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Sample records for anesthesia gas-guided protocol

  1. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients

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    Villafranca Alex

    2009-11-01

    Full Text Available Abstract Background Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists has called for adequately powered and rigorously designed clinical trials to determine whether the use of such monitors decreases the incidence of awareness in various settings. The aim of this study is to determine with increased precision whether incorporating the bispectral index into a structured general anesthesia protocol decreases the incidence of awareness with explicit recall among a subset of surgical patients at increased risk for awareness and scheduled to receive an inhalation gas-based general anesthetic. Methods/Design BAG-RECALL is a multi-center, randomized, controlled clinical trial, in which 6,000 patients are being assigned to bispectral index-guided anesthesia (target range, 40 to 60 or end-tidal anesthetic gas-guided anesthesia (target range, 0.7 to 1.3 age-adjusted minimum alveolar concentration. Postoperatively, patients are being assessed for explicit recall at two intervals (0 to 72 hours, and 30 days after extubation. The primary outcome of the trial is awareness with explicit recall. Secondary outcomes include postoperative mortality, psychological symptoms, intensive care and hospital length of stay, average anesthetic gas administration, postoperative pain and nausea and vomiting, duration of stay in the recovery area, intra-operative dreaming, and postoperative delirium. Discussion This trial has been designed to complement two other clinical trials: B-Unaware and MACS (ClinicalTrials.gov numbers, NCT00281489 and NCT00689091

  2. Potential anesthesia protocols for space exploration missions.

    Science.gov (United States)

    Komorowski, Matthieu; Watkins, Sharmila D; Lebuffe, Gilles; Clark, Jonathan B

    2013-03-01

    In spaceflight beyond low Earth's orbit, medical conditions requiring surgery are of a high level of concern because of their potential impact on crew health and mission success. Whereas surgical techniques have been thoroughly studied in spaceflight analogues, the research focusing on anesthesia is limited. To provide safe anesthesia during an exploration mission will be a highly challenging task. The research objective is thus to describe specific anesthesia procedures enabling treatment of pre-identified surgical conditions. Among the medical conditions considered by the NASA Human Research Program Exploration Medical Capability element, those potentially necessitating anesthesia techniques have been identified. The most appropriate procedure for each condition is thoroughly discussed. The substantial cost of training time necessary to implement regional anesthesia is pointed out. Within general anesthetics, ketamine combines the unique advantages of preservation of cardiovascular stability, the protective airway reflexes, and spontaneous ventilation. Ketamine side effects have for decades tempered enthusiasm for its use, but recent developments in mitigation means broadened its indications. The extensive experience gathered in remote environments, with minimal equipment and occasionally by insufficiently trained care providers, confirms its high degree of safety. Two ketamine-based anesthesia protocols are described with their corresponding indications. They have been designed taking into account the physiological changes occurring in microgravity and the specific constraints of exploration missions. This investigation could not only improve surgical care during long-duration spaceflights, but may find a number of terrestrial applications in isolated or austere environments.

  3. Newer Anesthesia and Rehabilitation Protocols Enable Outpatient Hip Replacement in Selected Patients

    OpenAIRE

    Berger, Richard A; Sanders, Sheila A.; Thill, Elizabeth S.; Sporer, Scott M.; Della Valle, Craig

    2009-01-01

    Advancements in the surgical approach, anesthetic technique, and the initiation of rapid rehabilitation protocols have decreased the duration of hospitalization and subsequent length of recovery following elective total hip arthroplasty. We assessed the feasibility and safety of outpatient total hip arthroplasty in 150 consectutive patients. A comprehensive perioperative anesthesia and rehabilitation protocol including preoperative teaching, regional anesthesia, and preemptive oral analgesia ...

  4. Impact of Anesthesia Protocols on In Vivo Bioluminescent Bacteria Imaging Results.

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    Thomas Chuzel

    Full Text Available Infectious murine models greatly benefit from optical imaging using bioluminescent bacteria to non-invasively and repeatedly follow in vivo bacterial infection. In this context, one of the most critical parameters is the bioluminescence sensitivity to reliably detect the smallest number of bacteria. Another critical point is the anesthetic approaches that have been demonstrated to impact the bioluminescence flux emission in studies with luciferase-transfected tumor cells. However, this impact has never been assessed on bacteria bioluminescent models. To this end, we investigated the effects of four anesthesia protocols on the bioluminescence flux in a central venous catheter murine model (SKH1-hr(hr mice infected by a bioluminescent S. aureus Xen36 strain. Bioluminescence imaging was performed on mice anesthetized by either ketamine/xylazine (with or without oxygen supplementation, or isoflurane carried with air or oxygen. Total flux emission was determined in vivo daily for 3 days and ex vivo at the end of the study together with a CFU counting of the biofilm in the catheter. Bioluminescence flux differences appear between the different anesthetic protocols. Using a ketamine/xylazine anesthesia (with air, bacteria detection was impossible since the bioluminescence signal remains in the background signal. Mice anesthetized with isoflurane and oxygen led to a signal significantly higher to the background all along the kinetics. The use of isoflurane in air presents a bioluminescence signal similar to the use of ketamine/xylazine with oxygen. These data highlight the importance of oxygen to improve bioluminescence flux by bacteria with isoflurane as well as with ketamine/xylazine anesthetics. As a conclusion, we recommend the use of isoflurane anesthetic with oxygen to increase the bioluminescence sensitivity in this kind of study.

  5. Impact of Anesthesia Protocols on In Vivo Bioluminescent Bacteria Imaging Results.

    Science.gov (United States)

    Chuzel, Thomas; Sanchez, Violette; Vandamme, Marc; Martin, Stéphane; Flety, Odile; Pager, Aurélie; Chabanel, Christophe; Magnier, Luc; Foskolos, Marie; Petit, Océane; Rokbi, Bachra; Chereul, Emmanuel

    2015-01-01

    Infectious murine models greatly benefit from optical imaging using bioluminescent bacteria to non-invasively and repeatedly follow in vivo bacterial infection. In this context, one of the most critical parameters is the bioluminescence sensitivity to reliably detect the smallest number of bacteria. Another critical point is the anesthetic approaches that have been demonstrated to impact the bioluminescence flux emission in studies with luciferase-transfected tumor cells. However, this impact has never been assessed on bacteria bioluminescent models. To this end, we investigated the effects of four anesthesia protocols on the bioluminescence flux in a central venous catheter murine model (SKH1-hr(hr) mice) infected by a bioluminescent S. aureus Xen36 strain. Bioluminescence imaging was performed on mice anesthetized by either ketamine/xylazine (with or without oxygen supplementation), or isoflurane carried with air or oxygen. Total flux emission was determined in vivo daily for 3 days and ex vivo at the end of the study together with a CFU counting of the biofilm in the catheter. Bioluminescence flux differences appear between the different anesthetic protocols. Using a ketamine/xylazine anesthesia (with air), bacteria detection was impossible since the bioluminescence signal remains in the background signal. Mice anesthetized with isoflurane and oxygen led to a signal significantly higher to the background all along the kinetics. The use of isoflurane in air presents a bioluminescence signal similar to the use of ketamine/xylazine with oxygen. These data highlight the importance of oxygen to improve bioluminescence flux by bacteria with isoflurane as well as with ketamine/xylazine anesthetics. As a conclusion, we recommend the use of isoflurane anesthetic with oxygen to increase the bioluminescence sensitivity in this kind of study.

  6. Hematology of Nile tilapia (Oreochromis niloticus subjected to anesthesia and anticoagulation protocols

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    Nadia Cristine Weinert

    2015-12-01

    Full Text Available Clinical hematology facilitates the diagnosis of disease and can act as a prognostic indicator of pathological conditions in fish. The aim of the present study was to evaluate hematological parameters of Nile tilapia (Oreochromis niloticus subjected to different anesthetics and anticoagulants. Thirty apparently healthy fishes (average weight of 473 ± 35. 50 g and mean total length of 29. 33 ± 0. 37 cm, were selected from the local commercial fish farm in the Lages municipality (Santa Catarina, Brazil. The animals were randomly divided into three groups of 10. In two groups, anesthesia was induced with eugenol (70 mg·L- 1 (EG and Benzocaine hydrochloride (100 mg·L-1 (BG, respectively. Anesthesia was not administered to fish of the third group (CG/control group. Blood samples were obtained by venipuncture of the caudal vessels and placed into microtubes containing sodium heparin or Na2EDTA for further analysis. The results were analyzed by Sigma Stat for Windows, the paired t-test for significant differences between anticoagulants of the same group, and analysis of variance followed by the Tukey test for comparison of means between groups (p ? 0. 05. Most of the observed changes in the erythrogram were significantly higher for the anticoagulant heparin and benzocaine group in comparison to the control group. However, the values obtained for the leukogram were significantly higher for all groups subjected to the Na2EDTA anticoagulant, suggesting that heparin may cause cell clumping. The results suggest that the anesthetics under investigation effectively minimizes the effects of stress caused by handling and invasive procedures, and that the anticoagulant heparin causes less hemolysis in comparison to Na2EDTA for Nile tilapia. Thus, the hematological variations attributed to different anesthetic protocols and/or different anticoagulants should be considered for the species Oreochromis niloticus.

  7. A rapid and effective nonsurgical artificial insemination protocol using the NSET™ device for sperm transfer in mice without anesthesia.

    Science.gov (United States)

    Stone, Barbara J; Steele, Kendra H; Fath-Goodin, Angelika

    2015-08-01

    Artificial insemination (AI) is an assisted reproductive technique that is implemented successfully in humans as a fertility treatment, performed extensively for commercial breeding of livestock, and is also successful in laboratory rodents. AI in the mouse may be especially useful for breeding of transgenic or mutant mice with fertility problems, expansion of mouse colonies, and as an alternative to in vitro fertilization. Nonsurgical AI techniques for the mouse have been described previously but are not often implemented due to technical difficulties. Here we compare various protocols for preparation of CD1 recipients prior to AI for naïve (in estrus), ovulation-induced, and superovulated females. Timing of hormone administration relative to sperm delivery is also compared. An improved protocol for nonsurgical AI in mice is described, which incorporates a convenient hormone administration schedule for female recipients and rapid, non-stressful sperm transfer without the need for anesthesia or analgesia.

  8. Combat Anesthesia: A Case Report of a Gunshot Wound and New Trauma Protocols.

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    Strube, Peter D; Perkins, Andrew D

    2015-08-01

    Revolutionary innovations and technical advances in the disciplines of medicine, surgery, and anesthesia are inextricably connected to military conflict. The demonstrated lifesaving value of these novel approaches in high-acuity trauma has provided the impetus for translation of these elements into injury care in the civilian environment. One element of this battlefield medical revolution is the implementation and refinement of forward surgical care. All US military services have unique configurations of this surgical team to match their expeditionary capacity. The US Army Forward Surgical Team (FST) is a small, mobile surgical unit fielded since the 1990s, but not ubiquitously used until the current contingency operations in southwest Asia. The FST has been used in a variety of ways during the current conflict with or without augmentation by a forward support medical company, Area Support Medical Company, and Brigade Medical Company also known as C-Med. Far forward stand-alone FST have often been emplaced to provide a surgical capability for patients in austere operational environments and to optimize casualty survival in situations of high-risk operations and/or with potential for protracted evacuation.

  9. Optimization of anesthesia protocol for resting-state fMRI in mice based on differential effects of anesthetics on functional connectivity patterns.

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    Grandjean, Joanes; Schroeter, Aileen; Batata, Imene; Rudin, Markus

    2014-11-15

    Resting state-fMRI (rs-fMRI) in mice allows studying mechanisms underlying functional connectivity (FC) as well as alterations of FC occurring in murine models of neurological diseases. Mouse fMRI experiments are typically carried out under anesthesia to minimize animal movement and potential distress during examination. Yet, anesthesia inevitably affects FC patterns. Such effects have to be understood for proper interpretation of data. We have compared the influence of four commonly used anesthetics on rs-fMRI. Rs-fMRI data acquired under isoflurane, propofol, and urethane presented similar patterns when accounting for anesthesia depth. FC maps displayed bilateral correlation with respect to cortical seeds, but no significant inter-hemispheric striatal connectivity. In contrast, for medetomidine, we detected bilateral striatal but compromised inter-hemispheric cortical connectivity. The spatiotemporal patterns of the rs-fMRI signal have been rationalized considering anesthesia depth and pharmacodynamic properties of the anesthetics. Our results bridge the results from different studies from the burgeoning field of mouse rs-fMRI and offer a framework for understanding the influences of anesthetics on FC patterns. Utilizing this information, we suggest the combined use of medetomidine and isoflurane representing the two proposed classes of anesthetics; the combination of low doses of the two anesthetics retained strong correlations both within cortical and subcortical structures, without the potential seizure-inducing effects of medetomidine, rendering this regimen an attractive anesthesia for rs-fMRI in mice.

  10. Spinal and epidural anesthesia

    Science.gov (United States)

    ... you epidural or spinal anesthesia is called an anesthesiologist. First, the area of your back where the ... Chan VWS. Spinal, epidural, and caudal anesthesia. In: Miller RD, ed. Miller's Anesthesia . 8th ed. Philadelphia, PA: ...

  11. Obesity and Anesthesia

    Science.gov (United States)

    ... Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery Obesity and Anesthesia More than one-third of Americans ... Sleep Apnea, a chronic medical problem common with obesity, can present with serious breathing problems before, during, ...

  12. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ... 6620 | E-mail: info@sambahq.org Copyright | 2016 Society for Ambulatory Anesthesia Home | Search | Terms | Privacy Policy | ...

  13. Marsupial, insectivore, and chiropteran anesthesia.

    Science.gov (United States)

    Pye, G W

    2001-01-01

    This article covers the manual restraint and anesthesia of marsupials, insectivores, and chiroptera. Marsupials commonly kept as pets in the U.S. [e.g., eastern gray kangaroos (Macropus giganteus), Bennett's wallabies (Macropus rufogriseus), and sugar gliders (Petaurus breviceps)] are covered in detail. Marsupial species kept in zoological parks [e.g., Tasmanian devils, koalas (Phascolarctos cinereus), and common wombats (Vombatus ursinus)] are covered in less detail. Of the insectivores, only the African hedgehog (Atelerix albiventris) and the European hedgehog (Erinaceus europaeus) are commonly kept as pets and, consequently, the insectivore section concentrates on discussing these two species. The section on chiropteran anesthesia is divided into two broad categories: the megachiropterans (flying foxes and fruit bats) and the microchiropterans (insectivorous bats). Most of the information on the species covered in this article is anecdotal, and this should be kept in mind when using the anesthesia protocols described.

  14. Anesthesia for fetoscopic intervention

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    Jamil S Anwari

    2014-01-01

    Full Text Available This is the first case report on anesthesia for fetoscopy performed in Saudi Arabia. Epidural anesthesia was given to the mother in her late second trimester for the fetoscopic intervention. The anesthesia related issues such as physiological and anatomical changes in pregnancy, tocolytic medications and their interactions with anesthesia, anesthetizing/sedating the primary patient are discussed.

  15. Topical anesthesia

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    Mritunjay Kumar

    2015-01-01

    Full Text Available Topical anesthetics are being widely used in numerous medical and surgical sub-specialties such as anesthesia, ophthalmology, otorhinolaryngology, dentistry, urology, and aesthetic surgery. They cause superficial loss of pain sensation after direct application. Their delivery and effectiveness can be enhanced by using free bases; by increasing the drug concentration, lowering the melting point; by using physical and chemical permeation enhancers and lipid delivery vesicles. Various topical anesthetic agents available for use are eutectic mixture of local anesthetics, ELA-max, lidocaine, epinephrine, tetracaine, bupivanor, 4% tetracaine, benzocaine, proparacaine, Betacaine-LA, topicaine, lidoderm, S-caine patch™ and local anesthetic peel. While using them, careful attention must be paid to their pharmacology, area and duration of application, age and weight of the patients and possible side-effects.

  16. [General anesthesia].

    Science.gov (United States)

    Feiss, P

    2001-04-30

    General anaesthesia is a reversible loss of consciousness induced and maintained with a hypnotic drug given either by venous injection and infusion, or by inhalation. A potent opioid is usually associated to inhibit the transmission of pain and thus to lessen sympathetic and endocrine reactions to nociceptive stimuli. Myorelaxation is used to facilitate tracheal intubation and surgery. Whatever the anaesthetic protocol use, the patient and anaesthesia machine require close monitoring. In addition to vital signs, the depth of anaesthesia may be monitored using automated electroencephalographic analysis and myorelaxation should always be monitored using a nerve stimulator, but pain or analgesia evaluation is only based on clinical signs of sympathetic stimulation. Because anaesthesia-related death and morbidity have decreased considerably, future improvements in outcome should concern perioperative comfort, i.e. prevention of cognitive disturbances, nausea, vomiting and pain.

  17. [Automated anesthesia record system].

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    Zhu, Tao; Liu, Jin

    2005-12-01

    Based on Client/Server architecture, a software of automated anesthesia record system running under Windows operation system and networks has been developed and programmed with Microsoft Visual C++ 6.0, Visual Basic 6.0 and SQL Server. The system can deal with patient's information throughout the anesthesia. It can collect and integrate the data from several kinds of medical equipment such as monitor, infusion pump and anesthesia machine automatically and real-time. After that, the system presents the anesthesia sheets automatically. The record system makes the anesthesia record more accurate and integral and can raise the anesthesiologist's working efficiency.

  18. Anesthesia methods used by anesthetic specialists for circumcision cases

    Science.gov (United States)

    Altaş, Cafer; Küçükosman, Gamze; Yurtlu, Bülent S.; Okyay, Rahşan D.; Aydın, Bengü G.; Pişkin, Özcan; Çimencan, Murat; Ayoğlu, Hilal; Hancı, Volkan; Özkoçak-Turan, Işıl

    2017-01-01

    Objectives: To examine the anesthesiologist’s choice for anesthesia techniques and drugs in circumcision and determine the preoperative examination, intraoperative monitoring techniques, postoperative analgesia methods, and common complications among anesthesiologists working in Turkey. Methods: This cross-sectional study was conducted at Bulent Ecevit University Hospital, Zonguldak, Turkey, between May and July 2012. Survey data were obtained via survey forms through electronic data over the web. The questionnaire consists of 20 questions. These questions included demographic data, methods of anesthesia for circumcision, postoperative analgesia methods, and monitoring methods. Results: The data were obtained from 206 anesthesiologists who agreed to participate in the survey. Circumcision was performed most frequently in the age group of 3-6 years old. It was found that 47% of routine preoperative laboratory tests were coagulation parameters and complete blood count tests. The most common method of anesthesia was laryngeal mask. The frequency of administration of regional anesthesia was 37.4%, and caudal block was more preferable. Bupivacaine as a local anesthetic in regional anesthesia and midazolam and ketamine were the most preferred agents in sedoanalgesia. During regional anesthesia, ultrasound was most often used by anesthesiologists (31.6%). Conclusion: Ambulatory anesthesia protocols, which are also needed in circumcision, can be improved with international recommendation, and these protocols could be conformed as sociocultural structure in societies. This study should be regarded as a preliminary study to attract attention on anesthesia techniques in circumcision. PMID:28042634

  19. Chest CT in children: anesthesia and atelectasis

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    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  20. [Anesthesia for ambulatory patients].

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    Landauer, B

    1975-11-13

    The specific problems of outpatient anesthesia are discussed with respect to the patient's condition, the anesthesist's qualification and pharmacological properties of anesthetics used. Methohexitone seems to be the best choice for induction. Problems may arise from the use of Propanidid, Ketamin and Diazepam. Nitrousoxide and Enflurane are a suitable completion. Endotracheal intubation, if needed, is facilitated by Suxamethonium, which is rapidly eliminated. Practical aspects of timing, premedication, induction, maintenance and ending of anesthesia are pointed out. After 1-2 hours the patient can be allowed to leave the hospital accompanied by a responsible person. Driving a car is not recommended before 24 hours have elapsed since anesthesia.

  1. Intraoperative patient information handover between anesthesia providers

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    Choromanski, Dominik; Frederick, Joel; McKelvey, George Michael; Wang, Hong

    2014-01-01

    Abstract Currently, no reported studies have evaluated intraoperative handover among anesthesia providers. Studies on anesthetic handover in the US recovery room setting observed that handover processes are insufficient and, in many instances, significant intraoperative events are disregarded. An online survey tool was sent to anesthesia providers at US anesthesia residency programs nationwide (120 out of the 132 US programs encompassing around 4500 residents and their academic MDAs) and a smaller survey selection of CRNAs (10 institutions about 300 CRNAs in the metropolitan area of Detroit, MI, USA) to collect information on handover practices. The response rate to this survey (n = 216) was comprised of approximately 5% (n = 71) of the resident population in US anesthesia programs, 5% (n = 87) of MDAs , and 20% (n = 58) of the CRNAs. Out of all respondents (n = 212), 49.1 % had no hand-over protocol at their institution and 88% of respondents who did have institutional handover protocols believed them insufficient for effective patient handover. In addiiton, 84.8% of all responders reported situations where there was insufficient information received during a patient handover. Only 7% of the respondents reported never experiencing complications or mismanagement due to poor or incomplete hand-overs. In contrast, 60% reported rarely having complications, 31% reported sometimes having complications, and 3% reported frequent complications. In conclusion, handover transition of patient care is a vulnerable and potentially life-threatening event in the operating room. Our preliminary study suggests that current intraoperatvive handover practices among anesthesia providers are suboptimal and that national patient handover guidelines are required to improve patient safety. PMID:25332710

  2. Anesthesia & Down Syndrome

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    ... tests used to verify existence and severity of valvular heart disease. Unfortunately, not all adults with Down syndrome will ... exams without sedation or anesthesia. Suspected existence of valvular heart disease must be communicated to the anesthesiologist prior to ...

  3. Risk management in anesthesia.

    Science.gov (United States)

    Cabrini, L; Levati, A

    2009-11-01

    Anesthesia is considered a leading discipline in the field of patient safety. Nevertheless, complications still occur and can be devastating. A substantial portion of anesthesia-related adverse events are preventable since risk factors can be detected and eliminated. Risk management (RM) in anesthesia includes preventive and remedial measures to minimize patient anesthesia-related morbidity and mortality. RM involves all aspects of anesthesia care. Classically, the following four steps are needed to prevent critical incidents or to learn from them: (1) detection of problems, (2) assessment, (3) implementation of solutions, and (4) verification of effectiveness. Problems and solutions can be identified into the fields of structures, processes and personnel. Authoritative agencies like the World Health Organization, the World Federation of Societies of Anesthesiologists, the Section and Board of Anesthesiology of the European Union of Medical Specialties and the Italian Scientific Society of Anesthesiologists (Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva SIAARTI) have proposed initiatives addressing safety in the operating room. The central role of a well-trained, constantly present anesthesiologist and the usefulness of checklists have been highlighted. Cost cutting and production pressure in medical care are potential threats to safety. A shared knowledge of the best standards of care and of the potential consequences of unscrupulous actions could make the daily management of conflicting interests easier. A correctly applied RM can be a powerful, highly beneficial aid to our practice.

  4. The Develoment of Anesthesia.

    Science.gov (United States)

    Davis, Audrey B.

    1982-01-01

    Until the eighteenth century, doctors were reluctant to use chemicals to alleviate pain because they accepted the religious/moral beliefs of their day, claiming that pain was beneficial for the body. Traces technical developments in the control of pain, discussing relationships of anesthesia to social, cultural, and scientific factors and…

  5. Local anesthesia: a review.

    Science.gov (United States)

    Malamed, S F; Sykes, P; Kubota, Y; Matsuura, H; Lipp, M

    1992-01-01

    Local anesthetics are the most widely administered drugs in dentistry. Significant advances have been made in past decades that have greatly increased both the safety and the efficacy of these important drugs. This paper reviews the history of local anesthesia, pharmacokinetics and clinical implications, techniques, complications, and future directions in the quest for more effective pain control in dentistry.

  6. Anesthesia for thoracoscopic surgery

    OpenAIRE

    Conacher I

    2007-01-01

    Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therape...

  7. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  8. Safe Anesthesia For Every Tot

    DEFF Research Database (Denmark)

    Weiss, Markus; Vutskits, Laszlo; Hansen, Tom G

    2015-01-01

    PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus...... on the safe conduct of pediatric anesthesia. This initiative aims to provide guidance on markers of quality anesthesia care. The introduction and implementation of national regulations of 'who, where, when and how' are required and will result in an improved perioperative outcome in vulnerable children....... The improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps...

  9. Acute Paraplegia After General Anesthesia

    Directory of Open Access Journals (Sweden)

    Gholam Hossein Ghaedi

    2011-08-01

    Full Text Available Acute paraplegia is a rare but catastrophic complication of surgeries performed on aorta and corrective operations of vertebral column. Trauma to spinal cord after spinal anesthesia and ischemia of spinal cord also may lead to acute paraplegia. Acute paraplegia as a complication of general anesthesia in surgeries performed on sites other than aorta and vertebral column is very rare. Here we present a 56 year old woman with acute paraplegia due to spinal cord infarction after laparoscopic cholecystectomy under general anesthesia probably caused by atherosclerosis of feeding spinal arteries and ischemia of spinal cord after reduction of blood flow possibly due to hypotension during general anesthesia.

  10. Anesthesia of the geriatric equine

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    Doherty TJ

    2012-08-01

    Full Text Available Reza Seddighi, Thomas J DohertyDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, Veterinary Medical Center, University of Tennessee, Knoxville, TN, USAAbstract: Advancements in veterinary medicine have resulted in an increased number of geriatric horses being presented for medical or surgical procedures that require general anesthesia. Due to the physiological changes associated with aging and the likelihood of concurrent disease conditions, the geriatric equine is at an increased risk during anesthesia. The main physiological changes associated with aging, and their impact on anesthesia, are discussed in this review.Keywords: geriatric, equine, anesthesia

  11. Anesthesia for Adults Having Eye Surgery

    Science.gov (United States)

    ... Condiciones Chinese Conditions Anesthesia for Adults Having Eye Surgery En Español What kinds of anesthesia are available for adults having eye surgery? A “general”, “local”, or “topical” anesthesia is necessary ...

  12. Delayed emergence after anesthesia.

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    Tzabazis, Alexander; Miller, Christopher; Dobrow, Marc F; Zheng, Karl; Brock-Utne, John G

    2015-06-01

    In most instances, delayed emergence from anesthesia is attributed to residual anesthetic or analgesic medications. However, delayed emergence can be secondary to unusual causes and present diagnostic dilemmas. Data from clinical studies is scarce and most available published material is comprised of case reports. In this review, we summarize and discuss less common and difficult to diagnose reasons for delayed emergence and present cases from our own experience or reference published case reports/case series. The goal is to draw attention to less common reasons for delayed emergence, identify patient populations that are potentially at risk and to help anesthesiologists identifying a possible cause why their patient is slow to wake up.

  13. Nurse anesthesia and multiculturalism.

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    Horton, B J; Waugaman, W R

    1996-01-01

    Program directors from 90 accredited nurse anesthesia programs in the United States and Puerto Rico were surveyed concerning multicultural issues. This article summarizes the identified needs of clients and student nurse anesthetists from culturally diverse backgrounds. Noteworthy findings include the perception that clients were more disadvantaged than students because of differences in socioeconomic status; the fact that about half of the programs provided students with instruction on cultural differences; and the observation that specific units of instruction within courses were the most frequent way of giving instruction in this subject area.

  14. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I

    2007-01-01

    Full Text Available Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therapeutic for thoracotomy. Perioperative management needs to reflect the concern for these complex, and complicating, processes to the morbidity of thoracoscopic surgery.

  15. Anesthesia and pulmonary hypertension.

    Science.gov (United States)

    McGlothlin, Dana; Ivascu, Natalia; Heerdt, Paul M

    2012-01-01

    Anesthesia and surgery are associated with significantly increased morbidity and mortality in patients with pulmonary hypertension due mainly to right ventricular failure, arrhythmias, postoperative hypoxemia, and myocardial ischemia. Preoperative risk assessment and successful management of patients with pulmonary hypertension undergoing cardiac surgery involve an understanding of the pathophysiology of the disease, screening of patients at-risk for pulmonary arterial hypertension, analysis of preoperative and operative risk factors, thorough multidisciplinary planning, careful intraoperative management, and early recognition and treatment of postoperative complications. This article will cover each of these aspects with particular focus on the anesthetic approach for non-cardiothoracic surgeries.

  16. Anesthesia for geriatric patients.

    Science.gov (United States)

    Deiner, S; Silverstein, J H

    2011-02-01

    The number of elderly surgical patients will be increasing in Italy. Slowly, anesthesiologists are developing the expertise to care for these patients. The information available to apply to these cases is now the topic of a number of anesthesia textbooks dedicated to the elderly. In this article, we review some of the more recent findings and provide some tips to help guide the care of elderly patients. It is hoped that practitioners will use this information to improve the care of these patients and conduct additional research to further improve care in the future.

  17. [Anesthesia and bodybuilding].

    Science.gov (United States)

    Hokema, Frank; Pietsch, Uta-Carolin; Führer, Dagmar; Kaisers, Udo

    2008-05-01

    A strong tendency toward body enhancement and body forming in western industrial societies makes it more likely for each anesthesiologist to get involved in the care of bodybuilders. These patients quite frequently consume androgenic anabolic steroids, human growth hormone and other drugs or substances which are believed to accelerate muscle gain. Cardiovascular, hepatic, psychiatric, hormonal and infectious side effects or complications are common and rarely monitored by health care professionals. The anesthesia risk is not exactly known but seems to be determined mainly by cardiovascular events like myocardial ischemia and dysrhythmias.

  18. Anesthesia and cor triatriatum

    Directory of Open Access Journals (Sweden)

    Federica Scavonetto

    2014-01-01

    Full Text Available Aims and Objectives: Cor triatriatum sinistrum (CTS and cor triatriatum dextrum (CTD are rare congenital anomalies characterized by the presence of a perforated septum which divides the respective atrium into a proximal and distal chamber. This report reviews the perioperative course of patients with uncorrected cor triatriatum (CT undergoing procedures requiring anesthesia. In addition, we performed a literature search that examines the experience of others regarding the peri-operative course of patients with CT. Materials and Methods: A computerized search of a medical record database was conducted to identify patients with a clinical diagnosis of uncorrected CTD and CTS undergoing surgical procedures. Descriptive statistics were used. Results: We identified 12 adult patients with asymptomatic CTS (n = 7 and CTD (n = 5 who underwent 23 anesthetics. There were no perioperative complications which could be attributed directly to the anatomy of CT. Conclusions: Our observation and review of the literature suggest that patients with asymptomatic CT typically tolerate anesthesia and surgical procedures well.

  19. Influence of Ringer’s lactated solution in continuous infusion and general anesthesia on hematocrit in dogs

    Directory of Open Access Journals (Sweden)

    Rogério Luizari Guedes

    2015-08-01

    Full Text Available The measurement of serum parameters during general anesthesia procedures are subject to variations due to differences in protocol, splenic storage, and by the instituted fluid therapy. The aim of this study was to assess the hematocrit changes promoted by controlled fluid therapy and general anesthesia. Six mongrel female dogs underwent an anesthetic protocol with acepromazine (0.03 mg kg-1 and tramadol (5 mg kg-1 for premedication, induction with propofol (3 mg kg-1, and maintained with isoflurane and mechanical ventilation for 120 minutes. After induction, they were infused with 10 ml kg hr-1 of Ringer’s lactate solution. Hematocrit measurements were performed from the start until 72 hours from anesthesia and evaluated statistically to check if there were significant changes over time. The fluid therapy, the acepromazine and propofol in the anesthetic protocol promotes a significant reduction of hematocrit up to four hours after general anesthesia.

  20. [Regional anesthesia and cancer immunology].

    Science.gov (United States)

    Igarashi, Toru; Mori, Katsuya; Inoue, Kei; Suzuki, Takeshi; Morisaki, Hiroshi

    2013-09-01

    Regional anesthesia has been widely applied as an excellent method for perioperative analgesia. Recent studies suggested that regional anesthesia is a promising approach to minimize the risk of surgical site infection and postoperative cancer recurrence, subsequently providing the benefits to the long-term outcome. In particular, it is of great interest that regional anesthesia might be able to reduce cancer recurrence. In cancer patients, innate immunity against cancer could be depressed, resulting in the predisposition to evoke metastasis. Besides, during the perioperative periods, tumor immunity is significantly depressed due to surgical pain, activation of sympathetic nervous system, inflammatory responses, and others. In this review article, we discuss the tumor immunity during the perioperative period, with focus on the alterations of tumor immunity and regional anesthesia.

  1. Transverse myelitis following spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Jha Sanjeev

    2006-01-01

    Full Text Available Spinal anesthesia is widely used during surgical procedures. It is generally safe and the frequency of severe, permanent neurological complications associated with it has been reported to be extremely low. We report a patient, who developed paraplegia following spinal anesthesia. A 29-year-old male was referred with acute, flaccid, sensory motor paraplegia, with bladder and bowel involvement. He developed this immediately after an operation for inguinal hernia under spinal anesthesia. Spinal magnetic resonance imaging revealed hemorrhagic myelitis in the conus at D12. He was referred after he did not respond to intravenous methylprednisolone for 10 days. This case brings up the difficulty encountered in determination of the interspace used for spinal anesthesia and the potential for traumatic injury to the spinal cord. It also demonstrates the tragic outcome after a clinician violates some important, standard and established guidelines.

  2. Clinical relevance in anesthesia journals

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Møller, Ann M

    2006-01-01

    The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles.......The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles....

  3. Anesthesia for outpatient female sterilization.

    Science.gov (United States)

    Fishburne, J I

    1983-04-01

    This issue of the Bulletin deals with the principles of anesthesia for outpatient female sterilization with emphasis on techniques for laparoscopy and minilaparotomy. General anesthesia techniques provide analgesia, amnesia, and muscle relaxation and are particularly useful for managing the anxious patient. Disadvantages include increased expense, need for specialized equipment, and highly trained personnel, and delayed recovery. Complications, though relatively rare, can be life-threatening and include aspiration of stomach contents, hypoxia, hypercarbia, hypotension, hypertension, cardiac arrhythmias, cardiorespiratory arrest, and death. There is no single preferred technique of general anesthesia, athough most anesthetists employ methods that allow rapid recovery of faculties, enabling the patient to be discharged soon after surgery. To accomplish this end, light anesthesia with sodium thiopental induction and nitrous oxide maintenance is often used. Short duration muscle relaxation with an agent such as succinylcholine supplements this technique. Other techniques include light anesthesia with inhalational anesthetic agents and the use of intravenous ketamine. Local anesthesia augmented by systemic and/or inhalational analgesia is supplanting general anesthesia techniques for laparoscopy in many locales. This approach is also particularly well-suited for minilaparotomy in developing countries, where it has achieved its greatest popularity. The local technique carries with it reduced morbidity and mortality but may not entirely relieve discomfort. The primary danger of local anesthesia is respiratory depression due to excessive narcosis and sedation. The operator must be alert to the action of the drugs and should always use the minimal effective dose. Although toxicity due to overdosage with local anesthetic drugs is occasionally experienced, allergic reactions to the amide-linkage drugs such as lidocaine or bupivacaine are exceedingly rare. For outpatient

  4. Adenotomy under general anesthesia.

    Science.gov (United States)

    Vokurka, J; Jakoubková, S; Vít, Z; Drahokoupilová, M

    1989-01-01

    Experience obtained from adenotomy (AT) under general anesthesia using Ketamin hydrochloride (Ketalar, Narkamon) in children are presented in this paper. The authors had used intramuscular premedication with Prothazin, Dolsin and Atropin at the first stage, then they shifted to oral administration of a combination of Diazepam, Theadryl and Atropin. Ketamin may be applied intravenously in the dosage of 1.0 to 1.5 mg/kg of body weight in most children. Where it is not possible, a triple dose into the muscle is used. A total of 2,266 AT were performed. About 70% of patients were calm during the operation, once a suspected aspiration was considered but it was not confirmed. The main contribution of the method is 100% amnesia of the surgery made. The procedure is a compromise between a requirement for minimal traumatization of the child's psyche by the intervention and the resources available, particularly the need of personnel at the majority of otorhinolaryngo-logical departments nowadays.

  5. Impact of anesthesia on pathophysiology and mortality following subarachnoid hemorrhage in rats

    Directory of Open Access Journals (Sweden)

    Hockel Konstantin

    2012-03-01

    Full Text Available Abstract Background Anesthesia is indispensable for in vivo research but has the intrinsic potential to alter study results. The aim of the current study was to investigate the impact of three common anesthesia protocols on physiological parameters and outcome following the most common experimental model for subarachnoid hemorrhage (SAH, endovascular perforation. Methods Sprague-Dawley rats (n = 38 were randomly assigned to (1 chloral hydrate, (2 isoflurane or (3 midazolam/medetomidine/fentanyl (MMF anesthesia. Arterial blood gases, intracranial pressure (ICP, mean arterial blood pressure (MAP, cerebral perfusion pressure (CPP, and regional cerebral blood flow (rCBF were monitored before and for 3 hours after SAH. Brain water content, mortality and rate of secondary bleeding were also evaluated. Results Under baseline conditions isoflurane anesthesia resulted in deterioration of respiratory parameters (arterial pCO2 and pO2 and increased brain water content. After SAH, isoflurane and chloral hydrate were associated with reduced MAP, incomplete recovery of post-hemorrhagic rCBF (23 ± 13% and 87 ± 18% of baseline, respectively and a high anesthesia-related mortality (17 and 50%, respectively. Anesthesia with MMF provided stable hemodynamics (MAP between 100-110 mmHg, high post-hemorrhagic rCBF values, and a high rate of re-bleedings (> 50%, a phenomenon often observed after SAH in humans. Conclusion Based on these findings we recommend anesthesia with MMF for the endovascular perforation model of SAH.

  6. Stabilizing membrane domains antagonizes anesthesia

    CERN Document Server

    Machta, Benjamin B; Nouri, Mariam; McCarthy, Nicola L C; Gray, Erin M; Miller, Ann L; Brooks, Nicholas J; Veatch, Sarah L

    2016-01-01

    Diverse molecules induce general anesthesia with potency strongly correlated both with their hydrophobicity and their effects on certain ion channels. We recently observed that several anesthetics inhibit heterogeneity in plasma membrane derived vesicles by lowering the critical temperature ($T_c$) for phase separation. Here we exploit conditions that stabilize membrane heterogeneity to test the correlation between the anesthetic potency of n-alcohols and effects on $T_c$. First we show that hexadecanol acts oppositely to anesthetics on membrane mixing and antagonizes ethanol induced anesthesia in a tadpole behavioral assay. Second, we show that two previously described `intoxication reversers' raise $T_c$ in vesicles and counter ethanol's effects in vesicles, mimicking the findings of previous electrophysiological measurements. Third, we find that hydrostatic pressure, long known to reverse anesthesia, also raises $T_c$ in vesicles with a magnitude that counters the effect of an anesthetic at relevant concen...

  7. EEG entropy measures in anesthesia

    Directory of Open Access Journals (Sweden)

    Zhenhu eLiang

    2015-02-01

    Full Text Available Objective: Entropy algorithms have been widely used in analyzing EEG signals during anesthesia. However, a systematic comparison of these entropy algorithms in assessing anesthesia drugs’ effect is lacking. In this study, we compare the capability of twelve entropy indices for monitoring depth of anesthesia (DoA and detecting the burst suppression pattern (BSP, in anesthesia induced by GA-BAergic agents.Methods: Twelve indices were investigated, namely Response Entropy (RE and State entropy (SE, three wavelet entropy (WE measures (Shannon WE (SWE, Tsallis WE (TWE and Renyi WE (RWE, Hilbert-Huang spectral entropy (HHSE, approximate entropy (ApEn, sample entropy (SampEn, Fuzzy entropy, and three permutation entropy (PE measures (Shannon PE (SPE, Tsallis PE (TPE and Renyi PE (RPE. Two EEG data sets from sevoflurane-induced and isoflu-rane-induced anesthesia respectively were selected to assess the capability of each entropy index in DoA monitoring and BSP detection. To validate the effectiveness of these entropy algorithms, phar-macokinetic / pharmacodynamic (PK/PD modeling and prediction probability analysis were applied. The multifractal detrended fluctuation analysis (MDFA as a non-entropy measure was compared.Results: All the entropy and MDFA indices could track the changes in EEG pattern during different anesthesia states. Three PE measures outperformed the other entropy indices, with less baseline vari-ability, higher coefficient of determination and prediction probability, and RPE performed best; ApEn and SampEn discriminated BSP best. Additionally, these entropy measures showed an ad-vantage in computation efficiency compared with MDFA.Conclusion: Each entropy index has its advantages and disadvantages in estimating DoA. Overall, it is suggested that the RPE index was a superior measure.Significance: Investigating the advantages and disadvantages of these entropy indices could help improve current clinical indices for monitoring DoA.

  8. Double balloon enteroscopy examinations in general anesthesia

    Institute of Scientific and Technical Information of China (English)

    Laszlo; Zubek; Lena; Szabo; Peter; Laszlo; Lakatos; Janos; Papp; Janos; Gal; Gabor; Elo

    2010-01-01

    AIM:To demonstrate that the double balloon enteroscopy(DBE) can be safely performed in general anesthesia with intubation.METHODS:We performed a retrospective examination between August 2005 and November 2008 amongpatients receiving intubation narcosis due to DBE examination.The patients were grouped based on sex,age and physical status.Anesthesia records includedduration of anesthesia,quantity of medication usedand anesthesia-related complications.We determinedthe frequency of complications in the differen...

  9. The thermodynamics of general anesthesia

    CERN Document Server

    Heimburg, T; Heimburg, Thomas; Jackson, Andrew D.

    2006-01-01

    It is known that the action of general anesthetics is proportional to their partition coefficient in lipid membranes (Meyer-Overton rule). This solubility is, however, directly related to the depression of the temperature of the melting transition found close to body temperature in biomembranes. We propose a thermodynamic extension of the Meyer-Overton rule which is based on free energy changes in the system and thus automatically incorporates the effects of melting point depression. This model provides a quantitative explanation of the pressure reversal of anesthesia. Further, it explains why inflammation and the addition of divalent cations reduce the effectiveness of anesthesia.

  10. Influence of a Brief Episode of Anesthesia during the Induction of Experimental Brain Trauma on Secondary Brain Damage and Inflammation

    OpenAIRE

    Clara Luh; Katharina Gierth; Ralph Timaru-Kast; Kristin Engelhard; Christian Werner; Thal, Serge C.

    2011-01-01

    It is unclear whether a single, brief, 15-minute episode of background anesthesia already modulates delayed secondary processes after experimental brain injury. Therefore, this study was designed to characterize three anesthesia protocols for their effect on molecular and histological study endpoints. Mice were randomly separated into groups that received sevoflurane (sevo), isoflurane (iso) or an intraperitoneal anesthetic combination (midazolam, fentanyl and medetomidine; comb) prior to tra...

  11. Anesthetic management of minimally invasive intervention in pediatric oncohematology: possibilities and limitations of inhalation and intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2014-07-01

    Full Text Available In contrast to the "adult" medicine, pediatric oncology and hematology requires considerably more anesthesiologist participation in diagnosticsand treatment. According to data of Federal Research Center of Pediatric Hematology, Oncology and Immunology more than 70 % of indications for general anesthesia are minimally invasive interventions. The purpose of general anesthesia for small interventions is to provide patient safety and comfort during painful and fear-inducing manipulations. Protocols of inhalation and intravenous anesthesia recommended for widespread use in pediatric patients are presented.

  12. Anesthetic management of minimally invasive intervention in pediatric oncohematology: possibilities and limitations of inhalation and intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2013-01-01

    Full Text Available In contrast to the "adult" medicine, pediatric oncology and hematology requires considerably more anesthesiologist participation in diagnosticsand treatment. According to data of Federal Research Center of Pediatric Hematology, Oncology and Immunology more than 70 % of indications for general anesthesia are minimally invasive interventions. The purpose of general anesthesia for small interventions is to provide patient safety and comfort during painful and fear-inducing manipulations. Protocols of inhalation and intravenous anesthesia recommended for widespread use in pediatric patients are presented.

  13. Intestinal circulation during inhalation anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Tverskoy, M.; Gelman, S.; Fowler, K.C.; Bradley, E.L.

    1985-04-01

    This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of /sub 86/Rb and 9-microns spheres labeled with /sup 141/Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001). Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO/sub 2/) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines.

  14. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2009-01-01

    There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...

  15. Anesthesia and the developing brain

    DEFF Research Database (Denmark)

    Davidson, Andrew J; Becke, Karin; de Graaff, Jurgen

    2015-01-01

    It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large...

  16. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

    Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th......, the administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

  17. [Emergencies evolving from local anesthesia].

    Science.gov (United States)

    Kaufman, E; Garfunkel, A; Findler, M; Elad, S; Zusman, S P; Malamed, S F; Galili, D

    2002-01-01

    Local anesthesia is without doubt the most frequently used drug in dentistry and in medicine. In spite of records of safety set by using these drugs, there is evidence to adverse reactions ranging from 2.5%-11%. Most of the reactions originate from the autonomic system. A recent, well-planned study indicates that adverse reactions are highly correlated to the medical status of the patient: the higher the medical risk, the greater the chance to experience an adverse reaction. This study also found that adverse reactions highly correlated to the concentration of adrenalin. Another recent study found a direct relationship between adverse reactions and the level of anxiety experienced by the patient and to the dental procedure. Most of the reactions in this study occurred either immediately at injection time and within 2 hours following the injection. Since the beginning of last century, vasoconstrictors have been added to local anesthesia solutions in order to reduce toxicity and prologue activity of the LA. However, today it is commonly agreed that this addition to local anesthesia should not be administered to cardiac patients especially those suffering from refractory dysrhythmias, angina pectoris, post myocardial infarction (6 months) and uncontrolled hypertension. Other contraindications to vasoconstrictors are endocrine disorders such as hyperthyroidism, hyperfunction of the medullary adrenal (pheochromocytoma) and uncontrolled diabetes mellitus. Cross reactivity of local anesthetic solutions can occur with MAO inhibitors, non specific beta adrenergic blockers, tricyclic antidepressants, phenothiazides and cocaine abusers. Noradrenaline added to local anesthetics as a vasoconstrictor has been described as a trigger to a great increase in blood pressure and therefore has been forbidden for use in many countries. This paper describes 4 cases of severe complications following the injections of local anesthesia of which three ended in fatality.

  18. [Anesthesia in ophthalmology (author's transl)].

    Science.gov (United States)

    Gemperlé, M

    1977-02-01

    General anesthesia in ophthalmological surgery has become a great fashion. However there are still many problems especially in intraocular surgery. The eye with normal intraocular pressure generally needs no special technique. Most of the usual anesthesia produce a slight hypotonia with the exception of Succinylcholine, whose effect is contrary. Unfortunately this is not the case in eyes with pathologically increased intraocular pressure as in the different forms of glaucoma. Eye surgeons and anesthesists therefore look for solutions to this problem which in principle consist in the application of medicaments, which not seldom are rather agressive. The controlled hypotension by ganglion blockers, the curarisation in the state of being awake, the rapid perfusion of solutions with high osmotique effect (isolated or associated) represent such measures. The one has the disadvantage to be applied during so-called subvigile anesthesias where the security that the patient is asleep is rather doubtful; the other has the disadvantage that it requires a rapid perfusion of solutions with highly osmotic effect. It goes without saying that these conditions represent risks especially if one considers that the candidates for this type of intervention very often are senile persons with prearious cardiovascular equilibrium, with insufficient renal function and with insufficient arterial cerebral circulation. These are some of the problems which are to be discussed.

  19. SPLIT SKIN GRAFT HARVESTING UNDER LOCAL ANESTHESIA INFILTRATION VERSUS TOPICAL LOCAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Shahi

    2014-04-01

    Full Text Available OBJECTIVE: To compare the effectiveness of topical local anesthesia using PRILOX cream versus local anesthesia infiltration using lignocaine and adrenaline in harvesting split skin graft. METHODS: A prospective study of 58 patients requiring split skin graft was carried. One group comprising 29 patients underwent harvesting of split skin graft under topical local anesthesia using PRILOX cream while the other group had local anesthesia infiltration using lignocaine and adrenaline. RESULTS: There were no significant differences between the 2 groups in terms of operating time, per operative pain, post-operative pain and post-operative requirement of analgesia. There was significant difference in time and pain during administration of local anesthesia and patient’s acceptability/ satisfaction with method of anesthesia. CONCLUSION: Topical local anesthesia using PRILOX cream can be used effectively for harvesting of split skin graft and is good alternative to local anesthesia infiltration.

  20. Articaine and lidocaine for maxillary infiltration anesthesia.

    Science.gov (United States)

    Vähätalo, K.; Antila, H.; Lehtinen, R.

    1993-01-01

    This study was undertaken to compare the anesthetic properties of articaine hydrochloride with 1:200,000 epinephrine (Ultracain DS) and lidocaine with 1:80,000 epinephrine (Xylocain-Adrenalin) for maxillary infiltration anesthesia. Twenty healthy dental student volunteers were included in this double-blind study. Each subject received 0.6 mL of each test solution at different times. Infiltration anesthesia was performed on the upper lateral incisor. The onset and duration of anesthesia were monitored using an electric pulp tester. No statistically significant differences were seen in the onset and duration of anesthesia between the articaine and lidocaine solutions. PMID:7943919

  1. Fully Automated Anesthesia, Analgesia and Fluid Management

    Science.gov (United States)

    2016-09-05

    General Anesthetic Drug Overdose; Adverse Effect of Intravenous Anesthetics, Sequela; Complication of Anesthesia; Drug Delivery System Malfunction; Hemodynamic Instability; Underdosing of Other General Anesthetics

  2. Apnea after Awake Regional and General Anesthesia in Infants : The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial

    NARCIS (Netherlands)

    Davidson, Andrew J.; Morton, Neil S.; Arnup, Sarah J.; De Graaff, Jurgen C.; Disma, Nicola; Withington, Davinia E.; Frawley, Geoff; Hunt, Rodney W.; Hardy, Pollyanna; Khotcholava, Magda; Von Ungern Sternberg, Britta S.; Wilton, Niall; Tuo, Pietro; Salvo, Ida; Ormond, Gillian; Stargatt, Robyn; Locatelli, Bruno Guido; McCann, Mary Ellen; Lee, Katherine; Sheppard, Suzette; Hartmann, Penelope; Ragg, Philip; Backstrom, Marie; Costi, David; Von Ungern-Sternberg, Britta S.; Knottenbelt, Graham; Montobbio, Giovanni; Mameli, Leila; Giribaldi, Gaia; Prato, Alessio Pini; Mattioli, Girolamo; Wolfler, Andrea; Izzo, Francesca; Sonzogni, Valter; Van Gool, Jose T D G; Numan, Sandra C.; Kalkman, Cor J.; Hagenaars, J. H M; Absalom, Anthony R.; Hoekstra, Frouckje M.; Volkers, Martin J.; Furue, Koto; Gaudreault, Josee; Berde, Charles; Soriano, Sulpicio; Young, Vanessa; Sethna, Navil; Kovatsis, Pete; Cravero, Joseph P.; Bellinger, David; Marmor, Jacki; Lynn, Anne; Ivanova, Iskra; Hunyady, Agnes; Verma, Shilpa; Polaner, David; Thomas, Joss; Meuller, Martin; Haret, Denisa; Szmuk, Peter; Steiner, Jeffery; Kravitz, Brian; Suresh, Santhanam; Hays, Stephen R.; Taenzer, Andreas H.; Maxwell, Lynne G.; Williams, Robert K.; Bell, Graham T.; Dorris, Liam; Adey, Claire; Bagshaw, Oliver; Chisakuta, Anthony; Eissa, Ayman; Stoddart, Peter; Davis, Annette; Myles, Paul; Wolf, Andy; McIntosh, Neil; Carlin, John; Leslie, Kate; De Lima, Jonathan; Hammer, Greg; Field, David; Gebski, Val; Tibboel, Dick

    2015-01-01

    Background: Postoperative apnea is a complication in young infants. Awake regional anesthesia (RA) may reduce the risk; however, the evidence is weak. The General Anesthesia compared to Spinal anesthesia study is a randomized, controlled trial designed to assess the influence of general anesthesia (

  3. Apnea after Awake Regional and General Anesthesia in Infants : The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial

    NARCIS (Netherlands)

    Davidson, Andrew J; Morton, Neil S; Arnup, Sarah J; de Graaff, Jurgen C; Disma, Nicola; Withington, Davinia E; Frawley, Geoff; Hunt, Rodney W; Hardy, Pollyanna; Khotcholava, Magda; von Ungern Sternberg, Britta S; Wilton, Niall; Tuo, Pietro; Salvo, Ida; Ormond, Gillian; Stargatt, Robyn; Locatelli, Bruno Guido; McCann, Mary Ellen; Absalom, Anthony

    2015-01-01

    BACKGROUND: Postoperative apnea is a complication in young infants. Awake regional anesthesia (RA) may reduce the risk; however, the evidence is weak. The General Anesthesia compared to Spinal anesthesia study is a randomized, controlled trial designed to assess the influence of general anesthesia (

  4. Dexmedetomidine: Expanding role in anesthesia

    Directory of Open Access Journals (Sweden)

    Jyotsna S Paranjpe

    2013-01-01

    Full Text Available The potential uses of dexmedetomidine (DEX, a highly selective α2 - adrenoceptor agonist are very diverse. DEX appears to mimic many of the actions of mythical ′ideal′ sedative/analgesic agent. Although not orally active, DEX shows good bioavailability when administered via various other routes like intranasal, buccal, IM than intra-venous. DEX has similar pharmacokinetics in all age groups. Its side effects are predictable and easily treatable, hence it has found place as a part of fast-tracking anesthesia regimens in children. DEX is the sedative of choice for peri-operative use in high risk patients, since it is cardioprotective, neuroprotective and renoprotective. Premedication with DEX obtunds the autonomic pressor responses due to laryngoscopy and endotracheal intubation when used as an adjuvant to general anesthesia. DEX in high doses offers another approach to managing morbidly obese patients and patients with a compromised airway; without causing any cardio-respiratory depression. It is near ideal hypotensive agent used for controlled hypotension. Its value as a primary sedative and analgesic is becoming more accepted and evident in critically ill patients; in adult and paediatric intensive care units. Besides use in locoregional anesthesia, it is also used as an opioid substitute, for treatment of substance withdrawal, as an anti-shivering agent, for treatment of delirium and as an end of life medication. Availability of an antidote (Atipamezole with similar elimination half life is taking the drug into new frontiers. However, use of DEX is contraindicated in patients with hepatic failure, hypovolemic shock, advanced heart block or ventricular dysfunction.

  5. [Carotid endarterectomy under local anesthesia].

    Science.gov (United States)

    Kuz'min, A L; Belov, Iu V

    2001-01-01

    Results of carotid endarterectomy (CEAE) in 193 patients with different degree of cerebrovascular insufficiency were analyzed. All the patients were men with carotid atherosclerosis (age from 39 to 68 years, mean age 53.6 +/- 0.4). A total of 253 CEAEs were performed under local anesthesia (60 patients underwent consecutive bilateral operations). In early postoperative period 3 patients died, one of them--of ischemic stroke due to thrombosis of internal carotid artery on the side of the operation. Non-fatal stroke was in 1 patient. There were no intraoperative cerebral complications. This testifies to reliability of cerebral circulation control through direct contact with patient.

  6. Presbycusis: reversible with anesthesia drugs?

    Science.gov (United States)

    Kocher, Carl A

    2009-02-01

    Age-related hearing impairment, or presbycusis, is a degenerative condition not currently treatable by medication. It is therefore significant that the author, as a patient, experienced a reversal of high-frequency hearing loss during a 2-day period following abdominal surgery with general anesthesia. This report documents the surgery and the subsequent restoration of hearing, which was bilateral and is estimated to have exceeded 50dB at 4kHz. A possible role is noted for anesthetic agents such as lidocaine, propofol, or fentanyl. This experience may hold a clue for research toward the development of medical treatments for presbycusis.

  7. Partial intravenous anesthesia in cats and dogs.

    Science.gov (United States)

    Duke, Tanya

    2013-03-01

    The partial intravenous anesthesia technique (PIVA) is used to lower the inspired concentration of an inhalational anesthetic by concurrent use of injectable drugs. This technique reduces the incidence of undesirable side-effects and provides superior quality of anesthesia and analgesia. Drugs commonly used for PIVA include opioids, alpha-2 adrenergic agonists, injectable anesthetic agents, and lidocaine. Most are administered by intravenous infusion.

  8. Spinal morphine anesthesia and urinary retention.

    Science.gov (United States)

    Mahan, K T; Wang, J

    1993-11-01

    Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented.

  9. Influencing Anesthesia Provider Behavior Using Anesthesia Information Management System Data for Near Real-Time Alerts and Post Hoc Reports.

    Science.gov (United States)

    Epstein, Richard H; Dexter, Franklin; Patel, Neil

    2015-09-01

    In this review article, we address issues related to using data from anesthesia information management systems (AIMS) to deliver near real-time alerts via AIMS workstation popups and/or alphanumeric pagers and post hoc reports via e-mail. We focus on reports and alerts for influencing the behavior of anesthesia providers (i.e., anesthesiologists, anesthesia residents, and nurse anesthetists). Multiple studies have shown that anesthesia clinical decision support (CDS) improves adherence to protocols and increases financial performance through facilitation of billing, regulatory, and compliance documentation; however, improved clinical outcomes have not been demonstrated. We inform developers and users of feedback systems about the multitude of concerns to consider during development and implementation of CDS to increase its effectiveness and to mitigate its potentially disruptive aspects. We discuss the timing and modalities used to deliver messages, implications of outlier-only versus individualized feedback, the need to consider possible unintended consequences of such feedback, regulations, sustainability, and portability among systems. We discuss statistical issues related to the appropriate evaluation of CDS efficacy. We provide a systematic review of the published literature (indexed in PubMed) of anesthesia CDS and offer 2 case studies of CDS interventions using AIMS data from our own institution illustrating the salient points. Because of the considerable expense and complexity of maintaining near real-time CDS systems, as compared with providing individual reports via e-mail after the fact, we suggest that if the same goal can be accomplished via delayed reporting versus immediate feedback, the former approach is preferable. Nevertheless, some processes require near real-time alerts to produce the desired improvement. Post hoc e-mail reporting from enterprise-wide electronic health record systems is straightforward and can be accomplished using system

  10. Medication errors in anesthesia: unacceptable or unavoidable?

    Directory of Open Access Journals (Sweden)

    Ira Dhawan

    Full Text Available Abstract Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated. Often drug errors that occur cannot be reversed. The best way to ‘treat' drug errors is to prevent them. Wrong medication (due to syringe swap, overdose (due to misunderstanding or preconception of the dose, pump misuse and dilution error, incorrect administration route, under dosing and omission are common causes of medication error that occur perioperatively. Drug omission and calculation mistakes occur commonly in ICU. Medication errors can occur perioperatively either during preparation, administration or record keeping. Numerous human and system errors can be blamed for occurrence of medication errors. The need of the hour is to stop the blame - game, accept mistakes and develop a safe and ‘just' culture in order to prevent medication errors. The newly devised systems like VEINROM, a fluid delivery system is a novel approach in preventing drug errors due to most commonly used medications in anesthesia. Similar developments along with vigilant doctors, safe workplace culture and organizational support all together can help prevent these errors.

  11. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study...... was to investigate the effect of anesthesia and surgery on serum tryptase in the absence of anaphylaxis....

  12. Mortality in anesthesia: a systematic review

    Directory of Open Access Journals (Sweden)

    Leandro Gobbo Braz

    2009-01-01

    Full Text Available This systematic review of the Brazilian and worldwide literature aims to evaluate the incidence and causes of perioperative and anesthesia-related mortality. Studies were identified by searching the Medline and Scielo databases, followed by a manual search for relevant articles. Our review includes studies published between 1954 and 2007. Each publication was reviewed to identify author(s, study period, data source, perioperative mortality rates, and anesthesia-related mortality rates. Thirty-three trials were assessed. Brazilian and worldwide studies demonstrated a similar decline in anesthesia-related mortality rates, which amounted to fewer than 1 death per 10,000 anesthetics in the past two decades. Perioperative mortality rates also decreased during this period, with fewer than 20 deaths per 10,000 anesthetics in developed countries. Brazilian studies showed higher perioperative mortality rates, from 19 to 51 deaths per 10,000 anesthetics. The majority of perioperative deaths occurred in neonates, children under one year, elderly patients, males, patients of ASA III physical status or poorer, emergency surgeries, during general anesthesia, and cardiac surgery followed by thoracic, vascular, gastroenterologic, pediatric and orthopedic surgeries. The main causes of anesthesia-related mortality were problems with airway management and cardiocirculatory events related to anesthesia and drug administration. Our systematic review of the literature shows that perioperative mortality rates are higher in Brazil than in developed countries, while anesthesia-related mortality rates are similar in Brazil and in developed countries. Most cases of anesthesia-related mortality are associated with cardiocirculatory and airway events. These data may be useful in developing strategies to prevent anesthesia-related deaths.

  13. Alzheimer’s disease and anesthesia

    Directory of Open Access Journals (Sweden)

    Marie-Amélie ePapon

    2011-01-01

    Full Text Available Cognitive disorders such as post-operative cognitive dysfunction, confusion, and delirium, are common following anesthesia in the elderly, with symptoms persisting for months or years in some patients. Alzheimer's disease (AD patients appear to be particularly at risk of cognitive deterioration following anesthesia, and some studies suggest that exposure to anesthetics may increase the risk of AD. Here, we review the literature linking anesthesia to AD, with a focus on the biochemical consequences of anesthetic exposure on AD pathogenic pathways.

  14. Systemic toxisity of local anesthethics during regional anesthesia in orthopedics and traumatology

    Directory of Open Access Journals (Sweden)

    V. A. Koryachkin

    2015-01-01

    Full Text Available There are cases of accidental intravascular injection of local anesthetic when performing regional anesthesia. The frequency of this complication was 0.28 per 1,000. We describe the clinical manifestations and the basic principles of the treatment of local anesthetics systemic toxicity. Discussed in detail the mechanism of action of fat emulsion and the protocol of lipid resuscitation Accidental intravascular injection of local anesthetics. The mechanism of action of fat emulsion and the protocol of lipidrescue accidental intravascular injection of local anesthetics was discussed.

  15. Local Anesthesia Combined With Sedation Compared With General Anesthesia for Ambulatory Operative Hysteroscopy

    DEFF Research Database (Denmark)

    Brix, Lone Dragnes; Thillemann, Theis Muncholm; Nikolajsen, Lone

    2016-01-01

    anesthesia combined with sedation (group LA + S; n = 76) or general anesthesia (group GA; n = 77). Primary outcome was the worst pain intensity score in the postanesthesia care unit (PACU) rated by the patients on a numerical rating scale. FINDING: Data from 144 patients were available for analysis (LA + S...... was shorter (P anesthesia with sedation can be recommended as a first choice anesthetic technique for operative ambulatory hysteroscopy....

  16. Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy.

    Science.gov (United States)

    Stone, Alexander B; Sheinberg, Rosanne; Bertram, Amanda; Seymour, Anastasia Rowland

    2016-04-01

    This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use.

  17. Interaction between anesthesia, gender, and functional outcome task following diffuse traumatic brain injury in rats.

    Science.gov (United States)

    O'Connor, Christine A; Cernak, Ibolja; Vink, Robert

    2003-06-01

    A number of experimental and clinical studies have demonstrated that functional outcome following traumatic brain injury differs between males and females. Some studies report that females have a better outcome than males following trauma while others report the opposite. In experimental studies, some of the contradictory results may be due to the different experimental conditions, including type of anesthesia and the outcome measures employed. In the present study we have used three different anesthetic protocols and four different outcome measures to determine how these parameters interact and affect functional outcome following traumatic brain injury in male and female rats. Diffuse traumatic brain injury was induced in adult male and female animals using the impact-acceleration brain injury model. Mortality in female animals was no different than males when using halothane anesthesia, slightly better than males when using isoflurane anesthesia, but significantly worse than males under pentobarbital anesthesia. Female animals always performed better than males on rotarod tests of motor outcome, with this effect being unrelated to anesthetic effects. Conversely, in cognitive tests using the Barnes Maze, only isoflurane-anesthetized females performed better than their male counterparts. Similarly, in an open field activity task, females always performed better than males after trauma, with isoflurane-anesthetized females also performing significantly better than the halothane-anesthetized female group after injury. Our results suggest that female animals do better than males after diffuse traumatic brain injury, although this observation is dependent upon the type of anesthesia and the functional task employed. Isoflurane is particularly protective in females, pentobarbital is deleterious to female outcome, while halothane anesthesia has the least influence on gender-related outcome.

  18. Ocular risk management in patients undergoing general anesthesia: an analysis of 39,431 surgeries

    Directory of Open Access Journals (Sweden)

    Newton Kara-Junior

    2015-08-01

    Full Text Available OBJECTIVE:This study sought to describe and analyze ocular findings associated with nonocular surgery in patients who underwent general anesthesia.METHODS:The authors retrospectively collected a series of 39,431 surgeries using standardized data forms.RESULTS:Ocular findings were reported in 9 cases (2.3:10,000, which involved patients with a mean age of 58.9±19.5 years. These cases involved patients classified as ASA I (33%, ASA II (55% or ASA III (11%. General anesthesia with propofol and remifentanil was used in 4 cases, balanced general anesthesia was used in 4 cases, and regional block was used in combination with balanced general anesthesia in one case. Five patients (55% underwent surgery in the supine position, one patient (11% underwent surgery in the lithotomy position, two patients (22% underwent surgery in the prone position, and one patient (11% underwent surgery in the lateral position. Ocular hyperemia was detected in most (77% of the 9 cases with ocular findings; pain/burning of the eyes, visual impairment, eye discharge and photophobia were observed in 55%, 11%, 11% and 11%, respectively, of these 9 cases. No cases involved permanent ocular injury or vision loss.CONCLUSION:Ophthalmological findings after surgeries were uncommon, and most of the included patients were relatively healthy. Minor complications, such as dehydration or superficial ocular trauma, should be prevented by following systematic protocols that provide appropriate ocular occlusion with a lubricating ointment and protect the eye with an acrylic occluder. These procedures will refine the quality of anesthesia services and avoid discomfort among patients, surgeons and anesthesia staff.

  19. [The choice of a pediatric anesthesia ventilator].

    Science.gov (United States)

    Kern, D; Larcher, C; Cottron, N; Ait Aissa, D; Fesseau, R; Alacoque, X; Delort, F; Masquère, P; Agnès, E; Visnadi, G; Fourcade, O

    2013-12-01

    The technology of anesthesia ventilators has substantially progressed during last years. The choice of a pediatric anesthesia ventilator needs to be led by multiple parameters: requirement, technical (pneumatic performance, velocity of halogenated or oxygen delivery), cost (purchase, in operation, preventive and curative maintenance), reliability, ergonomy, upgradability, and compatibility. The demonstration of the interest of pressure support mode during maintenance of spontaneous ventilation anesthesia makes this mode essential in pediatrics. In contrast, the financial impact of target controlled inhalation of halogenated has not be studied in pediatrics. Paradoxically, complex and various available technologies had not been much prospectively studied. Anesthesia ventilators performances in pediatrics need to be clarified in further clinical and bench test studies.

  20. Anesthesia in a Baird's tapir (Tapirus bairdii).

    Science.gov (United States)

    Trim, C M; Lamberski, N; Kissel, D I; Quandt, J E

    1998-06-01

    A Baird's tapir (Tapirus bairdii) was satisfactorily immobilized on two occasions with i.m. detomidine (0.065-0.13 mg/kg) and butorphanol (0.13-0.2 mg/kg). On the second occasion, anesthesia was induced by i.v. administration of ketamine (2.2 mg/kg). Twenty minutes later, endotracheal intubation was performed after an additional i.v. injection of ketamine (1.5 mg/kg). Anesthesia was maintained with isoflurane, which provided excellent conditions for radiology and surgery. Anesthesia was associated with hypoxemia when the tapir was allowed to breathe air and with hypoventilation. Mean arterial pressure remained satisfactory. No antagonist drugs were administered, and recovery from anesthesia was rapid and smooth.

  1. Anesthesia: What to Expect (For Parents)

    Science.gov (United States)

    ... a wide variety of modern medicines and monitoring technology to make sure that kids are stable and as comfortable as possible before, during, and after their ... Parents MORE ON THIS TOPIC Anesthesia Basics Types of ...

  2. [Use of head tent for anesthesia of children (author's transl)].

    Science.gov (United States)

    Postel, J P; Milhaud, A; Brille, P; Kpenou, R

    1981-01-01

    The authors relate their experience of 61 inhalation anesthesia of children from 5 months to 15 years years old. Head-tent is usually employed for intensive care as a method to administrate pure oxygen. Children are often afraid of the face-mask and tolerate head-tent easier. Three different protocols were studied: Nitrous oxide and oxygen mixture at different level (50 p. cent oxygen, 50 p. cent nitrous-oxide; or 30 p. cent oxygen, 70 p. cent nitrous oxide). The authors also used halothan in the inhalated mixture. The rebreathing level of CO2 in the head-tent according to the gas flow was measured. No incident, nor accident are related. This new anesthetic apparatus is easy to use, well accepted by children.

  3. Ocular complications associated with local anesthesia administration in dentistry.

    Science.gov (United States)

    Boynes, Sean G; Echeverria, Zydnia; Abdulwahab, Mohammad

    2010-10-01

    The most widely used method for controlling pain during dental procedures is the intraoral administration of local anesthetics in close proximity to a specific nerve or fiber to obtund nerve conduction. The most commonly anesthetized nerves in dentistry are branches or nerve trunks associated with the maxillary and mandibular divisions of the trigeminal nerve (cranial nerve V). However, other nerves may be inadvertently affected by intraoral local anesthesia injections, resulting in anesthetic complications of structures far from the oral cavity. Practitioners should be aware of potential ocular complications following intraoral injections in dentistry. These complications include oculomotor paralysis and vision loss. The knowledge of these conditions and their potential cause should alert the dentist to the importance of appropriate injection techniques and an understanding of management protocol.

  4. Investigations Regarding Anesthesia during Hypovolemic Conditions.

    Science.gov (United States)

    1983-09-25

    supplier (J.G. Boswell Co.) artificially inseminates all swine, thus breeding is exactly controlled, and genetic make-up known and reproducible. Their...the facility is not required thus eliminating unproductive quarantine time and diminishing housing costs. Since our supplier artificially insem...this .ouiu be beneficial % hen iniucing anesthesia during . hypovole.iia. I.en used tor induction of anesthesia ouring hypovolemia, ketamine incrcases

  5. Single-lung ventilation in pediatric anesthesia.

    Science.gov (United States)

    Choudhry, Dinesh K

    2005-12-01

    Single-lung ventilation is requested for an increasing spectrum of surgical procedures in infants and children. A clear understanding of the physiology of single-lung ventilation, the techniques of lung separation, and the technical skill necessary to apply these techniques are essential for an anesthesiologist practicing thoracic anesthesia. This article focuses on various devices available for single-lung ventilation in the pediatric age group, the relevant respiratory physiology, and the strategies that optimize oxygenation during one-lung anesthesia.

  6. Mobile anesthesia: Ready, set, pack, and go

    OpenAIRE

    Khayata, Issam; Bourque, Jesse

    2012-01-01

    Introduction: Although we get into the habit of thinking that anesthesia cannot be safely delivered without the availability of all equipments available in a state of the art Operating room, we find ourselves faced with situations where the availability and mobility of all this equipment is limited ; this results in the impetus to start a thought process of how we can perform mobile anesthesia with less technology. Disaster situations, such as earthquakes, floods, or armed conflicts, might ha...

  7. Advances in local anesthesia in dentistry.

    Science.gov (United States)

    Ogle, Orrett E; Mahjoubi, Ghazal

    2011-07-01

    Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics. Safety devices are also discussed, along with an innovative method for reducing the annoying numbness of the lip and tongue following local anesthesia.

  8. Anesthesia and analgesia for geriatric veterinary patients.

    Science.gov (United States)

    Baetge, Courtney L; Matthews, Nora S

    2012-07-01

    The number of geriatric veterinary patients presented for anesthesia appears to be increasing. This article summarizes physiologic changes that occur in geriatric patients that are relevant to anesthesia. Proper patient preparation and vigilant monitoring are the best defense against anesthetic problems in the geriatric animal. The authors also discuss particular anesthetic problems as they relate to geriatric patients and seek to present solutions to these problems.

  9. About Forum of Anesthesia and Monitoring

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Forum of Anesthesia and Monitoring is one of the leading publications for the specialties of Anesthesia,Intensive Care and Pain in China, sponsored by Beijing Committee of Anesthesiologists of Chinese Medical Association and Medical Information Limited. Published since 1993, it is widely regarded as the popular scientific journal in the specialty. This is evidenced not just by its circulation, but by its influences to the young anesthetists in China.

  10. About Forum of Anesthesia and Monitoring

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Forum of Anesthesia and Monitoring is one of the leading publications for the specialties of Anesthesia.Intensive Care and Pain in China. sponsored by Beijing Committee of Anesthesiologists of Chinese Medical Association and Medical Information Limited. Published since 1993, it is widely regarded as the popular scientific journal in the specialty. This is evidenced not just by its circulation, but by its influences to the.young anesthetists in China.

  11. Anesthesia Approach in Endovascular Aortic Reconstruction

    Directory of Open Access Journals (Sweden)

    Ayşin Alagöl

    2013-03-01

    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  12. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

    Full Text Available Introduction: Elective upper and lower GI endoscopy is usually performed in children on an outpatient basis with the child under sedation or general anesthesia (GA. The objective of this study was to describe Anesthesia related complications in   children undergoing elective GI endoscopy.   Materials and Methods: The study design was descriptive on 1388 patients undergoing elective GI endoscopy in Sheikh Hospital from 2009 to 2013. All patient received propofol or standard inhalational anesthesia. We examined patients’ demographic data  ,  location of GI endoscopy ,  perioperative vital singe ,  recovery time , respiratory and cardiac complications , post operative nausea and vomiting , agitation , diagnosis and outcome   Results: Pediatric patients aged 2 to 17 years. 29 % of elective GI endoscopy was upper GI endoscopy and 70.3 % was lower GI endoscopy and 0.7 was both of them. 47.7 % of Pediatric patients were female and 52.3 % was male. We haven’t significant or fatal anesthesia related respiratory and cardiac complications (no apnea, no cardiac arrest. 8 patients (0.5% have transient bradicardia in post operative care Unit. 83 patients (5.9% have post operative nausea and vomiting controlled by medication.  6 patients (0.4% have post operative agitation controlled by medication.   Conclusions: General anesthesia and deep sedation in children undergoing elective GI endoscopy haven’t significant or fatal anesthesia related complications. We suggest Anesthesia for infants, young children, children with neurologic impairment, and some anxious older children undergoing elective GI endoscopy. Keyword: Anesthesia, Complication, Endoscopy, Pediatric.

  13. Epidural anesthesia in repeated cesarean section.

    Directory of Open Access Journals (Sweden)

    Rolando T. Espín González

    2003-04-01

    Full Text Available Background: A spectacular development has been experimented in the Anesthesiology branch in the last few years in the different areas of its competence in which the attendance activity on obstetric patients as well as every aspect related with its adequate practice is of a great importance. Objective: to evaluate the efficacy of epidural anesthesia in repetitive cesarean. Methods: a descriptive retrospective study of a series of cases (112in which epidural anesthesia in repetitive cesarean was applied from January 2001 to December 2001 in the surgical unit of the Gynecological obstetric service at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ in Cienfuegos city, Cuba. Some variables such as fixation time of the anesthesia, its duration, transurgical and postsurgical hemodynamic behavior, complications related with the anesthesia, evaluation of the new born baby and, the level of satisfaction of the patients were analyzed. Results: The immediate transurgical and postsurgical hemodynamic behavior was stable predominating normotension and the normal cardiac frequency. The complications related to anesthesia were minimal. The level of satisfaction of the patients was elevated. No alterations in new born babies were presented. As a conclusion, it may be stated that epidural anesthesia in repetitive cesarean is a safety and reliable anesthetic method.

  14. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair : Data from the General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes

    NARCIS (Netherlands)

    Frawley, Geoff; Bell, Graham; Disma, Nicola; Withington, Davinia E; de Graaff, Jurgen C; Morton, Neil S; McCann, Mary Ellen; Arnup, Sarah J; Bagshaw, Oliver; Wolfler, Andrea; Bellinger, David; Davidson, Andrew J; Absalom, Anthony

    2015-01-01

    BACKGROUND: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes

  15. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair : Data from the General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes

    NARCIS (Netherlands)

    Frawley, Geoff; Bell, Graham; Disma, Nicola; Withington, Davinia E; de Graaff, Jurgen C; Morton, Neil S; McCann, Mary Ellen; Arnup, Sarah J; Bagshaw, Oliver; Wolfler, Andrea; Bellinger, David; Davidson, Andrew J

    2015-01-01

    BACKGROUND: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes

  16. Histology protocols

    Directory of Open Access Journals (Sweden)

    CarloAlberto Redi

    2010-06-01

    Full Text Available Tim D. Hewitson & Ian A. Darby (Eds Humana press, Totowa, New Jersey (USA Series: Springer Protocols Methods in Molecular Biology, Volume 611, 2010 Pages: 230; € 83.15 ISBN: 978-1-60327-344-2 Impressive as it can sounds in the era that Biology see a clear dominance of reductionism with the idea that complexity can be disentagled more and more thanks to the use of molecular tools, the reader will remain fascinated by this slim and agile volume devoted to bring together what apparently are two separeted words: molecular biology and histology. Simply remembering to the youngest scientists.....

  17. [Application of Non-intubated Anesthesia in VATS].

    Science.gov (United States)

    Dai, Xiaotan; Song, Pingping; Zhang, Baijiang

    2016-05-20

    Tracheal intubation general anesthesia technique is widely used in video-assisted thoracic surgery (VATS) because it can improve the safety of VATS, but the complications of tracheal intubation can not be avoided. How to develop a "minimally invasive" surgery (including micro anesthesia) has become a hot topic in the field of minimally invasive surgery. Along with the progress of the anesthesia management technology and the risk management in the operation, the technology of non-intubated anesthesia was successfully applied to VATS, namely using local anesthesia to maintain patients intraoperative independent ventilation and intraoperative only mild sedation or fully conscious state of implementation of thoracoscope surgery, therefore is also called awake VATS. The anesthesia method not only reduces the anesthesia injury of tracheal intubation, but also conforms to the idea of rapid rehabilitation surgery. Based on non-intubated anesthesia in VATS in the brief history of development, the anesthesia selection, operation advantages and risks are reviewed in this paper.

  18. The Application of Topical Anesthesia Combined with Subconjunctival Anesthesia for Glaucoma Surgery

    Institute of Scientific and Technical Information of China (English)

    Shengsong Huang; Minbin Yu; Jie Lian; Min Fan; Changyu Qiu

    2003-01-01

    Purpose: To evaluate the feasibility, reliability and analgesia effect of topical anesthesia combined with subconjunctival anesthesia in anti-glaucomatous surgery.Methods: Two hundred and four cases (357 eyes) underwent anti-glaucomatous surgeries under topical anesthesia with 0.5% Alcaine eye drops combined with subconjunctival anesthesia with 2% Lidocaine. The analgesic effect was analysed with visual analogue pain scale.Results: Among all of 357 eyes, 62 eyes underwent peripheral iridectomy, 67 eyes underwent simple trabeculectomy, 167 eyes underwent compound brabeculectomy and 12 eyes nonpenetrating trabecular surgery. The effects of anesthesia were as follows: 304 eyes(85.2%) were painless (Grade I ), 50 eyes (14.0%) were slight painful (Grade Ⅱ ), and 3 eyes (0.8%) were more painful (Grade Ⅲ ) during surgery. And no severe complications were observed in all the cases during surgery and postoperatively. Amaurosis fugax was not observed in the glaucoma patients at the late stage with narrow visual fields and poor visual ability.Conclusion: Topical anesthesia combined with subconjunctival anesthesia is effective,safe and simple anesthesia alternative in routine anti-glaucomatous surgery, especially for the glaucoma patients at the late stage with narrow visual fields and poor visual ability. It is worthy of being applied widely.

  19. Ethical euthanasia and short-term anesthesia of the chick embryo.

    Science.gov (United States)

    Aleksandrowicz, Ewa; Herr, Ingrid

    2015-01-01

    Fertilized chicken eggs are suggested as an alternative to mammalian models. The chorioallantoic membrane (CAM) of the chick embryo is widely used for examination of angiogenesis, xenotransplants and for virus production. Unfortunately, it is mostly not taken into account, that the chick embryo's ability to experience pain starts to develop at day 7 of breeding. In our view, this model is only in accordance with the 3 R principles, if an appropriate anesthesia of the chick embryo in potentially painful procedures is provided. Although many experimental approaches are performed on the none-innervated CAM, the euthanasia of the embryo strongly requires a more human technique than the usually used freezing at -20°C, decapitation or in ovo fixation with paraformaldehyde without prior anesthesia. However, protocols regarding feasible and ethical methods for anesthesia and euthanasia of avian embryos are currently not available. Therefore, we established an easy and reliable method for the euthanasia and short-term anesthesia of the chick embryo.

  20. Anesthesia and critical-care delivery in weightlessness: A challenge for research in parabolic flight analogue space surgery studies

    Science.gov (United States)

    Ball, Chad G.; Keaney, Marilyn A.; Chun, Rosaleen; Groleau, Michelle; Tyssen, Michelle; Keyte, Jennifer; Broderick, Timothy J.; Kirkpatrick, Andrew W.

    2010-03-01

    BackgroundMultiple nations are actively pursuing manned exploration of space beyond low-earth orbit. The responsibility to improve surgical care for spaceflight is substantial. Although the use of parabolic flight as a terrestrial analogue to study surgery in weightlessness (0 g) is well described, minimal data is available to guide the appropriate delivery of anesthesia. After studying anesthetized pigs in a 0 g parabolic flight environment, our group developed a comprehensive protocol describing prolonged anesthesia in a parabolic flight analogue space surgery study (PFASSS). Novel challenges included a physically remote vivarium, prolonged (>10 h) anesthetic requirements, and the provision of veterinary operating room/intensive care unit (ICU) equivalency on-board an aircraft with physical dimensions of ethical approval, multiple ground laboratory sessions were conducted with combinations of anesthetic, pre-medication, and induction protocols on Yorkshire-cross specific pathogen-free (SPF) pigs. Several constant rate infusion (CRI) intravenous anesthetic combinations were tested. In each regimen, opioids were administered to ensure analgesia. Ventilation was supported mechanically with blended gradients of oxygen. The best performing terrestrial 1 g regime was flight tested in parabolic flight for its effectiveness in sustaining optimal and prolonged anesthesia, analgesia, and maintaining hemodynamic stability. Each flight day, a fully anesthetized, ventilated, and surgically instrumented pig was transported to the Flight Research Laboratory (FRL) in a temperature-controlled animal ambulance. A modular on-board surgical/ICU suite with appropriate anesthesia/ICU and surgical support capabilities was employed. ResultsThe mean duration of anesthesia (per flight day) was 10.28 h over four consecutive days. A barbiturate and ketamine-based CRI anesthetic regimen supplemented with narcotic analgesia by bolus administration offered the greatest prolonged hemodynamic

  1. Survey of international regional anesthesia fellowship directors

    Directory of Open Access Journals (Sweden)

    Lansdown AK

    2013-07-01

    Full Text Available Andrew K Lansdown,1,2 Paul G McHardy,1 Sanjiv C Patel,1,3 Catherine M Nix,1 Colin JL McCartney1 1Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; 2University of Sydney, Sydney, NSW, Australia; 3University College Hospital, London, UK Background: The scope of regional anesthesia fellowship programs has not been analyzed but may provide insights that could improve fellowship training and standards. Methods: Regional anesthesia fellowship directors across the world were asked to complete a comprehensive survey that detailed the range of educational and practical experience and attitudes as well as assessment procedures offered in their programs. Results: The survey response rate was 66% (45/68. Overall, the range of activities and the time and resources committed to education during fellowships is encouraging. A wide range of nerve block experience is reported with most programs also offering acute pain management, research, and teaching opportunities. Only two-thirds of fellowships provide formal feedback. This feedback is typically a formative assessment. Conclusion: This is the first survey of regional anesthesia fellowship directors, and it illustrates the international scope and continuing expansion of education and training in the field. The results should be of interest to program directors seeking to benchmark and improve their educational programs and to faculty involved in further curriculum development. Keywords: anesthesia, regional, fellowship, education

  2. Before Anesthesia: The Patient's Active Role Makes a Difference

    Science.gov (United States)

    ... anesthesia, a candidate must have a four-year bachelor of science degree in nursing or other appropriate ... can—and should—take an active role in these preparations by communicating and cooperating with your anesthesia ...

  3. [Anesthesia for cesarean section in patients with fetal anomaly].

    Science.gov (United States)

    Nakano, S; Tashiro, C; Nishimura, M; Ueyama, H; Uchiyama, A; Kubota, A; Suehara, N

    1991-05-01

    Twenty-two cases of Cesarean section due to fetal anomaly diagnosed prenatally were reviewed in terms of the anesthetic managements. In 6 cases, diazepam 0.3 mg.kg-1, which provides fetal anesthesia for surgery scheduled immediately after birth, was administered intravenously to the mothers with/without fentanyl (2 general anesthesia and 4 regional anesthesia). The diagnosis of their fetuses was congenital diaphragmatic hernia, congenital cystic adenomatoid malformation of the lung, gastroschisis or omphalocele. No fetal anesthesia was performed in the other 16 cases (15 spinal anesthesia and 1 general anesthesia). Seven of their fetuses were diagnosed as hydrops. Since the general condition of the diseased newborn is known to be deteriorated after receiving various stress and aerophagia, fetal anesthesia in Cesarean delivery has the advantage of stress reduction and prevention of aerophagia. When the newborn is considered to need immediate neonatal resuscitation or intensive care including surgery, fetal anesthesia may be a choice of anesthetic technique.

  4. Transient Neurological Symptoms after Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Zehra Hatipoglu

    2013-02-01

    Full Text Available Lidocaine has been used for more than 50 years for spinal anesthesia and has a remarkable safety record. In 1993, a new adverse effect, transient neurologic toxicity was described in patients recovering from spinal anesthesia with lidocaine. Transient neurological symptoms have been defined as pain in the lower extremities (buttocks, thighs and legs after an uncomplicated spinal anesthesia and after an initial full recovery during the immediate postoperative period (less than 24 h. The incidence of transient neurological symptoms reported in prospective, randomized trials varies from 4% to 37%. The etiology of transient neurological symptoms remains unkonwn. Despite the transient nature of this syndrome, it has proven to be difficult to treat effectively. Drug or some interventional therapy may be necessary. [Archives Medical Review Journal 2013; 22(1.000: 33-44

  5. Discrimination of auditory stimuli during isoflurane anesthesia.

    Science.gov (United States)

    Rojas, Manuel J; Navas, Jinna A; Greene, Stephen A; Rector, David M

    2008-10-01

    Deep isoflurane anesthesia initiates a burst suppression pattern in which high-amplitude bursts are preceded by periods of nearly silent electroencephalogram. The burst suppression ratio (BSR) is the percentage of suppression (silent electroencephalogram) during the burst suppression pattern and is one parameter used to assess anesthesia depth. We investigated cortical burst activity in rats in response to different auditory stimuli presented during the burst suppression state. We noted a rapid appearance of bursts and a significant decrease in the BSR during stimulation. The BSR changes were distinctive for the different stimuli applied, and the BSR decreased significantly more when stimulated with a voice familiar to the rat as compared with an unfamiliar voice. These results show that the cortex can show differential sensory responses during deep isoflurane anesthesia.

  6. Percutaneous Nephrolithotomy under Spinal Anesthesia with Marcaine

    Directory of Open Access Journals (Sweden)

    S.M.R. Rabani

    2010-01-01

    Full Text Available Introduction & Objective: The efficacy of Percutaneous Nephrolithotomy (PCNL in the treatment of renal stones has been proven in its indications. The main method of anesthesia in this procedure is general anesthesia. We used spinal anesthesia (SA as an alternative method of anesthesia with many benefits. This study was intended to show the possibility of SA as a more comfortable method of anesthesia for the surgeon , the anesthesiologist and the patient via more cooperation of the patient during changing the position and prevention of some complications mostly in upper extremities and neck. Materials & Methods: In a prospective clinical trial study, a total of 112 patients underwent PCNL under SA with marcaine , from Nov 2004 till Feb 2009. Their mean age was 36 years (22-48, at first the syringe was stained by epinephrine and then 2 -3.5 ml marcaine was used for SA and addition of analgesics , sedatives or both., if needed. The rest of the procedure was done as routine.Results: Stone clearance was achieved in 82% of the patients and the rest were managed by ESWL. The mean operation time was 126 minutes (90-220, 36% of the patients needed sedation, analgesia, or both, specially those with bigger stones. 6% of the patients had upper pole stones .Blood transfusion was needed only in one patient. No significant complication was observed in this study.Conclusion: PCNL under SA afforded the surgeon and the anesthesiologist the opportunity of more patient cooperation during position changes and precludes some morbidities that may happen under general anesthesia because the patient is awake and able to portend.

  7. Phrenic nerve blocage with spinal anesthesia for laparoscopic Nissen fundoplication

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2015-06-01

    Full Text Available In this case, we describe a patient having laparoscopic Nissen fundoplication (LNF under spinal anesthesia with phrenic nerve blockade. It’s emphasized that in this type of operations, spinal anesthesia may be an alternative method rather the general anesthesia and the resulting shoulder pain in laparoscopic surgery performed under spinal anesthesia can be prevented by phrenic nerve blockade. J Clin Exp Invest 2015; 6 (2: 186-188

  8. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    OpenAIRE

    Tapar, Hakan; SÜREN, Mustafa; Kaya, Ziya; Arıcı, Semih; Karaman, Serkan; Kahveci, Mürsel

    2012-01-01

    Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to...

  9. Inguinal hernioraphy under local anesthesia in the elderly patients

    OpenAIRE

    2012-01-01

    Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years) and theyounger. Anesthesia methods, additional anesthesia r...

  10. Implementation of an Anesthesia Information Management System (AIMS)

    OpenAIRE

    Douglas, James R.; Ritter, Melody J.

    2011-01-01

    During the administration of anesthesia, the anesthesia provider has historically created a paper record, charted manually, that included extensive patient care–related data (vital signs, other parameters, etc) and commentaries. DocuSys, a proprietary anesthesia information management system (AIMS), creates an electronic version of the anesthesia record and provides additional information. It electronically captures data from clinical monitors and other sources, including scheduling applicati...

  11. Availability and Readability of Online Patient Education Materials Regarding Regional Anesthesia Techniques for Perioperative Pain Management.

    Science.gov (United States)

    Kumar, Gunjan; Howard, Steven K; Kou, Alex; Kim, T Edward; Butwick, Alexander J; Mariano, Edward R

    2016-08-02

    OBJECTIVE : Patient education materials (PEM) should be written at a sixth-grade reading level or lower. We evaluated the availability and readability of online PEM related to regional anesthesia and compared the readability and content of online PEM produced by fellowship and nonfellowship institutions. METHODS : With IRB exemption, we constructed a cohort of online regional anesthesia PEM by searching Websites from North American academic medical centers supporting a regional anesthesiology and acute pain medicine fellowships and used a standardized Internet search engine protocol to identify additional nonfellowship Websites with regional anesthesia PEM based on relevant keywords. Readability metrics were calculated from PEM using the TextStat 0.1.4 textual analysis package for Python 2.7 and compared between institutions with and without a fellowship program. The presence of specific descriptive PEM elements related to regional anesthesia was also compared between groups. RESULTS : PEM from 17 fellowship and 15 nonfellowship institutions were included in analyses. The mean (SD) Flesch-Kincaid Grade Level for PEM from the fellowship group was 13.8 (2.9) vs 10.8 (2.0) for the nonfellowship group (p = 0.002). We observed no other differences in readability metrics between fellowship and nonfellowship institutions. Fellowship-based PEM less commonly included descriptions of the following risks: local anesthetic systemic toxicity (p = 0.033) and injury due to an insensate extremity (p = 0.003). CONCLUSIONS : Available online PEM related to regional anesthesia are well above the recommended reading level. Further, fellowship-based PEM posted are at a higher reading level than PEM posted by nonfellowship institutions and are more likely to omit certain risk descriptions.

  12. Anesthesia care for the professional singer.

    Science.gov (United States)

    Meacham, Ryan K; Schindler, Joshua

    2015-06-01

    The professional singer comes to the day of surgery with a measure of anxiety about the effects of anesthesia or surgery on his or her voice. A detailed informed consent should be obtained to discuss and document risks, as well as set realistic expectations for recovery. The smallest endotracheal tube possible should be used to intubate in the least traumatic way. Movement of the tube should be minimized, both during anesthesia, as well as in emergence. Postoperative care may be coordinated with an otolaryngologist and speech language pathologist as the singer plans a return to performance.

  13. Nurse Anesthetists' Perceptions Regarding Utilization of Anesthesia Support Personnel

    Science.gov (United States)

    Ford, Mary Bryant

    2010-01-01

    Anesthesia support personnel (ASP) provide direct support to health care providers administering anesthesia (Certified Registered Nurse Anesthetists [CRNAs] and anesthesiologists). Because these anesthesia providers are caring for a patient whom they cannot legally or ethically leave unattended, ASP are employed to bring them extra supplies or…

  14. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger;

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to inve...

  15. Inguinal hernioraphy under local anesthesia in the elderly patients

    Directory of Open Access Journals (Sweden)

    Nurettin Kahramansoy

    2012-12-01

    Full Text Available Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years and theyounger. Anesthesia methods, additional anesthesia requirementand complications were compared.Results: Of totally 177 patients, 30.5% were elderly.Operation type, anesthesia method and score of operationalrisk differed between groups. The percentage of comorbidity (55.6% in the elderly was significantly high (p<0.001. Among elderly, the frequency of co morbidity wasslightly higher in patients who had local anesthesia comparedto spinal and general anesthesia. Patients in youngand middle ages preferred to be operated less under localanesthesia (34.1% compared to elderly (70.4%. Therewas one case (2.6% converted to general anesthesiaas an additional anesthesia in the elderly group. Postoperativecomplications were slight more frequent in elderly.These cases were five in number (31.3% and were operatedunder spinal or general anesthesia (p=0.002.Conclusions: The frequency of co morbidity and riskscore of operation (ASA category rise in the elderly.However, inguinal hernioraphy can be performed underlocal anesthesia without complication and conversion togeneral anesthesia.Key words: Inguinal hernia; aged; comorbidity; local anesthesia

  16. 21 CFR 868.5240 - Anesthesia breathing circuit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia breathing circuit. 868.5240 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5240 Anesthesia breathing circuit. (a) Identification. An anesthesia breathing circuit is a device that is intended to administer medical gases to...

  17. Boosting bioluminescence neuroimaging: an optimized protocol for brain studies.

    Science.gov (United States)

    Aswendt, Markus; Adamczak, Joanna; Couillard-Despres, Sebastien; Hoehn, Mathias

    2013-01-01

    Bioluminescence imaging is widely used for optical cell tracking approaches. However, reliable and quantitative bioluminescence of transplanted cells in the brain is highly challenging. In this study we established a new bioluminescence imaging protocol dedicated for neuroimaging, which increases sensitivity especially for noninvasive tracking of brain cell grafts. Different D-Luciferin concentrations (15, 150, 300 and 750 mg/kg), injection routes (i.v., i.p., s.c.), types of anesthesia (Isoflurane, Ketamine/Xylazine, Pentobarbital) and timing of injection were compared using DCX-Luc transgenic mice for brain specific bioluminescence. Luciferase kinetics was quantitatively evaluated for maximal photon emission, total photon emission and time-to-peak. Photon emission followed a D-Luciferin dose-dependent relation without saturation, but with delay in time-to-peak increasing for increasing concentrations. The comparison of intravenous, subcutaneous and intraperitoneal substrate injection reflects expected pharmacokinetics with fastest and highest photon emission for intravenous administration. Ketamine/Xylazine and Pentobarbital anesthesia showed no significant beneficial effect on maximal photon emission. However, a strong difference in outcome was observed by injecting the substrate pre Isoflurane anesthesia. This protocol optimization for brain specific bioluminescence imaging comprises injection of 300 mg/kg D-Luciferin pre Isoflurane anesthesia as an efficient and stable method with a signal gain of approx. 200% (compared to 150 mg/kg post Isoflurane). Gain in sensitivity by the novel imaging protocol was quantitatively assessed by signal-to-noise calculations of luciferase-expressing neural stem cells grafted into mouse brains (transplantation of 3,000-300,000 cells). The optimized imaging protocol lowered the detection limit from 6,000 to 3,000 cells by a gain in signal-to-noise ratio.

  18. Correlation of bupivacaine 0.5% dose and conversion from spinal anesthesia to general anesthesia in cesarean sections

    NARCIS (Netherlands)

    Seljogi, D; Wolff, A P; Scheffer, G J; van Geffen, G J; Bruhn, J

    2016-01-01

    BACKGROUND: Failed spinal anesthesia for cesarean sections may require conversion to general anesthesia. The aim of this study was to determine whether the administered spinal bupivacaine dose for performing a cesarean section under spinal anesthesia was related to the conversion rate to general ane

  19. Awareness during general anesthesia: An Indian viewpoint

    Directory of Open Access Journals (Sweden)

    Reshma P Ambulkar

    2016-01-01

    Conclusion: Awareness under anesthesia is a distressing complication with a potential for long-term psychological consequences, and every effort should be undertaken to prevent it. It is reassuring though that our data in Indian cancer patients at high risk for intra-operative awareness suggests that it is an uncommon occurrence.

  20. Testing haptic sensations for spinal anesthesia.

    LENUS (Irish Health Repository)

    2011-01-01

    Having identified key determinants of teaching and learning spinal anesthesia, it was necessary to characterize and render the haptic sensations (feeling of touch) associated with needle insertion in the lower back. The approach used is to match recreated sensations (eg, "pop" through skin or dura mater) with experts\\' perceptions of the equivalent clinical events.

  1. [Clinical utility of thoracoscopy under local anesthesia].

    Science.gov (United States)

    Ishii, Yoshiki

    2007-07-01

    Thoracoscopy has been recently established as an indispensable technique for diagnosis and treatment of respiratory diseases. Although, thoracoscopy is usually applied under general anesthesia by a surgeon, it can also be applied by a chest physician under local anesthesia if the target is limited to pleural diseases. The main objective of medical thoracoscopy under local anesthesia is to establish a diagnosis of pleural effusions by means of observation and biopsy in the thoracic cavity. Our main target diseases are the pleuritis carcinomatosa, malignant mesothelioma and tuberculous pleuritis. These 3 diseases are the diseases with which medical thoracoscopy is most useful because they can be reliably diagnosed by biopsies and because early diagnosis and early treatment are essential. In case of the pneumothorax, treatment with bulla looping or cauterization may be possible, but we do not treat pneumothorax with medical thoracoscopy because it is impossible to approach and find air leaks of lesions located in or near blind spots such as the apex or mediastinal part In case of acute emphysema, it is important to release adhesions and perform effective drainage using thoracoscopy as soon as possible since deposition of fibrin tends to form quickly compartments that make drainage difficult. Scince medical thoracoscopy under local anesthesia is rapid, easy, safe, and well-tolerated procedure with an excellent diagnostic yield, it is recommended as a diagnostic procedure for cases with pleural diseases.

  2. Optimizing anesthesia techniques in the ambulatory setting

    NARCIS (Netherlands)

    E. Galvin

    2007-01-01

    textabstractAmbulatory surgery refers to the process of admitting patients, administering anesthesia and surgical care, and discharging patients home following an appropriate level of recovery on the same day. The word ambulatory is derived from the latin word ambulare, which means ''to walk''. This

  3. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding...

  4. The Biochemical Impact of Surgery and Anesthesia

    NARCIS (Netherlands)

    J.W. Hol (Jaap Willem)

    2014-01-01

    markdownabstract__Abstract__ General anesthesia has been considered by some medical historians as one of the most important contributions to modern medicine second to perhaps the concept of antiseptic medicine and hygiene. The first historical mention of a deep unnatural sleep so that surgery can t

  5. Low dose spinal anesthesia for knee arthroscopy

    Directory of Open Access Journals (Sweden)

    Lakhin R.E.

    2015-06-01

    Full Text Available Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

  6. Outpatient varicocelectomy performed under local anesthesia

    Institute of Scientific and Technical Information of China (English)

    Geng-Long Hsu; Pei-Ying Ling; Cheng-Hsing Hsieh; Chii-Jye Wang; Cheng-Wen Chen; Hsien-Sheng Wen; Hsiu-Mei Huang; E. Ferdinand Einhorn; Guo-Fang Tseng

    2005-01-01

    Aim: To report a series of varicocelectomy performed under pure local anesthesia. Methods: From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale (VAS)was used to assess whether the pain level was acceptable. Results: The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % (567/575) of men could go back to work by the end of the first post-operative week and only 8 (1.4 %) men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of (18.5 ± 11.3) mm that was regarded as tolerable. Conclusion: This study has shown varicocelectomy under local anesthesia to be possible,simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.

  7. Regional anesthesia techniques for ambulatory orthopedic surgery.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2012-02-03

    PURPOSE OF REVIEW: The purpose of this review is to present advances in the use of regional anesthetic techniques in ambulatory orthopedic surgery. New findings regarding the use of both neuraxial anesthesia and peripheral nerve block are discussed. RECENT FINDINGS: Neuraxial anesthesia: The use of short-acting local anesthetic agents such as mepivacaine, 2-chloroprocaine, and articaine permits rapid onset intrathecal anesthesia with early recovery profiles. Advantages and limitations of these agents are discussed.Peripheral nerve block: Peripheral nerve blocks in limb surgery have the potential to transform this patient cohort into a truly ambulatory, self-caring group. Recent trends and evidence regarding the benefits of regional anesthesia techniques are presented.Continuous perineural catheters permit extension of improved perioperative analgesia into the ambulatory home setting. The role and reported safety of continuous catheters are discussed. SUMMARY: In summary, shorter acting, neuraxial, local anesthetic agents, specific to the expected duration of surgery, may provide superior recovery profiles in the ambulatory setting. A trend towards more peripheral and selective nerve blocks exists. The infrapatellar block is a promising technique to provide analgesia following knee arthroscopy. Improved analgesia seen in the perioperative period can be safely and effectively extended to the postoperative period with the use of perineural catheters.

  8. [Horner syndrome following combined spinal-epidural anesthesia].

    Science.gov (United States)

    Karaca, Ömer; Kumaş Solak, Sezen; Demirgan, Serdar; Bademci, Mehmet

    2016-07-01

    Horner syndrome is rarely observed in connection with epidural anesthesia. It is characterized by ptosis, enophthalmos, miosis, anisocoria, and conjunctival hyperemia in the affected eye, as well as anhydrosis and flushing on the affected side of the face. It is usually a complication spontaneously resolved without permanent neurological deficits. Intraoral anesthesia; stellate ganglion, cervical or brachial plexus blocks; thoracic, lumbar or caudal epidural anesthesia, and intrapleural analgesia are the main causes for Horner syndrome related to anesthesia. Among other causes of Horner syndrome are head and neck surgery, trauma, and puncture of internal jugular vein. The present case of unilateral Horner syndrome appeared in the aortobifemoral bypass after lumbar spinal- epidural anesthesia.

  9. Comparison of Anesthesia Quality for Arthroscopic Knee Surgery: Combined Sciatic Femoral Block and Unilateral Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Sinem Sarı

    2015-08-01

    Full Text Available Objective: We aimed to evaluate the quality of anesthesia of combined sciatic and femoral 3-in-1 nerve blocks (CSFB and unilateral spinal anesthesia technique with low-dose levobupivacaine in outpatients undergoing knee arthroscopy surgery. Materials and Methods: Forty American Society of Anesthesiologists (ASA physical status I-II patients were randomly allocated into two groups and unilateral spinal anesthesia with low-dose levobupivacaine (group S, n=20 or CSFB (group B, n=20 was performed. Besides the quality of anesthesia, anesthetic effectiveness, hemodynamic values, duration of the technique application, maximum motor and sensorial block levels and durations, the first analgesics need, and total analgesic consumptions during postoperative 24 hours and determined complications were compared between the two groups. Results: The quality of anesthesia was better in group S, no patient received either sedation or analgesic intraoperatively while first analgesic need and number of patient was higher (p=0.014, p<0.001, p=0.032 respectively. The duration of technical application was shorter while maximum motor and sensorial block levels were higher in group S (p<0.0001, p=0.008, p<0.001 respectively. Motor block duration was significantly longer in group B (p<0.0001. Conclusion: We concluded that CSFB practice is an effective anesthetic alternative for unilateral spinal anesthesia. Introduction

  10. A Wavelet Transform Based Method to Determine Depth of Anesthesia to Prevent Awareness during General Anesthesia

    Directory of Open Access Journals (Sweden)

    Seyed Mortaza Mousavi

    2014-01-01

    Full Text Available Awareness during general anesthesia for its serious psychological effects on patients and some juristically problems for anesthetists has been an important challenge during past decades. Monitoring depth of anesthesia is a fundamental solution to this problem. The induction of anesthesia alters frequency and mean of amplitudes of the electroencephalogram (EEG, and its phase couplings. We analyzed EEG changes for phase coupling between delta and alpha subbands using a new algorithm for depth of general anesthesia measurement based on complex wavelet transform (CWT in patients anesthetized by Propofol. Entropy and histogram of modulated signals were calculated by taking bispectral index (BIS values as reference. Entropies corresponding to different BIS intervals using Mann-Whitney U test showed that they had different continuous distributions. The results demonstrated that there is a phase coupling between 3 and 4 Hz in delta and 8-9 Hz in alpha subbands and these changes are shown better at the channel T7 of EEG. Moreover, when BIS values increase, the entropy value of modulated signal also increases and vice versa. In addition, measuring phase coupling between delta and alpha subbands of EEG signals through continuous CWT analysis reveals the depth of anesthesia level. As a result, awareness during anesthesia can be prevented.

  11. Olfactory bulb encoding during learning under anesthesia

    Science.gov (United States)

    Nicol, Alister U.; Sanchez-Andrade, Gabriela; Collado, Paloma; Segonds-Pichon, Anne; Kendrick, Keith M.

    2014-01-01

    Neural plasticity changes within the olfactory bulb are important for olfactory learning, although how neural encoding changes support new associations with specific odors and whether they can be investigated under anesthesia, remain unclear. Using the social transmission of food preference olfactory learning paradigm in mice in conjunction with in vivo microdialysis sampling we have shown firstly that a learned preference for a scented food odor smelled on the breath of a demonstrator animal occurs under isofluorane anesthesia. Furthermore, subsequent exposure to this cued odor under anesthesia promotes the same pattern of increased release of glutamate and gamma-aminobutyric acid (GABA) in the olfactory bulb as previously found in conscious animals following olfactory learning, and evoked GABA release was positively correlated with the amount of scented food eaten. In a second experiment, multiarray (24 electrodes) electrophysiological recordings were made from olfactory bulb mitral cells under isofluorane anesthesia before, during and after a novel scented food odor was paired with carbon disulfide. Results showed significant increases in overall firing frequency to the cued-odor during and after learning and decreases in response to an uncued odor. Analysis of patterns of changes in individual neurons revealed that a substantial proportion (>50%) of them significantly changed their response profiles during and after learning with most of those previously inhibited becoming excited. A large number of cells exhibiting no response to the odors prior to learning were either excited or inhibited afterwards. With the uncued odor many previously responsive cells became unresponsive or inhibited. Learning associated changes only occurred in the posterior part of the olfactory bulb. Thus olfactory learning under anesthesia promotes extensive, but spatially distinct, changes in mitral cell networks to both cued and uncued odors as well as in evoked glutamate and GABA

  12. Role of intraseptal anesthesia for pain-free dental treatment

    Directory of Open Access Journals (Sweden)

    G Gazal

    2016-01-01

    Full Text Available Pain control during the dental procedure is essentials and challenging. A complete efficacious pulp anesthesia has not been attained yet. The regional anesthesia such as inferior alveolar nerve block (IANB only does not guarantee the effective anesthesia with patients suffering from irreversible pulpitis. This main aim of this review was to discuss various aspects of intraseptal dental anesthesia and its role significance in pain-free treatment in the dental office. In addition, reasons of failure and limitations of this technique have been highlighted. Literature search was conducted for peer-reviewed articles published in English language in last 30 years. Search words such as dental anesthesia, pain control, intraseptal, and nerve block were entered using a web of knowledge and Google scholar databases. Various dental local anesthesia techniques were reviewed. A combination of block anesthesia, buccal infiltration and intraligamentary injection resulted in deep anesthesia (P = 0.003, and higher success rate compared to IANB. For pain-free management of conditions such as irreversible pulpitis, buccal infiltration (4% articaine, and intraosseous injection (2% lidocaine are better than intraligamentary and IANB injections. Similarly, nerve block is not always effective for pain-free root canal treatment hence, needing supplemental anesthesia. Intraseptal anesthesia is an efficient and effective technique that can be used in maxillary and mandibular adult dentition. This technique is also beneficial when used in conjunction to the regional block or local dental anesthesia.

  13. Practice characteristics among dental anesthesia providers in the United States.

    Science.gov (United States)

    Boynes, Sean G; Moore, Paul A; Tan, Peter M; Zovko, Jayme

    2010-01-01

    General descriptions or "snapshots" of sedation/general anesthesia practices during dental care are very limited in reviewed literature. The objective of this study was to determine commonalities in dental sedation/anesthesia practices, as well as to accumulate subjective information pertaining to sedation/anesthesia care within the dental profession. This questionnaire-based survey was completed by participating anesthesia providers in the United States. A standardized questionnaire was sent via facsimile, or was delivered by mail, to 1500 anesthesia providers from a randomized list using an online database. Data from the returned questionnaires were entered onto an Excel spreadsheet and were imported into a JMP Statistical Discovery Software program for analyses. Quantitative evaluations were confined to summation of variables, an estimation of means, and a valid percent for identified variables. A total of 717 questionnaires were entered for data analysis (N=717). Data from this study demonstrate the wide variation that exists in sedation/anesthesia care and those providing its administration during dental treatment in the United States. The demographics of this randomized population show anesthesia providers involved in all disciplines of the dental profession, as well as significant variation in the types of modalities used for sedation/anesthesia care. Data from this study reveal wide variation in sedation/anesthesia care during dental treatment. These distinctions include representation of sedation/anesthesia providers across all disciplines of the dental profession, as well as variations in the techniques used for sedation/anesthesia care.

  14. Anesthesia information management systems: past, present, and future of anesthesia records.

    Science.gov (United States)

    Kadry, Bassam; Feaster, William W; Macario, Alex; Ehrenfeld, Jesse M

    2012-01-01

    Documenting a patient's anesthetic in the medical record is quite different from summarizing an office visit, writing a surgical procedure note, or recording other clinical encounters. Some of the biggest differences are the frequent sampling of physiologic data, volume of data, and diversity of data collected. The goal of the anesthesia record is to accurately and comprehensively capture a patient's anesthetic experience in a succinct format. Having ready access to physiologic trends is essential to allowing anesthesiologists to make proper diagnoses and treatment decisions. Although the value provided by anesthesia information management systems and their functions may be different than other electronic health records, the real benefits of an anesthesia information management system depend on having it fully integrated with the other health information technologies. An anesthesia information management system is built around the electronic anesthesia record and incorporates anesthesia-relevant data pulled from disparate systems such as laboratory, billing, imaging, communication, pharmacy, and scheduling. The ability of an anesthesia information management system to collect data automatically enables anesthesiologists to reliably create an accurate record at all times, regardless of other concurrent demands. These systems also have the potential to convert large volumes of data into actionable information for outcomes research and quality-improvement initiatives. Developing a system to validate the data is crucial in conducting outcomes research using large datasets. Technology innovations outside of healthcare, such as multitouch interfaces, near-instant software response times, powerful but simple search capabilities, and intuitive designs, have raised the bar for users' expectations of health information technology.

  15. The comparison of anesthesia effect of lung surgery through video-assisted thoracic surgery: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Jing-Dong Ke

    2015-01-01

    Conclusion: These results indicated that epidural anesthesia can save operating time and postoperative hospital stay time. But epidural anesthesia and general anesthesia have the same effect on complications.

  16. Protocol Implementation Generator

    DEFF Research Database (Denmark)

    Carvalho Quaresma, Jose Nuno; Probst, Christian W.

    2010-01-01

    necessary tools. In this paper, we present the Protocol Implementation Generator (PiG), a framework that can be used to add protocol generation to protocol negotiation, or to easily share and implement new protocols throughout a network. PiG enables the sharing, verification, and translation...... of communication protocols. With it, partners can suggest a new protocol by sending its specification. After formally verifying the specification, each partner generates an implementation, which can then be used for establishing communication. We also present a practical realisation of the Protocol Implementation...... Generator framework based on the LySatool and a translator from the LySa language into C or Java....

  17. General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

    Directory of Open Access Journals (Sweden)

    Lucía Vizcaíno-Martínez

    2014-01-01

    Full Text Available Objective: The aim was to evaluate general anesthesia (GA plus ilioinguinal nerve block (IIB versus spinal anesthesia (SA in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. Materials and Methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, maintenance with sevoflurane, airway management with laryngeal mask allowing spontaneous ventilation and ultrasound-guided IIB; SA group, patients who underwent spinal block with 2% mepivacaine. The study variables were pain intensity, assessed by visual analog scale, analgesic requirements until hospital discharge, time to ambulation and discharge, postoperative complications-related to both techniques and satisfaction experienced. Results: Thirty-two patients were enrolled; 16 patients in each group. The differences regarding pain were statistically significant at 2 h of admission (P < 0.001 and at discharge (P < 0.001 in favor of the GA plus ilioinguinal block group. In addition in this group, analgesic requirements were lower than SA group (P < 0.001, with times of ambulation and discharge significantly shorter. The SA group had a higher tendency to develop complications and less satisfaction. Conclusion: General anesthesia plus IIB is better than SA regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients.

  18. Magnesium in obstetric anesthesia and intensive care.

    Science.gov (United States)

    Kutlesic, Marija S; Kutlesic, Ranko M; Mostic-Ilic, Tatjana

    2017-02-01

    Magnesium, one of the essential elements in the human body, has numerous favorable effects that offer a variety of possibilities for its use in obstetric anesthesia and intensive care. Administered as a single intravenous bolus dose or a bolus followed by continuous infusion during surgery, magnesium attenuates stress response to endotracheal intubation, and reduces intraoperative anesthetic and postoperative analgesic requirements, while at the same time preserving favorable hemodynamics. Applied as part of an intrathecal or epidural anesthetic mixture, magnesium prolongs the duration of anesthesia and diminishes total postoperative analgesic consumption with no adverse maternal or neonatal effects. In obstetric intensive care, magnesium represents a first-choice medication in the treatment and prevention of eclamptic seizures. If used in recommended doses with close monitoring, magnesium is a safe and effective medication.

  19. Anesthesia for a Patient with Myotonic Dystrophy

    Directory of Open Access Journals (Sweden)

    Dilek Kalaycı

    2016-09-01

    Full Text Available Myotonic dystrophy is the most common myotonic syndrome causing abnormalities of the skeletal and smooth muscles as well as problems related to the cardiac, gastrointestinal and endocrine systems. In affected people, reduced functional residual capacity, vital capacity, and peak inspiratory pressure are observed within the respiratory system. As would be expected, anesthetic management of these patients is challenging for anesthesiologists. In addition, delayed recovery from anesthesia and cardiac and pulmonary complications may develop in the intraoperative and early postoperative periods due to sensitivity to sedatives, anesthetic agents, and neuromuscular blocking agents. Myotonic dystrophy can be performed with the use of appropriate anesthesia procedures as well as carefully communication between anesthesiologists and surgeons. In conclusion, myotonic dystrophy has variations, which makes it important to preoperatively determine specific surgical and anesthetic management strategies for each patient. In this article, we present a patient with myotonic dystrophy who underwent laparoscopic cholecystectomy surgery for symptomatic cholelithiasis and to discuss the relevant literature.

  20. Robust Adaptive Control of Hypnosis During Anesthesia

    Science.gov (United States)

    2007-11-02

    1 of 4 ROBUST ADAPTIVE CONTROL OF HYPNOSIS DURING ANESTHESIA Pascal Grieder1, Andrea Gentilini1, Manfred Morari1, Thomas W. Schnider2 1ETH Zentrum...A closed-loop controller for hypnosis was designed and validated on humans at our laboratory. The controller aims at regulat- ing the Bispectral Index...BIS) - a surro- gate measure of hypnosis derived from the electroencephalogram of the patient - with the volatile anesthetic isoflurane administered

  1. Anesthesia for Patients with Traumatic Brain Injuries.

    Science.gov (United States)

    Bhattacharya, Bishwajit; Maung, Adrian A

    2016-12-01

    Traumatic brain injury (TBI) represents a wide spectrum of disease and disease severity. Because the primary brain injury occurs before the patient enters the health care system, medical interventions seek principally to prevent secondary injury. Anesthesia teams that provide care for patients with TBI both in and out of the operating room should be aware of the specific therapies and needs of this unique and complex patient population.

  2. The effects of cigarette smoking on anesthesia.

    OpenAIRE

    Rodrigo, C.

    2000-01-01

    Cigarette smoke contains over 4000 substances, some of which are harmful to the smoker. Some constituents cause cardiovascular problems, increasing the blood pressure, heart rate, and the systemic vascular resistance. Some cause respiratory problems, interfering with oxygen uptake, transport, and delivery. Further, some interfere with respiratory function both during and after anesthesia. Some also interfere with drug metabolism. Various effects on muscle relaxants have been reported. Risk of...

  3. The National Anesthesia Clinical Outcomes Registry.

    Science.gov (United States)

    Liau, Adrian; Havidich, Jeana E; Onega, Tracy; Dutton, Richard P

    2015-12-01

    The Anesthesia Quality Institute (AQI) was chartered in 2008 by the American Society of Anesthesiologists to develop the National Anesthesia Clinical Outcomes Registry (NACOR). In this Technical Communication, we will describe how data enter NACOR, how they are authenticated, and how they are analyzed and reported. NACOR accepts case-level administrative, clinical, and quality capture data from voluntarily participating anesthesia practices and health care facilities in the United States. All data are transmitted to the AQI in summary electronic files generated by billing, quality capture, and electronic health care record software, typically on a monthly basis. All data elements are mapped to fields in the NACOR schema in accordance with a publicly available data dictionary. Incoming data are loaded into NACOR by AQI technologists and are subject to both manual and automated review to identify systematically missing elements, miscoding, and inadvertent corruption. Data are deidentified in compliance with Health Insurance Portability and Accountability Act regulations. The database server of AQI, which houses the NACOR database, is protected by 2 firewalls within the American Society of Anesthesiologists' network infrastructure; this system has not been breached. The NACOR Participant User File, a deidentified case-level dataset of information from NACOR, is available to researchers at participating institutions. NACOR architecture and the nature of the Participant User File include both strengths and weaknesses.

  4. Analysis of anesthesia practice and needs in Louisiana.

    Science.gov (United States)

    de Lanzac, K S; Miller, M K; Eyrich, J E

    2001-07-01

    The Louisiana State University Health Sciences Center Department of Anesthesiology performed an analysis of anesthesia practice and needs within the State of Louisiana. The State of Louisiana currently has approximately 300 practicing anesthesiologists (physicians), 700 certified registered nurse anesthetists (CRNAs), and does not currently utilize anesthesiologist assistants (AAs). Approximately 500,000 anesthesia encounters occur annually in Louisiana. Although there is a recognized critical shortage of anesthesiologists nationally, this document will focus mainly on the issue of mid-level providers of anesthesia services. The overwhelming majority of surgical and obstetric procedures is performed using the anesthesia care team approach both nationally and in the State of Louisiana. Within the anesthesia care team model, the practice of certified registered nurse anesthetists and anesthesiologist assistants are interchangeable, and both would meet the need for mid-level anesthesia providers in the State of Louisiana.

  5. Randomized study of phentolamine mesylate for reversal of local anesthesia.

    Science.gov (United States)

    Laviola, M; McGavin, S K; Freer, G A; Plancich, G; Woodbury, S C; Marinkovich, S; Morrison, R; Reader, A; Rutherford, R B; Yagiela, J A

    2008-07-01

    Local anesthetic solutions frequently contain vasoconstrictors to increase the depth and/or duration of anesthesia. Generally, the duration of soft-tissue anesthesia exceeds that of pulpal anesthesia. Negative consequences of soft-tissue anesthesia include accidental lip and tongue biting as well as difficulty in eating, drinking, speaking, and smiling. A double-blind, randomized, multicenter, Phase 2 study tested the hypothesis that local injection of the vasodilator phentolamine mesylate would shorten the duration of soft-tissue anesthesia following routine dental procedures. Participants (122) received one or two cartridges of local anesthetic/vasoconstrictor prior to dental treatment. Immediately after treatment, 1.8 mL of study drug (containing 0.4 mg phentolamine mesylate or placebo) was injected per cartridge of local anesthetic used. The phentolamine was well-tolerated and reduced the median duration of soft-tissue anesthesia in the lip from 155 to 70 min (p < 0.0001).

  6. The heart rate variability when conducting anesthesia

    Directory of Open Access Journals (Sweden)

    Khmel'nitskiy I.V.

    2016-03-01

    Full Text Available The study was performed on the base of 10 years of using different methods of analysis of heart rate variability as an indicator of direct and reverse connection of the sympatho-adrenal system in the preoperative diagnosis and anesthetic monitoring. The possibility of predicting the depth of anaesthesia was analyzed, for depending on significant amounts of external and internal conditions, the level of anesthesia changes significantly. In this regard the influence of drugs and technological means of influencing the condition of all life-supporting systems, and the autonomic nervous system in particular, before, during and after anesthesia is of great practical interest. The balance of the pharmacological protection of the vegetative balance in the surgical aggression is studied, as well as the use of heart rate variability as a non-specific method in relation to nosological forms of pathology, both under internal and external influences. A review of a number of sources confirms that heart rate is virtually the only high-speed method to present the sympatho-vagal regulation, the most accessible somatic parameter for estimation of the cardiovascular system functioning in anesthesiology. The heart rate variability serves as an indicator of functional condition of autonomous (vegetative nervous system. It is proposed to perform the continuous monitoring of the autonomic indices of the heart rhythm, which allows to register sympaho-vagal imbalance. Dynamic monitoring, timely interpretation of heart rate variability are constantly in the spotlight, but the approach and methodology of the domestic and foreign authors distinctly differ on the following points: heart rythmography as a visual method of assessing information about the dynamics of slow-wave processes, spectral analysis of the heart sinus rhythm as the best method of analysis of large and small wave activity, tests of functional diagnostics for subsequent measurement of the autonomic nervous

  7. [Initial experiences with propofol (Disoprivan) for anesthesia induction in pediatric anesthesia].

    Science.gov (United States)

    Motsch, J; Must, W; Hutschenreuter, K

    1988-09-01

    Propofol is a new intravenous anesthetic agent that provides smooth and rapid induction of anesthesia. A short elimination half-life guarantees rapid recovery. Since it has been reformulated as an emulsion in soya bean oil, anaphylactoid reactions are unlikely to occur. As compared to adults, there is very little experience with propofol in pediatric anesthesia. The aim of this study was to evaluate propofol as an induction agent in children with respect to cardiovascular and respiratory effects and to investigate the incidence of other side-effects. METHOD. In 25 ASA I children aged 3-12 years (6.4 +/- 2.7 SD) anesthesia was induced with a single dose of propofol, after standard premedication with atropine 0.01 mg/kg and Thalamonal 0.04 ml/kg. Anesthesia was maintained with halothane, nitrous oxide, and oxygen. Blood pressure (BP), heart rate (HR), and arterial oxygen saturation (SaO2) were measured before and each minute for 6 min after propofol administration. The incidence of side-effects during induction of anesthesia as well as during recovery and the postoperative period were recorded. RESULTS. Propofol 2.5 mg/kg produced rapid and smooth induction of anesthesia. Mean arterial pressure decreased after 1 min by 14.3% with a maximum of 16.8% after 3 min. HR was influenced differently by propofol; children with initially high HR had a decrease in HR, whereas in children with a low initial rate, HR increased transiently. After 1 min, no further changes occurred. Although no apnea was observed, respiration was shallow and depressed, as indicated by a decrease in SaO2. Two children complained of pain and 4 of discomfort at the site of the injection; 1 of these developed transient phlebitis.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    Directory of Open Access Journals (Sweden)

    Donmez T

    2016-10-01

    Full Text Available Turgut Donmez,1 Vuslat Muslu Erdem,2 Oguzhan Sunamak,3 Duygu Ayfer Erdem,2 Huseyin Imam Avaroglu1 1Department of General Surgery, 2Department of Anesthesiology and Reanimation, Lutfiye Nuri Burat State Hospital, 3Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Background: Laparoscopic total extraperitoneal (TEP inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA. To date, no reports compare the efficacy of spinal anesthesia (SA with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. Materials and methods: Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I or the SA TEP group (Group II. Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg and fentanyl (10 µg were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation. Results: All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (P<0.0001 and 4 h (P=0.002 after the procedure for the SA and GA groups, respectively. There was no difference between the two groups regarding complications, hospital stay, recovery, or surgery time. Generally, patients were more satisfied with SA than GA (P<0.020. Conclusion: TEP inguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better

  9. Nonoperating room anesthesia for the gastrointestinal endoscopy suite.

    Science.gov (United States)

    Tetzlaff, John E; Vargo, John J; Maurer, Walter

    2014-06-01

    Anesthesia services are increasingly being requested for gastrointestinal (GI) endoscopy procedures. The preparation of the patients is different from the traditional operating room practice. The responsibility to optimize comorbid conditions is also unclear. The anesthetic techniques are unique to the procedures, as are the likely events that require intervention by the anesthesia team. The postprocedure care is also unique. The future needs for anesthesia services in GI endoscopy suite are likely to expand with further developments of the technology.

  10. Total Extraperitoneal Preperitoneal Laparoscopic Hernia Repair Using Spinal Anesthesia

    OpenAIRE

    2006-01-01

    Background: Laparoscopic herniorrhaphy is a well-debated approach to inguinal hernia repair. Multiple technical and outcome variables have been compared with those of traditional open inguinal hernia repairs. One of these variables is the choice of anesthesia. To date, no reports describe the use of spinal anesthesia for laparoscopic hernia repairs. We present herein a review of our experience with spinal anesthesia for the total extraperitoneal preperitoneal laparoscopic hernia repair (TEP)....

  11. Unforgettable Ups and Downs of Acupuncture Anesthesia in China.

    Science.gov (United States)

    Jin, Lei; Wu, Jin-Song; Chen, Gong-Bai; Zhou, Liang-Fu

    2017-02-15

    Acupuncture Anesthesia originated from the pain relief and pain prevention theory in acupuncture and moxibustion. This technique is a new exploration of anesthesiology and an original achievement of China, representing a landmark combination of Traditional Chinese Medicine (TCM) and Western medicine. Acupuncture Anesthesia was initiated in 1958, and, reflecting the historical background of China after the 1960s, the use of this technique widely spread throughout the country. Reaching other countries after 1971, Acupuncture Anesthesia made a significant impact, drawing attention from medical academia worldwide. Thus, Acupuncture Anesthesia has made a special contribution to the medical science of modern China.

  12. Classifying depth of anesthesia using EEG features, a comparison.

    Science.gov (United States)

    Esmaeili, Vahid; Shamsollahi, Mohammad Bagher; Arefian, Noor Mohammad; Assareh, Amin

    2007-01-01

    Various EEG features have been used in depth of anesthesia (DOA) studies. The objective of this study was to find the excellent features or combination of them than can discriminate between different anesthesia states. Conducting a clinical study on 22 patients we could define 4 distinct anesthetic states: awake, moderate, general anesthesia, and isoelectric. We examined features that have been used in earlier studies using single-channel EEG signal processing method. The maximum accuracy (99.02%) achieved using approximate entropy as the feature. Some other features could well discriminate a particular state of anesthesia. We could completely classify the patterns by means of 3 features and Bayesian classifier.

  13. [General anesthesia for two patients taking methylphenidate (Ritalin)].

    Science.gov (United States)

    Kasuga, Takaho; Meno, Aki; Honda, Masahiro; Momoeda, Kanako; Nagase, Masaki; Hanaoka, Kazuo

    2008-06-01

    We experienced anesthesia care for two patients taking methylphenidate (Ritalin), which is a central nervous system stimulant of amphetamine analogues, usually administered for narcolepsy or refractory depression. The proper dose of methylphenidate is 20-60 mg per day. General anesthesia with epidural anesthesia was administered to both cases for total hip replacement. One patient could discontinue taking methylphenidate five days before the operation, but the other patient could not. Both cases needed more anesthetics than usual on induction, but very stable condition could be maintained during and after the operations. We consider that it is possible to perform general anesthesia safely for patients taking a usual dose of methylphenidate.

  14. Local anesthesia: A feasible option for pediatric frontalis sling surgery.

    Science.gov (United States)

    William, Jerald; Abbott, Joseph; Kipioti, Athina; Reuser, Tristan

    2011-01-01

    The purpose of this study was to demonstrate the suitability of local anesthesia in the pediatric age group for oculoplastic procedures. The authors present a case of frontalis sling surgery performed under local anesthesia in a 15-year-old boy with bilateral congenital ptosis. No significant technical difficulties were encountered during the procedure. Optimal intraoperative eyelid placement was facilitated by the patient's comfort and cooperation. For some selected children, local anesthesia is a good alternative to general anesthesia to obtain the best outcome.

  15. Research on Protocol Migration

    Institute of Scientific and Technical Information of China (English)

    汪芸; 顾冠群; 等

    1996-01-01

    This paper elaborates the concept and model of protocol migration in network interconnection.Migration strategies and principles are discussed and several cases are studied in detail which show the basic procedure and techniques used in protocol migration.

  16. Comparison of Total Intravenous Anesthesia (TIVA with Inhalation Anesthesia in Pediatric Bronchoscopy

    Directory of Open Access Journals (Sweden)

    Majid Razavi

    2013-12-01

    Full Text Available Background: Because of airway stimulations during the bronchoscopy and lack of direct access to the airway, preferred method of anesthesia for rigid bronchoscopy is already controversial. In this study we compared inhalation anesthesia with total intravenous anesthesia (TIVA for rigid bronchoscopy. Method and Materials: 30 patients aged 2-6 years were chosen divided on two same groups. Anesthesia in group I maintained with halothane and in group II maintained with remifentanil and propofol. Oxygenation, heart rate, respiratory rate, coughing, bucking, laryngospasm, bronchospasm were evaluated during and after surgery. Also Operation success and surgeon’s satisfaction were recorded as well.Results: Demographic findings were the same in both groups. Oxygenation and heart rate were more stable in group II (P=0.047 and P=0.026 respectively but there was no significant difference in respiratory rate between two groups (P=1. Success rate was also similar in both groups but surgeon’s satisfaction was significantly higher in TIVA (P=0.003. There was not any significant different between complications in two groups. Conclusion: We suggest TIVA for rigid bronchoscopy because of better oxygenation, more homodynamic stability, surgeon’s satisfaction, lack of air pollution and less interference with surgeon’s visual field.

  17. [Anesthesia for geriatric patients : Part 2: anesthetics, patient age and anesthesia management].

    Science.gov (United States)

    Herminghaus, A; Löser, S; Wilhelm, W

    2012-04-01

    Part 2 of this review on geriatric anesthesia primarily describes the multiple influences of age on the pharmacokinetics and pharmacodynamics of different anesthetic agents and their impact on clinical practice. In the elderly the demand for opioids is reduced by almost 50% and with total intravenous anesthesia the dosages of propofol and remifentanil as well as recovery times are more determined by patient age than by body weight. As a result depth of anesthesia monitoring is recommended for geriatric patients to individually adjust the dosing to patients needs. With muscle relaxants both delayed onset of action and prolonged duration of drug effects must be considered with increasing age and as this may lead to respiratory complications, neuromuscular monitoring is highly recommended. The following measures appear to be beneficial for geriatric patients: thorough preoperative assessment, extended hemodynamic monitoring, use of short-acting anesthetics in individually adjusted doses best tailored by depth of anesthesia monitoring, intraoperative normotension, normothermia and normocapnia, complete neuromuscular recovery at the end of the procedure and well-planned postoperative pain management in order to reduce or avoid the use of opioids.

  18. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    Science.gov (United States)

    Donmez, Turgut; Erdem, Vuslat Muslu; Sunamak, Oguzhan; Erdem, Duygu Ayfer; Avaroglu, Huseyin Imam

    2016-01-01

    Background Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). To date, no reports compare the efficacy of spinal anesthesia (SA) with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. Materials and methods Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I) or the SA TEP group (Group II). Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg) and fentanyl (10 µg) were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation. Results All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (Pinguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better patient satisfaction than GA. PMID:27822053

  19. Assessment of different anesthesia depth under total intravenous anesthesia on postoperative cognitive function in laparoscopic patients

    Directory of Open Access Journals (Sweden)

    Delin Zhang

    2016-01-01

    Full Text Available Background: This study aimed to compare the effects of different depths of sedation during total intravenous anesthesia (TIVA with remifentanil and propofol given by target-controlled infusion (TCI on postoperative cognitive function in young and middle-aged patients undergoing gynecological laparoscopic surgery. Materials and Methods: A total of 150 American Society of Anesthesiologists physical Status I/II patients scheduled for gynecological laparoscopic operation were randomly divided into three groups. Anesthesia was maintained with intravenous infusion of TCI propofol and remifentanil, intermittent injected intravenously with rocuronium. The infusion concentration of propofol and remifentanil was adjusted to maintain bispectral index (BIS at 30 24 sores on the day before anesthesia and the day after surgery in all three groups. However, the first group had the significantly higher MMSE scores than the other two groups after surgery (P < 0.05. Compared with that before anesthesia, TMT completion time was shorter on the day after surgery in the first group, while prolonged in the third group (P < 0.05. The first group had the significantly lower TMT completion time than the other two groups (P < 0.05. Conclusion: The depth of sedation, 30 < BIS value ≤ 40, under TIVA with remifentanil and propofol given by TCI had the minimal influence on postoperative cognitive function.

  20. Topological Design of Protocols

    CERN Document Server

    Jaffe, Arthur; Wozniakowski, Alex

    2016-01-01

    We give a topological simulation for tensor networks that we call the two-string model. In this approach we give a new way to design protocols, and we discover a new multipartite quantum communication protocol. We introduce the notion of topologically compressed transformations. Our new protocol can implement multiple, non-local compressed transformations among multi-parties using one multipartite resource state.

  1. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding...... on the use of premedication, choice of anesthetics, and management of postoperative pain. This review reflects on both general considerations concerning geriatric patients but also on the specific features of perioperatively used drugs and anesthetics that might have an impact on patients with Alzheimer...

  2. Anesthesia for the child with cancer.

    Science.gov (United States)

    Latham, Gregory J

    2014-03-01

    Children with cancer undergo a host of surgeries and procedures that require anesthesia during the various phases of the disease. A safe anesthetic plan includes consideration of the direct effects of tumor, toxic effects of chemotherapy and radiation therapy, the specifics of the surgical procedure, drug-drug interactions with chemotherapy agents, pain syndromes, and psychological status of the child. This article provides a comprehensive overview of the anesthetic management of the child with cancer, focuses on a systems-based approach to the impact from both tumor and its treatment in children, and presents a discussion of the relevant anesthetic considerations.

  3. Oxidative Stress and Anesthesia in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Peivandi Yazdi A

    2014-04-01

    Full Text Available Free radical and peroxide production lead to intracellular damage. On the other hand, free radicals are used by the human immune system to defend against pathogens. The aging process could be limited by oxidative stress in the short term. Chronic diseases like diabetes mellitus (DM are full-stress conditions in which remarkable metabolic functional destructions might happen. There is strong evidence regarding antioxidant impairment in diabetes. Performing a particular method for anesthesia in diabetic patients might prevent or modify excessive free radical formation and oxidative stress. It seems that prescribing antioxidant drugs could promote wound healing in diabetics.  

  4. Anatomy of an anesthesia information management system.

    Science.gov (United States)

    Shah, Nirav J; Tremper, Kevin K; Kheterpal, Sachin

    2011-09-01

    Anesthesia information management systems (AIMS) have become more prevalent as more sophisticated hardware and software have increased usability and reliability. National mandates and incentives have driven adoption as well. AIMS can be developed in one of several software models (Web based, client/server, or incorporated into a medical device). Irrespective of the development model, the best AIMS have a feature set that allows for comprehensive management of workflow for an anesthesiologist. Key features include preoperative, intraoperative, and postoperative documentation; quality assurance; billing; compliance and operational reporting; patient and operating room tracking; and integration with hospital electronic medical records.

  5. SURVEILLANCE OF BACTERIAL CONTAMINATION OF ANESTHESIA MACHINE AND PERIPHERAL INTRAVENOUS CANNULA DURING GENERAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Ch. Srinivas

    2015-01-01

    Full Text Available BACKGROUND: Given the expanding role of the anesthesiologist as the “total perioperative physician,” the increasing number of invasive procedures performed by anesthesiologists, and the increase in the prevalence of emerging diseases, stringent attention to infection control practices is paramount. AIM : To find out the bacterial contamination of anesthesia machine and internal lumen of the injection port of peri pheral intravenous cannula, and evaluation of its risk factors during general anesthesia procedures. MATERIALS AND METHODS: 50 general anaesthesia procedures were selected randomly after the approval of ethics committee and informed consent from the patien t. Samples were taken for bacterial culture on 2 sites in anesthesia machine (Adjustable pressure limiting valve {APL} and agent concentration dial of inhaled anesthetics{AD} and internal lumen of the injection port of peripheral intravenous cannula befor e starting and after completion of procedures. Bacteria and colony count were identified according to standard laboratory methods . RESULTS : Adjustable pressure limiting valve area was contaminated with bacteria in 12% (6/50 before starting procedure and 34% (17/50 after completion of procedures. Agent concentration dial of inhaled anesthetic site was contaminated with bacteria in 10% (5/50 before starting procedure and 28% (14/50 after completion of procedures. Bacterial contamination occurred in the i nternal lumen of the injection port of peripheral intravenous cannula in 16% (8/50 during general anesthesia. Isolated bacteria in anesthesia machine and peripheral intra venous cannula sites are STAPHYLO COCCI, STREPTOCOCCI, MICRO COCCI, ENTERO COCCI, E. COLI, and PSEUDOMONAS . CONCLUSION: Bacterial contamination is significantly associated with procedure order in a day (bacterial contamination rate is increased from first procedure to fifth procedure in a day. It is significantly associated with surgical s pecialty highest in

  6. Influence of local mucosal anesthesia combined with non tracheal intubation general anesthesia on EMR patients' intra-operative serum indexes

    Institute of Scientific and Technical Information of China (English)

    Sheng-Yong Liang

    2015-01-01

    Objective:To analyze the influence of local mucosal anesthesia combined with non tracheal intubation general anesthesia on EMR patients’ intra-operative serum indexes.Methods: 162 patients who received EMR from September 2013 to September 2014 in our hospital were enrolled and randomly divided into the observation group, including 81 cases, who received local mucosal anesthesia combined with non tracheal intubation general anesthesia, and the control group, including 81 cases, who received local mucosal anesthesia combined with routine tracheal intubation general anesthesia. Then inflammation index, stress index and immune index, etc were compared.Results:1) after general anesthesia, serum cytokine levels of IL-23, IL-32, PCT,β-EP and TNF-α, etc of the observation group were all significantly lower than those of the control group(P<0.05); 2) after general anesthesia, serum cytokine levels of COR, ET, TH and Ins, etc of the observation group were significantly lower than those of the control group(P<0.05); 3) after general anesthesia, serum levels of sICAM 1, CD11b, CD18 and CD20 of the observation group were lower than those of the control group; CD56 level was higher than that of the control group(P<0.05).Conclusion:Local mucosal anesthesia combined with non tracheal intubation general anesthesia provides sufficient anesthetic depth for EMR patients, and at the same time, can effectively reduce intra-operative systemic inflammatory response and stress response and contribute to the protection of body's immune function.

  7. Epidural anesthesia, hypotension, and changes in intravascular volume

    DEFF Research Database (Denmark)

    Holte, Kathrine; Foss, Nicolai B; Svensén, Christer;

    2004-01-01

    BACKGROUND: The most common side effect of epidural or spinal anesthesia is hypotension with functional hypovolemia prompting fluid infusions or administration of vasopressors. Short-term studies (20 min) in patients undergoing lumbar epidural anesthesia suggest that plasma volume may increase wh...

  8. Local anesthesia for endovascular abdominal aortic aneurysm repair

    NARCIS (Netherlands)

    Verhoeven, ELG; Cina, CS; Tielliu, IFJ; Zeebregts, CJ; Prins, TR; Eindhoven, GB; Span, MM; Kapma, MR; van den Dungen, JJAM

    2005-01-01

    Objectives: This study reports the results of a prospective continuous cohort of patients treated for endovascular aneurysm repair (EVAR) with a unified anesthetic strategy based on the use of local anesthesia (LA) in all patients, while reserving regional (RA) or general anesthesia (GA) only for th

  9. [Correction of the mental status during ketamine anesthesia].

    Science.gov (United States)

    Vorob'ev, A A; Shpilenia, L S; Zobin, M L

    1987-03-01

    Possibilities of pharmacological correction of the patient's mental state while performing Ketamin anesthesia were studied. The optimal results were obtained by the complex of Seduxen prior to and Pyracetam after anesthesia. It considerably reduced the frequency and degree of hallucinative--illusional disturbances and simultaneously markedly accelerated the restoration of the disturbed consciousness.

  10. General anesthesia suppresses normal heart rate variability in humans

    Science.gov (United States)

    Matchett, Gerald; Wood, Philip

    2014-06-01

    The human heart normally exhibits robust beat-to-beat heart rate variability (HRV). The loss of this variability is associated with pathology, including disease states such as congestive heart failure (CHF). The effect of general anesthesia on intrinsic HRV is unknown. In this prospective, observational study we enrolled 100 human subjects having elective major surgical procedures under general anesthesia. We recorded continuous heart rate data via continuous electrocardiogram before, during, and after anesthesia, and we assessed HRV of the R-R intervals. We assessed HRV using several common metrics including Detrended Fluctuation Analysis (DFA), Multifractal Analysis, and Multiscale Entropy Analysis. Each of these analyses was done in each of the four clinical phases for each study subject over the course of 24 h: Before anesthesia, during anesthesia, early recovery, and late recovery. On average, we observed a loss of variability on the aforementioned metrics that appeared to correspond to the state of general anesthesia. Following the conclusion of anesthesia, most study subjects appeared to regain their normal HRV, although this did not occur immediately. The resumption of normal HRV was especially delayed on DFA. Qualitatively, the reduction in HRV under anesthesia appears similar to the reduction in HRV observed in CHF. These observations will need to be validated in future studies, and the broader clinical implications of these observations, if any, are unknown.

  11. [New method of conduction anesthesia in the maxilla].

    Science.gov (United States)

    Efimov, Iu V; Tel'ianova, Iu V; Efimova, E Iu

    2014-01-01

    There was the research aimed at improving the effeciency of intraosseous anesthesia in the maxilla by blocking the infraorbital nerve conduction along its entire length. In the experimental part of the needle puncture defined place and character of the spreading of contrast medium into the upper jaw. In the clinical part of the study shows the advantages of the proposed method of intraosseous anesthesia.

  12. The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

    NARCIS (Netherlands)

    Postma, Ineke R.; van Veen, Teelkien R.; Mears, Scott L.; Zeeman, Gerda G.; Haeri, Sina; Belfort, Michael A.

    2014-01-01

    Objective Neuraxial anesthesia is known to reduce sympathetic tone and mean arterial pressure. Effects on cerebral hemodynamics in pregnancy are not well known. We hypothesize that cerebral hemodynamic parameters will change with respect to baseline following regional analgesia/anesthesia. Study Des

  13. Anesthesia Maintenance During Mini-Invasive Cardiac Valve Surgery

    Directory of Open Access Journals (Sweden)

    L. A. Krichevsky

    2013-01-01

    Full Text Available Based on own experience and published data the authors analyze the features and specific components of anesthesia maintenance during mini-invasive cardiac valve surgery. The following clinically relevant aspects of anesthesia and perioperative intensive care were identified: preoperative patient selection and surgical and anesthesia risk prediction; one-lung ventilation; peripheral connection of circulation and specific features of its performance; control of oxygen delivery in the bed of aortic arch branches; and echocardiographic monitoring. The main risks and probable complications due to these interventions, such as cerebral hypoxia, respiratory failure, pulmonary hypertension, etc., are described. The mechanisms of their development and the modes of prevention and treatment are shown. Key words: anesthesia in cardiac surgery, mini-invasive cardiac surgery, one-lung ventilation, anesthesia during cardiac valve surgery.

  14. Nonlinear analysis of anesthesia dynamics by Fractal Scaling Exponent.

    Science.gov (United States)

    Gifani, P; Rabiee, H R; Hashemi, M R; Taslimi, P; Ghanbari, M

    2006-01-01

    The depth of anesthesia estimation has been one of the most research interests in the field of EEG signal processing in recent decades. In this paper we present a new methodology to quantify the depth of anesthesia by quantifying the dynamic fluctuation of the EEG signal. Extraction of useful information about the nonlinear dynamic of the brain during anesthesia has been proposed with the optimum Fractal Scaling Exponent. This optimum solution is based on the best box sizes in the Detrended Fluctuation Analysis (DFA) algorithm which have meaningful changes at different depth of anesthesia. The Fractal Scaling Exponent (FSE) Index as a new criterion has been proposed. The experimental results confirm that our new Index can clearly discriminate between aware to moderate and deep anesthesia levels. Moreover, it significantly reduces the computational complexity and results in a faster reaction to the transients in patients' consciousness levels in relations with the other algorithms.

  15. Central temperature changes are poorly perceived during epidural anesthesia.

    Science.gov (United States)

    Glosten, B; Sessler, D I; Faure, E A; Karl, L; Thisted, R A

    1992-07-01

    Hypothermia and shivering are common during epidural anesthesia for cesarean delivery but are not always accompanied by a sensation of coldness. To test the hypothesis that central temperature changes are not perceived during epidural anesthesia, we measured central and skin temperatures and thermal perception in 30 patients undergoing cesarean delivery with epidural anesthesia. Central temperature decreased 1.0 +/- 0.6 degrees C from control values during anesthesia and surgery, but thermal perception scores did not reflect central temperatures (P = 0.56) or changes in central temperature (P = 0.63). A feeling of warmth was significantly correlated with increased mean skin temperature (P = 0.02) and increased upper body skin temperature (P = 0.03). We conclude that central temperature is poorly perceived and is less important than skin temperature in determining thermal perception during high levels of epidural anesthesia.

  16. Hypnosis and dental anesthesia in children: a prospective controlled study.

    Science.gov (United States)

    Huet, Adeline; Lucas-Polomeni, Marie-Madeleine; Robert, Jean-Claude; Sixou, Jean-Louis; Wodey, Eric

    2011-01-01

    The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.

  17. 27-Gauge Vitrectomy for Symptomatic Vitreous Floaters with Topical Anesthesia

    Science.gov (United States)

    Lin, Zhong; Moonasar, Nived; Wu, Rong Han; Seemongal-Dass, Robin R.

    2017-01-01

    Purpose Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can range from minor to severe. The surgery procedure of vitrectomy for symptomatic vitreous floaters is much simpler, mainly reflecting in the nonuse of sclera indentation, photocoagulation, and the apparently short surgery duration. The use of 27-gauge cannulae makes the puncture of the sclera minimally invasive. Hence, retrobulbar anesthesia, due to its rare but severe complications, seemed excessive for this kind of surgery. Method Three cases of 27-gauge, sutureless pars plana vitrectomy for symptomatic vitreous floaters with topical anesthesia are reported. Results The vitrectomy surgeries were successfully performed with topical anesthesia (proparacaine, 0.5%) without operative or postoperative complications. Furthermore, none of the patients experienced apparent pain during or after the surgery. Conclusion Topical anesthesia can be considered for 27-guage vitrectomy in patients with symptomatic vitreous floaters. PMID:28203195

  18. Optimization of a pain model: effects of body temperature and anesthesia on bladder nociception in mice.

    Science.gov (United States)

    Sadler, Katelyn E; Stratton, Jarred M; DeBerry, Jennifer J; Kolber, Benedict J

    2013-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating urological condition that is resistant to treatment and poorly understood. To determine novel molecular treatment targets and to elucidate the contribution of the nervous system to IC/BPS, many rodent bladder pain models have been developed. In this study we evaluated the effects of anesthesia induction and temperature variation in a mouse model of bladder pain known as urinary bladder distension (UBD). In this model compressed air is used to distend the bladder to distinct pressures while electrodes record the reflexive visceromotor response (VMR) from the overlying abdominal muscle. Two isoflurane induction models are commonly used before UBD: a short method lasting approximately 30 minutes and a long method lasting approximately 90 minutes. Animals were anesthetized with one of the methods then put through three sets of graded bladder distensions. Distensions performed following the short anesthesia protocol were significantly different from one another despite identical testing parameters; this same effect was not observed when the long anesthesia protocol was used. In order to determine the effect of temperature on VMRs, animals were put through three graded distension sets at 37.5 (normal mouse body temperature), 35.5, and 33.5°C. Distensions performed at 33.5 and 35.5°C were significantly lower than those performed at 37.5°C. Additionally, Western blot analysis revealed significantly smaller increases in spinal levels of phosphorylated extracellular-signal regulated kinase 2 (pERK2) following bladder distension in animals whose body temperature was maintained at 33.5°C as opposed to 37.5°C. These results highlight the significance of the dynamic effects of anesthesia on pain-like changes and the importance of close monitoring of temperature while performing UBD. For successful interpretation of VMRs and translation to human disease, body temperature should be maintained at 37.5

  19. Anesthesia considerations in the obese gravida.

    LENUS (Irish Health Repository)

    Tan, Terry

    2011-12-01

    Obesity is associated with serious morbidity during pregnancy, and obese women also are at a high risk of developing complications during labor, leading to an increased risk for instrumental and Cesarean deliveries. The engagement of the obstetrical anesthetist in the management of this group of high-risk patients should be performed antenatally so that an appropriate management strategy can be planned in advance to prevent an adverse outcome. Good communication between all care providers is essential. The obese patient in labor should be encouraged to have a functioning epidural catheter placed early in labor. Apart from providing analgesia and alleviating physiological derangements during labor, the presence of a functioning epidural catheter can also be used to induce anesthesia quickly in the event of an emergency cesarean section, thus avoiding a general anesthesia, which has exceedingly high risks in the obese parturient. Successful management of the obese patient necessitates a comprehensive strategy that encompasses a multidisciplinary and holistic approach from all care-providers.

  20. Anesthesia for subglottic stenosis in pediatrics

    Directory of Open Access Journals (Sweden)

    Eid Essam

    2009-01-01

    Full Text Available Any site in the upper airway can get obstructed and cause noisy breathing as well as dyspnea. These include nasal causes such as choanal atresia or nasal stenosis; pharyngeal causes including lingual thyroid; laryngeal causes such as laryngomalacia; tracheobronchial causes such as tracheal stenosis; and subglottic stenosis. Lesions in the oropharynx may cause stertor, while lesions in the laryngotracheal tree will cause stridor. Subglottic stenosis is the third leading cause of congenital stridors in the neonate. Subglottic Stenosis presents challenges to the anesthesiologist. Therefore, It is imperative to perform a detailed history, physical examination, and characterization of the extent and severity of stenosis. Rigid endoscopy is essential for the preoperative planning of any of the surgical procedures that can be used for correction. Choice of operation is dependent on the surgeon′s comfort, postoperative capabilities, and severity of disease. For high-grade stenosis, single-stage laryngotracheal resection or cricotracheal resection are the best options. It has to be borne in mind that the goal of surgery is to allow for an adequate airway for normal activity without the need for tracheostomy. Anesthesia for airway surgery could be conducted safely with either sevofl uraneor propofol-based total intravenous anesthesia.

  1. Anesthesia for subglottic stenosis in pediatrics.

    Science.gov (United States)

    Eid, Essam A

    2009-07-01

    Any site in the upper airway can get obstructed and cause noisy breathing as well as dyspnea. These include nasal causes such as choanal atresia or nasal stenosis; pharyngeal causes including lingual thyroid; laryngeal causes such as laryngomalacia; tracheobronchial causes such as tracheal stenosis; and subglottic stenosis. Lesions in the oropharynx may cause stertor, while lesions in the laryngotracheal tree will cause stridor. Subglottic stenosis is the third leading cause of congenital stridors in the neonate. Subglottic Stenosis presents challenges to the anesthesiologist. Therefore, It is imperative to perform a detailed history, physical examination, and characterization of the extent and severity of stenosis. Rigid endoscopy is essential for the preoperative planning of any of the surgical procedures that can be used for correction. Choice of operation is dependent on the surgeon's comfort, postoperative capabilities, and severity of disease. For high-grade stenosis, single-stage laryngotracheal resection or cricotracheal resection are the best options. It has to be borne in mind that the goal of surgery is to allow for an adequate airway for normal activity without the need for tracheostomy. Anesthesia for airway surgery could be conducted safely with either sevofluraneor propofol-based total intravenous anesthesia.

  2. Leroy D Vandam, MD: an anesthesia journey.

    Science.gov (United States)

    Ortega, Rafael A

    2005-08-01

    Leroy D Vandam, MD was a remarkable man--an intricate amalgamation of an artist, scientist, and physician. He was a bastion of medical historical knowledge. Dr Vandam became a most influential anesthesiologist, some say, a giant. He was an example of someone who, with resolve, overcame adversity. His artwork is displayed in countless places, and several of his paintings form part of the Wood Library Museum Heritage Series. Dr Vandam was first a surgeon, but he abandoned surgery and pursued a career in anesthesiology under the leadership of Robert Dripps. He completed his residency training at the University of Pennsylvania and joined its staff in 1949. When he arrived at Brigham and Women's Hospital in the 1950s as director of anesthesia, he embarked on one of the most illustrious careers in American anesthesiology. Dr Vandam published more than 250 original articles, chapters, abstracts, and other reports on a wide variety of subjects including history, art, and pharmacology. His classic article on the complications of neuroaxial blocks is a seminal work in anesthesiology. This article describes how an anesthesiologist who shared an interest with Dr Vandam in the history of anesthesiology came to produce a movie based on his career, the evolution of anesthesia equipment, and the transformation of our specialty.

  3. Bispectral index monitoring prevent awareness during total intravenous anesthesia: a prospective, randomized,double-blinded, multi-center controlled trial

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chen; GUO Jian-rong; JIN Yao-jun; WU Gang; YUAN Wei; YUAN Zhi-guo; YUE Yun; XU Liang; MA Ya-qun; SUN Yan-xia; LI Yan-hong; ZHANG Liang; FENG Chun-sheng; LUO Bing; ZHAO Zhen-long

    2011-01-01

    Background Awareness is a serious complication of general anesthesia.In China,the incidence of intraoperative awareness was 1% in patients undergoing total intravenous anesthesia (TIVA).In this study,we compared the incidence of awareness between Bispectral index (BIS)-guided and routine TIVA protocol and evaluated the effect of BIS on preventing awareness.Methods A prospective,randomized,double-blinded,multicenter controlled trial was performed.Patients (≥18 years of age) undergoing TIVA were randomly divided into BIS-guided group (Group A,BIS was monitored and recommended to maintain between 40-60) and control group (Group B,BIS was monitored but the screen was covered).The intraoperative BIS values were downloaded and the BIS trends of confirmed awareness cases were analyzed to determine whether light anesthesia existed.Results Of the total 5228 patients,2919 patients were assigned to Group A and 2309 to Group B.Four cases of confirmed awareness (0.14%) were reported in the BIS-guided group and 15 (0.65%) in the control group (P=0.002,OR=0.21,95% confidence intervals:0.07-0.63).The incidence of possible awareness (0.14% vs.0.26%,P=0.485) and dreaming (3.1% vs.3.1%,P=0.986) was comparable between BIS-guided group and the control group.Among the 19 confirmed awareness cases,intraoperative BIS trends of six cases were downloaded and identified.Five of them showed signs of light anesthesia as BIS >60 and lasted 19-106 minutes,whereas one case had a stable BIS trend and the values were within 60 during the operation.Another five awareness cases were reviewed for anesthesia procedures,of which improper light anesthesia were confirmed.Conclusions BIS-guided TIVA (BIS was recommended to maintain between 40-60) decreased the risk of awareness compared with routine TIVA.The main reason for awareness was light anesthesia.

  4. Comparison of Sedation With Local Anesthesia and Regional Anesthesia in Transurethral Resection of Prostate (TURP

    Directory of Open Access Journals (Sweden)

    H Aghamohammadi

    2008-12-01

    Full Text Available ABSTRACT: Introduction & Objective: Transurethral Resection of Prostate (TURP is usually performed under regional or general anesthesia. An alternative to conventional anesthesia is performing of TURP under local anesthetic infiltration with sedation. The aim of this study was to evaluate the efficacy and complication of sedoanalgesia in TURP. Material & Methods: In a prospective clinical trial from September 2006 to December 2007, 60 patients (30 in each group with prostate hypertrophy, candidate for TURP, were randomly assigned into two groups. In the first group, standard spinal anesthesia was done. In the second group, five minutes before the operation, 25 mgs of diazepam plus 25-50 mgs of pethedine was intravenously administered followed by injection of 10 ml lidocaine 2% gel in the urethra and the skin in the suprapubic area was anesthetized with 2 ml of 1% lidocaine. Using a 22 gauge nephrostomy needle, the suprapubic skin was punctured and the needle was directed toward prostate apex and 10-20ml of 1% lidocaine was injected at the serosal aspect of the rectal wall. For dorsal nerve block, 5-10ml of 1% lidocaine was injected at penopubic junction, and then a standard TURP was performed. Patients were switched to another anesthetic technique if the selected technique failed. Severity of pain was assessed by visual analogue scale. Results: The average prostate size was 25 grs (range10-50grs in the local anesthetic group (group 1 and 27.5 grs (range 10-50 grs in the spinal group (group2. In the local anesthetic group, 82.3% had no or mild pain while moderate to severe pain was reported in 16, 7% of the patients. In the group with spinal anesthesia, these were 93.1% and 6.9% respectively. Intolerable pain was observed in 23.3% and 13.8% of groups 1 and 2 respectively (p>0.05. Two patients in spinal group and 5 in local anesthetic group (3 due to severe pain and 2 for unsatisfaction required conversion to general anesthesia or receiving

  5. INTRAOCULAR PRESSURE, MEAN ARTERIAL BLOOD PRESSURE AND PUPILLARY DIAMETER IN RABBITS ( (Oryctolagus cuniculus SUBJECTED TO RETROBULBAR BLOCK WITH DIFFERENT ANESTHETIC PROTOCOLS

    Directory of Open Access Journals (Sweden)

    Renata Maria Monção da Silva

    2015-10-01

    Full Text Available The aim of this study was to evaluate four protocols of loco regional anesthesia for ophthalmic procedures that could provide safety and life support, in addition to maintain intraocular pressure stable, with eye centralization and eyelid akinesia. 20 New Zealand rabbits were used to perform local anesthesia by retrobulbar block with four protocols: 2% lidocaine with epinephrine, 2% lidocaine without epinephrine associated with tramadol, 1% ropivacaine and bupivacaine 0.5 %. Each animal received an anesthetic volume of 1 mL. All anesthetic protocols used promoted eyelid akinesia and centralization of the eye during the assessment period. The retrobulbar block with the proposed anesthetic protocols proved to be feasible and safe for the maintenance of intraocular pressure, invasive blood pressure and pupillary diameter and can be used in intraocular surgeries, respecting the time of action of each anesthetic. All protocols showed an excellent blockage action but bupivacaine promoted the highest pupil diameter compared to the other drugs tested.

  6. Acupuncture in ambulatory anesthesia: a review

    Directory of Open Access Journals (Sweden)

    Norheim AJ

    2015-09-01

    Full Text Available Arne Johan Norheim,1 Ingrid Liodden,1 Terje Alræk1,2 1National Research Center in Complementary and Alternative Medicine (NAFKAM, Department of Community Medicine, Faculty of Health Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, 2The Norwegian School of Health Sciences, Institute of Acupuncture, Kristiania University College, Oslo, NorwayBackground: Post-anesthetic morbidities remain challenging in our daily practice of anesthesia. Meta-analyses and reviews of acupuncture and related techniques for postoperative nausea and vomiting (POVN and postoperative vomiting (POV show promising results while many clinicians remain skeptical of the value of acupuncture. Given the interest in finding safe non-pharmacological approaches toward postoperative care, this body of knowledge needs to be considered. This review critically appraises and summarizes the research on acupuncture and acupressure in ambulatory anesthesia during the last 15 years.Methods: Articles were identified through searches of Medline, PubMed, and Embase using the search terms “acupuncture” or “acupuncture therapy” in combination with “ambulatory anesthesia” or “ambulatory surgery” or “day surgery” or “postoperative”. A corresponding search was done using “acupressure” and “wristbands”. The searches generated a total of 104, 118, and 122 references, respectively.Results: Sixteen studies were included; eight studies reported on acupuncture and eight on acupressure. Nine studies found acupuncture or acupressure effective on primary endpoints including postoperative nausea and vomiting, postoperative pain, sore throat, and emergence agitation. Four studies found acupuncture had a similar effect to antiemetic medication.Conclusion: Overall, the studies were of fairly good quality. A large proportion of the reviewed papers highlights an effect of acupuncture or acupressure on postoperative morbidities in an ambulatory setting

  7. COMPARATIVE STUDY OF SPINAL ANESTHESIA AND GENERAL ANESTHESIA IN CHILDREN UNDERGOING SURGERIES BELOW UMBILICUS

    Directory of Open Access Journals (Sweden)

    Ashish

    2014-09-01

    Full Text Available AIM: Aim of our study to compare the spinal anaesthesia and general anaesthesia in children undergoing surgeries below umbilicus. OBJECTIVE: to assess the patient comfort in pt. with GA and pt. with spinal anaesthesia, the adequate surgical condition, assess the hemodynamic change, assess the post op analgesia and to assess the post op complication. MATERIAL AND METHOD: 60 ASA grade I & II children of either sex, aged 5-12 yrs undergoing elective surgeries for the lower abdominal, perineal and lower limb surgeries were taken. After taking a detailed history, thorough general physical examination, all pertinent investigation were carried out to exclude any systemic disease. Patients were classified randomly into 2 groups (30 patients in each group. Group A: General anesthesia was given. Group P: subarachnoid block was given. Intraoperative monitoring consisted of SPO2, PR, NIBP, RR and assessment of duration of post-operative analgesia. P-value <0.05 consider significant. RESULT: Analysis revealed that there were no significant differences between the patients with respect to age, sex, duration and type of surgery In SAB since less general anaesthetic drug including parental opioid are used the risk and postoperative respiratory depression is minimal. The stress response to surgery is also limited and recovery is fast. Postoperatively complications like sore throat, laryngeal irritation, cough etc. was also less associated with it. CONCLUSION pediatric spinal anesthesia is not only a safe alternative to general anesthesia but often the anesthesia technique of choice in many lower abdominal and lower limb surgeries in children. The misconception regarding its safety and flexibility is broken and is now found to be even more cost effective. It is much preferred technique special for common day case surgeries generally performed in the pediatric age group.

  8. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    OpenAIRE

    2016-01-01

    Turgut Donmez,1 Vuslat Muslu Erdem,2 Oguzhan Sunamak,3 Duygu Ayfer Erdem,2 Huseyin Imam Avaroglu1 1Department of General Surgery, 2Department of Anesthesiology and Reanimation, Lutfiye Nuri Burat State Hospital, 3Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Background: Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). ...

  9. Current options in local anesthesia for groin hernia repairs.

    Science.gov (United States)

    Kulacoglu, Hakan; Alptekin, Alp

    2011-01-01

    Inguinal hernia repair is one of the most common procedures in general surgery. All anesthetic methods can be used in inguinal hernia repairs. Local anesthesia for groin hernia repair had been introduced at the very beginning of the last century, and gained popularity following the success reports from the Shouldice Hospital, and the Lichtenstein Hernia Institute. Today, local anesthesia is routinely used in specialized hernia clinics, whereas its use is still not a common practice in general hospitals, in spite of its proven advantages and recommendations by current hernia repair guidelines. In this review, the technical options for local anaesthesia in groin hernia repairs, commonly used local anaesthetics and their doses, potential complications related to the technique are evaluated. A comparison of local, general and regional anesthesia methods is also presented. Local anaesthesia technique has a short learning curve requiring simple training. It is easy to learn and apply, and its use is in open anterior repairs a nice way for health care economics. Local anesthesia has been shown to have certain advantages over general and regional anesthesia in inguinal hernia repairs. It is more economic and requires a shorter time in the operating room and shorter stay in the institution. It causes less postoperative pain, requires less analgesic consumption; avoids nausea, vomiting, and urinary retention. Patients can mobilize and take oral liquids and solid foods much earlier. Most importantly, local anesthesia is the most suitable type of anesthesia in elder, fragile patients and patients with ASA II-IV scores.

  10. An anesthesia information system for monitoring and record keeping during surgical anesthesia.

    Science.gov (United States)

    Klocke, H; Trispel, S; Rau, G; Hatzky, U; Daub, D

    1986-10-01

    We have developed an anesthesia information system (AIS) that supports the anesthesiologist in monitoring and recording during a surgical operation. In development of the system, emphasis was placed on providing an anesthesiologist-computer interface that can be adapted to typical situations during anesthesia and to individual user behavior. One main feature of this interface is the integration of the input and output of information. The only device for interaction between the anesthesiologist and the AIS is a touch-sensitive, high-resolution color display screen. The anesthesiologist enters information by touching virtual function keys displayed on the screen. A data window displays all data generated over time, such as automatically recorded vital signs, including blood pressure, heart rate, and rectal and esophageal temperatures, and manually entered variables, such as administered drugs, and ventilator settings. The information gathered by the AIS is presented on the cathode ray tube in several pages. A main distributor page gives an overall view of the content of every work page. A one-page record of the anesthesia is automatically plotted on a multicolor digital plotter during the operation. An example of the use of the AIS is presented from a field test of the system during which it was evaluated in the operating room without interfering with the ongoing operation. Medical staff who used the AIS imitated the anesthesiologist's recording and information search behavior but did not have responsibility for the conduct of the anesthetic.

  11. Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia

    Directory of Open Access Journals (Sweden)

    LaQuia A. Vinson

    2016-08-01

    Full Text Available The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA or office-based general anesthesia (OBGA in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029. Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

  12. Multiparty Quantum Cryptographic Protocol

    Institute of Scientific and Technical Information of China (English)

    M. Ramzan; M. K. Khan

    2008-01-01

    We propose a multiparty quantum cryptographic protocol. Unitary operators applied by Bob and Charlie, on their respective qubits of a tripartite entangled state encoding a classical symbol that can be decoded at Alice's end with the help of a decoding matrix. Eve's presence can be detected by the disturbance of the decoding matrix. Our protocol is secure against intercept-resend attacks. Furthermore, it is efficient and deterministic in the sense that two classical bits can be transferred per entangled pair of qubits. It is worth mentioning that in this protocol, the same symbol can be used for key distribution and Eve's detection that enhances the effciency of the protocol.

  13. Propofol alternatives in gastrointestinal endoscopy anesthesia

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Although propofol has been the backbone for sedation in gastrointestinal endoscopy, both anesthesiologists and endoscopists are faced with situations where an alternative is needed. Recent national shortages forced many physicians to explore these options. A midazolam and fentanyl combination is the mainstay in this area. However, there are other options. The aim of this review is to explore these options. The future would be, invariably, to move away from propofol. The reason is not in any way related to the drawbacks of propofol as a sedative. The mandate that requires an anesthesia provider to administer propofol has been a setback in many countries. New sedative drugs like Remimazolam might fill this void in the future. In the meantime, it is important to keep an open eye to the existing alternatives.

  14. TONSILLECTOMY UNDER LOCAL ANESTHESIA IN MALI

    Directory of Open Access Journals (Sweden)

    SACKO HB

    2015-04-01

    Full Text Available BACKGROUND The objective of this study was to analyze a series of tonsillectomies performed in the ENT Reference CentreoftheHealth, DistrictIVBAMAKOMALI PATIENTS and METHODS The study was conducted between June 2003 and May 2013 focused on 166 patients. Patients with chronic tonsillitis, obstructive hypertrophy of the Palatine tonsils, caseous tonsillitis were included in the study. The method of dissection of the tonsils in sitting position (home position was the technique used. RESULTS A predominance of female 114 (68.70% were observed. The average age of the patients was 25 years with extremes from 12 to 54 years. Tonsillectomy was bilateral in all patients of the study. The main indications were: chronic tonsillitis 101 (60.84%. There was no major complication during the postoperative period. CONCLUSION Tonsillectomy under local anesthesia is well tolerated by patients in a tropical environment. Its cost is less.

  15. Neurologic deficits and arachnoiditis following neuroaxial anesthesia.

    Science.gov (United States)

    Aldrete, J A

    2003-01-01

    Of late, regional anesthesia has enjoyed unprecedented popularity; this increase in cases has brought a higher frequency of instances of neurological deficit and arachnoiditis that may appear as transient nerve root irritation, cauda equina, and conus medullaris syndromes, and later as radiculitis, clumped nerve roots, fibrosis, scarring dural sac deformities, pachymeningitis, pseudomeningocele, and syringomyelia, etc., all associated with arachnoiditis. Arachnoiditis may be caused by infections, myelograms (mostly from oil-based dyes), blood in the intrathecal space, neuroirritant, neurotoxic and/or neurolytic substances, surgical interventions in the spine, intrathecal corticosteroids, and trauma. Regarding regional anesthesia in the neuroaxis, arachnoiditis has resulted from epidural abscesses, traumatic punctures (blood), local anesthetics, detergents, antiseptics or other substances unintentionally injected into the spinal canal. Direct trauma to nerve roots or the spinal cord may be manifested as paraesthesia that has not been considered an injurious event; however, it usually implies dural penetration, as there are no nerve roots in the epidural space posteriorly. Sudden severe headache while or shortly after an epidural block using the loss of resistance to air approach usually suggests pneumocephalus from an intradural injection of air. Burning severe pain in the lower back and lower extremities, dysesthesia and numbness not following the usual dermatome distribution, along with bladder, bowel and/or sexual dysfunction, are the most common symptoms of direct trauma to the spinal cord. Such patients should be subjected to a neurological examination followed by an MRI of the effected area. Further spinal procedures are best avoided and the prompt administration of IV corticosteroids and NSAIDs need to be considered in the hope of preventing the inflammatory response from evolving into the proliferative phase of arachnoiditis.

  16. General Anesthesia with Preserved Spontaneous Breathing through an Intubation Tube

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2010-01-01

    Full Text Available Objective: to study whether spontaneous patient breathing may be preserved during elective operations under general anesthesia with tracheal intubation. Subjects and methods. One hundred and twelve patients undergoing elective surgeries under general endotracheal anesthesia were randomized into 2 groups: 1 patients who had forced mechanical ventilation in the volume-controlled mode and 2 those who received assisted ventilation as spontaneous breathing with mechanical support. Conclusion. The study shows that spontaneous breathing with mechanical support may be safely used during some surgical interventions in patients with baseline healthy lungs. Key words: Pressure Support, assisted ventilation, spontaneous breathing, general anesthesia, lung function.

  17. Advanced techniques and armamentarium for dental local anesthesia.

    Science.gov (United States)

    Clark, Taylor M; Yagiela, John A

    2010-10-01

    Computer-controlled local anesthetic delivery (C-CLAD) devices and systems for intraosseous (IO) injection are important additions to the dental anesthesia armamentarium. C-CLAD using slow infusion rates can significantly reduce the discomfort of local anesthetic infusion, especially in palatal tissues, and facilitate palatal approaches to pulpal nerve block that find special use in cosmetic dentistry, periodontal therapy, and pediatric dentistry. Anesthesia of single teeth can be obtained using either C-CLAD intraligamentary injections or IO injections. Supplementary IO anesthesia is particularly suited for providing effective pain control of teeth diagnosed with irreversible pulpitis.

  18. SURVEY ON CLINICAL STUDY OF COMPOUND ACUPUNCTURE ANESTHESIA IN RESENT 10 YEARS IN CHINA

    Institute of Scientific and Technical Information of China (English)

    秦必光; 胡北喜; 等

    2002-01-01

    In the present paper,the authors make a review on the progresses of acupuncture anesthesia(AA) from (1)historical development,(2)research on acupuncture combined with local anesthesia;(3)research on acupuncture combined with epidural anesthesia;and (4)research on acupuncture combined with general anesthesia.Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definits analyesic effect and many advantages,and should be investigated further.

  19. General anesthesia in tetanus patient undergoing emergency surgery: A challenge for anesthesiologist.

    Science.gov (United States)

    Mahajan, Reena; Kumar, Amit; Singh, Shiv Kumar

    2014-01-01

    Tetanus is an acute often fatal disease produced by gram positive obligate anaerobic bacterium Clostridium tetani. Tetanolysin damages local tissue and provides optimal conditions for bacterial multiplication. It is therefore important to perform a wide debridement of any wound suspected of being a portal of entry for the bacteria. Little evidence exists to recommend specific anesthetic protocols. We encountered a child scheduled for fracture both bone forearm with developing tetanus. Initial management done with intravenous (i.v) diazepam, phenobarbitone, and metronidazole. After premedication with midazolam and fentanyl, induction was done by propofol 60 mg, vecuronium 2.5 mg, ventilated with O2+ N2O 50:50 with sevoflurane 2% and tracheal intubation was done with 5.5 ID cuffed PVC endotracheal tube. Anesthesia was maintained with sevoflurane 2% and vecuronium intermittently when required. Intraop vitals were stable. On completion of surgery, reversal given and patient was extubated uneventfully and shifted to recovery room. Little evidence exists to recommend specific anesthetic technique for tetanus patient posted for surgery. When present, obvious wounds should be surgically debrided. Ideally patients considered for surgery should undergo anesthesia and surgery before severe autonomic dysfunction develops. Most anesthetic managements are based on limited evidence. However, we used sevoflurane and vecuronium successfully, further study is needed to establish their efficacy and safety. Major challenges lie in the control of muscle rigidity and spasm, autonomic disturbances and prevention of complications.

  20. [Ultra-fast opiate detoxification under general anesthesia: preliminary results of the Liege protocol].

    Science.gov (United States)

    Pinto, E; Reggers, J; Delhez, M; Fuchs, S; Venneman, I; Lamy, M; Ansseau, M

    2001-08-01

    Many studies support the hypothesis of a substantial benefit in inducing an Opiate Receptor Blockade through a Rapid Opiate Detoxification under general Anaesthesia (RODA) in opiate dependent patients. However, prospective studies and long term evaluation of the technique are lacking. In order to evaluate long-term abstinence rates after a RODA among a sample of opiate addicts, a study was started in March 1999 at the University of Liège. To date, 45 patients were evaluated (mean age: 29 +/- 5 years) with a mean opiate dependence duration of 8 +/- 4 years. Most of them were both heroin and methadone dependent; 42.2% of them were included while 31.1% did not complete the whole inclusion procedure and 26.7% were excluded. None experienced severe withdrawal symptoms. At six months, abstinence rate was 67% and 46% at one year. These preliminary results suggest the interest of the procedure in carefully selected patients.

  1. Effects of thoracic epidural anesthesia on pulmonary venous admixture and oxygenation with isoflurane or propofol anesthesia during one lung ventilation

    Directory of Open Access Journals (Sweden)

    Reda S. Abdelrahman

    2012-10-01

    Conclusions: The administration of thoracic epidural anesthesia, either combined with propofol or isoflurane, was not associated with a relevant impairment of oxygenation during OLV. Therefore Pre-emptive analgesia via an epidural thoracic catheter can be used safely as a standard in lung surgery, decreasing the anesthesia requirements when combined with GA, maximizing the benefits of each form of anesthesia and improving the outcome in patients with cardiopulmonary diseases, hence it was found that it has no effect on oxygenation during OLV, and it is associated with stable hemodynamics.

  2. Transport Protocol Throughput Fairness

    Directory of Open Access Journals (Sweden)

    Saleem Bhatti

    2009-11-01

    Full Text Available Interest continues to grow in alternative transport protocols to the Transmission Control Protocol (TCP. These alternatives include protocols designed to give greater efficiency in high-speed, high-delay environments (so-called high-speed TCP variants, and protocols that provide congestion control without reliability. For the former category, along with the deployed base of ‘vanilla’ TCP – TCP NewReno – the TCP variants BIC and CUBIC are widely used within Linux: for the latter category, the Datagram Congestion Control Protocol (DCCP is currently on the IETF Standards Track. It is clear that future traffic patterns will consist of a mix of flows from these protocols (and others. So, it is important for users and network operators to be aware of the impact that these protocols may have on users. We show the measurement of fairness in throughput performance of DCCP Congestion Control ID 2 (CCID2 relative to TCP NewReno, and variants Binary Increase Congestion control (BIC, CUBIC and Compound, all in “out-of-the box” configurations. We use a testbed and endto- end measurements to assess overall throughput, and also to assess fairness – how well these protocols might respond to each other when operating over the same end-to-end network path. We find that, in our testbed, DCCP CCID2 shows good fairness with NewReno, while BIC, CUBIC and Compound show unfairness above round-trip times of 25ms.

  3. Coded Splitting Tree Protocols

    DEFF Research Database (Denmark)

    Sørensen, Jesper Hemming; Stefanovic, Cedomir; Popovski, Petar

    2013-01-01

    This paper presents a novel approach to multiple access control called coded splitting tree protocol. The approach builds on the known tree splitting protocols, code structure and successive interference cancellation (SIC). Several instances of the tree splitting protocol are initiated, each...... instance is terminated prematurely and subsequently iterated. The combined set of leaves from all the tree instances can then be viewed as a graph code, which is decodable using belief propagation. The main design problem is determining the order of splitting, which enables successful decoding as early...... as possible. Evaluations show that the proposed protocol provides considerable gains over the standard tree splitting protocol applying SIC. The improvement comes at the expense of an increased feedback and receiver complexity....

  4. PNEUMOTHORAX AFTER MODIFIED RADICAL MASTECTOMY UNDER GENERAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Amminikutty

    2014-11-01

    Full Text Available A 67 yrs old lady who underwent modified Radical mastectomy under General Anesthesia developed pneumothorax in the immediate post-operative period. She was treated with chest tube insertion and was discharged from hospital 8 days later

  5. Moderate hyperventilation during intravenous anesthesia increases net cerebral lactate efflux

    NARCIS (Netherlands)

    F. Grüne (Frank); S. Kazmaier (Stephan); B. Sonntag (Barbara); R.J. Stolker (Robert); A. Weyland (Andreas)

    2014-01-01

    textabstractBACKGROUND:: Hyperventilation is known to decrease cerebral blood flow (CBF) and to impair cerebral metabolism, but the threshold in patients undergoing intravenous anesthesia is unknown. The authors hypothesized that reduced CBF associated with moderate hyperventilation might impair cer

  6. 42 CFR 482.52 - Condition of participation: Anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... qualified doctor of medicine or osteopathy. The service is responsible for all anesthesia administered in... anesthesiologist; (2) A doctor of medicine or osteopathy (other than an anesthesiologist); (3) A dentist,...

  7. FDA Issues Anesthesia Warning for Pregnant Women, Kids Under 3

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162543.html FDA Issues Anesthesia Warning for Pregnant Women, Kids Under ... agency news release. She is director of the FDA's Center for Drug Evaluation and Research. "Parents and ...

  8. After Anesthesia: The Patient's Active Role Assists in Recovery

    Science.gov (United States)

    ... anesthesia, a candidate must have a four-year bachelor of science degree in nursing or other appropriate ... you were treated if you have any questions. These professionals are interested in your welfare and want ...

  9. The development of pediatric anesthesia and intensive care in Scandinavia

    DEFF Research Database (Denmark)

    Nilsson, Krister; Ekström-Jodal, Barbro; Meretoja, Olli

    2015-01-01

    The initiation and development of pediatric anesthesia and intensive care have much in common in the Scandinavian countries. The five countries had to initiate close relations and cooperation in all medical disciplines. The pediatric anesthesia subspecialty took its first steps after the Second...... World War. Relations for training and exchange of experiences between Scandinavian countries with centers in Europe and the USA were a prerequisite for development. Specialized pediatric practice was not a full-time position until during the 1950s, when the first pediatric anesthesia positions were...... created. Scandinavian anesthesia developed slowly. In contrast, Scandinavia pioneered both adult and certainly pediatric intensive care. The pioneers were heavily involved in the teaching and training of anesthetists and nurses. This was necessary to manage the rapidly increasing work. The polio epidemics...

  10. Effect of Tramadol on Medetomidine and Ketamine Anesthesia in Dogs

    Directory of Open Access Journals (Sweden)

    W. Choi, H. S. Jang, S. H. Yun, J. S. Park, Y. S. Kwon and K. H. Jang*

    2011-04-01

    Full Text Available The analgesic effects of three different doses of tramadol as a preanesthetic in medetomidine-ketamine anesthesia in dogs were compared. Twenty-eight healthy adult mongrel dogs were used. The dogs were divided into four groups at random; 1 ml kg-1 of normal saline, 1, 2 or 4mg kg-1 of tramadol premedication (group Control, TRA1, TRA2 and TRA4 was then administered intravenously followed by medetomidine and ketamine anesthesia. The behavioral changes, the duration of surgical anesthesia, blood gas parameters (pH, pO2, and pCO2, heart rate, and systolic/diastolic pressure were observed. Tramadol (4mg kg-1 pretreatment significantly increased the degree of sedation when compared with the control, TRA1 and TRA2 groups at 15 min after tramadol administration (P<0.05. The duration of surgical anesthesia was significantly increased by tramadol (4mg kg-1 pretreatment when compared with that of the control group (P<0.05. There were no significant differences in behavioral changes, blood gas parameters (pH, pO2 and pCO2, heart rate, and arterial pressure among the groups. Tramadol at 4mg kg-1 did not affect the cardiovascular system and recovery of anesthesia, but significantly increased the duration of surgical anesthesia with medetomidine and ketamine. This result suggests that intravenous tramadol at 4mg kg-1 is a useful preanesthetic agent for extending the surgical level of anesthesia in medetomidine-ketamine anesthesia in dogs.

  11. Cardiac Dysrhythmias with General Anesthesia during Dental Surgery

    OpenAIRE

    Rodrigo, Chandra R.

    1988-01-01

    Dysrhythmias with general anesthesia during dental surgery have been frequently reported. The incidence appears higher in spontaneously breathing patients lightly anesthetized with halothane. Anxiety, sitting posture, hypoxia, Chinese race, and heart disease appear to aggravate the condition. Use of beta blockers or lidocaine prior to anesthesia, intravenous induction, controlled ventilation with muscle relaxants, and use of isoflurane or enflurane in spontaneously breathing patients appear t...

  12. General Anesthesia for a Patient With Pelizaeus-Merzbacher Disease

    OpenAIRE

    Kamekura, Nobuhito; Nitta, Yukie; Takuma, Shigeru; Fujisawa, Toshiaki

    2016-01-01

    We report the successful management of general anesthesia for a patient with Pelizaeus-Merzbacher disease (PMD). PMD is one of a group of progressive, degenerative disorders of the cerebral white matter. The typical clinical manifestations of PMD include psychomotor retardation, nystagmus, abnormal muscle tone, seizures, and cognitive impairment. General anesthesia for a patient with PMD may be difficult mainly because of seizures and airway complications related to poor pharyngeal muscle con...

  13. Rational use of oxygen in medical disease and anesthesia

    DEFF Research Database (Denmark)

    Meyhoff, Christian S; Staehr, Anne K; Rasmussen, Lars S

    2012-01-01

    Supplemental oxygen is often administered during anesthesia and in critical illness to treat hypoxia, but high oxygen concentrations are also given for a number of other reasons such as prevention of surgical site infection (SSI). The decision to use supplemental oxygen is, however, controversial......, because of large heterogeneity in the reported results and emerging reports of side-effects. The aim of this article is to review the recent findings regarding benefits and harms of oxygen therapy in anesthesia and acute medical conditions....

  14. Review of pharmacokinetic models for target controlled infusions in anesthesia

    Directory of Open Access Journals (Sweden)

    Subash Kennedy Sivasubramaniam

    2014-06-01

    Full Text Available Intravenous injection of anesthetic drugs dates back to the 17th Century when opium and chloral hydrate have been injected intravenously. It was not until the 1930s intravenous anesthesia became popular with the invention of barbiturates.Early intravenous anesthetic agents such as barbiturates were ideal for induction of anesthesia, but not suitable for maintenance of anesthesia. Most of these drugs accumulated significantly with increasing durations of infusion and also resulted in cardiorespiratory depression. The invention of propofol and shorter acting opioid analgesics such as remifentanil and alfentanil have revolutionized intravenous anesthesia. The rapid onset and offset of these drugs lends itself to being suitable agents for maintenance of anesthesia over prolonged periods of time. Detailed understanding of the pharmacokinetics of propofol and remifentanil, combined with technological advances in intravenous pumps capable of accurate delivery of drugs have resulted in great development of the field of total intravenous anesthesia and target controlled infusions. I would like to discuss, in this article, the pharmacokinetics and pharmacokinetic models behind these intravenous infusion pumps. [Int J Basic Clin Pharmacol 2014; 3(3.000: 417-423

  15. Fetal and maternal analgesia/anesthesia for fetal procedures.

    Science.gov (United States)

    Van de Velde, Marc; De Buck, Frederik

    2012-01-01

    For many prenatally diagnosed conditions, treatment is possible before birth. These fetal procedures can range from minimal invasive punctions to full open fetal surgery. Providing anesthesia for these procedures is a challenge, where care has to be taken for both mother and fetus. There are specific physiologic changes that occur with pregnancy that have an impact on the anesthetic management of the mother. When providing maternal anesthesia, there is also an impact on the fetus, with concerns for potential negative side effects of the anesthetic regimen used. The question whether the fetus is capable of feeling pain is difficult to answer, but there are indications that nociceptive stimuli have a physiologic reaction. This nociceptive stimulation of the fetus also has the potential for longer-term effects, so there is a need for fetal analgesic treatment. The extent to which a fetus is influenced by the maternal anesthesia depends on the type of anesthesia, with different needs for extra fetal anesthesia or analgesia. When providing fetal anesthesia, the potential negative consequences have to be balanced against the intended benefits of blocking the physiologic fetal responses to nociceptive stimulation.

  16. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2015-07-15

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  17. [Evaluation of muscle relaxant requirement for hospital anesthesia].

    Science.gov (United States)

    Shchegolev, A V; Levshankov, A I; Bogomolov, B N; Pereloma, V I; Dumnov, A G

    2013-03-01

    The rationale for cost-effectiveness of modern muscle relaxants (MR) administration in general anesthesia was evaluated. New MRs are more expensive than traditionally used pipecuronium and succinylcholine. However, the old MRs are often required as a block reversion with anticholinesterase medicines at the end of surgery, the longer artificial lung ventilation and observation in patients during recovery in intensive care unit. It was found that the district military hospital had done an annual average of about 900 general anesthesia assisted with artificial ventilation and muscle relaxation. About 2% of all anesthesias accrue to short-term anesthesia, the 27% to medium-term and 71% to long-term. 81% of the medium-term anesthesia accrue small hospitals. According to cost/effectiveness the most optimal muscle relaxants administration scheme for short-term (up to 30 min) anesthesia was mivacurium, for the operation of medium duration (30-120 min)--rocuronium, for long-term (120 min)--pipecuronium. An electronic form of annual report, which allows to obtain the necessary data for calculation of annual muscle relaxants demand and costs both in hospital and in the whole of the armed forces quickly, was developed.

  18. Anesthesia for euthanasia influences mRNA expression in healthy mice and after traumatic brain injury.

    Science.gov (United States)

    Staib-Lasarzik, Irina; Kriege, Oliver; Timaru-Kast, Ralph; Pieter, Dana; Werner, Christian; Engelhard, Kristin; Thal, Serge C

    2014-10-01

    Tissue sampling for gene expression analysis is usually performed under general anesthesia. Anesthetics are known to modulate hemodynamics, receptor-mediated signaling cascades, and outcome parameters. The present study determined the influence of anesthetic paradigms typically used for euthanization and tissue sampling on cerebral mRNA expression in mice. Naïve mice and animals with acute traumatic brain injury induced by controlled cortical impact (CCI) were randomized to the following euthanasia protocols (n=10-11/group): no anesthesia (NA), 1 min of 4 vol% isoflurane in room air (ISO), 3 min of a combination of 5 mg/kg midazolam, 0.05 mg/kg fentanyl, and 0.5 mg/kg medetomidine intraperitoneally (COMB), or 3 min of 360 mg/kg chloral hydrate intraperitoneally (CH). mRNA expression of actin-1-related gene (Act1), FBJ murine osteosarcoma viral oncogene homolog B (FosB), tumor necrosis factor alpha (TNFα), heat shock protein beta-1 (HspB1), interleukin (IL)-6, tight junction protein 1 (ZO-1), IL-1ß, cyclophilin A, micro RNA 497 (miR497), and small cajal body-specific RNA 17 were determined by real-time polymerase chain reaction (PCR) in hippocampus samples. In naïve animals, Act1 expression was downregulated in the CH group compared with NA. FosB expression was downregulated in COMB and CH groups compared with NA. CCI reduced Act1 and FosB expression, whereas HspB1 and TNFα expression increased. After CCI, HspB1 expression was significantly higher in ISO, COMB, and CH groups, and TNFα expression was elevated in ISO and COMB groups. MiR497, IL-6, and IL-1ß were upregulated after CCI but not affected by anesthetics. Effects were independent of absolute mRNA copy numbers. The data demonstrate that a few minutes of anesthesia before tissue sampling are sufficient to induce immediate mRNA changes, which seem to predominate in the early-regulated gene cluster. Anesthesia-related effects on gene expression might explain limited reproduciblity of real

  19. Comparison of acceptance, preference and efficacy between pressure anesthesia and classical needle infiltration anesthesia for dental restorative procedures in adult patients

    Directory of Open Access Journals (Sweden)

    Chetana Sachin Makade

    2014-01-01

    Full Text Available Introduction: Intraoral local anesthesia is essential for delivering dental care. Needless devices have been developed to provide anesthesia without injections. Little controlled research is available on its use in dental restorative procedures in adult patients. The aims of this study were to compare adult patients acceptability and preference for needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Materials and Methods: Twenty non fearful adults with no previous experience of dental anesthesia were studied using split-mouth design. The first procedure was performed with classical needle infiltration anesthesia. The same amount of anesthetic solution was administered using MADA jet needleless device in a second session one week later, during which a second dental restorative procedure was performed. Patients acceptance was assessed using Universal pain assessment tool while effectiveness was recorded using soft tissue anesthesia and pulpal anesthesia. Patients reported their preference for the anesthetic method at the third visit. The data was evaluated using chi square test and student′s t-test. Results: Pressure anesthesia was more accepted and preferred by 70% of the patients than traditional needle anesthesia (20%. Both needle and pressure anesthesia was equally effective for carrying out the dental procedures. Conclusion: Patients experienced significantly less pain and fear (p<0.01 during anesthetic procedure with pressure anesthesia. However, for more invasive procedures needle anesthesia will be more effective.

  20. IPv6 Protocol Analyzer

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    With the emerging of next generation Intemet protocol (IPv6), it is expected to replace the current version of Internet protocol (IPv4) that will be exhausted in the near future. Besides providing adequate address space, some other new features are included into the new 128 bits of IP such as IP auto configuration, quality of service, simple routing capability, security, mobility and multicasting. The current protocol analyzer will not be able to handle IPv6 packets. This paper will focus on developing protocol analyzer that decodes IPv6 packet. IPv6 protocol analyzer is an application module,which is able to decode the IPv6 packet and provide detail breakdown of the construction of the packet. It has to understand the detail construction of the IPv6, and provide a high level abstraction of bits and bytes of the IPv6 packet.Thus it increases network administrators' understanding of a network protocol,helps he/she in solving protocol related problem in a IPv6 network environment.

  1. ATM and Internet protocol

    CERN Document Server

    Bentall, M; Turton, B

    1998-01-01

    Asynchronous Transfer Mode (ATM) is a protocol that allows data, sound and video being transferred between independent networks via ISDN links to be supplied to, and interpreted by, the various system protocols.ATM and Internet Protocol explains the working of the ATM and B-ISDN network for readers with a basic understanding of telecommunications. It provides a handy reference to everyone working with ATM who may not require the full standards in detail, but need a comprehensive guide to ATM. A substantial section is devoted to the problems of running IP over ATM and there is some discussion o

  2. Playing With Population Protocols

    Directory of Open Access Journals (Sweden)

    Xavier Koegler

    2009-06-01

    Full Text Available Population protocols have been introduced as a model of sensor networks consisting of very limited mobile agents with no control over their own movement: A collection of anonymous agents, modeled by finite automata, interact in pairs according to some rules. Predicates on the initial configurations that can be computed by such protocols have been characterized under several hypotheses. We discuss here whether and when the rules of interactions between agents can be seen as a game from game theory. We do so by discussing several basic protocols.

  3. Linear Logical Voting Protocols

    DEFF Research Database (Denmark)

    DeYoung, Henry; Schürmann, Carsten

    2012-01-01

    . In response, we promote linear logic as a high-level language for both specifying and implementing voting protocols. Our linear logical specifications of the single-winner first-past-the-post (SW- FPTP) and single transferable vote (STV) protocols demonstrate that this approach leads to concise......Current approaches to electronic implementations of voting protocols involve translating legal text to source code of an imperative programming language. Because the gap between legal text and source code is very large, it is difficult to trust that the program meets its legal specification...... implementations that closely correspond to their legal specification, thereby increasing trust....

  4. [Anesthesia in thymectomy. Experience with 115 cases].

    Science.gov (United States)

    Villani, A; Primieri, P; Adducci, G; Mennella, M; Lattanzi, A; De Cosmo, G

    1993-03-01

    The authors have conducted a retrospective study on 115 patients with myasthenia gravis undergoing transsternal or transcervical thymectomy at the Policlinico A. Gemelli of Rome in the period June 1984- to June 1991. A prolonged postoperative mechanical ventilation immediately and a few days following surgery was required respectively in 7 and 3 patients, while atelectasia and broncopneumonia have developed in 10 patients. No relationship could be established between the incidence of respiratory complications and factors such as preoperative symptomatology and treatment anesthetic agents, the surgical approach to the thymus and thymic pathology. However a significantly greater postoperative morbidity has been observed in the group of patients receiving suxametonium as compared to the patients receiving non-depolarizing muscle relaxants. Vecuronium and atracurium very frequently allowed ad adequate resumption of spontaneous respiration after anesthesia and made possible a safe early extubation of patients before leaving the operating room. The authors also stressed that all patients, irrespective of their clinical conditions, must be transferred after thymectomy. Oto the surgical ICU where anticholinesterase therapy can be safely restarted and cardiorespiratory status carefully monitored.

  5. Reactive Software Agent Anesthesia Decision Support System

    Directory of Open Access Journals (Sweden)

    Grant H. Kruger

    2011-12-01

    Full Text Available Information overload of the anesthesiologist through technological advances have threatened the safety of patients under anesthesia in the operating room (OR. Traditional monitoring and alarm systems provide independent, spatially distributed indices of patient physiological state. This creates the potential to distract caregivers from direct patient care tasks. To address this situation, a novel reactive agent decision support system with graphical human machine interface was developed. The system integrates the disparate data sources available in the operating room, passes the data though a decision matrix comprising a deterministic physiologic rule base established through medical research. Patient care is improved by effecting change to the care environment by displaying risk factors and alerts as an intuitive color coded animation. The system presents a unified, contextually appropriate snapshot of the patient state including current and potential risk factors, and alerts of critical patient events to the operating room team without requiring any user intervention. To validate the efficacy of the system, a retrospective analysis focusing on the hypotension rules were performed. Results show that even with vigilant and highly trained clinicians, deviations from ideal patient care exist and it is here that the proposed system may allow more standardized and improved patient care and potentially outcomes.

  6. 1996 : Track Count Protocol

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The goal of St. Vincent National Wildlife Refuge's Track Count Protocol is to provide an index to the population size of game animals inhabiting St. Vincent Island.

  7. Quantum deniable authentication protocol

    Science.gov (United States)

    Shi, Wei-Min; Zhou, Yi-Hua; Yang, Yu-Guang

    2014-07-01

    The proposed quantum identity authentication schemes only involved authentication between two communicators, but communications with deniability capability are often desired in electronic applications such as online negotiation and electronic voting. In this paper, we proposed a quantum deniable authentication protocol. According to the property of unitary transformation and quantum one-way function, this protocol can provide that only the specified receiver can identify the true source of a given message and the specified receiver cannot prove the source of the message to a third party by a transcript simulation algorithm. Moreover, the quantum key distribution and quantum encryption algorithm guarantee the unconditional security of this scheme. Security analysis results show that this protocol satisfies the basic security requirements of deniable authentication protocol such as completeness and deniability and can withstand the forgery attack, impersonation attack, inter-resend attack.

  8. Unconditionally Secure Protocols

    DEFF Research Database (Denmark)

    Meldgaard, Sigurd Torkel

    the secure computation. Especially we look at the communication complexity of protocols in this model, and perfectly secure protocols. We show general protocols for any finite functionality with statistical security and optimal communication complexity (but exponential amount of preprocessing). And for two......This thesis contains research on the theory of secure multi-party computation (MPC). Especially information theoretically (as opposed to computationally) secure protocols. It contains results from two main lines of work. One line on Information Theoretically Secure Oblivious RAMS, and how...... they are used to speed up secure computation. An Oblivious RAM is a construction for a client with a small $O(1)$ internal memory to store $N$ pieces of data on a server while revealing nothing more than the size of the memory $N$, and the number of accesses. This specifically includes hiding the access pattern...

  9. USA-USSR protocol

    CERN Multimedia

    1970-01-01

    On 30 November the USA Atomic Energy Commission and the USSR State Committee for the Utilization of Atomic Energy signed, in Washington, a protocol 'on carrying out of joint projects in the field of high energy physics at the accelerators of the National Accelerator Laboratory (Batavia) and the Institute for High Energy Physics (Serpukhov)'. The protocol will be in force for five years and can be extended by mutual agreement.

  10. Determine the Influence of Time Held in “Knockdown” Anesthesia on Survival and Stress of Surgically Implanted Juvenile Salmonids

    Energy Technology Data Exchange (ETDEWEB)

    Woodley, Christa M.; Wagner, Katie A.; Knox, Kasey M.

    2012-01-31

    The Juvenile Salmon Acoustic Telemetry System (JSATS) was developed for the U.S. Army Corp of Engineers Portland District (USACE) to address questions related to survival and performance measures of juvenile salmonids as they pass through the Federal Columbia River Power System (FCRPS). Researchers using JSATS acoustic transmitters (ATs) were tasked with standardizing the surgical implantation procedure to ensure that the stressors of handling and surgery on salmonids were consistent and less likely to cause effects of tagging in survival studies. Researchers questioned whether the exposure time in 'knockdown' anesthesia (or induction) to prepare fish for surgery could influence the survival of study fish (CBSPSC 2011). Currently, fish are held in knockdown anesthesia after they reach Stage 4 anesthesia until the completion of the surgical implantation of a transmitter, varies from 5 to 15 minutes for studies conducted in the Columbia Basin. The Columbia Basin Surgical Protocol Steering Committee (CBSPSC ) expressed concern that its currently recommended 10-minute maximum time limit during which fish are held in anesthetic - tricaine methanesulfonate (MS-222, 80 mg L-1 water) - could increase behavioral and physiological costs, and/or decrease survival of outmigrating juvenile salmonids. In addition, the variability in the time fish are held at Stage 4 could affect the data intended for direct comparison of fish within or among survival studies. Under the current recommended protocol, if fish exceed the 10-minute time limit, they are to be released without surgical implantation, thereby increasing the number of fish handled and endangered species 'take' at the bypass systems for FCRPS survival studies.

  11. Breast augmentation under general anesthesia versus monitored anesthesia care: a retrospective comparative study.

    Science.gov (United States)

    Eldor, Liron; Weissman, Avi; Fodor, Lucian; Carmi, Nurit; Ullmann, Yehuda

    2008-09-01

    Breast augmentation is one of the leading esthetic surgeries, enjoying high satisfaction rates. Pain, nausea, and vomiting are frequent shortcomings of the immediate postoperative period. The aim of this study was to compare breast augmentation from the anesthetic point of view: general anesthesia (GA) versus monitored anesthesia care (MAC). The charts of 115 patients were reviewed in this retrospective study performed over a period of 2 years. Sixty-nine women chose to have the surgery done under MAC, and 46 under GA. Statistically significant differences were noted in both postoperative hospital stay (16.1 +/- 6.78 hours vs. 11.7 +/- 6.10 hours) and frequency of vomiting (mean, 0.5 vs. 0.22 times per patient) after GA and MAC, respectively (Mann-Whitney, P < 0.01). Postoperative pain, assessed using the visual analog scale, was significantly higher (mean visual analog scale, 5 vs. 3.27) when the prosthesis was placed in the submuscular plane compared with the subglandular plane (Mann-Whitney, P = 0.043). When offered a choice, more women preferred MAC over GA for their breast augmentation procedure. Less vomiting and shorter postoperative hospitalization were prominent in the MAC group.

  12. Effects of propofol anesthesia and sevoflurane anesthesia on the differentiation of human T-helper cells during surgery

    Institute of Scientific and Technical Information of China (English)

    JI Fu-hai; WANG Yu-lan; YANG Jian-ping

    2011-01-01

    Background Surgical stress causes a helper T-cell type 2 (Th2)-dominant status and disturbs the Th1/Th2 cytokine balance. Anesthesia can suppress the stress response to surgery, therefore it may inhibit the imbalance in the Th1/Th2 ratio. In this study, we assessed if propofol anesthesia and sevoflurane anesthesia influence the Th1/Th2 cytokine balance, and which anesthesia method better attenuates this ratio.Methods Twenty-eight patients with an American Society of Anesthesiologists (ASA) physical status of I undergoing laparoscopic cholecystectomy were selected. They were randomly allocated into two groups of 14. Group 1 received propofol anesthesia by a target-controlled-infusion (TCI) pump and group 2 received sevoflurane anesthesia.Non-invasive blood pressure, heart rate, and end-expiration CO2 partial pressure were monitored during anesthesia. The depth of anesthesia was measured using the bispectral index (BIS), and maintained between 50 and 60. During surgery we adjusted the doses of propofol and sevoflurane according to the BIS. Samples of peripheral blood were taken before the induction of anesthesia (T1), after the induction of anesthesia (T2), at the beginning of surgery (T3), at the end of surgery (T4) and on the first day after surgery (D1). Blood samples were analyzed to give the Th1/Th2 ratio and plasma level of cortisol.Results Non-invasive blood pressure, heart rate and end-expiration CO2 partial pressure were not notably different in the two groups. At T4, the percentage of T1 cells was higher in group 1 and had statistical significance (P <0.05). The percentage of T2 cells was not significantly different in the two groups. At T4, the difference in the Th1/Th2 ratio was significantly different. At T3, T4, and D1, the plasma level of cortisol was lower in group 1(P <0.05).Conclusion Compared with sevoflurane, propofol can preferably promote Th cells to differentiate into Th1 cells and inhibit surgical stress. Propofol may therefore be

  13. Spinal anesthesia for laparoscopic cholecystectomy: Thoracic vs. Lumbar Technique

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2014-01-01

    Full Text Available Aims: In our group, after a study showing that spinal anesthesia is safe when compared with general anesthesia, spinal anesthesia has been the technique of choice for this procedure. This is a prospective study with all patients undergoing LC under spinal anesthesia in our department since 2007. Settings and Design: Prospective observational. Materials and Methods: From 2007 to 2011, 369 patients with symptoms of colelithiasis, laparoscopic cholecystectomy were operated under spinal anesthesia with pneumoperitoneum and low pressure CO 2. We compared 15 mg of hyperbaric bupivacaine and lumbar puncture with 10 or 7.5 mg of hyperbaric bupivacaine thoracic puncture, all with 25 μg fentanyl until the sensory level reached T 3 . Intraoperative parameters, post-operative pain, complications, recovery, patient satisfaction, and cost were compared between both groups. Statistical Analysis Used: Means were compared by ANOVA or Kruskal-Wallis test, the percentages of the Chi-square test or Fisher′s exact test when appropriate. Time of motor and sensory block in spinal anesthesia group was compared by paired t test or Mann-Whitney test. Differences were considered significant when P ≤ 0.05, and for comparisons of mean pain visual scale, we employed the Bonferroni correction applied to be considered significant only with P ≤ 0.0125 Results: All procedures were completed under spinal anesthesia. The use of lidocaine 1% was successful in the prevention of shoulder pain in 329 (89% patients. There were significant differences in time to reach T 3 , obtaining 15 mg > 10 mg = 7.5 mg. There is a positive correlation between the dose and the incidence of hypotension. The lowest doses gave a decrease of 52.2% in the incidence of hypotension. There was a positive correlation between the dose and duration of sensory and motor block. Sensory block was almost twice the motor block at all doses. With low doses, 60% of patients went from table to stretcher

  14. Alternate methods to teach history of anesthesia.

    Science.gov (United States)

    Desai, Manisha S; Desai, Sukumar P

    2014-02-01

    Residency programs in anesthesiology in the United States struggle to balance the conflicting needs of formal didactic sessions, clinical teaching, and clinical service obligations. As a consequence of the explosion in knowledge about basic and applied sciences related to our specialty, residents and fellows are expected to make substantial efforts to supplement formal lectures with self-study. There is strong evidence to suggest that members of the younger generation use nontraditional methods to acquire information. Although training programs are not required to include topics related to history of anesthesia (HOA) in the didactic curriculum, and despite the fact that such knowledge does not directly impact clinical care, many programs include such lectures and discussions. We describe and discuss our experience with 3 alternate modalities of teaching HOA.First, we provide brief descriptions of HOA-related historical narratives and novels within the domain of popular literature, rather than those that might be considered textbooks. Second, we analyze content in movies and videodiscs dealing with HOA and determine their utility as educational resources. Third, we describe HOA tours to sites in close proximity to our institutions, as well as those in locations elsewhere in the United States and abroad.We suggest that informal HOA teaching can be implemented by every residency program without much effort and without taking away from the traditional curriculum. Participating in this unique and enriching experience may be a means of academic advancement. It is our hope and expectation that graduates from programs that incorporate such exposure to HOA become advocates of history and may choose to devote a part of their academic career toward exploration of HOA.

  15. Evaluation of anesthesia applications in interventional neuroradiology cases

    Directory of Open Access Journals (Sweden)

    Ziya Kaya

    2012-12-01

    Full Text Available Objectives: In this study, we aimed to evaluate anesthesiaapplications of the patients underwent invasive interventionalneuroradiology applications.Materials and methods: Between June 2004 and October2004, 152 emergency or elective adult patients whowere undergone general anesthesia were evaluated retrospectively.Information about the patients was taken fromradiology, anesthesia notes and university’s informationsystem. Patients were evaluated in terms of age, gender,American Society of Anesthesiologists score, indicationof application, the existence of concomitant diseases, anesthesiatechnique, anesthetic medications and the possibilityof whether patient were in intensive care unit.Results: Of all, 55.3% of the patients (n=84 were femaleand 44,7% (n=68 were male. General anesthesia wasapplied in all cases and propofol was preferred mostly ininduction and sevoflurane was preferred in maintenance.Surgically, 81,6% of the patients was elective and 18,4%was emergency patients. Diagnoses of patients were asfollow: Cerebral aneurysm 63,8%, arteriovenous malformation19,7%, thrombolytic therapy 8%, tumor embolization5,3% and carotid stenting 3,2%. Totally 58 patientswere taken into intensive care unit and 6 of these died.Conclusions: In order to provide a safe and efficient patientcare, we think that permanent anesthesia equipmentis necessary together with good physical conditions of theoperation room, proficiency of neuroradiologist, the closerelationship between the patient and anesthetist and agood knowledge of underlying neuropathology. J Clin ExpInvest 2012; 3(4: 493-499Key words: Interventional radiology, general anesthesia,cerebral aneurysm, arterio-venous malformations.

  16. A History of Intravenous Anesthesia in War (1656-1988).

    Science.gov (United States)

    Roberts, Matthew; Jagdish, S

    2016-01-01

    The practice of anesthesia in war places significant restraints on the choice of anesthetic technique used; these include, but are not limited to, safety, simplicity, and portability. Ever since intravenous anesthesia became a practical alternative, there have been military doctors who felt that this technique was particularly suited to this environment. The challenge, as in civilian practice, has been to find the appropriate drugs as well as simple and safe delivery systems. The urgency of war has always stimulated innovation in medicine to counteract the ongoing development of weapons of war and their effects on the human body and to achieve improved survival as public expectations rise. This article traces the development of and the use of intravenous anesthesia by military physicians for battle casualties. The story starts long before the era of modern anesthesia, and the discussion concludes in the dog days of the cold war. The rapidly increasing interest in intravenous anesthesia in both civilian and military practice since the early 1990s is left for other authors to examine.

  17. Advances in Anesthesia Delivery in the Deployed Setting.

    Science.gov (United States)

    Wilson, John E; Barras, William P

    2016-01-01

    Lessons learned over the past decade and a half of combat casualty management has brought about numerous advances in trauma anesthesia practice. In the post-Vietnam era, deployable anesthesia equipment centered on the capability to provide a balanced anesthetic technique, utilizing a combination of volatile gas and intravenous anesthetic adjuncts. The evolution of the modern battlefield has forced anesthesia providers across the military to adapt to mission requirements that often dictate a surgical capability that is more rapidly mobile and less reliant on logistical support. Institutional medical equipment development has focused on fielding a lighter, more mobile volatile gas delivery method. Despite numerous advances in anesthetic gas delivery, many veteran anesthesia providers have come to recognize the value of alternative anesthetic techniques in the deployed setting. One of the most appealing advances in combat anesthesia practice is the emergence of total intravenous anesthetics (TIVA) for trauma management and resuscitation. Although there have been numerous developments in anesthetic equipment for use in the deployed setting, TIVA has many advantages over volatile gas administration. Future research, development, and education should focus on TIVA and the ability to provide this as an alternative safe anesthetic for patients in austere environments. It is imperative to retain the lessons we have learned in order to adapt more effectively in future conflicts. This accumulation of knowledge must inform future innovative solutions to the challenges of casualty management in a deployed setting.

  18. [General anesthesia for a pregnant patient with PAPA syndrome].

    Science.gov (United States)

    Ohno, Seika; Ariyama, Jun; Tsujita, Miki; Ueshima, Hironobu; Imanishi, Hirokazu; Terao, Kazuhisa; Mieda, Tsutomu; Kitamura, Akira

    2014-08-01

    A 31-year-old female, with 22 weeks of pregnancy, presented with sudden onset of severe headache. CT scan showed diffuse subarachnoid hemorrhage. A cerebral angiogram showed dissecting aneurysm of right cerebral artery. To obliterate the aneurysm and prevent rupture, the patient underwent coil embolization via an endovascular approach under general anesthesia because the procedure under sedation with local anesthesia was too risky for re-bleeding. The patient has been diagnosed as PAPA syndrome. Although the arthritis was now stable and she was taking no drug, remarkable osteoarthritis was observed. The cervical spine X ray demonstrated no cervical ankylosis. As patient was sedated with propofol, airway examination could not be done except noticing thyromental distance of seven centimeters. Patient's trachea was intubated using Macintosh size #3 laryngoscope blade and a 7.0 non-styletted tracheal tube at the first attempt without any problems (Cormack grade I). Anesthesia was maintained with sevoflurane, fentanyl and remifentanil. After the end of endovascular surgery, the patient was transferred to the intensive care unit under mechanical ventilation. She was weaned from mechanical ventilation 2 days later but consciousness was unclear. Right incomplete paralysis was also observed. MRI revealed vasospasm on the bilateral internal carotid artery. The patient underwent percutaneous tansluminalangioplasty coil and intraarterial injection of fasudil hydrochloride under local anesthesia. The consciousness recovered fully and the paralysis was improved. The patient delivered the baby by Caesarean sections under combined spinal and epidural anesthesia at 36 weeks without any problems with both the mother and baby.

  19. Implementation of an Anesthesia Information Management System (AIMS)

    Science.gov (United States)

    Douglas, James R.; Ritter, Melody J.

    2011-01-01

    During the administration of anesthesia, the anesthesia provider has historically created a paper record, charted manually, that included extensive patient care–related data (vital signs, other parameters, etc) and commentaries. DocuSys, a proprietary anesthesia information management system (AIMS), creates an electronic version of the anesthesia record and provides additional information. It electronically captures data from clinical monitors and other sources, including scheduling applications and laboratory computers. The AIMS facilitates chart entries such as drug doses and case narratives. Benefits of an AIMS include improved legibility of the anesthesia record and greater efficiency in documentation efforts. Use of the AIMS assists the practitioner with decision support logic, such as the timing of antibiotic administration and the inclusion of legally required documentation. Upon case completion, the AIMS data are immediately available to other information systems, such as billing and medical records. Data can be made available from a single case or, more important, from thousands of cases to analyze variables such as efficiency of services, adherence to best practices, patient outcomes, and clinical research. The AIMS was deployed at the main campus of the Ochsner Health System on March 26, 2009. In this article, we discuss the issues involved in the AIMS implementation process: the successes, surprises, and continued challenges. PMID:21734847

  20. Advances in the use of intravenous techniques in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Eng MR

    2015-07-01

    Full Text Available Matthew R Eng,1 Paul F White1,2 1Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; 2White Mountain Institute, The Sea Ranch, CA, USA Summary statement: Advances in the use of intravenous techniques in ambulatory anesthesia has become important for the anesthesiologist as the key perioperative physician in outpatient surgery. Key techniques and choices of anesthetics are important in accomplishing fast track goals of ambulatory surgery. Purpose of review: The anesthesiologist in the outpatient environment must focus on improving perioperative efficiency and reducing recovery times while accounting for patients' well-being and safety. This review article focuses on recent intravenous anesthetic techniques to accomplish these goals. Recent findings: This review is an overview of techniques in intravenous anesthesia for ambulatory anesthesia. Intravenous techniques may be tailored to accomplish outpatient surgery goals for the type of surgical procedure and individual patient needs. Careful anesthetic planning and the application of the plans are critical to an anesthesiologist's success with fast-track ambulatory surgery. Conclusion: Careful planning and application of intravenous techniques are critical to an anesthesiologist's success with fast-track ambulatory surgery. Keywords: intravenous anesthesia, outpatient anesthesia, fast-track surgery

  1. Possibilities of creating meaningful encounters in anesthesia nursing

    DEFF Research Database (Denmark)

    Aagaard, Karin

    Anesthesia nursing is performed in a highly technological environment with restricted time for interaction with patients. Patients are in a vulnerable position, which can be characterized by anxiety regarding the anesthetic and surgical procedure. The bedrock of effective nursing care is to facil......Anesthesia nursing is performed in a highly technological environment with restricted time for interaction with patients. Patients are in a vulnerable position, which can be characterized by anxiety regarding the anesthetic and surgical procedure. The bedrock of effective nursing care...... of nursing. In this dissertation, focused ethnography is used to explore the interactions between patients and nurse anesthetists before general anesthesia. Moreover, it will explore the professional identity of nurse anesthetists, in relation to the situation of preparing patients for general anesthesia....... A micro-substantive theory is developed regarding the opportunities for creating meaningful encounters between patients and nurse anesthetists. The theory is based on three dominant motivations for interaction in anesthesia nursing. The context of care is not committed and responsive to the core elements...

  2. Remifentanil consumption in septoplasty surgery under general anesthesia

    Science.gov (United States)

    Al-Mustafa, Mahmoud M.; Al Oweidi, Abdelkarim S.; Al-Zaben, Khaled R.; Qudaisat, Ibraheem Y.; Abu-Halaweh, Sami A.; Al-Ghanem, Subhi M.; Massad, Islam M.; Samarah, Walid K.; Al-Shaer, Reem A.; Ismail, Said I.

    2017-01-01

    Objectives: To evaluate the influence of the ORM1 variants in codon 118 on the intra-operative remifentanil consumption under general anesthesia. Methods: A prospective gene association study, performed at the Jordan University Jordan, Amman, Jordan from September 2013 to August 2014. It includes patients who underwent septoplasty surgery under general anesthesia. All patients received standard intravenous anesthesia. Anesthesia maintained with fixed dose of Sevoflurane and variable dose of Remifentanil to keep the systolic blood pressure between 90-100 mm Hg. The Remifentanil dose was calculated and correlated with ORM1 genotype variance. Results: Genotype and clinical data were available for 123 cases. The A118A genotype was seen in 96 patients (78%), the A118G genotype was seen in 25 patients (20.3%), and only 2 patients had genotype G118G (1.6%). The G118G variant was removed from the statistical analysis due to small sample size. There was a significant effect of ORM1 genotype variant and the amount of remifentanil consumed. The A118A genotype received 0.173 ± 0.063 µg kg-1 min-1 and the A118G genotype received 0.316 ± 0.100 µg kg-1 min-1 (p<0.0001). Conclusion: The ORM1 gene has a role in intra-operative remifentanil consumption in patients who underwent septoplasty surgery under general anesthesia. The A118G gene required higher dose of remifentanil compared with the A118A genotype. PMID:28133690

  3. Laparoscopic hernioplasty with epidural anesthesia; a report of 20 patients

    Directory of Open Access Journals (Sweden)

    Talebpour M

    2007-06-01

    Full Text Available Background: The incidence of inguinal hernia is 15 cases per 1,000 populations. The most common surgical methods of hernia repair are conventional open hernioplasty and laparoscopic hernioplasty. The advantages of laparoscopic hernioplasty are that the regional anatomy is observable, and bilateral herniorrhaphy can be performed at the same time. Since laparoscopic hernia is usually performed under general anesthesia, to shorten the length of hospital stay and to prevent complications, in this study, we evaluated the use of epidural anesthesia during hernioplasty. Methods: This study included 20 male patients treated by a single surgeon. We recorded the PCO2 levels before, during and after surgery, as well as the pain and intra-abdominal pressure. Results: Only one patient required conversion to general anesthesia. Three patients had hernia on the left side only, 14 patients on the right only and three patients had bilateral hernia. The PCO2 levels did not change (P=0.789. Fifty percent of patients had no postoperative pain. The median time to return to work or normal physical activity was 7 days. Conclusion: Laparoscopic inguinal herniorrhaphy is a feasible alternative to open surgical hernia repair. Employing epidural anesthesia prevents the complications of general anesthesia. This method achieves a shorter hospital stay and time to return to normal activity, as well as reduction in pain. Controlled trials comparing laparoscopic and tension-free open herniorrhaphy are needed to further assess the relative benefits of this procedure.

  4. Implementation of an Anesthesia Information Management System (AIMS).

    Science.gov (United States)

    Douglas, James R; Ritter, Melody J

    2011-01-01

    During the administration of anesthesia, the anesthesia provider has historically created a paper record, charted manually, that included extensive patient care-related data (vital signs, other parameters, etc) and commentaries. DocuSys, a proprietary anesthesia information management system (AIMS), creates an electronic version of the anesthesia record and provides additional information. It electronically captures data from clinical monitors and other sources, including scheduling applications and laboratory computers. The AIMS facilitates chart entries such as drug doses and case narratives. Benefits of an AIMS include improved legibility of the anesthesia record and greater efficiency in documentation efforts. Use of the AIMS assists the practitioner with decision support logic, such as the timing of antibiotic administration and the inclusion of legally required documentation. Upon case completion, the AIMS data are immediately available to other information systems, such as billing and medical records. Data can be made available from a single case or, more important, from thousands of cases to analyze variables such as efficiency of services, adherence to best practices, patient outcomes, and clinical research. The AIMS was deployed at the main campus of the Ochsner Health System on March 26, 2009. In this article, we discuss the issues involved in the AIMS implementation process: the successes, surprises, and continued challenges.

  5. Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.

    Science.gov (United States)

    Nair, Bala G; Grunzweig, Katherine; Peterson, Gene N; Horibe, Mayumi; Neradilek, Moni B; Newman, Shu-Fang; Van Norman, Gail; Schwid, Howard A; Hao, Wei; Hirsch, Irl B; Patchen Dellinger, E

    2016-06-01

    Poor perioperative glycemic management can lead to negative surgical outcome. Improved compliance to glucose control protocol could lead to better glucose management. An Anesthesia Information Management System based decision support system-Smart Anesthesia Manager™ (SAM) was used to generate real-time reminders to the anesthesia providers to closely adhere to our institutional glucose management protocol. Compliance to hourly glucose measurements and correct insulin dose adjustments was compared for the baseline period (12 months) without SAM and the intervention period (12 months) with SAM decision support. Additionally, glucose management parameters were compared for the baseline and intervention periods. A total of 1587 cases during baseline and 1997 cases during intervention met the criteria for glucose management (diabetic patients or non-diabetic patients with glucose level >140 mg/dL). Among the intervention cases anesthesia providers chose to use SAM reminders 48.7 % of the time primarily for patients who had diabetes, higher HbA1C or body mass index, while disabling the system for the remaining cases. Compliance to hourly glucose measurement and correct insulin doses increased significantly during the intervention period when compared with the baseline (from 52.6 to 71.2 % and from 13.5 to 24.4 %, respectively). In spite of improved compliance to institutional protocol, the mean glucose levels and other glycemic management parameters did not show significant improvement with SAM reminders. Real-time electronic reminders improved intraoperative compliance to institutional glucose management protocol though glycemic parameters did not improve even when there was greater compliance to the protocol.

  6. [Anesthesia and sedation by admixture of xenon-oxygen in dentistry. Part I].

    Science.gov (United States)

    Rabinovich, S A; Zavodilenko, L A; Babikov, A S

    2014-01-01

    The modern out-patient dental treatment which is performed under combined anesthesia with of xenon-oxygen inhalations provides comfortable conditions for the doctor and the patient, effective anesthesia and safe level of the sedation controlled by dentist.

  7. Cleft-lift operation for pilonidal sinuses under tumescent local anesthesia

    DEFF Research Database (Denmark)

    Bertelsen, Claus Anders

    2011-01-01

    The use of tumescent local anesthesia in the Bascom cleft-lift procedure has not been described before.......The use of tumescent local anesthesia in the Bascom cleft-lift procedure has not been described before....

  8. Auditory information processing during adequate propofol anesthesia monitored by electroencephalogram bispectral index

    NARCIS (Netherlands)

    C. Kerssens (Chantal); J. Klein (Jan); A. van der Woerd; B. Bonke (Benno)

    2001-01-01

    textabstractMemory for intraoperative events may arise from inadequate anesthesia when the hypnotic state is not continuously monitored. Electroencephalogram bispectral index (BIS) enables monitoring of the hypnotic state and titration of anesthesia to an adequate level

  9. Anesthesia for an elderly female with a rare congenital heart disease – A case report

    Directory of Open Access Journals (Sweden)

    Bassant M. Abdelhamid

    2016-10-01

    The patient had future neck femur, arthroplasty under hemi spinal anesthesia. After one month she presented to us with dislocated joint, and hemiarthroplasty under hemispinal anesthesia was done again.

  10. Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty

    Directory of Open Access Journals (Sweden)

    Liehua Liu

    2016-01-01

    Full Text Available Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females with osteoporotic vertebral compression fractures with a mean age of 71.4±8.8 years (range: 60 to 89 received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA. Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects. Results. VAS of CLIA + EPIA and CLIA group was 2.5±0.7 and 4.3±1.0, respectively, and there was significant difference (P=0.001. In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted. Summary. Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

  11. Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty

    Science.gov (United States)

    2016-01-01

    Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females) with osteoporotic vertebral compression fractures with a mean age of 71.4 ± 8.8 years (range: 60 to 89) received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA) and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA). Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects. Results. VAS of CLIA + EPIA and CLIA group was 2.5 ± 0.7 and 4.3 ± 1.0, respectively, and there was significant difference (P = 0.001). In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted. Summary. Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty. PMID:27766261

  12. DNA repair protocols

    DEFF Research Database (Denmark)

    Bjergbæk, Lotte

    In its 3rd edition, this Methods in Molecular Biology(TM) book covers the eukaryotic response to genomic insult including advanced protocols and standard techniques in the field of DNA repair. Offers expert guidance for DNA repair, recombination, and replication. Current knowledge of the mechanisms...... that regulate DNA repair has grown significantly over the past years with technology advances such as RNA interference, advanced proteomics and microscopy as well as high throughput screens. The third edition of DNA Repair Protocols covers various aspects of the eukaryotic response to genomic insult including...... recent advanced protocols as well as standard techniques used in the field of DNA repair. Both mammalian and non-mammalian model organisms are covered in the book, and many of the techniques can be applied with only minor modifications to other systems than the one described. Written in the highly...

  13. Blind Cognitive MAC Protocols

    CERN Document Server

    Mehanna, Omar; Gamal, Hesham El

    2008-01-01

    We consider the design of cognitive Medium Access Control (MAC) protocols enabling an unlicensed (secondary) transmitter-receiver pair to communicate over the idle periods of a set of licensed channels, i.e., the primary network. The objective is to maximize data throughput while maintaining the synchronization between secondary users and avoiding interference with licensed (primary) users. No statistical information about the primary traffic is assumed to be available a-priori to the secondary user. We investigate two distinct sensing scenarios. In the first, the secondary transmitter is capable of sensing all the primary channels, whereas it senses one channel only in the second scenario. In both cases, we propose MAC protocols that efficiently learn the statistics of the primary traffic online. Our simulation results demonstrate that the proposed blind protocols asymptotically achieve the throughput obtained when prior knowledge of primary traffic statistics is available.

  14. Cytoskeleton - Methods and Protocols

    Directory of Open Access Journals (Sweden)

    CarloAlberto Redi

    2010-03-01

    Full Text Available Cytoskeleton - Methods and ProtocolsSecond edition, 2010; Ray H. Gavin (Ed; Springer Protocols methods in molecular biology, vol. 586 Humana press, Totowa, New Jersey (USA; Pages: 390; €95.44; ISBN: 978-1-60761-375-6Ray H. Gavin, from the Brooklyn College of The City University of New York, Brooklyn, NY, USA, wrote a few line as preface of this book. This is quite understandable: there is not a great need of words when there are facts that sustain and favour the dissemination of a cultural product. This is the case of the second edition of Cytoskeleton - Methods and Protocols, which appears just ten years after the first edition...

  15. Modified technique of iontophoretic anesthesia for myringotomy in children.

    Science.gov (United States)

    Epley, J M

    1977-06-01

    A modified technique is described for iontophoretic anesthesia in children who require myringotomy and insertion of a tube (tympanostomy). Principal modifications include the following procedures: (1) preoperative parenteral sedation; (2) relatively painless injection of lidocaine hydrochloride-epinephrine hydrochloride solution into the external auditory canal skin after iontophoresis alone to eliminate the extreme bony canal wall tenderness; (3) injection of lidocaine-epinephrine solution into an atelectatic middle ear to anesthetize the promontory for painless tube insertion; (4) substitution of a disposable ECG electrode for a metal plate electrode to eliminate the possibility of electrical burn from metal-to-skin contact. These modifications enhance the effectiveness and the safety of iontophoretic anesthesia, minimize the need for general anesthesia, and liberalize the indications for tympanostomy.

  16. [Clinical experience of usage of neurostimulator in regionar anesthesia].

    Science.gov (United States)

    Rudenko, M I; Kolobaeva, E G

    2006-09-01

    The elaboration of more reliable and simple methods of transmitted and plexus anestesias has provided a wide clinical usage of regionar anestesia (RA) during the operations on extremities. The creation of devices to identificate (locate) nerval bearer and plexes was also an important factor for increasing quantity of RA. For such identification we use the portable "Innervator 232" neurostimulator manufactured by "Fisher & Paykel Ltd.", New Zealand. Successful conduction of transmitted and plexus anesthesia depends a lot on anesthesiologist's knowledge of anatomy-topography location of nerval bearer and plexes, precise fulfillment of anesthesia, manual capabilities of physician and obtaining a paresthesia or muscular contraction during the identification of nerval bearer with the help of neurostimulator. RA is secure, effective, and provides less risk for a patient. With neurostimulation the amount of successful anesthesias increases up to 98%. The neurostimulator is easy to use, clinically effective in emergency and planned surgeries for identification of nerval bearer and plexes.

  17. Dimensional characterization of anesthesia dynamic in reconstructed embedding space.

    Science.gov (United States)

    Gifani, P; Rabiee, H R; Hashemi, M; Ghanbari, M

    2007-01-01

    The depth of anesthesia quantification has been one of the most research interests in the field of EEG signal processing and nonlinear dynamical analysis has emerged as a novel method for the study of complex systems in the past few decades. In this investigation we use the concept of nonlinear time series analysis techniques to reconstruct the attractor of anesthesia from EEG signal which have been obtained from different hypnotic states during surgery to give a characterization of the dimensional complexity of EEG by Correlation Dimension estimation. The dimension of the anesthesia strange attractor can be thought of as a measure of the degrees of freedom or the ;complexity' of the dynamics at different hypnotic levels. The results imply that for awaked state the correlation dimension is high, On the other hand, for light, moderate and deep hypnotic states these values decrease respectively; which means for anesthetized situation we expect lower correlation dimension.

  18. Current Strategies in Anesthesia and Analgesia for Total Knee Arthroplasty.

    Science.gov (United States)

    Moucha, Calin Stefan; Weiser, Mitchell C; Levin, Emily J

    2016-02-01

    Total knee arthroplasty is associated with substantial postoperative pain that may impair mobility, reduce the ability to participate in rehabilitation, lead to chronic pain, and reduce patient satisfaction. Traditional general anesthesia with postoperative epidural and patient-controlled opioid analgesia is associated with an undesirable adverse-effect profile, including postoperative nausea and vomiting, hypotension, urinary retention, respiratory depression, delirium, and an increased infection rate. Multimodal anesthesia--incorporating elements of preemptive analgesia, neuraxial perioperative anesthesia, peripheral nerve blockade, periarticular injections, and multimodal oral opioid and nonopioid medications during the perioperative and postoperative periods--can provide superior pain control while minimizing opioid-related adverse effects, improving patient satisfaction, and reducing the risk of postoperative complications.

  19. Effect of Mixed Anesthesia on Cardiac Function by Phonocardiogram

    Institute of Scientific and Technical Information of China (English)

    Fei Han; Hong-Mei Yan; Xin-Chuan Wei; Qing Yan

    2008-01-01

    Objective of this investigation is to further analyze the cardiac function status change by phonocar diogram during mixed anesthesia which is conducted by midazolam, skelaxin, fentanyi and propofoL The results show that blood pressure, heart rate, amplitude of R wave and T wave, amplitude of first heart sound (Si) and second heart sound (52) about 37 subjects after anesthesia decrease compared with baseline, while the. ratio of first heart sound and second heart sound (Si/S2) and the ratio of diastole duration and systole duration (DIS) increase. Our study demonstrates that phonocardiogram as a noninvasive, high benefit/cost ratio, objective, repeatable and portable method can be used for the monitoring and evaluation of cardiac function status during anesthesia and operations.

  20. Surgically assisted rapid maxillary expansion under local anesthesia: case report

    Directory of Open Access Journals (Sweden)

    João Frank Carvalho DANTAS

    2009-12-01

    Full Text Available is indicated for the treatment of transverse maxillary deficiency in patients with skeletal maturity, through the association of orthodontic and surgical procedures. It leads to an increase in the maxillary arch, resulting in better accommodation of the tongue and correcting the black corridors. This procedure can be performed under local anesthesia with low risk of complications, thus being considered a practical alternative treatment. Case report and conclusion: This article reports a case of surgically assisted maxillary expansion performed under local anesthesia in an outpatient setting. The patient had a clinical picture of transverse maxillary deficiency. Performing SARPE under local anesthesia in an outpatient setting is a viable procedure, of low cost, easy implementation and low risk of complications once it is performed according to the appropriate technique.

  1. [Physiology in Relation to Anesthesia Practice: Preface and Comments].

    Science.gov (United States)

    Yamada, Yoshitsugu

    2016-05-01

    It has been long recognized that anesthesia practice is profoundly based in physiology. With the advance of the technology of imaging, measurement and information, a serious gap has emerged between anesthesia mainly handling gross systemic parameters and molecular physiology. One of the main reasons is the lack of establishment of integration approach. This special series of reviews deals with systems physiology covering respiratory, cardiovascular, and nervous systems. It also includes metabolism, and fluid, acid-base, and electrolyte balance. Each review focuses on several physiological concepts in each area, explaining current understanding and limits of the concepts based on the new findings. They reaffirm the importance of applying physiological inference in anesthesia practice and underscore the needs of advancement of systems physiology.

  2. INGUINAL HERNIOPLASTY IN ELDERLY PATIENTS UNDER LOCAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Shahi

    2014-05-01

    Full Text Available OBJECTIVE: To evaluate the feasibility and safety of inguinal hernioplasty under local anesthesia in elderly patients with significant comorbidity. METHODS: A prospective study of 68 patients requiring inguinal mesh hernioplasty for inguinal hernia was carried. One group comprising 34 patients under 60 years of age underwent inguinal mesh hernioplasty while the other group comprising 34 patients over 60 years of age. The comorbid conditions and complications were compared between both groups. RESULTS: Inguinal mesh hernioplasty in elderly patients is more likely associated with comorbid conditions than younger patients in terms of hypertension, chronic obstructive pulmonary disease, cardiovascular diseases, benign prostatic hyperplasia etc. CONCLUSION: Elective inguinal mesh hernioplasty under local anesthesia has good results in elderly patients with significant comorbidities. Inguinal mesh hernioplasty under local anesthesia is safe and results in good success rate in elderly patients with significant comorbidities

  3. Apoptosis - Methods and Protocols

    Directory of Open Access Journals (Sweden)

    CarloAlberto Redi

    2010-03-01

    Full Text Available Apoptosis - Methods and ProtocolsSecond edition, 2009; Peter Erhardt and Ambrus Toth (Eds; Springer Protocols - Methods in molecular biology, vol. 559; Humana press, Totowa, New Jersey (USA; Pages: 400; €88.35; ISBN: 978-1-60327-016-8The editors rightly begin the preface telling us that: “The ability to detect and quantify apoptosis, to understand its biochemistry and to identify its regulatory genes and proteins is crucial to biomedical research”. Nowadays this is a grounding concept of biology and medicine. What is particularly remarkable...

  4. IP Routing Protocols

    Science.gov (United States)

    Nolasco Pinto, Armando

    2002-03-01

    Uyless Black is a widely known expert in computer networks and data communications. He is author of more than ten books in the communication technologies field, which puts him in a good position to address this topic. In IP Routing Protocols he starts by providing the background and concepts required for understanding TCP/IP technology. This is done clearly and assumes little prior knowledge of the area. As might be expected, he emphasizes the IP route discovery problem. Later he details several routing protocols.

  5. Use of the Computadorized Local Anesthesia System The Wand in Pediatric Dentistry

    OpenAIRE

    Faraco Junior,Italo Medeiros; Ana Letícia Rower DABLE; Andréia Bertani OTTONI; MARQUEZAN,Marcela; Maximiano Ferreira TOVO; Kramer,Paulo Floriani

    2007-01-01

    Introduction: The positive behavior of pediatric patients depends, among others variables, on the success of local anesthesia. Objective: In sight of this, we carried out a review about anesthesic techniques using the computerized anesthesia. This system has as main objective to reduce the discomfort caused by the traditional anesthesia, by controlling two important factors for the success of the local anesthesia: the pressure and the volume of anesthesic. Conclusion: The majority of the revi...

  6. Massive transfusion protocols: current best practice

    Directory of Open Access Journals (Sweden)

    Hsu YM

    2016-03-01

    Full Text Available Yen-Michael S Hsu,1 Thorsten Haas,2 Melissa M Cushing1 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland Abstract: Massive transfusion protocols (MTPs are established to provide rapid blood replacement in a setting of severe hemorrhage. Early optimal blood transfusion is essential to sustain organ perfusion and oxygenation. There are many variables to consider when establishing an MTP, and studies have prospectively evaluated different scenarios and patient populations to establish the best practices to attain improved patient outcomes. The establishment and utilization of an optimal MTP is challenging given the ever-changing patient status during resuscitation efforts. Much of the MTP literature comes from the trauma population, due to the fact that massive hemorrhage is the leading cause of preventable trauma-related death. As we come to further understand the positive and negative clinical impacts of transfusion-related factors, massive transfusion practice can be further refined. This article will first discuss specific MTPs targeting different patient populations and current relevant international guidelines. Then, we will examine a wide selection of therapeutic products to support MTPs, including newly available products and the most suitable of the traditional products. Lastly, we will discuss the best design for an MTP, including ratio-based MTPs and MTPs based on the use of point-of-care coagulation diagnostic tools. Keywords: hemorrhage, MTP, antifibrinolytics, coagulopathy, trauma, ratio, logistics, guidelines, hemostatic

  7. Transient Oliguria during Anesthesia in Cerebral Salt Wasting Syndrome.

    Science.gov (United States)

    Lee, Kwang Ho; Park, Jong Taek; Cho, Dong Woo; Song, Seung Woo; Lim, Hyun Kyo

    2016-09-01

    Cerebral salt wasting syndrome is a hyponatremic and hypovolemic condition caused by intracranial disorders, such as head injury, subarachnoid hemorrhage, brain tumor, and brain operations. We report a case of a 5-year-old girl that had cerebral salt wasting syndrome with marked polyuria who showed transient oliguria during general anesthesia. The patient had undergone an operation for traumatic intracranial hemorrhage three months prior and has had marked polyuria and hyponatremia since then. After induction of anesthesia for cranioplasty, the patient had oliguria during surgery and then resumed polyuria in the post-operative period.

  8. CLINICAL EFFECTS OF ROPIVACAINE MESYLATE IN EPIDURAL ANESTHESIA AND ANALGESIA

    Institute of Scientific and Technical Information of China (English)

    Jian-qing Xu; Bo Zhu; Tie-hu Ye

    2005-01-01

    @@ SINCE the report that ropivacaine hydrochloride, a new amide local anesthetic, is of lower cardiac toxicity both in animals and humans,1 several studies have shown it to be a clinically effective local anesthetic widely used for both epidural anesthesia2-4 and analgesia5-7. Ropivacaine mesylate made in China is structurally from ropivacaine hydrochloride by substituting a mesylate group for hydrochloride group.8 This study was designed to clinically provide a double-blind comparison of ropivacaine mesylate with ropivacaine hydrochloride in epidural anesthesia and analgesia.

  9. Quality and safety in anesthesia and perioperative care

    CERN Document Server

    Ruskin, Keith J; Rosenbaum, Stanley H

    2016-01-01

    Quality and Safety in Anesthesia and Perioperative Care offers practical suggestions for improving quality of care and patient safety in the perioperative setting. The book highlights concepts such as situation awareness, staff resource management, threat and error management, checklists, explicit practices for monitoring, and safety culture. Quality and Safety in Anesthesia and Perioperative Care is a must-have resource for those preparing for the quality and safety questions on the American Board of Anesthesiology certification examinations and clinicians and trainees in all practice setting

  10. Influence of a brief episode of anesthesia during the induction of experimental brain trauma on secondary brain damage and inflammation.

    Directory of Open Access Journals (Sweden)

    Clara Luh

    Full Text Available It is unclear whether a single, brief, 15-minute episode of background anesthesia already modulates delayed secondary processes after experimental brain injury. Therefore, this study was designed to characterize three anesthesia protocols for their effect on molecular and histological study endpoints. Mice were randomly separated into groups that received sevoflurane (sevo, isoflurane (iso or an intraperitoneal anesthetic combination (midazolam, fentanyl and medetomidine; comb prior to traumatic brain injury (controlled cortical impact, CCI; 8 m/s, 1 mm impact depth, 3 mm diameter. Twenty-four hours after insult, histological brain damage, neurological function (via neurological severity score, cerebral inflammation (via real-time RT-PCR for IL6, COX-2, iNOS and microglia (via immunohistochemical staining for Iba1 were determined. Fifteen minutes after CCI, the brain contusion volume did not differ between the anesthetic regimens (sevo = 17.9±5.5 mm(3; iso = 20.5±3.7 mm(3; comb = 19.5±4.6 mm(3. Within 24 hours after injury, lesion size increased in all groups (sevo = 45.3±9.0 mm(3; iso = 31.5±4.0 mm(3; comb = 44.2±6.2 mm(3. Sevo and comb anesthesia resulted in a significantly larger contusion compared to iso, which was in line with the significantly better neurological function with iso (sevo = 4.6±1.3 pts.; iso = 3.9±0.8 pts.; comb = 5.1±1.6 pts.. The expression of inflammatory marker genes was not significantly different at 15 minutes and 24 hours after CCI. In contrast, significantly more Iba1-positive cells were present in the pericontusional region after sevo compared to comb anesthesia (sevo = 181±48/mm(3; iso = 150±36/mm(3; comb = 113±40/mm(3. A brief episode of anesthesia, which is sufficient for surgical preparations of mice for procedures such as delivering traumatic brain injury, already has a significant impact on the extent of secondary brain damage.

  11. Anesthesia-Related Maternal Mortality in the United States : 1979-2002

    NARCIS (Netherlands)

    Hawkins, Joy L.; Chang, Jeani; Palmer, Susan K.; Gibbs, Charles P.; Callaghan, William M.

    2011-01-01

    OBJECTIVE: To examine 12 years of anesthesia-related maternal deaths from 1991 to 2002 and compare them with data from 1979 to 1990, to estimate trends in anesthesia-related maternal mortality over time, and to compare the risks of general and regional anesthesia during cesarean delivery. METHODS: T

  12. Protocol Materials: A Clarification.

    Science.gov (United States)

    Innerd, Wilfred; O'Gorman, David

    "Protocol materials" are records or recordings of a wide variety of behavioral situations. Characteristically they are neither simulated nor extensively edited. They are to be used for the empirical verification of concepts derived from both educational theory and the social sciences. They are attempts to capture reality so that it may be studied…

  13. THE MASTER PROTOCOL CONCEPT

    Science.gov (United States)

    Allegra, Carmen J.

    2015-01-01

    During the past decade, biomedical technologies have undergone an explosive evolution---from the publication of the first complete human genome in 2003, after more than a decade of effort and at a cost of hundreds of millions of dollars---to the present time, where a complete genomic sequence can be available in less than a day and at a small fraction of the cost of the original sequence. The widespread availability of next generation genomic sequencing has opened the door to the development of precision oncology. The need to test multiple new targeted agents both alone and in combination with other targeted therapies, as well as classic cytotoxic agents, demand the development of novel therapeutic platforms (particularly Master Protocols) capable of efficiently and effectively testing multiple targeted agents or targeted therapeutic strategies in relatively small patient subpopulations. Here, we describe the Master Protocol concept, with a focus on the expected gains and complexities of the use of this design. An overview of Master Protocols currently active or in development is provided along with a more extensive discussion of the Lung Master Protocol (Lung-MAP study). PMID:26433553

  14. Principles of Protocol Design

    DEFF Research Database (Denmark)

    Sharp, Robin

    This is a new and updated edition of a book first published in 1994. The book introduces the reader to the principles used in the construction of a large range of modern data communication protocols, as used in distributed computer systems of all kinds. The approach taken is rather a formal one...

  15. Security Protocol Design: A Case Study Using Key Distribution Protocols

    Directory of Open Access Journals (Sweden)

    Reiner Dojen

    2009-10-01

    Full Text Available Nowadays security protocols are a key component in providing security services for fixed and mobile networks. These services include data confidentiality, radio link encryption, message integrity, mobile subscriber authentication, electronic payment, certified e-mail, contract signing and nonrepudiation. This paper is concerned with design of effective security protocols. Security protocols are introduced and some common attacks against security protocols are discussed. The vulnerabilities that lead to theattacks are analyzed and guidelines for effective security protocol design are proposed. The presented guidelines are applied to the Andrew Secure RPC protocol and its adapted versions. It is demonstrated that compliance with the guidelines successfully avoidsfreshness and parallel session attacks.

  16. [Practical advices in choosing local anesthesia tools in dentistry. Management of carpule's quality in local anesthesia in dentistry].

    Science.gov (United States)

    Kuzin, A V

    2014-01-01

    The equipment for local anesthesia is described in this article. Practical recommendations for the selection of the injection needle length, size, bevel type is given. Using dental needle for local anesthesia should be guided by the "one injection - one needle" rule, as a needle tends to deform by even the slightest contact with jawbone. Some of the shortcomings of carpule quality may be detected before use: signs of cup corrosion, the presence of sediment, air bubbles, rubber plunger disposition. In the case of such defects being identified all the package should not be used. The use of such carpule in clinical practice is unsafe.

  17. The History of Geriatric Anesthesia in the United States and the Society for the Advancement of Geriatric Anesthesia.

    Science.gov (United States)

    Rooke, G Alec

    2015-09-01

    Creation of the American Society of Anesthesiologists Committee on Geriatric Anesthesia provided an opportunity for individuals to interact, strategize, and work with medical organizations outside of anesthesiology. These opportunities expanded with creation of the Society for the Advancement of Geriatric Anesthesia. The American Geriatrics Society provided a major boost when they realized it was important for surgical and related specialties to take an active role in the care of older patients. From this have come educational grants to improve residency training and establishment of a major research grant program now managed by the National Institutes of Health. Nevertheless, for improved care of the older patient, the level of involvement has to increase.

  18. Anesthesia in Pacific oyster, Crassostrea gigas

    OpenAIRE

    Suquet, Marc; De Kermoysan, Goulwen; Araya, Ricardo Gonzalez; Queau, Isabelle; Lebrun, Luc; Le Souchu, Pierrick; Mingant, Christian

    2009-01-01

    Un protocole complet d'anesthésie chez les huîtres creuses devrait faciliter l'échantillonnage successif des mêmes animaux, sans les sacrifier, favorisant notamment l'étude de la gamétogenèse. Cette étude a pour but de définir des conditions fiables d'anesthésie adaptées à l'huître creuse, Crassostrea gigas. Trois groupes de 10 huîtres chacun (poids moyen $\\pm $ écart-type, 32,1 $\\pm $ 9,0 g) ont été anesthésiés dans des récipients de 5 L. Parmi les différents anesthésiants testés : benzocaïn...

  19. A family of quantum protocols

    CERN Document Server

    Devetak, I; Winter, A

    2003-01-01

    We introduce two dual, purely quantum protocols: for entanglement distillation assisted by quantum communication (``mother'' protocol) and for entanglement assisted quantum communication (``father'' protocol). We show how a large class of ``children'' protocols (including many previously known ones) can be derived from the two by direct application of teleportation or super-dense coding. Furthermore, the parent may be recovered from most of the children protocols by making them ``coherent''. We also summarize the various resource trade-offs these protocols give rise to.

  20. Does Ondansetron Modify Sympathectomy Due to Subarachnoid Anesthesia?

    DEFF Research Database (Denmark)

    Terkawi, Abdullah S; Mavridis, Dimitris; Flood, Pamela;

    2016-01-01

    BACKGROUND: Disagreement among many underpowered studies has led to an equivocal understanding of the efficacy of the 5-HT3 antagonist ondansetron in preventing the consequences of sympathectomy after subarachnoid anesthesia. The authors assessed the efficacy of ondansetron with respect to the ov...

  1. Seizure-like activity during fentanyl anesthesia. A case report.

    OpenAIRE

    Webb, M. D.

    1990-01-01

    Fentanyl induced seizures have been described previously in the literature. Clinical observations has labeled the movements seen in fentanyl anesthesia as seizure activity but electroencephalographic studies have not supported this. A case of seizure-like activity after the administration of fentanyl in a 20-year-old female is reported.

  2. Anesthesia for off-pump coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Thomas M Hemmerling

    2013-01-01

    Full Text Available The evolution of techniques and knowledge of beating heart surgery has led anesthesia toward the development of new procedures and innovations to promote patient safety and ensure high standards of care. Off-pump coronary artery bypass (OPCAB surgery has shown to have some advantages compared to on-pump cardiac surgery, particularly the reduction of postoperative complications including systemic inflammation, myocardial injury, and cerebral injury. Minimally invasive surgery for single vessel OPCAB through a limited thoracotomy incision can offer the advantage of further reduction of complications. The anesthesiologist has to deal with different issues, including hemodynamic instability and myocardial ischemia during aorto-coronary bypass grafting. The anesthesiologist and surgeon should collaborate and plan the best perioperative strategy to provide optimal care and ensure a rapid and complete recovery. The use of high thoracic epidural analgesia and fast-track anesthesia offers particular benefits in beating heart surgery. The excellent analgesia, the ability to reduce myocardial oxygen consumption, and the good hemodynamic stability make high thoracic epidural analgesia an interesting technique. New scenarios are entering in cardiac anesthesia: ultra-fast-track anesthesia with extubation in the operating room and awake surgery tend to be less invasive, but can only be performed on selected patients.

  3. Fetal heart rate changes associated with general anesthesia.

    Science.gov (United States)

    Fedorkow, D M; Stewart, T J; Parboosingh, J

    1989-07-01

    Decreased fetal heart rate variability was noted 90 seconds after the induction of general anesthesia with sodium thiopentone and fentanyl in a patient undergoing basket extraction of a renal calculus at 30 weeks' gestation. The fetal sleep pattern lasted for 105 minutes after the anesthetic was discontinued, 45 minutes after the mother was fully awake.

  4. Experience and Thinking on Study of Pneumonectomy by Acupuncture Anesthesia

    Institute of Scientific and Technical Information of China (English)

    吴焕淦; 施征; 朱余明; 周恩华; 周红; 童稳圃; 顾陈怿; 陆黎

    2008-01-01

    @@ Acupuncture anesthesia is a great breakthrough in the development history of acupuncture science in China. It has promoted the development of acupuncture science, promoted the study on acupuncture from multiple subjects of modem natural sciences and has become an important component part in the studies of modem life science[1].

  5. Xenon Anesthesia Improves Respiratory Gas Exchanges in Morbidly Obese Patients

    Directory of Open Access Journals (Sweden)

    Antonio Abramo

    2010-01-01

    Full Text Available Background. Xenon-in-oxygen is a high density gas mixture and may improve PaO2/FiO2 ratio in morbidly obese patients uniforming distribution of ventilation during anesthesia. Methods. We compared xenon versus sevoflurane anesthesia in twenty adult morbidly obese patients (BMI>35 candidate for roux-en-Y laparoscopic gastric bypass and assessed PaO2/FiO2 ratio at baseline, at 15 min from induction of anaesthesia and every 60 min during surgery. Differences in intraoperative and postoperative data including heart rate, systolic and diastolic pressure, oxygen saturation, plateau pressure, eyes opening and extubation time, Aldrete score on arrival to the PACU were compared by the Mann-Whitney test and were considered as secondary aims. Moreover the occurrence of side effects and postoperative analgesic demand were assessed. Results. In xenon group PaO2-FiO2 ratio was significantly higher after 60 min and 120 min from induction of anesthesia; heart rate and overall remifentanil consumption were lower; the eyes opening time and the extubation time were shorter; morphine consumption at 72 hours was lower; postoperative nausea was more common. Conclusions. Xenon anesthesia improved PaO2/FiO2 ratio and maintained its distinctive rapid recovery times and cardiovascular stability. A reduction of opioid consumption during and after surgery and an increased incidence of PONV were also observed in xenon group.

  6. Ambulatory anesthesia in plastic surgery: opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Facque AR

    2015-10-01

    Full Text Available Alexander R Facque, Peter J Taub Division of Plastic and Reconstructive Surgery, Department of Surgery, Mount Sinai Medical Center, New York, NY, USA Abstract: In 2013, there were 17 million procedures performed by plastic and reconstructive surgeons in the United States in the private office or ambulatory “surgicenter” setting, as well as additional operations performed in hospitals on an outpatient basis. As interest in performing increasingly complex surgical procedures on an outpatient basis continues to grow, the surgeon and anesthesiologist alike must be prepared to offer safe and reliable anesthesia and analgesia in the ambulatory setting. Surgeons must be aware of the possible techniques that will be employed in their surgeries in order to anticipate and prepare patients for possible postoperative side effects, and anesthesiologists must be prepared to offer such techniques in order to ensure a relatively rapid return to normal activity despite potentially having undergone major surgery. The following is a review of the specific considerations that should be given to ambulatory plastic surgery patients with comments on recent developments in the techniques used to safely administer agreeable and effective anesthesia. Keywords: ambulatory surgery, cosmetic anesthesia, outpatient, ambulatory anesthesia

  7. Dexmedetomidine for the prevention of shivering during spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Burhanettin Usta

    2011-01-01

    Full Text Available PURPOSE: The aim of this study was to evaluate the effect of dexmedetomidine on shivering during spinal anesthesia. METHODS: Sixty patients (American Society of Anesthesiologists physical status I or II, aged 18-50 years, scheduled for elective minor surgical operations under spinal anesthesia with hyperbaric bupivacaine, were enrolled. They were administered saline (group C, n = 30 or dexmedetomidine (group D, n = 30. Motor block was assessed using a Modified Bromage Scale. The presence of shivering was assessed by a blinded observer after the completion of subarachnoid drug injection. RESULTS: Hypothermia was observed in 21 patients (70% in group D and in 20 patients (66.7% in group C (p = 0.781. Three patients (10% in group D and 17 patients (56.7% in group C experienced shivering (p = 0.001. The intensity of shivering was lower in group D than in group C (p = 0.001. Time from baseline to onset of shivering was 10 (5-15 min in group D and 15 (5-45 min in group C (p = 0.207. CONCLUSION: Dexmedetomidine infusion in the perioperative period significantly reduced shivering associated with spinal anesthesia during minor surgical procedures without any major adverse effect during the perioperative period. Therefore, we conclude that dexmedetomidine infusion is an effective drug for preventing shivering and providing sedation in patients during spinal anesthesia.

  8. Effect of a training model in local anesthesia teaching

    NARCIS (Netherlands)

    Brand, H.S.; Baart, J.A.; Maas, N.E.; Bachet, I.

    2010-01-01

    The aim of this study was to evaluate the preclinical use of a training model in local anesthesia teaching on the subsequent clinical administration of a local anesthetic. Sixty-five dental students gave their first injection to a fellow dental student: twenty-two students after previous experience

  9. The Ryder Cognitive Aid Checklist for Trauma Anesthesia.

    Science.gov (United States)

    Behrens, Vicente; Dudaryk, Roman; Nedeff, Nicholas; Tobin, Joshua M; Varon, Albert J

    2016-05-01

    Despite mixed results regarding the clinical utility of checklists, the anesthesia community is increasingly interested in advancing research around this important topic. Although several checklists have been developed to address routine perioperative care, few checklists in the anesthesia literature specifically target the management of trauma patients. We adapted a recently published "trauma and emergency checklist" for the initial phase of resuscitation and anesthesia of critically ill trauma patients into an applicable perioperative cognitive aid in the form of a pictogram that can be downloaded by the medical community. The Ryder Cognitive Aid Checklist for Trauma Anesthesia is a letter-sized, full-color document consisting of 2 pages and 5 sections. This cognitive aid describes the essential steps to be performed: before patient arrival to the hospital, on patient arrival to the hospital, during the initial assessment and management, during the resuscitation phase, and for postoperative care. A brief online survey is also presented to obtain feedback for improvement of this tool. The variability in utility of cognitive aids may be because of the specific clinical task being performed, the skill level of the individuals using the cognitive aid, overall quality of the cognitive aid, or organizational challenges. Once optimized, future research should be focused at ensuring successful implementation and customization of this tool.

  10. Laser pediatric crowns performed without anesthesia: a contemporary technique.

    Science.gov (United States)

    Jacboson, B; Berger, J; Kravitz, R; Patel, P

    2003-01-01

    Extensive caries resulting in the need for a stainless steel crown in primary teeth may now be prepared with the use of the WaterlaseTM YSGG Laser, (Biolase) hard and soft-tissue laser. The use of the laser eliminates the need for local anesthesia, thereby providing optimal patient comfort and compliance.

  11. Determination of Rate of Hearing Changes After Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    F Omidi

    2008-07-01

    Full Text Available Introduction: Hearing loss after surgery is reported rarely. Its prevalence rate is different and reported to be between 3-92%. Hearing loss is often subclinical and not diagnosed without audiometry. The aim of this study was to determine rate of hearing changes after spinal anesthesia in patients undergoing surgery with spinal anesthesia. Methods: In this descriptive study, forty male patients scheduled for repair of inguinal hernia under spinal anesthesia were selected by simple sampling method. Before surgery, audiometry was performed for both the ears of the patients. Audiomatery was performed again by the audiometry specialist on day one, five, fifteen and two months after surgery. Results: Hearing loss was observed in 13 (32.5% patients. Hearing loss in 12 patients (92% was in low hearing frequency range and 1 patient (8% was in mid hearing frequency. Hearing loss in 8 patients (61% was ipsilateral and in 5 patients (39% was bilateral. Hearing loss in 9 patients (69% on 5th day and 2 patients (5/15% on 15th day resolved spontaneously. Conclusion: Results of this study conformed that hearing loss after spinal anesthesia is not a serious problem and can resolve spontaneously. It seems that there is relationship between hearing loss and headache.

  12. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Shah U

    2015-04-01

    Full Text Available Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA. Patient satisfaction is a complex concept that is influenced by multiple factors. A patient's viewpoint and knowledge plays an influential role in patient satisfaction with ambulatory surgery. Medical optimization and psychological preparation of the patient plays a pivotal role in the success of ambulatory surgery. Postoperative pain, nausea, and vomiting are the most important symptoms for the patient and can be addressed by multimodal drug regimens. Shared decision making, patient–provider relationship, communication, and continuity of care form the main pillars of patient satisfaction. Various psychometrically developed instruments are available to measure patient satisfaction, such as the Iowa Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, but none have been developed specifically for ambulatory surgery. The ASA has made recommendations for data collection for patient satisfaction surveys and emphasized the importance of reporting the data to the Anesthesia Quality Institute. Future research is warranted to develop a validated tool to measure patient satisfaction in ambulatory surgery. Keywords: patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives

  13. Anesthesia and analgesia for caesaren section in dog

    Directory of Open Access Journals (Sweden)

    Vasiljević Maja

    2014-01-01

    Full Text Available This work presents a case of a pregnant female dog, of English bulldog breed, three years old, which was brought to Belgrade Faculty of Veterinary Medicine because of inability for normal parturition. Cesarean section is an urgent intervention both in human and in veterinary medicine. Anesthesia of a pregnant dog should be carried out very carefully, because of all the physiological changes that appear during pregnancy, as well as the impact of anesthetics on embryos themselves. Anesthetics, analgesics and sedatives pass through blood brain barrier, but also their transport goes through placenta to embryo, so for that reason it is not possible to anesthetize only mother and to avoid anesthesia effects on the embryo. Therefore, anesthetics with short time of action which metabolize quickly and have minimal negative effect on embryos are recommended. When choosing the right analgesics and anesthetics, there should be known that female dogs in which it is necessary to do Cesarean section belong to the group of high risk patients. Pregnant female dogs are exposed to hypoventilation, hypoxia, hypercapnia, intense heart work, vomiting and regurgitation as well. Reversible anesthetics are recommended to provide shorter duration time of anesthesia, and in accordance, inhalation anesthetics doses are minimal. Application of α2- agonist in premedication, propophol in induction, as well as maintaining general inhalation anesthesia with sevofluran, along with local analgesia, proved to be the ideal combination in this case of cesarean section.

  14. Anesthesia and postoperative delirium in older adults undergoing hip surgery

    NARCIS (Netherlands)

    Slor, C.J.; de Jonghe, J.F.M.; Vreeswijk, R.; Groot, E.; Ploeg, T.V.D.; van Gool, W.A.; Eikelenboom, P.; Snoeck, M.; Schmand, B.; Kalisvaart, K.J.

    2011-01-01

    OBJECTIVES: To examine the effects of general anesthesia on the risk of incident postoperative delirium in older adults undergoing hip surgery. DESIGN: Secondary analysis of haloperidol prophylaxis for delirium clinical trial data. Predefined risk factors for delirium were assessed prior to surgery.

  15. Analgesia and anesthesia for neonates : Study design and ethical issues

    NARCIS (Netherlands)

    Anand, KJS; Aranda, JV; Berde, CB; Buckman, S; Capparelli, EV; Carlo, WA; Hummel, P; Lantos, P; Johnston, CC; Lehr, VT; Lynn, AM; Oberlander, TF; Raju, TNK; Soriano, SG; Taddio, A; Walco, GA; Maxwell, L.G.

    2005-01-01

    Objective: The purpose of this article is to summarize the clinical, methodologic, and ethical considerations for researchers interested in designing future trials in neonatal analgesia and anesthesia, hopefully stimulating additional research in this field. Methods: The MEDLINE, PubMed, EMBASE, and

  16. Integration of the enterprise electronic health record and anesthesia information management systems.

    Science.gov (United States)

    Springman, Scott R

    2011-09-01

    Fewer than 5% of anesthesia departments use an electronic medical record (EMR) that is anesthesia specific. Many anesthesia information management systems (AIMS) have been developed with a focus only on the unique needs of anesthesia providers, without being fully integrated into other electronic health record components of the entire enterprise medical system. To understand why anesthesia providers should embrace health information technology (HIT) on a health system-wide basis, this article reviews recent HIT history and reviews HIT concepts. The author explores current developments in efforts to expand enterprise HIT, and the pros and cons of full enterprise integration with an AIMS.

  17. Combined spinal–epidural anesthesia for an elderly patient with proportionate dwarfism for laparotomy

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-01-01

    Full Text Available Anesthesia in a dwarf patient may be challenging as various anatomical anomalies make both general and regional anesthesia difficult. These patients may have atlantoaxial instability, potential for airway obstruction, and associated respiratory problems that may pose problems for general anesthesia. Spinal stenosis, osteophytes, short pedicles, or a small epidural space could complicate regional anesthesia in dwarfs which could lead to difficulties in locating the epidural space and increase the risk of dural puncture. Spinal stenosis may impair cerebrospinal fluid flow such that identification of dural puncture is difficult. This elderly dwarf patient had history of bronchial asthma with restriction of neck extension, managed successfully using combined spinal–epidural anesthesia.

  18. Combined spinal and general anesthesia is better than general anesthesia alone for laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Poonam S Ghodki

    2014-01-01

    Full Text Available Context: Spinal anesthesia (SA was combined with general anesthesia (GA for achieving hemodynamic stability in laparoscopic hysterectomy. Aims: The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anesthetics, vasodilators, and recovery profile. Settings and Design: We conducted a prospective, randomized study in ASAI/II patients posted for laparoscopic hysterectomy, who were willing to participate in the study. Materials and Methods: Patients were randomly assigned to receive SA with GA (group SGA or plain GA (group GA. Group SGA received 10 mg bupivacaine (heavy for SA. GA was administered using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators, recovery profile, and regression of SA were studied. Statistical analysis used: Descriptive statistics in the form of mean, standard deviation, frequency, and percentages were calculated for interval and categorical variables, respectively. One-way analysis of variance (ANOVA was applied for noting significant difference between the two groups, with chi-square tests for categorical variables and post-hoc Bonferroni test for interval variables. Comparison of heart rate (HR, mean arterial pressure (MAP, SPO2, and etCO2 was done with Student′s t-test or Mann-Whitney test, wherever applicable. Results: Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to group GA was statistically significant (P < 0.01. Group GA showed additional requirement of metoprolol (53.33% and higher concentration of isoflurane (P < 0.001 to combat the increased MAP. Recovery was early and quick in group SGA as

  19. Assessment of current undergraduate anesthesia course in a Saudi University

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    Tarek Shams

    2013-01-01

    Full Text Available Background: The assessment of the anesthesia course in our university comprises Objective Structured Clinical Examinations (OSCEs, in conjunction with portfolio and multiple-choice questions (MCQ. The objective of this study was to evaluate the outcome of different forms of anesthesia course assessment among 5 th year medical students in our university, as well as study the influence of gender on student performance in anesthesia. Methods: We examined the performance of 154, 5 th year medical students through OSCE, portfolios, and MCQ. Results: The score ranges in the portfolio, OSCE, and MCQs were 16-24, 4.2-28.9, and 15.5-44.5, respectively. There was highly significant difference in scores in relation to gender in all assessments other than the written one (P=0.000 for Portfolio, OSCE, and Total exam, whereas P=0.164 for written exam. In the generated linear regression model, OSCE alone could predict 86.4% of the total mark if used alone. In addition, if the score of the written examination is added, OSCE will drop to 57.2% and the written exam will be 56.8% of the total mark. Conclusions: This study demonstrates that different clinical methods used to assess medical students during their anesthesia course were consistent and integrated. The performance of female was superior to male in OSCE and portfolio. This information is the basis for improving educational and assessment standards in anesthesiology and for introducing a platform for developing modern learning media in countries with dearth of anesthesia personnel.

  20. Costs of anesthetics and other drugs in anesthesia

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    Majstorović Branislava M.

    2012-01-01

    Full Text Available Introduction. Drugs are real and transparent costs of treatment, which are subject to constant monitoring and changes. The study was aimed at measuring and analyzing consumption of anesthetics and other drugs in anesthesia in the Clinical Centre of Serbia. Material and Methods. This paper is part of a five-year (2005-2009, academic, pharmacoeconomic retrospective-prospective study (the 4th phase. We calculated the costs of anesthetics and other drugs in all anesthetized patients at the Institute of Anesthesia and Reanimation, Clinical Center of Serbia in 2006. The data, obtained from the Clinical Centre of Serbia Database, were analyzed by descriptive statistical methods using computer program Microsoft Office Excel 2003 and the Statistical Package for the Social Sciences (SPSS for Windows. Results. The amount of money spent for the application of 33,187 general and 16,394 local anesthesia and 20,614 anesthesiology procedures was 83,322,046.36 RSD (Euros 1,054,705.4, which was 5.93% of the funds allocated for all drugs used at the Clinical Center of Serbia. Of the total fund for drugs, 57.8% was spent for anesthetics (local anesthetics 1.2% and muscle relaxants, whereas 42.2% was spent for other drugs in anesthesia. The highest amount was spent at the Emergency Center (35.8%, then at the Cardio-surgery (11.9% and the Neurosurgery (10.9% because of the large number and length of surgical interventions. Conclusion. There is no space for rationalizing the costs of anesthetics and other drugs in anesthesia.

  1. Ambulatory surgery with chloroprocaine spinal anesthesia: a review

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    Ghisi D

    2015-11-01

    Full Text Available Daniela Ghisi, Stefano Bonarelli Department of Anaesthesia and Postoperative Intensive Care, Istituto Ortopedico Rizzoli, Bologna, Italy Abstract: Spinal anesthesia is a reliable and safe technique for procedures of the lower extremities. Nevertheless, some of its characteristics may limit its use for ambulatory surgery, including delayed ambulation, risk of urinary retention, and pain after block regression. The current availability of short-acting local anesthetics has renewed interest for this technique also in the context of short- and ultra-short procedures. Chloroprocaine (CP is an amino-ester local anesthetic with a very short half-life. It was introduced and has been successfully used for spinal anesthesia since 1952. Sodium bisulfite was then added as a preservative after 1956. The drug was then abandoned in the 1980s for several reports of neurological deficits in patients receiving accidentally high doses of intrathecal CP during epidural labor analgesia. Animal studies have proven the safety of the preservative-free formulation, which has been extensively evaluated in volunteer studies as well as in clinical practice with a favorable profile in terms of both safety and efficacy. In comparison with bupivacaine, 2-chloroprocaine (2-CP showed faster offset times to end of anesthesia, unassisted ambulation, and discharge from hospital. These findings suggests that 2-CP may be a suitable alternative to low doses of long-acting local anesthetics in ambulatory surgery. Its safety profile also suggests that 2-CP could be a valid substitute for intrathecal short- and intermediate-acting local anesthetics, such as lidocaine and mepivacaine – often causes of transient neurological symptoms. In this context, literature suggests a dose ranging between 30 and 60 mg of 2-CP for procedures lasting 60 minutes or less, while 10 mg is considered the no-effect dose. The present review describes recent evidence about 2-CP as an anesthetic agent for

  2. Symmetric cryptographic protocols

    CERN Document Server

    Ramkumar, Mahalingam

    2014-01-01

    This book focuses on protocols and constructions that make good use of symmetric pseudo random functions (PRF) like block ciphers and hash functions - the building blocks for symmetric cryptography. Readers will benefit from detailed discussion of several strategies for utilizing symmetric PRFs. Coverage includes various key distribution strategies for unicast, broadcast and multicast security, and strategies for constructing efficient digests of dynamic databases using binary hash trees.   •        Provides detailed coverage of symmetric key protocols •        Describes various applications of symmetric building blocks •        Includes strategies for constructing compact and efficient digests of dynamic databases

  3. Mitosis Methods & Protocols

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    CarloAlberto Redi

    2010-06-01

    Full Text Available Mitosis Methods & Protocols Andrew D. McAinsh (Edt Humana press, Totowa, New Jersey (USA Series: Springer Protocols Methods in Molecular Biology, Volume 545, 2009 ISBN: 978-1-60327-992-5   It is quite clear from the contents of this book that the remarkably fascinating phenomenon of mitosis (that captured, and still is capturing, the attention of entire generations of scientists is still open to research. This is mainly due to our lack of knowledge of so many multifaced events of this extraordinarly complex process. The reader giving a glace through the Contents and Contributors sections is speechless: All of the first-class models (i.e., budding yeast, Caenorabditis, Drosophila, Xenopus and Human are presented..... 

  4. [Regional anesthesia of the airways in difficult tracheal intubation in a conscious patient with spontaneous respiration].

    Science.gov (United States)

    Dziadz'ko, A M

    2002-01-01

    Clinical pattern of anesthesia, hemodynamic and gas exchange states were evaluated in 64 patients with congenital or acquired damage of maxillary-facial region due to tumor or trauma. 51 patients were intubated under locoregional anesthesia of the upper respiratory tract (superior laryngeal nerves, glossopharyngeal nerves, intratracheal anesthesia) by means of blind nasal or oral fiberoptic retrograde and by using laryngeal mask technique. In 12 cases fiberoptic device was used for intubation under local anesthesia by lidocaine solution. There was no airways obstruction in any case. Satisfactory anesthesia in oropharynx, larynx and trachea was reached in all cases, the most profound blockage of airways and lack of pharyngeal and laryngeal reflexes being in patients under locoregional anesthesia. So locoregional anesthesia can be used for awake intubation.

  5. Awake caudal anesthesia for inguinal hernia operations: successful use in low birth weight neonates.

    Science.gov (United States)

    Geze, S; Imamoğlu, M; Cekic, B

    2011-09-01

    Neonates with inguinal hernia face a relatively high risk of incarcerated hernia and bowel obstruction and this therefore requires surgical treatment. Complications following general anesthesia even for minor surgery are more common in low birth weight neonates than in term neonates. Caudal epidural anesthesia without adjunct general anesthesia has been recommended for neonates to reduce the risk of postoperative complications. The successful application of awake caudal anesthesia with levobupivacaine for inguinal hernia repair in 15 low birth weight neonates is reported. Single dose caudal epidural anesthesia was administered for inguinal hernia surgery to avoid complications associated with general anesthesia. Caudal block was performed with 2.5 mg/kg body weight (BW) levobupivacaine. Caudal anesthesia can be recommended as an effective technique for avoiding postoperative anesthetic complications in low birth weight neonates.

  6. Cognitive Protocol Stack Design

    Science.gov (United States)

    2015-12-30

    SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS (ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park , NC 27709-2211 cognitive...related to mobility and topology changes in a wireless multi-hop ad hoc network. (xv) We used a cross-layer formulation to design transmission...the transmission parameters, the implemented protocol and the network topology . The solution adopted involves a heuristic metric to measure how the

  7. Dysphonia risk screening protocol

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    Katia Nemr

    2016-03-01

    Full Text Available OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children, 29.25 (adult women, 22.75 (adult men, and 27.10 (seniors. CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

  8. Comparison of minute distribution frequency for anesthesia start and end times from an anesthesia information management system and paper records.

    Science.gov (United States)

    Phelps, Michael; Latif, Asad; Thomsen, Robert; Slodzinski, Martin; Raghavan, Rahul; Paul, Sharon Leigh; Stonemetz, Jerry

    2016-06-07

    Use of an anesthesia information management system (AIMS) has been reported to improve accuracy of recorded information. We tested the hypothesis that analyzing the distribution of times charted on paper and computerized records could reveal possible rounding errors, and that this effect could be modulated by differences in the user interface for documenting certain event times with an AIMS. We compared the frequency distribution of start and end times for anesthesia cases completed with paper records and an AIMS. Paper anesthesia records had significantly more times ending with "0" and "5" compared to those from the AIMS (p distribution of minutes recorded with AIMS was almost evenly distributed, unlike those from paper records that still showed significant end-digit preference. The accuracy of anesthesia case start times and case end times, as inferred by statistical analysis of the distribution of the times, is enhanced with the use of an AIMS. Furthermore, the differences in AIMS user interface for documenting case start and case end times likely affects the degree of end-digit preference, and likely accuracy, of those times.

  9. Is there any benefit in associating neuraxial anesthesia to general anesthesia for coronary artery bypass graft surgery?

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: The use of neuraxial anesthesia in cardiac surgery is recent, but the hemodynamic effects of local anesthetics and anticoagulation can result in risk to patients. OBJECTIVE: To review the benefits of neuraxial anesthesia in cardiac surgery for CABG through a systematic review of systematic reviews. CONTENT: The search was performed in Pubmed (January 1966 to December 2012, Embase (1974 to December 2012, The Cochrane Library (volume 10, 2012 and Lilacs (1982 to December 2012 databases, in search of articles of systematic reviews. The following variables: mortality, myocardial infarction, stroke, in-hospital length of stay, arrhythmias and epidural hematoma were analyzed. CONCLUSIONS: The use of neuraxial anesthesia in cardiac surgery remains controversial. The greatest benefit found by this review was the possibility of reducing postoperative arrhythmias, but this result was contradictory among the identified findings. The results of findings regarding mortality, myocardial infarction, stroke and in-hospital length of stay did not show greater efficacy of neuraxial anesthesia.

  10. The Comparison Of Total Intravenous Anesthesia (Propofol, Alfentanyl Plus Midazolam, Alfentanyl With General Anesthesia In D&C Patients

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    Shoeibi G

    2004-07-01

    Full Text Available Background: Total Intravenous Anesthesia (TIVA compared to general anesthesia has some pits and falls. Many drugs have been employed for this anesthesia. Propofol is accounted as the last advent anesthetic drug. It belongs to alkyl phenol families and has been accounted one of the best choices for the continuous infusion. Invention of midazolam as the first water soluble benzodiazepine was also an important event in anesthesia and it can be used as continuous infusion for the anesthesia. Materials and Methods: In this randomized controlled clinical trial, alfentanyl plus propofol or midazolam were used for TIVA anesthesia in 60 female patients undergoing Dilatation and Curettage (D&C in Dr.Shariati hospital in March 2002 till March 2003. They were allocated reandomly in two group of alfentanyl plus propofol (propofol group or alfentanyl plus midazolam (midazolam group Results: There was no significant difference in mean of age between propofol group and midazolam group (P>0.05, also There was no significant difference in preanesthesia condition such as blood pressure and heart rate between propofol group and midazolam group (p>0.05. After induction of anesthesia there was a gross blood pressure decrease in both group that it was greater in midazolam group (85 mmHg versus 73 mmHg, P0.05 also there was just one naloxane injection in midazolam group that have no significant difference between groups (P>0.05. Recovery room stay was significantly lower in propofol group (25 minutes versus 39 minutes, P<0.05. Conclusion: The results of this study was similar to Vuyk et.al.In their study there was a significant lower recovery time estimated by psychomotor reflexes and there was significant lower drowsiness, place and time orientation time compared to midazolam group. Finally according to the results of this study it can be resulted that TIVA with propofol is more suitable than midazolam and it can lower hospitalization time and cost. In future studies

  11. Guidelines for administration of local anesthesia for dermatosurgery and cosmetic dermatology procedures

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    Mysore Venkataram

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Dermatosurgery and Cosmetic dermatology procedures are being performed by increasing number of dermatologists. Most dermatosurgeries are performed in an outpatient setting and as day care surgeries, under local anesthesia. Hence, it is important to improve patient comfort during all procedures. These guidelines seek to lay down directives in the use of local anesthesia, outline the different local anesthetics, the mode of administration, complications arising out of such procedure and management of the same. Facility for administration of local anesthesia: Local anesthesia is usually administered in the dermatologist′s procedure room. The room should be equipped to deal with any emergencies arising from administration of local anesthesia. Qualifications of local anesthesia administrator: Local anesthesia administrator is a person who applies or injects local anesthetic agent for causing analgesia. Procedures done under local anesthesia are classified as Level I office procedures and require the administrator to have completed a course in Basic Cardiac Life Support (BCLS. Evaluation of patients for topical or infiltrative anesthesia: Details of patient′s past medical history and history of medications should be noted. Allergy to any medications should be specifically enquired and documented. Patients for tumescent anesthesia need additional precautions to be observed as described in these guidelines. Methods of administration of local anesthesia: Different methods include topical anesthesia, field block, ring block, local infiltration and nerve block. Also, it includes use of local anesthetics for anesthetizing oral and genital mucosa. Tumescent anesthesia is a special form of local anesthesia used in liposuction and certain selected procedures. Local anesthetic agents: Different local anesthetics are available such as lignocaine, prilocaine, bupivacaine. The dermatologist should be aware of the

  12. Automatic Validation of Protocol Narration

    DEFF Research Database (Denmark)

    Bodei, Chiara; Buchholtz, Mikael; Degano, Pierpablo;

    2003-01-01

    We perform a systematic expansion of protocol narrations into terms of a process algebra in order to make precise some of the detailed checks that need to be made in a protocol. We then apply static analysis technology to develop an automatic validation procedure for protocols. Finally, we...

  13. Comparison of the effects and complications of unilateral spinal anesthesia versus standard spinal anesthesia in lower-limb orthopedic surgery

    Directory of Open Access Journals (Sweden)

    Seyyed Mostafa Moosavi Tekye

    2014-06-01

    Full Text Available Introduction: A restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes. This prospective randomized study compared unilateral and bilateral spinal anesthesia with respect to the intra- and postoperative advantages and complications of each technique. Material and methods: Spinal anesthesia was induced with 0.5% hyperbaric bupivacaine and a 25-G Quincke needle (Dr. J in two groups of patients with physical status ASA I-II who had been admitted for orthopedic surgeries. In group A, dural puncture was performed with the patient in a seated position using 2.5 cm3 of hyperbaric bupivacaine. Each patient was then placed in the supine position. In group B, dural puncture was performed with the patient in the lateral decubitus position with 1.5 cm3 of hyperbaric bupivacaine. The lower limb was the target limb. The speed of injection was 1 mL/30 s, and the duration of time spent in the lateral decubitus position was 20 min. Results: The demographic data were similar in both groups. The time to the onset of the sensory and motor block was significantly shorter in group A (p = 0.00. The duration of motor and sensory block was shorter in group B (p < 0.05. The success rate for unilateral spinal anesthesia in group B was 94.45%. In two patients, the spinal block spread to the non-dependent side. The incidence of complications (nausea, headache, and hypotension was lower in group B (p = 0.02. Conclusion: When unilateral spinal anesthesia was performed using a low-dose, low-volume and low-flow injection technique, it provides adequate sensory-motor block and helps to achieve stable hemodynamic parameters during orthopedic surgery on a lower limb. Patients were more satisfied with this technique as opposed to the conventional approach. Furthermore, this technique avoids unnecessary paralysis on the non-operated side.

  14. Differences between Total Intravenous Anesthesia and Inhalation Anesthesia in Free Flap Surgery of Head and Neck Cancer.

    Directory of Open Access Journals (Sweden)

    Yi-Ting Chang

    Full Text Available Many studies have evaluated risk factors associated with complications after free flap surgery, but these studies did not evaluate the impact of anesthesia management. The goal of the current study was to evaluate the differences between patients who received inhalation and total intravenous anesthesia (TIVA in free flap surgery.One hundred and fifty-six patients who underwent free flap surgery for head and neck cancer were retrospectively divided into the TIVA (96 patients and the inhalation group (87 patients. Perioperative hemodynamic data and postoperative medical complications were determined by documented medical records.Ninety-six patients in the TIVA group were compared with 87 patients who received inhalation anesthesia. There were no differences in gender, age, classification of physical status based on American Society for Anesthesiologists (ASA score, and cormobidities between the two groups. Patients in the TIVA group required less perioperative crystalloid (4172.46 ± 1534.95 vs. 5183.91 ± 1416.40 ml, p < 0.0001 and colloid (572.46 ± 335.14 vs. 994.25 ± 434.65 ml, p < 0.0001 to maintain hemodynamic stability. Although the mean anesthesia duration was shorter in the TIVA group (11.02 ± 2.84 vs. 11.70± 1.96 hours, p = 0.017, the blood loss was similar between groups (p = 0.71. There was no difference in surgical complication rate, but patients in the TIVA group developed fewer pulmonary complications (18 vs. 47, p = 0.0008. After multivariate regression, patients in the TIVA group had a significantly reduced risk of pulmonary complication compared with the inhalation group (Odds ratio 0.41, 95% CI 0.18-0.92.Total intravenous anesthesia was associated with significantly fewer pulmonary complications in patients who received free flap reconstruction.

  15. Effect of hydralazine on duration of soft tissue local anesthesia following dental treatment: a randomized clinical trial.

    Science.gov (United States)

    Fakheran Esfahani, Omid; Pouraboutaleb, Mohammad Fazel; Khorami, Behnam

    2015-01-01

    Prolonged numbness following routine dental treatments can cause difficulties in speaking and swallowing and may result in inadvertent biting of soft tissues. Local injection of vasodilator agents may represent a solution to this problem. The aim of this study was to evaluate the effect of submucosal injection of hydralazine hydrochloride (HCl) on the duration of oral soft tissue anesthesia after routine dental treatment. This randomized, single-blinded, controlled clinical trial included 50 patients who received inferior alveolar nerve block (2% lidocaine with 1:100,000 epinephrine) for simple restorative treatment. Upon completion of the dental treatment, patients randomly received a hydralazine HCl or sham injection in the same site as the local anesthetic injection. The reversal time to normal sensation of soft tissues (lips, tongue, and perioral skin) was evaluated and reported every 5 minutes by the patients, who followed an assessment protocol that they were taught in advance of treatment. Median recovery times in the hydralazine group and the sham group were 81.4 (SD, 3.6) and 221.8 (SD, 6.3) minutes, respectively. Based on Kaplan-Meier survival analysis, the duration of soft tissue anesthesia in the 2 groups was significantly different (P local anesthetic-induced soft tissue numbness and the related functional problems.

  16. Safe extensive tumescent liposuction with segmental infiltration of lower concentration lidocaine under monitored anesthesia care.

    Science.gov (United States)

    Wang, Gang; Cao, Wei-Gang; Li, Sheng-Li; Liu, Li-Na; Jiang, Zhao-Hua

    2015-01-01

    Tumescent anesthesia makes it feasible to perform liposuction in an office setting. There are often patients who desire extensive liposuction on approximately 30% of total body surface area, which means the lidocaine total dose might be over the dosing recommendation. So the segmental infiltration is applied, although the concentration of lidocaine in tumescent fluid is gradually reduced to 0.0252%. Moreover, supplemental intravenous (IV) sedation using monitored anesthesia care is usually applied concurrently to help alleviate discomfort and pain of the patients during tumescent anesthetic infusion and fat extraction which in turn increases the risks of potential lidocaine toxicity due to possible drug interactions. This study was to demonstrate the safety of segmental infiltration of tumescent fluid with lower lidocaine concentration combined with IV sedation in extensive liposuction and determine whether the risk of lidocaine toxicity is increased in this protocol. Ten female patients who requested the extensive liposuction participated in the study. The targeted areas were divided into 2 segments and treated in turn in 1 session. Lidocaine (1600 mg) was infiltrated into the first segment, and approximately 928 mg lidocaine was subsequently infiltrated after accomplishment of the first segment operation. Serum levels of lidocaine were taken every 4 hours during the first 24 hours after the second infiltration. The average time of the procedure is 222 (33) minutes. The dose and total amount of lidocaine injected are 40.7 (5.8) mg/kg and 2528.2 (155.2) mg, respectively. The total volume of the infusates and aspirates are 9918.1 (494) and 6325 (1461.6) mL, respectively, the ratio of total infusates to total aspirates is 1.66 (0.45). The total aspirated fat and fluids are 3280 (1051.8) and 3045 (824.1) mL, respectively. The peak lidocaine levels [2.18 (0.63) μg/mL] occurred after 12 to 20 hours [16.4 (2.27) hours]. No significant correlation between dose per

  17. CT protocol review and optimization.

    Science.gov (United States)

    Kofler, James M; Cody, Dianna D; Morin, Richard L

    2014-03-01

    To reduce the radiation dose associated with CT scans, much attention is focused on CT protocol review and improvement. In fact, annual protocol reviews will soon be required for ACR CT accreditation. A major challenge in the protocol review process is determining whether a current protocol is optimal and deciding what steps to take to improve it. In this paper, the authors describe methods for pinpointing deficiencies in CT protocols and provide a systematic approach for optimizing them. Emphasis is placed on a team approach, with a team consisting of at least one radiologist, one physicist, and one technologist. This core team completes a critical review of all aspects of a CT protocol and carefully evaluates proposed improvements. Changes to protocols are implemented only with consensus of the core team, with consideration of all aspects of the CT examination, including image quality, radiation dose, patient care and safety, and workflow.

  18. FRENCH PROTOCOL CARDS

    CERN Multimedia

    Division des Ressources Humaines; Human Resources Division; Tel. 74683-79494

    2000-01-01

    Senior officials, holders of FRENCH PROTOCOL cards (blue cards) due to expire on 31.12.2000, are requested to return these cards and those of family members, for extension to: Bureau des cartes, Bât 33.1-009/1-015 Should the three spaces for authentication on the back of the card be full, please enclose two passport photographs for a new card. In the case of children aged 14 and over, an attestation of dependency and a school certificate should be returned with the card.

  19. FRENCH PROTOCOL CARDS

    CERN Multimedia

    Division du Personnel

    1999-01-01

    Senior officials, holders of FRENCH PROTOCOL cards (blue cards) due to expire on 31.12.1999, are requested to return these cards and those of family members, for extension to:Bureau des cartes, bâtiment 33.1-025Should the 3 spaces for authentication on the back of the card be full, please enclose 2 passport photographs for a new card.In the case of children aged 14 and over, an attestation of dependency and a school certificate should be returned with the card.Personnel DivisionTel. 79494/74683

  20. The influence of various anesthesia techniques on postoperative recovery and discharge criteria among geriatric patients

    Directory of Open Access Journals (Sweden)

    Dilsen Ornek

    2010-01-01

    Full Text Available OBJECTIVE: We aim to compare selective spinal anesthesia and general anesthesia with regard to postoperative recovery and fast-track eligibility in day surgeries. MATERIALS AND METHOD: Sixty geriatric outpatient cases, with ASA II-III physical status and requiring shortduration transurethral intervention, were enrolled in the study. The cases were split into 2 groups: as general anesthesia (Group GA and selective spinal anesthesia (Group SSA. Group GA (n = 30 received propofol 2 mg kg-1 (until loss of eyelash reflex, remifentanil induction 0.5-1 µg kg-1, and laryngeal mask. Maintenance was achieved by 4-6% desflurane in 60% N2O and 40% O2 along with remifentanil infusion at 0.05 µg /kg-1 /min-1. Drugs were discontinued after the withdrawal of the ureteroscope, and extubation was carried out with 100% O2. Group SSA (n = 30 received 0.5% spinal anesthesia via L4-5 space by 0.5% hyperbaric bupivacaine 5 mg. Anesthesia preparation time, time to surgical anesthesia level, postoperative fast-tracking, and time to White-Song recovery score of 12, were noted. In the operating room, we evaluated hemodynamics, nausea/vomiting, surgeon and patient satisfaction with anesthesia, perioperative midazolam-fentanyl administration, postoperative pain, and discharge time. RESULTS: Anesthesia preparation time, length of surgery, anesthesia-related time in the operating room, time to sit, and time to walk were significantly low in Group GA (p < 0.05, whereas time to fast-track eligibility, length of stay in the PACU, discharge time, and other parameters were similar in both of the groups. CONCLUSION: While anesthesia preparation time, length of surgery, start time of surgery, time to sit, and time to walk were shorter in the General Anesthesia group, time to fast-track eligibility, phase 1 recovery time, and discharge time were similar among patients subjected to selective spinal anesthesia.

  1. Anesthesia in a patient with Stiff Person Syndrome.

    Science.gov (United States)

    Yagan, Ozgur; Özyilmaz, Kadir; Özmaden, Ahmet; Sayin, Özgür; Hanci, Volkan

    2016-01-01

    Stiff Person Syndrome (SPS), typified by rigidity in muscles of the torso and extremities and painful episodic spasms, is a rare autoimmune-based neurological disease. Here we present the successful endotracheal intubation and application of TIVA without muscle relaxants on an SPS patient. A 46 years old male patient was operated with ASA-II physical status because of lumber vertebral compression fracture. After induction of anesthesia using lidocaine, propofol and remifentanil tracheal intubation was completed easily without neuromuscular blockage. Anesthesia was maintained with propofol, remifentanil and O2/air mixture. After a problem-free intraoperative period the patient was extubated and seven days later was discharged walking with aid. Though the mechanism is not clear neuromuscular blockers and volatile anesthetics may cause prolonged hypotonia in patients with SPS. We think the TIVA technique, a general anesthetic practice which does not require neuromuscular blockage, is suitable for these patients.

  2. [Risk management in anesthesia and critical care medicine].

    Science.gov (United States)

    Eisold, C; Heller, A R

    2017-02-16

    Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are continuing staff education, algorithms and standard operating procedures (SOP), working according to the principles of crisis resource management (CRM) and last but not least the continuous work-up of mistakes identified by critical incident reporting systems.

  3. Mortality incidence in outpatient anesthesia for dentistry in Ontario.

    Science.gov (United States)

    Nkansah, P J; Haas, D A; Saso, M A

    1997-06-01

    Studies determining anesthesia mortality rates in dentistry have been published, yet a similar investigation has never been conducted in Canada. Therefore the objective of this study was to determine the incidence of mortality when general anesthesia or deep sedation was administered by qualified dentists in the province of Ontario. Mortality data were obtained from the years 1973 to 1995 inclusive. The number of general anesthetics and deep sedations administered annually by qualified in dental offices was calculated by surveying all oral and maxillofacial surgeons and dental anesthetists in Ontario in 1990 and 1995. The results provided an estimate of 2,830,000 cases from 1973 to 1995 inclusive. Over this time period there were four deaths associated with cases in which either an oral and maxillofacial surgeon or dental anesthetist administered the general anesthetic or deep sedation, yielding a mortality rate of 1.4 per 1,000,000. This mortality incidence is similar to rates already published for outpatient dentistry.

  4. [Value of flexible fiberoptic bronchoscopy under local anesthesia in infants].

    Science.gov (United States)

    Bodart, E; De Lange, M; Vliers, A

    1993-06-01

    From October 1991 through April 1992, 16 infants aged 5 to 25 months (mean age 14.3 months) underwent bronchoscopy with a flexible fiberoptic bronchoscope, under local anesthesia. The technique is described in detail. Reasons for bronchoscopy included recurrent or persistent pneumonia (n = 4), persistent atelectasia (n = 4), lymphadenopathy and/or airway compression (n = 2), suspected foreign body (n = 2), bronchoalveolar lavage to investigate diffuse interstitial lung disease (n = 2), and severe recurrent wheezing (n = 2). The procedure established the accurate diagnosis in 14 cases. Adverse events (32%) were minor (transient hypoxia, n = 3; moderate fever, n = 1; and laryngospasm, n = 1) and resolved completely. Flexible fiberoptic bronchoscopy under local anesthesia is a simple procedure which is safe in patients under 30 months of age when performed by a experienced operator in an adequate facility. This method is useful for the diagnosis and/or treatment of a broad spectrum of conditions.

  5. Hyperkalemic periodic paralysis episode during halothane anesthesia in a horse.

    Science.gov (United States)

    Bailey, J E; Pablo, L; Hubbell, J A

    1996-06-01

    A 7-month-old Quarter Horse filly was admitted for surgical repair of a right olecranon fracture. Anesthesia was achieved with xylazine hydrochloride, guaifenesin, ketamine hydrochloride, and halothane. Two and a half hours after induction of anesthesia, myotonia, muscle fasciculations, and sweating, concurrent with high serum potassium concentration and associated electrocardiographic changes consistent with hyperkalemic periodic paralysis, were observed. Treatment included intermittent positive-pressure ventilation, changing intravenous administration of fluids from lactated Ringer's solution to 0.9% NaCl solution, and administration of calcium gluconate, glycopyrrolate, dopamine, and sodium bicarbonate. Clinical signs resolved with the return of serum potassium concentrations to the reference range. The horse was confirmed to be heterozygous for hyperkalemic periodic paralysis by DNA testing.

  6. Impact of a patient safety curriculum for nurse anesthesia students.

    Science.gov (United States)

    Ardizzone, Laura L; Enlow, William M; Evanina, Eileen Y; Schnall, Rebecca; Currie, Leanne

    2009-12-01

    Patient safety has become an important aspect of national health care initiatives. The purpose of this evaluation was to measure the impact of a patient safety education series for students enrolled in a nurse anesthesia program. Baseline surveys that measured patient safety competencies across three domains, attitudes, skills and knowledge, were administered to the students. A patient safety education series was delivered to the cohort and the survey was then readministered. Mean scores were compared using independent samples t tests. Attitude scores did not change from baseline to posttest. Participants scored higher on posttest means for both the patient safety skills and knowledge domains. Incorporating patient safety content into the nurse anesthesia master's degree curriculum may enhance clinicians' skills and knowledge related to patient safety, and the addition of a patient safety curriculum is important during the formative education process.

  7. Medication error report: Intrathecal administration of labetalol during obstetric anesthesia

    Directory of Open Access Journals (Sweden)

    Baisakhi Laha

    2015-01-01

    Full Text Available Labetalol, a combined alfa and beta-adrenergic receptor antagonist, is used as an antihypertensive drug. We report a case of an acute rise in blood pressure and lower limb pain due to the inadvertent intrathecal administration of labetalol, mistaking it for bupivacaine, during obstetric anesthesia. The situation was rescued by converting to general anesthesia. The cesarean delivery was uneventful, and mother as well as newborn child showed no ill-effect. This particular medication error was attributable to a failure on the part of the doctors administering the injection to read and cross-check medication labels and the practice of keeping multiple injections together. In the absence of an organized medication error reporting system and action on that basis, such events may recur in future.

  8. Nerves and Anesthesia: A physics perspective on medicine

    CERN Document Server

    Heimburg, Thomas

    2014-01-01

    We present a recent theory for nerve pulse propagation and anesthesia and argue that both nerve activity and the action of anesthetics can be understood on the basis of simple physical laws. It was found experimentally that biological membranes melt from a solid state to a liquid state just below physiological temperature. Such melting processes have a profound influence on the physical properties of cell membranes. They make it possible for mechanical pulses (solitons) to travel along nerve axons. In these pulses, a region of solid phase travels in the liquid nerve membrane. These pulses display many properties associated with the action potential in nerves. Both general and local anesthetics lower melting temperatures of membranes. Thus, they make it more difficult to excite the nerve membrane. Since hydrostatic pressure increases melting temperatures, it counteracts anesthesia. This theory has the virtue of providing a simple explanation of the famous Meyer-Overton correlation, which states that the effect...

  9. Anesthesia for patients with renal/hepatic disease.

    Science.gov (United States)

    Weil, Ann B

    2010-05-01

    General anesthesia may be necessary for patients with significant disease processes such as renal disease or hepatic disease. A basic understanding of the effects of general anesthetics on these organs and the anticipated problems of renal and hepatic impairment on the anesthetic process is necessary to optimize conditions for patients with renal or hepatic disease. Patient preparation, drug selection, and monitoring strategies will be discussed for patients with renal and liver disease.

  10. Transient Oliguria during Anesthesia in Cerebral Salt Wasting Syndrome

    OpenAIRE

    Lee, Kwang Ho; Park, Jong Taek; Cho, Dong Woo; Song, Seung Woo; Lim, Hyun Kyo

    2016-01-01

    Cerebral salt wasting syndrome is a hyponatremic and hypovolemic condition caused by intracranial disorders, such as head injury, subarachnoid hemorrhage, brain tumor, and brain operations. We report a case of a 5-year-old girl that had cerebral salt wasting syndrome with marked polyuria who showed transient oliguria during general anesthesia. The patient had undergone an operation for traumatic intracranial hemorrhage three months prior and has had marked polyuria and hyponatremia since then...

  11. Exposure to ketamine anesthesia affects rat impulsive behavior

    Directory of Open Access Journals (Sweden)

    António Melo

    2016-11-01

    Full Text Available Introduction: Ketamine is a General Anesthetic that activates several neurotransmitter pathways in various part of the brain. The acute effects as general anesthetic are the most well-known and sought-after: to induce loss of responsiveness and to produce immobility during invasive procedures. However, there is a concern that repeated exposure might induce behavioral changes that could outlast their acute effect. Most research in this field describes how GA affects cognition and memory. Our work is to access if general anesthesia with ketamine can disrupt the motivational behaviour trait, more specifically measuring impulsive behaviour.Methods: With the aim to evaluate the effects of exposure to repeat anesthetic procedures with ketamine in motivational behavior, we tested animals in a paradigm of impulsive behavior, the Variable Delay-to-Signal (VDS. In addition, accumbal and striatal medium spiny neurons morphology was assessed. Results: Our results demonstrated that previous exposure to ketamine deep-anesthesia affects inhibitory control (impulsive behavior. Specifically, ketamine exposed animals maintain a subnormal impulsive rate in the initial periods of the delays. However, and in longer delays while control animals progressively refrain their premature unrewarded actions, ketamine-exposed animals show a different profile of response with higher premature unrewarded actions in the last seconds. Animals exposed to multiple ketamine anesthesia also failed to show an increase in premature unrewarded actions between the initial and final periods of 3s delays. These behavioral alterations are paralleled by an increase in dendritic length of medium spiny neurons of the nucleus accumbens.Conclusions: This demonstrates that ketamine anesthesia acutely affects impulsive behavior. Interestingly, it also opens up the prospect of using ketamine as an agent with the ability to modulate impulsivity trait.

  12. An update on local anesthesia for pediatric dental patients

    OpenAIRE

    Peedikayil, Faizal C.; Vijayan, Ajoy

    2013-01-01

    Pain control is an important part of dentistry, particularly in the management of children. Behavior guidance, and dose and technique of administration of the local anesthetic are important considerations in the successful treatment of a pediatric patient. The purpose of the present review is to discuss the relevant data on topics involved, and on the current methods available in the administration of local anesthesia used for pediatric dental patients.

  13. Local anesthesia selection algorithm in patients with concomitant somatic diseases.

    Science.gov (United States)

    Anisimova, E N; Sokhov, S T; Letunova, N Yu; Orekhova, I V; Gromovik, M V; Erilin, E A; Ryazantsev, N A

    2016-01-01

    The paper presents basic principles of local anesthesia selection in patients with concomitant somatic diseases. These principles are history taking; analysis of drugs interaction with local anesthetic and sedation agents; determination of the functional status of the patient; patient anxiety correction; dental care with monitoring of hemodynamics parameters. It was found that adhering to this algorithm promotes prevention of urgent conditions in patients in outpatient dentistry.

  14. Mechanical ventilation and respiratory mechanics during equine anesthesia.

    Science.gov (United States)

    Moens, Yves

    2013-04-01

    The mechanical ventilation of horses during anesthesia remains a crucial option for optimal anesthetic management, if the possible negative cardiovascular side effects are managed, because this species is prone to hypercapnia and hypoxemia. The combined use of capnography and pitot-based spirometry provide complementary information on ventilation and respiratory mechanics, respectively. This facilitates management of mechanical ventilation in conditions of changing respiratory system compliance (ie, laparoscopy) and when investigating new ventilatory strategies including alveolar recruitment maneuvers and optimization of positive expiratory pressure.

  15. Anecdotes from the history of anesthesia in dentistry.

    OpenAIRE

    Trieger, N.

    1995-01-01

    I believe that dentists have made important contributions to anesthesiology and patient care. Medical anesthesiology is now being required to provide more same-day or ambulatory care. Where it was once good sport to criticize dentists providing brief anesthesia services for their patients, it has now become appropriate for physician anesthesiologists to use shorter-acting agents, improved physiologic monitoring, reversal agents, and early discharge as part of their care of patients. Anecdotes...

  16. Postoperative rhabdomyolysis following pars-plana vitrectomy under general anesthesia

    OpenAIRE

    Campbell JP; Soelberg C; Lauer AK

    2013-01-01

    John P Campbell,1 Cobin Soelberg,2 Andreas K Lauer11Retina Division, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA; 2Division of Anesthesiology, Oregon Health and Science University, Portland, OR, USAImportance: Rhabdomyolysis is a known, but rare, complication of general anesthesia. To the authors' knowledge, it has never before been reported following an ocular surgery, and we could find no similar cases in the surgical literature following any brief s...

  17. Postoperative rhabdomyolysis following pars-plana vitrectomy under general anesthesia

    Directory of Open Access Journals (Sweden)

    Campbell JP

    2013-08-01

    Full Text Available John P Campbell,1 Cobin Soelberg,2 Andreas K Lauer11Retina Division, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA; 2Division of Anesthesiology, Oregon Health and Science University, Portland, OR, USAImportance: Rhabdomyolysis is a known, but rare, complication of general anesthesia. To the authors' knowledge, it has never before been reported following an ocular surgery, and we could find no similar cases in the surgical literature following any brief surgical procedure. We believe this case to be unique in those regards and aim to raise awareness among ophthalmologists of this postoperative complication, as timely intervention can prevent renal failure and death.Observations: We report the case of a 58-year-old male who developed rhabdomyolysis following vitrectomy for retinal detachment repair under general anesthesia. The patient had several risk factors for this complication including morbid obesity, type II diabetes mellitus, and American Society of Anesthesia class III risk profile. His postoperative course was notable for significant myalgias in the postoperative recovery area, followed several hours later by oliguria, "root beer" colored urine, and a markedly elevated creatinine kinase level. He was hospitalized for two days for intravenous hydration and monitoring of his renal function and has fully recovered.Relevance: As the prevalence of obesity and type II diabetes mellitus increase worldwide, ophthalmologists need to be aware of the signs and symptoms of postoperative rhabdomyolysis. Treatment often requires inpatient hospitalization to prevent the associated morbidity and mortality.Keywords: rhabdomyolysis, general anesthesia, vitrectomy, retinal detachment, obesity, diabetes

  18. Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kongsap P

    2012-11-01

    Full Text Available Pipat KongsapDepartment of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandPurpose: To evaluate the effectiveness of subconjunctival anesthesia as compared to retrobulbar anesthesia for pain control during manual small-incision cataract surgery (MSICS performed by third-year residents.Design: A randomized, controlled trial.Patients and methods: A total of 150 patients undergoing routine cataract surgery were randomly assigned to receive either subconjunctival anesthesia (group 1, n = 75 or retrobulbar anesthesia (group 2, n = 75. Third-year residents performed MSICS using the modified Blumenthal technique. Subconjunctival anesthesia was administered by injecting 2% xylocaine with adrenalin into the superior conjunctiva, and retrobulbar anesthesia by injecting 2 mL of 2% xylocaine with adrenalin into the retrobulbar space. We studied the following variables: intraoperative pain score rated on a 100-point visual analog scale (VAS, operative time, and injection and operative complications.Results: A mean age of 69 vs 70 years, an operative time of 47.1 (SD, 9.9 min vs 47.7 (10.9 min, and a median (interquartile range pain score of 40 (range, 20–70 vs 40 (range, 20–50 were observed in the subconjunctival and the retrobulbar groups, respectively. The injection complication of subconjunctival hemorrhage was significantly higher in the subconjunctival group (25.3% compared to the retrobulbar group (1.3%. The operative complication rate between groups was not different (P > 0.05.Conclusion: Both, superior subconjunctival anesthesia and retrobulbar anesthesia were effective during MSICS when used in a residency training program.Keywords: subconjunctival anesthesia, retrobulbar anesthesia, cataract surgery, small-incision cataract surgery, visual analog scale, pain score

  19. Alternating-pulse iontophoresis for targeted cutaneous anesthesia

    Science.gov (United States)

    Meyer, Peter F.; Oddsson, Lars I E.

    2003-01-01

    In studies of sensory contributions to motor control, it may be advantageous to temporarily reduce the sensitivity of specific sensory systems. This article details a method for non-invasively inducing cutaneous anesthesia, leaving proprioceptive and motor functions intact. This method, called alternating-pulse iontophoresis, differs from conventional direct-current (DC) iontophoretic drug delivery in that adjacent drug delivery electrodes are stimulated out-of-phase. The total current delivered at any instant is then less than that produced during a comparable DC application, while the uniformity of drug delivery is expected to improve. Effective delivery of local anesthetics to the cutaneous foot soles by alternating-pulse iontophoresis was demonstrated using cutaneous pressure sensory threshold levels (STL's) assessed with Semmes-Weinstein monofilaments (arbitrary units of perceived force, or a.u.). Thirteen of 16 healthy subjects achieved a level of anesthesia greater than or equal to that normally associated with clinical peripheral sensory neuropathy. Average STL's measured prior to the anesthesia procedure were 4.00 a.u. ( approximately 10 mN). Immediately following the procedure, STL's were elevated to an average of 5.40 a.u. ( approximately 246 mN) and averaged 4.97 a.u. ( approximately 92 mN) after 50 min of standing. A number of research and clinical applications for this technique are suggested.

  20. Anesthesia and cancer recurrences: The current knowledge and evidence

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available Surgical removal of solid tumors is of utmost importance as total resection can be curative. The surgical insult however itself may result in tumor micrometastasis coupled with depression of cell-mediated immunity culminating in tumor recurrence. Recent research suggests that few anesthetic agents or procedures can influence pathophysiology of metastasis in the postoperative period. Whereas opioids and volatile anesthetics have been implicated in angiogenesis and immunosuppression, evidences accumulated over the recent years have undoubtedly highlighted the attenuation of immunosuppression by regional anesthetic agents thereby making it superior over general anesthesia in preventing cancer recurrence. As anesthetic drugs are given at that time when patient is at the maximum risk of spread of metastasis, thus an understanding of the effect of anesthesia drugs and their impact on tumor metastasis is important so that appropriate anesthetic strategy can be made to improve long term survival in these patients. The purpose of the present review is therefore to emphasize the pivotal role of various anesthetic agents and anesthesia techniques in preventing tumor recurrence after surgery.

  1. Endocrinopathies: The current and changing perspectives in anesthesia practice

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Kaur, Gurpreet

    2015-01-01

    The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer. PMID:26180760

  2. Anesthesia for thoracic surgery: A survey of middle eastern practice

    Directory of Open Access Journals (Sweden)

    Abdelazeem Eldawlatly

    2012-01-01

    Full Text Available Purpose: The main objective of this survey is to describe the current practice of thoracic anesthesia in the Middle Eastern (ME region. Methods: A prospective online survey. An invitation to participate was e-mailed to all members of the ME thoracic-anaesthesia group. A total of 58 members participated in the survey from 19 institutions in the Middle East. Questions concerned ventilation strategies during one-lung ventilation (OLV, anesthesia regimen, mode of postoperative analgesia, use of lung isolation techniques, and use of i.v. fluids. Results: Volume-controlled ventilation was favored over pressure-controlled ventilation (62% vs 38% of respondents, P<0.05; 43% report the routine use of positive end-expiratory pressure. One hundred percent of respondents report using double-lumen tube (DLT as a first choice airway to establish OLV. Nearly a third of respondents, 31.1%, report never using bronchial blocker (BB in their thoracic anesthesia practice. Failure to pass a DLT and difficult airway are the most commonly cited indications for BB use. Regarding postoperative analgesia, the majority 61.8% favor thoracic epidural analgesia over other techniques (P<0.05. Conclusions: Our survey provides a contemporary snapshot of the ME thoracic anesthetic practice.

  3. Paperless anesthesia: uses and abuses of these data.

    Science.gov (United States)

    Anderson, Brian J; Merry, Alan F

    2015-12-01

    Demonstrably accurate records facilitate clinical decision making, improve patient safety, provide better defense against frivolous lawsuits, and enable better medical policy decisions. Anesthesia Information Management Systems (AIMS) have the potential to improve on the accuracy and reliability of handwritten records. Interfaces with electronic recording systems within the hospital or wider community allow correlation of anesthesia relevant data with biochemistry laboratory results, billing sections, radiological units, pharmacy, earlier patient records, and other systems. Electronic storage of large and accurate datasets has lent itself to quality assurance, enhancement of patient safety, research, cost containment, scheduling, anesthesia training initiatives, and has even stimulated organizational change. The time for record making may be increased by AIMS, but in some cases has been reduced. The question of impact on vigilance is not entirely settled, but substantial negative effects seem to be unlikely. The usefulness of these large databases depends on the accuracy of data and they may be incorrect or incomplete. Consequent biases are threats to the validity of research results. Data mining of biomedical databases makes it easier for individuals with political, social, or economic agendas to generate misleading research findings for the purpose of manipulating public opinion and swaying policymakers. There remains a fear that accessibility of data may have undesirable regulatory or legal consequences. Increasing regulation of treatment options during the perioperative period through regulated policies could reduce autonomy for clinicians. These fears are as yet unsubstantiated.

  4. Evolution of Electroencephalogram Signal Analysis Techniques during Anesthesia

    Directory of Open Access Journals (Sweden)

    Mahmoud I. Al-Kadi

    2013-05-01

    Full Text Available Biosignal analysis is one of the most important topics that researchers have tried to develop during the last century to understand numerous human diseases. Electroencephalograms (EEGs are one of the techniques which provides an electrical representation of biosignals that reflect changes in the activity of the human brain. Monitoring the levels of anesthesia is a very important subject, which has been proposed to avoid both patient awareness caused by inadequate dosage of anesthetic drugs and excessive use of anesthesia during surgery. This article reviews the bases of these techniques and their development within the last decades and provides a synopsis of the relevant methodologies and algorithms that are used to analyze EEG signals. In addition, it aims to present some of the physiological background of the EEG signal, developments in EEG signal processing, and the effective methods used to remove various types of noise. This review will hopefully increase efforts to develop methods that use EEG signals for determining and classifying the depth of anesthesia with a high data rate to produce a flexible and reliable detection device.

  5. Evolution of electroencephalogram signal analysis techniques during anesthesia.

    Science.gov (United States)

    Al-Kadi, Mahmoud I; Reaz, Mamun Bin Ibne; Ali, Mohd Alauddin Mohd

    2013-05-17

    Biosignal analysis is one of the most important topics that researchers have tried to develop during the last century to understand numerous human diseases. Electroencephalograms (EEGs) are one of the techniques which provides an electrical representation of biosignals that reflect changes in the activity of the human brain. Monitoring the levels of anesthesia is a very important subject, which has been proposed to avoid both patient awareness caused by inadequate dosage of anesthetic drugs and excessive use of anesthesia during surgery. This article reviews the bases of these techniques and their development within the last decades and provides a synopsis of the relevant methodologies and algorithms that are used to analyze EEG signals. In addition, it aims to present some of the physiological background of the EEG signal, developments in EEG signal processing, and the effective methods used to remove various types of noise. This review will hopefully increase efforts to develop methods that use EEG signals for determining and classifying the depth of anesthesia with a high data rate to produce a flexible and reliable detection device.

  6. Evaluation of Bacterial Contamination in Anesthesia Breathing Circuits

    Directory of Open Access Journals (Sweden)

    F Farnia

    2007-07-01

    Full Text Available Introduction : Hospital infections are one of the important reasons of mortality and incurred expenses. Therefore, we must control these infections by identifying contamination sources. The aim of this study was the determination of bacterial pollution of corrugated anesthesia sets in surgical rooms. Methods: This study was an analytic-description one performed in training hospitals of Yazd city. Research sample was 440 cases provided from different parts of corrugate after completing the anesthesia period by wet sterile swabs and transferred to culture media. On Thursday, each week, a sample from different parts of tube after sterilizing with cetrimide solution was obtained. Finally, after 24 hours, culture medias were studied for colony growth. Results: Obtained results indicated that of 440 cases taken samples, 343 cases were without bacterial pollution, 71 cases (19.29% had bacterial pollution of samples before sterilizing and 26 cases (36.1% were polluted after tube sterilizing. Conclusion: Sampling and culturing from used equipment and tools in hospital is one of the important actions for identifying and controlling hospital infections. Obtained results from this study indicated that of 440 cases, there were 97 cases of pollution. Therefore, it is suggested that anti bacterial filters should be installed before Y form piece of tubes in anesthesia machines and disposable corrugated tubes should replace traditional tubes. In addition, it seems necessary that wider investigations should be done.

  7. Achieving pulpal anesthesia with a topical anesthetic paste

    Directory of Open Access Journals (Sweden)

    Bradley Carn

    2015-01-01

    Full Text Available Aim: The efficacy of a topically applied formulation of tetracaine base (6% was investigated against benzocaine in achieving pulpal anesthesia in a randomized, placebo-controlled, double-blind study. Materials and Methods: Subjects′ baseline pulpal responses to an electric pulp tester were measured, followed by a 10 min application of either tetracaine anesthetic paste (TAP, benzocaine (20%, or placebo. Treatments were removed and pulp testing was performed at 10 min, 15 min, and 20 min postapplication. Results: TAP produced significant pulpal anesthesia at 184% ± 7.2% above baseline versus 14% ± 1.7% above baseline for benzocaine at 15 min (P < 0.03. Differences between treatments were tested with the Wilcoxon test and the Steel-Dwass test, which is the nonparametric version of the all-pairs Tukey′s honestly significant difference test. Conclusion: Achieving profound anesthesia with a topical anesthetic paste could lead to injection less procedure, improved postsurgical incisional pain management, and ameliorate pain associated with a variety of lesions.

  8. Ketamine and midazolam anesthesia in Pacific martens (Martes caurina).

    Science.gov (United States)

    Mortenson, Jack A; Moriarty, Katie M

    2015-01-01

    Abstract The use of midazolam as a tranquilizer for anesthesia in mustelids in conjunction with the cyclohexamine ketamine is not well documented. Because midazolam is fast acting, inexpensive, and quickly metabolized, it may serve as a good alternative to other more commonly used tranquilizers. We trapped and anesthetized 27 Pacific martens (Martes caurina) in Lassen National Forest (northern California, US) August 2010-April 2013. We assessed anesthesia with ketamine at 18 and 25 mg/kg combined with 0.2 mg/kg of midazolam by comparing mean times of induction, return to consciousness, and recovery, plus physiologic parameters. No reversal was used for the midazolam portion of the anesthetic. Mean (±SD) induction for both ketamine dosages was 1.7±0.5 and 1.8±1.0 min, respectively. Return to consciousness mean times were 8.0 min longer (Pmidazolam provided reliable field anesthesia for Pacific martens, and supplemental oxygen is recommended as needed.

  9. Endocrinopathies: The current and changing perspectives in anesthesia practice

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer.

  10. Propofol for Anesthesia and Postoperative Sedation Resulted in Fewer Inflammatory Responses than Sevoflurane Anesthesia and Midazolam Sedation after Thoracoabdominal Esophagectomy.

    Science.gov (United States)

    Nakanuno, Ryuichi; Yasuda, Toshimichi; Hamada, Hiroshi; Yoshikawa, Hiroshi; Nakamura, Ryuji; Saeki, Noboru; Kawamoto, Masashi

    2015-09-01

    Responses to surgical stress can be modulated by anesthetics. We prospectively compared the effects of two different anesthetic/sedative techniques on the peak postoperative bladder temperature (BT) and the postoperative C-reactive protein (CRP) level. Twenty patients who were scheduled to undergo elective thoracoabdominal esophagectomy were allocated to receive either propofol anesthesia followed by propofol sedation (PP group, n = 10) or sevoflurane anesthesia followed by midazolam sedation (SM group, n = 10). In each case, the patient's peak bladder temperature was measured on the morning after surgery, and their serum CRP levels were assessed on postoperative days (POD) 1, 2, and 3. The patients' postoperative clinical courses were also evaluated. The peak postoperative BT (degrees C) (37.6 ± 0.4 vs. 38.2 ± 0.6, respectively; p midazolam sedation.

  11. BEST-PRACTICE GUIDELINES FOR FIELD-BASED SURGERY AND ANESTHESIA OF FREE-RANGING WILDLIFE. I. ANESTHESIA AND ANALGESIA.

    Science.gov (United States)

    Chinnadurai, Sathya K; Strahl-Heldreth, Danielle; Fiorello, Christine V; Harms, Craig A

    2016-04-01

    Field anesthesia is often necessary for both invasive and noninvasive procedures on wild animals. We describe basic principles of safe anesthetic delivery, monitoring, and recovery for application in procedures involving free-ranging wildlife. For invasive procedures, the potential for immediate and lasting pain must be addressed and appropriate analgesia provided. In situations where the minimum standard of safe anesthesia and effective analgesia cannot be provided, the investigator and approving bodies should rigorously evaluate the risk to the patient against the value of the data obtained. This document is intended to serve as a resource for Institutional Animal Care and Use Committees, biologists, veterinarians, and other researchers planning projects that involve free-ranging wildlife in field conditions.

  12. Inhibitory effect of pentobarbital anesthesia on venous stasis induced arteriolar vasoconstriction in the dog hindleg

    DEFF Research Database (Denmark)

    Bülow, J; Henriksen, O; Amtorp, Ole

    1984-01-01

    venous stasis. In another experimental series the effect of general pentobarbital anesthesia on the vasoconstrictor activity in response to venous stasis locally in subcutaneous and muscle tissue in the hind limb was examined in 6 dogs. It was found that during the first 2-3 h of anesthesia...... the vasoconstrictor response was present in both tissues although the response in muscle tissue exhibited a great variation between the dogs during this period. However, after 4-5 h of anesthesia the response was abolished in both tissues. During neurolept anesthesia with fentanyl/N2O the same vasoconstrictor...... response was demonstrated in the hindleg 1 h and 5 h after induction of the anesthesia. It is concluded that pentobarbital anesthesia abolishes the arteriolar constriction induced by venous stasis. The mechanism may be blockade of the local sympathetic vasoconstrictor fibres or interference with myogenic...

  13. Laparoscopic cholecystectomy under continuous spinal anesthesia in a patient with Steinert's disease

    Directory of Open Access Journals (Sweden)

    Mariana Correia

    2016-04-01

    Full Text Available ABSTRACT Steinert's disease is an intrinsic disorder of the muscle with multisystem manifestations. Myotonia may affect any muscle group, is elicited by several factors and drugs used in general anesthesia like hypnotics, sedatives and opioids. Although some authors recommend the use of regional anesthesia or combined anesthesia with low doses of opioids, the safest anesthetic technique still has to be established. We performed a continuous spinal anesthesia in a patient with Steinert's disease undergoing laparoscopic cholecystectomy using 10 mg of bupivacaine 0.5% and provided ventilatory support in the perioperative period. Continuous spinal anesthesia was safely used in Steinert's disease patients but is not described for laparoscopic cholecystectomy. We reported a continuous spinal anesthesia as an appropriate technique for laparoscopic cholecystectomy and particularly valuable in Steinert's disease patients.

  14. Total Intravenous Anesthesia Including Ketamine versus Volatile Gas Anesthesia for Combat-related Operative Traumatic Brain Injury

    Science.gov (United States)

    2008-07-01

    Anesthesiology 2008; 109:44–53 Copyright © 2008, the American Society of Anesthesiologists , Inc. Lippincott Williams & Wilkins, Inc. Total...Health Sciences Center San Antonio, Texas. † Director, Tri-Services Anesthesia Re- search Group Initiative on TIVA (TARGIT), Anesthesiologist , Brooke...in the United States: A public health perspective. J Head Trauma Rehabil 1999; 14:602–15 5. Finkelstein EA, Corso PS, Miller TR: The Incidence and

  15. MR arthrography of the shoulder: Do we need local anesthesia?

    Energy Technology Data Exchange (ETDEWEB)

    Spick, Claudio, E-mail: claudio.spick@meduniwien.ac.at [Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090 Vienna (Austria); Szolar, Dieter H.M.; Reittner, Pia; Preidler, Klaus W.; Tillich, Manfred [Diagnostikum Graz-Südwest, Weblinger Guertel 25, 8054 Graz (Austria)

    2014-06-15

    Purpose: To assess pain intensity with and without subcutaneous local anesthesia prior to intraarticular administration of contrast medium for magnetic resonance arthrography (MRa) of the shoulder. Materials and methods: This single-center study was conducted after an IRB waiver of authorization, between January 2010 and December 2012. All patients provided written, informed consent for the procedure. Our prospectively populated institutional database was searched, based on our inclusion criteria. There were 249 outpatients (178 men and 71 women; mean age, 44.4 years ± 14.6; range, 15–79) who underwent MRa and were enrolled in this study. Patients were excluded if they had received surgery of the shoulder before MRa, had undergone repeated MRa of the same shoulder, and/or had undergone MRa of both shoulders on the same day. Patients were randomly assigned into one of three groups. Patients in group A (n = 61) received skin infiltration with local anesthesia. Patients in control group B (n = 92) and group C (n = 96) did not receive local anesthesia. Pain levels were immediately assessed after the injection for MRa using a horizontal visual analog scale (VAS) that ranged from 0 to 10. To compare the pain scores of the three groups for male and female patients, a two-way analysis of variance was used. A p-value equal to or less than 0.05 was considered to indicate a significant result. Results: Patients who received local anesthesia (group A) showed a mean pain level on the VAS of 2.6 ± 2.3. In patients who did not receive local anesthetics (groups B and C), a mean pain level on the VAS of 2.6 ± 2.2 and 2.7 ± 2.4 were detected, respectively. Between the three groups, no statistically significant difference in pain intensity was detected (p = .960). There were significant differences in subjective pain perception between men and women (p = .009). Moreover, the sex difference in all three groups was equal (p = .934). Conclusion: Local anesthesia is not required to

  16. Stream Control Transmission Protocol Steganography

    CERN Document Server

    Fraczek, Wojciech; Szczypiorski, Krzysztof

    2010-01-01

    Stream Control Transmission Protocol (SCTP) is a new transport layer protocol that is due to replace TCP (Transmission Control Protocol) and UDP (User Datagram Protocol) protocols in future IP networks. Currently, it is implemented in such operating systems like BSD, Linux, HP-UX or Sun Solaris. It is also supported in Cisco network devices operating system (Cisco IOS) and may be used in Windows. This paper describes potential steganographic methods that may be applied to SCTP and may pose a threat to network security. Proposed methods utilize new, characteristic SCTP features like multi-homing and multistreaming. Identified new threats and suggested countermeasures may be used as a supplement to RFC 5062, which describes security attacks in SCTP protocol and can induce further standard modifications.

  17. Protocols for Scholarly Communication

    CERN Document Server

    Pepe, Alberto; Pepe, Alberto; Yeomans, Joanne

    2007-01-01

    CERN, the European Organization for Nuclear Research, has operated an institutional preprint repository for more than 10 years. The repository contains over 850,000 records of which more than 450,000 are full-text OA preprints, mostly in the field of particle physics, and it is integrated with the library's holdings of books, conference proceedings, journals and other grey literature. In order to encourage effective propagation and open access to scholarly material, CERN is implementing a range of innovative library services into its document repository: automatic keywording, reference extraction, collaborative management tools and bibliometric tools. Some of these services, such as user reviewing and automatic metadata extraction, could make up an interesting testbed for future publishing solutions and certainly provide an exciting environment for e-science possibilities. The future protocol for scientific communication should naturally guide authors towards OA publication and CERN wants to help reach a full...

  18. A PROGRAMMED LABOUR - PROTOCOL

    Directory of Open Access Journals (Sweden)

    Savita

    2014-12-01

    Full Text Available A Prospective randomized Clinical study of outcome of labour following. “A Programmed labour. Protocol” was done at Department of OBG, MRMC Gulbarga. The Protocol was aimed with dual. Objective of Providing Pain relief during labour and teaching the goal of safe motherhood by optimizing objective outcome. AIMS AND OBJECTIVES: Shortening of duration of labour. Effect of labour analgesia. Monitoring of the events during labour. Lowering the incidence of operative deliveries. METHODS: 100 cases primi pregnant women admitted in labour room are randomly selected. It is designed to apply to low risk primi parous, singleton cephalic presentation without evidence of CPD and spontaneous onset of labour. RESULTS: Shortened duration of all the stages of Labour, especially significant reduction in duration of active phase of labour. CONCLUSION: The programmed labour is simple easy and effective method for painless and safe delivery.

  19. Anesthesia Technique In A Patient With Langerhans Cell Histiocytosis For Diagnostic Biopsy

    Directory of Open Access Journals (Sweden)

    Abdi S

    2005-07-01

    Full Text Available Histiocytosis under general anesthesia. In these patients, depend on organs involvement and dysfunction, anesthesia technique and specific drugs should be selected.of langerhans cells consist of a range of clinical manifestations, including bone eosimophilic granuloma, Hand-Schuller-Chiristian syndrome and Letterer-Siwe disease. Definitive diagnosis is based on biopsy of involved tissues. This report describes anesthesia technique in a 2 years old girl for diagnostic biopsy

  20. A comparison of side effects and cost for spinal andgeneral anesthesia in geriatric patients

    OpenAIRE

    E. Nasiri; R.Nemat; F. Sohail Arshadi; R.A.Mohammadpour

    2006-01-01

    AbstractBackground and purpose: There is still debate regarding advantages and disadvantages of regional versus general anesthesia techniques. Some studies suggested that regional anesthesia technique probably reduces postoperative morbidity and mortality.In this retrospective historical cohort study, we compared the cost-effectiveness for spinal and general anesthesia in elderly patients.Materials and methods : A total of 120 medical records of elderly participants whom underwent general or ...

  1. The Comparison of the Effects of Sevoflurane Inhalation Anesthesia and Intravenous Propofol Anesthesia on Oxidative Stress in One Lung Ventilation

    Directory of Open Access Journals (Sweden)

    Engin Erturk

    2014-01-01

    Full Text Available Background. The aim of this study is to compare the effects of sevoflurane and propofol on one lung ventilation (OLV induced ischemia-reperfusion injury (IRI by determining the blood gas, ischemia-modified albumin (IMA, and malonyldialdehyde (MDA. Material and Methods. Forty-four patients undergoing thoracic surgery with OLV were randomized in two groups (sevoflurane Group S, propofol Group P. Anesthesia was inducted with thiopental and was maintained with 1–2.5% of sevoflurane within the 40/60% of O2/N2O mixture in Group S. In Group P anesthesia was inducted with propofol and was maintained with infusion of propofol and remifentanil. Hemodynamic records and blood samples were obtained before anesthesia induction (t1, 1 min before two lung ventilation (t2, 30 min after two lung ventilation (t3, and postoperative sixth hours (t4. Results. Heart rate at t2 and t3 in Group P was significantly lower than that in Group S. While there were no significant differences in terms of pH and pCO2, pO2 at t2 and t3 in Group S was significantly lower than that in Group P. IMA levels at t4 in Group S were significantly lower than those in Group P. Conclusion. Sevoflurane may offer protection against IRI after OLV in thoracic surgery.

  2. Survey protocol for invasive species

    OpenAIRE

    Menza, Charles

    2009-01-01

    This protocol was developed by the Biogeography Branch of NOAA’s Center for Coastal Monitoring and Assessment to support invasive species research by the Papahānaumokuākea Marine National Monument. The protocol’s objective is to detect Carijoa riisei and Hypnea musciformis in deepwater habitats using visual surveys by technical divers. Note: This protocol is designed to detect the presence or absence of invasive species. A distinct protocol is required to collect information on abundance ...

  3. Static Validation of Security Protocols

    DEFF Research Database (Denmark)

    Bodei, Chiara; Buchholtz, Mikael; Degano, P.;

    2005-01-01

    We methodically expand protocol narrations into terms of a process algebra in order to specify some of the checks that need to be made in a protocol. We then apply static analysis technology to develop an automatic validation procedure for protocols. Finally, we demonstrate that these techniques ...... suffice to identify several authentication flaws in symmetric and asymmetric key protocols such as Needham-Schroeder symmetric key, Otway-Rees, Yahalom, Andrew secure RPC, Needham-Schroeder asymmetric key, and Beller-Chang-Yacobi MSR...

  4. Isoflurane compared with fentanyl-midazolam-based anesthesia in patients undergoing heart transplantation

    Science.gov (United States)

    Hsu, Che-Hao; Hsu, Yung-Chi; Huang, Go-Shine; Lu, Chih-Cherng; Ho, Shung-Tai; Liaw, Wen-Jinn; Tsai, Yi-Ting; Lin, Chih-Yuan; Tsai, Chien-Sung; Lin, Tso-Chou

    2016-01-01

    Abstract Inhalation anesthetics provide myocardial protection for cardiac surgery. This study was undertaken to compare the perioperative effects between isoflurane and fentanyl-midazolam-based anesthesia for heart transplantation. A retrospective cohort study was conducted by reviewing the medical records of heart transplantation in a single medical center from 1990 to 2013. Patients receiving isoflurane or fentanyl-midazolam-based anesthesia were included. Those with preoperative severe pulmonary, hepatic, or renal comorbidities were excluded. The perioperative variables and postoperative short-term outcomes were analyzed, including blood glucose levels, urine output, inotropic use, time to extubation, and length of stay in the intensive care units. After reviewing 112 heart transplantations, 18 recipients with fentanyl-midazolam-based anesthesia, and 29 receiving isoflurane anesthesia with minimal low-flow technique were analyzed. After cessation of cardiopulmonary bypass, recipients with isoflurane anesthesia had a significantly lower mean level and a less increase of blood glucose, as compared with those receiving fentanyl-based anesthesia. In addition, there was less use of dobutamine upon arriving the intensive care unit and a shorter time to extubation after isoflurane anesthesia. Compared with fentanyl-midazolam-based anesthesia, isoflurane minimal low-flow anesthesia maintained better perioperative homeostasis of blood glucose levels, less postoperative use of inotropics, and early extubation time among heart-transplant recipients without severe comorbidities. PMID:27583900

  5. Effect of general anesthesia in infancy on long-term recognition memory in humans and rats.

    Science.gov (United States)

    Stratmann, Greg; Lee, Joshua; Sall, Jeffrey W; Lee, Bradley H; Alvi, Rehan S; Shih, Jennifer; Rowe, Allison M; Ramage, Tatiana M; Chang, Flora L; Alexander, Terri G; Lempert, David K; Lin, Nan; Siu, Kasey H; Elphick, Sophie A; Wong, Alice; Schnair, Caitlin I; Vu, Alexander F; Chan, John T; Zai, Huizhen; Wong, Michelle K; Anthony, Amanda M; Barbour, Kyle C; Ben-Tzur, Dana; Kazarian, Natalie E; Lee, Joyce Y Y; Shen, Jay R; Liu, Eric; Behniwal, Gurbir S; Lammers, Cathy R; Quinones, Zoel; Aggarwal, Anuj; Cedars, Elizabeth; Yonelinas, Andrew P; Ghetti, Simona

    2014-09-01

    Anesthesia in infancy impairs performance in recognition memory tasks in mammalian animals, but it is unknown if this occurs in humans. Successful recognition can be based on stimulus familiarity or recollection of event details. Several brain structures involved in recollection are affected by anesthesia-induced neurodegeneration in animals. Therefore, we hypothesized that anesthesia in infancy impairs recollection later in life in humans and rats. Twenty eight children ages 6-11 who had undergone a procedure requiring general anesthesia before age 1 were compared with 28 age- and gender-matched children who had not undergone anesthesia. Recollection and familiarity were assessed in an object recognition memory test using receiver operator characteristic analysis. In addition, IQ and Child Behavior Checklist scores were assessed. In parallel, thirty three 7-day-old rats were randomized to receive anesthesia or sham anesthesia. Over 10 months, recollection and familiarity were assessed using an odor recognition test. We found that anesthetized children had significantly lower recollection scores and were impaired at recollecting associative information compared with controls. Familiarity, IQ, and Child Behavior Checklist scores were not different between groups. In rats, anesthetized subjects had significantly lower recollection scores than controls while familiarity was unaffected. Rats that had undergone tissue injury during anesthesia had similar recollection indices as rats that had been anesthetized without tissue injury. These findings suggest that general anesthesia in infancy impairs recollection later in life in humans and rats. In rats, this effect is independent of underlying disease or tissue injury.

  6. [Continuous spectrum analysis during anesthesia and the recovery period in infants under 1 year of age].

    Science.gov (United States)

    Meyer, P; Bensouda, A; Mayer, M N; Barrier, G

    1989-01-01

    Continuous spectral EEG activity monitoring has been used in adults as a monitor of brain activity during anesthesia. It has not been used in infants. We studied 22 infants less than 7 months old undergoing minor surgery. Halothane alone or minimal Halothane anesthesia associated with caudal epidural anesthesia were used. Life-Scan analysis, in spite of wide individual variations, allowed us to detect infraclinical hypoxia episodes, it provided informations about operative confort, depth of anesthesia and added in the post-operative period an objective criteria to clinical evaluation of pain. A wide use of such a monitoring is warranted in infants.

  7. [Application of three compartment model and response surface model to clinical anesthesia using Microsoft Excel].

    Science.gov (United States)

    Abe, Eiji; Abe, Mari

    2011-08-01

    With the spread of total intravenous anesthesia, clinical pharmacology has become more important. We report Microsoft Excel file applying three compartment model and response surface model to clinical anesthesia. On the Microsoft Excel sheet, propofol, remifentanil and fentanyl effect-site concentrations are predicted (three compartment model), and probabilities of no response to prodding, shaking, surrogates of painful stimuli and laryngoscopy are calculated using predicted effect-site drug concentration. Time-dependent changes in these calculated values are shown graphically. Recent development in anesthetic drug interaction studies are remarkable, and its application to clinical anesthesia with this Excel file is simple and helpful for clinical anesthesia.

  8. Is it possible to predict hypotension during onset of spinal anesthesia in elderly patients?

    DEFF Research Database (Denmark)

    Meyhoff, Christian S; Haarmark, Christian; Kanters, Jørgen K

    2009-01-01

    STUDY OBJECTIVE: To evaluate the sensitivity and specificity of various predictors of hypotension during onset of spinal anesthesia in elderly patients. DESIGN: Prospective study. SETTING: 32 ASA physical status I, II, and III patients, aged >or=60 years, scheduled for elective lower limb surgery...... with spinal anesthesia. INTERVENTIONS: Patients received spinal anesthesia with 10-17.5 mg of bupivacaine. No prophylactic ephedrine or fluid preloading was used. MEASUREMENTS: A 5-minute baseline was recorded and during onset of spinal anesthesia, hemodynamic changes were measured every 10 seconds from...

  9. Comparison between general anesthesia and spinal anesthesia in attenuation of stress response in laparoscopic cholecystectomy: A randomized prospective trial

    Directory of Open Access Journals (Sweden)

    Writuparna Das

    2015-01-01

    Full Text Available Background: Laparoscopy though minimally invasive produces significant hemodynamic surge and neuroendocrine stress response. Though general anesthesia (GA is the conventional technique, now-a-days, regional anesthesia has been accepted for laparoscopic diagnostic procedures, and its use is also being extended to laparoscopic surgeries. Objective: The aim was to compare the hemodynamic surge and neuroendocrine stress response during laparoscopic cholecystectomy (LC under GA and spinal anesthesia (SA in American Society of Anesthesiologists (ASA PS 1 patients. Materials and Methods: Thirty ASA physical status I patients, aged 18-65 years were randomly allocated into two equal groups of 15 each. Group A received GA with controlled ventilation. Patients were preoxygenated for 5 min with 100/5 oxygen, premedicated with midazolam 0.03 mg/kg intravenous (i.v, fentanyl 2 mcg/kg i.v; induction was done with thiopentone 3-5 mg/kg i.v; intubation was achieved after muscle relaxation with 0.5 mg/kg atracurium besylate i.v. Anesthesia was maintained with 1-2% sevoflurane and N2O:O2 (60:40 and intermittent i.v injection of atracurium besylate. Group B SA with 0.5% hyperbaric bupivacaine and 25 μg fentanyl along with local anesthetic instillation in the subdiaphragmatic space. Mean arterial pressure, heart rate (HR, oxygen saturation, end tidal carbon-dioxide were recorded. Venous blood was collected for cortisol assay before induction and 30 min after pneumoperitoneum. All data were collected in Microsoft excel sheet and statistically analyzed using SPSS software version 16 (SPSS Inc., Chicago, IL, USA. All numerical data were analyzed using Student′s t-test and paired t-test. Any value <0.05 was taken as significant. Results: Mean arterial pressure and mean HR and postpneumoperitoneum cortisol level were lower in group B than group A though the difference was not statistically significant in hemodynamic parameters but significant in case of cortisol

  10. Properties of slow oscillation during slow-wave sleep and anesthesia in cats

    Science.gov (United States)

    Chauvette, Sylvain; Crochet, Sylvain; Volgushev, Maxim; Timofeev, Igor

    2011-01-01

    Deep anesthesia is commonly used as a model of slow-wave sleep (SWS). Ketamine-xylazine anesthesia reproduces the main features of sleep slow oscillation: slow, large amplitude waves in field potential, which are generated by the alternation of hyperpolarized and depolarized states of cortical neurons. However, direct quantitative comparison of field potential and membrane potential fluctuations during natural sleep and anesthesia is lacking, so it remains unclear how well the properties of sleep slow oscillation are reproduced by the ketamine-xylazine anesthesia model. Here, we used field potential and intracellular recordings in different cortical areas in the cat, to directly compare properties of slow oscillation during natural sleep and ketamine-xylazine anesthesia. During SWS cortical activity showed higher power in the slow/delta (0.1-4 Hz) and spindle (8-14 Hz) frequency range, while under anesthesia the power in the gamma band (30-100 Hz) was higher. During anesthesia, slow waves were more rhythmic and more synchronous across the cortex. Intracellular recordings revealed that silent states were longer and the amplitude of membrane potential around transition between active and silent states was bigger under anesthesia. Slow waves were largely uniform across cortical areas under anesthesia, but in SWS they were most pronounced in associative and visual areas, but smaller and less regular in somatosensory and motor cortices. We conclude that although the main features of the slow oscillation in sleep and anesthesia appear similar, multiple cellular and network features are differently expressed during natural SWS as compared to ketamine-xylazine anesthesia. PMID:22016533

  11. Post anesthesia recovery rate evaluated by using White fast tracking scoring system

    Directory of Open Access Journals (Sweden)

    Munevera Hadžimešić

    2013-12-01

    Full Text Available Introduction: Postponed recuperation from anesthesia can lead to different complications such as apnoea, aspiration of gastric content whit consequent development of aspiration pneumonia, laryngospasm, bradycardia, and hypoxia. Aim of this research was to determine infl uence of propofol, sevoflurane and isoflurane anesthesia on post anesthesia recovery rate.Methods: This was a prospective study; it included 90 patients hospitalized in period form October 2011 to may 2012 year, all patients included in the study underwent lumbar microdiscectomy surgery. Patients were randomly allocated to one of three groups: group 1: propofol maintained anesthesia, group 2: sevoflurane and group 3: isofl urane maintained anesthesia. Assessments of recovery rate were done 1, 5 and 10 minutes post extubation using White fast tracking scoring system.Results: Significant difference was observed only 1 minute after extubation (p=0,025 finding recovery rate to be superior in propofol group. Propofol group compared to inhaled anesthesia with sevoflurane group, shows significantly faster recovery from anesthesia only one minute after extubation (p=0,046. In comparison of propofol group and isofl urane anesthesia group, statistical significance was noticed one minute following extubation (p=0,008. Comparison of propofol group and inhaled anesthesia groups recovery rates were not significantly different at all times measured. When we were comparing sevoflurane and isoflurane anesthesia, recovery rates shoved no signifi cant statistical difference.Conclusions: Recovery rate evaluated by using White fast tracking scoring system was superior and with fewer complications in propofol maintained in comparison to sevoflurane and isoflurane maintained anesthesia only one minute post extubation, while after fifth and tenth minute difference was lost.

  12. Sleep Apnea and Total Joint Arthroplasty under Various Types of Anesthesia

    Science.gov (United States)

    Memtsoudis, Stavros G.; Stundner, Ottokar; Rasul, Rehana; Sun, Xuming; Chiu, Ya-Lin; Fleischut, Peter; Danninger, Thomas; Mazumdar, Madhu

    2014-01-01

    Background and Objectives The presence of sleep apnea (SA) among surgical patients has been associated with significantly increased risk of perioperative complications. Although regional anesthesia has been suggested as a means to reduce complication rates among SA patients undergoing surgery, no data are available to support this association. We studied the association of the type of anesthesia and perioperative outcomes in patients with SA undergoing joint arthroplasty. Methods Drawing on a large administrative database (Premier Inc), we analyzed data from approximately 400 hospitals in the United States. Patients with a diagnosis of SA who underwent primary hip or knee arthroplasty between 2006 and 2010 were identified. Perioperative outcomes were compared between patients receiving general, neuraxial, or combined neuraxial-general anesthesia. Results We identified 40,316 entries for unique patients with a diagnosis for SA undergoing primary hip or knee arthroplasty. Of those, 30,024 (74%) had anesthesia-type information available. Approximately 11% of cases were performed under neuraxial, 15% under combined neuraxial and general, and 74% under general anesthesia. Patients undergoing their procedure under neuraxial anesthesia had significantly lower rates of major complications than did patients who received combined neuraxial and general or general anesthesia (16.0%, 17.2%, and 18.1%, respectively; P = 0.0177). Adjusted risk of major complications for those undergoing surgery under neuraxial or combined neuraxial-general anesthesia compared with general anesthesia was also lower (odds ratio, 0.83 [95% confidence interval, 0.74–0.93; P = 0.001] vs odds ratio, 0.90 [95% confidence interval, 0.82–0.99; P = 0.03]). Conclusions Barring contraindications, neuraxial anesthesia may convey benefits in the perioperative outcome of SA patients undergoing joint arthroplasty. Further research is needed to enhance an understanding of the mechanisms by which neuraxial

  13. Properties of slow oscillation during slow-wave sleep and anesthesia in cats.

    Science.gov (United States)

    Chauvette, Sylvain; Crochet, Sylvain; Volgushev, Maxim; Timofeev, Igor

    2011-10-19

    Deep anesthesia is commonly used as a model of slow-wave sleep (SWS). Ketamine-xylazine anesthesia reproduces the main features of sleep slow oscillation: slow, large-amplitude waves in field potential, which are generated by the alternation of hyperpolarized and depolarized states of cortical neurons. However, direct quantitative comparison of field potential and membrane potential fluctuations during natural sleep and anesthesia is lacking, so it remains unclear how well the properties of sleep slow oscillation are reproduced by the ketamine-xylazine anesthesia model. Here, we used field potential and intracellular recordings in different cortical areas in the cat to directly compare properties of slow oscillation during natural sleep and ketamine-xylazine anesthesia. During SWS cortical activity showed higher power in the slow/delta (0.1-4 Hz) and spindle (8-14 Hz) frequency range, whereas under anesthesia the power in the gamma band (30-100 Hz) was higher. During anesthesia, slow waves were more rhythmic and more synchronous across the cortex. Intracellular recordings revealed that silent states were longer and the amplitude of membrane potential around transition between active and silent states was bigger under anesthesia. Slow waves were mostly uniform across cortical areas under anesthesia, but in SWS, they were most pronounced in associative and visual areas but smaller and less regular in somatosensory and motor cortices. We conclude that, although the main features of the slow oscillation in sleep and anesthesia appear similar, multiple cellular and network features are differently expressed during natural SWS compared with ketamine-xylazine anesthesia.

  14. Internet Protocol Television (IPTV

    Directory of Open Access Journals (Sweden)

    Lokesh Mittal

    2012-09-01

    Full Text Available IPTV is one of the mostly used technology of Internet and IP application. IPTV is a service for the delivery of broadcast TV, movies on demand and other interactive multimedia services over a secure, end-to-end operator managed broadband IP data network with desired QoS to the public with a broadband Internet connection. IPTV system may also include Internet services such as Web access and VoIP where it may be called Triple Play and is typically supplied by a broadband operator using the same infrastructure. IPTV is not the Internet Video that simply allows users to watch videos, like movie previews and web-cams, over the Internet in a best effort fashion. IPTV technology offers revenue-generating opportunities for the telecom and cable service providers. For traditional telephone service providers, Triple Play is delivered using a combination of optical fiber and Digital Subscriber Line (DSL technologies to its residential base. IPTV is a system where a digital television service is delivered by using Internet Protocol over a network infrastructure, which may include delivery by a broadband connection. A general definition of IPTV is television content that, instead of being delivered through traditional broadcast and cable formats, is received by the viewer through the technologies used for computer networks. In this paper I am trying to discuss this topic as my knowledge, including what is IPTV, how it works, its advantages and its applications

  15. Bacterial contamination of anesthesia machines’ internal breathing-circuit-systems

    Science.gov (United States)

    Spertini, Verena; Borsoi, Livia; Berger, Jutta; Blacky, Alexander; Dieb-Elschahawi, Magda; Assadian, Ojan

    2011-01-01

    Background: Bacterial contamination of anesthesia breathing machines and their potential hazard for pulmonary infection and cross-infection among anesthetized patients has been an infection control issue since the 1950s. Disposable equipment and bacterial filters have been introduced to minimize this risk. However, the machines’ internal breathing-circuit-system has been considered to be free of micro-organisms without providing adequate data supporting this view. The aim of the study was to investigate if any micro-organisms can be yielded from used internal machines’ breathing-circuit-system. Based on such results objective reprocessing intervals could be defined. Methods: The internal parts of 40 anesthesia machines’ breathing-circuit-system were investigated. Chi-square test and logistic regression analysis were performed. An on-site process observation of the re-processing sequence was conducted. Results: Bacterial growth was found in 17 of 40 machines (43%). No significant difference was ascertained between the contamination and the processing intervals. The most common contaminants retrieved were coagulase negative Staphylococci, aerobe spore forming bacteria and Micrococcus species. In one breathing-circuit-system, Escherichia coli, and in one further Staphylococcus aureus were yielded. Conclusion: Considering the availability of bacterial filters installed on the outlet of the breathing-circuit-systems, the type of bacteria retrieved and the on-site process observation, we conclude that the contamination found is best explained by a lack of adherence to hygienic measures during and after re-processing of the internal breathing-circuit-system. These results support an extension of the re-processing interval of the anesthesia apparatus longer than the manufacturer’s recommendation of one week. However, the importance of adherence to standard hygienic measures during re-processing needs to be emphasized. PMID:22242095

  16. Acquisition of enhanced natural killer cell activity under anesthesia.

    Science.gov (United States)

    Hsueh, C M; Lorden, J F; Hiramoto, R N; Ghanta, V K

    1992-01-01

    An increase in natural killer (NK) cell activity can be conditioned with a one trial learning paradigm to demonstrate the interaction between the central nervous system (CNS) and the immune system. In order to demonstrate learning possibilities during 'non-conscious' state, mice were anesthetized with a ketamin/rompun mixture and underwent one trial learning with odor cue as the conditioned stimulus (CS) preceding the unconditioned stimulus (US). The results indicated that mice that were exposed to camphor odor cue under the influence of anesthesia can associate the signal with the poly I:C unconditioned stimulus and were able to recall the conditioned response upon reexposure to the CS. Secondly, the conditioned association made in a conscious state can be recalled by exposure to the same olfactory odor cue in a 'non-conscious' state. The increase in the conditioned change in NK cell activity of both situations was significantly higher than the control group. The results demonstrate that learning can take place and the learned response can be recalled under the reduced awareness caused by anesthesia. The findings we report are unusual and novel in that they demonstrate that the CNS can learn new associations under conditions where the host is apparently unaware of the signals being linked. Anesthesia combined with the long interstimulus interval indicates that certain neuronal pathways in the CNS are receptive to second signals (elicited by the US) even when the second signal is separated by one day. This means the conditioned learning of a physiological response can take place unconsciously at a separate level and under situations where the host is totally unaware of the events which the brain is processing and linking as incoming information.

  17. Total Intravenous Versus Inhalation Anesthesia in Patients Undergoing Laparoscopic Cholecystectomies. Effects on Two Proinflammatory Cytokines Serum Levels: Il-32 and TNF-Alfa.

    Directory of Open Access Journals (Sweden)

    Hadade Adina

    2016-01-01

    Full Text Available Introduction: It has been reported that as compared with total intravenous anesthesia (TIVA, inhalation anesthesia is increasing the postoperative level of proinflammatory interleukins.

  18. Regional anesthesia and analgesia for oral and dental procedures.

    Science.gov (United States)

    Rochette, Judy

    2005-07-01

    Regional anesthesia and analgesia benefit the client, the patient, and the practitioner, and their use is becoming the standard for care. Familiarity with the processes involved in the generation of pain aids in understanding the benefits of preemptive and multimodal analgesia. Local anesthetic blocks should be a key component of a treatment plan, along with opioids, nonsteroidal anti-inflammatory drugs, N-methyl-D-aspartate receptor antagonists, and other therapies. Nerve blocks commonly used for dentistry and oral surgery include the infraorbital, maxillary, mental,and mandibular blocks.

  19. Anesthesia experience along with familial Mediterranean fever and celiac disease

    Directory of Open Access Journals (Sweden)

    Mehmet Sargın

    2014-03-01

    Full Text Available (Anesthetic management in patient with Familial Mediterranean Fever and Celiac Disease Familial Mediterranean Fever is an autosomal recessive transmitted disease which often seen at Mediterranean origin society and it goes by deterioration at inflammation control. Celiac disease is a proximal small intestine disease which develops gluten intolerance by autoimmune mechanism in sensitive people. Association of Familial Mediterranean Fever and Celiac disease is a rare situation. In this article we present our anesthesia experience on a bilateral septic arthritis case who also have Familial Mediterranean Fever and Celiac disease association.

  20. Ranitidine versus cimetidine prior to emergency obstetric anesthesia.

    Science.gov (United States)

    Osman, H

    1995-06-01

    Twenty parturients in labour received emergency obstetric anesthesia were randomly divided into two equal groups. Group "R" received 150 mg oral ranitidine tablet on admission, followed by 50 mg infusion in 250 ml dextrose 5% over 30 minutes prior to anesthetic induction. Group "Ce" received 400 mg cimetidine oral tablet and 100 mg infusion in 250 ml dextrose 5% over 30 minutes. Ten parturients were considered as control. Ranitidine significantly reduced the maternal gastric volume with marked alkalinization of gastric pH. No significant changes were detected in the height, frequency or amplitude of uterine contraction or neonatal assessment.

  1. [Use of general anesthesia during fiber colonoscopy in cancer patients].

    Science.gov (United States)

    Zamiralova, O Ia; Shcherbakov, A M; Evtiukhin, A I

    2002-01-01

    The evidence on the attitude of 60 cancer out-patients to fibrocolonoscopy carried out under general anesthesia was evaluated versus different procedures of intravenous injection. Most patients were scared prior to examination; 83.3% felt sleepy during the procedure while 85% of those anesthetized wouldn't mind receiving narcosis for repeat examination. Propofol (diprivan) alone showed an advantage over midazolam (dormicum) in being more tolerable and cutting stay at hospital by a third. Ketamin proved undesirable due to psychomimetic effects and delayed regaining of consciousness.

  2. General anesthesia for the heaviest man in the world

    Directory of Open Access Journals (Sweden)

    Abdullah S Terkawi

    2014-01-01

    Full Text Available The prevalence of obesity has increased greatly over the last 20 years, resulting in an increase in the number of bariatric and nonbariatric surgeries in this population. We present the case of a 20-year-old male, weighing 610 kg (1345 lb, and believed to be the heaviest living man in the world. After 4 months of rigorous in-hospital weight reduction, now weighing 510 kg (1125 lb, he underwent a laparoscopic gastric sleeve procedure under general anesthesia. This report describes the management of his anesthetic and exemplifies the challenges associated with this patient population.

  3. Fetal anesthesia and pain management for intrauterine therapy.

    Science.gov (United States)

    Brusseau, Roland; Mizrahi-Arnaud, Arielle

    2013-09-01

    Anesthesia provision for fetal intervention differs from most other anesthetic situations insofar as anesthesiologists must care for 2 or more patients-each with potentially conflicting requirements. The first is the mother who can readily indicate discomforts, can be monitored directly, and to whom drugs may be administered directly and easily. For the fetus (or fetuses), nociception must be assumed or inferred indirectly, monitoring is limited at best, and drug administration is complicated and often indirect. Fetal and maternal hemodynamic stability must be assured; and a plan to resuscitate the fetus, should problems occur during the procedure, must be developed.

  4. Anesthesia and monitoring during whole body radiation in children

    DEFF Research Database (Denmark)

    Henneberg, S; Nilsson, A; Hök, B

    1991-01-01

    During whole body radiation therapy of children, treatment may be done in places not equipped with acceptable scavenging systems for anesthetic gases and where clinical observation of the patient may be impossible. In order to solve this problem, the authors have used a total intravenous (IV) ane....... This anesthetic technique and the stethoscope have been used in seven children. The total IV anesthesia proved to be a useful method for children during whole body radiation. The modified stethoscope functioned very well and was a useful complement to the monitoring equipment....

  5. Anesthesia and monitoring during whole body radiation in children

    DEFF Research Database (Denmark)

    Henneberg, S; Nilsson, A; Hök, B

    1990-01-01

    During whole body radiation therapy of children, treatment may be done in places not equipped with acceptable scavenging systems for anesthetic gases and where clinical observation of the patient may be impossible. In order to solve this problem, the authors have used a total intravenous (IV) ane....... This anesthetic technique and the stethoscope have been used in seven children. The total IV anesthesia proved to be a useful method for children during whole body radiation. The modified stethoscope functioned very well and was a useful complement to the monitoring equipment....

  6. Protocols.io: Virtual Communities for Protocol Development and Discussion.

    Science.gov (United States)

    Teytelman, Leonid; Stoliartchouk, Alexei; Kindler, Lori; Hurwitz, Bonnie L

    2016-08-01

    The detailed know-how to implement research protocols frequently remains restricted to the research group that developed the method or technology. This knowledge often exists at a level that is too detailed for inclusion in the methods section of scientific articles. Consequently, methods are not easily reproduced, leading to a loss of time and effort by other researchers. The challenge is to develop a method-centered collaborative platform to connect with fellow researchers and discover state-of-the-art knowledge. Protocols.io is an open-access platform for detailing, sharing, and discussing molecular and computational protocols that can be useful before, during, and after publication of research results.

  7. Anesthetic recovery and hemodynamic effects of continuous thiopental infusion versus halothane for maintenance anesthesia in patients undergoing ocular surgery

    NARCIS (Netherlands)

    Shoroghi, Mehrdad; Farahbakhsh, Farshid; Sheikhvatan, Mehrdad; Sheikhfathollahi, Mahmood; Abbasi, Ali; Talebi, Azam

    2011-01-01

    Purpose: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. Methods: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthe

  8. AN IMPROVED AUTHENTICATED KEY AGREEMENT PROTOCOL

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    In 1999, Seo and Sweeney proposed a simple authenticated key agreement protocol that was designed to act as a Diffie-Hellman key agreement protocol with user authentication.Various attacks on this protocol are described and enhanced in the literature. Recently, Ku and Wang proposed an improved authenticated key agreement protocol, where they asserted the protocol could withstand the existing attacks. This paper shows that Ku and Wang's protocol is still vulnerable to the modification attack and presents an improved authenticated key agreement protocol to enhance the security of Ku and Wang's protocol. The protocol has more efficient performance by replacing exponentiation operations with message authentication code operations.

  9. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial

    DEFF Research Database (Denmark)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels

    2016-01-01

    RATIONALE: Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes...... compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. AIM AND HYPOTHESIS: The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether....... Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. STUDY OUTCOMES: The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary...

  10. Treatment with Epinephrine (Adrenaline) in Suspected Anaphylaxis during Anesthesia in Denmark

    DEFF Research Database (Denmark)

    Garvey, Lene H; Belhage, Bo; Krøigaard, Mogens

    2011-01-01

    BACKGROUND:: Literature on the use of epinephrine in the treatment of anaphylaxis during anesthesia is very limited. The objective of this study was to investigate how often epinephrine is used in the treatment of suspected anaphylaxis during anesthesia in Denmark and whether timing of treatment ...

  11. Inhalation anesthesia in dumeril´s monitor with isofluane, sevofluane, and nitrus oxide

    DEFF Research Database (Denmark)

    Bertelsen, Mads Frost; Mosley, Craig; Crawshaw, Graham J.

    2005-01-01

    Induction and recovery from inhalation anesthesia of Dumeril´s monitors using isoflurane, sevoflurane and nitrus oxide were characterized using a randomized crossover design.......Induction and recovery from inhalation anesthesia of Dumeril´s monitors using isoflurane, sevoflurane and nitrus oxide were characterized using a randomized crossover design....

  12. [Five star dentistry - IV Congress of European Federation for the Advancement of Anesthesia in Dentistry].

    Science.gov (United States)

    Rabinovich, S A; Anisimova, E N; Zavodilenko, L A

    2015-01-01

    The Russian delegation of the European Federation for the Advancement of Anesthesia in Dentistry (EFAAD) participated in IV Congress of EFAAD where were considered such problems of dental and anxiolysis in patients with severe concomitant diseases and training dentists improvements on such problems as anesthesia, sedation, prophylaxis and emergency management inpatients with accompanying diseases.

  13. A case of acute spinal intradural hematoma due to spinal anesthesia

    Institute of Scientific and Technical Information of China (English)

    Josu M Avecillas-Chasn; Jordi A Matias-Guiu; Gustavo Gomez; Javier Saceda-Gutierrez

    2015-01-01

    Spinal intradural hematoma is a rare complication of diagnostic lumbar puncture or spinal anesthesia. This complication could be overlooked with devastating neurological consequences due to a delay in diagnosis. Here, we reported a case of a patient with a lumbar spinal intradural hematoma as a result of a difficult spinal anesthesia.

  14. Serial bronchoscopic lung lavage in pulmonary alveolar proteinosis under local anesthesia

    Directory of Open Access Journals (Sweden)

    K Rennis Davis

    2015-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare disease, characterized by alveolar accumulation of surfactant composed of proteins and lipids due to defective surfactant clearance by alveolar macrophages. Mainstay of treatment is whole lung lavage, which requires general anesthesia. Herein, we report a case of primary PAP, successfully treated with serial bronchoscopic lung lavages under local anesthesia.

  15. Reliability and validity of a tool to assess airway management skills in anesthesia trainees

    Directory of Open Access Journals (Sweden)

    Aliya Ahmed

    2016-01-01

    Conclusion: The tool designed to assess bag-mask ventilation and tracheal intubation skills in anesthesia trainees demonstrated excellent inter-rater reliability, fair test-retest reliability, and good construct validity. The authors recommend its use for formative and summative assessment of junior anesthesia trainees.

  16. The effects of anesthesia method on throat pain after elective rhinoplasty

    Directory of Open Access Journals (Sweden)

    Hedayatollah Elyassi

    2011-01-01

    Conclusions: Method of anesthesia had no independent role in predicting throat pain. Although larynx of subjects undergoing general anesthesia is manipulated by tracheal intubation, sedation has its specific risks for promoting throat pain after surgery. Therefore, neither CS nor GA is superior in terms of throat pain.

  17. [Characteristic features of systemic hemodynamics during cesarean section under general anesthesia with ketamine].

    Science.gov (United States)

    Moiseev, V N

    1983-02-01

    On the basis of a comparative investigation of the central hemodynamics by the method of integrative rheography of the body in two groups of women during the operation of cesarean section under general anesthesia with ether or ketamin the author makes a conclusion that ketamin is a good drug for anesthesia in urgent surgical situations.

  18. Prolonged analgesia following preoperative bupivacaine neural blockade for oral surgery performed under general anesthesia.

    Science.gov (United States)

    Chapman, P J; Ganendran, A

    1987-03-01

    The effectiveness of prolonged neural blockade following removal of impacted third molars under general anesthesia was evaluated in a controlled clinical study. There was a significant reduction in the amount of postoperative pain experienced, and no complications, either local or systemic, occurred. The technique has advantages, especially when general anesthesia is administered to outpatients.

  19. Professional Socialization in Nurse Anesthesia Educational Programs: Attitudes and Beliefs of Faculty Members and Recent Graduates

    Science.gov (United States)

    Buettner, Kevin Charles

    2013-01-01

    The purpose of this study was to better understand professional socialization in nurse anesthesia educational programs through an exploration of the attitudes and beliefs of faculty members and recent graduates. Participants for this cross-sectional, quasi-experimental online study included a convenience sample of 178 nurse anesthesia faculty…

  20. Vibration sensation as an indicator of surgical anesthesia following brachial plexus block

    Directory of Open Access Journals (Sweden)

    Seema Jindal

    2016-01-01

    Conclusions: Vibration sense serves as a reliable indicator for the onset of surgical anesthesia following brachial plexus block. Vibration sense testing with 128 Hz Rydel–Seiffer tuning fork along with motor power assessment should be used as an objective tool to assess the onset of surgical anesthesia following brachial plexus block.

  1. [Epidural anesthesia and analgesia in the perioperative treatment of a patient with Kartagener syndrome].

    Science.gov (United States)

    Errando, C L; Sifre, C; López-Alarcón, D

    1998-12-01

    Kartagener's syndrome is an inherited disease characterized by a triad of symptoms--bronchiectasis, situs inversus and sinusitis--and is classified as an immotile cilia syndrome. Patients may experience specific airway problems when undergoing anesthesia for surgical procedures. We report the case of a woman with Kartagener's syndrome who underwent surgery under epidural anesthesia with postoperative epidural analgesia, both techniques proving successful.

  2. Anesthesia Management of a Patient with Kearn%u2019s - Sayre Syndrome

    Directory of Open Access Journals (Sweden)

    Biricik Çakmak

    2013-03-01

    Full Text Available Kearn’s Sayre Syndrome is a multi-system mitochondrial myopathy which has rarely seen. We report a patient with Kearn’s Sayre syndrome who had laparoscopic cholesistectomy and pyeloplasty operation under combined spinal epidural anesthesia and importance of anesthesia management of this syndrome.

  3. GENERAL ANESTHESIA: IS IT SAFE FOR NEWBORNS, INFANTS AND YOUNG CHILDREN ?

    Directory of Open Access Journals (Sweden)

    Nancheva Jasminka

    2016-07-01

    Full Text Available The exposure of neonates, infants and small children to general anesthesia is becoming a common occurrence. Accumulating preclinical data indicate that exposure to commonly used general anesthetic agents during key periods of brain development in this population(between late gestation and 3 to 4 years of age, can lead to apoptotic neurodegeneration, synapse loss, and cognitive and neurobehavioral deficits that persist as the organism matures. New work suggests that infants and small children undergoing some types of surgery could have better recovery if they receive regional anesthesia rather than general anesthesia. In response to this concerns, the Food and drug administration (FDA and the International Research Society in anesthesia (IARS started an initiative called Smart Tots (Strategies for Mitigating Anesthesia- related neuro Toxicity in Tots which examine the effects of anesthesia on brain development. Also another two major prospective studies are ongoing in children : PANDA (Pediatric Anesthesia Neurodevelopment assessment Study project is a large, multi-center study based at the Morgan Stanley Children’s Hospital of New York at Columbia University, and another one is GAS study which is a multisite randomized controlled trial comparing neurodevelopment outcomes in infant receiving general anesthesia compared to spinal and other regional anesthetics to the stress response to surgery. The findings from these studies will help researches to design the safest anesthetic regimens and to develop the new and safer anesthetic drugs for use in pediatric medicine.

  4. Anesthesia Management of a Patient with Kearn%u2019s - Sayre Syndrome

    OpenAIRE

    Biricik Çakmak

    2013-01-01

    Kearn’s Sayre Syndrome is a multi-system mitochondrial myopathy which has rarely seen. We report a patient with Kearn’s Sayre syndrome who had laparoscopic cholesistectomy and pyeloplasty operation under combined spinal epidural anesthesia and importance of anesthesia management of this syndrome.

  5. SURVEY ON CLINICAL STUDY OF COMPOUND ACUPUNCTURE ANESTHESIA IN RECENT 10 YEARS IN CHINA

    Institute of Scientific and Technical Information of China (English)

    QIN Biguang; HU Beixi; ZHANG Lanying

    2002-01-01

    In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA)acupuncture anesthesia provides e new anesthetic measure for surgical operations and has a definite analgesic effect and many advantages, and should be investigated further.

  6. Nursing and psychological treatment during tension-free inguinal hernia repair under local nerve blocked anesthesia

    Institute of Scientific and Technical Information of China (English)

    ZHAO Li-hui

    2007-01-01

    Tension-free inguinal hernia repair under local nerve blocked anesthesia ia an up-to-date technology and is different from the traditional approach.The aim of this study isto evaluate the nursing and psychological treatment during operation under local nerve blocked anesthesia.

  7. Anesthesia effect comparison between total intravenous anesthesia and intravenous-inhalation anesthesia%全凭静脉麻醉与静吸复合麻醉效果比较

    Institute of Scientific and Technical Information of China (English)

    关勇; 洪玉丽

    2011-01-01

    Objective: To investigate the clinical anesthesia effect of the total intravenous anesthesia and intravenous-inhalation anesthesia, in order to seek more safer anesthesia method. Methods: 98 cases of patients with total intravenous anesthesia were treated as the observation group from January to December 2010, and 98 cases with intravenous-inhalation anesthesia were treated as the control group at the same time. Then the hemodynamic changes, eyes opening time, recalling of pain, adverse reaction in 24 h of the two groups were compared. Results: The heart rate of the observation group during surgery was (75±9) times/min, which was lower than that of observation group postoperation [(83 ±9) times/min] and control group intraoperation [(80±8) times/min], the differences were statistically significant (P0.05). Conclusion: Compared with intravenous-inhalation anesthesia, the controllability and anesthesia effect of total intravenous anesthesia is good, and the adverse effects rate is lower than intravenous-inhalation anesthesia.%目的:探讨全凭静脉麻醉与静吸复合麻醉的临床麻醉效果,从而为寻找更安全的麻醉方法提供依据.方法:选取2010年1~12月采用全凭静脉麻醉进行择期手术患者98例作为观察组,选取同期静吸复合麻醉择期手术98例患者作为对照组,比较两组血流动力学变化、术毕呼之睁眼时间、麻醉清醒后患者对术中疼痛的回忆、术后24 h不良反应发生情况.结果:观察组术中心率为(75±9)次/min,低于本组诱导前心率[(83±9)次/min]及对照组术中心率[(80±8)次/min],差异有统计学意义(P0.05).结论:全凭静脉麻醉与静吸复合麻醉比较,其可控性、麻醉效果均较好,且不良反应发生率低于静吸复合麻醉.

  8. Implementing enhanced recovery after bariatric surgery protocol: a retrospective study.

    Science.gov (United States)

    Proczko, Monika; Kaska, Lukasz; Twardowski, Pawel; Stepaniak, Pieter

    2016-02-01

    While the demand for bariatric surgery is increasing, hospital capacity remains limited. The ERABS (Enhanced Recovery After Bariatric Surgery) protocol has been implemented in a number of bariatric centers. We retrospectively compared the operating room logistics and postoperative complications between pre-ERABS and ERABS periods in an academic hospital. The primary endpoint was the length of stay in hospital. The secondary endpoints were turnover times-the time required for preparing the operating room for the next case, induction time (from induction of anesthesia until a patient is ready for surgery), surgical time (duration of surgery), procedure time (duration of stay in the operating room), and the incidence of re-admissions, re-operations and complications during admission and within 30 days after surgery. Of a total of 374 patients, 228 and 146 received surgery following the pre-ERABS and ERABS protocols, respectively. The length of hospital stay was significantly shortened from 3.7 (95 % confidence interval [CI] 3.1-4.7) days to 2.1 (95 % CI 1.6-2.6) days (P surgery, respectively (P < 0.001 for both), by introducing the ERABS protocol. Induction times were reduced from 15.2 (95 % CI 14.3-16.1) min to 12.5 (95 % CI 11.7-13.3) min (P < 0.001).Turnover times were shortened significantly from 38 (95 % CI 44-32) min to 11 (95 % CI 8-14) min. The incidence of re-operations, re-admissions and complications did not change.

  9. Addressing the mandate for hand-off education: a focused review and recommendations for anesthesia resident curriculum development and evaluation.

    Science.gov (United States)

    Lane-Fall, Meghan B; Brooks, Amber K; Wilkins, Sara A; Davis, Joshua J; Riesenberg, Lee Ann

    2014-01-01

    The Accreditation Council for Graduate Medical Education requires that residency programs teach residents about handoffs and ensure their competence in this communication skill. Development of hand-off curricula for anesthesia residency programs is hindered by the paucity of evidence regarding how to conduct, teach, and evaluate handoffs in the various settings where anesthesia practitioners work. This narrative review draws from literature in anesthesia and other disciplines to provide recommendations for anesthesia resident hand-off curriculum development and evaluation.

  10. Evaluating echocardiogram and indirect blood pressure results in male western lowland gorillas (Gorilla gorilla gorilla) during three phases of an anesthetic protocol.

    Science.gov (United States)

    Napier, Julia E; Kutinsky, Ilana B; Armstrong, Douglas L; Orton, Donald; Hicks, Christie L; Waldoch, Jennifer; Devlin, William H

    2013-12-01

    Until the majority of the great ape population is trained for conscious cardiac evaluations, most individuals will require general anesthesia to perform echocardiograms. Within the veterinary community, concern exists that certain anesthetic protocols may exacerbate or artificially induce signs of cardiac disease. Because of potential cardiovascular effects, medetomidine has generally been used cautiously in patients with cardiac disease. The combination of ketamine and medetomidine is frequently used by many institutions because of its reversibility. To date, no published studies have obtained physiologic or echocardiographic parameters comparing different anesthetic protocols. In this study, with the use of seven adult male gorillas (Gorilla gorilla gorilla) with and without cardiac disease, echocardiographic and indirect blood pressure data during three phases of an anesthetic protocol were collected. The initial echocardiographic study was completed with ketamine/ medetomidine alone (5-7 mg/kg, i.m., and 0.05-0.07 mg/kg, i.m., respectively); the second study was completed after the addition of sevoflurane inhalant anesthesia to this procedure; and the third study was completed after reversal of medetomidine by administration of atipamezole (5:1 with the medetomidine dose given at induction). Without exception, ejection fractions were 15-25% lower under anesthesia with medetomidine as compared to ejection fractions after administration of atipamezole. Indirect blood pressures were higher on ketamine/ medetomidine, lower with addition of sevoflurane, and considerably lower after administration of atipamezole.

  11. Analysis of efficiency of the double- centrifugation protocol to prepare platelet rich plasma (PRP – an experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Michel Reis MESSORA

    2009-09-01

    Full Text Available Introduction and objective:The purpose of this study was to evaluatethe concentrations of platelets obtained from platelet rich plasma (PRP prepared according to the double-centrifugation protocol. Material and methods: Eight adult male rabbits (White New Zealand weighing 2.8 to 4 kg were used.After general anesthesia, 10 ml of blood were drawn from each animal via cardiac puncture. Each blood sample was centrifuged according to the protocol of Sonnleitner et al.(2000.The peripheral blood (total from each animal and the PRP samples platelets were counted manually. Data were submitted to statistical analysis.The normality of the data was confirmed and the Student’s t test was applied (p < 0.05.Results: PRP samples presented an average platele count significantly higher than that of peripheral blood.Conclusion Within the limits of this study, it was concluded that the double centrifugation protocol was adequate to prepare PRP .

  12. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery.

  13. Effect of general anesthesia and major versus minor surgery on late postoperative episodic and constant hypoxemia

    DEFF Research Database (Denmark)

    Rosenberg, J; Oturai, P; Erichsen, C J;

    1994-01-01

    STUDY OBJECTIVE: To evaluate the relative contribution of general anesthesia alone and in combination with the surgical procedure to the pathogenesis of late postoperative hypoxemia. DESIGN: Open, controlled study. SETTING: University hospital. PATIENTS: 60 patients undergoing major abdominal...... surgery and 16 patients undergoing middle ear surgery, both with comparable general anesthesia. MEASUREMENTS AND MAIN RESULTS: Patients were monitored with continuous pulse oximetry on one preoperative night and the second postoperative night. Significant episodic or constant hypoxemia did not occur...... on the second postoperative night following middle ear surgery and general anesthesia, but severe episodic and constant hypoxemia did occur on the second postoperative after major abdominal surgery and general anesthesia. CONCLUSIONS: General anesthesia in itself is not an important factor in the development...

  14. Lidocaine for prolonged and intensified spinal anesthesia by coadministration of propranolol in the rat.

    Science.gov (United States)

    Chen, Yu-Wen; Chu, Chin-Chen; Chen, Yu-Chung; Hung, Ching-Hsia; Li, Yung-Tsung; Wang, Jhi-Joung

    2011-09-26

    Although the coadministration of lidocaine with propranolol interferes with the metabolic profile (pharmacokinetics), its pharmacodynamics is still unclear. In this report, we investigate whether propranolol can potentiate the effect of lidocaine. Rats received spinal anesthesia with lidocaine co-injected with propranolol. After intrathecal injections of drugs in rats, three neurobehavioral examinations (motor function, proprioception, and nociception) were performed. We showed that lidocaine and propranolol elicited a spinal blockade in motor function, proprioception, and nociception. Propranolol at the dose of 0.82 μmol/kg produced no spinal anesthesia. Co-administration of lidocaine [50% effective dose (ED(50)) or ED(95)] and propranolol (0.82 μmol/kg) produced greater spinal anesthesia than lidocaine (ED(50) or ED(95)), respectively. These preclinical findings demonstrated that propranolol and lidocaine displayed spinal anesthesia. When combined with propranolol, lidocaine elicited a supra-additive effect of spinal anesthesia.

  15. Comparing anesthesia with isoflurane and fentanyl/fluanisone/midazolam in a rat model of cardiac arrest

    DEFF Research Database (Denmark)

    Secher, Niels; Malte, Christian Lind; Tønnesen, Else

    2016-01-01

    CA model. We hypothesize that isoflurane anesthesia improves short-term outcome following resuscitation from CA compared with a subcutaneous fentanyl/fluanisone/midazolam anesthesia. METHODS: Male Sprague Dawley rats were randomized to anesthesia with isoflurane (n=11) or fentanyl...... samples for Endothelin-1 and cathecolamines were drawn before and after CA. KEY FINDINGS: Compared with fentanyl/fluanisone/midazolam anesthesia, isoflurane resulted in a shorter time to return of spontaneous circulation (ROSC), less use of epinephrine, increased coronary perfusion pressure during CPR......, higher mean arterial pressure post ROSC, increased plasma levels of Endothelin-1 and decreased levels of epinephrine. The choice of anesthesia did not affect ROSC rate or systemic O2 consumption. CONCLUSION: Isoflurane reduces time to ROSC, increases coronary perfusion pressure, and improves hemodynamic...

  16. Prevention of thromboembolism following elective hip surgery. The value of regional anesthesia and graded compression stockings

    DEFF Research Database (Denmark)

    Wille-Jørgensen, P; Christensen, S W; Bjerg-Nielsen, A

    1989-01-01

    Ninety-eight patients scheduled for elective hip arthroplasty receiving either general or regional anesthesia and graded compression stockings as the only thromboprophylactic treatment were screened for postoperative deep-venous thrombosis with 99mTc-plasmin scintimetry. The diagnosis of deep......-venous thrombosis was established by phlebography and the diagnosis of pulmonary embolism by pulmonary perfusion and ventilation scintigraphy. Of 65 patients surgically treated under general anesthesia, 20 (31%) developed deep-venous thrombosis and six developed pulmonary embolism. Of 33 patients surgically treated...... using regional anesthesia, three (9%) developed deep-venous thrombosis and one developed a pulmonary embolus. The number of patients developing deep-venous thrombosis was significantly lower in the group receiving regional anesthesia compared with the group receiving general anesthesia. The results...

  17. The Study of Oral Clonidine Effect in Duration of Spinal Anesthesia with Lidocaine and Its Complications

    Directory of Open Access Journals (Sweden)

    M. Baalbaki

    2003-07-01

    Full Text Available There are many kinds of intervention to prolong the duration of spinal anesthesia which one of them is preoperation oral drugs. The purpose of this study was determination of clonidine effects in duration of spinal anesthesia and its complications. This study was a double - blinded randomized controlled clinical trial in 40-60 years old males of Mobasher and Ekbatan hospitals in Hamadan. In this study there were 40 cases candidated for spinal anesthesia and we divided them to 2 groups i.e. test and control then the results were recorded on questionnaire sheets. The test cases were prescribed 0.2 mg clonidine P.O. preoperatively and their duration of spinal anesthesia prolonged 11 minutes averagely and decreased its complications related to control prescribed placebo. Hence , the result showed preparation oral clonidine prolongs the duration of spinal anesthesia and decreases its complications like hypotention , nausea and vomiting.

  18. [Hernia repair and local anesthesia. Results of a controlled randomized clinical trial].

    Science.gov (United States)

    Milone, F; Salvatore, G; Leongito, M; Milone, M

    2010-01-01

    In the past, general and spinal anesthesia were used for hernia surgery, but nowadays local anesthesia has become the method of choice for hernia repair, especially in outpatient patients. The one-day surgery is sufficient in the management of this pathology. The advantages of local anesthesia are simplicity, safety, extended postoperative analgesia, early mobilization, lack post-anesthesia effects, and low costs. From January 2004 to December 2008 we observed 297 male patients with inguinal hernia. These patients were divided, with rigorous chronological order of hospital admission, in two study groups, different for anesthetic techniques used. Our controlled randomized clinical trial examines the effectiveness of local anesthesia to reduce the time of hospitalization, without alteration of results, and particularly the degree of satisfaction of patients surgical treated for inguinal hernia.

  19. SIP protocol model for OMNET++

    Directory of Open Access Journals (Sweden)

    Jan Kucerak

    2016-01-01

    Full Text Available The article describes our new SIP protocol implementation for the OMNeT++ simulation framework. OMNeT++ simulation framework provides an extensive support of IP related protocols, nevertheless a working SIP protocol implementation is missing. Real measurements were also done using a SIPp traffic generator and the results are compared to those obtained by our new SIP model. Since this work is a part of bigger project concerned strictly on measuring "first response times" over networks with a faulty transmission links, the actually collected statistics are focused only this way.

  20. [Anesthesia management of geriatric patients with arterial pressure-based cardiac output monitoring FloTrac sensor for emergency surgery].

    Science.gov (United States)

    Yamamoto, Shunsuke; Goto, Koji; Yasuda, Norihisa; Kusaka, Junya; Hidaka, Seigo; Miyakawa, Hiroshi; Noguchi, Takayuki

    2009-06-01

    In cases of emergency surgery for geriatric patients, immediate anesthesia induction and careful intraoperative management is necessary without sufficient preoperative information. We report anesthesia management of a 96-year and a 90-year old patients with FloTrac sensor which is an arterial pressure-based cardiac output monitoring device and is able to manage critical patients effectively and safely during anesthesia.

  1. Anesthesia in pregnant women with HELLP syndrome: case report

    Directory of Open Access Journals (Sweden)

    Eduardo Barbin Zuccolotto

    Full Text Available Abstract Background and objectives: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24% and perinatal (up 40% mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. Case report: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100 mmHg and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome. Indicated for general anesthesia, we opted for total intravenous with intubation after rapid sequence induction with propofol and remifentanil in continuous target-controlled infusion, and rocuronium at a dose of 1.2 mg/kg. Maintenance was achieved with propofol and remifentanil. The surgical procedure was uneventful, the child was born with APGAR 1/5 and transferred to the NICU. At the end of surgery, the patient was extubated in the operating room and taken to the ICU. The postoperative period was uneventful with no changes worthy of note and the patient was discharged on the sixth postoperative day. Conclusion: When general anesthesia is the choice in parturient with HELLP syndrome, tracheal intubation with rapid sequence induction due to possible difficult airway, as well as the use of drugs to control the hemodynamic response can minimize the complications associated with the procedure, as occurred in this case.

  2. A review of tricaine methanesulfonate for anesthesia of fish

    Energy Technology Data Exchange (ETDEWEB)

    Carter, Kathleen M.; Woodley, Christa M.; Brown, Richard S.

    2011-01-01

    Tricaine methanesulfonate (TMS) is the only FDA approved anesthetic for use in a select number of fish species, including salmonids. It is used widely in hatcheries and research to immobilize fish for marking or transport and to suppress sensory systems during invasive procedures. Improper use can decrease fish viability and possibly distort physiological data. Since animals may be anesthetized by junior staff or students who may have little experience in fish anesthesia, training in the proper use of TMS may decrease variability in results and increase fish survival. This document acts as a primer on the use of TMS for anesthetizing juvenile salmonids, with an emphasis on its use in surgical applications. Within, we briefly discuss many aspects TMS. We describe the legal uses for TMS, and what is currently known about the proper storage and preparation of the anesthetic. We outline methods and precautions for administration and changes in fish behavior during progressively deeper anesthesia. We also discuss the physiological effects of TMS and its potential for decreasing fish health.

  3. Congenital Corneal Anesthesia and Neurotrophic Keratitis: Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Flavio Mantelli

    2015-01-01

    Full Text Available Neurotrophic keratitis (NK is a rare degenerative disease of the cornea caused by an impairment of corneal sensory innervation, characterized by decreased or absent corneal sensitivity resulting in epithelial keratopathy, ulceration, and perforation. The aetiopathogenesis of corneal sensory innervation impairment in children recognizes the same range of causes as adults, although they are much less frequent in the pediatric population. Some extremely rare congenital diseases could be considered in the aetiopathogenesis of NK in children. Congenital corneal anesthesia is an extremely rare condition that carries considerable diagnostic and therapeutic problems. Typically the onset is up to 3 years of age and the cornea may be affected in isolation or the sensory deficit may exist as a component of a congenital syndrome, or it may be associated with systemic somatic anomalies. Accurate diagnosis and recognition of risk factors is important for lessening long-term sequelae of this condition. Treatment should include frequent topical lubrication and bandage corneal or scleral contact lenses. Surgery may be needed in refractory cases. The purpose of this review is to summarize and update data available on congenital causes and treatment of corneal hypo/anesthesia and, in turn, on congenital NK.

  4. Anesthesia Management in a Patient with Niemann Pick Disease

    Directory of Open Access Journals (Sweden)

    Zeynep Akoğul

    2013-04-01

    Full Text Available Niemann-Pick disease (NPD is an autosomal recessive, lipid storage disorder caused by the deficiency of the lysosomal enzyme sphingomyelinase or defective cholesterol transport from lysosome to cytosol. The clinical symptoms and signs include dysphagia, loss of motor function, hepatosplenomegaly, recurred respiratory infections, seizure, mental retardation, spasticity, myoclonic jerks and ataxia, but vary depending on the type of this disease. According to the observed pathology, patients require specialized therapy. Due to the high prevalence of the pathology in this group of patients, surgical interventions requiring general anaesthesia are common. Anesthetists have some difficulties with this group of patients. One of them is difficult ventilation because of hepatosplenomegaly and the other is difficult intubation. The metabolism of some of the anesthetic agents may be affected due to chronic use of anticonvulsant agents. Liver enzymes are elevated and platelet counts are reduced. Here we report an anesthesia management, difficulties and post-op follow up in a female child having NPD. Anesthetists have some difficulties in ventilation and intubation with NPD patients. In this situation ventilation should be with low tidal volume and high frequency. Because anesthetic agents might cause liver damage, they should be used cautiously. As a result, with keeping mind all these pathologies, anesthesia management to these patients should be used cautiously. (Journal of Current Pediatrics 2013; 11: 42-4

  5. Anesthesia and thyroid surgery: The never ending challenges

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Sehgal, Vishal

    2013-01-01

    Thyroidectomy is the most common endocrine surgical procedure being carried out throughout the world. Besides, many patients who have deranged thyroid physiology, namely hyperthyroidism and hypothyroidism, have to undergo various elective and emergency surgical procedures at some stage of their life. The attending anesthesiologist has to face numerous daunting tasks while administering anesthesia to such patients. The challenging scenarios can be encountered at any stage, be it preoperative, intra-op or postoperative period. Preoperatively, deranged thyroid physiology warrants optimal preparation, while anticipated difficult airway due to enlarged thyroid gland further adds to the anesthetic challenges. Cardiac complications are equally challenging as also the presence of various co-morbidities which make the task of anesthesiologist extremely difficult. Thyroid storm can occur during intra-op and post-op period in inadequately prepared surgical patients. Postoperatively, numerous complications can develop that include hemorrhage, laryngeal edema, nerve palsies, tracheomalacia, hypocalcemic tetany, pneumothorax, etc., The present review aims at an in-depth analysis of potential risk factors and challenges during administration of anesthesia and possible complications in patients with thyroid disease. PMID:23776893

  6. Subarachnoid versus General Anesthesia in Penile Prosthetic Implantation: Outcomes Analyses

    Directory of Open Access Journals (Sweden)

    Gerard D. Henry

    2012-01-01

    Full Text Available The leading patient complaint during the perioperative period for penile prosthesis implantation is postoperative pain, while emesis and urticaria also affect the procedure’s perceived success. In analyzing surgical outcomes, assessment of the anesthetic for postoperative pain and side effects should be included. This paper retrospectively reviews 90 consecutive, primary inflatable penile prosthetic operations performed by a single surgeon at one private medical center. Fifty-seven patients were included in final analysis. Patients who had more than one procedure that day or who used chronic pain medication were excluded. The type and amount of each drug used for each respective side effect (within the first 24 hours after procedure were compared to determine relative benefit. Twenty patients received general anesthesia (denoted herein as “GA” and 37 received spinal (or also known as subarachnoid anesthesia (denoted herein as “SA”. Patients receiving GA had significantly greater (P<0.0001 occurrence and amount of intravenous pain treatment than those receiving SA. Patients with SA required less intravenous pain medication and less treatment for nausea/emesis.

  7. Interoperation between AODV protocol and AOHR protocol for mobile ad hoc networks

    Science.gov (United States)

    Wu, Shaochuan; Wang, Changhong; Zhang, Jiayan

    2009-12-01

    Although AOHR protocol has some excellent performance, no actual network utilizes AOHR as routing protocol. It is because that this protocol cannot interoperate with AODV protocol, which is the most famous routing protocol and used all over the world. The cost will be very huge to replace AODV protocol with AOHR protocol for existing networks, so the only feasible method is to modify AOHR protocol to interoperate with AODV as introduced in this paper. The simulation results prove that the modified AOHR protocol can help the existing AODV protocol provide routing service, and the interoperation of these two routing protocols is realized.

  8. Process for Reviewing Survey Protocols

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document describes the process for conducting two types of reviews of survey protocols. A quick assessment is used to acknowledge and describe to potential...

  9. Assessment of Established Survey Protocols

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A form and instructions for quickly and briefly assessing a previously (prior to 2013) reviewed or approved survey protocol for use as a National or Regional survey...

  10. National Elk Refuge vaccination protocol

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Proposal by the State of Wyoming, Wyoming Game and Fish Department, to vaccinate elk on the National Elk Refuge. The proposal provides a protocol for vaccinating elk...

  11. Improved Authenticated Multi-Key Agreement Protocol

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hua; YUAN Zheng; WEN Qiaoyan

    2006-01-01

    Zhou et al give an attack on Harn's modified authenticated multi-key agreement protocol, and give a protocol that can prevent the unknown key-share attack. The paper points out that the protocol is vulnerable to a concatenation attack. This paper proposes an improved authenticated multi-key agreement protocol which shows how to make Harn's protocol more secure by modifying the signature and verification. And this protocol can escape the concatenation attack.

  12. Formal Modeling of Communication Protocols.

    Science.gov (United States)

    1981-03-01

    problems have been developed. 4 FORMAL MODELING OF COMMUNICATION PROTOCOLS The state machine model is motivated by the observation that protocols may be...simplest types of state machine model because they have only a single state variable (the state) which takes on a relatively small range of values. For...grammar, this correspondence is very apparent. For each state of the state machine model , we define a nonterminal symbol in the grammar. The inputs

  13. Anestesia para colonoscopia: anestesia inhalatoria con sevoflurano frente a anestesia intravenosa con propofol Colonoscopic anesthesia: Inhalatory anesthesia with sevoflurane versus intravenous anesthesia with propofol

    Directory of Open Access Journals (Sweden)

    S. De la Torre Carazo

    2012-03-01

    Full Text Available Introducción: Las exploraciones endoscópicas como la colonoscopia son actualmente cada vez más frecuentes, tanto por prescripción clínica, como para despistaje del cáncer de colon, siendo precisa Anestesia/sedación prácticamente en todos los casos. La técnica más frecuentemente usada es la intravenosa con propofol, en algunos casos no puede realizarse, y se plantea una alternativa inhalatoria. Objetivo: comparación de las características de una técnica habitual con propofol (A y de una inhalatoria con Sevoflurano (B. Sujetos y Método: Se estudian las características de ambas técnicas en dos grupos de 150 pacientes cada uno, valorándose las ventajas de cada una, complicaciones, tolerancia, tiempo de recuperación, aceptación por el endoscopista y el paciente de ambas técnicas. Resultados: en ambas técnicas las complicaciones son muy escasas, el grado de tolerancia es buena/muy buena en el 99% del grupo (A, frente a un 97% del grupo (B. Discusión: Aunque no hemos encontrado publicaciones comparando ambas técnicas en anestesia para colonoscopia, el uso de Sevoflurano ha demostrado características similarmente favorables en pacientes contraindicados para el uso de propofol, siempre que cambiemos el esquema de anestésia intravenosa por inhalatoria. Conclusión: Ambas técnicas son igualmente útiles y seguras, pudiendo emplearse la técnica inhalatoria con Sevoflurano en los pacientes en los que el propofol resulte inadecuado, con iguales prestaciones y versatilidad.Introduction: The exploratory endoscopy and colonoscopy are now increasingly common, both clinical prescription, and for colon cancer screening, needing Anesthesia / sedation in virtually all cases. The most commonly used is intravenous propofol, which in some cases cannot be performed, and an alternative is inhaled. Objective: To compare the characteristics of a standard technique with propofol (A and an inhalation with sevoflurane (B. Subjects and Methods: We

  14. Comparison of recovery profiles of propofol AND sevoflurane anesthesia with bispectral index monitoring (BIS in general anesthesia

    Directory of Open Access Journals (Sweden)

    Mukesh Somvanshi

    2015-03-01

    Method: Fifty ASA physical status I-II patients of either sex, aged between 18 and 60 years were randomly divided into two groups to receive either propofol infusion (group P, n=25 or sevoflurane (group S, n=25. Cardiovascular parameters, SpO2 and bispectral index (BIS scores were recorded. Time to eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9 and the incidence of complications were noted. Results: Early recovery times [eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9] were significantly longer in group P (P 0.05. The incidence of post-operative nausea and vomiting was significantly higher in group S. Conclusions: The present study which adjusted propofol infusion rate and sevoflurane concentration according to BIS scores revealed that maintenance of anesthesia with sevoflurane is associated with faster recovery than anesthesia with propofol. Propofol resulted in a significantly lower incidence of postoperative nausea and vomiting. [Natl J Med Res 2015; 5(1.000: 52-56

  15. Effects of adenosine agonist R-phenylisopropyl-adenosine on halothane anesthesia and antinociception in rats

    Institute of Scientific and Technical Information of China (English)

    Hai-chun MA; Yan-fen WANG; Chun-sheng FENG; Hua ZHAO; Shuji DOHI

    2005-01-01

    Aim: To investigate the antinociceptive effect of adenosine agonist Rphenylisopropyl-adenosine (R-PIA) given to conscious rats by intracerebroventricular (ICV) and intrathecal (IT), and identify the effect of R-PIA on minimum alveolar concentration (MAC) of halothane with pretreatment of A1 receptor an tagonist 8-cyclopentyl-1,3-dipropylxanthine (DPCPX) or K+ channel blocker 4-aminopyridine (4-AP). Methods: Sprague-Dawley rats were implanted with 24 gauge stainless steel guide cannula using stereotaxic apparatus and ICV method, and an IT catheter (PE-10, 8.5 cm) was inserted into the lumbar subarachnoid space, while the rats were under pentobarbital anesthesia. After one week of recovery from surgery, rats were randomly assigned to one of the following protocols: MAC of halothane, or tail-flick latency. All measurements were performed after R-PIA (0.8-2.0 μg) microinjection into ICV and IT with or without pretreatment of DPCPX or 4-AP. Results: Microinjection of adenosine agonist R PIA in doses of 0.8-2.0 μg into ICV and IT produced a significant dose- and time dependent antinociceptive action as reflected by increasing latency times and ICV administration of adenosine agonist R-PIA (0.8 μg) reducing halothane anes thetic requirements (by 29%). The antinociception and reducing halothane requirements effected by adenosine agonist R-PIA was abolished by DPCPX and 4-AP. Conclusion: ICV and IT administration of adenosine agonist R-PIA produced an antinociceptive effect in a dose-dependent manner and decreased hal othane MAC with painful stimulation through activation of A1 receptor subtype, and the underlying mechanism involves K+ channel activation.

  16. Quality control and assurance in anesthesia: A necessity of the modern times.

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Jindal, Ravi

    2014-01-01

    The advent of newer developments in anesthesia techniques and current clinical scenario has necessitated assurance of quality anesthesia services delivery. Numerous factors including availability of newer drugs, availability of newer advanced monitoring gadgets, increased awareness among the patient population, implementation of newer medico-legal laws and professional competitiveness has mandated a quality control and assurance in anesthesia. These domains of quality control are adapted from public health and are being incorporated into daily anesthesia practice in a gradual and phased manner. Quality control and assurance can be assessed and measured with certain quality indicators, which are also helpful in determining the perioperative outcome in anesthesia and surgical practice. Patient's perception about various anesthetic procedures, drug effects and recovery state are the prime underlying basis for assessing the quality assurance and control. At the same time, a positive impact of feedback mechanism cannot be under-emphasized while aiming for improvement in delivery of quality anesthesia services. The current review is aimed at highlighting the important aspects associated with quality assurance and quality control in anesthesia practice.

  17. The role of regional and neuroaxial anesthesia in patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Dempsey Z

    2011-10-01

    Full Text Available Zoey Sarah Dempsey1, Simone Rowell2, Rose McRobert31Department of Anaesthesia, Southern General Hospital, Glasgow, Lanarkshire, 2Department of Anaesthesia, Western Infirmary, Glasgow, Lanarkshire, 3Department of Anaesthesia, The Ayr Hospital, Ayr, Aryshire, UKAbstract: Systemic sclerosis (SSc, previously known as progressive systemic sclerosis, is a form of scleroderma and a multisystem connective tissue disease which can impact on every aspect of anesthetic care, especially airway management. In this review we outline clinical manifestations and current medical treatment of the disease, and general principles of anesthetizing these patients. We focus on the role of regional anesthesia, including neuroaxial anesthesia, which may serve as a safe alternative to general anesthesia but can be technically challenging. We address concerns regarding abnormal responses to local anesthesia which have previously been reported in patients with SSc, and explore future developments in technology and pharmacology, which may enable regional anesthesia to be performed more successfully and with fewer complications.Keywords: systemic sclerosis, scleroderma, regional anesthesia, neuroaxial anesthesia

  18. A psychoeducational intervention reduces the need for anesthesia during radiotherapy for young childhood cancer patients

    Directory of Open Access Journals (Sweden)

    Linsenmeier Claudia

    2008-06-01

    Full Text Available Abstract Background Radiotherapy (RT has become an important treatment modality in pediatric oncology, but its delivery to young children with cancer is challenging and general anesthesia is often needed. Methods To evaluate whether a psychoeducational intervention might reduce the need for anesthesia, 223 consecutive pediatric cancer patients receiving 4141 RT fractions during 244 RT courses between February 1989 and January 2006 were studied. Whereas in 154 RT courses corresponding with 2580 RT fractions patients received no psychoeducational intervention (group A, 90 RT courses respectively 1561 RT fractions were accomplished by using psychoeducational intervention (group B. This tailored psychoeducational intervention in group B included a play program and interactive support by a trained nurse according to age to get familiar with staff, equipment and procedure of radiotherapy. Results Group A did not differ significantly from group B in age at RT, gender, diagnosis, localization of RT and positioning during RT. Whereas 33 (21.4% patients in group A got anesthesia, only 8 (8.9% patients in group B needed anesthesia. The median age of cooperating patients without anesthesia decreased from 3.2 to 2.7 years. In both uni- and multivariate analyses the psychoeducational intervention significantly and independently reduced the need for anesthesia. Conclusion We conclude that a specifically tailored psychoeducational intervention is able to reduce the need for anesthesia in children undergoing RT for cancer. This results in lower costs and increased cooperation during RT.

  19. New visible endotracheal intubation method using the endoscope system for mice inhalational anesthesia.

    Science.gov (United States)

    Konno, Kenjiro; Itano, Naoki; Ogawa, Teppei; Hatakeyama, Mika; Shioya, Kyoko; Kasai, Noriyuki

    2014-06-01

    Appropriate and effective anesthesia is critical, because it has a strong influence on laboratory animals, and its affect greatly impacts the experimental data. Inhalational anesthesia by endotracheal intubation is currently prevailing in general anesthesia and is prefered over injection anesthesia, especially for large laboratory animals, because it is a safe and easy control agent. However, it is not common for small laboratory animals, because of the high degree of technical skills required. We assessed the capability of use for mice of the endotracheal intubation by using the endoscope system "TESALA AE-C1" and inhalational anesthesia using a ventilator. Endotracheal intubation was successfully performed on all 10 C57BL/6 mice injected with M/M/B: 0.3/4/5 comprised of medetomidine, midazoram and butorphanol, at a dose of 0.3 mg/kg + 4.0 mg/kg + 5.0 mg/kg body weight/mouse, respectively. After the intubated mice were connected with the inhalational anesthesia circuit and the ventilator, vital signs were measured until 15 min after the connection. The data with M/M/B: 0.3/4/5 showed stable and normal values, which indicated that this new endotracheal intubation method was simple, reliable and safe, which mean that this anesthesia is favorable in regard to the animal's welfare.

  20. Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery.

    Science.gov (United States)

    Doger, Cihan; Kahveci, Kadriye; Ornek, Dilsen; But, Abdulkadir; Aksoy, Mustafa; Gokcinar, Derya; Katar, Didem

    2016-01-01

    Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n = 30) and low-flow sevoflurane anesthesia group (Group L, n = 30). The fresh gas flow rate was of 4 L/min in high-flow sevoflurane anesthesia group and 1 L/min in low-flow sevoflurane anesthesia group. Heart rate (HR), mean arterial blood pressure (MABP), peripheral oxygen saturation (SpO2), and end-tidal carbon dioxide concentration (ETCO2) were recorded. Pulmonary function tests were performed before and 2, 8, and 24 hours after surgery. Results. There was no significant difference between the two groups in terms of HR, MABP, SpO2, and ETCO2. Pulmonary function test results were similar in both groups at all measurement times. Conclusions. The effects of low-flow sevoflurane anesthesia on pulmonary functions are comparable to high-flow sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy.

  1. Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Cihan Doger

    2016-01-01

    Full Text Available Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n=30 and low-flow sevoflurane anesthesia group (Group L, n=30. The fresh gas flow rate was of 4 L/min in high-flow sevoflurane anesthesia group and 1 L/min in low-flow sevoflurane anesthesia group. Heart rate (HR, mean arterial blood pressure (MABP, peripheral oxygen saturation (SpO2, and end-tidal carbon dioxide concentration (ETCO2 were recorded. Pulmonary function tests were performed before and 2, 8, and 24 hours after surgery. Results. There was no significant difference between the two groups in terms of HR, MABP, SpO2, and ETCO2. Pulmonary function test results were similar in both groups at all measurement times. Conclusions. The effects of low-flow sevoflurane anesthesia on pulmonary functions are comparable to high-flow sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy.

  2. A comparative study of pain following endodontic treatment under general anesthesia

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    Feizi Ghader

    2015-01-01

    Full Text Available   Background and Aims: Postoperativee endodontic pain is an outstanding problem for dental patients. Therefore, a successful management of endodontic pain has become as one of the main dental objectives. The aim of the present study was to compare the postoperative endodontic pain in patients under general anesthesia versus local anesthesia.   Materials and Methods: For conducting this clinical trial study, 50 patients having mandibular molars candidate for root canal therapy were selected. Twenty-five patients treated under general anesthesia because of their fear, anxiety or gag reflex. Other 25 patients treated under local anesthesia. All teeth were prepared using engine-driven rotary system in a crown-down technique and filled using lateral condensation technique. Heft- parker visual analog scale was used to measure the degree of pain at 6, 12, 24, and 48 hours after the treatment. Mann-Whitney, Chi-square, and T-tests were used to compare the intensity of postoperative pain between the groups.   Results: The mean intensity of postoperative pain in local and general anesthesia groups at 6, 12 and 24 hours had statistically significant difference (P<0.05.   Conclusion: Postoperative pain in patients who treated under general anesthesia was significantly less than the patients who treated under local anesthesia.

  3. Comparison of two epinephrine concentrations in an articaine solution for local anesthesia in children.

    Science.gov (United States)

    Zurfluh, Monika A; Daubländer, Monika; van Waes, Hubertus J M

    2015-01-01

    Painless dental treatment is of major interest in pediatric dentistry. Local anesthesia contains epinephrine, which prolongs soft tissue anesthesia.This, however, is often a source of iscomfort for children and is responsible for certain side effects (e.g., self-inflicted soft tissue lesions). The aim of this study was to investigate whether an epinephrine-reduced articaine solution could reduce the duration of soft tissue anesthesia and thereby reduce the risk of self-inflicted soft tissue lesions, while still providing an adequate anesthesia. In a non-interventional clinical study, routine dental treatment was performed on children and adolescents. An articaine 4% solution with an epinephrine-reduced solution (Ubistesin™ mite, 1:400,000) and a conventional epinephrine solution (Ubistesin™ forte, 1:100,000) were compared in terms of duration of soft tissue anesthesia. One hundred and fifty-eight patients (mite: 75, forte: 83) were treated (80% with infiltration anesthesia). In both groups, the average volume of the injection was comparable (mite: 1.2 ml, forte: 1.1 ml). One patient from each group showed unwanted side effects. In both groups, the local anesthesia was complete or sufficient (96%) to perform the planned treatment. The average treatment time was 24 minutes in the mite group and 28 minutes in the forte group. The difference in mean duration of soft tissue anesthesia was statistically significant (p = 0.001, mite: 2.1 h, forte: 2.8 h). Thanks to its high efficacy, tolerance, and reduced soft tissue anesthesia, the articaine 4% solution with the reduced epinephrine concentration (1:400,000) was considered a safe and suitable drug for routine treatments in pediatric dentistry.

  4. Comparison of two local anesthesia techniques (conventional & akinosi for inferior alveolar dental nerve

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    Refua Y

    2001-09-01

    Full Text Available Different techniques for local anesthesia are used in the mandible. The purpose of this study"nwas to determine the effects of inferior alveolar dental nerve blocks by comparing the two akinosi and"nconventional techniques. 80 patients (aged 15-60 years old were randomly divided into tow groups for"nextracting the mandibuler posterior teeth by akinosi and conventional techniques. Patients were all"ninjected with 1.8 ml of Lidocaine 2% plus Adernaline j^nnnn .Then the Pain Sensation during injection,"npositive aspiration, beginning time of anesthesia, duration of anesthesia depth of anesthesia, and the anesthesia of soft tissue related to sensory nerves were evaluated. The results showed that the pain sensation in conventional technique was significantly higher than that of akinosi technique. The number of positive aspirations in conventional technique (12,5% was higher than that of akinosi (5% but not significantly different. The long buccal nerve anesthesia in akinosi technique (75% was significantly higher than that of conventional technique. There was no significant difference between the two techniques for the depth of anesthesia. The success rate was 87.5% in conventional technique and 80% in akinosi technique. The average time of lips anesthesia in conventional technique was 3 minutes compared with 4 minutes in akinosi technique, which was not significantly different from each other. However, the beginning time of aneshtesia in tongue was significantly lower in conventional technique. No significant difference in the duration of anesthesia in lips and tonques between the two techniques was observed.

  5. Influence of anesthesia techniques of caesarean section on memory, perception and speech

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    Volkov O.O.

    2014-06-01

    Full Text Available In obstetrics postoperative cognitive dysfunctions may take place after caesarean section and vaginal delivery with poor results both for mother and child. The goal was to study influence of anesthesia techniques following caesarian section on memory, perception and speech. Having agreed with local ethics committee and obtained informed consent depending on anesthesia method, pregnant women were divided into 2 groups: 1st group (n=31 had spinal anesthesia, 2nd group (n=34 – total intravenous anesthesia. Spinal anesthesia: 1.8-2.2 mLs of hyperbaric 0.5% bupivacaine. ТIVА: Thiopental sodium (4 mgs kg-1, succinylcholine (1-1.5 mgs kg-1. Phentanyl (10-5-3 µgs kg-1 hour and Diazepam (10 mgs were used after newborn extraction. We used Luria’s test for memory assessment, perception was studied by test “recognition of time”. Speech was studied by test "name of fingers". Control points: 1 - before the surgery, 2 - in 24h after the caesarian section, 3 - on day 3 after surgery, 4 - at discharge from hospital (5-7th day. The study showed that initially decreased memory level in expectant mothers regressed along with the time after caesarean section. Memory is restored in 3 days after surgery regardless of anesthesia techniques. In spinal anesthesia on 5-7th postoperative day memory level exceeds that of used in total intravenous anesthesia. The perception and speech do not depend on the term of postoperative period. Anesthesia technique does not influence perception and speech restoration after caesarean sections.

  6. Sufentanil citrate: a new opioid analgesic for use in anesthesia.

    Science.gov (United States)

    Rosow, C E

    1984-01-01

    Sufentanil citrate is a potent analogue of fentanyl that has been evaluated primarily for use in opioid anesthesia. It is a pure mu receptor agonist and produces the typical spectrum of opioid effects. The major side effects are truncal rigidity and prolonged respiratory depression. In doses of 4-30 micrograms/kg sufentanil produces hypnosis and suppresses most hemodynamic and hormonal responses to surgery without producing significant cardiovascular depression. In this respect sufentanil and fentanyl have clear advantages over morphine, meperidine and potent inhalation anesthetics. Compared to fentanyl, sufentanil has a more rapid onset and shorter duration of action. The relatively high concentration of commercially available sufentanil injection will make it much more convenient for its intended application than fentanyl injection. This new agent will be used primarily for open-heart surgery and major operations in patients with severe cardiovascular compromise.

  7. Phentolamine mesylate for accelerating recovery from lip and tongue anesthesia.

    Science.gov (United States)

    Hersh, Elliot V; Lindemeyer, Rochelle G

    2010-10-01

    Phentolamine mesylate, at dosages from 0.4 to 0.8 mg in adults and adolescents and at dosages from 0.2 to 0.4 mg in children aged 4 to 11 years, has been proven to be safe and effective for the reversal of soft tissue anesthesia (lip and tongue numbness) and the associated functional deficits resulting from a local dental anesthetic injection containing a vasoconstrictor. Its ability to block a-adrenergic receptors on blood vessels induces vasodilation and enhances the redistribution of the local anesthetic away from the injection site. The low dosages administered for dental local anesthetic reversal in all likelihood accounts for the lack of significant cardiovascular effects that are associated with the medical use of the drug for hypertensive conditions associated with catecholamine excess.

  8. [Outpatient anesthesia--the office-based anesthetist].

    Science.gov (United States)

    Fischer, Guntram

    2013-03-01

    The aim of the present article is to describe the field of activity and prevailing conditions for office-based anesthetists in Germany. From the introduction of outpatient operations on the basis of actual numbers, data and facts, we present the project profile and the structures of the different fields of activity and practice constellations for office-based anesthesiology. Particular emphasis is placed on the requirements for room space and technical facilities, the criteria for patient selection, and the structural and procedural quality as well as quality management of outpatient anesthesia. With the aid of current numerical data the anesthetic procedures performed in the outpatient field through to the possibilities for development of continuous regional anesthetic procedures in catheter technique are illustrated. In conclusion, we discuss the economic conditions and the health-care economic significance together with a description of the current health-care quality of ambulant anesthesiology and the possibilities for participation in an error-reporting system.

  9. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia

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    Haruka Nakanishi

    2015-01-01

    Full Text Available Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the submandibular gland worsened and he required emergent reintubation due to airway compromise. The cause of submandibular gland swelling seemed to be an obstruction of the salivary duct due to surgical positioning. Conclusion. Once submandibular swelling and edematous change around the submandibular gland occur, they can worsen and compromise the air way within several hours after operation. Adequate precaution must be taken for any predisposing skull-base surgery that requires strong cervical rotation and flexion.

  10. Outcome of Anesthesia and Open Heart Surgery in Pregnant Patients

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    Golamali Mollasadeghi

    2007-06-01

    Full Text Available Background: Cardiovascular disease is an important non-obstetric cause of maternal and fetal /neonatal morbidity and mortality during pregnancy. For a pregnant woman with cardiac disease, the potential inability of the maternal cardiovascular system to contend with normal pregnancy-induced physiologic changes may produce deleterious effects on both mother and fetus. To determine the most frequent surgical indications of maternal and fetal mortality, we studied 15 cases of severe cardiac disease in pregnant women who required cardiac surgical procedures. Methods: In this descriptive study, fifteen pregnant women who underwent cardiac surgery were studied. Maternal age ranged from 27 to 36 years, and gestational age varied from 4 to 22 weeks. Most of the patients were in New York Heart Association Classes II and III. Opioid- based anesthesia with fentanyl citrate (50µ/kg or sufentanil (5µ/kg plus low dose of thiopental were used for the induction of anesthesia. During non-pulsatile cardio-pulmonary bypass, core temperature was between 28-36 °C, average CBP time was 61.2±22 min, average aortic cross-clamp time was 34.13±14 min, and mean pump pressure was maintained between 65-80 mmHg. Results: Ten patients had severe mitral valve disease (66.6%, three had aortic valve disease (20%, one had subvalvular aortic stenosis (6.7%, and the remaining one had left atrial myxoma (6.7%. There were five fetal deaths (33.3% and one maternal death (6.7%. Conclusion: It seems that open heart surgery in the first trimester is very hazardous for the fetus and may lead to fetal death. If possible, surgery should be carried out in the second trimester of pregnancy. The recommendations are simply guidelines because research data and clinical experience in this area are limited.

  11. Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Carlos Roddgo Cámara; Francisco Javier Guzmán; Ernesto Alexis Barrera; Andrés Jesús Cabello; Armando Garcia; Nancy Esthela Fernández; Eloy Caballero; Jesus Ancer

    2008-01-01

    AIM:To investigate the effects of ketamine anesthesia on the motility alterations and tissue injury caused by ischemia/reperfusion in rats.METHODS:Thirty maIe Wistar rats weighing 200-250 g were used.Ischemia was induced by obstructing blood flow in 25% of the total small intestinal length(ileum)with a vascular clamp for 45 min,after which either 60 min or 24 h of reperfusion was allowed.Rats were either anesthetized with pento-barbital sodium(50 mg/kg)or ketamine(100 mg/kg).Control groups received sham surgery,After 60 min of reperfusion,the intestine was examined for mor-phological alterations,and after 24 h intestinal basic electrical rhythm(BER)frequency was calculated,and intestinal transit determined in all groups.RESULTS:The intestinal mucosa in rats that were anesthetized with ketamine showed moderate alterations such as epithelial lifting,while ulceration and hemorrhage was observed in rats that received pento-barbital sodium after 60 min of reperfusion.Quantitative analysis of structural damage using the Chiu scale showed significantly Iess injury in rats that received ketamine than in rats that did not(2.35±1.14 vs 4.58 ±0.50,P<0.0001).The distance traveled by a marker,expressed as percentage of total intestinal length,in rats that received pentobarbital sodium was 20% ± 2% in comparison with 25.9% ±1.64% in rats that received ketamine(P=0.017).BER was not statistically different between groups.CONCLUSION:Our results show that ketamine anesthesia is associated with diminished intestinal iniury and abolishes the intestinal transit delay induced by ischemia/reperfusion.(C)2008 The WJG Press.All rights reserved.

  12. Meningitis tras anestesia espinal Meningitis after a spinal anesthesia

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    A. L. Vázquez-Martínez

    2008-03-01

    Full Text Available La meningitis post-punción es una importante complicación de la anestesia espinal. Describimos el caso de un varón de cuarenta y seis años que ingresó para tratamiento quirúrgico de una hernia umbilical, la cirugía se realizó bajo anestesia intradural. Tras la intervención el paciente comenzó con un cuadro clínico compatible con meningitis, que se confirmó tras examen del líquido cefalorraquídeo. Se trató con antibióticos a pesar de la no identificación de gérmenes, siendo la evolución favorable. El diagnóstico etiológico de una meningitis iatrogénica no siempre es posible, pero siempre debemos tener en cuenta esta posibilidad. En este artículo queremos revisar la situación actual del problema, especialmente la profilaxis y la actitud terapéutica.Post-dural puncture meningitis is a serious complication of spinal anesthesia. We describe the case of a forty six years old male who was admitted for surgical intervention of an umbilical hernia, performed under spinal anesthesia. After surgery the patient developed a clinical syndrome compatible with meningitis, the diagnosis was confirmed by examination of the cerebrospinal fluid. Broad-spectrum antibiotics were started although spinal cultures were negatives, and the patient's clinical course was favourable. The meningitis differential diagnosis may be difficult, but we must think about this possibility. In this case report ,we want to check the present situation, specially the prevention and medical treatment.

  13. Anesthesia management for MitraClip device implantation

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    Harikrishnan Kothandan

    2014-01-01

    Full Text Available Aims and Objectives: Percutaneous MitraClip implantation has been demonstrated as an alternative procedure in high-risk patients with symptomatic severe mitral regurgitation (MR who are not suitable (or denied mitral valve repair/replacement due to excessive co morbidity. The MitraClip implantation was performed under general anesthesia and with 3-dimensional transesophageal echocardiography (TEE and fluoroscopic guidance. Materials and Methods: Peri-operative patient data were extracted from the electronic and paper medical records of 21 patients who underwent MitraClip implantations. Results: Four MitraClip implantation were performed in the catheterization laboratory; remaining 17 were performed in the hybrid operating theatre. In 2 patients, procedure was aborted, in one due to migration of the Chiari network into the left atrium and in second one, the leaflets and chords of the mitral valve torn during clipping resulting in consideration for open surgery. In the remaining 19 patients, MitraClip was implanted and the patients showed acute reduction of severe MR to mild-moderate MR. All the patients had invasive blood pressure monitoring and the initial six patients had central venous catheterization prior to the procedure. Intravenous heparin was administered after the guiding catheter was introduced through the inter-atrial septum and activated clotting time was maintained beyond 250 s throughout the procedure. Protamine was administered at the end of the procedure. All the patients were monitored in the intensive care unit after the procedure. Conclusions: Percutaneous MitraClip implantation is a feasible alternative in high-risk patients with symptomatic severe MR. Anesthesia management requirements are similar to open surgical mitral valve repair or replacement. TEE plays a vital role during the MitraClip implantation.

  14. Learning and teaching motor skills in regional anesthesia: a different perspective.

    Science.gov (United States)

    Slater, Reuben J; Castanelli, Damian J; Barrington, Michael J

    2014-01-01

    Existing literature on learning in regional anesthesia broadly covers the rate of skill acquisition and the structure of educational programs. A complementary body of literature spanning psychology to medical education can be found describing skill acquisition in other fields. Concepts described in this literature have direct application to the teaching of regional anesthesia. This review introduces a selection of these complementary educational concepts, applying them to ultrasound-guided regional anesthesia skills education. Key educational concepts presented in this article can be divided into 3 sections, namely, how residents acquire manual skills, how tutors teach, and type of feedback.

  15. Hernioplastías inguinales con anestesia exclusivamente local / Inguinal Hernioplasties With Local Anesthesia

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    Coturel A

    2015-11-01

    Full Text Available Lichtenstein inguinal hernia repair was described in 1974 by Irving Lichestein, who proposed a free tension surgical treatment. Currently this technique is performed anesthetic spinal block. However, many studies marke benefits of local anesthesia: prolonged postoperative analgesia, inexpensive, easy to perform and safe in patients at high risk. A retrospective observational study was performed. The inguinal hernia repair with only local anesthesia is a feasible technique, with similar results regarding recurrence. It has no specific complications of spinal anesthesia. Performed a randomized missing on costs, pain and quality of life postoperatively prospective analysis

  16. Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature.

    Science.gov (United States)

    Kumari, Anita; Gupta, Ruchi; Bajwa, Sukhminder Jit Singh; Singh, Amrinder

    2014-01-01

    Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs timely reporting and exploring all the possible causes of these unusual and possibly avoidable events. The present case reports are an important addition to a series of recently published mishaps that occurred during spinal anesthesia in young and healthy patients.

  17. Inflammatory Profile of Awake Function-Controlled Craniotomy and Craniotomy under General Anesthesia

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    Markus Klimek

    2009-01-01

    Results. Plasma IL-6 level significantly increased with time similarly in both groups. No significant plasma IL-8 and IL-10 change was observed in both experimental groups. The VAS pain score was significantly lower in the awake group compared to the anesthesia group at 12 hours postoperative. Postoperative anxiety and stress declined similarly in both groups. Conclusion. This study suggests that awake function-controlled craniotomy does not cause a significantly different inflammatory response than craniotomy performed under general anesthesia. It is also likely that function-controlled craniotomy does not cause a greater emotional challenge than tumor resection under general anesthesia.

  18. Anesthesia for Children With Craniofacial Abnormalities in the Developing Countries: Challenges and Future Directions.

    Science.gov (United States)

    Melookaran, Ann M; Rao, Sirisha A; Antony, Sible B; Herrera, Adriana

    2015-06-01

    Interest in global health to provide safer pediatric surgical care in developing countries has increased during the last decade. A collaborative effort between surgeons and anesthesiologists has provided the opportunity to deliver specialized care to children, particularly in the areas of cleft lip and palate repair. However, medical resources, facilities, and adequately trained personnel, especially in pediatric anesthesia, are often limited in these countries. Challenges, educational efforts, and future directions for the globalization of anesthesia are discussed. Involvement of international entities may help raise awareness, channel efforts, expand programs and encourage volunteerism to ultimately provide safer care to pediatric patients, have better outcomes and reduced anesthesia-related morbidity and mortality.

  19. Anesthesia Dolorosa of Trigeminal Nerve, a Rare Complication of Acoustic Neuroma Surgery

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    Foad Elahi

    2014-01-01

    Full Text Available Anesthesia dolorosa is an uncommon deafferentation pain that can occur after traumatic or surgical injury to the trigeminal nerve. This creates spontaneous pain signals without nociceptive stimuli. Compression of the trigeminal nerve due to acoustic neuromas or other structures near the cerebellopontine angle (CPA can cause trigeminal neuralgia, but the occurrence of anesthesia dolorosa subsequent to acoustic tumor removal has not been described in the medical literature. We report two cases of acoustic neuroma surgery presented with anesthesia dolorosa along the trigeminal nerve distribution. The patients’ pain was managed with multidisciplinary approaches with moderate success.

  20. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

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    Aysun Postaci

    2012-01-01

    Full Text Available Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  1. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia.

    Science.gov (United States)

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-07-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  2. The 2013 Gerard W. Ostheimer Lecture: What's New in Obstetric Anesthesia?

    Science.gov (United States)

    Palanisamy, A

    2014-02-01

    The "What's New in Obstetric Anesthesia?" lecture is delivered annually in honor of the eminent obstetric anesthesiologist Gerard. W. Ostheimer. This lecture summarizes topics of importance and clinical relevance published in the fields of obstetric anesthesia, obstetrics, and perinatology in the preceding year. The review is a redacted version of the lecture delivered at the Society for Obstetric Anesthesia and Perinatology's Annual Meeting in April 2013. Special emphasis is placed on non-invasive technologies and biomarkers that have the potential to improve clinical care of the pregnant woman. Furthermore, sufficient attention is focused on medical diseases that have their onset or are worsened during pregnancy.

  3. When local anesthesia becomes universal: pronounced systemic effects of subcutaneous lidocaine in bullfrogs (Lithobates catesbeianus)

    DEFF Research Database (Denmark)

    Williams, catherine; Alstrup, Aage Kristian Olsen; Bertelsen, Mads

    2017-01-01

    Sodium channel blockers are commonly injected local anesthesia but are also routinely used in general immersion anesthesia for fish and amphibians. Here we report the effects of subcutaneous injection of lidocaine (5 or 50 mg kg-1) in the hind limb of bullfrogs (Lithobates catesbeianus) on reflexes......). Reflexes were regained over 4 h. Systemic sedative effects were not coupled to local anti-nociception, as a forceps pinch test at the site of injection provoked movement at the height of the systemic effect (tested at 81 ± 4 min). Amphibians are routinely subject to general anesthesia via exposure...

  4. The relationship between respiratory sinus arrhythmia and heart rate during anesthesia in rat

    DEFF Research Database (Denmark)

    Moldovan, M; Spulber, S; Saravan, V

    2004-01-01

    rats, slowing of HR is associated with an increase in HF. The aim of this study was to investigate whether this relationship between HF and HR is preserved during anesthesia in rat. A 15 minutes long ECG signal was recorded from rats (N=15) under moderate chloral hydrate (CHL) anesthesia. Recordings......) the decrease in HR that occurs during CHL anesthesia in rat correlates with an increase in RSA; (2) atropine reduces RSA and the time-dependent decrease in HR; (3) the time-dependent increase in RSA is preserved after atropine. We conclude that the correlation between RSA and HR reflects the cardio...

  5. [Anesthesia for medical students : A brief guide to practical anesthesia in adults with a web-based video illustration].

    Science.gov (United States)

    Mathis, S; Schlafer, O; Abram, J; Kreutziger, J; Paal, P; Wenzel, V

    2016-12-01

    In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career.Traditional strategies to teach medical students in anesthesiology in medical school consist of airway management or cardiopulmonary resuscitation attempts in manikins. Anesthesiology is a complex interaction consisting of anatomy, physiology, pharmacology, clinical evaluation, experience, knowledge, and manual skills. While some medical schools offer teaching in high fidelity simulators, clinical teaching in the operating room is often limited. When medical students opt for a clinical rotation in anesthesiology, there is a chance to demonstrate the fascinating world of anesthesiology, but this chance has to be utilized carefully by anesthesiologists, as young talents have to be discovered, supported, and challenged.We have put together a short guide for medical students for a clinical rotation in anesthesiology in adults in order to generate basic knowledge and interest in anesthesiology as well as a sense of achievement. Basic knowledge about premedication, induction, maintenance and strategies for anesthesia is discussed. Further, the most important anesthesia drugs are discussed and manual skills, such as intravenous cannulation, mask ventilation, intubation, and regional anesthesia are featured with QR-code based video illustrations on a smartphone or personal computer. We did not discuss possible local mannerism and special patient groups (e. g., children, special medical history), local guidelines

  6. The mesh network protocol evaluation and development

    OpenAIRE

    Pei Ping; PETRENKO Y.N.

    2015-01-01

    In this paper, we introduce a Mesh network protocol evaluation and development. It has a special protocol. We could easily to understand that how different protocols are used in mesh network. In addition to our comprehension, Multi – hop routing protocol could provide robustness and load balancing to communication in wireless mesh networks.

  7. Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery

    Directory of Open Access Journals (Sweden)

    Hiroaki Kawano

    2016-02-01

    Full Text Available BACKGROUND: We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. METHODS: Patients were randomly divided into three groups: those maintained with sevoflurane (Group S, n = 42, propofol (Group P, n = 42, or combined propofol and sevoflurane (Group PS, n = 42. We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use, incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24 h after surgery. RESULTS: The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2 h (74%, 76% and 43%, respectively, p = 0.001 and 0-24 h (71%, 76% and 38%, respectively, p < 0.0005. The incidence of nausea at 0-2 h (Group S = 57%, Group P = 26% and Group PS = 21%, p = 0.001 and 0-24 h (Group S = 62%, Group P = 29% and Group PS = 21%, p < 0.0005 was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24 h. CONCLUSION: Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. We term this novel method of anesthesia "combined intravenous-volatile anesthesia (CIVA".

  8. Cryptographic Protocols under Quantum Attacks

    CERN Document Server

    Lunemann, Carolin

    2011-01-01

    The realm of this thesis is cryptographic protocol theory in the quantum world. We study the security of quantum and classical protocols against adversaries that are assumed to exploit quantum effects to their advantage. Security in the quantum world means that quantum computation does not jeopardize the assumption, underlying the protocol construction. But moreover, we encounter additional setbacks in the security proofs, which are mostly due to the fact that some well-known classical proof techniques are forbidden by certain properties of a quantum environment. Interestingly, we can exploit some of the very same properties to the benefit of quantum cryptography. Thus, this work lies right at the heart of the conflict between highly potential effects but likewise rather demanding conditions in the quantum world.

  9. Lightweight Distance Bounding Protocol against Relay Attacks

    Science.gov (United States)

    Kim, Jin Seok; Cho, Kookrae; Yum, Dae Hyun; Hong, Sung Je; Lee, Pil Joong

    Traditional authentication protocols are based on cryptographic techniques to achieve identity verification. Distance bounding protocols are an enhanced type of authentication protocol built upon both signal traversal time measurement and cryptographic techniques to accomplish distance verification as well as identity verification. A distance bounding protocol is usually designed to defend against the relay attack and the distance fraud attack. As there are applications to which the distance fraud attack is not a serious threat, we propose a streamlined distance bounding protocol that focuses on the relay attack. The proposed protocol is more efficient than previous protocols and has a low false acceptance rate under the relay attack.

  10. Induction of ischemic stroke in awake freely moving mice reveals that isoflurane anesthesia can mask the benefits of a neuroprotection therapy

    Directory of Open Access Journals (Sweden)

    Angela eSeto

    2014-04-01

    Full Text Available Anesthetics such as isoflurane are commonly used to sedate experimental animals during the induction of stroke. Since these agents are known to modulate synaptic excitability, inflammation and blood flow, they could hinder the development and discovery of new neuroprotection therapies. To address this issue, we developed a protocol for inducing photothrombotic occlusion of cerebral vessels in fully conscious mice and tested two potential neuroprotectant drugs (a GluN2B or α4β2 nicotinic receptor antagonist. Our data show in vehicle treated mice that just 20 minutes of exposure to isoflurane during stroke induction can significantly reduce ischemic cortical damage relative to mice that were awake during stroke. When comparing potential stroke therapies, none provided any level of neuroprotection if the stroke was induced with anesthesia. However, if mice were fully conscious during stroke, the α4β2 nicotinic receptor antagonist reduced ischemic damage by 23% relative to vehicle treated controls, whereas the GluN2B antagonist had no significant effect. These results suggest that isoflurane anesthesia can occlude the benefits of certain stroke treatments and warrant caution when using anesthetics for pre-clinical testing of neuroprotective agents.

  11. The Kyoto protocol development; La viabilite du protocole de Kyoto

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, R. [Harvard Univ., Barrow, AK (United States); Guesneris, R. [College de France, 75 - Paris (France)

    2002-04-01

    From the author R. Cooper point of view the Kyoto Protocol is a flawed concept. The reasons for dropping Kyoto are presented in this paper insisting that rejecting Kyoto not means to imply that global climate change is not a serious problem. After a presentation of the US policy facing the Climatic Change, some concluding propositions are proposed. (A.L.B.)

  12. Protocol Writing in Clinical Research

    Science.gov (United States)

    Al-Jundi, Azzam

    2016-01-01

    Writing a research proposal is probably one of the most challenging and difficult task as research is a new area for the majority of postgraduates and new researchers. The purpose of this article is to summarize the most important steps and necessary guidelines for producing a standard research protocol. Academic and administrative success of any project is usually determined by acquiring a grant for the related field of research. Hence, the quality of a protocol is primarily required to achieve success in this scientific competition. PMID:28050522

  13. Developing protocols for obstetric emergencies.

    Science.gov (United States)

    Roth, Cheryl K; Parfitt, Sheryl E; Hering, Sandra L; Dent, Sarah A

    2014-01-01

    There is potential for important steps to be missed in emergency situations, even in the presence of many health care team members. Developing a clear plan of response for common emergencies can ensure that no tasks are redundant or omitted, and can create a more controlled environment that promotes positive health outcomes. A multidisciplinary team was assembled in a large community hospital to create protocols that would help ensure optimum care and continuity of practice in cases of postpartum hemorrhage, shoulder dystocia, emergency cesarean surgical birth, eclamptic seizure and maternal code. Assignment of team roles and responsibilities led to the evolution of standardized protocols for each emergency situation.

  14. Superposition Attacks on Cryptographic Protocols

    DEFF Research Database (Denmark)

    Damgård, Ivan Bjerre; Funder, Jakob Løvstad; Nielsen, Jesper Buus

    2011-01-01

    Attacks on classical cryptographic protocols are usually modeled by allowing an adversary to ask queries from an oracle. Security is then defined by requiring that as long as the queries satisfy some constraint, there is some problem the adversary cannot solve, such as compute a certain piece...... of information. In this paper, we introduce a fundamentally new model of quantum attacks on classical cryptographic protocols, where the adversary is allowed to ask several classical queries in quantum superposition. This is a strictly stronger attack than the standard one, and we consider the security...

  15. The Simplest Protocol for Oblivious Transfer

    DEFF Research Database (Denmark)

    Chou, Tung; Orlandi, Claudio

    2015-01-01

    Oblivious Transfer (OT) is the fundamental building block of cryptographic protocols. In this paper we describe the simplest and most efficient protocol for 1-out-of-n OT to date, which is obtained by tweaking the Diffie-Hellman key-exchange protocol. The protocol achieves UC-security against...... optimizations) is at least one order of magnitude faster than previous work. Category / Keywords: cryptographic protocols / Oblivious Transfer, UC Security, Elliptic Curves, Efficient Implementation...

  16. The Network Protocol Analysis Technique in Snort

    Science.gov (United States)

    Wu, Qing-Xiu

    Network protocol analysis is a network sniffer to capture data for further analysis and understanding of the technical means necessary packets. Network sniffing is intercepted by packet assembly binary format of the original message content. In order to obtain the information contained. Required based on TCP / IP protocol stack protocol specification. Again to restore the data packets at protocol format and content in each protocol layer. Actual data transferred, as well as the application tier.

  17. Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials

    DEFF Research Database (Denmark)

    Honnens de Lichtenberg, M; Krogh, J; Rye, B

    1992-01-01

    Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used...... on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. In the other trial 29 patients received EMLA cream on 1 side of the scrotum before bilateral mepivacaine infiltration. There was significantly...... less pain on the sides with the anesthetic cream (p less than 0.001). Many patients would pay the price of the cream. In conclusion, EMLA cream cannot replace but it can supplement infiltration anesthesia during vasectomy....

  18. PREDICTORS OF ATTITUDE OF PARTURIENTS SELECTED FOR CESAREAN SECTION TOWARD SPINAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    M.R. Afhami

    2004-11-01

    Full Text Available There are many factors contributing to success of regional anesthesia. Patients’ attitude toward spinal anesthesia is one of the most important of these factors. This is a descriptive study performed on 100 healthy parturient selected for elective cesarean section in Alzahra Obstetric Hospital,Tabriz, Iran. The aim of this study was to evaluate patients’ attitude and their knowledge about spinal anesthesia. Patients were selected randomly. Data collection was performed using a questionnaire. Statistical programs used were Student’s t test and Chi square for demographic characteristics. The most important factors which influenced patients’ attitude were nausea and vomiting (27%, fear of pain (34%, fear of needle puncture (15% and discomfort during return of sensory and motor functions (6%. Being awake during surgery and witnessing birth of neonate were the most pleasant stages of anesthesia (19%. It seems that providing enough and appropriate information about the procedure at preoperative visit can increase acceptance of this regional anesthetic technique.

  19. Evaluation of caudal epidural anesthesia efficacy by measurement of feet skin temperature in children

    Directory of Open Access Journals (Sweden)

    M. Yu. Kurochkin

    2015-04-01

    Full Text Available Caudal epidural anesthesia in children is not performed in pure form, but only in combination with superficial general anesthesia. Therefore, a search for reliable evaluation criteria of the caudal epidural block onset in children remains actual. Aim. To evaluate effectiveness of caudal epidural anesthesia efficacy by measurement of feet skin temperature in children. Methods and results. We investigated feet skin temperature before the caudal blockade by bupivacaine and after 15–20 minutes in 30 children. The control group included 20 children who underwent total intravenous anesthesia. The study showed that feet skin temperature after caudal blockade significantly increased from 30,1±0,15°C to 33,0±0,1°C (10% and in the control group it did not change significantly. Conclusion. Thus, feet skin thermometry may be considered to be a reliable non-invasive method for assessing the onset of the caudal block.

  20. Comparing prophylactic effect of phenylephrine and ephedrine on hypotension during spinal anesthesia for hip fracture surgery

    Directory of Open Access Journals (Sweden)

    Rahman Abbasivash

    2016-01-01

    Conclusion: At the doses of ephedrine and phenylephrine administered in this trial, phenylephrine was better to prevent hypotension during hip fracture surgery with spinal anesthesia. Higher frequency of hypotension was observed in the ephedrine group.

  1. The modifying effect of anesthetic technique on the metabolic and endocrine responses to anesthesia and surgery

    DEFF Research Database (Denmark)

    Kehlet, H

    1988-01-01

    and the widespread use of the term "stress free anesthesia" in surgery is therefore not valid. However, continuous administration of local anesthetic agents in the epidural space is the most effective technique in so far as reduction of the stress response is concerned. The clinical implication of a variable...... reduction in the stress response to surgery by different anesthetic techniques remains largely unsettled, since only few controlled studies have been published on the clinical effects of pain relief and general anesthesia. However, a vast amount of data exist from controlled studies comparing regional...... anesthesia with local anesthetics and general anesthesia. The cumulative experience from these studies have demonstrated an advantageous effect on postoperative morbidity parameters such as blood loss, postoperative thromboembolic complications, pulmonary infective complications, gastrointestinal motility...

  2. Articaine: a review of its use for local and regional anesthesia

    Directory of Open Access Journals (Sweden)

    Snoeck M

    2012-06-01

    Full Text Available Marc SnoeckDepartment of Anaesthesia, Canisius-Wilhelmina Hospital, Nijmegen, The NetherlandsAbstract: Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine, and there is no conclusive evidence demonstrating above-average neurotoxicity. Articaine proved to be suitable and safe for procedures requiring a short duration of action in which a fast onset of anesthesia is desired, eg, dental procedures and ambulatory spinal anesthesia, in normal and in special populations.Keywords: articaine, regional anesthesia, pharmacodynamics, pharmacokinetics, therapeutic use, tolerability, neurotoxicity

  3. Comparison of Intravenous Dexmedetomidine and Midazolam for Bispectral Index-Guided Sedation During Spinal Anesthesia.

    Science.gov (United States)

    Jo, Youn Yi; Lee, Dongchul; Jung, Wol Seon; Cho, Noo Ree; Kwak, Hyun Jeong

    2016-10-04

    BACKGROUND Despite the high frequency of hypotension during spinal anesthesia with proper sedation, no previous report has compared the hemodynamic effects of dexmedetomidine and midazolam sedation during spinal anesthesia. We compared the effects of bispectral index (BIS)-guided intravenous sedation using midazolam or dexmedetomidine on hemodynamics and recovery profiles in patients who underwent spinal anesthesia. MATERIAL AND METHODS One hundred and sixteen adult patients were randomly assigned to receive either midazolam (midazolam group; n=58) or dexmedetomidine (dexmedetomidine group; n=58) during spinal anesthesia. Systolic, diastolic, and mean arterial pressures; heart rates; peripheral oxygen saturations; and bispectral index scores were recorded during surgery, and Ramsay sedation scores and postanesthesia care unit (PACU) stay were monitored. RESULTS Hypotension occurred more frequently in the midazolam group (Pmidazolam sedation.

  4. Electronic dental anesthesia in a patient with suspected allergy to local anesthetics: report of case.

    Science.gov (United States)

    Malamed, S F; Quinn, C L

    1988-01-01

    A 56-year-old patient with alleged allergy to local anesthetics required restorative dental treatment. Electronic dental anesthesia was used successfully, in lieu of injectable local anesthetics, to manage intraoperative pain associated with the restoration of vital mandibular teeth.

  5. Monosynaptic functional connectivity in cerebral cortex during wakefulness and under graded levels of anesthesia

    Directory of Open Access Journals (Sweden)

    Jeannette A Vizuete

    2012-10-01

    Full Text Available The balance between excitation and inhibition is considered to be of significant importance for neural computation and cognitive function. Excitatory and inhibitory functional connectivity in intact cortical neuronal networks in wakefulness and graded levels of anesthesia has not been systematically investigated. We compared monosynaptic excitatory and inhibitory spike transmission probabilities using pairwise cross-correlogram analysis. Spikes were measured at 64 sites in the visual cortex of rats with chronically implanted microelectrode arrays during wakefulness and three levels of anesthesia produced by desflurane. Anesthesia decreased the number of active units, the number of functional connections, and the strength of excitatory connections. Connection probability (number of connections per number of active unit pairs was unaffected until the deepest anesthesia level, at which a significant increase in the excitatory to inhibitory ratio of connection probabilities was observed. The results suggest that the excitatory-inhibitory balance is altered at an anesthetic depth associated with unconsciousness.

  6. Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods: Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0.75% pure bupivacaine (8-12 mg) was applied to patients in Group Ⅰ (n= 30). Patients in Group Ⅱ (n=30) received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results: The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ. Obturator nerve reflex was observed in 15 (50.0%) patients in Group Ⅰ, but none (0%) in Group Ⅱ (P<0.01). Conclusion: Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.

  7. Comparison of remifentanil and low-dose fentanyl for fast-track cardiac anesthesia

    DEFF Research Database (Denmark)

    Khanykin, Boris; Siddiqi, Rizwan; Jensen, Per F

    2013-01-01

    BACKGROUND: Different anesthetic techniques have been used for fast tracking in cardiac anesthesia. Remifentanil, with its unique pharmacokinetic profile, could be an ideal drug for fast tracking. Possible limitations of remifentanil are rapid onset of postoperative pain after discontinuation...... of the drug infusion, which may increase the risk of an ischemic event. We conducted this randomized study to compare the efficacy of remifentanil versus low doses of fentanyl in fast-track cardiac anesthesia. It has been hypothesized that remifentanil would provide a safe anesthesia with no impact...... anesthesia. The study was designed as a prospective randomized study. The primary outcomes were changes in the cardiac index and creatine kinase MB fraction (CKMB), extubation times, mobilization times, and lengths of stay in the intensive care unit (ICU) and the hospital. Frequency of myocardial infarction...

  8. Cardiovascular consequence of reclining vs. sitting beach-chair body position for induction of anesthesia

    DEFF Research Database (Denmark)

    Larsen, Soren L.; Lyngeraa, Tobias S.; Maschmann, Christian P.

    2014-01-01

    The sitting beach-chair position is regularly used for shoulder surgery and anesthesia may be induced in that position. We tested the hypothesis that the cardiovascular challenge induced by induction of anesthesia is attenuated if the patient is placed in a reclining beach-chair position....... Anesthesia was induced with propofol in the sitting beach-chair (n = 15) or with the beach-chair tilted backwards to a reclining beach-chair position (n = 15). The last group was stepwise tilted to the sitting beach-chair position prior to surgery. Hypotension was treated with ephedrine. Continuous...... ± 12 vs. 45 ± 15 % reduction from baseline, p = 0.04) and ScO2 (7 ± 6 vs. 1 ± 8% increase from baseline, p = 0.02) and received less ephedrine (mean: 4 vs. 13 mg, p = 0.048). The higher blood pressure and lower need of vasopressor following induction of anesthesia in the reclining compared...

  9. Effects of anesthesia on [11C]raclopride binding in the rat brain

    DEFF Research Database (Denmark)

    Alstrup, Aage Kristian Olsen; Simonsen, Mette; Møller, Arne

    Background Very often rats are anesthetized prior to micro positron emission tomography (microPET) brain imaging in order to prevent head movements. Anesthesia can be administered by inhalation agents, such as isoflurane, or injection mixtures, such as fentanyl-fluanisone-midazolam. Unfortunately......, anesthesia affects a variety of physiological variables, including in the brain. Aim The aim of this study was to compare the effects of inhalation and injection anesthesia on the binding potential of the dopaminergic D2/3 tracer [11C]raclopride used for PET brain imaging in human and animal studies....... Materials & Methods Nine male Lew/Mol rats were assigned to either inhalation (isoflurane; N=4) or injection (fentanyl-fluanisone-midazolam; N=5) anesthesia. Catheters were surgically placed in femoral arteries and veins for blood sampling and tracer injection. After a short attenuation scan, the rats were...

  10. Regional or general anesthesia for fast-track hip and knee replacement - what is the evidence?

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Aasvang, Eske Kvanner

    2015-01-01

    Regional anesthesia for knee and hip arthroplasty may have favorable outcome effects compared with general anesthesia by effectively blocking afferent input, providing initial postoperative analgesia, reducing endocrine metabolic responses, and providing sympathetic blockade with reduced bleeding...... and less risk of thromboembolic complications but with undesirable effects on lower limb motor and urinary bladder function. Old randomized studies supported the use of regional anesthesia with fewer postoperative pulmonary and thromboembolic complications, and this has been supported by recent large non......-randomized epidemiological database cohort studies. In contrast, the data from newer randomized trials are conflicting, and recent studies using modern general anesthetic techniques may potentially support the use of general versus spinal anesthesia. In summary, the lack of properly designed large randomized controlled...

  11. Total intravenous anesthesia without muscle relaxant in a patient with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Lee, Dongchul; Lee, Kyung Cheon; Kim, Ji Young; Park, Yeon Soo; Chang, Young Jin

    2008-01-01

    A 63-year-old woman with amyotrophic lateral sclerosis (ALS) was scheduled for open reduction and internal fixation of the right tibia. Total intravenous anesthesia using propofol and remifentanil without muscle relaxant was selected as the anesthetic method, in order to avoid the possible occurrence of ventilatory depression due to abnormal responses to muscle relaxants and exacerbation of the motor neuron disease. After standard and neuromuscular monitoring devices were applied, anesthesia was induced and maintained with target controlled infusion of propofol and remifentanil in the range of 2.5-5.0 microg x ml(-1) and 2.5-5.0 ng x ml(-1), respectively. To avoid delayed neuromuscular recovery, we did not use any muscle relaxant at all. Intubation was successful and there were no remarkable events during anesthesia, except for three brief hypotensive events; there was no exacerbation of ALS itself during or after the anesthesia. She was discharged on postoperative day 3, without any discomfort.

  12. Prevalence and specifications of postoperative sore throat following general endotracheal anesthesia in patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Zeynab Maghsood-Taleghani

    2007-01-01

    Full Text Available Introduction: Tracheal intubation is a standard technique for the performance of general anesthesia which might lead to stress in patient. This study has been done to evaluate prevalence and specifications of postoperative sore throat following general endotracheal anesthesia in patients undergoing open reduction surgery of extremity limbs fractures.Methods and Materials: In this cross-sectional study a number of 78 patients with 15-65 year old undergoing open reduction surgery of extremity limbs fractures were selected upon to researcher characteristics and in un-randomized sampling. Sensory, affective, intensity and general condition of pain were assessed in 1 and 24 hour after general anesthesia and extubation by using McGill Pain Questionnaire-Short Form (MPQ-SF questionnaire. Results: Upon to result, average age was 29 year and base on McGill Pain Questionnaire-Short Form (MPQ-SF questionnaire results, average score of sensory components of sore throat, 1 and 24 hour after general anesthesia was 3.42 and 1.2 respectively, and average score of affective components of sore throat 1 and 24 hour after general anesthesia was 1.14 and.46 respectively, and average score of sore throat intensity, 1 and 24 hour after general anesthesia was 3.51 and 1.18, respectively. 75.6% of patients had sore throat 1 hour after general anesthesia and 24 hour after decrease to 29.5%. In general, the majority of patients (33.3% said that their sore throat intensity is discomforting. Pair t test revealed a significant difference between sensory and affective components and also intensity of sore throat in 1 and 24 hour after general anesthesia. Average score of sore throat intensity in females was greater than males. Pearson correlation test revealed a significant difference between age and sore throat intensity in 24 hour after general anesthesia.Conclusion: According to results of this study, awareness to complication following general endotracheal anesthesia and

  13. Choice of the method of anesthesia management of traumatological surgeries in young patients

    Directory of Open Access Journals (Sweden)

    Наталія Миколаївна Богуславська

    2015-07-01

    Full Text Available Aim of research. Study of the hemodynamic state, evaluation of the pain level, stress markers and its correlations in traumatologic patients of the young age in conditions of the different kinds of anesthesia.Materials and methods. The research includes 102 patients: 72 men (70,6 %, 30 women (29,4 % 18 – 45years old (33,5±0,7 years, who underwent osteosynthesis because of traumatic injure of limbs. Patients were separated into 3 groups depending on the kind of anesthesia: I group (n=32 – underwent surgery in conditions of conduction anesthesia without sedation (average age 31,9±1,3 years, II group (n=44 – underwent surgery in conditions of conduction anesthesia with sedation (35,0±1,0 years, III group (n=26 – underwent surgery in conditions of intravenous anesthesia (32,7±1,4years.Results of research. MAPB level at the surgery stages didn’t exceed the output values in patients of all groups. As for HR it must be noticed its increase in patients of the 1 and II groups at the traumatic stage and at the end of surgery that can be explained by an effect of adrenaline added to the local anesthetic. The pain level was the lowest in the group of patients who underwent an anesthesia with sedation in first postsurgical day. Hyperglycemia was noticed in patients of the 1 group in first postsurgical day, and in patients of the III group – the tendency to hypercortisolemia. The cortisone-insulin ratio at the surgery stages was maximal in patients of the 1 group and in postsurgical day – in the III group. НОМА index at the surgery stages was within norm in patients of all groups and only in postsurgical day it had a tendency to increase in patients of the I group.Conclusions. Conduction anesthesia without sedation, conduction anesthesia with sedation (propofol and intravenous anesthesia (propofol, fentanyl demonstrate hemodynamic stability at osteosynthesis in young patients. The conduction anesthesia with sedation (propofol and

  14. Effect of remifentanil combined with propofol anesthesia on stress response, blood gas index in patients with laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    Yan-Dong Jiang; Su-Min Zhao

    2016-01-01

    Objective:To observe the effect of remifentanil combined with propofol anesthesia on stress response, blood gas index in patients with laparoscopic cholecystectomy. Methods:A total of 88 patients with laparoscopic cholecystectomy were randomly divided into the observation group (46 cases) and the control group (42 cases). After anesthesia induction,the observation group was given remifentanil combined with propofol intravenous anesthesia for continuous anesthesia, and control group was given isoflurane and propofol. Stress response (TNF-αα, CRP, BG, COGT), blood gas index (PaO2, PCO2, PH value) before surgery, before anesthesia maintained, and after surgery between two groups were compared. Results: Before anesthesia maintained and after surgery, PaO2 and PCO2 levels of the two groups increased with before surgery (P0.05). pH value of the two groups showed no change before and after surgery. Before anesthesia maintained and after surgery, TNF-αα, CRP, BG, COGT of the two groups increased with before surgery (P0.05) at before anesthesia maintained. While to the end of surgery, these index of the control group was significantly higher than that in the observation group (P<0.05). Conclusions:Remifentanil combined with propofol anesthesia can make blood gas index stable as well as isoflurane combined with propofol anesthesia, but inhibit stress response more significantly.

  15. Stress of anesthesia with M.S. 222 and Benzocaine in Rainbow Trout (Salmo gairdneri)

    Science.gov (United States)

    Wedemeyer, Gary

    1970-01-01

    Rainbow trout (Salmo gairdneri) anesthetized with M.S. 222 for periods up to 12 min experience interrenal ascorbate depletion, uremia, and moderate hypercholesterolemia. Anesthesia with neutralized M.S. 222 (pH 7) or benzocaine prevented these changes and significantly reduced the variability in plasma glucose, cholesterol, and cortisol, indicating that the stress of anesthesia with M.S. 222 is due to the low pK of the sulfonic acid moiety.

  16. Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine

    OpenAIRE

    Elif Basagan-Mogo; Suna Goren; Gulsen Korfali; Gurkan Turker; Fatma Nur Kaya

    2010-01-01

    OBJECTIVE: The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. INTRODUCTION: Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting ...

  17. Con: pediatric anesthesia training in developing countries is best achieved by out of country scholarships.

    Science.gov (United States)

    Walker, Isabeau A

    2009-01-01

    Medical migration is damaging health systems in developing countries and anesthesia delivery is critically affected, particularly in sub-Saharan Africa. 'Within country' postgraduate anesthesia training needs to be supported to encourage more doctors into the specialty. Open-ended training programs to countries that do not share the same spectrum of disease should be discouraged. Donor agencies have an important role to play in supporting sustainable postgraduate training programs.

  18. Instructional Methods for Neuroscience in Nurse Anesthesia Graduate Programs: A Survey of Educational Programs

    Science.gov (United States)

    1999-10-01

    i INSTRUCTIONAL METHODS FOR NEUROSCIENCE IN NURSE ANESTHESIA GRADUATE PROGRAMS : A SURVEY OF EDUCATIONAL PROGRAMS Michael R. Sanchez APPROVED... GRADUATE PROGRAMS : A SURVEY OF EDUCATIONAL PROGRAMS 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Michael R...certifies that the use of any copyrighted material in the thesis entitled: Instructional methods for neuroscience in nurse anesthesia graduate programs : A

  19. Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

    OpenAIRE

    2010-01-01

    Beyazit ZencirciKahramanmaras, TurkeyBackground: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was succes...

  20. Sudden Sensorineural Hearing Loss after Orthopedic Surgery under Combined Spinal and Epidural Anesthesia

    OpenAIRE

    Ditza de Vilhena; Luís Pereira; Delfim Duarte; Nuno Oliveira

    2016-01-01

    Postoperative hearing loss following nonotologic surgery is rare. For patients undergoing subarachnoid anesthesia, the loss of cerebral spinal fluid and hence the drop in intracranial pressure can result in hearing loss and cranial nerve palsy. We report a case in which a patient sustained orthopedic surgery under combined spinal and epidural anesthesia complicated by severe and persistent sensorineural hearing loss. This report is a reminder that postoperative sudden sensorineural hearing lo...