalence of 1:50,000 - 1:100,000 live births . 1 The genetic disorder causes a reduction in the synthesis of the copper transporting protein ceruloplasmin. Clinical presentation may vary from asymptomatic patients to those presenting with fulminant liver disease or neurological symptoms or psychiatric illness. The course of events in a pregnant patient depends upon the preconception status of the disease spectrum. The neuro - psychiatric illness and hepatorenal involvement in antenatal period may get worsene d. The risk of ascitis, Gatrointestinal bleeding and Varicial rupture is increased in pregnant women with pre - existing cirrhosis. Elevated serum copper levels are associated with post - partum depression (PPD. Copper accumulation may lead to erythrocyte hemolysis resulting in Coombs negative haemolytic anaemia (10 – 15%. There is also an increased risk of Hypertensive disorders in Pregnancy, HELLP syndrome and placental abruption. The disease status at the time of presentation for surgery should determine the mode of Anaesthesia, intraoperative management and post - operative care. Hepatic dysfunction can cause delayed recovery with General anaesthesia. Pre - existing neuro psychological problems may get aggravated by the hypnotic and sedative drugs. Excessive copper may interfere with neuromuscular transmission. Pre - existing neurological deficiency must be documented before attempting an Epidural or a subarachnoid block. We report a case of a primigravida with previously diagnosed Wilson’s disease initially presented with neurological symptoms and muscular weakness in the lower limbs. Though treated for 3yrs with trientene and zinc, she was on irregular treatment when posted for Emergency Caesarean section. After a proper Preanesthetic evaluation of the patient, LSCS was conducted under subarachnoid block. A good intra operative and post - operative monitoring resulted in good maternal and neonatal outcome. We conclude that regional anaesthesia can be safely administered for Caesarean delivery in patients with Wilson’s disease.

  14. Agglutinins and cardiac surgery: a web based survey of cardiac anaesthetic practice; questions raised and possible solutions

    OpenAIRE

    Shah, S.; Gilliland, H; Benson, G

    2014-01-01

    Introduction Cardiac surgery involves cardiopulmonary bypass during which the core temperature is generally lowered to hypothermic levels. Patients presenting for cardiac surgery are sometimes reported to have cold or warm autoantibodies at the time of blood screening. It is known that cold agglutinins may cause potentially life-threatening haemolysis, intracoronary haemagglutination leading to inadequate cardioplegia distribution, thrombosis, embolism, ischaemia or infarction. The risk (if a...

  15. Multi-level approach to anaesthetic effects produced by sevoflurane or propofol in humans : 1. BIS and blink reflex

    NARCIS (Netherlands)

    Mourisse, J.; Lerou, J.; Struys, M.; Zwarts, M.; Booij, L.

    2007-01-01

    Background. The relative roles of forebrain and brainstem in producing adequate anaesthesia are unclear. Methods. We simultaneously analysed the effects of sevoflurane (Group S; n = 18) or propofol (Group P; n = 29) on the bispectral index (BIS) and the first component of the blink reflex (RI). The

  16. ANAESTHETIC MANAGEMENT OF AN ADULT PATIENT WITH UNCORRECTED VENTRICULAR SEPTAL DEFECT POSTED FOR OBSTRUCTED INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Shivaramu

    2015-08-01

    Full Text Available Adults with unrepaired acyanotic heart disease scheduled for a non - cardiac surgery present serious concerns for the anaesthesiologists. Ventricular septal defect (VSD, is an acyanotic congenital heart disease, characterized by a left to right shunt. The incidence varies between 2 to 6 per 1000 live births. It is found in 30% to 60% of all the newborns with congenital heart disease, thus making it one of the most common congenital heart diseases VSD is the commonest form of CHD. Unlike ASD, the majority will undergo spontaneous closure : 40% by the age of 2yr and 90% by the age of 10 yr . 1 The goal of anesthetic management should be to maintain intravascular volume. Systemic and pulmonary vascular resistance changes, such as might occur due to acidosis, hypothermia, hypercarbia or excessive airway pressures, should be avoided. Maintenance of preload, contractility and sinus rhythm is of major importance. The c omplex pathophysiologies of such heart disease, in addition to the circumstances of emergency operation, exacerbate the total anesthetic risk. We present here a rare case of obstructed right sided inguinal hernia repair with successful outcome in an adult with ventricular septal defect.

  17. The effect of i.v. indomethacin on the gastric mucosal electrical potential difference and blood flow in anaesthetized dogs

    DEFF Research Database (Denmark)

    Højgaard, L; Ewald, H; Holm, I E; Bünger, C; Krag, E; Bülow, J B

    1988-01-01

    Indomethacin inhibits prostaglandin synthesis and causes gastric mucosal damage. The correlation between the gastric mucosal function and gastric blood flow was investigated. The intragastric liquid junction corrected potential difference (PD) across the stomach wall was used to characterize the...... reduction was seen after indomethacin. PD and flow reductions correlated (R = 0.92). As indomethacin given IV caused a parallel impairment of gastric mucosal function and blood flow, part of the indomethacin-related mucosal damaging effects might be due to the flow reduction....

  18. Is skin conductance a predictor of arousal, noxious stimuli and pain in the sedated and anaesthetized patient?

    OpenAIRE

    2011-01-01

    Hudledningsevne som mål på smertefulle stimuli. Lege og forsker Ann Christin Gjerstad har sett på en metode for å oppdage ubehag og smerte hos pasienter som ligger på sykehus og av ulike grunner ikke kan meddele seg på vanlig måte. Dette er gjort ved hjelp av hudledningsevne som måler svetteutsondring i håndflater eller under føttene. En fryktet komplikasjon for pasienter som skal gjennom et sykehusopphold er muligheten for å oppleve smerte uten mulighet til å få kommunisert dette ti...

  19. Anaesthetic Bodies and the Absence of Feeling: Pain and Self-Mutilation in Later Nineteenth-Century Psychiatry

    Directory of Open Access Journals (Sweden)

    Sarah Chaney

    2012-12-01

    Full Text Available This paper addresses the overlapping ways in which self-inflicted injury was understood in relation to an absence of pain during the long nineteenth century, arguing that a clear distinction between bodily and mental suffering cannot be made in this period. The medical view that self-infliction of injury must necessarily be pathological is shown to have emerged from earlier philosophical approaches to pain. This was cemented by the formation of a somatic model of self-mutilation, based on the concept of cutaneous anaesthesia, particularly in the work of Wilhelm Griesinger in Germany. In contrast, the words of asylum patients provide a much broader spectrum of ways in which injuries might have been understood. Nonetheless, the meanings attributed generally emphasize self-mutilation as a response to physical, rather than emotional, pain, indicating the widespread nature of physical aetiologies of insanity. Such a somatic approach also permeated psychological models of self-inflicted injury in the late nineteenth and early twentieth centuries, as shown through examination of Richard von Krafft-Ebing’s concept of ‘sexual anaesthesia’, William James’s association of anaesthesia with the absence of emotion, and self-mutilation and fixed ideas in the work of Pierre Janet. The study of self-mutilation thus provides an interesting angle from which to explore the complexity of notions of body and mind, in relation to concepts of pain.

  20. Post-operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

    DEFF Research Database (Denmark)

    Jensen, K; Kehlet, H; Lund, Claus

    2007-01-01

    BACKGROUND: Laparoscopic cholecystectomy is now often an ambulatory procedure, but dependent on short-term post-operative complaints of pain and post-operative nausea and vomiting (PONV). The efficacy of post-anaesthesia care units (PACUs) is therefore important to facilitate return to normal...... functions. We investigated the feasibility and efficacy of a standardized, evidence-based anaesthesia/analgesic regime to identify residual problems in the early post-operative phase. METHODS: One hundred and thirty-four consecutive patients admitted for elective laparoscopic cholecystectomy at Hvidovre...... intra-operatively, and in the PACU on demand (prn) administration of sufentanil, morphine, paracetamol, ondansetron, droperidol, oral fluids and oxygen (if SpO(2) < 93%) with PACU discharge using a modified Aldrete score. RESULTS: Protocol violations were moderate and occurred unsystematically, 8% had...

  1. Post-operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

    DEFF Research Database (Denmark)

    Jensen, K; Kehlet, H; Lund, Claus Michael;

    2007-01-01

    University Hospital between 15 March and 30 September 2005 were included in the study. The standardized, evidence-based regime consisted of total intravenous (i.v.) anaesthesia (propofol-remifentanil), well-defined fluid therapy, dexamethasone, ketorolac, ondansetron, sufentanil and incisional bupivacaine...... intra-operatively, and in the PACU on demand (prn) administration of sufentanil, morphine, paracetamol, ondansetron, droperidol, oral fluids and oxygen (if SpO(2) < 93%) with PACU discharge using a modified Aldrete score. RESULTS: Protocol violations were moderate and occurred unsystematically, 8% had...

  2. ANAESTHETIC MANAGEMENT OF ELDERLY PATIENT WITH PERMANENT PACEMAKER FOR EXCISION OF SUSPECTED ADRENAL MASS – A CHALLENGING CASE

    Directory of Open Access Journals (Sweden)

    Ketaki

    2014-01-01

    Full Text Available Pacemakers and the underlying pathophysiologies leading to their implantation present challenges to the anesthetist 1 . Patients with an implanted cardiac pulse generator often have significant co - morbid disease in addition to their cardiac rhythm disturbance. Our ability to care for these patients requires attention to both their medical , psychological and surgical problems. We present the case of a 60 year old man with a permanent pacemaker posted for excision of a suspected adrenal mass.

  3. In Vitro Contracture Test Results and Anaesthetic Management of a Patient with Emery-Dreifuss Muscular Dystrophy for Cardiac Transplantation

    Directory of Open Access Journals (Sweden)

    Frank Schuster

    2012-01-01

    Full Text Available Emery-Dreifuss muscular dystrophy (EDMD is a hereditary neuromuscular disorder characterized by slowly progressive muscle weakness, early contractures, and dilated cardiomyopathy. We reported an uneventful general anaesthesia using total intravenous anaesthesia (TIVA for cardiac transplantation in a 19-year-old woman suffering from EDMD. In vitro contracture test results of two pectoralis major muscle bundles of the patient suggest that exposition to triggering agents does not induce a pathological sarcoplasmic calcium release in the lamin A/C phenotype. However, due to the lack of evidence in the literature, we would recommend TIVA for patients with EDMD if general anaesthesia is required.

  4. Comparison of the effects of two intrathecal anaesthetic techniques for transurethral prostatectomy on haemodynamic and pulmonary function.

    LENUS (Irish Health Repository)

    Walsh, K H

    2012-02-03

    BACKGROUND AND OBJECTIVE: Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group) and hyperbaric bupivacaine 10 mg (limiting spread by maintaining the upright position for 15 min) and fentanyl 25 microg (fentanyl group) in terms of haemodynamic and pulmonary function. METHODS: Thirty ASA I-III patients were randomly selected and underwent spinal anaesthesia with either hyperbaric bupivacaine 15 mg (immediately positioned supine) or hyperbaric bupivacaine 10 mg (upright for 15 min) and fentanyl 25 microg. RESULTS: The greatest changes in mean arterial pressure (P = 0.9), ephedrine requirements (P = 0.8) and mean maximum change in forced vital capacity (P = 0.5) were similar in both groups. CONCLUSIONS: The addition of fentanyl 25 microg to bupivacaine 10 mg and limiting the spread of the block does not improve either haemodynamic or pulmonary function compared with bupivacaine 15 mg in patients undergoing transurethral prostatectomy.

  5. No proarrhythmic properties of the antibiotics Moxifloxacin or Azithromycin in anaesthetized dogs with chronic-AV block

    DEFF Research Database (Denmark)

    Thomsen, Morten Bækgaard; Beekman, J D M; Attevelt, N J M;

    2006-01-01

    The therapeutically available quinolone antibiotic moxifloxacin has been used as a positive control for prolonging the QT interval in both clinical and non-clinical studies designed to assess the potential of new drugs to delay cardiac repolarization. Despite moxifloxacin prolonging QT, it has not...

  6. Anaesthetic management of laparoscopic surgery for rectal cancer in patients of dilated cardiomyopathy with poor ejection fraction: a case report

    Science.gov (United States)

    Wu, Yao-Hua; Hu, Liang; Xia, Jin; Hao, Quan-Shui; Feng, Li; Xiang, Hong-Bing

    2015-01-01

    A patient with dilated cardiomyopathy with poor ejection fraction posted for laparoscopic surgery for rectal cancer which was successfully performed under general anesthesia with endotracheal intubation and mechanical ventilation was reported. Our observations strongly indicate that detailed preoperative assessment, watchful intraoperative monitoring, and skillful optimization of fluid status and hemodynamic play important role in the high risk patient under general anesthesia with endotracheal intubation and mechanical ventilation. PMID:26309623

  7. Effective dose 50 of desflurane for laryngeal mask airway removal in anaesthetized children in cataract surgeries with subtenon block

    Directory of Open Access Journals (Sweden)

    Sameer Sethi

    2015-01-01

    Full Text Available Background: Quantification of the depth of desflurane anesthesia required for laryngeal mask airway (LMA removal in children has been done with the use of intravenous fentanyl or caudal anesthesia. This study aimed to determine the end-tidal concentration of desflurane required for LMA removal in children without the use of caudal or opioid analgesia in children undergoing elective cataract surgery. Materials and Methods: Our study enrolled 25 American Society of Anesthesiologists I and II children aged 2-10 years, undergoing elective cataract surgery. Anesthesia was induced with sevoflurane and oxygen/nitrous oxide using face mask and a size 2 LMA inserted. A subtenon block was administered in all children before surgical incision. Desflurane was used for maintenance of anesthesia. Predetermined end tidal concentration of desflurane was maintained for 10 min at the end of surgery before LMA removal was attempted. End tidal concentrations were increased/decreased using the Dixon up-down method (with 0.5% as a step size in the next patient depending on the previous patient′s response. Patient responses to LMA removal were classified as "movement" or "no movement." Results: 50% effective dose (ED 50 for successful removal of the LMA with desflurane in the presence of subtenon block was 3.6% (3.20-3.97% and that the 95% ED 95 was 4.648% (4.15-6.47%. Conclusion: Laryngeal mask airway removal can be successfully accomplished in 50% and 95% anesthetized children at 3.6% and 4.65% end-tidal desflurane concentration.

  8. ANAESTHETIC MANAGEMENT OF A CASE OF TEMPOROMANDIBULAR JOINT ANKYLOSIS POSTED FOR BILATERAL BREAST SURGERY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Athaluri Vishnu

    2014-07-01

    Full Text Available BACKGROUND: Temporomandibular joint (TMJ ankylosis is associated with partial or complete restriction of mouth opening and poses a significant problem to the anesthesiologist making the airway management very challenging. Alternative methods of securing the airway should be kept ready because conventional laryngoscopy and intubation are impossible. Thoracic epidural anesthesia (TEA is one of the options to avoid general anesthesia in this case. We aimed to manage a case of bilateral modified radical mastectomy with TMJ ankylosis solely under thoracic epidural anesthesia. METHODOLOGY: Female patient of 32 years of age, with bilateral TMJ ankylosis with no mouth opening was posted for bilateral breast surgery. Thoracic epidural was instituted at T4-T5 interspace and 18G epidural catheters was secured. Alternative airway management strategies were included in our plan if thoracic epidural fails. OBSERVATION: Adequate preparation of the patient, counseling about anesthetic plan of management, placement of epidural catheter by an experienced anesthesiologist helped in the successful management of this case. CONCLUSION: Regional anesthesia techniques are safer alternatives to provide intraoperative anesthesia with difficult airway for bilateral breast surgeries.

  9. PET study of the [{sup 11}C]raclopride binding in the striatum of the awake cat: effects of anaesthetics and role of cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Hassoun, Wadad; Ginovart, Nathalie; Zimmer, Luc; Gualda, Veronique; Bonnefoi, Frederic [CERMEP, Lyon (France); Le Cavorsin, Marion; Leviel, Vincent [CNRS UMR5123, Villeurbanne (France)

    2003-01-01

    Cats were trained to stay in a containment box, without developing any signs of behavioural stress, while their head was maintained in a position that allowed positron emission tomography (PET) experiments to be performed. The binding potential for [{sup 11}C]raclopride (BP{sub raclo}), a radioligand with good specificity for dopamine (DA) receptors of the D{sub 2} type, was measured in the striatum and in three experimental situations: awake, anaesthetised with ketamine (50 mg kg{sup -1} h{sup -1}; i.m.) and anaesthetised with halothane (1.5%). Non-specific binding was evaluated in the cerebellum. In the striatum of both sides, the BP{sub raclo} was unmodified by ketamine anaesthesia when compared with awake animals. In contrast, a large increase in BP{sub raclo} was observed under halothane anaesthesia. The non-specific binding of [{sup 11}C]raclopride, evaluated in the cerebellum, was also unchanged under ketamine anaesthesia but greatly increased under halothane anaesthesia. To evaluate whether changes in the cerebral blood flow (CBF) resulting from the different experimental situations could be at the root of these discrepancies, injections of [{sup 15}O]H{sub 2}O were performed; measurements revealed a drastically increased CBF under halothane anaesthesia and a slight enhancement under ketamine anaesthesia, when compared with the waking state. These results are the first to be obtained on this topic in awake cats, and show that the BP{sub raclo} is greatly dependent on alterations in the CBF. (orig.)

  10. Benzocaína e eugenol como anestésicos para juvenis do pampo Trachinotus marginatus Benzocaine and eugenol as anaesthetics for pompano juvenile Trachinotus marginatus

    OpenAIRE

    Marcelo Hideo Okamoto; Marcelo Borges Tesser; Luiz Roberto Louzada; Renato Adriano dos Santos; Luís André Sampaio

    2009-01-01

    O objetivo deste trabalho foi avaliar a eficácia da benzocaína e do eugenol como anestésicos para juvenis de Trachinotus marginatus. Foram testadas concentrações de 25, 50, 75, 100 e 150ppm de benzocaína e de 25, 37,5, 50, 62,5 e 75ppm de eugenol. Os testes foram realizados em aquários de vidro contendo 30l de água (salinidade 30‰ e temperatura 19°C). Os peixes (51,4±13,5g) foram expostos individualmente às diferentes concentrações de cada anestésico (n=5 para cada concentração). E...

  11. Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

    Directory of Open Access Journals (Sweden)

    Khaled EL-Radaideh

    2015-01-01

    Full Text Available Introduction. This study compared streamlined liner of the pharynx airway (SLIPA and I-gel noninflatable, single-use, supraglottic airway device (SAD performance in anesthetized, paralyzed adults. Methods. Eighty adults (ASA physical statuses I–III who were undergoing elective procedures under general anesthesia with an SAD were enrolled in this prospective, randomized, single-blind study. Subjects were randomly and evenly assigned to the SLIPA or I-gel group for intraoperative airway management. Ease and number of insertions, insertion time, oropharyngeal sealing pressure, hemodynamic response, oxygen saturation (SpO2, end-tidal CO2 (EtCO2, and peri- and postoperative complications were examined. Results. The SLIPA and I-gel devices were successfully inserted in 100% and 95% of subjects, respectively. In two I-gel subjects (5%, ventilation was not possible after two attempts, but a size 55 SLIPA was successfully inserted in both cases. Forty-two and 38 patients were ultimately included in the SLIPA and I-gel groups, respectively. Insertion time was significantly shorter with the SLIPA (11.19±3.03 s than with the I-gel (15.05±6.37 s, P=0.003. Oropharyngeal sealing pressure was significantly higher in SLIPA (28.76±3.11 cmH2O than in I-gel (25.9±3.65 cmH2O subjects (P=0.001. Blood staining occurred more frequently in SLIPA (n=8, 19.0% than in I-gel (n=5, 13.2% patients (P<0.01. Heart rate, mean arterial blood pressure, SpO2, and EtCO2 were not significantly different between groups. Conclusion. Although blood staining incidence was higher, SLIPA insertion was easier and faster than I-gel insertion. The SLIPA provided better airway sealing pressure. Both devices had similar mechanical ventilation and oxygenation characteristics and comparable hemodynamic stability. Both noninflatable SADs are useful, but SLIPA rapid insertion and good airway sealing make it an effective alternative to the I-gel.

  12. The effects of L-carnitine and alpha-tocopherol on acid excretion defect during the acute ureteral obstruction in anaesthetized rats

    Directory of Open Access Journals (Sweden)

    Ashtiyani SC

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Ureteral obstruction has been shown to induce renal oxidative stress, suppressed energy metabolism and defected acid excretion. This study was aimed to examine the improving effects of L-carnitine, a facilitating cofactor for mitochondrial oxidation of fatty-acids as well as a scavenger of free-radicals, and a-tocopherol as the most potent antioxidant on these renal disorders at early hours following release of unilateral ureteral obstruction. "n"nMethods: The left ureter was ligated in 60 anaesthetised rats, L-carnitine, a-tocopherol, or their vehicles (normal saline and olive oil, respectively were injected (i.p. in four groups. Each rat was re-anesthetized and cannulated, and ureteral legation was released at exactly 24h after UUO-induction. A 30-min clearance period performed to separately collect urine from both kidneys. The collected urine and arterial blood samples were given to pH-gas analyzer and autoanalyzer, and malondialdehyde (MDA, ATP and ADP levels were assessed in preserved kidneys. There were also sham and control groups (n=8-10 in each."n"nResults: In the post-obstructed kidney of vehicle-treated groups with respect to the equivalent kidney of sham group, there were increases in MDA (p<0.001, ADP (p<0.01, urinary pH (p<0.001, absolute (p<0.05 and fractional bicarbonate excretions (p<0.01, but decreases in ATP, ATP/ADP (both p<0.001, and urinary PCO2 (p<0.01. a-tocopherol could normalize MDA level but did not affect the altered amounts of energy metabolic indices and acid-base excretions, while L-carnitine improved all of them except of decreased urinary PCO2."n"nConclusions: Increased bicarbonate-excretion in post-obstructed kidney is due to defected acid-secretion at collecting duct, which is not related to ureteral obstruction-induced renal oxidative stress and suppressed energy metabolism.

  13. Histamine release from basophil leukocytes in asthma patients after in vitro provocation with various neuromuscular blocking drugs and intravenous anaesthetic agents

    DEFF Research Database (Denmark)

    Guldager, H; Søndergaard, I

    1987-01-01

    Basophil histamine release is a relatively new investigation technique, which can be used in the diagnosis of anaphylactoid reactions. Our aim in this investigation was to determine reference values for asthma patients and normal subjects. Blood from eight asthmatic patients and eight normal...

  14. Cardioprotective efficacy depends critically on pharmacological dose, duration of ischaemia, health status of animals and choice of anaesthetic regimen: a case study with folic acid

    OpenAIRE

    Zuurbier, Coert J.; Heinen, Andre; Koeman, Anneke; Stuifbergen, Roy; Hakvoort, Theodorus BM; Weber, Nina C; Hollmann, Markus W.

    2014-01-01

    Background Acute, high-dose folic acid (FA) administration has recently been shown to possess unprecedented effective cardioprotection against ischaemia/reperfusion (I/R) injury. Here we explore the translation potential of FA as treatment modality for cardiac I/R. Methods Dependency of FA protection on dose, ischaemia duration, and eNOS was examined in an isolated mouse heart I/R model, whereas dependency on animal health status and anaesthesia was examined in an in vivo rat model of regiona...

  15. Validation of the unassisted, gum-elastic bougie-guided, laryngeal mask airway-ProSeal™ placement technique in anaesthetized patients

    Directory of Open Access Journals (Sweden)

    Aaron M Joffe

    2012-01-01

    Full Text Available Aims: The laryngeal mask airway-ProSeal™ can be inserted digitally, by introducer tool, or by railroading it over a bougie placed first in the patient′s oesophagus, which is highly successful, but as originally described, requires an assistant. An unassisted bougie-guided placement technique has also been described, but no data on its effectiveness have been reported. Methods: We reviewed data collected during a randomized, controlled trial comparing the air-Q® Intubating Laryngeal Airway and LMA-Proseal™, in which all LMA-Proseal™ devices were inserted using the unassisted (one-operator, bougie-guided placement technique. Results: Forty-eight devices were placed. All devices were placed successfully. Successful placement was achieved in 47 (98% patients on first attempt and in one (2% patient on the third attempt. Mean (SD time required for insertion establishing ventilation was 28 (11 s. Mean (SD airway seal pressure was 30 (6 cmH 2 O. Gross blood was found on four (8% devices upon removal, but no oropharyngeal injuries were noted on oral exam in the recovery unit prior to discharge. The most common complaints in recovery and 24 h post-operatively were sore throat [discharge: mild = 18/48 (38%; 24 h: mild = 9/38 (19%, moderate = 1/38 (3%] and pain on swallowing [discharge: mild = 7/48 (15%; 24 h: mild = 2/38 (6%]. Conclusions: Our data confirm that in experienced hands, bougie-guided placement of the LMA-Proseal™ without the aid of an assistant can be accomplished quickly and successfully without affecting the expected clinical performance of the device.

  16. Acute SGLT inhibition normalizes O2 tension in the renal cortex but causes hypoxia in the renal medulla in anaesthetized control and diabetic rats.

    Science.gov (United States)

    O'Neill, Julie; Fasching, Angelica; Pihl, Liselotte; Patinha, Daniela; Franzén, Stephanie; Palm, Fredrik

    2015-08-01

    Early stage diabetic nephropathy is characterized by glomerular hyperfiltration and reduced renal tissue Po2. Recent observations have indicated that increased tubular Na(+)-glucose linked transport (SGLT) plays a role in the development of diabetes-induced hyperfiltration. The aim of the present study was to determine how inhibition of SLGT impacts upon Po2 in the diabetic rat kidney. Diabetes was induced by streptozotocin in Sprague-Dawley rats 2 wk before experimentation. Renal hemodynamics, excretory function, and renal O2 homeostasis were measured in anesthetized control and diabetic rats during baseline and after acute SGLT inhibition using phlorizin (200 mg/kg ip). Baseline arterial pressure was similar in both groups and unaffected by SGLT inhibition. Diabetic animals displayed reduced baseline Po2 in both the cortex and medulla. SGLT inhibition improved cortical Po2 in the diabetic kidney, whereas it reduced medullary Po2 in both groups. SGLT inhibition reduced Na(+) transport efficiency [tubular Na(+) transport (TNa)/renal O2 consumption (Qo2)] in the control kidney, whereas the already reduced TNa/Qo2 in the diabetic kidney was unaffected by SGLT inhibition. In conclusion, these data demonstrate that when SGLT is inhibited, renal cortex Po2 in the diabetic rat kidney is normalized, which implies that increased proximal tubule transport contributes to the development of hypoxia in the diabetic kidney. The reduction in medullary Po2 in both control and diabetic kidneys during the inhibition of proximal Na(+) reabsorption suggests the redistribution of active Na(+) transport to less efficient nephron segments, such as the medullary thick ascending limb, which results in medullary hypoxia. PMID:26041448

  17. PET study of the [11C]raclopride binding in the striatum of the awake cat: effects of anaesthetics and role of cerebral blood flow

    International Nuclear Information System (INIS)

    Cats were trained to stay in a containment box, without developing any signs of behavioural stress, while their head was maintained in a position that allowed positron emission tomography (PET) experiments to be performed. The binding potential for [11C]raclopride (BPraclo), a radioligand with good specificity for dopamine (DA) receptors of the D2 type, was measured in the striatum and in three experimental situations: awake, anaesthetised with ketamine (50 mg kg-1 h-1; i.m.) and anaesthetised with halothane (1.5%). Non-specific binding was evaluated in the cerebellum. In the striatum of both sides, the BPraclo was unmodified by ketamine anaesthesia when compared with awake animals. In contrast, a large increase in BPraclo was observed under halothane anaesthesia. The non-specific binding of [11C]raclopride, evaluated in the cerebellum, was also unchanged under ketamine anaesthesia but greatly increased under halothane anaesthesia. To evaluate whether changes in the cerebral blood flow (CBF) resulting from the different experimental situations could be at the root of these discrepancies, injections of [15O]H2O were performed; measurements revealed a drastically increased CBF under halothane anaesthesia and a slight enhancement under ketamine anaesthesia, when compared with the waking state. These results are the first to be obtained on this topic in awake cats, and show that the BPraclo is greatly dependent on alterations in the CBF. (orig.)

  18. Effects of prolonged surface pressure on the skin blood flowmotions in anaesthetized rats-an assessment by spectral analysis of laser Doppler flowmetry signals

    International Nuclear Information System (INIS)

    The objective of this study is to assess the effect of prolonged surface compression on the skin blood flowmotion in rats using spectral analysis based on wavelets transform of the periodic oscillations of the cutaneous laser Doppler flowmetry (LDF) signal. An external pressure of 13.3 kPa (100 mmHg) was applied to the trochanter area and the distal lateral tibia of Sprague-Dawley rats via two specifically designed pneumatic indentors. The loading duration was 6 hours/day for 4 consecutive days. Five frequency intervals were identified (0.01-0.04 Hz, 0.04-0.15 Hz, 0.15-0.4 Hz, 0.4-2 Hz and 2-5 Hz) corresponding to endothelial related metabolic, neurogenic, myogenic, respiratory and cardiac origins. The absolute amplitude of oscillations of each particular frequency interval and the normalized amplitude were calculated for quantitative assessments. The results showed that (1) tissue compression following the above schedule induced significant decrease in the normalized amplitude in the frequency interval of 0.01-0.04 Hz both in the trochanter area (p < 0.001) and tibialis area (p = 0.023) (2) prolonged compression induced significant increase in the absolute amplitude (p = 0.004 for the trochanter area and p = 0.017 for the tibialis area) but significant decrease in the normalized amplitude (p = 0.023 for the trochanter area and p = 0.026 for the tibialis area) in the frequency interval of 0.15-0.4 Hz, and (3) at the tibialis area, the flowmotion amplitude (frequency interval 0.15-0.4 Hz) measured prior to the daily tissue compression schedule was found to be significantly higher on day 4 than the measurements obtained on day 1. However, this finding was not observed at the trochanter area. Our results suggested that prolonged compression might induce endothelial damage and affect the endothelial related metabolic activities

  19. Why are children still having preventable extractions under general anaesthetic? A service evaluation of the views of parents of a high caries risk group of children.

    Science.gov (United States)

    Olley, R C; Hosey, M T; Renton, T; Gallagher, J

    2011-04-23

    Introduction Despite overall improvements in oral health, the number of children admitted to hospital for extraction of teeth due to caries under general anaesthesia (GA) has been reported as increasing dramatically in England. The new UK government plans to transform NHS dentistry by improving oral health.Aim To evaluate the dental care received by children who required caries-related extractions under GA and obtain the views of their parents or guardians on their experiences of oral health services and the support they would like to improve their child's oral health, to inform future planning.Method An interview questionnaire was designed and piloted to collect data from a consecutive sample of 100 parents or guardians during their child's pre-operative assessment appointment. This took place at one London dental hospital between November 2009 and February 2010.Results Most children were either white (43%) or black British (41%); the average age was seven years (range 2-15, SD 3.1, SE 0.31) and the female:male ratio was 6:5. Most (84%) had experienced dental pain and 66% were referred by a general dental practitioner (GDP). A large proportion of parents or guardians (47%) reported previous dental treatment under GA in their children or child's sibling/s. Challenges discussed by parents in supporting their child's oral health included parenting skills, child behaviour, peer pressure, insufficient time, the dental system and no plans for continuing care for their child. Three out of four parents (74%) reported that they would like support for their child's oral health. Sixty percent of all parents supported school/nursery programmes and 55% supported an oral health programme during their pre-assessment clinic.Discussion These findings suggest that the oral health support received by high caries risk children is low. Health promotion programmes tailored to this cohort are necessary and our findings suggest that they would be welcomed by parents. PMID:21508990

  20. Elimination of low steady-state concentrations of [5,6-H]prostaglandin E in the pulmonary and the systemic circulations of anaesthetized rats

    DEFF Research Database (Denmark)

    Bukhave, K.; Hansen, Harald S.

    1977-01-01

    right atrium, respectively. The levels of [H]prostaglandin E were measured at different infusion time intervals and the H-labeled hydrophobic metabolites characterized. Cardiac output was estimated by a modification of the dye injection method, using I-labelled albumin as the marker. From the cardiac...

  1. The effects of N omega-nitro-L-arginine methyl ester, sodium nitroprusside and noradrenaline on venous return in the anaesthetized cat.

    OpenAIRE

    Bower, E. A.; Law, A. C.

    1993-01-01

    1. The vascular actions of N omega-nitro-L-arginine methyl ester (L-NAME), sodium nitroprusside and noradrenaline were investigated in cats under chloralose anaesthesia with controlled vascular tone and ventilation. Cardiac output, heart rate, vascular pressures and mean circulatory filling pressure (MCFP) were measured. Total peripheral resistance (TPR) and resistance to venous return (Rvr) were calculated from steady-state readings. 2. L-NAME (37 mumol kg-1, i.v.) administered to ten cats r...

  2. Successful intubation of a difficult airway due to a large obstructive vocal cord polyp augmented by the delivery of a transtracheal injection of local anaesthetic.

    Science.gov (United States)

    George, Jayan; Kader, Jishar Abdul; Arumugam, Sivasundari; Murphy, Anthony

    2015-01-01

    We describe a case of a very difficult intubation which was safely navigated through careful planning. Our patient presented initially with increasing hoarseness and shortness of breath over a 6-month period. This was investigated and the patient was found to have a large vocal cord mass and was referred for urgent microlaryngoscopy and vocal cord polypectomy. On the day of surgery the obstruction was noted and awake fiberoptic bronchoscopy was used with a remifentanil infusion. Given the mass was large and increased in size with expiration, the time frame to pass the tube was extremely short. We delivered a transtracheal injection of local anaesthesia. This approach allowed for safe passage of the endotracheal tube. In patients such as this it may be worth considering the use of a transtracheal injection in the first instance. PMID:26628451

  3. Validation of the unassisted, gum-elastic bougie-guided, laryngeal mask airway-ProSeal™ placement technique in anaesthetized patients

    OpenAIRE

    Joffe, Aaron M.; Schroeder, Kristopher M; Shepler, John A; Richard E Galgon

    2012-01-01

    Aims: The laryngeal mask airway-ProSeal™ can be inserted digitally, by introducer tool, or by railroading it over a bougie placed first in the patient′s oesophagus, which is highly successful, but as originally described, requires an assistant. An unassisted bougie-guided placement technique has also been described, but no data on its effectiveness have been reported. Methods: We reviewed data collected during a randomized, controlled trial comparing the air-Q® Intubating Laryngeal Airway and...

  4. Sympathetic activity of S-(+)-ketamine low doses in the epidural space

    OpenAIRE

    2014-01-01

    BACKGROUND AND OBJECTIVES: S-(+)-ketamine is an intravenous anaesthetic and sympathomimetic with properties of local anaesthetic. It has an effect of an analgetic and local anaesthetic when administered epidurally, but there are no data whether low doses of S-(+)-ketamine have sympathomimetic effects. The aim of this study was to determine whether low doses of S-(+)-ketamine, given epidurally together with local anaesthetic, have any effect on sympathetic nervous system, both systemic and be...

  5. Methohexitone, propofol and etomidate in electroconvulsive therapy for depression: a naturalistic comparison study.

    LENUS (Irish Health Repository)

    Eranti, Savithasri V

    2009-02-01

    Methohexitone has been the most widely used anaesthetic for electroconvulsive therapy (ECT). However, recent scarcity and erratic availability has led to use of other anaesthetics with differing effects upon ECT. We compared treatment parameters and response to ECT in patients anaesthetised with different anaesthetics in a routine clinical setting.

  6. Intravenous anaesthesia in goats: A review

    OpenAIRE

    T. Brighton Dzikiti

    2013-01-01

    Intravenous anaesthesia is gradually becoming popular in veterinary practice. Traditionally, general anaesthesia is induced with intravenous drugs and then maintained with inhalation agents. Inhalation anaesthetic agents cause more significant dose-dependent cardiorespiratory depression than intravenous anaesthetic drugs, creating a need to use less of the inhalation anaesthetic agents for maintenance of general anaesthesia by supplementing with intravenous anaesthesia drugs. Better stil...

  7. Modeling based evaluation of the hypnotic and anaesthetic interactions between midazolam, propofol and alfentanil%咪达唑仑、异丙酚与阿芬太尼联合催眠作用的模型化评价

    Institute of Scientific and Technical Information of China (English)

    王晶晶; 尹芳; 陈君超; 吕映华; 刘红霞; 郑青山

    2016-01-01

    目的:3个临床麻醉药咪达唑仑(X1)、异丙酚(X2)与阿芬太尼(X3)单用和不同组合联用,可使手术病人获得不同的催眠作用。由于其间存在复杂的相互作用,已有的研究尚未完全阐明,有必要重新进行定量评价。方法本研究基于文献数据,采用权重配方模型进行定量分析和模拟研究,寻找临床优化组方。结果权重配方模型成功地建立,显示3个组分均存在明显的量效关系,其中X3>X2>X1,彼此间有较强的协同作用;联合使用的量效曲线较陡,受试者对联合用药敏感,易于获得满意疗效。通过基于最终模型的模拟,列出了若干种临床用药方案供临床选择应用。结论权重配方模型可以有效地应用于麻醉药相互作用分析,可提供临床联合用药所需的各类信息。%Objective To reevaluate the hypnotic interactions between midazolam, propofol and alfentanil by the approach of modeling and sim-ulation.Methods The weighted modification model was used to analyze the interactions among the three drugs based on the data from a published paper, and then the simulations of doses were conducted for combina-tions.Results The model was fitted to the data successfully, and indi-cated that the three drug presented an apparent dose-effect relationship with alfentanil >propofol >midazolam.The strong synergy existed a-mong the three drugs.The subjects showed a significant response to the combinations.The simulations displayed the schemes of combinations for clinical practice.Conclusion The weighted modification model is a valid approach to identify optical combinations for guiding rational admini-stration of the three drugs, and the model can fully interpret the characteristics of interactions.

  8. 复方丹参注射液对麻醉犬血流动力学的影响%Effect of Compound Radix Salivae Miltiorrhizae Injection on Hemodynamics of Anaesthetized Dogs

    Institute of Scientific and Technical Information of China (English)

    倪荷芳; 沈祥春

    2001-01-01

    目的 观察复方丹参注射液对麻醉家犬动脉收缩压SAP、DAP、MAP、HR、CO的影响。方法 用3%戊巴比妥纳静脉麻醉分离股静脉插入静脉插管、分离股功脉插入动脉插管,以测量动脉血压。结果 表明复方丹参注射液均可明显增加心输出量。结论 复方丹参注射液具有降低SAP、DAP、MAP,增加冠脉流量(CBF)和心输出量。%OBJECTIVE To observe the effect of Compound Radix SalivaeMiltiorrhizae Injection on the artery systolic pressure SAP, DAP, MAP, HR and CO of dogs. METHOD Intravenous anesthesia with 3% pentobarbital sodium was performed to dissociate the femoral vein and femoral artery so as to insert the vein and artery cannulae to measure blood pressure. RESULT Compound Radix Salivae Miltiorrhizae Injection can markedly increase cardiac output. CONCLUSION Compound Radix Salivae Miltiorrhizae Injection has the functions to reduce AP, DAP and MAP and increase coronary blood flow and cardiac output.

  9. Spontaneous breathing during anaesthesia: first, do no harm

    OpenAIRE

    2007-01-01

    Controlled respiration and mechanical ventilation have long been part of anaesthetic practice. Modern surgery, anaesthetic techniques, and new agents require a reappraisal of this established habit. In many circumstances the adverse effects of mechanical ventilation can be avoided by the use of the laryngeal mask and allowing spontaneous ventilation. In addition to the more prominent advantages, such as less sore throat, reliable assessment of anaesthetic depth, and good recovery, there may b...

  10. Use of brachial plexus blockade and medetomidine-ketamine-isoflurane anaesthesia for repair of radio-ulna fracture in an adult cheetah (acinonyx jubatus)

    OpenAIRE

    Kimeli, Peter; Mogoa, Eddy M; Mwangi, Willy E; Kipyegon, Ambrose N; Kirui, Gilbert; Muasya, Daniel W; John D. Mande; Kariuki, Edward; Mijele, Dominic

    2014-01-01

    Background Regional anaesthetic techniques have been used in combination with systemic analgesics during small animal surgery to provide multimodal analgesia. Brachial plexus nerves block using local anaesthetics provides analgesia of the thoracic limb through desensitization of the nerves that provide sensory and motor innervation. This has been shown to reduce intra-operative anesthetic requirements and provide postoperative pain relief. Decreasing the doses of general anaesthetics allows m...

  11. The cardiovascular and platelet actions of 9 beta-methyl carbacyclin (ciprostene), a chemically stable analogue of prostacyclin, in the dog and monkey.

    OpenAIRE

    Allan, G.; Follenfant, M. J.; Lidbury, P.; Oliver, P. L.; Whittle, B. J.

    1985-01-01

    9 beta-Methyl carbacyclin (9 beta Me; ciprostene) is a synthetic, chemically stable analogue of prostacyclin (PGI2; epoprostenol). The platelet anti-aggregating and cardiovascular effects of 9 beta Me have been compared to PGI2 in anaesthetized monkeys and dogs. In addition, their haemodynamic effects have been compared in open-chest anaesthetized dogs and conscious dogs. Intravenous infusion of 9 beta Me and PGI2 to the anaesthetized monkey resulted in a dose-dependent hypotension, tachycard...

  12. Operative blood transfusion quality improvement audit

    OpenAIRE

    Al Sohaibani, Mazen; Al Malki, Assaf; Pogaku, Venumadhav; Al Dossary, Saad; Al Bernawi, Hanan

    2014-01-01

    Context: To determine how current anesthesia team handless the identification of surgical anaesthetized patient (right patient). And the check of blood unit before collecting and immediately before blood administration (right blood) in operating rooms where nurses have minimal duties and responsibility to handle blood for transfusion in anaesthetized patients. Aims: To elicit the degree of anesthesia staff compliance with new policies and procedures for anaesthetized surgical patient the bloo...

  13. Cardiopulmonary and sedative effects of anaesthesia produced by climazolam in combination with medetomidine and fentanvl. An experimental study

    OpenAIRE

    Granholm, Mikael

    1993-01-01

    Kirurgia. Vain tiivistelmÀ. Koko työ lainattavissa Viikin tiedekirjastosta. In veterinary practice intraveneous anaesthesia has numerous advantages. An important advantage is the ease and rapidity of induction. Compared to administration of inhalant anaesthetics, a minimum of apparatus is necessary in administration of intraveneous anaesthetic agents. The possibility of antagonization of certain drugs used as intraveneous anaesthetics increases the safety of anaesthesia. The unpl...

  14. Hydrogen bonding and anaesthesia

    Science.gov (United States)

    Sándorfy, C.

    2004-12-01

    General anaesthetics act by perturbing intermolecular associations without breaking or forming covalent bonds. These associations might be due to a variety of van der Waals interactions or hydrogen bonding. Neurotransmitters all contain OH or NH groups, which are prone to form hydrogen bonds with those of the neurotransmitter receptors. These could be perturbed by anaesthetics. Aromatic rings in amino acids can act as weak hydrogen bond acceptors. On the other hand the acidic hydrogen in halothane type anaesthetics are weak proton donors. These two facts together lead to a probable mechanism of action for all general anaesthetics.

  15. Perioperative management of a patient with Gilberts syndrome and rheumatic heart disease

    OpenAIRE

    Ranjan, R. V.; Ramachandran, T. R.; David George Veliath; Diana Coelho

    2012-01-01

    Anaesthetic management of patients with hepatic dysfunction can be quite challenging, as many anaesthetic agents are metabolized by liver. Heart disease on anti coagulation can pose additional challenge. Here we report a case of Gilbert's syndrome with rheumatic heart disease on anti coagulation posted for elective hernia repair.

  16. A systematic review of peri-operative melatonin

    DEFF Research Database (Denmark)

    Andersen, L P H; Werner, M U; Rosenberg, J;

    2014-01-01

    We systematically reviewed randomised controlled trials of peri-operative melatonin. We included 24 studies of 1794 participants that reported eight peri-operative outcomes: anxiety; analgesia; sleep quality; oxidative stress; emergence behaviour; anaesthetic requirements; steal induction; and......%, respectively. Qualitative reviews suggested the melatonin improved sleep quality and emergence behaviour, and might be capable of reducing oxidative stress and anaesthetic requirements....

  17. Cardiac Catheterization in Thoraco-Omphalocardiopagus Twins: A Case Report

    Directory of Open Access Journals (Sweden)

    Minati Choudhury

    2008-01-01

    literature on the anaesthetic management of these cases is sparse. The following case report details the expert and vigilant anaesthetic management leading to successful diagnostic cardiac catheterization. The report emphasizes the importance of synchronous ventilation, teamwork and communication required in cases such as this. This case report also details the difficulties encountered and how to overcome them during the prolonged procedure.

  18. GENERAL ANAESTHESIA FOR A CHILD WITH CLEIDOCRANIAL DYSPLASIA: A CASE REPORT

    OpenAIRE

    Sangeetha; Kevin Koshy; Shabna; Mangesh

    2014-01-01

    We present a case of a child with Cleidocranial Dysplasia (CD) undergoing multiple teeth extraction. This is an autosomal dominant skeletal dysplasia characterized by developmental abnormalities of bony structures such as supernumerary teeth, brachycephalic skull, short stature and hypoplastic or aplastic clavicles. These structural abnormalities may pose challenges to anaesthetic management. However, there are only limited literatures describing anaesthetic implications o...

  19. Iatrogenic psoas abscess. Case report

    DEFF Research Database (Denmark)

    Bernstein, Inge Thomsen; Hansen, B J

    1991-01-01

    A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago.......A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago....

  20. Caudal bupivacaine supplemented with caudal or intravenous clonidine in children undergoing hypospadias repair

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Henneberg, Steen Winther; Walther-Larsen, Søren;

    2004-01-01

    Clonidine is used increasingly in paediatric anaesthetic practice to prolong the duration of action of caudal block with a local anaesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and i.v. clonidine...... on postoperative analgesia produced by caudal bupivacaine after hypospadias repair....

  1. Caudal bupivacaine supplemented with caudal or intravenous clonidine in children undergoing hypospadias repair: a double-blind study

    DEFF Research Database (Denmark)

    Hansen, T G; Henneberg, S W; Walther-Larsen, S;

    2004-01-01

    Clonidine is used increasingly in paediatric anaesthetic practice to prolong the duration of action of caudal block with a local anaesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and i.v. clonidine...... on postoperative analgesia produced by caudal bupivacaine after hypospadias repair....

  2. Anaesthesia for non-obstetric surgery during pregnancy

    Directory of Open Access Journals (Sweden)

    Madhusudan Upadya

    2016-01-01

    Full Text Available Non-obstetric surgery during pregnancy posts additional concerns to anaesthesiologists. The chief goals are to preserve maternal safety, maintain the pregnant state and achieve the best possible foetal outcome. The choice of anaesthetic technique and the selection of appropriate anaesthetic drugs should be guided by indication for surgery, nature, and site of the surgical procedure. Anaesthesiologist must consider the effects of the disease process itself and inhibit uterine contractions and avoid preterm labour and delivery. Foetal safety requires avoidance of potentially dangerous drugs and assurance of continuation of adequate uteroplacental perfusion. Until date, no anaesthetic drug has been shown to be clearly dangerous to the human foetus. The decision on proceeding with surgery should be made by multidisciplinary team involving anaesthesiologists, obstetricians,surgeons and perinatologists. This review describes the general anaesthetic principles, concerns regarding anaesthetic drugs and outlines some specific conditions of non-obstetric surgeries.

  3. 意识指数监测用于无痛结肠镜检查麻醉中药物应用的指导意义%The instructional significance of monitoring on index of consciousness to the drug application for anaesthetic in the pa-tients checked with painless colonoscopy

    Institute of Scientific and Technical Information of China (English)

    林艳君; 杨晓辉; 杨占民

    2015-01-01

    Objective To discuss the advantage of index of consciousness (IOC) used in patients undergoing painless colonoscopy. Methods 100 patients aged 18~65 with ASAⅠ~Ⅱwere randomly divided into group A (propofol) and group B (propofol with IOC). Propofol was adjusted by consciousness and hemodynamics in group A,while by IOC and hemodynamics in group B. IOC was controlled at 40~60. The total amount of propofol,the awakening and replying time and adverse reaction were recorded. Results Compared with group A,the total amount of propofol,the awakening and replying time were less or shorter in group B. The occurrence rate of adverse reaction of respiratory depression, nausea and vomiting, bradyrhythmia in group B was lower than group A (P0.05). Conclusion IOC monitoring can reach a more reasonable anesthesia depth with propofol in painless colonoscopy, it can decrease the dose of propofol and adverse reaction, also recover rapidly.%目的:观察意识指数(IOC)用于无痛结肠镜检查麻醉中药物应用的指导意义。方法100例ASAⅠ~Ⅱ级接受无痛结肠镜检查的患者,年龄18~65岁,随机分成2组:单纯异丙酚组(A组)与IOC 监测异丙酚组(B 组),各50例。A 组根据患者意识和血流动力学调整异丙酚用量,B组根据IOC值和血流动力学调整异丙酚用量,检查中维持IOC值40~60。分别记录异丙酚总量、苏醒和应答时间及不良反应情况。结果2组患者均顺利完成检查,与A 组比较,B组的异丙酚总量减少,苏醒和应答时间均缩短(P<0.05)。 B组呼吸抑制、恶心呕吐、心动过缓的不良反应发生率明显低于A组,B组体动发生多于A组,但两组的发生率未见明显统计学差异。结论 IOC监测下异丙酚用于无痛结肠镜检查可以达到更合理的麻醉深度,并减少异丙酚用量,术后恢复快,不良反应少。

  4. 老年患者腰麻联合静脉应用右美托咪定的麻醉效应与安全性%Anaesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine in elderly patients

    Institute of Scientific and Technical Information of China (English)

    储靖; 李宏; 张强

    2013-01-01

    Objective To evaluate anesthetic effect and safety of lumbar anesthesia combined with intravenous dexmedetomidine (DMT) in elderly patients.Methods The elderly patients (aged 65 to 75 years) undergoing prostate electrocision through urethra from January 2012 to May 2013 in Logistics College Hospital of Chinese People's Armed Police Forces were enrolled into this study and were divided into DMT group and control group using a random number table.The patients in the two groups received bupivacaine (5.0 mg/ml) 2.0 ml for lumbar anesthesia.The patients in the DMT group received a slow intravenous bolus of DMT (0.5 μg/kg) before anesthesia and pumped DMT continuously at a rate of 0.5 μg/(kg · h) until the end of operation.The patients in the control group received the same volume of 0.9% sodium chloride solution for injection at the same rate.The anesthetic effects (maximal sensory block plane and regression time,sedation score),adverse reactions and the residence time in post anesthesia care uint were compared between the two groups.Results A total of 86 patients were enrolled into this study.DMT group comprised 43 cases with the average age of (69 ± 5) years and the control group comprised 43 cases with the average age of (71 ± 6) years.There were no significant differences in the systolic pressure,diastolic pressure,heart rate,pulse oxygen saturation (SpO2) and maximal sensory block plane of patients during the operation between the two groups.The differences of regression time of maximal sensory block plane,sedation score during operation,incidence of hypotension,incidence of bradycardia,and the residence time in post anesthesia care unit between DMT group and the control group were (223 ± 38) min vs.(155±26) min,(4.2±1.9) vs.(2.1±1.3),20.9%(9 cases) vs.2.3%(1 case),44.2%(19 cases) vs.4.7% (2 cases),and (245 ±43) min vs.(195 ± 38) min,respectively.The differences were statistically significant (all P < 0.05).The difference in incidence of excessive sedation between DMT group and the control group [9.3% (4 cases)vs.0] was not statistically significant,the incidence of low pulse oxygen saturation [14.0% (6 cases) vs 0] was statistically significant (P < 0.05).The patients who developed hypotension,bradycardia and low pulse oxygen saturation received ephedrine,atropine and oxygen,respectively.The patients' above-mentioned symptoms were improved after the treatment.Conclusions Lumbar anesthesia combined with intravenously DMT may enhance the effects of analgesia and sedation,and is relatively safe for elderly patients.The clinician should pay attention to the adverse reactions such as hypotension,bradycardia and low pulse oxygen saturation.The monitoring of adverse reactions should be intensified.Once adverse reactions develop,the symptomatic treatment should be given.%目的 评估老年患者腰麻联合静脉应用右美托咪定(DMT)的麻醉效应和安全性.方法 2012年1月至2013年5月在武警后勤学院附属医院拟行经尿道前列腺电切术的老年患者(65 ~75岁)纳入本研究,用随机数字表法随机分为DMT组和对照组.2组患者均用5.0 mg/ml布比卡因2.0 ml腰麻,腰麻前DMT组缓慢静脉注射DMT 0.5 μg/kg,并以0.5 μg/(kg·h)的速度持续静脉泵入至手术结束.对照组以相同速度静脉注射及泵入等容量0.9%氯化钠注射液.比较2组患者的麻醉效应(最高感觉阻滞平面及其消退时间、镇静评分)、不良反应发生情况和在麻醉后监护病房(PACU)的停留时间.结果 86例患者纳入本研究.DMT组43例,平均年龄(69±5)岁;对照组43例,平均年龄(71±6)岁.2组患者术中收缩压、舒张压、心率、脉搏血氧饱和度及最高感觉阻滞平面的差异均无统计学意义.DMT组与对照组比较,最高感觉阻滞平面消退时间[(223±38) min比(155±26)min]、术中镇静评分[(4.2±1.9)分比(2.1±1.3)分]、低血压发生率[20.9%(9例)比2.3%(1例)]、心动过缓发生率[44.2%(19例)比4.7%(2例)]、在PACU停留时间[(245 ± 43) min比(195 ±38)min]及低氧饱和度发生率[14.0%(6例)比0]的差异均有统计学意义(均P<0.05).过度镇静发生率[9.3%(4例)比0]差异无统计学意义(P>0.05).对出现血压降低、心动过缓和低氧饱和度的患者分别予以麻黄碱、阿托品及吸氧后,症状均得到改善.结论 老年患者行腰麻联合静脉应用DMT可增强镇痛与镇静效果且较为安全.应警惕心动过缓、低血压、低氧饱和度等不良反应,加强监测并及时处理.

  5. Comparación del efecto anestésico del aceite de clavo, solución salina y solución coloidal en juveniles de Chirostoma jordani (Woolman, 1894) Comparison of anaesthetic effect of clove oil, saline solution and colloidal solution in juvenile Chirostoma jordani (Woolman, 1894)

    OpenAIRE

    G. Vázquez; Castro, T.; Hernández, A.; Castro, J.; Lara, R.

    2013-01-01

    Los peces de la especie Chirostoma jordani presentan un intenso estrés durante las prácticas de manejo, dejándolos susceptibles a enfermedades y a tasas altas de mortalidad. El objetivo del presente estudio fue comparar el efecto anestésico del aceite de clavo, solución salina y una solución coloidal (Pentabiocare) en juveniles de Chirostoma jordani. Para cada tratamiento se utilizaron 18 ejemplares de C. jordani de dos meses de edad. Los tratamientos constaron en aceite de clavo (5, 8, 13 y ...

  6. Anestetiklerin Özelliklerini Ve Nitroz-Oksit-Oksijen-Sıvı Anestezinin Kısa Bir Tarihi

    OpenAIRE

    UYANIK, A.; ŞAHİNOĞLU, A.H.

    2010-01-01

    Properties of Anaesthetics and a Brief History of Nitrous Oxide-Oxygen-Liquid Anaesthetic Anesthesia %/ In this paper, the physical, chemical, physico-chemical properties of the commonly used gas and liquid anaesthetics and a brief history of nitrous oxide-oxygen-liquid anaesthe¬tic anaesthesia are reviewed. Bu makalede, günümüz anestezisinde yaygın olarak kullanılan gaz ve sıvı anestetiklerin fiziksel, kimyasal, fızikokimyasal özellikleri ve tarihçesi hakkında özet bilgi verilmiştir...

  7. Asystole Following Profound Vagal Stimulation During Hepatectomy

    Directory of Open Access Journals (Sweden)

    Preeta John

    2008-01-01

    Full Text Available Asystole in a non laparoscopic upper abdominal surgery following intense vagal stimulation is a rare event. This case report highlights the need for awareness of such a complication when a thoracic epidural anaesthetic has been given in addition to a general anaesthetic for an upper abdominal procedure. A combined thoracic epidural and general anaesthetic was given. The anterior abdominal wall was retracted forty minutes after administration of the epidural bolus. This maneuver resulted in a profound vagal response with bradycardia and asystole. The patient was resuscitated successfully with a cardiac massage, atropine and adrenaline and the surgery was resumed. Surgery lasted eleven hours and was uneventful.

  8. Epidural anaesthesia and analgesia - effects on surgical stress responses and implications for postoperative nutrition

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, H

    2002-01-01

    : Epidural local anaesthetic blockade of afferent stimuli reduces endocrine metabolic responses, and improve postoperative catabolism. Furthermore, dynamic pain relief is achieved with improved pulmonary function and a pronounced reduction of postoperative ileus, thereby providing optimal conditions for...

  9. EFFECTS OF ANESTHESIA (MS222) ON LIVER BIOTRANSFORMATION IN RAINBOW TROUT (ONCORHYNCHUS MYKISS)

    Science.gov (United States)

    Tricaine methanesulfonate (3-aminobenzoic acid ethyl ester methanesulfonate; MS222) is a widely used fish anaesthetic. While there have been several studies addressing the impact of its use on subsequently measured biotransformation rates, the measured influence on normal functio...

  10. Ultrasound-guided locoregional anaesthesia for carotid endarterectomy

    DEFF Research Database (Denmark)

    Martusevicius, Robertas; Swiatek, F; Joergensen, L G;

    2012-01-01

    Ultrasound guidance is increasingly used for invasive anaesthetic procedures to improve efficacy, facilitate performance and reduce risk of complications. Herein, we present a simple approach to ultrasound-guided locoregional anaesthesia for patients undergoing eversion carotid endarterectomy....

  11. Plants and Medicinal Chemistry--2

    Science.gov (United States)

    Bailey, D.

    1977-01-01

    Second of a two part article on the influence of plants on medicinal chemistry. This part considers how drugs work, the attempts to develop anaesthetics safer than cocaine, and useful poisons. (Author/SL)

  12. Survey of the use of rapid sequence induction in the accident and emergency department

    OpenAIRE

    Walker, A.; Brenchley, J

    2000-01-01

    Objectives—To determine the current position regarding the use of rapid sequence induction (RSI) by accident and emergency (A&E) medical staff and the attitudes of consultants in A&E and anaesthetics towards this.

  13. Membrane-Introduction Mass Spectrometry Analysis of Desflurane, Propofol and Fentanyl in Plasma and Cerebrospinal Fluid for Estimation BBB Properties.

    Science.gov (United States)

    Cherebillo, Vyacheslav Yu; Elizarov, Andrei Yu; Polegaev, Andrei V

    2015-09-01

    A possibility to use the Membrane-Introduction Mass Spectrometry (MIMS) with membrane separator interface has evolved into a powerful method for measurement of anaesthetic agents absolute concentration in blood plasma and cerebrospinal fluid for the study of blood-brain barrier (BBB) properties. Recent advanced a new membrane material was used for drug concentration measurement in biologic fluids. A hydrophobic membrane was used in the interface to separate anaesthetic agents from biological fluids: inhalational anaesthetic desflurane,hypnotic propofol, analgesic fentanyl. The selective detection of volatile anesthetic agents in blood does not require long-term sample processing before injecting the sample into mass-spectrometer interface, in contrast to chromatographic methods. Mass-spectrometric interface for the measurement of anaesthetic agent concentration in biological fluids (blood plasma and cerebrospinal fluid) is described. Sampling of biological fluids was performed during balanced inhalational (desflurane, fentanyl) anaesthesia and total intravenous (propofol, fentanyl) anaesthesia. PMID:26412969

  14. Inhibition by substance P of some peripheral actions of acetylcholine in the cat

    OpenAIRE

    Clark, S.L.; Ryall, R. W.

    1982-01-01

    1 The effect of substance P on contractions of the nictitating membrane and pressor responses to acetylcholine (ACh) and dimethylphenyl-piperazinium (DMPP) which were mediated via nocotinic receptors was studied in cats anaesthetized with chloralose.

  15. Thrombelastographische Blutgerinnungsuntersuchungen gesunder Schweine unter Xenonmono- bzw. einer Kombinationsnarkose aus Xenon und den volatilen Inhalationsanästhetika Isofluran, Sevofluran, Halothan und Enfluran

    OpenAIRE

    Schorn, Britta Jeanette

    2005-01-01

    Background: Before introducing new anaesthetics into clinical practice possible side effects have to be studied. This study was performed to clarify whether xenon anaesthesia or xenon in combinations with other volatile anaesthetics, such as isoflurane, sevflurane, halothane or enflurane alter blood coagulation.Methods: The study was performed with 40 healthy pigs. They first underwent xenon monoanaesthesia (65 Vol%) and were then randomly assigned to combinations of xenon and isoflurane, xen...

  16. Anaesthesia and airway management in mucopolysaccharidosis

    OpenAIRE

    Walker, Robert; Belani, Kumar G.; Braunlin, Elizabeth A.; Bruce, Iain A.; Hack, Henrik; Harmatz, Paul R.; Jones, Simon; Rowe, Richard; Solanki, Guirish A.; Valdemarsson, Barbara

    2012-01-01

    This paper provides a detailed overview and discussion of anaesthesia in patients with mucopolysaccharidosis (MPS), the evaluation of risk factors in these patients and their anaesthetic management, including emergency airway issues. MPS represents a group of rare lysosomal storage disorders associated with an array of clinical manifestations. The high prevalence of airway obstruction and restrictive pulmonary disease in combination with cardiovascular manifestations poses a high anaesthetic ...

  17. Anatomical Variations in the Emergence of the Cutaneous Nerves from the Nerve Point in the Neck and Identification of the Landmarks to Locate the Nerve Point with Its Clinical Implications: A Cadaveric Study on South Indian Human Foetuses

    OpenAIRE

    Gupta, Chandni; D’Souza, Antony Sylvan; Raythe, Biswabswabina

    2013-01-01

    Objective: The cutaneous nerves from the cervical plexuses are anaesthetized by using local anaesthetics for pain relief or when minor surgical operations are performed. Knowing the variations in these nerves is important for anaestheticists to administer an effective anaesthesia to a particular nerve. So, the aim of this study was to look for the variations in the emerging patterns of the cervical cutaneous nerves in the neck and to locate the nerve point in the neck by using the superficial...

  18. Re-evaluation of hyaluronidase in peribulbar anaesthesia.

    OpenAIRE

    Prosser, D P; Rodney, G E; Mian, T; Jones, H. M.; Khan, M Y

    1996-01-01

    AIMS/BACKGROUND: Hyaluronidase can augment the actions of local anaesthetics in peribulbar anaesthesia. However, evidence suggests satisfactory anaesthesia can be achieved using mixtures without hyaluronidase. A randomised double blind study was conducted on 50 patients, undergoing peribulbar anaesthesia, to validate this observation. METHODS: Patients received a standard mixture of local anaesthetic (0.5% bupivacaine and 2% lignocaine in a 1:1 ratio) with or without hyaluronidase (25 IU/ml o...

  19. Liposuction: Anaesthesia challenges

    OpenAIRE

    Jayashree Sood; Lakshmi Jayaraman; Nitin Sethi

    2011-01-01

    Liposuction is one of the most popular treatment modalities in aesthetic surgery with certain unique anaesthetic considerations. Liposuction is often performed as an office procedure. There are four main types of liposuction techniques based on the volume of infiltration or wetting solution injected, viz dry, wet, superwet, and tumescent technique. The tumescent technique is one of the most common liposuction techniques in which large volumes of dilute local anaesthetic (wetting solution) are...

  20. Membrane-Introduction Mass Spectrometry Analysis of Desflurane, Propofol and Fentanyl in Plasma and Cerebrospinal Fluid for Estimation BBB Properties

    OpenAIRE

    Cherebillo, Vyacheslav Yu.; Elizarov, Andrei Yu.; Polegaev, Andrei V.

    2015-01-01

    A possibility to use the Membrane-Introduction Mass Spectrometry (MIMS) with membrane separator interface has evolved into a powerful method for measurement of anaesthetic agents absolute concentration in blood plasma and cerebrospinal fluid for the study of blood-brain barrier (BBB) properties. Recent advanced a new membrane material was used for drug concentration measurement in biologic fluids. A hydrophobic membrane was used in the interface to separate anaesthetic agents from biological ...

  1. Cardiac Catheterization in Thoraco-Omphalocardiopagus Twins: A Case Report

    OpenAIRE

    Minati Choudhury; Usha Kiran

    2008-01-01

    The incidence of conjoined twin is rare and anaesthesia for procedures on conjoined twins is a demanding, exacting and meticulous exercise, whether prior to or during separation. literature on the anaesthetic management of these cases is sparse. The following case report details the expert and vigilant anaesthetic management leading to successful diagnostic cardiac catheterization. The report emphasizes the importance of synchronous ventilation, teamwork and communication required in cases...

  2. Anaesthesia for head and neck surgery: United Kingdom National Multidisciplinary Guidelines

    OpenAIRE

    Charters, P; Ahmad, I.; Patel, A; Russell, S

    2016-01-01

    This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The anaesthetic considerations for head and neck cancer surgery are especially challenging given the high burden of concurrent comorbidity in this patient group and the need to share the airway with the surgical team. This paper provides recommendations on the anaesthetic considerations during surgery for head and neck cancer. Recommendations • All theatre sta...

  3. GENERAL ANAESTHESIA FOR A CHILD WITH CLEIDOCRANIAL DYSPLASIA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sangeetha

    2014-12-01

    Full Text Available We present a case of a child with Cleidocranial Dysplasia (CD undergoing multiple teeth extraction. This is an autosomal dominant skeletal dysplasia characterized by developmental abnormalities of bony structures such as supernumerary teeth, brachycephalic skull, short stature and hypoplastic or aplastic clavicles. These structural abnormalities may pose challenges to anaesthetic management. However, there are only limited literatures describing anaesthetic implications of CD patients. Characteristics of this genetic disorder and implications for the anaesthesiologist are discussed.

  4. Anaesthesia of conjoined twins - case series.

    Science.gov (United States)

    Kobylarz, Krzysztof

    2014-01-01

    As any complex surgical procedure, separation of conjoined twins requires complex anaesthesia management that is a prerequisite of performing the operation, while complex postoperative care is a decisive factor in the survival of the patients. The paper describes the anaesthetic management for surgical operations in ten sets of conjoined twins in the Children's Hospital of Cracow during 1977-2005. The anaesthetic technique and associated problems are summarized. PMID:24858964

  5. Generelle anæstetika potentielle neurotoksicitet for den immature hjerne

    DEFF Research Database (Denmark)

    Clausen, Nicola G; Venø, Søren; Astvad, Mads;

    2014-01-01

    Animal studies (including non-human primates) have shown that most general anaesthetics cause enhanced neuroapoptosis with subsequent long-term neurocognitive deficits later in life. Some human cohort studies have indicated an association between anaesthesia/surgery and adverse neurocognitive...... outcome whereas other studies have not. Overall, the data do not justify any change in paediatric anaesthetic clinical practice. Naturally, the risks and benefits of a procedure should always be carefully considered before exposing a child to general anaesthesia....

  6. Comparison of sigma- and kappa-opiate receptor ligands as excitatory amino acid antagonists.

    OpenAIRE

    Berry, S. C.; Dawkins, S. L.; Lodge, D.

    1984-01-01

    Using the technique of microelectrophoresis in pentobarbitone-anaesthetized cats and rats, the effects of benzomorphans, with known actions at sigma- and kappa- opioid receptors, were tested on responses of spinal neurones to amino acids and acetylcholine. The racemic mixture and both enantiomers of the sigma opiate receptor agonist, N-allylnormetazocine (SKF 10, 047), and the dissociative anaesthetic, ketamine, reduced or abolished excitation evoked by N-methyl-aspartate (NMA) with only smal...

  7. Unusual cause of the subcapsular renal haematoma

    International Nuclear Information System (INIS)

    In 2 woman patients, the authors found subcapsular renal haematomas after paravertebral injection of a local anaesthetic as part of lumbago treatment. Clinical course and radiological findings are demonstrated. Whereas formation of subcapsular renal haematomas is a well-known phenomenon after traumas, iatrogenic and intentional punctures and a few renal and general diseases, renal lesion after paravertebral injection of a local anaesthetic is an extremely rare occurrence. (orig.)

  8. Intubation after rapid sequence induction performed by non-medical personnel during space exploration missions: a simulation pilot study in a Mars analogue environment

    OpenAIRE

    Komorowski, Matthieu; Fleming, Sarah

    2015-01-01

    Background The question of the safety of anaesthetic procedures performed by non anaesthetists or even by non physicians has long been debated. We explore here this question in the hypothetical context of an exploration mission to Mars. During future interplanetary space missions, the risk of medical conditions requiring surgery and anaesthetic techniques will be significant. On Earth, anaesthesia is generally performed by well accustomed personnel. During exploration missions, onboard medica...

  9. Lidoflazine in the early stages of acute myocardial ischaemia.

    OpenAIRE

    Coker, S. J.; Fagbemi, O.; Parratt, J R

    1982-01-01

    1 Pretreatment of anaesthetized rats with intravenously administered lidoflazine (an antianginal agent) reduced the incidence and severity of ventricular arrhythmias which resulted from acute coronary artery ligation. Ventricular fibrillation was completely prevented by doses of 50 micrograms/kg and 2 mg/kg and no animal so treated died ( contrast 50% incidence of fibrillation in the controls and 30% mortality). 2 In anaesthetized greyhound dogs, lidoflazine (2 mg/kg) administration resulted ...

  10. Bispectral index-guided anaesthesia for off-pump coronary artery bypass grafting

    OpenAIRE

    Muralidhar Kanchi; Banakal Sanjay; Murthy Keshav; Garg Rajneesh; Rani G; Dinesh R

    2008-01-01

    Bispectral index (BIS) monitoring may assist reduction in utilisation of anaesthetic agents during general surgical procedures. This study was designed to test whether the use of BIS monitoring reduces the anaesthetic requirements during off-pump coronary artery bypass grafting (CABG). This prospective - clinical trial was conducted on 40 adult patients undergoing elective off-pump CABG. Patients received either isoflurane or propofol anaesthesia. BIS monitoring, which guided the dose of anae...

  11. Untersuchungen zur Wirksamkeit und Gewebeverträglichkeit von Lokalanästhetika bei der Kastration männlicher Saugferkel

    OpenAIRE

    Zankl, Anke

    2007-01-01

    Analysis of efficacy and tissue tolerance of local anaesthetics administered prior to castration of male suckling piglets Objective of this project was to examine the efficacy and tissue tolerance of various local anaesthetics used in castration of male suckling piglets. Four to six days old healthy animals were randomized into trial groups (I to IX). Animals of the control groups (I to IV) were treated analogous to the castration groups (V to IX) but not castrated. In groups "Handlin...

  12. Molecular and cellular mechanisms of general anaesthesia

    Science.gov (United States)

    Franks, N. P.; Lieb, W. R.

    1994-02-01

    General anaesthetics are much more selective than is usually appreciated and may act by binding to only a small number of targets in the central nervous system. At surgical concentrations their principal effects are on ligand-gated (rather than voltage-gated) ion channels, with potentiation of postsynaptic inhibitory channel activity best fitting the pharmacological profile observed in general anaesthesia. Although the role of second messengers remains uncertain, it is now clear that anaesthetics act directly on proteins rather than on lipids.

  13. Extracapsular cataract extraction under local anaesthesia without retrobulbar injection.

    OpenAIRE

    Redmond, R M; Dallas, N L

    1990-01-01

    Day-case cataract surgery and the need for local anaesthesia are likely to increase. Retrobulbar (and peribulbar) anaesthetic injection is a common technique in cataract surgery, but serious complications are persistently reported. Subconjunctival injection is an alternative that avoids these risks. This retrospective study compares two groups of patients that underwent extracapsular cataract surgery under local anaesthetic. One group (retrobulbar) had uncomplicated retrobulbar injection with...

  14. Intravenous anaesthesia in goats: A review

    Directory of Open Access Journals (Sweden)

    T. Brighton Dzikiti

    2013-02-01

    Full Text Available Intravenous anaesthesia is gradually becoming popular in veterinary practice. Traditionally, general anaesthesia is induced with intravenous drugs and then maintained with inhalation agents. Inhalation anaesthetic agents cause more significant dose-dependent cardiorespiratory depression than intravenous anaesthetic drugs, creating a need to use less of the inhalation anaesthetic agents for maintenance of general anaesthesia by supplementing with intravenous anaesthesia drugs. Better still, if anaesthesia is maintained completely with intravenous anaesthetic drugs, autonomic functions remain more stable intra-operatively. Patient recovery from anaesthesia is smoother and there is less pollution of the working environment than happens with inhalation anaesthetic agents. Recently, a number of drugs with profiles (pharmacokinetic and pharmacodynamic suitable for prolonged intravenous anaesthesia have been studied, mostly in humans and, to a certain extent, in dogs and horses. There is currently very little scientific information on total intravenous anaesthesia in goats, although, in the past few years, some scholarly scientific articles on drugs suitable for partial intravenous anaesthesia in goats have been published. This review article explored the information available on drugs that have been assessed for partial intravenous anaesthesia in goats, with the aim of promoting incorporation of these drugs into total intravenous anaesthesia protocols in clinical practice. That way, balanced anaesthesia, a technique in which drugs are included in anaesthetic protocols for specific desired effects (hypnosis, analgesia, muscle relaxation, autonomic stabilisation may be utilised in improving the welfare of goats undergoing general anaesthesia.

  15. Anaesthesia for a child with adrenoleukodystrophy: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sien Hui Tan

    2014-01-01

    Full Text Available We present a 9-year-old boy with X-linked cerebral adrenoleukodystrophy (X-linked ALD and previous umbilical cord transplant who required general anaesthesia. An anaesthetic plan for each individual should be tailored to ensure the best possible anaesthetic care for these patients. The anaesthetic considerations include mental retardation, seizure disorder, hypotonia, liver function abnormalities, gastro-oesophageal reflux, impaired adrenocortical function and immunosuppression. Pre-operative sedation should be avoided because of hypotonia of the pharyngeal muscles. Anti-convulsants are continued, and potentially epileptogenic anaesthetic agents are avoided. The patient was intubated using a modified rapid sequence induction with a head up position of 30 degrees. Four other cases have been reported in literature. Nevertheless, there is still no established anaesthetic management for these patients, and total intravenous anaesthesia can be considered as a safe and alternative method of anaesthesia. To the best of our knowledge, this is the first reported use of total intravenous anaesthesia with propofol and remifentanil in a case of cerebral adrenoleukodystrophy, and with a favourable outcome.

  16. Oxidative and antioxidative effects of desflurane and sevoflurane on rat tissue in vivo

    International Nuclear Information System (INIS)

    General anaesthetics are often used in patients who are under oxidative stress due to a critical illness or surgical trauma. Some anaesthetics may worsen oxidative stress and some may act as antioxidants. The aim of this study was to evaluate liver, brain, kidney, and lung tissue oxidative stress in rats exposed to desflurane and sevoflurane and in unexposed rats. The animals were divided in three groups: control (received only air); sevoflurane (8 %), and desflurane (4 %). After four hours of exposure, we evaluated the levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), Cu, and Zn. Exposure to either of the anaesthetics significantly increased lung MDA levels compared to control (Mann-Whitney U test; P<0.05), probably because it is the tissue directly exposed to anaesthetic gases. Oxidative stress and antioxidant activity in other tissues varied between the desflurane and sevoflurane groups. Our results suggest that anaesthesiologist should not only be aware of the oxidative or antioxidative potential of anaesthetics they use, but should also base their choices on organs which are the most affected by their oxidative action. (authors)

  17. Anaesthesia practice and reproductive outcomes: Facts unveiled

    Directory of Open Access Journals (Sweden)

    Amrutha Bindu Nagella

    2015-01-01

    Full Text Available Background and Aims: Anaesthetic practice is associated with a risk of chronic exposure to anaesthetic agents. With the advent of newer inhalational agents and changing anaesthetic practices, the risks for anaesthesiologists with regard to adverse reproductive outcomes is unknown. Hence, a nationwide online survey was conducted to study the anaesthetic practices prevalent in India and their association, if any, with poor reproductive outcomes. Methods: The online survey involved 9974 anaesthesiologists. A questionnaire soliciting information regarding anaesthetic practice techniques, reproductive outcomes and perinatal outcomes was designed. All the anaesthesiologists in the ISA National database were mailed a link to the above questionnaire. Results: Female anaesthesiologists and spouses of male anaesthesiologists had a higher incidence of first trimester spontaneous abortions than the general population. Female anaesthesiologists when compared with spouses of male anaesthesiologists faced more difficulty with conception (P = 0.015. Female anaesthesiologists who worked in the operating room (OR in their first trimester of gestation had a higher incidence of spontaneous abortions than those who did not work in the OR (P = 0.05. Longer hours of general anaesthesia conducted in the first trimester of pregnancy was associated with a higher risk of birth defects in their progeny (P = 0.05. Conclusion: Spontaneous abortions and birth defects were higher in female anaesthesiologists who worked in the OR in the first trimester of gestation. Both female anaesthesiologists and spouses of male anaesthesiologists had a greater risk for a first trimester miscarriage than the general population.

  18. Anaesthesia for positron emission tomography scanning of animal brains.

    Science.gov (United States)

    Alstrup, Aage Kristian Olsen; Smith, Donald F

    2013-01-01

    Positron emission tomography (PET) provides a means of studying physiological and pharmacological processes as they occur in the living brain. Mice, rats, dogs, cats, pigs and non-human primates are often used in studies using PET. They are commonly anaesthetized with ketamine, propofol or isoflurane in order to prevent them from moving during the imaging procedure. The use of anaesthesia in PET studies suffers, however, from the drawback of possibly altering central neuromolecular mechanisms. As a result, PET findings obtained in anaesthetized animals may fail to correctly represent normal properties of the awake brain. Here, we review findings of PET studies carried out either in both awake and anaesthetized animals or in animals given at least two different anaesthetics. Such studies provide a means of estimating the extent to which anaesthesia affects the outcome of PET neuroimaging in animals. While no final conclusion can be drawn concerning the 'best' general anaesthetic for PET neuroimaging in laboratory animals, such studies provide findings that can enhance an understanding of neurobiological mechanisms in the living brain. PMID:23349451

  19. The in vivo genotoxicity of cisplatin, isoflurane and halothane evaluated by alkaline comet assay in Swiss albino mice.

    Science.gov (United States)

    Brozovic, Gordana; Orsolic, Nada; Knezevic, Fabijan; Horvat Knezevic, Anica; Benkovic, Vesna; Sakic, Katarina; Borojevic, Nikola; Dikic, Domagoj

    2011-08-01

    The aim of this study was to evaluate the genotoxicity of repeated exposure to isoflurane or halothane and compare it with the genotoxicity of repeated exposure to cisplatin. We also determined the genotoxicity of combined treatment with inhalation anaesthetics and cisplatin on peripheral blood leucocytes (PBL), brain, liver and kidney cells of mice. The mice were divided into six groups as follows: control, cisplatin, isoflurane, cisplatin-isoflurane, halothane and cisplatin-halothane, and were exposed respectively for three consecutive days. The mice were treated with cisplatin or exposed to inhalation anaesthetic; the combined groups were exposed to inhalation anaesthetic after treatment with cisplatin. The alkaline comet assay was performed. All drugs had a strong genotoxicity (Pdamage on the PBL and kidney cells, in contrast to halothane, which had stronger genotoxicity on brain and liver cells. The combination of cisplatin and isoflurane induced lower genotoxicity on PBL than isoflurane alone (Pbrain cells, but in the combined treatment with cisplatin, the effect decreased to the level of cisplatin alone. Halothane also induced the strongest DNA damage of the liver cells, while the combination with cisplatin increased its genotoxicity even more. The genotoxicity of cisplatin and isoflurane on kidney cells were nearly at the same level, but halothane caused a significantly lower effect. The combinations of inhalation anaesthetics with cisplatin had stronger effects on kidney cells than inhalation anaesthetics alone. The observed drugs and their combinations induced strong genotoxicity on all of the mentioned cells. PMID:21509577

  20. The effects of ropivacaine hydrochloride on coagulation and fibrinolysis. An assessment using thromboelastography.

    LENUS (Irish Health Repository)

    Porter, J M

    2012-02-03

    Amide local anaesthetics impair coagulation by inhibition of platelet function and enhanced fibrinolysis. The potential therefore exists that the presence of amide local anaesthetics in the epidural space could contribute to the therapeutic failure of an epidural autologous blood patch. Ropivacaine is an aminoamide local anaesthetic increasingly used for epidural analgesia and anaesthesia, particularly in obstetric practice. This study was undertaken to investigate whether concentrations of ropivacaine in blood, which could occur clinically in the epidural space, alter coagulation or fibrinolysis. Thromboelastography was used to assess clotting and fibrinolysis of blood to which ropivacaine had been added. Although modest alterations in maximum amplitude, coagulation time and alpha angle were observed, the effect of ropivacaine on clotting and fibrinolysis was not clinically significant. We conclude that it is unlikely that the presence of ropivacaine in the epidural space would reduce the efficacy of an early or prophylactic epidural blood patch.

  1. Hypnosis as sole anaesthesia for skin tumour removal in a patient with multiple chemical sensitivity.

    Science.gov (United States)

    Facco, E; Pasquali, S; Zanette, G; Casiglia, E

    2013-09-01

    A female patient with multiple chemical sensitivity and previous anaphylactoid reactions to local anaesthetics was admitted for removal of a thigh skin tumour under hypnosis as sole anaesthesia. The hypnotic protocol included hypnotic focused analgesia and a pre-operative pain threshold test. After inducing hypnosis, a wide excision was performed, preserving the deep fascia, and the tumour was removed; the patient's heart rate and blood pressure did not increase during the procedure. When the patient was de-hypnotised, she reported no pain and was discharged immediately. Our case confirms the efficacy of hypnosis and demonstrates that it may be valuable as a sole anaesthetic method in selected cases. Hypnosis can prevent pain perception and surgical stress as a whole, comparing well with anaesthetic drugs. PMID:23845031

  2. Electrical nerve stimulation as an aid to the placement of a brachial plexus block : clinical communication

    Directory of Open Access Journals (Sweden)

    K.E. Joubert

    2002-07-01

    Full Text Available Most local anaesthetic blocks are placed blindly, based on a sound knowledge of anatomy. Very often the relationship between the site of deposition of local anaesthetic and the nerve to be blocked is unknown. Large motor neurons may be stimulated with the aid of an electrical current. By observing for muscle twitches, through electrical stimulation of the nerve, a needle can be positioned extremely close to the nerve. The accuracy of local anaesthetic blocks can be improved by this technique. By using the lowest possible current a needle could be positioned within 2-5mm of a nerve. The correct duration of stimulation ensures that stimulation of sensory nerves does not occur. The use of electrical nerve stimulation in veterinary medicine is a novel technique that requires further evaluation.

  3. LAT gel, a powerful tool underused in the repair of paediatric lacerations.

    Science.gov (United States)

    Wang, B; Hill, V K P; Wilson, M H; Felstead, A M

    2014-08-01

    Paediatric lacerations presenting to emergency departments are a common cause of referral to surgical specialties in the UK. LAT gel (lidocaine, adrenaline, and tetracaine) is a safe and effective topical anaesthetic that can aid with the closure of uncomplicated lacerations, particularly in the paediatric trauma setting. The benefits to both the patient and management in terms of the avoidance of a general anaesthetic and the freeing up of hospital resources (e.g. beds, staffing, emergency theatre) make it an invaluable tool in the arsenal of the emergency department. The authors describe a reliable method of anaesthetizing lacerations with LAT gel and question its underuse within the emergency departments in the South West region of the UK. PMID:24861471

  4. Continuous peripheral nerve blocks in children.

    Science.gov (United States)

    Dadure, C; Capdevila, X

    2005-06-01

    In recent years, regional anaesthesia in children has generated increasing interest. Continuous peripheral nerve blocks have an important role in the anaesthetic arsenal, allowing effective, safe and prolonged postoperative pain management. Indications for continuous peripheral nerve blocks depend on benefits/risks analysis of each technique for each patient. The indications include surgery associated with intense postoperative pain, surgery requiring painful physical therapy, and complex regional pain syndrome. Continuous peripheral nerve blocks are usually performed under general anaesthesia or sedation, and require appropriate equipment in order to decrease the risk of nerve injury. New techniques, such as transcutaneous stimulation or ultrasound guidance, appear to facilitate nerve and plexus identification in paediatric patients. Nevertheless, continuous peripheral nerve block may mask compartment syndrome in certain surgical procedure or trauma. Finally, ropivacaine appears to be the best local anaesthetic for continuous peripheral nerve blocks in children, requiring low flow rate with low concentration of the local anaesthetic. PMID:15966500

  5. A randomized clinical trial of a brief hypnosis intervention to control venepuncture-related pain of paediatric cancer patients.

    Science.gov (United States)

    Liossi, Christina; White, Paul; Hatira, Popi

    2009-04-01

    Venepuncture for blood sampling can be a distressing experience for a considerable number of children. A prospective controlled trial was conducted to compare the efficacy of a local anaesthetic (EMLA) with a combination of EMLA with self-hypnosis in the relief of venepuncture-induced pain and anxiety in 45 paediatric cancer outpatients (age 6-16years). A secondary aim of the trial was to test whether the intervention will have a beneficial effect on parents' anxiety levels during their child's procedure. Patients were randomized to one of three groups: local anaesthetic, local anaesthetic plus hypnosis, and local anaesthetic plus attention. Results confirmed that patients in the local anaesthetic plus hypnosis group reported less anticipatory anxiety, and less procedure-related pain and anxiety, and were rated as demonstrating less behavioural distress during the procedure than patients in the other two groups. Parents whose children were randomized to the local anaesthetic plus hypnosis condition experienced less anxiety during their child's procedure than parents whose children had been randomized to the other two conditions. The therapeutic benefit of the brief hypnotic intervention was maintained in the follow-up. The present findings are particularly important in that this study was a randomized, controlled trial conducted in a naturalistic medical setting. In this context, convergence of subjective and objective outcomes was reached with large effect sizes that were consistently supportive of the beneficial effects of self-hypnosis, an intervention that can be easily taught to children, is noninvasive and poses minimal risk to young patients and their parents. PMID:19231082

  6. Anaesthesia Management in a Patient with Waardenburg Syndrome and Review of the Literature.

    Science.gov (United States)

    Peker, Kevser; Ergil, Julide; Öztürk, İbrahim

    2015-10-01

    Waardenburg syndrome is a rare autosomal dominant disease that may cause hearing loss, pigmentary abnormalities, neurocristopathy and partial albinism. Incidence is estimated as 2%-3% among the cases of congenital deafness and 1/42,000 of the general population. Children with Waardenburg syndrome usually require anaesthesia for the cochlear implant operation in early age. The features of the syndrome that may bear importance for anaesthetic management are laryngomalacia, multiple muscle contractures, limited neck movements, cyanotic cardiopathy and electrolyte imbalance. Patients with Waardenburg syndrome stand for difficult airway. We aimed to report anaesthetic management of a child with Waardenburg syndrome who underwent surgery for cochlear implantation. PMID:27366529

  7. The effect of 0.5% ropivacaine on epidural blood flow

    DEFF Research Database (Denmark)

    Dahl, J B; Simonsen, L; Mogensen, T;

    1990-01-01

    Twenty patients scheduled for elective abdominal surgery received epidural analgesia with 20 ml 0.5% ropivacaine or 0.5% bupivacaine. Epidural blood flow was measured by an epidural 133Xe clearance technique on the day before surgery (no local anaesthetic) and again 1 h before surgery, 30 min after...... injection of the local anaesthetic during continuous infusion (8 ml/h). Median initial blood flow was 5.0 ml/min and 6.0 ml/min per 100 g tissue in patients receiving ropivacaine and bupivacaine, respectively. After epidural bupivacaine, blood flow increased in 8 of 10 patients to 6.9 ml/min per 100 g...

  8. Efficacy of low-dose epidural anaesthesia in surgery of the anal canal--a randomised controlled trial.

    Science.gov (United States)

    Kausalya, R; Jacob, R

    1994-04-01

    The aim of the study was to compare in terms of patient comfort, surgical requirements and anaesthetic safety, the difference between epidural and general anaesthesia in patients undergoing surgery of the anal canal. The study was undertaken on 50 adult patients undergoing anal surgery. By random allocation 25 were given a general anaesthetic while 25 were given a low-dose epidural using 0.375% bupivacaine. Advantages and disadvantages of both methods were noted in the study. It was concluded that low-dose epidural is a more effective means of providing analgesia, while maintaining adequate sphincter tone for surgery on the anal canal, than general anaesthesia. PMID:8210019

  9. Inguinal hernia repair: anaesthesia, pain and convalescence

    DEFF Research Database (Denmark)

    Callesen, Torben

    2003-01-01

    less serious complications is lower by local anaesthesia, compared to other anaesthetic techniques. Of special interest is, that the rate of urinary retention can be eliminated by the use of local anaesthesia. Local anaesthesia results, in comparative studies, in a higher degree of patient satisfaction...... recurrent hernias, can and ought to be performed as day case surgery, irrespective of the chosen anaesthetic technique, as there are no medical or surgical contraindications to this. Social causes may indicate, that overnight stay may be advisable or desirable, preferably in a patient hotel facility...

  10. Anaesthesia for emergency ventriculo-peritoneal shunt in an adolescent with Noonan′s syndrome

    Directory of Open Access Journals (Sweden)

    Tanvir Samra

    2014-01-01

    Full Text Available A 15-year-old boy with Noonan′s syndrome was admitted for emergency ventriculo-peritoneal shunt. Intraoperative course was complicated by hypertensive urgency, which was effectively managed with high doses of esmolol (500 μg/kg/min. Difficult airway was anticipated due to presence of webbed neck and facial dysmorphism. Tracheal intubation was however successfully accomplished with the aid of a bougie. This report thus highlights the unique anaesthetic problems encountered during anaesthetic management of such a case, which is worth sharing.

  11. Development of a multi-source feedback tool for consultant anaesthetist performance.

    Science.gov (United States)

    Noonan, Craig L F; Monagle, John; Castanelli, Damian

    2011-05-01

    The process of development, and implementation, of a multi-source feedback tool for consultant anaesthetists is described. Rater groups included the anaesthetist-in-charge, anaesthetic assistants, anaesthetic trainees and, for some, the nurse-in-charge of the floor. Multiple items were developed to rate consultant behaviour, especially non-technical aspects of behaviour, and used across some or all of the rater groups. Response rates for items and by rater groups are discussed. The collated information formed part of the annual staff appraisal process conducted by the director. The information is useful for the director and the process is well-accepted by the staff. PMID:21612724

  12. Nitrous oxide anaesthesia and vomiting. The effect of nitrous oxide anaesthesia on the incidence of vomiting following gynaecological laparoscopy.

    Science.gov (United States)

    Lonie, D S; Harper, N J

    1986-07-01

    Eighty-seven patients undergoing routine laparoscopy were divided randomly into two groups to study the effect of nitrous oxide anaesthesia on the incidence of postoperative vomiting. Patients in group A received nitrous oxide as part of their anaesthetic, while in group B nitrous oxide was omitted. Significantly fewer patients in group B vomited when compared with group A (17 percent and 49 percent respectively; p less than 0.005). We suggest that an anaesthetic technique which avoids nitrous oxide may be especially indicated in patients undergoing laparoscopy. PMID:2944432

  13. Transient impairment of the axolemma following regional anaesthesia by lidocaine in humans

    DEFF Research Database (Denmark)

    Moldovan, Mihai; Lange, Kai Henrik Wiborg; Aachmann-Andersen, Niels Jacob; Kjær, Troels Wesenberg; Olsen, Niels Vidiendal; Krarup, Christian

    2014-01-01

    The local anaesthetic lidocaine is known to block voltage-gated Na(+) channels (VGSCs), although at high concentration it was also reported to block other ion channel currents as well as to alter lipid membranes. The aim of this study was to investigate whether the clinical regional anaesthetic......-channel gating, modelling indicated that, apart from up to a 4-fold reduction in the number of functioning VGSCs, lidocaine also caused a decrease of passive membrane resistance and an increase of capacitance. Our data suggest that the lidocaine effects, even at clinical 'sub-blocking' concentrations, could...

  14. Congenital lobar emphysema: diagnostic and therapeutic challenges.

    Science.gov (United States)

    Mulvany, James Jackson; Weatherall, Andrew; Charlton, Amanda; Selvadurai, Hiran

    2016-01-01

    Congenital lobar emphysema (CLE), a rare condition that usually presents in the neonatal period, can be a diagnostic and therapeutic challenge for the treating clinician. If unrecognised, it is a significant risk at the time of anaesthetic induction. We describe a case of CLE in a 3-month-old boy who was initially treated for suspected aspiration pneumonia at the referring hospital. We highlight the importance of careful consideration of common childhood respiratory illness as well as pneumothorax in the differential diagnosis, and the significance of appropriate preoperative anaesthetic management. We also emphasise the importance of acknowledging a mother's concerns when taking a paediatric history. PMID:27335360

  15. Discovery and development of veterinary pharmaceuticals in telemetered animals

    OpenAIRE

    dr. Zwijnenberg, R.J.G.

    2010-01-01

    The NMDA antagonist Perzinfotel was tested for anaesthetic sparing properties in telemetered dogs and cats when used in a pre-anaesthetic protocol. In dogs, IV, SQ and IM administration of perzinfotel (10-30 mg/kg) decreased the mean isoflurane MAC values by 32 – 44%. The greatest MAC reduction (59%) was observed with a combination of 20 mg/kg perzinfotel and 0.2 mg/kg butorphanol. Thus, all doses of perzinfotel resulted in a significant reduction of MAC. A dose of 30 mg/kg resulted in signif...

  16. God behandlingseffekt af botulinum toxin A hos systemisk sklerodermi patienter med digitale sår

    DEFF Research Database (Denmark)

    Nielsen, Jane Baumgartner; Hvid, Lone; Olesen, Anne Braae

    2014-01-01

    In this case we describe a successful combined treatment with local anaesthetics and botulinum toxin A. A 61-year-old man with systemic sclerosis of limited type presented treatment refractory digital ulcers on his toes with a poor response to conventional treatment. A combined treatment as above......-mentioned prevented a threatening amputation and improved quality of life, reduction of pain and healing of wounds. Using botulinum toxin A combined with local anaesthetics to severe toe digital ulcers in patients with systemic sclerosis may be a solution, when other treatments have been ineffective and amputation...

  17. Adenosine A1 receptor agonists inhibit trigeminovascular nociceptive transmission

    DEFF Research Database (Denmark)

    Goadsby, P J; Hoskin, K L; Storer, R J;

    2002-01-01

    There is a considerable literature to suggest that adenosine A1 receptor agonists may have anti-nociceptive effects, and we sought to explore the role of adenosine A1 receptors in a model of trigeminovascular nociceptive transmission. Cats were anaesthetized (alpha-chloralose 60 mg/kg, intraperit......There is a considerable literature to suggest that adenosine A1 receptor agonists may have anti-nociceptive effects, and we sought to explore the role of adenosine A1 receptors in a model of trigeminovascular nociceptive transmission. Cats were anaesthetized (alpha-chloralose 60 mg...

  18. Airway management in a patient with bullous pemphigoid

    International Nuclear Information System (INIS)

    Airway management in patients with pemphigoid lesions has anaesthetic implications. We report a case of a 23 years old female with bullous pemphigoid who presented with laryngeal stenosis and critical airway narrowing. The airway was initially managed with jet ventilation. Anaesthesia was maintained with propofol infusion and ventilation was performed by introducing a size 10 French gauge suction catheter through the stenotic laryngeal orifice. Thirty minutes into anaesthesia, she developed subcutaneous emphysema and decreased air entry on right side of the chest but remained hemodynamically stable. The airway was further managed by tracheostomy. This case report highlights complications that can occur during the anaesthetic management of such cases. (author)

  19. Peak and averaged bicoherence for different EEG patterns during general anaesthesia

    Directory of Open Access Journals (Sweden)

    Myles Paul

    2010-11-01

    Full Text Available Abstract Background Changes in nonlinear neuronal mechanisms of EEG generation in the course of general anaesthesia have been extensively investigated in research literature. A number of EEG signal properties capable of tracking these changes have been reported and employed in anaesthetic depth monitors. The degree of phase coupling between different spectral components is a marker of nonlinear EEG generators and is claimed to be an important aspect of BIS. While bicoherence is the most direct measure of phase coupling, according to published research it is not directly used in the calculation of BIS, and only limited studies of its association with anaesthetic depth and level of consciousness have been published. This paper investigates bicoherence parameters across equal band and unequal band bifrequency regions, during different states of anaesthetic depth relating to routine clinical anaesthesia, as determined by visual inspection of EEG. Methods 41 subjects scheduled for day surgery under general anaesthesia were recruited into this study. EEG bicoherence was analysed using average and smoothed-peak estimates calculated over different regions on the bifrequency plane. Statistical analysis of associations between anaesthetic depth/state of consciousness and bicoherence estimates included linear regression using generalised linear mixed effects models (GLMs, ROC curves and prediction probability (Pk. Results Bicoherence estimates for the δ_θ region on the bifrequency plane were more sensitive to anaesthetic depth changes compared to other bifrequency regions. Smoothed-peak bicoherence displayed stronger associations than average bicoherence. Excluding burst suppression and large transients, the δ_θ peak bicoherence was significantly associated with level of anaesthetic depth (z = 25.74, p 2 = 0.191. Estimates of Pk for this parameter were 0.889(0.867-0.911 and 0.709(0.689-0.729 respectively for conscious states and anaesthetic depth

  20. [Continuous peripheral regional analgesia in children].

    Science.gov (United States)

    Lacroix, F

    2007-06-01

    Continuous peripheral nerve blocks (CPNB) have important role in the therapeutic arsenal, anaesthetic or analgesic in children. Indications for CPNB depend on benefits/risks analysis for each patient. The indications include surgery associated with intense postoperative pain, surgery requiring painful physical therapy, and complex regional pain syndrome. CPNB are usually performed under sedation or general anaesthesia, and require appropriate equipment in order to decrease the risk of nerve injury. Nevertheless, CPNB may mask compartment syndrome in trauma or certain surgical procedure. Finally, ropivacaine, and perhaps levobupivacaine, appears to be the best local anaesthetic for continuous peripheral nerve blocks in children, requiring low flow rate with low concentration. PMID:17543494

  1. Pharmacokinetics and clinical efficacy of long-term epidural ropivacaine infusion in children

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Ilett, K F; Lim, S I;

    2000-01-01

    pressure every 4 h. Total and free plasma concentrations were measured by high-performance liquid chromatography at 0, 1, 6, 12, 24, 36, 48, 72 and 96 h. Analgesia was of high quality and side effects were minor. No clinical signs of local anaesthetic toxicity were seen. Total (100-3189 micrograms litre-1...

  2. Effects of ketamine on pro-inflammatory mediators in equine models

    NARCIS (Netherlands)

    Lankveld, D.P.K.

    2007-01-01

    Ketamine is frequently used in both human and veterinary anaesthesia. Beside its anaesthetic and analgesic effects, ketamine has been demonstrated to possess anti-inflammatory properties in rodents and humans. To date, no data are available on the anti-inflammatory effects of ketamine in horses. Thi

  3. A review of a pleural service.

    Science.gov (United States)

    Aujayeb, A; Parker, S; Bourke, S; Miller, J; Cooper, D

    2016-12-01

    This paper reviews the organisation and outcomes of a pleural service, specifically geared towards the management of malignant pleural effusions, in a district general hospital in the north east of England. We summarise the evidence behind local anaesthetic thoracoscopy and indwelling pleural catheters. We then summarise the review of our service, including a discussion around complications. PMID:27092367

  4. Halogen bonded complexes between volatile anaeshetics (chloroform, halothane, enflurane, isoflurane) and formaldehyde: a theoretical study

    Czech Academy of Sciences Publication Activity Database

    Zierkiewicz, W.; Wieczorek, R.; Hobza, Pavel; Michalska, D.

    2011-01-01

    Roč. 13, č. 11 (2011), s. 5105-5113. ISSN 1463-9076 R&D Projects: GA MŠk LC512 Institutional research plan: CEZ:AV0Z40550506 Keywords : halogen bond * anaesthetics * ab initio calculation Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 3.573, year: 2011

  5. Tumescent anaesthesia.

    LENUS (Irish Health Repository)

    Conroy, Patrick H

    2013-01-31

    Tumescent anaesthesia describes the practice of injecting a very dilute solution of local anaesthetic combined with epinephrine and sodium bicarbonate into tissue until it becomes firm and tense (tumescent). It was initially described in the field of liposuction but now surgical applications for the technique are widely varied ranging across vascular surgery, breast surgery, plastic surgery and ENT procedures. It is widely used in both hospital- and office-based environments and may form the sole method of anaesthesia for surgery. Advantages include a reduction in blood loss through both epinephrine-induced vasoconstriction as well as hydrostatic compression from the tumescent effect. Sodium bicarbonate reduces pain associated with the injection of an acidic local anaesthetic solution. Due to the unique pharmacokinetic profile of this technique lidocaine doses of 35 mg\\/kg bodyweight have been shown to be safe for liposuction procedures. Tumescent lidocaine is absorbed very slowly from subcutaneous tissues producing lower, and more delayed, peak blood levels compared to other routes, as well as extended postoperative analgesia. Slow systemic absorption allows the rapid hepatic plasma clearance of lidocaine to maintain safe local anaesthetic blood levels. This slow absorption from subcutaneous tissue has been likened to a depot injection. Careful attention must be given to appropriate local anaesthetic dosage alterations in cases of co-administration with agents affecting hepatic drug clearance or conditions reducing liver blood supply. Adherence to these pharmacological principles has produced an exemplary safety record for this technique to date.

  6. Peroperative depth of anaesthesia may influence postoperative opioid requirements

    DEFF Research Database (Denmark)

    Henneberg, S W; Rosenborg, D; Weber Jensen, E;

    2005-01-01

    Studies on monitoring the depth of anaesthesia have shown that with the use of these monitors the peroperative consumption of anaesthetics can be reduced. Studies have also indicated that the peroperative depth of anaesthesia may affect the postoperative course. The purpose of this study was to...

  7. Novel instrumentation for real-time monitoring using miniaturized flow systems with integrated biosensors

    NARCIS (Netherlands)

    Freaney, R.; McShane, A.; Keaveny, T.V.; McKenna, M.; Rabenstein, K.; Scheller, F.W.; Pfeiffer, D.; Urban, G.; Moser, I.; Jobst, G.; Manz, A.; Verpoorte, E.; Widmer, M.W.; Diamond, D.; Dempsey, E.; Saez De Viteri, F.J.; Smyth, M.

    1997-01-01

    A prototype miniaturized Total Chemical Analysis System (μTAS) has been developed and applied to on-line monitoring of glucose and lactate in the core blood of anaesthetized dogs. The system consists of a highly efficient microdialysis sampling interface sited in a small-scale extracorporeal shunt c

  8. Reposition af næsefrakturer i lokal anæstesi versus generel anæstesi

    DEFF Research Database (Denmark)

    Koch, Klaus U; Gano, Lars; Kjeldsen, Anette Drøhse

    2007-01-01

    cause of damage was violence. The average interval from trauma to treatment was 4.1 days. 60% of the patients filed cosmetic results equal to or better than before fracturing the nose regardless of the anaesthetic procedure, while 69% of the patients experienced the function of the nose as equal to or...

  9. Posterior spinal instrumented fusion for idiopathic scoliosis in patients with multisystemic neurodegenerative disorder: a report of two cases.

    Science.gov (United States)

    Loh, K W; Chan, C Yw; Chiu, C K; Bin Hasan, M S; Kwan, M K

    2016-08-01

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke (MELAS) syndrome is a progressive multisystemic neurodegenerative disorder. MELAS syndrome impairs oxidative phosphorylation and predisposes patients to lactic acidosis, particularly under metabolic stress. We report 2 siblings with MELAS-associated idiopathic scoliosis who underwent posterior spinal instrumented fusion with measures taken to minimise anaesthetic and surgical stress, blood loss, and operating time. PMID:27574278

  10. Anaesthesia care for emergency endoscopy for peptic ulcer bleeding. A nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Duch, Patricia; Haahr Raunkjær, Camilla; Møller, Morten Hylander;

    2016-01-01

    OBJECTIVE: Currently, no standard approach exists to the level of monitoring or presence of staff with anaesthetic expertise required during emergency esophago-gastro-duodenoscopy (EGD) for peptic ulcer bleeding (PUB). We assess the association between anaesthesia care and mortality. We further d...

  11. Anaesthesia for awake craniotomy is safe and well-tolerated

    DEFF Research Database (Denmark)

    Andersen, Jakob Hessel; Olsen, Karsten Skovgaard

    2010-01-01

    Awake craniotomy for tumour resection has been performed at Glostrup Hospital since 2004. We describe and discuss the various anaesthetic approaches for such surgery and retrospectively analyse the 44 planned awake craniotomies performed at Glostrup Hospital. The surgery falls into four phases: c...

  12. Postoperativ smertebehandling af børn

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Henneberg, Steen Winther; Hole, P

    1996-01-01

    stressed, and such methods are presented. Acute Pain Service is mentioned and the most important pharmacological aspects regarding non-steroidal anti-inflammatory drugs, paracetamol, opioids and local anaesthetics are discussed. The management of postoperative pain in neonates is reviewed separately. It is...

  13. Lovende resultater ved ultralydvejledt anlæggelse af nerveblokade hos børn

    DEFF Research Database (Denmark)

    Lefort, Michèle Reeslev; Henneberg, Steen; Bille, Anders Bastholm;

    2011-01-01

    Nerve blocks play an increasingly important role in pediatric regional anaesthesia. The benefits are numerous compared to standard pain regimens. The use of ultrasound (US) for nerve blocks lowers the volume of local anaesthetics applied, shortens the on-set time and results in higher success rat...

  14. Diagnostic and therapeutic lumbar puncture performed safely and efficiently with a thin blunt needle

    DEFF Research Database (Denmark)

    Møller, Anders; Afshari, Arash; Bjerrum, Ole Weis

    2013-01-01

    The risk of postdural puncture headache following lumbar puncture can be reduced by choosing a blunt spinal needle or by using a smaller needle diameter. Reports indicate that lumbar puncture practiced outside of the anaesthetic discipline does not adhere to the current level of evidence. To exam...

  15. [On the surface-anesthetic activity of some ether alcohols (author's transl)].

    Science.gov (United States)

    Riemschneider, R; Rufer, C; Chik, W H

    1978-01-01

    An account of the preparation and surface anesthetic potency of 12 ether alcohols of the type X-O-Y-OH is given in this paper. The anaesthetic intensity and effective duration of a chloronaphthalene derivative of this type lie within the range of action of cocain. PMID:582907

  16. Bilateral brachial plexus blocks in a patient of hypertrophic obstructive cardiomyopathy with hypertensive crisis

    Directory of Open Access Journals (Sweden)

    Rohini V Bhat Pai

    2013-01-01

    Full Text Available Hypertrophic obstructive cardiomyopathy (HOCM is a challenge to anesthesiologists due to the complex pathophysiology involved and various perioperative complications associated with it. We present a 50-year-old man, a known case of HOCM, who successfully underwent emergency haemostasis, and debridement of the traumatically amputated right upper limb and the contused lacerated wound on the left forearm under bilateral brachial plexus blocks. His co-morbidities included hypertension (in hypertensive crisis and diabetes mellitus. He was full stomach and also had an anticipated difficult airway. The management included invasive pressure monitoring and labetalol infusion for emergent control of blood pressure. The regional anaesthesia technique required careful consideration to the dosage of local anaesthetics and staggered performance of brachial plexus blocks on each of the upper limbs to avoid local anaesthetic toxicity. Even though bilateral brachial plexus blocks are rarely indicated, it seemed to be the most appropriate anaesthetic technique in our patient. With careful consideration of the local anaesthetic toxicity and meticulous technique, bilateral brachial plexus blocks can be successfully performed in those patients where general anaesthesia is deemed to be associated with higher risk.

  17. Rapid sequence induction in the emergency department: a strategy for failure

    OpenAIRE

    Carley, S; Gwinnutt, C.; Butler, J.; Sammy, I; Driscoll, P

    2002-01-01

    Background: Rapid sequence induction (RSI) is increasingly used by emergency physicians in the emergency department. A feared complication of the technique is the inability to intubate and subsequently ventilate the patient. Current drills based on anaesthetic practice may be unsuitable for use in the emergency department.

  18. Axillary Brachial Plexus Blockade for the Reflex Sympathetic Dystrophy Syndrome.

    Science.gov (United States)

    Ribbers, G. M.; Geurts, A. C. H.; Rijken, R. A. J.; Kerkkamp, H. E. M.

    1997-01-01

    Reflex sympathetic dystrophy syndrome (RSD) is a neurogenic pain syndrome characterized by pain, vasomotor and dystrophic changes, and often motor impairments. This study evaluated the effectiveness of brachial plexus blockade with local anaesthetic drugs as a treatment for this condition. Three patients responded well; three did not. (DB)

  19. Tobacco Interventions and Anaesthesia - A Review

    Directory of Open Access Journals (Sweden)

    Usha Saha

    2009-01-01

    This is a review of tobacco& its products, their health consequences, diseases caused, anaesthetic consider-ations& their role in helping these patients quit smoking Preventing nicotine addiction and improving smoking cessa-tion strategies should be the priority and despite these being only partially successful, strong measures at all levels should he continued& enforced.

  20. Propofol with ketamine following sedation with xylazine for routine induction of general anaesthesia in horses.

    Science.gov (United States)

    Posner, L P; Kasten, J I; Kata, C

    2013-12-01

    To document the suitability of intravenous propofol and ketamine following sedation with xylazine for routine anaesthetic induction in horses. Retrospective. 100 client-owned horses. Anaesthetic records were evaluated to determine: signalment, anaesthetic drug and dosages, need for additional induction agents, notation of any adverse events, duration of anaesthesia and recovery characteristics (rough or smooth, and rapid or prolonged). Horses were sedated with xylazine 0.99±(0.2) mg/kg intravenous and 23 horses were also administered butorphanol 0.02±(0.001) mg/kg intravenous. Horses were anaesthetised with a combination of propofol 0.40±(0.1) mg/kg intravenous and ketamine 2.8±(0.3) mg/kg intravenous. Six horses required additional ketamine. None became apnoeic and no adverse events were noted. Anaesthesia was maintained with isoflurane in 66 horses and a combination of guaifenesin, ketamine and xylazine (GKX) in 34 horses. Total anaesthesia time was 125.4±(46) minutes. Fifty-one horses were administered romifidine 0.016 (±0.008) mg/kg intravenous at recovery. Time from orotracheal extubation to standing was 27.6±(25) minutes. Of the 58 records with recovery characteristics, the number per category was: rapid n=6, prolonged n=3, smooth n=46, rough n=6. Intravenous propofol and ketamine following xylazine provided satisfactory anaesthetic inductions and recoveries in a varied population of horses without any clinically relevant adverse events. PMID:24218416

  1. A METHOD FOR STUDYING THE PHARMACODYNAMIC PROFILE OF NEUROMUSCULAR BLOCKING-AGENTS ON VOCAL CORD MOVEMENTS IN ANESTHETIZED CATS

    NARCIS (Netherlands)

    VANDENBROM, RHG; HOUWERTJES, MC; AGOSTON, S

    1991-01-01

    1 A new in vivo experimental method is described whereby the neuromuscular blocking effects of muscle relaxants can be investigated on the intrinsic laryngeal muscles of anaesthetized cats. The peripheral tibialis anterior muscle preparation is employed in the same animal to compare the blocking eff

  2. The scrotal elevator: a novel scrotal retractor for perineal approach surgery

    Directory of Open Access Journals (Sweden)

    Guy F. Nash

    2011-07-01

    Full Text Available Thorough examination under anaesthetic of the rectum and anus demands an adequate view of the perineum. Traditionally patients are placed in the Lloyd-Davies position when anorectal access is required. However, in male patients, the scrotum may obscure the perineum making it difficult to perform an adequate examination...

  3. Effects of topical ropivacaine on eicosanoids and neurotransmitters in the rectum of patients with distal ulcerative colitis

    DEFF Research Database (Denmark)

    Hillingsø, J.G.; Kjeldsen, J.; Schmidt, P.T.;

    2002-01-01

    Background: Topical administration of lidocaine has been suggested to have beneficial clinical effects in patients with active ulcerative colitis, but the mechanism of action, if any, remains obscure. As local anaesthetics may exert anti-inflammatory actions through their inhibition of nervous re...

  4. Effects of topical ropivacaine on eicosanoids and neurotransmitters in the rectum of patients with distal ulcerative colitis

    DEFF Research Database (Denmark)

    Hillingsø, Jens; Kjeldsen, J; Schmidt, P T;

    2002-01-01

    BACKGROUND: Topical administration of lidocaine has been suggested to have beneficial clinical effects in patients with active ulcerative colitis, but the mechanism of action, if any, remains obscure. As local anaesthetics may exert anti-inflammatory actions through their inhibition of nervous re...

  5. A comparison between the v-gel supraglottic airway device and the cuffed endotracheal tube for airway management in spontaneously breathing cats during isoflurane anaesthesia

    NARCIS (Netherlands)

    van Oostrom, H.; Krauss, M.W.; Sap, R.

    2013-01-01

    Abstract OBJECTIVE: To compare airway management using the v-gel supraglottic airway device (v-gel SGAD) to that using an endotracheal tube (ETT), with respect to practicability, leakage of volatile anaesthetics and upper airway discomfort in cats. STUDY DESIGN: Prospective, randomized clinical tria

  6. Inverse relationship between age-dependent erythrocyte activity of methaemoglobin reductase and prilocaine-induced methaemoglobinaemia during infancy

    DEFF Research Database (Denmark)

    Nilsson, A; Engberg, G; Henneberg, S;

    1990-01-01

    We have measured plasma concentrations of local anaesthetics, and the substance fraction of methaemoglobin (MetHb), in infants less than 3 months of age, after application of a lignocaine-prilocaine cream (EMLA). A total of EMLA 2 g was applied over four different skin areas, totalling 16 cm2, for...

  7. Plasma concentrations of prilocaine and lidocaine and methaemoglobin formation in infants after epicutaneous application of a 5% lidocaine-prilocaine (EMLA)

    DEFF Research Database (Denmark)

    Engberg, G; Danielson, K; Henneberg, S;

    1987-01-01

    total, 2 ml of EMLA was applied to 4 x 4 cm of skin surface for 4 h and blood samples for detection of Met-Hb and plasma levels of local anaesthetics were taken at 0, 2, 4 and 8 h after the application. After removal of the cream the infants were operated mainly for minor procedures under general...

  8. The scrotal elevator: a novel scrotal retractor for perineal approach surgery

    OpenAIRE

    Nash, Guy F

    2011-01-01

    Thorough examination under anaesthetic of the rectum and anus demands an adequate view of the perineum. Traditionally patients are placed in the Lloyd-Davies position when anorectal access is required. However, in male patients, the scrotum may obscure the perineum making it difficult to perform an adequate examination...

  9. Effects of voluntarily-ingested buprenorphine on plasma corticosterone levels, body weight, water intake, and behaviour in permanently catheterised rats

    DEFF Research Database (Denmark)

    Goldkuhl, Renée; Hau, Jann; Abelson, Klas

    2010-01-01

    corticosterone levels in the postoperative period, compared to controls treated with local anaesthetics. Buprenorphine-treated rats consumed more water and maintained body weight better. Behavioural observations indicated that buprenorphine changed the behaviour in non-operated rats but there was no difference...

  10. Ventilatory failure due to improper capnography connector

    OpenAIRE

    Prakash, Ravi; Kushwaha, Brij B.; Singh, Brijesh Pratap

    2014-01-01

    Ventilatory failure due to improper or loose breathing circuit connection can occur in anaesthetic practice and may lead to significant morbidity and mortility. We report here an unusual incidence of ventilatory failure due loose capnography connector which obstructed the outer tube of Bain's circuit and presented as airway obstruction.

  11. Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Møller, Ann M

    2011-01-01

    Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded stu...

  12. Depth of anaesthesia monitoring in obese patients: a randomized study of propofol-remifentanil

    DEFF Research Database (Denmark)

    Meyhoff, C S; Meyhoff, Christian Sylvest; Henneberg, S W;

    2009-01-01

    BACKGROUND: In obese patients, depth of anaesthesia monitoring could be useful in titrating intravenous anaesthetics. We hypothesized that depth of anaesthesia monitoring would reduce recovery time and use of anaesthetics in obese patients receiving propofol and remifentanil. METHODS: We investig......BACKGROUND: In obese patients, depth of anaesthesia monitoring could be useful in titrating intravenous anaesthetics. We hypothesized that depth of anaesthesia monitoring would reduce recovery time and use of anaesthetics in obese patients receiving propofol and remifentanil. METHODS: We...... investigated 38 patients with a body mass index >or=30 kg/m(2) scheduled for an abdominal hysterectomy. Patients were randomized to either titration of propofol and remifentanil according to a cerebral state monitor (CSM group) or according to usual clinical criteria (control group). The primary end point was.......04). During surgery, when the cerebral state index was continuously between 40 and 60, the corresponding optimal propofol infusion rate was 10 mg/kg/h based on ideal body weight. CONCLUSION: No significant reduction in time to eye opening could be demonstrated when a CSM was used to titrate propofol and...

  13. [Anaesthesia in connection with liver transplantation

    DEFF Research Database (Denmark)

    Secher, N.H.; Nissen, P.; Swiatek, F.A.;

    2008-01-01

    The anaesthetic plan for liver transplantation focuses on maintaining central blood volume and thereby cerebral oxygenation. Normovolaemia represents a central blood volume that establishes a maximal venous oxygen saturation, and a value of 85% (78-90%) is maintained during the operation by...

  14. Localization of thermogenesis induced by single infusion of ephedrine in dog

    DEFF Research Database (Denmark)

    Madsen, J; Bülow, J; Larsen, O G;

    1993-01-01

    The localization of the thermogenic effect of ephedrine (1 mg.kg-1 infused intravenously over 10 min.) was studied in 6 fasted dogs anaesthetized with etorfin-acepromazin-N2O. Three experiments were performed in each animal to determine the effect of ephedrine on a) splanchnic oxygen uptake, b...

  15. Planning the operation.

    Science.gov (United States)

    Kiely, Edward M; Spitz, Lewis

    2015-10-01

    The management of conjoined twins falls into three distinct groups-non-operative, emergency separation and elective separation. Planning meetings involving all the personnel who will be required during the operation are held. The radiological findings are presented and the anaesthetic, nursing and intensive care requirements are highlighted. PMID:26382260

  16. Depth of the thoracic epidural space in children.

    NARCIS (Netherlands)

    Masir, F.; Driessen, J.J.; Thies, K.C.; Wijnen, M.H.W.A.; Egmond, J. van

    2006-01-01

    Thoracic epidural anaesthesia in anaesthetized children requires a meticulous technique and may have an increased success rate when the distance between skin and epidural space is known. The objective of this observational study was to measure the skin to epidural distance (SED) during thoracic epid

  17. Recovery of older patients undergoing ambulatory anaesthesia with isoflurane or sevoflurane.

    LENUS (Irish Health Repository)

    Mahajan, V A

    2007-06-01

    Delayed recovery of cognitive function is a well-recognized phenomenon in older patients. The potential for the volatile anaesthetic used to contribute to alterations in postoperative cognitive function in older patients following minor surgical procedures has not been determined. We compared emergence from isoflurane and sevoflurane anaesthesia in older surgical patients undergoing urological procedures of short duration.

  18. Pre-operative testing for pregnancy in Dublin day surgery units.

    LENUS (Irish Health Repository)

    Wong, L F A

    2013-06-01

    The safety of anaesthetic agents in early pregnancy cannot be guaranteed. Certain types of surgery, particularly gynaecological, may also be dangerous. It is therefore important to ensure that, female patients are not inadvertently pregnant when undergoing elective surgery. Different hospitals have different policies and guidelines in place to determine female patients\\' pregnancy status prior to elective surgery.

  19. Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity?

    DEFF Research Database (Denmark)

    Imberger, G; Orr, A; Thorlund, K; Wetterslev, J; Myles, P; Møller, Ann

    2014-01-01

    BACKGROUND: /st> The role of nitrous oxide in modern anaesthetic practice is contentious. One concern is that exposure to nitrous oxide may increase the risk of cardiovascular complications. ENIGMA II is a large randomized clinical trial currently underway which is investigating nitrous oxide and...

  20. Tolerability of the capsaicin 8% patch following pretreatment with lidocaine or tramadol in patients with peripheral neuropathic pain: A multicentre, randomized, assessor-blinded study

    NARCIS (Netherlands)

    Jensen, T.S.; Hoye, K.; Fricova, J.; Vanelderen, P.J.L.; Ernault, E.; Siciliano, T.; Marques, S.

    2014-01-01

    BACKGROUND: Application of the capsaicin 8% patch is associated with treatment-related discomfort. Consequently, pretreatment for 60 min with anaesthetic cream is recommended; however, this may be uncomfortable and time consuming. METHODS: We conducted a multicentre, randomized (1:1), assessor-blind

  1. Successful living donor liver transplant in a very small child

    OpenAIRE

    Vijay Kumar; Raman Raina

    2010-01-01

    Liver transplantation in small children poses perioperative challenges that are different from those seen in adults. We present our successful anaesthetic experience in a 7-month-old infant who has been the youngest case of successful living donor liver transplant performed in our institution till the day this article was being prepared.

  2. Inverse relationship between age-dependent erythrocyte activity of methaemoglobin reductase and prilocaine-induced methaemoglobinaemia during infancy

    DEFF Research Database (Denmark)

    Nilsson, A; Engberg, G; Henneberg, S; Danielson, K; De Verdier, C H

    1990-01-01

    concentrations of local anaesthetics were low (maximum values: prilocaine 78 ng ml-1, lignocaine 412 ng ml-1). The activity of erythrocyte MetHb reductase (cytochrome b5 reductase) was analysed. Data from a previously studied group of infants aged 3-12 months were included also. Enzyme activity did not reach...

  3. ZP123 increases gap junctional conductance and prevents reentrant ventricular tachycardia during myocardial ischemia in open chest dogs

    DEFF Research Database (Denmark)

    Xing, Dezhi; Kjølbye, Anne Louise; Nielsen, Morten S;

    2003-01-01

    demonstrated that 10 nM ZP123 improved gap junctional intercellular conductance by 69% +/- 20% in pairs of guinea pig ventricular myocytes. VT was induced by programmed stimulation in alpha-chloralose anaesthetized open chest dogs 1 to 4 hours after coronary artery occlusion. Three-dimensional activation...

  4. FUSIMOTOR EFFECTS OF MIDBRAIN STIMULATION ON JAW MUSCLE-SPINDLES OF THE ANESTHETIZED CAT

    NARCIS (Netherlands)

    TAYLOR, A; JUCH, PJW

    1993-01-01

    The effects of electrical stimulation within the midbrain on fusimotor output to the jaw elevator muscles were studied in anaesthetized cats. Muscle spindle afferents recorded in the mesencephalic trigeminal nucleus were categorised as primary or secondary by their responses to succinylcholine durin

  5. The asleep-awake technique using propofol-remifentanil anaesthesia for awake craniotomy for cerebral tumours

    DEFF Research Database (Denmark)

    Olsen, Karsten Skovgaard

    2008-01-01

    Background and objective: We retrospectively reviewed the first 25 planned cases of awake craniotomies using the 'asleep-awake' technique, an alternative to the often-used 'asleep-awake-asleep' technique. Methods: The patients were anaesthetized using propofol/remifentanil anaesthesia, a laryngeal...

  6. Brain Connectivity Dissociates Responsiveness from Drug Exposure during Propofol-Induced Transitions of Consciousness

    OpenAIRE

    Chennu, Srivas; O? Connor, Stuart; Adapa, Ram; Menon, David K; Bekinschtein, Tristan A.

    2016-01-01

    Accurately measuring the neural correlates of consciousness is a grand challenge for neuroscience. Despite theoretical advances, developing reliable brain measures to track the loss of reportable consciousness during sedation is hampered by significant individual variability in susceptibility to anaesthetics. We addressed this challenge using high-density electroencephalography to characterise changes in brain networks during propofol sedation. Assessments of spectral connectivity networks be...

  7. Einfluss der intraluminalen Osmolarität auf die Elektrolyt-, Wasser- und Glucoseresorption sowie die transmurale Potentialdifferenz im proximalen Jejunum der Ratte

    OpenAIRE

    Perk, Annette

    2011-01-01

    Summary : Net transport of sodium, potassium, chloride, water and glucose as well astransmural potential difference, as affected by intraluminal osmolarity, were investigated in the luminally perfused proximal jejunum in the anaesthetized rat. The following findings were obtained: Intraluminal hypertonic conditions in comparison to isotonicity reduced sodium and chloride absorption and reversed net water absorption, while potassium secretion and glucose absorption were not significantly affec...

  8. BRAIN-STEM INFLUENCES ON BICEPS REFLEX ACTIVITY AND MUSCLE TONE IN THE ANESTHETIZED RAT

    NARCIS (Netherlands)

    JUCH, PJW; SCHAAFSMA, A; VANWILLIGEN, JD

    1992-01-01

    This study analyzes the effect of electrical stimulation of the locus coeruleus (LC) and adjacent brainstem structures on the tonic reflex (TVR), the tonic stretch reflex (TSR) and on muscle tone (MT) in anaesthetized rat. Increases in TVR. TSR and MT of the m. biceps were evoked from regions rostra

  9. A naturalistic glyceryl trinitrate infusion migraine model in the rat

    DEFF Research Database (Denmark)

    Ramachandran, Roshni; Bhatt, Deepak Kumar; Ploug, Kenneth Beri;

    2012-01-01

    Glyceryl trinitrate (GTN) infusion is a reliable method to provoke migraine-like headaches in humans. Previous studies have simulated this human model in anaesthetized or in awake rodents using GTN doses 10,000 times higher than used in humans. The relevance of such toxicological doses to migraine...

  10. The respiratory drive to thoracic motoneurones in the cat and its relation to the connections from expiratory bulbospinal neurones

    DEFF Research Database (Denmark)

    Saywell, S A; Anissimova, N P; Ford, T W;

    2007-01-01

    of connection revealed were related to the presence and size of central respiratory drive potentials in the same motoneurones. Intracellular recordings were made from motoneurones in segments T5-T9 of the spinal cord of anaesthetized cats. Spike-triggered averaging from expiratory bulbospinal neurones...

  11. Peroperative depth of anaesthesia may influence postoperative opioid requirements

    DEFF Research Database (Denmark)

    Henneberg, S W; Rosenborg, D; Weber Jensen, E; Ahn, P; Nielsen, Jan Burgdorff; Thomsen, L L

    2005-01-01

    Studies on monitoring the depth of anaesthesia have shown that with the use of these monitors the peroperative consumption of anaesthetics can be reduced. Studies have also indicated that the peroperative depth of anaesthesia may affect the postoperative course. The purpose of this study was to...... evaluate a possible relation between the depths of anaesthesia and the postoperative pain score and consumption of morphine....

  12. The use of ketamine plus diazepam anaesthesia to increase the radiosensitivity of a C3H mouse mammary adenocarcinoma in hyperbaric oxygen

    International Nuclear Information System (INIS)

    The radiation response of mammary tumours transplanted into syngeneic C3H mice has been measured with the animals breathing air or 100% oxygen at 290 kPa (HPO), either with or without ketamine plus diazepam anaesthesia. The single doses needed to cure 37% of tumours within 40 days (TCDsub(37/40)) for mice anaesthetised with ketamine plus diazepam and for unanaesthetised mice irradiated in air were not significantly different, 66.5 Gy and 68.8 Gy respectively. When animals were irradiated in HPO, the TCD37 value was significantly reduced from 60 Gy with no anaesthetic to 41 Gy with ketamine plus diazepam anaesthesia; an enhancement ratio (ER) of 1.5. The total ER from no anaesthetic in air to anaesthetic in HPO was 1.7 (68.8/41). There was less CNS toxicity for ketamine plus diazepam than for sodium pentobarbitone anaesthesia in mice treated in HPO. The combination of ketamine and diazepam is an unusual anaesthetic in that it maintains blood pressure, cardiac output and respiration in man. Vascular effects and lowered body and tumour temperatures may also have influenced tumour oxygenation and radiation response. (author)

  13. CONTINUOUS MONITORING OF EXTRACELLULAR LACTATE CONCENTRATION BY MICRODIALYSIS LACTOGRAPHY FOR THE STUDY OF RAT MUSCLE METABOLISM INVIVO

    NARCIS (Netherlands)

    DEBOER, J; POSTEMA, F; PLIJTERGROENDIJK, H; KORF, J

    1991-01-01

    A method is described for the measurement and on-line monitoring of muscular extracellular lactate concentration in both anaesthetized and freely moving rats. This method is based on microdialysis sampling and lactic dehydrogenase-catalysed nicotinamide adenine dinucleotide, reduced (NADH)-fluoresce

  14. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS) : an international multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Davidson, Andrew J; Disma, Nicola; de Graaff, Jurgen C; Withington, Davinia E; Dorris, Liam; Bell, Graham; Stargatt, Robyn; Bellinger, David C; Schuster, Tibor; Arnup, Sarah J; Hardy, Pollyanna; Hunt, Rodney W; Takagi, Michael J; Giribaldi, Gaia; Hartmann, Penelope L; Salvo, Ida; Morton, Neil S; von Ungern Sternberg, Britta S; Locatelli, Bruno Guido; Wilton, Niall; Lynn, Anne; Thomas, Joss J; Polaner, David; Bagshaw, Oliver; Szmuk, Peter; Absalom, Anthony R; Frawley, Geoff; Berde, Charles; Ormond, Gillian D; Marmor, Jacki; McCann, Mary Ellen

    2016-01-01

    BACKGROUND: Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy

  15. Effects of posture on postoperative pulmonary function

    DEFF Research Database (Denmark)

    Nielsen, K G; Holte, Kathrine; Kehlet, H

    2003-01-01

    BACKGROUND: Pulmonary morbidity is still a relevant complication to major surgery despite improvements in surgical technique and anaesthetic methods. Postoperative posture may be a pathogenic factor, but the effects of changes in postoperative posture on pulmonary function have not been reviewed...

  16. Non-diabetic atypical necrobiosis lipoidica

    Directory of Open Access Journals (Sweden)

    Mittal R

    1994-01-01

    Full Text Available One 8 year female child had asymptomatic, anaesthetic, hypohidrotic, atrophic, yellowish, waxy plaque on the front of left thigh since 2 months. No nerve thickening was observed clinically or histopathologically. Hyperkeratosis, follicular keratosis, epidermal atrophy, degeneration of collagen, mononuclear granulomas and perivascular mononuclear infiltrate confirmed the clinical diagnosis of atypical necrobiosis lipoidica.

  17. Medical electrical equipment. Part 2-1: Particular requirements for the safety of electron accelerators in the range of 1 MeV to 50 MeV

    International Nuclear Information System (INIS)

    The International Standard has the statute of a Czech Technical Standard. The following topics are dealt with: requirements for the environment; protection against electric shock; protection against mechanical hazard; protection against unwanted or excessive radiation; protection against the ignition of flammable mixtures of anaesthetics; abnormal operation and failure states, testing the effect of environment; and requirements for design. (P.A.)

  18. The use anesthetic agents to promote welfare in anemonefish aquaculture: Case study to handling and long-distance transport

    Directory of Open Access Journals (Sweden)

    João Chambel

    2014-06-01

    The aim of this study was to evaluate the efficacy of three anaesthetic agents (80 to 110 mg/L of MS-222, 10 to 30 mg/L of clove oil and 100 to 350 mg/L of 2-phenoxyethanol in anaesthesia and the success of use different clove oil concentrations (1, 3 and 10 mg/L on water quality and survival of an ornamental anemonefish, Amphiprion percula, during long-distance transport in closed system for 48 hours. The lowest effective concentrations based on the efficacy criteria of complete anaesthetic induction within 180s, recovery within 300s and survival when exposed 30 min to anaesthetic was 15 mg/l for clove oil, 200 µl/L for 2-phenoxyethanol and 85 mg/L for MS-222. Above the concentrations of 30 mg/L, 300 µl/L and 100 mg/L of clove oil, 2-phenoxyethanol and MS-222 respectively, fish did not recovery when exposed to anaesthetic during 30min. During long-distance transport, clove oil slowed the increase on the ammonia concentration and the decrease on oxygen level, but did not affect the pH and only at concentration of 10 mg/L increase de mortality at 36 and 48 hours after packed. All concentrations showed a significance increase on water quality, reducing total ammonia from 9.31 ± 0.58 mg/L (control group to 5.43 ± 0.56 mg/L (1mg/L, 4.97 ± 0.59 mg/L (3mg/L and 3.88 ± 0.14 mg/L (10mg/L. This study showed that all anaesthetic agents under study can be used in anaesthesia of percula clownfish with optimal doses varied according to the anaesthetic, 15 to 25 mg/L of clove oil, 200 to 250 of 2-phenoxyethanol and 85 to 90 mg/L of MS-222, but clove oil was the anaesthetic agent more effectiveness and with major margin of safety for percula clownfish, and this anaesthesic (clove oil can be used in ornamental fish transportation, reducing the deterioration in water quality and ensuring a better transport environment and reduced stress for the fish. However must be careful related the dose in use, because an excess anesthesic may reduce dissolved oxygen and cause high

  19. Use of lidocaine, propranolol, amiodarone, and verapamil in toad envenoming (genus bufo in dogs

    Directory of Open Access Journals (Sweden)

    M. SAKATE

    2001-12-01

    Full Text Available Toad envenoming in dogs can cause death by cardiac fibrilation (CVF. Traditional therapy consists mainly of atropine and propranolol, the last one used to prevent the CVF, that is preceded by negative ventricular deflections (NVDs in the QRS complex of the electrocardiogram. This study intended to verify, comparatively, the lidocaine, propranolol, amiodarone, and verapamil abilities to prevent CVF in experimentally envenomed dogs. Thirty-six dogs were divided into 6 groups (GL, GP, GA, GV, GST, and GSV with n=6; the dogs were submitted to volatile anaesthesia. The animals of the groups GL, GP, GA, and GV received 0.38g of toad venom through oro-gastric catheter and were treated with the following drugs respectively: lidocaine (4mg/Kg, propranolol (0.1mg/Kg, amiodarone (8mg/Kg, and verapamil (2mg/Kg. These drugs were repeated if NVDs reappeared with cardiac frequency >150, GST was not treated and GSV was just anaesthetized. The following results were obtained: GL, NVDs present in 4 animals, 100% recuperation with 3.66 doses/animal; GP, NVDs present in 2 animals, 100% recuperation with 1.66 dose/animal, with bradycardia at the anaesthetic return; GA, NVDs present in 3 animals, 33.33% recuperation with 1.5 dose/animal; GV, NVDs present in 4 animals, 100% recuperation with 2.16 doses/animal; GST, NVD present in 6 animals, 100% death and GSV, NVDs absent, 100% recuperation. As a conclusion, the anaesthetic proceedings used, did not cause NVDs, the envenoming that was not treated was lethal, and among the antiarrhythmics drugs used, verapamil was the most efficient, as it did not cause any serious bradycardia at the anaesthetic return and did not require repeated administrations. For lidocaine, it was efficient but required various administrations; amiodarone could not prevent the death of 4 animals; propranolol was efficient in relation to NVDs control, but caused serious bradycardia at the anaesthetic return.

  20. EFFICACY OF TRANSFORAMINAL EPIDURAL STEROID INJECTION IN LUMBOSACRAL RADICULOPATHY

    Directory of Open Access Journals (Sweden)

    Saheel

    2016-02-01

    Full Text Available BACKGROUND Lumbosacral radiculopathy is a common medical and socioeconomic problem with a lifetime prevalence estimated to be around 40%-60%. In 1930, Evans reported that sciatica could be treated by epidural injection. The use of epidural corticosteroid injection for the treatment of axial and radicular back pain was first reported in 1953. Lumbar Transforminal Epidural Steroid Injections (TFESIs are performed to provide symptomatic relief in patients with radicular pain. A transforaminal epidural steroid injection (TFESI using a small volume of local anaesthetic will anaesthetize the spinal nerve and also partially anaesthetize the dura, the posterior longitudinal ligament, the intervertebral disc and facet joint. For these reasons, fluoroscopy-guided TFESI has become the preferred approach to epidural space. AIMS AND OBJECTIVES To study the role of transforaminal epidural steroid injection in management of radiculopathy. SETTINGS AND DESIGN This prospective study was conducted in the Department of Orthopaedics, SKIMS Medical College and Hospital, Bemina, Srinagar, J and K, India, for a 2-year period from November 2012 to October 2014; 110 cases, both male and female in the age group of 20-60 years having back pain with radiculopathy of varied types and duration without neurodeficit were enrolled in the study. MATERIALS AND METHODS After selecting a patient for giving transforaminal block, we used a local anaesthetic (2% Xylocaine. Contrast media, e.g. Iohexol was used to demarcate the correct positioning of the needle. A spinal needle (20-25 gauge and 5mL syringe were used to deliver the drug. CONCLUSION Transforaminal epidural steroid injections with long acting anaesthetic is an excellent form of conservative treatment in management of low back ache with radicular pain. It is relatively safe, simple, economical and shortens the time of recovery from severe pain, avoids risks and complications of surgery and also avoids long periods of bed

  1. Bispectral index-guided anaesthesia for off-pump coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Muralidhar Kanchi

    2008-01-01

    Full Text Available Bispectral index (BIS monitoring may assist reduction in utilisation of anaesthetic agents during general surgical procedures. This study was designed to test whether the use of BIS monitoring reduces the anaesthetic requirements during off-pump coronary artery bypass grafting (CABG. This prospective - clinical trial was conducted on 40 adult patients undergoing elective off-pump CABG. Patients received either isoflurane or propofol anaesthesia. BIS monitoring, which guided the dose of anaesthetic, was carried out in 50 percent of the patients. The amount of anaesthetic agent (isoflurane or propofol administered from the start of anaesthesia to the end of surgical procedure was calculated and were compared in four groups of patients - namely Group A (I-no BIS received isoflurane; end tidal concentration was maintained at 1-1.2% in a low flow technique throughout the procedure, Group B (I-BIS received isoflurane in a low flow technique; inspired concentration was dictated by BIS value maintained at 50; Group C (P-no BIS received propofol at a dose range of 4-8 mg/kg/hr and in Group D(P-BIS the propofol infusion rate was dictated by BIS value maintained at 50. The quantity of isoflurane was significantly less for Group B (I-BIS as compared with Group A (I-no BIS (37 ± 4 vs. 24 ± 4 ml; p< 0.05 and similarly the amount of propofol infused was significantly less in Group D (P-BIS as compared with Group C (P-no BIS (176 ± 9 vs. 120 ± 6 ml; p< 0.05. BIS guided anaesthesia reduces the anaesthetic agent required for the performance of off-pump CABG. This can be extrapolated in terms of saving agent and reduced cardiac depression during off-pump CABG.

  2. The proton transfer reaction mass spectrometer and its use in medical science: applications to drug assays and the monitoring of bacteria

    Science.gov (United States)

    Critchley, A.; Elliott, T. S.; Harrison, G.; Mayhew, C. A.; Thompson, J. M.; Worthington, T.

    2004-12-01

    Proton transfer reaction mass spectrometry (PTR-MS) enables monitoring of trace gases in air with high sensitivity without major gases interfering. In this paper, we present the potential use of a proton transfer reaction mass spectrometer for two medical applications; the monitoring of drugs and bacterial infection. The first study illustrates a feasibility trial to monitor the intravenous anaesthetic agent 2,6-di-isopropyl phenol (propofol), and two of its metabolites, on the breath of patients in real-time during surgery. Propofol is a commonly used intravenous anaesthetic. However, there is no method of instantaneously monitoring the plasma concentration of the agent during surgery, and therefore determining whether or not the plasma level is of such a value to ensure that the patient is correctly anaesthetized. That propofol and its metabolites were monitored in real-time using the PTR-MS suggests possibilities for routine intravenous anaesthesia monitoring analogous to that for volatile anaesthetic agents. In addition to the above work we also investigated proton transfer to another anaesthetic, sevoflurane. Comparisons between PTR-MS and selected ion flow tube (SIFT) investigations are presented. The second study presented in this paper investigated the volatile organic compounds emitted by microbial cell cultures. The objective was to show that different microbial cultures could be readily distinguished from the resulting mass spectra recorded using the PTR-MS. The initial results are encouraging, which taken together with the real-time analysis and high sensitivity of the PTR-MS, means that proton transfer reaction mass spectrometry has the potential to characterise bacterial infection rapidly.

  3. [PhysioFlex: a target-controlled self-regulating closed-circuit inhalation anesthesia regulator].

    Science.gov (United States)

    Nathan, N; Sperandio, M; Erdmann, W; Westerkamp, B; Van Dijk, G; Scherpereel, P; Feiss, P

    1997-01-01

    Physi Flex is the first commercially available apparatus capable for quantitative, or self-regulating target controlled inhalational anaesthesia, with a totally closed circuit, in adults and children. The fresh gas supply to the circuit is intermittent, automatically regulated by continuous monitoring of the volume and composition of the gas mixture in the breathing circuit. The circle system includes, instead of the two conventional one way valves, a blower creating a continuous unidirectional flow at 70 L.min-1. In addition to the CO2-absorber it contains an absorber with carbon, absorbing the anaesthetic vapour when switched into the circuit. The ventilator consists of four ventilating chambers, each one with a membrane separating the patient and the motor compartments. The displacement of the membranes generates and measures the tidal volume. Automatic ventilation is achieved by electric valves and motor gas, and manual ventilation using a bag. Spontaneous ventilation is also possible. The machine is operated via a computer with selects the number of ventilating chambers (one, two or four), and the tidal volume between 50 and 2,000 mL, depending on age, gender and weight of the patient. The computer maintains the gas volume and the gas and vapour concentrations at their preset values. The O2-flow and consumption, the N2O flow and uptake, FICO2 and FETCO2, FI and FET of the volatile anaesthetic, all other important data are displayed in a numerical and graphical form on a color screen and registered for a delayed analysis. The end tidal concentration of the volatile anaesthetic drives a stepmotor with a syringe containing the selected volatile anaesthetic agent with is directly injected into the breathing circuit where it is vaporized. Therefore the concentration of the anaesthetic vapour can be instantaneously increased with this injector at induction and lowered at end of anaesthesia with the carbon absorber, and the fresh gas consumption is significantly

  4. Quantifying the effect of isoflurane and nitrous oxide on somatosensory-evoked potentials

    Directory of Open Access Journals (Sweden)

    Usha Devadoss

    2010-01-01

    Full Text Available Anaesthetic techniques may have a significant effect on intraoperative-evoked potentials (EP. The present study is designed to compare Propofol anaesthesia with Isoflurane (with or without nitrous oxide during intraoperative somatosensory-evoked potential (SSEP monitoring in 15 ASA Grade I and II patients undergoing surgery for intracranial tumours. SSEPs in response to median and posterior tibial nerve stimulation were recorded under four different anaesthetic conditions: 1 Propofol infusion and ventilation with air-oxygen, 2 Isoflurane, 1.0 MAC and ventilation with air-oxygen, 3 Isoflurane 1.0 MAC and ventilation with nitrous oxide-oxygen, and 4 Return to Isoflurane, 1.0 MAC and ventilation with air-oxygen. Intraoperative monitoring of somatosensory evoked potentials is best recordable using Propofol. The morphology of the EP is reproducible with Isoflurane. This effect is exaggerated when it is advisable to avoid nitrous oxide.

  5. General versus regional anaesthesia for cataract surgery: effects on neutrophil apoptosis and the postoperative pro-inflammatory state.

    LENUS (Irish Health Repository)

    Goto, Y

    2012-02-03

    At clinically relevant concentrations, volatile anaesthetic agents influence neutrophil function. Our hypothesis was that sevoflurane would inhibit neutrophil apoptosis and consequently influence the postoperative pro-inflammatory state. In order to identify selectively the effect of the anaesthetic agent sevoflurane, we studied patients undergoing minimally stimulating (cataract) surgery randomly allocated to receive either sevoflurane (n = 11) or local anaesthesia (n = 12). Venous blood samples were taken immediately prior to anaesthesia and at 1, 8 and 24 h thereafter. The rate of neutrophil apoptosis, plasma concentration of cytokines and differential white cell count were measured. The rates of neutrophil apoptosis and plasma concentrations of IL-1beta, TNF-alpha and IL-8 at each time point were similar in the two groups. IL-6 concentrations increased significantly and to a similar extent compared to preanaesthetic levels at 8 and 24 h. This study demonstrates that sevoflurane does not influence the rate of neutrophil apoptosis, cytokine concentrations and neutrophil count following cataract surgery.

  6. Patterns in current anaesthesiological peri-operative practice for colonic resections: a survey in five northern-European countries

    DEFF Research Database (Denmark)

    Hannemann, P; Lassen, K; Hausel, J; Nimmo, S; Ljungqvist, O; Nygren, J; Soop, M; Fearon, K; Andersen, Jens; Revhaug, A; von Meyenfeldt, M F; Dejong, C H C; Spies, C

    2006-01-01

    BACKGROUND: For colorectal surgery, evidence suggests that optimal management includes: no pre-operative fasting, a thoracic epidural analgesia continued for 2 days post-operatively, and avoidance of fluid overload. In addition, no long-acting benzodiazepines on the day of surgery and use of short......-acting anaesthetic medication may be beneficial. We examined whether these strategies have been adopted in five northern-European countries. METHODS: In 2003, a questionnaire concerning peri-operative anaesthetic routines in elective, open colonic cancer resection was sent to the chief anaesthesiologist in 258...... digestive surgical centres in Scotland, the Netherlands, Denmark, Sweden and Norway. RESULTS: The response rate was 74% (n = 191). Although periods of pre-operative fasting up to 48 h were reported, most (> 85%) responders in all countries declared to adhere to guidelines for pre-operative fasting and oral...

  7. Does an allergy to fish pre-empt an adverse protamine reaction? A case report and a literature review.

    LENUS (Irish Health Repository)

    Collins, C

    2008-11-01

    The operating theatre exposes patients to myriad potential agents which could result in a life-threatening anaphylactic reaction. Anaesthetic drugs, blood products, and latex are only some of the possible allergens. Reactions are deemed to be anaphylactic when immediate sensitivity is combined with cardiovascular collapse. A patient who had a known allergy to shellfish presented for first time cardiopulmonary bypass. The perfusion team were concerned that there was a realistic possibility that an adverse reaction to protamine could occur. Anaphylactic reactions to protamine in patients allergic to fish have been reported. The anaesthetic team were informed and the necessary precautions taken. We report on the outcome for our patient and also discuss other risk factors and the types of reactions that can result when an adverse reaction to protamine occurs.

  8. Abdominal and internal intercostal motoneurones are strong synergists for expiration but are not synergists for Group I monosynaptic afferent inputs

    DEFF Research Database (Denmark)

    Ford, Tim W; Meehan, Claire Francesca; Kirkwood, Peter

    2014-01-01

    in 11 instances, 9 being in Group B Dist motoneurones. The complete absence of heteronymous monosynaptic Group I reflex excitation between muscles that are synergistically activated in expiration leads us to conclude that such connections from muscle spindle afferents of the thoracic nerves have......Internal intercostal and abdomininal motoneurones are strongly co-activated during expiration (Saywell et al. 2007; Road et al. 2013). We investigated whether that synergy was paralleled by synergistic Group I reflex excitation. Intracellular recordings were made from motoneurones of the internal...... intercostal nerve of T8 in anaesthetized cats and the specificity of the monosynaptic connections from afferents in each of the two main branches of this nerve was investigated by observing the presence or absence of short latency EPSPs from stimulation of each nerve branch. Cats were anaesthetized with...

  9. Influence of anaesthesia on canine hip dysplasia score.

    Science.gov (United States)

    Genevois, J-P; Chanoit, G; Carozzo, C; Remy, D; Fau, D; Viguier, E

    2006-10-01

    Hip dysplasia (HD) scores, based on the five grades, as defined by the Fédération Cynologique Internationale, were compared between anaesthetized (group 1, n = 3839) and non-sedated non-anaesthetized dogs (group 2, n = 1517). Each dog was radiographed in the standard ventro-dorsal hip joint extended position. Each radiograph was evaluated by the same reader blinded regarding the dog's status of anaesthesia. Results showed that there was a significant difference in hip dysplasia prevalence between group 1 (22%) compared with group 2 (9%) (P < 0.005). This difference was the result of a lower rate of hip-joint laxity assessment and the measurement of Norberg-Olsson angle <105 degrees in group 2 compared with group 1. The acetabular and femoral morphologies were not significantly different between the groups. The data confirm that the scoring of dogs for HD on standard radiographs with the hip joints extended is influenced by anaesthesia. PMID:16970631

  10. POSTOPERATIVE MUSCLE SPASM IN A CHILD WITH CEREBRAL PALSY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sanmuga Piriya

    2014-10-01

    Full Text Available Cerebral palsy is a non-progressive motor disorder which occurs due to hypoxic insult to fetus during perinatal period. These children often present for elective surgical procedures to correct various deformities. Peri-operative care of a child with cerebral palsy is a real challenge to the anaesthetics because of associated comorbidities. Yet another problem in these patients is behavior abnormality and difficulty in communication. Therefore regional anaesthesia is usually combined with general anaesthesia and not used alone. The two most important anaesthetics concerns in these patients are hypothermia and post-operative muscle spasm. Epidural analgesia is the most effective method of post-operative pain relief. Even though opioids can be used for post-operative analgesia, clonidine is more effective in relieving post-operative muscle spasm. In this case report we have discussed about the anesthetic management and postoperative muscle spasm in a child with cerebral palsy.

  11. Different immobilization procedures during irradiation influence the estimation of α/βratios in mouse lip mucosa

    International Nuclear Information System (INIS)

    In previous experiments an anaesthetic gas mixture of enflurane (Ethrane, Abbott, Belgium) and oxygen has been used to position mice for local irradiation. The development of a new immobilization method allowed the investigation of possible dose modifying effects of enflurane with different gasses as carrier on the radiation response of mouse lip mucosa. The effect of different immobilization procedures on single dose and fractionated irradiations was examined. The data collected emphasized the effect of different immobilization procedures on the estimation of α/β ratios, especially when large fraction sizes were involved. The data collected from experiments involving large fraction sizes should be avoided in the estimation of repair parameters. Further experimental work needs to be carried out to elucidate the possible dose modifying effects of anaesthetic agents in clinical practice, e.g. for infants and for patients undergoing intraoperative radiotherapy

  12. Differences in the effects of anaesthesia on hypoxia in normal tissues

    International Nuclear Information System (INIS)

    A study has been made of the effect of anaesthesia with sodium pentobarbitone on the mean skin reaction of mouse-tails 12 to 85 days after X-irradiation (0 to 7.5 krad). Anaesthetized mice were irradiated while breathing air or oxygen, or after the tails were clamped and nitrogen passed over the tails. The dose response curves showed that anaesthesia increased the radiosensitivity of the tissue. This increase can be ascribed to the suppression of the animal's temperature control mechanism by the anaesthetic, resulting is vasodilation of the blood vessels in the tail, and increase in oxygenation of the tissue. The effect is in contrast to that in many other tissues of the mouse. (U.K.)

  13. Effects of nitrous oxide on cerebral haemodynamics and metabolism during isoflurane anaesthesia in man

    International Nuclear Information System (INIS)

    Seven normoventilated and five hyperventilated healthy adults undergoing cholecystectomy and anaesthetized with methohexitone, fentanyl and pancuronium were studied with measurement of cerebral blood flow (CBF), cereal metabolic rate of oxygen (CMRo2), and quantified electroencephalography (EEG) under two sets of conditions: 1) 1.7% end-tidal concentration of isoflurane in air/oxygen: 2) 0.85% end-tidal concentration of isoflurane in nitrous oxide (N2O)/oxygen. The object was to study the effects of N2O during isoflurane anaesthesia on cerebral circulation, metabolism and neuroelectric activity. N2O in the anaesthetic gas mixture caused a 43% (P2 was not significantly altered by N2O. EEG demonstrated an activated pattern with decreased low frequency activity and increased high frequency activity. The results confirm that N2O is a potent cerebral vasodilator in man, although the mechanisms underlying the effects on CBF are still unclear. (au)

  14. AN UPDATE ON CLINICAL CONCEPTS OF PROPOFOL

    Directory of Open Access Journals (Sweden)

    Manisha

    2014-12-01

    Full Text Available : Propofol is an intravenous anaesthetic agent. Used as an induction agent it has replaced sodium thiopentone to a large extent. Apart from induction Propofol is used for maintenance of anaesthesia, intravenous sedation and as infusion in mechanically ventilated patients. Its faster and clear recovery has made it a drug of choice in day care cases. Propofol is cardiorespiratory depressant drug.It also lowers intracranial pressure and the laryngeal-pharyngeal reflexes. The properties of Propofol has made it a widely accepted anaesthetic agent. Wide application and easy availability has put the person using it at the risk of drug abuse. This article has focused on the clinical pharmacology, use, abuse and the future prospects of Propofol.

  15. Anatomy and physiology of respiratory system relevant to anaesthesia

    Directory of Open Access Journals (Sweden)

    Apeksh Patwa

    2015-01-01

    Full Text Available Clinical application of anatomical and physiological knowledge of respiratory system improves patient's safety during anaesthesia. It also optimises patient's ventilatory condition and airway patency. Such knowledge has influence on airway management, lung isolation during anaesthesia, management of cases with respiratory disorders, respiratory endoluminal procedures and optimising ventilator strategies in the perioperative period. Understanding of ventilation, perfusion and their relation with each other is important for understanding respiratory physiology. Ventilation to perfusion ratio alters with anaesthesia, body position and with one-lung anaesthesia. Hypoxic pulmonary vasoconstriction, an important safety mechanism, is inhibited by majority of the anaesthetic drugs. Ventilation perfusion mismatch leads to reduced arterial oxygen concentration mainly because of early closure of airway, thus leading to decreased ventilation and atelectasis during anaesthesia. Various anaesthetic drugs alter neuronal control of the breathing and bronchomotor tone.

  16. Absorption of topically applied hydrocortisone from the eye of the rhesus monkey

    International Nuclear Information System (INIS)

    Blood samples were collected from anaesthetized monkeys during one h a) afer topical application of an eyedrop of hydrocortisone acetate suspension, b) after topical application of a drop of the vehicle alone, and c) after no application at all. Radioimmunoassay (RIA) showed a rapid and similar increase of hydrocortisone plasma levels in all 3 kinds of experiments. RIA revealed that in monkeys the anaesthetic procedure alone was sufficient to cause a considerable increase of endogenous hydrocortisone levels overshadowing any systemic absorption of topical hydrocortisone. Using tritiated hydrocortisone instead a rapid increase of systemic absorption after topical application was found. A plasma concentration of 1% of the dose was found one min after topical instillation incresing to a maximum of 6-7% at 30 min. The half time of the slow phase of elimination was about 19 h. (author)

  17. Recipes for obstetric spinal hypotension: The clinical context counts.

    Science.gov (United States)

    Bishop, David G; Rodseth, Reitze N; Dyer, Robert A

    2016-09-01

    Hypotension following obstetric spinal anaesthesia remains a common and important problem. While recent research advances have brought us closer to the perfect recipe for the obstetric spinal anaesthetic, these advances have not been translated into practical guidelines able to reduce the unacceptable number of fatalities that occur in environments where resources are limited. In South Africa, more than half of anaesthetic deaths are still related to spinal hypotension. A gap exists between the 'perfect recipe', developed from a clinical context rooted in resource-rich research environments, and its application and performance in real-world resource-poor environments - conditions experienced by more than 75% of the world's population. This review attempts to define this knowledge gap and proposes a research agenda to address the deficiencies. PMID:27601104

  18. Postoperative changes in visual evoked potentials and cognitive function tests following sevoflurane anaesthesia.

    LENUS (Irish Health Repository)

    Iohom, G

    2012-02-03

    We tested the hypothesis that minor disturbance of the visual pathway persists following general anaesthesia even when clinical discharge criteria are met. To test this, we measured visual evoked potentials (VEPs) in 13 ASA I or II patients who did not receive any pre-anaesthetic medication and underwent sevoflurane anaesthesia. VEPs were recorded on four occasions, before anaesthesia and at 30, 60, and 90 min after emergence from anaesthesia. Patients completed visual analogue scales (VAS) for sedation and anxiety, a Trieger Dot Test (TDT) and a Digit Symbol Substitution Test (DSST) immediately before each VEP recording. These results were compared using Student\\'s t-test. P<0.05 was considered significant. VEP latency was prolonged (P<0.001) and amplitude diminished (P<0.05) at 30, 60, and 90 min after emergence from anaesthesia, when VAS scores for sedation and anxiety, TDT, and DSST had returned to pre-anaesthetic levels.

  19. Psychiatric patient and anaesthesia

    Directory of Open Access Journals (Sweden)

    Joginder Pal Attri

    2012-01-01

    Full Text Available Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient′s physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse.

  20. The effects of anesthetic agents on oxidative stress

    Science.gov (United States)

    Yakan, Selvinaz; Düzgüner, Vesile

    2016-04-01

    Oxidative stress can be defined as the instability between antioxidant defense of the body and the production of free radical that causes peroxydation on the lipid layer. Free radicals are reactive oxygen species that are produced in the course of normal metabolisms of aerobe organisms and they may cause disorders in cell structure and organelles by interacting macromolecules, like lipid, protein, nucleic acids. Therefore, they may cause cardiovascular, immune system, liver, kidney illnesses and many other illnesses like cancer, aging, cataract, diabetes. It is known that many drugs used for the purpose of anesthetizing may cause lipid peroxidation in organism. For these reasons, determining the Oxidative stress index of anaesthetic stress chosen in the ones that are exposed to long term anaesthetic agents and anaesthesia appliccations, is so substantial.