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Sample records for anesthesia general

  1. General anesthesia

    Science.gov (United States)

    General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel ... doctor called an anesthesiologist will give you the anesthesia. Sometimes, a certified and registered nurse anesthetist will ...

  2. 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.

  3. 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, 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....

  4. Anesthesia

    Science.gov (United States)

    ... arm or leg. A common type is epidural anesthesia, which is often used during childbirth. General - makes ... afterwards. Sedation can be used with or without anesthesia. The type of anesthesia or sedation you get ...

  5. Assessing pain responses during general anesthesia.

    Science.gov (United States)

    Stomberg, M W; Sjöström, B; Haljamäe, H

    2001-06-01

    Major technical and pharmacological achievements in recent years have greatly influenced the practice of anesthesia. Clinical signs related to the main aspects of anesthesia, i.e., hypnosis, analgesia, and muscular relaxation, are increasingly obtainable from variables supplied by the monitoring equipment. It is not known, however, to what extent more indirect, patient-associated clinical signs of pain/depth of anesthesia are still considered of importance and relied on in the intraoperative management of surgical patients. The aims of the present study were to assess what clinical signs, indirect as well as monitor-derived, are considered indicative of intraoperative pain or depth of anesthesia by nurse anesthetists during general anesthesia. In connection with anesthetic management of surgical patients, Swedish nurse anesthetists (N = 40) were interviewed about clinical signs that they routinely assessed and were asked if the observed signs were considered indicative mainly of intraoperative pain or depth of anesthesia. It was found that skin-associated responses (temperature, color, moisture/stickiness) were commonly considered to indicate intraoperative pain rather than depth of anesthesia. Respiratory movements, eye reactions, and circulatory responses were considered to be indicative of either pain or insufficient depth of anesthesia. The present data indicate that indirect physiological signs are still considered of major importance by anesthesia nurses during the anesthetic management of surgical patients. PMID:11759565

  6. Methylphenidate Actively Induces Emergence from General Anesthesia

    OpenAIRE

    Solt, Ken; Cotten, Joseph F.; Cimenser, Aylin; Wong, Kin F.K.; Chemali, Jessica J.; Brown, Emery N.

    2011-01-01

    Background: Although accumulating evidence suggests that arousal pathways in the brain play important roles in emergence from general anesthesia, the roles of monoaminergic arousal circuits are unclear. In this study, the authors tested the hypothesis that methylphenidate (an inhibitor of dopamine and norepinephrine transporters) induces emergence from isoflurane general anesthesia. Methods: Using adult rats, the authors tested the effect of intravenous methylphenidate on time to emergence...

  7. Consciousness fluctuation during general anesthesia: a theoretical approach to anesthesia awareness and memory modulation.

    Science.gov (United States)

    Cascella, Marco; Schiavone, Vincenzo; Muzio, Maria Rosaria; Cuomo, Arturo

    2016-08-01

    With anesthesia awareness as a model of study we debate the both fascinating and dangerous phenomenon called consciousness fluctuation that takes place during surgical anesthesia. In accordance with current scientific knowledge this paradox is the consequence of our limits in both precise knowledge of anesthesia mechanisms and our inability to accurately assess the level of anesthesia with brain monitoring. We also focus on the relationships between memory and anesthesia, as well as the possibility of interfering with memory during general anesthesia. PMID:27046232

  8. 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, the...

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

    OpenAIRE

    Lucía Vizcaíno-Martínez; Manuel Ángel Gómez-Ríos; Beatriz López-Calviño

    2014-01-01

    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, main...

  10. General versus epidural anesthesia for lumbar microdiscectomy.

    Science.gov (United States)

    Ulutas, Murat; Secer, Mehmet; Taskapilioglu, Ozgur; Karadas, Soner; Akyilmaz, Ahmet Aykut; Baydilek, Yunus; Kocamer, Betul; Ozboz, Ayse; Boyaci, Suat

    2015-08-01

    This study was a retrospective analysis of 850 lumbar microdiscectomy (LMD) under epidural anesthesia (EA; n=573) or general anesthesia (GA; n=277) performed by the same surgeon and paid by invoice to the Social Security Institution of the Turkish Republic between April 2003 and May 2013. Although GA is the most frequently used method of anesthesia during LMD, the choice of regional anesthetia (epidural, spinal or a combination of these) differs between surgeons and anesthetists. Studies have reported that EA in surgery for lumbar disc herniation may be more reliable than GA, as it enables the surgeon to communicate with the patient during surgery, but few studies have compared the costs of these two anesthetic methods in LMD. We found that EA patient costs were significantly lower than GA patient costs (p0.05). The anesthetic method used during LMD affected the complication rate, cost and efficiency of operating room use. We suggest that EA is an anesthetic method that can contribute to health care cost savings and enable LMD to be completed with less nerve root manipulation and more comfort, efficacy, reliability and cost efficiency without affecting the success rate of the surgical procedure. PMID:26067543

  11. General anesthesia versus segmental thoracic or conventional lumbar spinal anesthesia for patients undergoing laparoscopic cholecystectomy

    OpenAIRE

    Yousef, Gamal T.; Lasheen, Ahmed E.

    2012-01-01

    Background: Laparoscopic cholecystectomy became the standard surgery for gallstone disease because of causing less postoperative pain, respiratory compromise and early ambulation. Objective: This study was designed to compare spinal anesthesia, (segmental thoracic or conventional lumbar) vs the gold standard general anesthesia as three anesthetic techniques for healthy patients scheduled for elective laparoscopic cholecystectomy, evaluating intraoperative parameters, postoperative recovery an...

  12. 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.

  13. Awareness during general anesthesia: new technology for an old problem.

    Science.gov (United States)

    Halliburton, J R

    1998-05-01

    The possibility of awareness during general anesthesia causes apprehension for the patient and the Certified Registered Nurse Anesthetist (CRNA). The goals of general anesthesia are to prevent the sensation of pain and produce a state of sedation, hypnosis, and unconsciousness so the patient will not remember the surgical procedure. An inadequate level of anesthesia can result in patient awareness during surgery. The current practice of anesthesia relies on indirect hemodynamic measurements such as blood pressure and heart rate to monitor the sedative hypnotic state of the patient's brain during general anesthesia. Hemodynamic responses are not reliable for predicting awareness just as blood pressure and heart rate are not indicative of consciousness. Electroencephalogram (EEG) waveforms are known to be affected by anesthetics. Characteristic EEG waveforms are a direct indication of the patient's level of consciousness. Unprocessed and computer-processed EEG recordings have been used in an attempt to monitor the patient's level of consciousness during general anesthesia. A raw or unprocessed EEG recording to monitor the level of consciousness during general anesthesia is problematic. The EEG signal is complex, affected by artifact, and it requires a dedicated interpreter. Conventional processed EEG monitoring systems are problematic because of the complexity of the equipment and technical difficulty of reading the EEG recording. The purpose of this article is to describe the history of awareness during anesthesia and introduce a new processed EEG monitor, the Bispectral Index (BIS) (Aspect Medical Systems, Inc., Natick, MA) with implications for future clinical use and research. PMID:9726194

  14. 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.

  15. Active Emergence from Propofol General Anesthesia Is Induced by Methylphenidate

    OpenAIRE

    Chemali, Jessica J.; Van Dort, Christa J.; Brown, Emery N.; Solt, Ken

    2011-01-01

    Background: A recent study showed that methylphenidate induces emergence from isoflurane general anesthesia. Isoflurane and propofol are general anesthetics that may have distinct molecular mechanisms of action. The objective of this study was to test the hypothesis that methylphenidate actively induces emergence from propofol general anesthesia. Methods: Using adult rats, the effect of methylphenidate on time to emergence after a single bolus of propofol was determined. The ability of met...

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

    Science.gov (United States)

    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 control. In addition, the possibility of exacerbation of spasticity should be considered. A 20-year-old man with PMD required removal of impacted wisdom teeth under general anesthesia. General anesthesia was induced with thiamylal, fentanyl, and desflurane. Anesthesia was maintained with desflurane and continuous intravenous remifentanil under bispectral index and train-of-4 monitoring. Anesthesia lasted 1 hour 20 minutes and was completed uneventfully. Airway complications, seizures, and exacerbation of spasticity did not occur postoperatively. Preoperatively, our patient had no history of epilepsy attacks or aspiration pneumonia, and no clinical symptoms of gastroesophageal reflux disease. Therefore, exacerbation of spasticity was one of the most likely potential complications. Identification of these associated conditions and evaluation of risk factors during preoperative examination is important for performing safe anesthesia in these patients. PMID:27269667

  17. Nursing intervention in gynecologic brachytherapy under general anesthesia

    International Nuclear Information System (INIS)

    We reconsidered our nursing intervention in gynecologic intracavitary brachytherapy as general anesthesia was introduced. We recognized that safety, comfort, privacy protection and relief of anxiety of the patients were important points for nursing with corporation of other medical staffs. (author)

  18. 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

  19. Do Patients Fear Undergoing General Anesthesia for Oral Surgery?

    OpenAIRE

    Elmore, Jasmine R.; Priest, James H.; Laskin, Daniel M.

    2014-01-01

    Many patients undergoing major surgery have more fear of the general anesthesia than the procedure. This appears to be reversed with oral surgery. Therefore, patients need to be as well informed about this aspect as the surgical operation.

  20. Tapia's Syndrome after Posterior Cervical Spine Surgery under General Anesthesia

    OpenAIRE

    Park, Chang Kyu; Lee, Dong Chan; Park, Chan Joo; Hwang, Jang Hoe

    2013-01-01

    We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to p...

  1. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    OpenAIRE

    Tien-En Huang; Hsi-Kung Kuo; Sue-Ann Lin; Po-Chiung Fang; Pei-Chang Wu; Yi-Hao Chen; Yung-Jen Chen

    2007-01-01

    Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantagesand advantages, and the visual outcomes for simultaneous bilateralcataract surgery (SBCS) under general anesthesia.Methods: This retrospective case review pertained to a period spanning from June1998 through June 2005 inclusively, and comprised of 27 consecutivepatients (54 eyes) that underwent simultaneous bilateral cataract surgeryunder general anesthesia at the Kaohsiung Chang Gung Memorial Ho...

  2. Oral transmucosal fentanyl pretreatment for outpatient general anesthesia.

    OpenAIRE

    Moore, P. A.; Cuddy, M. A.; Magera, J. A.; Caputo, A. C.; A.H. Chen; Wilkinson, L. A.

    2000-01-01

    The oral transmucosal formulation of fentanyl citrate (OTFC) has been reported to be an effective sedative, providing convenient and atraumatic sedation for children prior to general anesthesia or painful diagnostic procedures. Thirty-three young children (24-60 months of age) scheduled for outpatient general anesthesia for treatment of dental caries were enrolled in this randomized placebo-controlled clinical trial. To determine the effectiveness of the OTFC premedication, patient behavior w...

  3. 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.

  4. General anesthesia for horses with specific problems

    International Nuclear Information System (INIS)

    We have discussed anesthetic techniques, special considerations, and expected complications involved in anesthetizing horses for abdominal, orthopedic, and head and neck surgery, and myelography and have described expected physiologic dysfunction that may require changes in anesthetic technique or supportive measures. The objective is high-quality patient care and reduction in anesthesia-related morbidity and death

  5. Effect of Epidural Block under General Anesthesia on Pulse Transit Time

    International Nuclear Information System (INIS)

    Epidural block under general anesthesia has been widely used to control postoperative pain. In this anesthetic state many hemodynamic parameters are changed. Moreover pulse transit time is influenced by this memodynamic change. PPT change in the finger and the toe due to relaxation of arterial wall muscle after general anesthesia and epidural block under general anesthesia. This study, in the both general anesthesia and epidural block under general anesthesia, ΔPTT of the toe and of the finger are measured. In addition, ΔPTT(toe-finger) of the epidural block under general anesthesia and of the general anesthesia were compared

  6. Effect of Epidural Block under General Anesthesia on Pulse Transit Time

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byeong Cheol [Choonhae College of Health Sciences, Ulsan (Korea, Republic of); Kim, Seong Min [Konkuk University, Seoul (Korea, Republic of); Jung, Dong Keun; Kim, Gi Ryon [Dong-A University, Busan (Korea, Republic of); Lee, He Jeong; Jeon, Gye Rock [Pusan National University, Busan (Korea, Republic of)

    2005-08-15

    Epidural block under general anesthesia has been widely used to control postoperative pain. In this anesthetic state many hemodynamic parameters are changed. Moreover pulse transit time is influenced by this memodynamic change. PPT change in the finger and the toe due to relaxation of arterial wall muscle after general anesthesia and epidural block under general anesthesia. This study, in the both general anesthesia and epidural block under general anesthesia, {Delta}PTT of the toe and of the finger are measured. In addition, {Delta}PTT(toe-finger) of the epidural block under general anesthesia and of the general anesthesia were compared

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

    International Nuclear Information System (INIS)

    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.

  8. 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.

  9. 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.

  10. Linking sleep and general anesthesia mechanisms: this is no walkover.

    Science.gov (United States)

    Bonhomme, V; Boveroux, P; Vanhaudenhuyse, A; Hans, P; Brichant, J F; Jaquet, O; Boly, M; Laureys, S

    2011-01-01

    This review aims at defining the link between physiological sleep and general anesthesia. Despite common behavioral and electrophysiological characteristics between both states, current literature suggests that the transition process between waking and sleep or anesthesia-induced alteration of consciousness is not driven by the same sequence of events. On the one hand, sleep originates in sub-cortical structures with subsequent repercussions on thalamo-cortical interactions and cortical activity. On the other hand, anesthesia seems to primarily affect the cortex with subsequent repercussions on the activity of sub-cortical networks. This discrepancy has yet to be confirmed by further functional brain imaging and electrophysiological experiments. The relationship between the observed functional modifications of brain activity during anesthesia and the known biochemical targets of hypnotic anesthetic agents also remains to be determined. PMID:22145259

  11. General anesthesia for nuclear magnetic resonance imaging

    International Nuclear Information System (INIS)

    The core of the MAGNETOM diagnostic device is a liquid helium-cooled cryogenic magnet, having the shape of a hollow cylinder about 2 m long, 50 to 60 cm i.d. Its inner space is designed to accommodate a bench with the patient, whose part examined, usually the head, is enclosed in a smaller coil and is located roughly in the center of the magnet. The examination takes 4 to 20 minutes, during which the patient must be fixed to prevent any motion. Inhalation anesthesia with spontaneous ventilation using the Jackson-Rees or Bain's system and a laryngeal mask is considered the safest way where no special equipment is employed. If artificial ventilation is necessary, balanced anesthesia with either manual ventilation using Bain's system or a fluidic type ventilator seems to be the best choice. The preparation of the patient prior to the examination, the premedication, and the monitoring equipment are described. (J.B.). 1 tab., 5 figs., 11 refs

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

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    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

  13. Cervical spinal cord compression after thyroidectomy under general anesthesia.

    Science.gov (United States)

    Yao, Wenlong; Qiu, Jin; Zhou, Zhiqiang; Zhang, Lin; Zhang, Chuanhan

    2014-02-01

    Cervical spinal cord injury is a rare but serious complication after general anesthesia. The risk factors include traumatic cervical injury, cervical spine instability, and difficult airway management. It has also occurred in the absence of cervical instability. Here we report a patient who had a history of intermittent neck pain without numbness. Preoperative radiologic examinations showed degenerative changes in the cervical spine. She developed progressive tingling and numbness in her limbs after thyroidectomy under general anesthesia. Magnetic resonance imaging showed a cervical disc protruding into the canal at C5-C6, which was considered to be induced by surgical positioning. She recovered after anterior cervical decompression and internal fixation surgery. PMID:23828450

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

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    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

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

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    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.

  16. 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. PMID:2730732

  17. The Thermodynamics of General and Local Anesthesia

    Science.gov (United States)

    Græsbøll, Kaare; Sasse-Middelhoff, Henrike; Heimburg, Thomas

    2014-05-01

    General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. This analysis is able to describe experimentally observed calorimetric profiles and permits prediction of the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff-effect of long-chain alcohols and the additivity of the effect of general and local anesthetics.

  18. The thermodynamics of general and local anesthesia

    CERN Document Server

    Graesboll, Kaare; Heimburg, Thomas

    2014-01-01

    General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. This analysis is able to describe experimentally observed calorimetric profiles and permits prediction of the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff-effect of long-chain alcohols and the additivity of the effect of general and local anesthetics.

  19. Acute Unilateral Parotid Glands Enlargement Following Endotracheal General Anesthesia: Report of Two Cases

    OpenAIRE

    Hung-Jr Chiou; Yuan-Ji Day; Allen H. Li; Jiin-Tarng Liou; Fu-Chao Liu

    2007-01-01

    Acute parotid gland enlargement in association with general anesthesia is rare and hasalso been called anesthesia mumps. We present two patients who were scheduled for lumbarspine surgery under general anesthesia. Each developed acute unilateral parotid glandenlargement over one side of the face proven by sonography. Case 1: A 52-year-old manwas scheduled for his third lumbar spine to first sacral spine surgery for scoliosis andspondylolisthesis. The patient was provided general anesthesia wi...

  20. Is Hydrogen Sulfide-Induced Suspended Animation General Anesthesia?

    OpenAIRE

    Li, Rosie Q.; McKinstry, Andrew R.; Moore, Jason T.; Caltagarone, Breanna M.; Eckenhoff, Maryellen F.; Eckenhoff, Roderic G.; Kelz, Max B.

    2012-01-01

    Hydrogen sulfide (H2S) depresses mitochondrial function and thereby metabolic rates in mice, purportedly resulting in a state of “suspended animation.” Volatile anesthetics also depress mitochondrial function, an effect that may contribute to their anesthetic properties. In this study, we ask whether H2S has general anesthetic properties, and by extension, whether mitochondrial effects underlie the state of anesthesia. We compared loss of righting reflex, electroencephalography, and electromy...

  1. 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 surgi...

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

    OpenAIRE

    Campbell, Peter

    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...

  3. Asystole during pulmonary artery catheter insertion under general anesthesia

    Directory of Open Access Journals (Sweden)

    Swapna Chaudhuri

    2012-01-01

    Full Text Available In spite of ongoing debate for the past 40 years, pulmonary artery catheters remain in use for invasive hemodynamic monitoring and management of critically ill patients. We describe a case of a sudden onset of asystolic cardiac arrest during the placement of a pulmonary artery catheter, while under general anesthesia. A brief review of the literature highlighting arrhythmic complications associated with pulmonary artery catheterization is also presented.

  4. Sedation or general anesthesia for transcatheter aortic valve implantation (TAVI)

    OpenAIRE

    Mayr, N. Patrick; Michel, Jonathan; Bleiziffer, Sabine; Tassani, Peter; Martin, Klaus

    2015-01-01

    Transfemoral transcatheter aortic valve implantation (TAVI) is nowadays a routine therapy for elderly patients with severe aortic stenosis (AS) and high perioperative risk. With growing experience, further development of the devices, and the expansion to “intermediate-risk” patients, there is increasing interest in performing this procedure under conscious sedation (TAVI-S) rather than the previously favoured approach of general anesthesia (TAVI-GA). The proposed benefits of TAVI-S include; r...

  5. Sedation or general anesthesia for transcatheter aortic valve implantation (TAVI).

    Science.gov (United States)

    Mayr, N Patrick; Michel, Jonathan; Bleiziffer, Sabine; Tassani, Peter; Martin, Klaus

    2015-09-01

    Transfemoral transcatheter aortic valve implantation (TAVI) is nowadays a routine therapy for elderly patients with severe aortic stenosis (AS) and high perioperative risk. With growing experience, further development of the devices, and the expansion to "intermediate-risk" patients, there is increasing interest in performing this procedure under conscious sedation (TAVI-S) rather than the previously favoured approach of general anesthesia (TAVI-GA). The proposed benefits of TAVI-S include; reduced procedure time, shorter intensive care unit (ICU) length of stay, reduced need for intraprocedural vasopressor support, and the potential to perform the procedure without the direct presence of an anesthetist for cost-saving reasons. To date, no randomized trial data exists. We reviewed 13 non-randomized studies/registries reporting data from 6,718 patients undergoing TAVI (3,227 performed under sedation). Patient selection, study methods, and endpoints have differed considerably between published studies. Reported rates of in-hospital and longer-term mortality are similar for both groups. Up to 17% of patients undergoing TAVI-S require conversion to general anesthesia during the procedure, primarily due to vascular complications, and urgent intubation is frequently associated with hemodynamic instability. Procedure related factors, including hypotension, may compound preexisting age-specific renal impairment and enhance the risk of acute kidney injury. Hypotonia of the hypopharyngeal muscles in elderly patients, intraprocedural hypercarbia, and certain anesthetic drugs, may increase the aspiration risk in sedated patients. General anesthesia and conscious sedation have both been used successfully to treat patients with severe AS undergoing TAVI with similar reported short and long-term mortality outcomes. The authors believe that the significant incidence of complications and unplanned conversion to general anesthesia during TAVI-S mandates the start-to-finish presence

  6. 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

  7. 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...... randomized controlled trials comparing modern general anesthesia and spinal anesthesia for knee and hip arthroplasty prevents final recommendations and calls for prospective detailed studies in this clinically important field....

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

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger; Krøigaard, Mogens; Belhage, Bo; Husum, Bent; Poulsen, Lars K

    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....

  9. An essential role for orexins in emergence from general anesthesia

    Science.gov (United States)

    Kelz, Max B.; Sun, Yi; Chen, Jingqiu; Cheng Meng, Qing; Moore, Jason T.; Veasey, Sigrid C.; Dixon, Shelley; Thornton, Marcus; Funato, Hiromasa; Yanagisawa, Masashi

    2008-01-01

    The neural mechanisms through which the state of anesthesia arises and dissipates remain unknown. One common belief is that emergence from anesthesia is the inverse process of induction, brought about by elimination of anesthetic drugs from their CNS site(s) of action. Anesthetic-induced unconsciousness may result from specific interactions of anesthetics with the neural circuits regulating sleep and wakefulness. Orexinergic agonists and antagonists have the potential to alter the stability of the anesthetized state. In this report, we refine the role of the endogenous orexin system in impacting emergence from, but not entry into the anesthetized state, and in doing so, we distinguish mechanisms of induction from those of emergence. We demonstrate that isoflurane and sevoflurane, two commonly used general anesthetics, inhibit c-Fos expression in orexinergic but not adjacent melanin-concentrating hormone (MCH) neurons; suggesting that wake-active orexinergic neurons are inhibited by these anesthetics. Genetic ablation of orexinergic neurons, which causes acquired murine narcolepsy, delays emergence from anesthesia, without changing anesthetic induction. Pharmacologic studies with a selective orexin-1 receptor antagonist confirm a specific orexin effect on anesthetic emergence without an associated change in induction. We conclude that there are important differences in the neural substrates mediating induction and emergence. These findings support the concept that emergence depends, in part, on recruitment and stabilization of wake-active regions of brain. PMID:18195361

  10. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    Directory of Open Access Journals (Sweden)

    Tien-En Huang

    2007-04-01

    Full Text Available Background: The aim of this study was to evaluate the indications, safety, benefits, disadvantagesand advantages, and the visual outcomes for simultaneous bilateralcataract surgery (SBCS under general anesthesia.Methods: This retrospective case review pertained to a period spanning from June1998 through June 2005 inclusively, and comprised of 27 consecutivepatients (54 eyes that underwent simultaneous bilateral cataract surgeryunder general anesthesia at the Kaohsiung Chang Gung Memorial Hospital,Taiwan. Surgery modalities included phacoemulsification, extracapsularcataract extraction, lens aspiration and intraocular lens implantation.Outcome measures included postoperative best correct visual acuity (BCVAas well as intraoperative and postoperative complication rates. Due to thebipolas distribution of the age, we arbitrarily divided our cases into youngergroup (Group Y, younger than 20 years old and older group (Group O, equalto or older than 20 years old.Results: Thirty-eight of the 54 eyes (60% in the younger group and 76.5% in theolder group, featuring measured preoperative and postoperative BSCVA,achieved improved visual acuity following SBCS. Two eyes (5.9% in theolder group demonstrated poorer visual acuity postoperatively than preoperatively.Seven patients (40% in the younger group and 17.6% in the oldergroup were not able to express VA due to their particular medical conditionssuch as mental disease and young age. Intraoperative and postoperative complicationrates were similar to those cited in previous reports of analogousbut unilateral extracapsular surgery and simultaneous bilateral cataractsurgery. Endophthalmitis did not arise in any of the eyes operated upon andreported on herein, and no examples of bilateral complications that resultedin visual loss occurred in our patients.Conclusion: SBCS could be a good choice when cataract surgery needs to be performedunder general anesthesia. The relative benefits of SBCS under general

  11. General anesthesia for the heaviest man in the world

    OpenAIRE

    Abdullah S. Terkawi; Mahmood Rafiq; Reaad Algadaan; Insha Ur Rehman; Doais, Khaled S.; Durieux, Marcel E.; Mazen AlSohaibani

    2014-01-01

    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 manage...

  12. 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.

  13. 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...

  14. General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis

    OpenAIRE

    Emery N Brown; Purdon, Patrick L.; Van Dort, Christa J.

    2011-01-01

    Placing a patient in a state of general anesthesia is crucial for safely and humanely performing most surgical and many nonsurgical procedures. How anesthetic drugs create the state of general anesthesia is considered a major mystery of modern medicine. Unconsciousness, induced by altered arousal and/or cognition, is perhaps the most fascinating behavioral state of general anesthesia. We perform a systems neuroscience analysis of the altered arousal states induced by five classes of intraveno...

  15. 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; Pedersen, M H; Kehlet, H

    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...... 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 of late postoperative constant and episodic hypoxemia, which instead may be related to the magnitude of trauma and/or opioid administration....

  16. Spinal and epidural anesthesia

    Science.gov (United States)

    Intraspinal anesthesia; Subarachnoid anesthesia; Epidural; Peridural anesthesia ... Spinal and epidural anesthesia have fewer side effects and risks than general anesthesia (asleep and pain-free). Patients usually recover their senses ...

  17. 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...... study. 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...

  18. Rupture of the Pulmonary Alveoli During General Anesthesia1,2

    OpenAIRE

    Miller, Ronald; Bongiorno, Frank

    1983-01-01

    The rupture of pulmonary alveoli during the induction of general anesthesia is a significant complication of general anesthesia that has been seldom reported in our literature. This article documents this occurrence in a patient scheduled for elective orthognathic surgery. The diagnosis and treatment are discussed.

  19. Myocardial fibrosis in a horse with polymorphic ventricular tachycardia observed during general anesthesia

    OpenAIRE

    Coudry, Virginie; Jean, Daniel; Desbois, Christophe; Tnibar, Aziz; Laugier, Claire; George, Catherine

    2007-01-01

    Ventricular dysrhythmias are more commonly associated with myocardial disease than are supraventricular dysrhythmias. Management of arrhythmias under general anesthesia is difficult because of the dysrhythmogenic effects of the anesthetic drugs. This report describes a severe ventricular dysrhythmia observed in a pony under general anesthesia, with a severe and old myocardial fibrosis found on postmortem examination.

  20. Different Aspects of General Anesthesia in Pediatric Dentistry: A Review

    Science.gov (United States)

    Ramazani, Nahid

    2016-01-01

    Context Most child population is able to undergo dental treatment in the conventional setting. However, some children fail to cope with in-office conscious state and cannot respond to usual management modalities. This review aims to discuss the topic further. Evidence Acquisition A computerized search in databases PubMed, MEDLINE, EMBASE, Google Scholar and Google were performed using dental general anesthesia related keywords. Original and review English-written articles that were limited to child population were retrieved without any limitation of publication date. The suitable papers were selected and carefully studied. A data form designed by author was used to write relevant findings. Results Preoperative oral examination and comprehensive evaluation of treatment needs is only possible after clinical and radiographic oral examination. Effective collaboration in dental GA team should be made to minimize psychological trauma of children who undergo dental GA. Before conducting comprehensive dental treatment under GA, the general health of the child and the success rate of procedures provided needs to be accurately evaluated. It is noteworthy that determination of the optimal timing for GA dental operation is of great importance. Providing safety with pediatric dental rehabilitation under GA is critical. Conclusions Besides criteria for case selection of dental GA, some degree of dental practitioner’s judgment is required to make decision. Pre- and post-operative instructions to parents or caregiver decrease the risk of complications. However, trained resuscitation providers, careful monitoring and advanced equipment minimize adverse outcomes. PMID:27307962

  1. Comparison of Postoperative Events between Spinal Anesthesia and General Anesthesia in Laparoscopic Cholecystectomy: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Wang, Xian-Xue; Zhou, Quan; Deng, Hui-Wei; Zhou, Ai-Guo; Guo, Hua-Jing; Huang, Fu-Rong

    2016-01-01

    Background. Laparoscopic cholecystectomy is usually carried out under general anesthesia. There were a few studies which have found spinal anesthesia as a safe alternative. We aimed to evaluate the postoperative events between spinal anesthesia and general anesthesia in patients undergoing laparoscopic cholecystectomy. Methods. We searched PubMed, Embase, and Cochrane Library (from inception to January 2016) for eligible studies. The primary outcome was the visual analogue scale score. Secondary outcomes included postoperative nausea and vomiting and urine retention 24 hours postoperatively. We calculated pooled risk ratios and 95% confidence interval using random- or fixed-effects models. Results. Eight trials involving 723 patients were listed. Meta-analysis showed that patients in spinal anesthesia groups have lower visual analogue scale score 24 hours postoperatively. There were significant decreases in the occurrence of postoperative nausea and vomiting in spinal anesthesia group when compared with general anesthesia group (odds ratios: 0.38, 95% confidence interval: 0.19–0.76; P = 0.006) with heterogeneity accepted (I2 = 13%; P = 0.33), while urine retention rate was increased in patients with spinal anesthesia (odds ratios: 4.95, 95% confidence interval: 1.24–19.71; P = 0.02) without any heterogeneity (I2 = 0%; P = 0.98). Conclusions. Spinal anesthesia may be associated with less postoperative pain and postoperative nausea and vomiting compared with general anesthesia. PMID:27525282

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

    Directory of Open Access Journals (Sweden)

    Jasminka Nancheva

    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.

  3. An essential role for orexins in emergence from general anesthesia

    OpenAIRE

    Kelz, Max B.; Sun, Yi; Chen, Jingqiu; Cheng Meng, Qing; Moore, Jason T.; Veasey, Sigrid C.; Dixon, Shelley; Thornton, Marcus; Funato, Hiromasa; Yanagisawa, Masashi

    2008-01-01

    The neural mechanisms through which the state of anesthesia arises and dissipates remain unknown. One common belief is that emergence from anesthesia is the inverse process of induction, brought about by elimination of anesthetic drugs from their CNS site(s) of action. Anesthetic-induced unconsciousness may result from specific interactions of anesthetics with the neural circuits regulating sleep and wakefulness. Orexinergic agonists and antagonists have the potential to alter the stability o...

  4. [Atelectasis in general anesthesia and alveolar recruitment strategies].

    Science.gov (United States)

    Martínez, G; Cruz, P

    2008-10-01

    Atelectasis occurs in most patients during general anesthesia and is the main cause of hypoxemia. The objective of this review is to examine the causes and diagnosis of atelectasis and the different strategies for reducing or preventing this complication and improving oxygenation. Pulmonary atelectasis is mainly caused by 3 factors: compression, gas absorption, and lack of surfactant. Compression and gas absorption are, however, the 2 most commonly implicated factors. Lung collapse is accentuated if pure oxygen is inhaled during induction or if the patient is morbidly obese. Laparoscopic, thoracic, and upper abdominal interventions also carry risk of lung collapse. Various techniques may be used to prevent atelectasis or to reopen collapsed lung tissue. These include using positive end-expiratory pressure or a high tidal volume-thus providing a higher airway pressure (vital capacity maneuver)-or both in combination. Alveolar recruitment strategies have been tried in bariatric surgery, single-lung ventilation, laparoscopy, and adult respiratory distress syndrome. Their application has reduced or prevented atelectasis, thereby reducing postoperative pulmonary complications. PMID:18982787

  5. Propofol-Based Sedation Versus General Anesthesia for Endoscopic Submucosal Dissection.

    Science.gov (United States)

    Yurtlu, Derya Arslan; Aslan, Fatih; Ayvat, Pinar; Isik, Yasemin; Karakus, Nesli; Ünsal, Belkis; Kizilkaya, Mehmet

    2016-05-01

    The main objective of this study is to evaluate general anesthesia or propofol-based sedation methods at gastric endoscopic submucosal dissection (ESD) procedures.The anesthetic method administered to cases undergoing upper gastrointestinal ESD between 2013 and 2015 was retrospectively investigated. Procedure time, lesion size, dissection speed, anesthesia time, adverse effects such as gag reflex, nausea, vomiting, cough, number of desaturation episodes (SpO2 fentanyl were significantly higher (P < 0.05). Anesthesia time, postoperative anesthesia care unit, and hospital stay durations were not significantly different between the groups.General anesthesia increased dissection speed and enhanced endoscopist performance when compared with propofol-based sedation technique. PMID:27196474

  6. Emergence from general anesthesia and the sleep-manifold

    Directory of Open Access Journals (Sweden)

    Darren Fletcher Hight

    2014-08-01

    Full Text Available The electroencephalogram (EEG during the re-establishment of consciousness after general anesthesia and surgery varies starkly between patients. Can the EEG during this emergence period provide a means of estimating the underlying biological processes underpinning the return of consciousness? Can we use a model to infer these biological processes from the EEG patterns? A frontal EEG was recorded from 84 patients. Ten patients were chosen for state-space analysis. Five showed archetypal emergences; which consisted of a progressive decrease in alpha power and increase peak alpha frequency before return of responsiveness. The five non-archetypal emergences showed almost no spectral EEG changes (even as the volatile general anesthetic decreased and then an abrupt return of responsiveness. We used Bayesian methods to estimate the likelihood of an EEG pattern corresponding to the position of the patient on a 2-dimensional manifold in a state space of excitatory connection strength vs change in intrinsic resting neuronal membrane conductivity. We could thus visualize the trajectory of each patient in the state-space during their emergence period. The patients who followed an archetypal emergence displayed a very consistent pattern; consisting of progressive increase in conductivity, and a temporary period of increased connection strength before return of responsiveness. The non-archetypal emergence trajectories remained fixed in a region of phase space characterized by a relatively high conductivity and low connection strength throughout emergence. This unexpected progressive increase in conductivity during archetypal emergence may be due to an abating of the surgical stimulus during this period. Periods of high connection strength could represent forays into dissociated consciousness, but the model suggests all patients reposition near the fold in the state space to take advantage of bi-stable cortical dynamics before transitioning to consciousness.

  7. Electrical stimulation of the parabrachial nucleus induces reanimation from isoflurane general anesthesia.

    Science.gov (United States)

    Muindi, Fanuel; Kenny, Jonathan D; Taylor, Norman E; Solt, Ken; Wilson, Matthew A; Brown, Emery N; Van Dort, Christa J

    2016-06-01

    Clinically, emergence from general anesthesia is viewed as a passive process where anesthetics are discontinued at the end of surgery and anesthesiologists wait for the drugs to wear off. The mechanisms involved in emergence are not well understood and there are currently no drugs that can actively reverse the state of general anesthesia. An emerging hypothesis states that brain regions that control arousal become active during emergence and are a key part of the return to wakefulness. In this study, we tested the hypothesis that electrical activation of the glutamatergic parabrachial nucleus (PBN) in the brainstem is sufficient to induce reanimation (active emergence) during continuous isoflurane general anesthesia. Using c-Fos immunohistochemistry as a marker of neural activity, we first show a selective increase in active neurons in the PBN during passive emergence from isoflurane anesthesia. We then electrically stimulated the PBN to assess whether it is sufficient to induce reanimation from isoflurane general anesthesia. Stimulation induced behavioral arousal and restoration of the righting reflex during continuous isoflurane general anesthesia. In contrast, stimulation of the nearby central inferior colliculus (CIC) did not restore the righting reflex. Spectral analysis of the electroencephalogram (EEG) revealed that stimulation produced a significant decrease in EEG delta power during PBN stimulation. The results are consistent with the hypothesis that the PBN provides critical arousal input during emergence from isoflurane anesthesia. PMID:26971629

  8. A comparative study of pain following endodontic treatment under general anesthesia

    Directory of Open Access Journals (Sweden)

    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.

  9. [Contribution of functional neuroimaging studies to the understanding of the mechanisms of general anesthesia].

    Science.gov (United States)

    Boveroux, P; Bonhomme, V; Kirsch, M; Noirhomme, Q; Ledoux, D; Hans, G; Laureys, S; Luxen, A; Brichant, J F

    2009-01-01

    Since the early beginning of anesthesia, almost 2 centuries ago, ignorance has prevailed regarding the cerebral mechanisms of the loss of consciousness induced by general anesthesia. The recent contribution of functional brain imaging studies has allowed considerable progress in that domain. Similarly, the study of brain function under general anesthesia is currently a major tool for the understanding of conscious phenomena. This functional approach leads to conceptual changes about the functioning brain and may ultimately provide tracks for new treatments and practical applications. All these aspects are reviewed in this paper, at the light of the most recent literature. PMID:20085014

  10. General anesthesia-associatedDNA damage in peripheral blood mononuclear cells of surgical patients

    Institute of Scientific and Technical Information of China (English)

    Wang Haiyan; Zhou Qi; Fu Huo

    2011-01-01

    Objective:To evaluate retrospectively the effect of general anesthesia onDNA damage in the blood mononuclear cells (PBMCs) of surgical patients in order to provide evidence for a better nursing care during the procedure.Methods: Clinical charts of76 patients who underwent operation under general anesthesia and76 healthy control subjects with documented results of DNA damage extent inPBMCs from the single-cell gel electrophoresis(SCGE) or comet assay and serum contents of superoxide dismutase(SOD) and malondialdehyde(MDA)from biochemical analyses were reviewed. The percentage of comet PBMCs and tailDNAand serum contents of SOD and MAD were analyzed by student t-test.Results: Compared with healthy control subjects, generally anesthetized surgical patients had significantly higher % cometPBMCs and % tail DNA(P<0.05) and significantly lower serum concentrations ofSOD (P<0.05) and significantly higher serum concentrations ofMAD (P<0.05). Compared with levels before general anesthesia in surgical patients, % cometPBMCs, % tailDNA, and serum levels ofMADwere significantly higher (P<0.05 or0.01), and serum levels ofSOD were significantly lower (P<0.05), after general anesthesia.Conclusions: General anesthesia during surgery causes a certain degree of hypoxia and PBMC damage. Particular attention should be paid to monitoring and maintenance of blood oxygen saturation in patients undergoing surgery under general anesthesia.

  11. Effects of deep sedation or general anesthesia on cardiac function in mice undergoing cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Kutschke William

    2009-05-01

    Full Text Available Abstract Background Genetically engineered mouse models of human cardiovascular disease provide an opportunity to understand critical pathophysiological mechanisms. Cardiovascular magnetic resonance (CMR provides precise reproducible assessment of cardiac structure and function, but, in contrast to echocardiography, requires that the animal be immobilized during image acquisition. General anesthetic regimens yield satisfactory images, but have the potential to significantly perturb cardiac function. The purpose of this study was to assess the effects of general anesthesia and a new deep sedation regimen, respectively, on cardiac function in mice as determined by CMR, and to compare them to results obtained in mildly sedated conscious mice by echocardiography. Results In 6 mildly sedated normal conscious mice assessed by echo, heart rate was 615 ± 25 min-1 (mean ± SE and left ventricular ejection fraction (LVEF was 0.94 ± 0.01. In the CMR studies of normal mice, heart rate was slightly lower during deep sedation with morphine/midazolam (583 ± 30 min-1, but the difference was not statistically significant. General anesthesia with 1% inhaled isoflurane significantly depressed heart rate (468 ± 7 min-1, p In mice with ischemic LV failure, ejection fraction measurements were comparable when performed during light sedation, deep sedation, and general anesthesia, respectively. Contrast-to-noise ratios were similar during deep sedation and during general anesthesia, indicating comparable image quality. Left ventricular mass measurements made by CMR during deep sedation were nearly identical to those made during general anesthesia (r2 = 0.99, mean absolute difference Conclusion In mice with normal cardiac function, CMR during deep sedation causes significantly less depression of heart rate and ejection fraction than imaging during general anesthesia with isoflurane. In mice with heart failure, the sedation/anesthesia regimen had no clear impact on

  12. Effect of Passive Smoke Exposure on General Anesthesia for Pediatric Dental Patients

    OpenAIRE

    Thikkurissy, S; Crawford, Bethany; Groner, Judith; Stewart, Roderick; Smiley, Megann K.

    2012-01-01

    The purpose of this study was to test the null hypothesis that children with environmental tobacco smoke (ETS) exposure (also known as passive smoke exposure) do not demonstrate an increased likelihood of adverse respiratory events during or while recovering from general anesthesia administered for treatment of early childhood caries. Parents of children (ages 19 months–12 years) preparing to receive general anesthesia for the purpose of dental restorative procedures were interviewed regardin...

  13. Behavioral and emotional effects of repeated general anesthesia in young children

    OpenAIRE

    Bakri, Mohamed H.; Ismail, Eman A.; Ali, Mohamed S.; Elsedfy, Ghada O.; Sayed, Taher A.; Ahmed Ibrahim

    2015-01-01

    Background: Preclinical and clinical data suggest the possibility of neurotoxicity following exposure of young children to general anesthetics with subsequent behavioral disturbances. The aim of the study was to determine the overall effect of repeated general anesthesia on behavior and emotions of young children aged 1½-5 years old, compared to healthy children. Materials and Methods: Thirty-five children underwent repeated anesthesia and surgery were matched with the same number of healthy ...

  14. Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index

    OpenAIRE

    Sayed Mohammad Reza Hadavi; Elaheh Allahyary; Saman Asadi

    2013-01-01

    Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S) because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS), end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S. Methods: This study was carried out on 60 parturient patients undergoing elective C/...

  15. Ingestion of a Fixed Partial Denture During General Anesthesia

    OpenAIRE

    Neustein, Steve; Beicke, Mark

    2007-01-01

    Dental trauma during anesthesia is a common occurrence. Many patients have had extensive dental work, which is more fragile than the natural dentition. This work may include crowns, fixed partial dentures (bridges), and porcelain veneers. We report for the first time, a case in which a fixed partial denture became dislodged and was ingested, and was recovered postoperatively with endoscopy.

  16. A Comparison of Satisfaction; Spinal versus General Anesthesia for Cesarean Section

    International Nuclear Information System (INIS)

    Objective: To compare the patients satisfaction with spinal and general anesthesia after cesarean section at CMH Lahore. Study Design: Randomized controlled trials. Study Setting: The study was conducted at the department of Obstetrics and Gynaecology combined military Hospital, Lahore, for 6 months from July to Dec 2011. Patients and Methods: Total 70 patients were included in the study and randomly divided into two groups of 35 each using random numbers table. All patients between ages of 20-40 years admitted for elective cesarean section and presented for following up at day 5-7 who never had any type of anesthesia in the past. There included in the study patients with complaints of migraine, low backaches, positive history or any other medical disorder were excluded from the study. Results: A total number of patients included were 70. Out of these selected patients, 35 procedures were carried out under spinal anesthesia and 35 under general anesthesia. Insignificant difference was found in satisfaction level of both the groups (p=0.220). There is significant difference for the future choice between two groups (p<0.001). Conclusion: Spinal anesthesia provides equal satisfaction for patients of cesarean section than general anesthesia. (author)

  17. 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

  18. Case Sequencing of Diagnostic Imaging Studies Performed Under General Anesthesia or Monitored Anesthesia Care During Nights and Weekends.

    Science.gov (United States)

    Mueller, Rashmi N; Dexter, Franklin; Truong, Van-Anh; Wachtel, Ruth E

    2015-11-01

    General anesthesia or monitored anesthesia care sometimes is provided in nonoperating room (OR) locations during nights and weekends (e.g., for magnetic resonance imaging [MRI] or computerized tomography [CT]). Rational and consistent scheduling and sequencing decisions for these diagnostic imaging procedures, including coordination with OR cases, cannot be done without knowing how long each case can wait to be started without risking a worsening of the patient's condition. We reviewed the medical records of the 81 patients who underwent diagnostic imaging procedures (78 = MRI, 3 = CT scan) under general anesthesia or monitored anesthesia care either on weekends or between 6 pm and 6 am at the University of Iowa Hospitals between March 2012 and February 2014. For 77.8% of patients, the indications could have changed clinical management within 4 hours (N = 63/81). Among the 63 imaging studies with potential immediate impact, there was documentation of results having been communicated to the treating team within 4 hours of the completion of imaging for 39 of the patients. Among the 39 patients, 15 promptly received medications or underwent procedures based on the imaging results. Thus, 15 of the 81 patients had a change in care (18.5%, 95% lower confidence limit = 11.2%). Our results are important since we showed previously that it is not possible to make rational and consistent decisions in case sequencing without knowing how long each case (including diagnostic imaging procedures) can wait to be started without a change in the patient's risk. The scheduled surgical procedure itself provides sufficient information to assess safe waiting times to start add-on cases (e.g., appendectomy). In contrast, MRI provides no context as to how potential findings will influence treatment. Our results show that the assumption cannot reasonably be made when sequencing cases that all imaging studies can or cannot wait longer than pending surgical procedures. Our results show that

  19. General Anesthesia for Dental Treatment in a Patient With Huntington's Chorea.

    Science.gov (United States)

    Haimov-Kaldess, Irena; Haim, Doron; Garfunkel, Adi

    2016-01-01

    General dentists may be challenged with treating patients with neurodegenerative brain disorders. The primary goal in general anesthesia for these patients is to provide airway protection and a rapid and safe recovery. This article discusses factors that are of significant concern to the dentistanesthesiologist team treating patients with Huntington's disease and other neurodegenerative conditions. It includes a case report that describes the treatment of a patient with a neurodegenerative disease characterized by uncontrolled movements and which required general anesthesia. The safety of the used necessary medication is accentuated. PMID:26863217

  20. [Effects of epidural analgesia combined with general anesthesia on hemodynamics during neck surgery].

    Science.gov (United States)

    Arakawa, M; Amemiya, N; Nagai, K; Kato, S; Goto, F

    1993-10-01

    The aim of the present study was to investigate the effect of epidural analgesia combined with general anesthesia on hemodynamics. Thirty patients undergoing surgery for the treatment of cancer of the neck were studied. The patients were divided into two groups of those who received epidural analgesia combined with general anesthesia group (Group 1) and those with general anesthesia alone (Group 2). Blood pressure was not different between the groups. But heart rate and rate pressure products in Group 1 were significantly lower than those of Group 2. CVP in Group 1 increased significantly to 10.1 +/- 2.9 mmHg during surgery from 6.8 +/- 1.8 mmHg at the beginning of the surgery. There was no difference in intraoperative blood loss and the amount of fluid infused between the two groups. These results suggest that epidural anesthesia combined with general anesthesia is effective to stabilize hemodynamics during cervical surgery, but we have to be careful about using local anesthetics during long cervical procedures, because it increases CVP which might result from the depression of cardiac function. PMID:8230698

  1. Physiological Signal Processing for Individualized Anti-nociception Management During General Anesthesia: A Review

    Science.gov (United States)

    Bonhomme, V.; Jeanne, M.; Boselli, E.; Gruenewald, M.; Logier, R.; Richebé, P.

    2015-01-01

    Summary Objective The aim of this paper is to review existing technologies for the nociception / anti-nociception balance evaluation during surgery under general anesthesia. Methods General anesthesia combines the use of analgesic, hypnotic and muscle-relaxant drugs in order to obtain a correct level of patient non-responsiveness during surgery. During the last decade, great efforts have been deployed in order to find adequate ways to measure how anesthetic drugs affect a patient’s response to surgical nociception. Nowadays, though some monitoring devices allow obtaining information about hypnosis and muscle relaxation, no gold standard exists for the nociception / anti-nociception balance evaluation. Articles from the PubMed literature search engine were reviewed. As this paper focused on surgery under general anesthesia, articles about nociception monitoring on conscious patients, in post-anesthesia care unit or in intensive care unit were not considered. Results In this article, we present a review of existing technologies for the nociception / anti-nociception balance evaluation, which is based in all cases on the analysis of the autonomous nervous system activity. Presented systems, based on sensors and physiological signals processing algorithms, allow studying the patients’ reaction regarding anesthesia and surgery. Conclusion Some technological solutions for nociception / antinociception balance monitoring were described. Though presented devices could constitute efficient solutions for individualized anti-nociception management during general anesthesia, this review of current literature emphasizes the fact that the choice to use one or the other mainly relies on the clinical context and the general purpose of the monitoring. PMID:26293855

  2. Effect of Oral Midazolam Premedication on Children’s Co-operation Before General Anesthesia in Pediatric Dentistry

    OpenAIRE

    Nasser Kaviani; Mina Shahtusi; Maryam Haj Norousali Tehrani; Sara Nazari

    2014-01-01

    Statement of the Problem: Premedication is expedient in reducing the psychological trauma from recalling the unpleasant pre-anesthetic phases, hence, inducing a trouble-free anesthesia. Purpose: This study aimed to determine the effectiveness of oral midazolam in co-operation of the subjects before general anesthesia and in recalling the pre-anesthetic phases, performed on children candidate for dental treatment under general anesthesia. Materials and Method: In this prospective clini...

  3. Response of left ventricular ejection fraction to recovery from general anesthesia: measurement by gated radionuclide angiography

    International Nuclear Information System (INIS)

    To test the hypothesis that, after anesthesia for noncardiac surgical procedures, the increased cardiac work during recovery induces wall motion and ejection fraction (EF) abnormalities in patients with mild angina pectoris, gated radionuclide angiography was performed in patients undergoing simple cholecystectomy under narcotic-relaxant general anesthesia. The ejection fraction was determined during anesthesia at the end of surgery, and then determined 3 min and 3 hr after extubation. A new angiography was performed 24 hr later, and a myocardial scintigraphy (Thallium 201) was performed during infusion of the coronary vasodilator, dipyridamole. In the first part of the investigation, eight patients without coronary artery disease (CAD) (group 1) and 20 patients with mild angina (group 2) were studied. In the second part of the study, seven patients (group 3) with mild angina pectoris received an intravenous infusion of 0.4 microgram X kg-1 X min-1 of nitroglycerin started before surgery and gradually decreased 4 hr after extubation. In group 1, EF remained unchanged at recovery. In contrast in group 2, EF responded abnormally to recovery: EF decreased from 55% during anesthesia to 45% 3 min after extubation (P less than 0.001). Patients in group 3, who received intravenous nitroglycerin, showed no change of EF at recovery. This study demonstrates that recovery from general anesthesia causes abnormalities in left ventricular function in patients suffering from CAD. These abnormalities are prevented by prophylactic intravenous nitroglycerin

  4. Response of left ventricular ejection fraction to recovery from general anesthesia: measurement by gated radionuclide angiography

    Energy Technology Data Exchange (ETDEWEB)

    Coriat, P.; Mundler, O.; Bousseau, D.; Fauchet, M.; Rous, A.C.; Echter, E.; Viars, P.

    1986-06-01

    To test the hypothesis that, after anesthesia for noncardiac surgical procedures, the increased cardiac work during recovery induces wall motion and ejection fraction (EF) abnormalities in patients with mild angina pectoris, gated radionuclide angiography was performed in patients undergoing simple cholecystectomy under narcotic-relaxant general anesthesia. The ejection fraction was determined during anesthesia at the end of surgery, and then determined 3 min and 3 hr after extubation. A new angiography was performed 24 hr later, and a myocardial scintigraphy (Thallium 201) was performed during infusion of the coronary vasodilator, dipyridamole. In the first part of the investigation, eight patients without coronary artery disease (CAD) (group 1) and 20 patients with mild angina (group 2) were studied. In the second part of the study, seven patients (group 3) with mild angina pectoris received an intravenous infusion of 0.4 microgram X kg-1 X min-1 of nitroglycerin started before surgery and gradually decreased 4 hr after extubation. In group 1, EF remained unchanged at recovery. In contrast in group 2, EF responded abnormally to recovery: EF decreased from 55% during anesthesia to 45% 3 min after extubation (P less than 0.001). Patients in group 3, who received intravenous nitroglycerin, showed no change of EF at recovery. This study demonstrates that recovery from general anesthesia causes abnormalities in left ventricular function in patients suffering from CAD. These abnormalities are prevented by prophylactic intravenous nitroglycerin.

  5. Effects of epidural analgesia using different concentrations of bupivacaine during combined general and epidural anesthesia

    Directory of Open Access Journals (Sweden)

    Unić-Stojanović Dragana

    2012-01-01

    Full Text Available Introduction. Thoracic epidural analgesia, combined with general anesthesia, is an established anesthetic choice for abdominal aortic surgery. However, there are controversies about the level of anesthesia as well as the dose and concentration of the local anesthetic used. The aim of the study was to compare the effects of two different concentrations of epidural bupivacaine on sevoflurane requirements and hemodynamic parameters during aortic surgery under combined epidural/general anesthesia. Methods and Material. Sixty patients scheduled for abdominal aortic surgery were randomly divided into two groups according to the concentration of local anesthetic used for epidural anesthesia: - Group 1- low concentration - where 0.125% bupivacaine was used, and - Group 2 - high concentration - where 0.5% bupivacaine was used at the beginning and then the concentration was reduced to 0.25%. Anesthesia was maintained with sevoflurane, the dose was adjusted to achieve the target entropy of 40-60. The measurements included the inspired sevoflurane concentrations, blood pressure, and heart rate at the beginning and every 5 min during the surgery. Results. Both groups had similar heart rate and blood pressure, but the inspired sevoflurane concentration was significantly higher and more variable in patients where bupivacaine 0.125% was used. Vasopressors were used more often and in higher doses in the 0.5% bupivacaine group, and in the same group the blood loss and fluid requirements were reduced. Conclusion. When 0.5% bupivacaine is used in combined thoracic epidural/ general anesthesia for aortic surgery, the sevoflurane concentrations are lower and less variable. In addition, the blood loss and fluid requirements are reduced.

  6. Effects of general and local anesthesia on the pharmacokinetics of cefazolin in patients undergoing orthopedic surgery.

    OpenAIRE

    Welch, W D; Jantzen, J P; K. Johnson; Bawdon, R E

    1985-01-01

    The pharmacokinetics of cefazolin in patients undergoing orthopedic surgery with either general (enflurane) or local (lidocaine or marcaine) anesthesia were studied. No differences in either mean serum levels at 30, 60, or 120 min after the intravenous injection of cefazolin or serum half-lives were seen between the two groups of patients.

  7. A case of sinus arrest caused by opening the mouth under general anesthesia.

    OpenAIRE

    Seo, K; Takayama, H.; Araya, Y.; Miura, K; Someya, G.

    1994-01-01

    We report a case in which transient sinus arrest was observed under general anesthesia. This was associated with opening the mouth and was thought to be caused by a trigeminovagal reflex. The reflex was interrupted by blocking bilaterally the third division of trigeminal nerve.

  8. Effect of cisatracurium versus atracurium on intraocular pressure in patients undergoing tracheal intubation for general anesthesia

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2011-01-01

    Conclusions: Compared with atracurium, administration of cisatracurium can better prevent the increase of IOP following tracheal intubation in general anesthesia. The observed difference might be related to different effects on hemodynamic variables. Application of these results in patients under ophthalmic surgery is warranted.

  9. Treatment Needs and Adverse Events Related to Dental Treatment under General Anesthesia for Individuals with Autism

    Science.gov (United States)

    Rada, Robert E.

    2013-01-01

    Individuals with autism can be quite challenging to treat in a routine dental-office setting, especially when extensive dental treatment and disruptive behavioral issues exist. Individuals with autism may also be at higher risk for oral disease. Frequently, general anesthesia is the only method to facilitate completion of the needed dental…

  10. Innovation: treatment by protons of a two years old girl under general anesthesia

    International Nuclear Information System (INIS)

    The proton therapy is a technique known for the treatment of skull tumors, skull base and face. Now it is possible to use it for young children because of the general anesthesia and teams collaboration. This method of treatment offers perspectives because of the number of young children treated. (N.C.)

  11. Dehydration, hemodynamics and fluid volume optimization after induction of general anesthesia

    OpenAIRE

    Yuhong Li; Rui He; Xiaojiang Ying; Robert G. Hahn

    2014-01-01

    OBJECTIVES: Fluid volume optimization guided by stroke volume measurements reduces complications of colorectal and high-risk surgeries. We studied whether dehydration or a strong hemodynamic response to general anesthesia increases the probability of fluid responsiveness before surgery begins. METHODS: Cardiac output, stroke volu...

  12. The influence of general anesthesia and surgery on cognition in old age: A twin study

    DEFF Research Database (Denmark)

    Dokkedal, Unni; Hansen, Tom G.; Rasmussen, Lars S;

    evidence for a substantial effect of general anesthesia on cognitive abilities, as only a modest difference was detected according to exposure to major surgery. Future unpaired and paired longitudinal studies will be conducted to assess cognitive decline in more detail and will include age at exposure and......Introduction: There is a pronounced variation in level of cognitive function and rate of cognitive decline in late life. Results from smaller human and animal studies suggest that exposure to anesthesia may be a risk factor for cognitive impairment. Using a twin design, the objective of the present...... study was to examine whether exposure to anesthesia and surgery is associated with level of cognitive function in middle and old age. Materials and Methods: The study is based on two population-based surveys comprising 8,503 Danish twins aged 45–102 years at study intake during 1995–2001. Through...

  13. [General anesthesia during short operations in patients using the herbal psychogenic stimulant CAT (Catha edulis)].

    Science.gov (United States)

    Nuzeĭli, M; Burov, N E; Marinchev, V N; Khureĭbi, Ia

    2009-01-01

    The specific features of general anesthesia during short inpatient operations were performed in 85 patients who were regular CAT users owing to their national habits. According to the herbal psychogenic stimulant CAT dependence, the patients were divided into 3 groups. The findings indicate that propofol (2 mg/kg) in combination with isoflurane and premedication as diatepam (0.1-0.15 mg/kg) and fentanyl (1 mg/kg) is the anesthesia of choice in all group patients. Ketamine in combination with isoflurane may be used in the controls and Group 1 patients with mild CAT dependence. In patients with moderate and severe CAT dependence, ketamine should be considered to be contraindicated due to the development of adverse psychomotor and somatic reactions requiring monitoring and drug correction in an intensive care unit. The results of the study have been introduced into practice on choosing the modes of anesthesia at the Revolution Hospital, Republic of Yemen. PMID:19824416

  14. One-week postoperative patency of lower extremity in situ bypass graft comparing epidural and general anesthesia

    DEFF Research Database (Denmark)

    Wiis, Julie Therese; Jensen-Gadegaard, Peter; Altintas, Ümit; Seidelin, Claus; Martusevicius, Robertas; Mantoni, Teit

    2014-01-01

    under epidural (n = 386) or general (n = 499) anesthesia. Thirty-day mortality (3.4% for epidural anesthesia versus 4.4% general anesthesia; P = 0.414) and comorbidity were comparable in the 2 groups. Graft occlusion within 7 days after surgery was reported in 93 patients, with a similar incidence in...... the epidural (10.1%) and general (10.8%) anesthesia groups (P = 0.730). When examining a subgroup of patients (n = 242) exposed to surgery on smaller vessels (femorodistal in situ bypass procedures, n = 253), the incidence of graft occlusion was also similar in the 2 groups at 14.0% and 9.......4%, respectively (P = 0.262). CONCLUSION: This retrospective study has shown that when graft patency is evaluated 7 days after surgery, anesthetic choice (epidural or general anesthesia) does not influence outcome....

  15. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal

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    Mercês Lobo

    2015-08-01

    Full Text Available BACKGROUND: Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results.OBJECTIVES: Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality in a tertiary center in Portugal and review the literature.METHODS: Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation.RESULTS: A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregional anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding per operative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference.CONCLUSIONS: We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers.

  16. Remifentanil at induction of general anesthesia for cesarean section: Double blind, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Shokoufeh Behdad

    2013-05-01

    Full Text Available Introduction: Remifentanil, with its rapid activity onset and short duration of action, may be more effective than other opioids for providing hemodynamic stability during obstetric anesthesia. However, there is some evidence of adverse effects on neonatal respiratory function. We investigated maternal and fetal effects of remifentanil during cesarean section surgery. Methods: Eighteen women with singleton term pregnancies, and physical class status of I or II as defined by the American Society of Anesthesia (ASA, who were undergoing general anesthesia for semi-elective cesarean section were randomized into two groups (40 in each group that received either and intravenous bolus of 0.5 µg/kg remifentanil or the same dose of saline as a placebo. Maternal hemodynamic variables and neonatal umbilical artery pH and Apgar score at first and fifth min were evaluated in both groups. Results: Systolic and diastolic blood pressure were significantly lower after tracheal intubation and skin incision in the remifentanil group as compared with the control group (p<0.05. There were no significant differences regarding heart rate between groups at any time (p>0.05. Apgar scores at first and fifth min were not significantly different among groups (p>0.05. No neonate required assisted ventilation or naloxan administration. Conclusion: Remifentanil may be a safe and effective drug for the induction of general anesthesia and surgical stimulation without subsequent neonatal depression. 

  17. Behavioral and emotional effects of repeated general anesthesia in young children

    Directory of Open Access Journals (Sweden)

    Mohamed H Bakri

    2015-01-01

    Full Text Available Background: Preclinical and clinical data suggest the possibility of neurotoxicity following exposure of young children to general anesthetics with subsequent behavioral disturbances. The aim of the study was to determine the overall effect of repeated general anesthesia on behavior and emotions of young children aged 1½-5 years old, compared to healthy children. Materials and Methods: Thirty-five children underwent repeated anesthesia and surgery were matched with the same number of healthy children who attended vaccination clinic, as a control group. Both groups were administered the child behavior checklist (CBCL 1½-5 years and Diagnostic and Statistical Manual of Mental Disorders (DSM oriented scale. Behavior data were collected through a semi-structured questionnaire. Results: The CBCL score revealed that children with repeated anesthesia were at risk to become anxious or depressed (relative risk [RR]; 95% confidence interval [CI] = 11 [1.5-80.7], to have sleep (RR; 95% CI = 4.5 [1.1-19.4], and attention problems (RR; 95% CI = 8 [1.1-60.6]. There was no difference in the risk between the two groups regarding emotionally reactive, somatic complaints, withdrawn problems, aggressive behavior, internalizing or externalizing problems. On DSM scale, children with repeated anesthesia were at risk to develop anxiety problems (RR; 95% CI = 3.7 [1.1-12.0], and attention deficit/hyperactivity problems (RR; 95% CI = 3 [1.1-8.4]. There was no difference in the risk between the two groups regarding affective, pervasive developmental and oppositional defiant problems. Conclusion: Young children who undergone repeated surgical procedures under general anesthesia were at risk for subsequent behavioral and emotional disturbances. Proper perioperative pain management, social support, and avoidance of unpleasant surgical experiences could minimize these untoward consequences.

  18. Risk of Autism Associated with General Anesthesia during Cesarean Delivery: A Population-Based Birth-Cohort Analysis

    Science.gov (United States)

    Chien, Li-Nien; Lin, Hsiu-Chen; Shao, Yu-Hsuan Joni; Chiou, Shu-Ti; Chiou, Hung-Yi

    2015-01-01

    The rates of Cesarean delivery (C-section) have risen to >30 % in numerous countries. Increased risk of autism has been shown in neonates delivered by C-section. This study examined the incidence of autism in neonates delivered vaginally, by C-section with regional anesthesia (RA), and by C-section with general anesthesia (GA) to evaluate the…

  19. General anesthesia in fibrodysplasia ossificans progressive: a case report and clinical review.

    Science.gov (United States)

    Liu, Jin-Xing; Hu, Rong; Sun, Yu; Jiang, Hong

    2014-01-01

    Fibrodysplasia ossificans progressiva (FOP) is a rare and devastating genetic disorder of connective tissue characterized by heterotopic bone formation and progressive musculoskeletal disability. Soft-tissue trauma may exacerbate this condition and lead to further ossification. We described the anesthetic and perioperative management of a 23-year-old male with FOP scheduled for dental extraction requiring general anesthesia. Preoperative examination revealed multisystem involvement including cranial and cervical ankylosis and severe restrictive lung disease. Nasal fiber-optic endotracheal intubation was chosen in our patient. Anesthesia was maintained with total intravenous anesthesia and ventilation was controlled throughout the surgery. Endotracheal tube was remained for mechanical ventilation until the second postoperative day and aggressive respiratory physiotherapy was performed after extubation. Additionally, extreme caution was taken to a femoral vascular access and an arterial catheter. Positioning of the patient was meticulous and air warming blanket was used to minimize soft tissue trauma. No significant documented intraoperative and postoperative adverse events appeared attributable to the anesthesia. PMID:24995115

  20. Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

    Directory of Open Access Journals (Sweden)

    Robert A. Goldberg

    2014-01-01

    Full Text Available To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia. Methods. In this retrospective case series, 30 patients (13 males and 17 females underwent tumor removal through eyelid crease (17 eyes, conjunctival (nine eyes, lateral canthal (two eyes, and transcaruncular (two eyes approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia. Results. The median (range age and follow-up duration were 48.5 (31–87 years old and 24.5 (4–375 weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases, pleomorphic adenoma (5 cases, solitary fibrous tumor (4 cases, neurofibroma (2 cases, schwannoma (2 cases, and orbital varix (1 case. None of the patients experienced recurrence. Conclusions. Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia.

  1. Effect of ondansetron in preventing postoperative nausea and vomiting under different conditions of general anesthesia: A preliminary, randomized, controlled study

    Science.gov (United States)

    Zhang, Dengxin; Shen, Zhiyun; You, Jie; Zhu, Xiaolian

    2013-01-01

    Methods Two hundred and forty patients were randomly allocated into six groups: Group I, anesthesia was maintained with sevoflurane; Group II, anesthesia was maintained with sevoflurane and 8 mg of ondansetron; Group III, anesthesia was maintained with propofol; Group IV, anesthesia was maintained with propofol and 8 mg of ondansetron; Group V, anesthesia was maintained with sevoflurane and propofol; Group VI, anesthesia was maintained with sevoflurane combined with propofol and 8 mg of ondansetron. Results We found that the incidence of vomiting was lower in group II (17.5%), group IV (7.5%), and group VI (10%) compared with group I (55%), group III (27.5%), and group V (30%), respectively (P < 0.05). The incidence of vomiting was also lower in group III (27.5%) and group V (30%) when compared with group I (55%) (P < 0.05). The incidence of nausea was 55% in group I, 42.5% in group II, 30% in group III, 27.5% in group IV, 30% in group V, and 30% in group VI. Groups III and V had a lower incidence of nausea than group I (P < 0.05). Conclusions We conclude that compared with sevoflurane anesthesia alone, anesthesia with either propofol alone or propofol combined with sevoflurane resulted in a reduced incidence of vomiting and nausea during the first 24 h after surgery. Administration of ondansetron effectively reduced the incidence of vomiting but not that of nausea for all three types of general anesthesia. PMID:23441598

  2. Redox Changes Induced by General Anesthesia in Critically Ill Patients with Multiple Traumas

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    Marius Papurica

    2015-01-01

    Full Text Available The critically ill polytrauma patient is a constant challenge for the trauma team due to the complexity of the complications presented. Intense inflammatory response and infections, as well as multiple organ dysfunctions, significantly increase the rate of morbidity and mortality in these patients. Moreover, due to the physiological and biochemical imbalances present in this type of patients, the bioproduction of free radicals is significantly accelerated, thus installing the oxidative stress. In the therapeutic management of such patients, multiple surgical interventions are required and therefore they are being subjected to repeated general anesthesia. In this paper, we want to present the pathophysiological implications of oxidative stress in critically ill patients with multiple traumas and the implications of general anesthesia on the redox mechanisms of the cell. We also want to summarize the antioxidant treatments able to reduce the intensity of oxidative stress by modulating the biochemical activity of some cellular mechanisms.

  3. Water Chreodes and the Mechanisms of Ligand Diffusion, General Anesthesia, and Sleep

    Directory of Open Access Journals (Sweden)

    Lemont B. Kier

    2011-01-01

    Full Text Available The concept of the presence of passageways, chreodes, created by the influence of the hydropathic states of amino acid side chains on the surface water of proteins, has been proposed. These chreodes facilitate and direct the diffusion of neurotransmitters through surface water, to the receptor or active site on a protein. This system of chreodes is vulnerable to the presence of some other molecules that may encounter the chreode system. This encounter and disruption has been proposed to explain the mechanism of general anesthesia. Based on much recent evidence of the similarities between anesthesia from volatile anesthetic agents and sleep, a comparable mechanism has been proposed for sleep. Since this must be an exogenous substance to be comparable to a general anesthetic agent, it was proposed that this exogenous, sleep-producing substance is elemental nitrogen. Recent evidence supports these hypotheses.

  4. Office-Based Plastic Surgery with General Anesthesia: Efficiency of Cost and Time

    OpenAIRE

    Spring, Michelle A.; Stoker, David A.; Holloway, John; Weintraub, Marcia; Stevens, W. Grant

    2007-01-01

    Office-based plastic surgery with general anesthesia has several benefits compared with hospital-based surgery. Office-based procedures can be done in a safe, cost- and time-efficient manner, with improved convenience for both the surgeon and the patient. A review and discussion of outpatient plastic surgery procedures at the Marina Outpatient Surgery Center in Marina del Rey, California, was performed.

  5. Continuous Infusion Propofol General Anesthesia for Dental Treatment in Patients With Progressive Muscular Dystrophy

    OpenAIRE

    Kawaai, Hiroyoshi; Tanaka, Kazuho; Yamazaki, Shinya

    2005-01-01

    Progressive muscular dystrophy may produce abnormal reactions to several drugs. There is no consensus of opinion regarding the continuous infusion of propofol in patients with progressive muscular dystrophy. We successfully treated 2 patients with progressive muscular dystrophy who were anesthetized with a continuous infusion of propofol. In case 1, a 19-year-old, 59-kg man with Becker muscular dystrophy and mental retardation was scheduled for dental treatment under general anesthesia. Gener...

  6. Dental Treatment of a Child Suffering from Non-bullous Congenital Ichthyosiform Erythroderma under General Anesthesia

    OpenAIRE

    Choudhary, Rahul; Satish, V.

    2015-01-01

    ABSTRACT Non-bullous congenital ichthyosiform erythroderma (NBCIE) is an autosomal recessive form of inherited icthyosis appears as fine white scales that gradually replace collodion membrane. This case report describes management of 5 years and 11-month-old child with NBCIE suffering from early childhood caries (ECC) under general anesthesia. How to cite this article: Choudhary R, Satish V. Dental Treatment of a Child Suffering from Non-bullous Congenital Ichthyosiform Erythroderma under Gen...

  7. Office bladder distention with Electromotive Drug Administration (EMDA) is equivalent to distention under General Anesthesia (GA)

    OpenAIRE

    Azevedo Kathryn J; Rose Amy E; Payne Christopher K

    2005-01-01

    Abstract Background Bladder distention is commonly used in diagnosis and treatment of interstitial cystitis (IC). Traditionally performed in the operating room under general or spinal anesthesia (GA), it is expensive and associated with short term morbidity. Office bladder distention using electromotive drug administration (EMDA) has been suggested as an alternative that is well tolerated by patients. We report the first comparative findings of patients undergoing both office distention with ...

  8. Decreasing the need for mechanical ventilation after surgery forretinopathy of prematurity: sedoanalgesia vs. general anesthesia

    OpenAIRE

    Ülgey, Ayşe; GÜNEŞ, IŞIN; BAYRAM, ADNAN; Aksu, Recep; BİÇER, CİHANGİR; UĞUR, FATİH; KARACA, ÇAĞATAY; Boyaci, Adem

    2015-01-01

    Background/aim: Premature infants experience more respiratory problems after surgical procedures. We aimed to compare general anesthesia with sedation regarding the need for postoperative mechanical ventilation in infants undergoing retinopathy of prematurity (ROP) surgery. Materials and methods: Sixty patients who underwent laser surgery for ROP were included in this study. This study was performed between October 2010 and December 2012. The sedation group (Group S, n = 30) received 1 mg/kg...

  9. Positive End-Expiratory Pressure and Variable Ventilation in Lung-Healthy Rats under General Anesthesia

    OpenAIRE

    Camilo, Luciana M.; Ávila, Mariana B.; Cruz, Luis Felipe S.; Ribeiro, Gabriel C. M.; Spieth, Peter M; Andreas A Reske; Marcelo Amato; Antonio Giannella-Neto; Walter A Zin; Carvalho, Alysson R.

    2014-01-01

    OBJECTIVES: Variable ventilation (VV) seems to improve respiratory function in acute lung injury and may be combined with positive end-expiratory pressure (PEEP) in order to protect the lungs even in healthy subjects. We hypothesized that VV in combination with moderate levels of PEEP reduce the deterioration of pulmonary function related to general anesthesia. Hence, we aimed at evaluating the alveolar stability and lung protection of the combination of VV at different PEEP levels. DESIGN: R...

  10. General anesthesia: as a challenge and treatment need option in pediatric dentistry

    OpenAIRE

    Machuca-Portillo, M.C.; Herrero, Rosana Hanke; López del Valle, Lydia; Machuca-Portillo, Guillermo; Bullon, Pedro

    2005-01-01

    Objetive. The purpose of this study was to determine the type and characteristics of the interventions, indications of dental treatment and procedures performed to patients treated under general anesthesia (GA) by pediatric dentistry residents, during the 1997-1999 period. Method. a sample of 57 hospital records of patientes treated as part of the Special Pediatric course at the Puerto rico Pediatric hostpial were reviewed. statistical analysis was done using the chi-square test for infere...

  11. The role of regional nerve block anesthesia for carotid endarterectomy: an experimental comparison with previous series with the use of general anesthesia and barbiturates for cerebral protection.

    Science.gov (United States)

    Agrifoglio, G; Agus, G B; Bonalumi, F; Costantini, A; Carlesi, R

    1987-01-01

    A retrospective analysis was performed on a consecutive series of 60 cases divided into two groups given carotid endarterectomy (C.E.) for atherosclerotic disease. In the first group general anesthesia and barbiturate cerebral protection were employed; in group two, loco-regional anesthesia. Indications and risk factors were similar in the two groups; the surgical procedure was identical. The differences in the results are reported and factors contributing to cerebral protection or reduction in the risk of stroke are analyzed. The analysis indicates that loco-regional anesthesia for C.E. is a reliable method for detecting cerebral ischemia and guaranteeing cerebral protection by means of a temporary shunt when strictly necessary. PMID:3450753

  12. Recruitment maneuvers in acute respiratory distress syndrome and during general anesthesia.

    Science.gov (United States)

    Chiumello, Davide; Algieri, Ilaria; Grasso, Salvatore; Terragni, Pierpaolo; Pelosi, Paolo

    2016-02-01

    The use of low tidal volume ventilation and low to moderate positive end-expiratory pressure (PEEP) levels is a widespread strategy to ventilate patients with non-injured lungs during general anesthesia and in intensive care as well with mild to moderate acute respiratory distress syndrome (ARDS). Higher PEEP levels have been recommended in severe ARDS. Due to the presence of alveolar collapse, recruitment maneuvers (RMs) by causing a transient elevation in airway pressure (i.e. transpulmonary pressure) have been suggested to improve lung inflation in non-inflated and poorly-inflated lung regions. Various types of RMs such as sustained inflation at high pressure, intermittent sighs and stepwise increases of PEEP and/or airway plateau inspiratory pressure have been proposed. The use of RMs has been associated with mixed results in terms of physiological and clinical outcomes. The optimal method for RMs has not yet been identified. The use of RMs is not standardized and left to the individual physician based on his/her experience. Based on the same grounds, RMs have been proposed to improve lung aeration during general anesthesia. The aim of this review was to present the clinical evidence supporting the use of RMs in patients with ARDS and during general anesthesia and as well their potential biological effects in experimental models of acute lung injury. PMID:25881732

  13. CT-guided percutaneous radiofrequency ablation of hepatic malignancies located in unusual regions under general anesthesia

    International Nuclear Information System (INIS)

    Objective: To discuss the feasibility of CT-guided percutaneous radiofrequency ablation (RFA) of liver malignancies located in unusual regions under general anesthesia, and to assess its clinical value. Methods: Eighteen patients with a total of 26 malignant hepatic lesions were enrolled in this study. The lesions were located at diaphragmatic surface, hepatic hilum, hepatic subcapsular site,side of inferior vena cava, side of gallbladder or near by colon. Transcatheter arterial chemoembolization was performed in all patients, which was followed by CT-guided percutaneous RFA under general anesthesia. The time used for puncturing and the time used for putting the needles to the scheduled sites were recorded. A follow-up for 115 months was conducted. The complications and the therapeutic results were observed. Results: For all patients,the procedure of puncture and needle placement was completed in 1-3 minutes. A total of 35 RFA procedures were conducted for 26 lesions. No severe complications occurred. Complete necrosis was observed in 20 tumors and partial necrosis in 6 tumors. Conclusion: The result of this study indicates that CT-guided percutaneous RFA under general anesthesia is a feasible technique for the treatment of liver malignancies located at unusual regions. This technique is very helpful for reducing the manipulating difficulty and lowing the complication risk of RFA procedures. (authors)

  14. [Characteristics of general anesthesia in the investigation of heart electrophysiology].

    Science.gov (United States)

    Narbutas, Kestutis; Lekas, Raimundas; Rimkiene, Aldona; Civinskiene, Genuvaite

    2002-01-01

    Investigating electrophysiological properties of the heart under acute experimental conditions, dogs are affected by operative stress because of traumatic surgical manipulations, so investigations are performed under general anaesthesia. Many anaesthetics together with their main function have desintegrating influence on autonomic regulation mechanisms. That is why anaesthetics used during experiments must fullfil such requirement--have minimal influence on autonomic nervous system (ANS) and heart conductivity system (HCS) interaction parameters or to make this influence insignificant. We did not found common anaesthesia methodics that can fullfil that requirements, so we decided to prepare new common anaesthesia methodics, which could fullfil requirements mentioned above. We choose medicaments according to their pharmacokinetics and pharmacodynamics action. For methodics optimization we've used 2 groups of dogs (mongrel dogs males weight 7-15 kg) (n = 10). We've applied different anaesthesia schemas on each group. Premedication in the I-st group was performed with intramuscle (i.m.) combination of diazepam, ketamine and phentanyl and for anaesthesia continuous intravenous (i.v.) infusion of thiopental and ketamine. In II-nd group premedication was performed with i.m. injection of ketamine/phentanyl combination and for anaesthesia--continuous i.v. infusion of thiopental. Induction in both groups was performed with i.v. thiopental injection. Suitability of premedication and anaesthesia was valued by adequativity of haemodynamics (heart rate 1/min) and surgical manipulations during experiments. Our conclusion is: investigating interaction of ANS and HCS methodics used in the I-st group of dogs is more suitable. PMID:12474758

  15. EEG slow-wave coherence changes in propofol-induced general anesthesia: Experiment and theory

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    Kaier eWang

    2014-10-01

    Full Text Available The electroencephalogram (EEG patterns recorded during general anesthetic-induced coma are closely similar to those seen during slow-wave sleep, the deepest stage of natural sleep; both states show patterns dominated by large amplitude slow waves. Slow oscillations are believed to be important for memory consolidation during natural sleep. Tracking the emergence of slow-wave oscillations during transition to unconsciousness may help us to identify drug-induced alterations of the underlying brain state, and provide insight into the mechanisms of general anesthesia. Although cellular-based mechanisms have been proposed, the origin of the slow oscillation has not yet been unambiguously established. A recent theoretical study by Steyn-Ross et al. [Physical Review X 3(2, 021005 (2013] proposes that the slow oscillation is a network, rather than cellular phenomenon. Modeling anesthesia as a moderate reduction in gap-junction interneuronal coupling, they predict an unconscious state signposted by emergent low-frequency oscillations with chaotic dynamics in space and time. They suggest that anesthetic slow-waves arise from a competitive interaction between symmetry-breaking instabilities in space (Turing and time (Hopf, modulated by gap-junction coupling strength. A significant prediction of their model is that EEG phase coherence will decrease as the cortex transits from Turing--Hopf balance (wake to Hopf-dominated chaotic slow-waves (unconsciousness. Here, we investigate changes in phase coherence during induction of general anesthesia. After examining 128-channel EEG traces recorded from five volunteers undergoing propofol anesthesia, we report a significant drop in sub-delta band (0.05--1.5 Hz slow-wave coherence between frontal, occipital, and frontal-occipital electrode pairs, with the most pronounced wake-versus-unconscious coherence changes occurring at the frontal cortex.

  16. EEG slow-wave coherence changes in propofol-induced general anesthesia: experiment and theory.

    Science.gov (United States)

    Wang, Kaier; Steyn-Ross, Moira L; Steyn-Ross, D A; Wilson, Marcus T; Sleigh, Jamie W

    2014-01-01

    The electroencephalogram (EEG) patterns recorded during general anesthetic-induced coma are closely similar to those seen during slow-wave sleep, the deepest stage of natural sleep; both states show patterns dominated by large amplitude slow waves. Slow oscillations are believed to be important for memory consolidation during natural sleep. Tracking the emergence of slow-wave oscillations during transition to unconsciousness may help us to identify drug-induced alterations of the underlying brain state, and provide insight into the mechanisms of general anesthesia. Although cellular-based mechanisms have been proposed, the origin of the slow oscillation has not yet been unambiguously established. A recent theoretical study by Steyn-Ross et al. (2013) proposes that the slow oscillation is a network, rather than cellular phenomenon. Modeling anesthesia as a moderate reduction in gap-junction interneuronal coupling, they predict an unconscious state signposted by emergent low-frequency oscillations with chaotic dynamics in space and time. They suggest that anesthetic slow-waves arise from a competitive interaction between symmetry-breaking instabilities in space (Turing) and time (Hopf), modulated by gap-junction coupling strength. A significant prediction of their model is that EEG phase coherence will decrease as the cortex transits from Turing-Hopf balance (wake) to Hopf-dominated chaotic slow-waves (unconsciousness). Here, we investigate changes in phase coherence during induction of general anesthesia. After examining 128-channel EEG traces recorded from five volunteers undergoing propofol anesthesia, we report a significant drop in sub-delta band (0.05-1.5 Hz) slow-wave coherence between frontal, occipital, and frontal-occipital electrode pairs, with the most pronounced wake-vs.-unconscious coherence changes occurring at the frontal cortex. PMID:25400558

  17. Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index

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    Sayed Mohammad Reza Hadavi

    2013-09-01

    Full Text Available Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS, end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S. Methods: This study was carried out on 60 parturient patients undergoing elective C/S. A standardized anesthetic technique was applied: induction with Thiopental (4-5 mg/kg and Succinylcholine (1.5-2 mg/kg as well as maintenance with O2, N2O, and isoflurane. Electrocardiogram, heart rate, blood pressure, Spo2, end-tidal isoflurane concentration, BIS, and any clinical signs of inadequate depth of anesthesia such as movement, sweating, lacrimation, coughing, and jerking were continuously monitored and recorded at 16 fixed time points during anesthesia. Results: A median BIS of less than 70 (range: 42-68 was obtained on all occasions during surgery; however, at each milestone, at least 20% of the patients had BIS values above 60. Hemodynamic parameters increased significantly in some patients, especially during laryngoscopy and intubation. No patient experienced recall or awareness. Conclusion: The currently used general anesthetic technique in our center appears inadequate in some milestones to reliably produce BIS values less than 60, which are associated with lower risk of awareness. Therefore, with respect to such desirable outcomes as good Apgar and clinical status in neonates, we would recommend the application of this method (if confirmed by further studies through larger dosages of anesthetic agents.

  18. Severe Unilateral Atelectasis after Induction of General Anesthesia: Due to Aspiration of Oropharyngeal Secretion?

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    Myoung Jin Ko

    2014-10-01

    Full Text Available A 27-year-old man underwent general anesthesia for arthroscopic Bankart repair surgery. Glycopyrrolate was administered for premedication and anesthesia was induced with propofol and rocuronium. After tracheal intubation, the patient’s position was changed to right lateral position for operation. Gradual elevation of airway pressure and decrease of oxygen saturation occurred, and was suspected to be due to endobrochial intubation. Nonetheless, the endotracheal tube was drawn to 22 cm at the upper incisor and breathing sound was not auscultated overthe right lung field. Bronchoscopy was performed for diagnosis, right main bronchus was filled withclear mucus secretion. After suction of the secretion, ventilation was improved. After finishing the operation, a chest X-ray showed aspiration pneumonia overthe right lung. The patient was treated with antibiotics and discharged uneventfully 5 days postoperatively.

  19. Percolation Model of Sensory Transmission and Loss of Consciousness Under General Anesthesia

    Science.gov (United States)

    Zhou, David W.; Mowrey, David D.; Tang, Pei; Xu, Yan

    2015-09-01

    Neurons communicate with each other dynamically; how such communications lead to consciousness remains unclear. Here, we present a theoretical model to understand the dynamic nature of sensory activity and information integration in a hierarchical network, in which edges are stochastically defined by a single parameter p representing the percolation probability of information transmission. We validate the model by comparing the transmitted and original signal distributions, and we show that a basic version of this model can reproduce key spectral features clinically observed in electroencephalographic recordings of transitions from conscious to unconscious brain activities during general anesthesia. As p decreases, a steep divergence of the transmitted signal from the original was observed, along with a loss of signal synchrony and a sharp increase in information entropy in a critical manner; this resembles the precipitous loss of consciousness during anesthesia. The model offers mechanistic insights into the emergence of information integration from a stochastic process, laying the foundation for understanding the origin of cognition.

  20. HEMODYNAMIC STATUS IN AIRWAY MANAGEMENT DURING GENERAL ANESTHESIA: COMPARISON OF THREE METHODS

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    K MONTAZERI

    2000-03-01

    Full Text Available Introduction. The laryngeal mask airway (LMA was recently introduced in general anesthesia as an alternative to the face mask or tracheal intubation for airway maintenance. Methods. The effects of LMA insertion, face mask or tracheal intubation on homodynamic status were studied in 195 normotensive patients who underwent elective transurethral lithotripsy (TUL. The patients were monitored with blood pressure measurement and pulse oximetry. Anesthesia was induced with sodium thiopental, succynilcholine and fentanyl and maintained with halothane, nitrous oxide and oxygen. Findings. The heart rate (HR and mean arterial pressure increased after LMA insertion. face mask or tracheal intubation, compared with baseline (P<0.05. The hemodynamic changes were significantly greater after tracheal intubation and face mask than after LMA insertion (P<0.05. Conclusion. We conclude that insertion of LMA is associated with less hemodynamic disturbances than face mask or tracheal intubation in normotensive patients undergoing elective operations.

  1. The changes of non-invasive hemoglobin and perfusion index of Pulse CO-Oximetry during induction of general anesthesia

    OpenAIRE

    Park, Seul Gi; Lee, Oh Haeng; Park, Yong-Hee; Shin, Hwa Yong; Kang, Hyun; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Cheol

    2015-01-01

    Background We hypothesized that induction of general anesthesia using sevoflurane improves the accuracy of non-invasive hemoglobin (SpHb) measurement of Masimo Radical-7® Pulse CO-Oximetry by inducing peripheral vasodilation and increasing the perfusion index (PI). The aim of this study is to investigate the change in the SpHb and the PI measured by Rad7 during induction of general anesthesia using sevoflurane. Methods The laboratory hemoglobin (Hblab) was measured before surgery by venous bl...

  2. Dextroamphetamine (but Not Atomoxetine Induces Reanimation from General Anesthesia: Implications for the Roles of Dopamine and Norepinephrine in Active Emergence.

    Directory of Open Access Journals (Sweden)

    Jonathan D Kenny

    Full Text Available Methylphenidate induces reanimation (active emergence from general anesthesia in rodents, and recent evidence suggests that dopaminergic neurotransmission is important in producing this effect. Dextroamphetamine causes the direct release of dopamine and norepinephrine, whereas atomoxetine is a selective reuptake inhibitor for norepinephrine. Like methylphenidate, both drugs are prescribed to treat Attention Deficit Hyperactivity Disorder. In this study, we tested the efficacy of dextroamphetamine and atomoxetine for inducing reanimation from general anesthesia in rats. Emergence from general anesthesia was defined by return of righting. During continuous sevoflurane anesthesia, dextroamphetamine dose-dependently induced behavioral arousal and restored righting, but atomoxetine did not (n = 6 each. When the D1 dopamine receptor antagonist SCH-23390 was administered prior to dextroamphetamine under the same conditions, righting was not restored (n = 6. After a single dose of propofol (8 mg/kg i.v., the mean emergence times for rats that received normal saline (vehicle and dextroamphetamine (1 mg/kg i.v. were 641 sec and 404 sec, respectively (n = 8 each. The difference was statistically significant. Although atomoxetine reduced mean emergence time to 566 sec (n = 8, this decrease was not statistically significant. Spectral analysis of electroencephalogram recordings revealed that dextroamphetamine and atomoxetine both induced a shift in peak power from δ (0.1-4 Hz to θ (4-8 Hz during continuous sevoflurane general anesthesia, which was not observed when animals were pre-treated with SCH-23390. In summary, dextroamphetamine induces reanimation from general anesthesia in rodents, but atomoxetine does not induce an arousal response under the same experimental conditions. This supports the hypothesis that dopaminergic stimulation during general anesthesia produces a robust behavioral arousal response. In contrast, selective noradrenergic stimulation

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

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    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.

  4. PREVENTION OF PERIOPERATIVE HYPOTHERMIA USING POLYETHYLENE PLASTIC BAGS IN PATIENTS WITH SURGERY UNDER GENERAL ANESTHESIA (IN SPANISH)

    OpenAIRE

    Reales-Osorio Ronald José1; Palomino-Romero Roberto; Ramos-Clason Enrique Carlos; Pulgarín-Díaz Jorge Iván; Guette-Viana Anamarina

    2014-01-01

    Introduction: perioperative hypothermia is a common finding in the rooms of surgery and it simultaneously is underestimated. The biggest heat loss in patients under general anesthesia is presented importatit factor for the development of postoperative complications for what, preserve the body temperature improves the quality of anesthesia and it is cost-effective. Objetive: to quantify the efficiency and safety of low density polyethylene (LDPE) plastic bags to prevent hypot...

  5. Hemodynamic stability in total intravenous propofol anesthesia with midazolam coinduction versus general balanced anaesthesia in laparoscopic cholecystectomy

    OpenAIRE

    Šurbatović Maja; Vesić Zoran; Đorđević Dragan; Radaković Sonja; Zeba Snježana; Jovanović Duško; Novaković Marijan

    2012-01-01

    Background/Aim. Laparoscopic cholecystectomy can be a greater challenge for anesthesiologist than for surgeon if the patient is ASA III with concomitant cardiovascular diseases. The aim of our study was to compare the effect of total intravenous anesthesia (TIVA - propofol with midazolam) and general balanced anesthesia (GBA - midazolam, thiopenton, nitrous oxide and O2) on hemodynamic stability in the ASA III patients who underwent laparoscopic cholecystectomy. Methods. In our study, 6...

  6. Effect of preoperative oral midazolam sedation on separation anxiety and emergence delirium among children undergoing dental treatment under general anesthesia

    OpenAIRE

    El Batawi, Hisham Yehia

    2015-01-01

    Aim: To investigate the possible effects of preoperative oral Midazolam on parental separation anxiety, emergence delirium, and post-anesthesia care unit time on children undergoing dental rehabilitation under general anesthesia. Methods: Randomized, prospective, double-blind study. Seventy-eight American Society of Anesthesiology (ASA) I children were divided into two groups of 39 each. Children of the first group were premedicated with oral Midazolam 0.5 mg/kg, while children of the control...

  7. The effect of local or general anesthesia on the physiology and behavior of tail docked pigs.

    Science.gov (United States)

    Sutherland, M A; Davis, B L; McGlone, J J

    2011-06-01

    Tail docking of pigs is a routine procedure on farms to help control tail-biting behavior; however, docking can cause pain. The objective of this research was to evaluate the effect of local or general anesthesia on the physiology (experiment 1) and behavior (experiment 2) of tail docked pigs. Pigs were allocated to one of six treatment groups: (i) sham docking (CON); (ii) docking using conventional cutting (CUT) with side-cutting pliers; (iii) CUT docking plus local anesthesia injected immediately before docking (LA); (iv) CUT docking plus short-acting local anesthesia applied topically to the tail wound (SHORT); (v) CUT docking plus long-acting anesthesia applied topically to the tail wound (LONG) and (vi) CUT docking while the pig was anesthetized with carbon dioxide gas (CO(2)). In experiment 1, blood samples were collected from pigs (10 pigs per treatment) before and 30, 60 and 120 min after docking to measure leukocyte counts and percentages and cortisol concentrations. In experiment 2, the above treatments were repeated (10 pigs per treatment); the percentage of stress vocalizations were recorded during the administration of the treatments and behavior was recorded for up to 120 min after docking or handling. All pigs were weighed before and 24 h after docking and wound healing was recorded until weaning. The neutrophil/lymphocyte ratio was greater (P pigs. At 30 min, cortisol concentrations were greater (P pigs. Cortisol concentrations did not differ (P > 0.05) between SHORT and CON pigs 30 min after docking. Cortisol concentrations did not differ (P > 0.05) among pigs given pain relief at the time of docking compared with pigs' docked without pain relief. Body weight change and wound scores did not differ (P > 0.05) among treatments. The percentage of stress vocalizations increased (P pigs in response to docking or handling. The percentage of time pigs spent lying without contact after docking tended to be greater (P = 0.06) in CUT pigs compared with all

  8. Postoperative encephalopathy: Pathophysiological and morphological bases of its prevention under general anesthesia

    Directory of Open Access Journals (Sweden)

    A. M. Ovezov

    2015-01-01

    Full Text Available In vitro and in vivo studies have provided sufficient evidence of the neurotoxicity of general anesthetics and their ability to cause postoperative cognitive dysfunction (POCD. The latter is one of the undesirable phenomena associated with general anesthesia. Recently, the prevention of postoperative cognitive impairments has been of particular relevance because of their high incidence, longer length of hospital stay, higher cost of treatment, worse quality of life in patients, and no approaches to drug correction and prevention. The review gives data on the negative effects of general anesthesia in patients of different age groups, highlights the pathogenetic mechanisms of POCD, and proposes its possible drug prevention and treatment strategies: identification of patients at high risk for POCD and both pre- and postoperative neuropsychological testing; intraoperative POCD prevention using a package of measures and, if inefficient, drug correction of found cognitive impairments just in the early postoperative period.

  9. Positive end-expiratory pressure and variable ventilation in lung-healthy rats under general anesthesia.

    Directory of Open Access Journals (Sweden)

    Luciana M Camilo

    Full Text Available OBJECTIVES: Variable ventilation (VV seems to improve respiratory function in acute lung injury and may be combined with positive end-expiratory pressure (PEEP in order to protect the lungs even in healthy subjects. We hypothesized that VV in combination with moderate levels of PEEP reduce the deterioration of pulmonary function related to general anesthesia. Hence, we aimed at evaluating the alveolar stability and lung protection of the combination of VV at different PEEP levels. DESIGN: Randomized experimental study. SETTING: Animal research facility. SUBJECTS: Forty-nine male Wistar rats (200-270 g. INTERVENTIONS: Animals were ventilated during 2 hours with protective low tidal volume (VT in volume control ventilation (VCV or VV and PEEP adjusted at the level of minimum respiratory system elastance (Ers, obtained during a decremental PEEP trial subsequent to a recruitment maneuver, and 2 cmH2O above or below of this level. MEASUREMENTS AND MAIN RESULTS: Ers, gas exchange and hemodynamic variables were measured. Cytokines were determined in lung homogenate and plasma samples and left lung was used for histologic analysis and diffuse alveolar damage scoring. A progressive time-dependent increase in Ers was observed independent on ventilatory mode or PEEP level. Despite of that, the rate of increase of Ers and lung tissue IL-1 beta concentration were significantly lower in VV than in VCV at the level of the PEEP of minimum Ers. A significant increase in lung tissue cytokines (IL-6, IL-1 beta, CINC-1 and TNF-alpha as well as a ventral to dorsal and cranial to caudal reduction in aeration was observed in all ventilated rats with no significant differences among groups. CONCLUSIONS: VV combined with PEEP adjusted at the level of the PEEP of minimal Ers seemed to better prevent anesthesia-induced atelectasis and might improve lung protection throughout general anesthesia.

  10. Feasibility of Respiratory Triggering for MR-Guided Microwave Ablation of Liver Tumors Under General Anesthesia

    International Nuclear Information System (INIS)

    We obtained clear and reproducible MR fluoroscopic images and temperature maps for MR image-guided microwave ablation of liver tumors under general anesthesia without suspending the artificial ventilation. Respiratory information was directly obtained from air-way pressure without a sensor on the chest wall. The trigger signal started scanning of one whole image with a spoiled gradient echo sequence. The delay time before the start of scanning was adjusted to acquire the data corresponding to the k-space center at the maximal expiratory phase. The triggered images were apparently clearer than the nontriggered ones and the location of the liver was consistent, which made targeting of the tumor easy. MR temperature images, which were highly susceptible to the movement of the liver, during microwave ablation using a proton resonance frequency method, could be obtained without suspending the artificial ventilation. Respiratory triggering technique was found to be useful for MR fluoroscopic images and MR temperature monitoring in MR-guided microwave ablation of liver tumors under general anesthesia

  11. A clinical evaluation of comprehensive dental treatment for children under general anesthesia.

    Science.gov (United States)

    Su, H L; Chen, P S

    1992-12-01

    The purpose of this study is to evaluate the comprehensive dental treatment for children under general anesthesia. From 1989 to 1991, 57 children with mean age of 3 years 2 months were treated, followed up with a minimal of 1 year. This procedure allows the dentition to be restored in one visit. Further care including preventive options and behavior shaping was provided on a 3-6 months recall schedule. The reasons for general anesthesia are that these children were either unable to accept treatment because of handicaps, extreme fear or young age. Their mean number of decayed tooth was 15 (Standard Deviation, SD = 5) and nearly three quarters of the children were under 6 years old. The most frequent treatment procedures were the extraction of teeth, composite resin restoration and Ni-Cr crown restoration. The Ni-Cr crown (1.7% failure rate) was more successful than the amalgam and composite resin restoration (9.7% failure rate). Pedo-strip crown had the highest failure rate (22%) for anterior teeth restoration. Nineteen children needed retreatment with conventional behavior guide. Six children had new caries and required further treatment. Thirty eight children returned for regular recall during the minimal 1 year follow-up period. PMID:1295652

  12. Sedation and general anesthesia for patients with Cornelia De Lange syndrome: A case series.

    Science.gov (United States)

    Moretto, Alessandra; Scaravilli, Vittorio; Ciceri, Valentina; Bosatra, Mariagrazia; Giannatelli, Federica; Ateniese, Bianca; Mariani, Milena; Cereda, Anna; Sosio, Simone; Zanella, Alberto; Pesenti, Antonio; Selicorni, Angelo

    2016-06-01

    Cornelia De Lange syndrome (CdLS) is a rare congenital disease characterized by typical facial dysmorphism, developmental disability, and limb deficiency defects. Various congenital malformations and medical complications have been described with gastroesophageal reflux as the major one. CdLS patients often require multiple high-risk anesthetic procedures. At San Gerardo Hospital (Monza, Italy) the management of CdLS patients is routinely organized through a standard protocol and a dedicated pediatric anesthesia team has been implemented. We report on a retrospective descriptive analysis of the anesthetic records of the CdLS patients admitted to San Gerardo Hospital from January 2010 to December 2015. We retrieved: demographics, genetic profiles, type of procedures, anesthetic approaches, anesthetics usage and complications. Data are reported as median (interquartile range) values. Twenty-seven patients (11 female), with age 12 (7-15) years old, weight 24 (14-35) kg, and severity score of 25 (18-32) were included. NIBPL mutations were the most frequently represented. We analyzed 58 procedures (30 esophagogastroduodenoscopies, 8 evoked auditory potential tests, 5 radiodiagnostics, 5 catheters positioning, 4 bronchoscopies) managed by sedation (36) and general anesthesia (6). Each patient underwent one (1-2) anesthetic procedure. Propofol (59%), sevoflurane (31%), fentanyl (24%), and ketamine (10%) were used. Three out of six endotracheal intubations were difficult. The only documented intraoperative complications were three episodes of desaturation (oxygen saturation <90%) occurring during sedations and were managed without the need for an invasive control of the airways. Implementation of a specific management protocol and a dedicated allowed to provide anesthesia to CdLS patients without the occurrence of major complications. © 2016 Wiley Periodicals, Inc. PMID:27145336

  13. Clinical application of self-expandable metallic stents in the treatment of malignant tracheal stenosis under general anesthesia

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of self-expandable metallic stent placement for the treatment of malignant tracheal stenosis under general anesthesia and fluoroscopic guidance. Methods: Under general anesthesia the placement of self-expandable metallic stent was performed in 10 patients with malignant tracheal stenosis, the procedure was completed under fluoroscopic guidance in all patients. Results: Successful tracheal stenting was achieved in all 10 patients. In one patient, a Y-shaped stent was used as the tracheal carina was involved in the airway stenosis. The symptoms of dyspnea and asthma were markedly improved immediately after the implantation of stent in all patients. Conclusion: Tracheal implantation of self-expandable metallic stent under general anesthesia and fluoroscopic guidance is a safe and effective treatment for malignant tracheal stenosis, it can promptly relieve various symptoms caused by malignant tracheal stenosis and obviously improve patient's living quality, therefore,t his technique is of great value in clinical practice. (authors)

  14. General anesthesia for dental care management of a patient with epidermolysis bullosa: 24-month follow-up.

    Science.gov (United States)

    Mello, Bianca Zeponi Fernandes; Neto, Natalino Lourenço; Kobayashi, Tatiana Yuriko; Mello, Marina Barbosa Almeida; Ambrosio, Eloá Cristina Passucci; Yaedú, Renato Yassutaka Faria; Machado, Maria Aparecida Andrade Moreira; Oliveira, Thais Marchini

    2016-07-01

    Epidermolysis bullosa comprises a group of uncommon skin-related diseases, characterized by the formation of blisters on mucocutaneous regions occurring spontaneously, following a trauma, exposure to heat, or as a result of minimal mechanical trauma. The dental treatment of the patient with epidermolysis bullosa raises many questions and discussions, due to the difficulty of carrying out the procedures. This report aimed to detail the clinical considerations of the treatment under general anesthesia of a patient with epidermolysis bullosa. The extraction of all deciduous teeth under general anesthesia was recommended based on the clinical and radiographic examinations. At 24-month follow-up, the patient had great improvement in oral hygiene without new caries lesions. The patient has been followed-up at every month for caries lesion prevention and permanent tooth development. The treatment under general anesthesia provided the ideal safe conditions and was beneficial for the patient. PMID:26936632

  15. Effects of Oral Clonidine in Preventing Postoperative Shivering After General Anesthesia

    Directory of Open Access Journals (Sweden)

    Sussan Soltani Mohammadi

    2007-01-01

    Full Text Available This randomized controlled study was performed to evaluate the efficacy of oral clonidine; an α 2-agonists which augments the inhibiting control of preoptic anterior hypothalamic region on the shivering center, before operation compared with placebo, in preventing postoperative shivering. Eighty ASA I and II patients, undergoing elective abdominal surgery under general anesthesia were randomized into two equal groups. Thirty minutes before anesthesia, patients were given either 0.2 mg oral clonidine (study group, n = 40 or placebo (control group, n = 40 as premedication. Patients were anesthetized with the same technique and drugs. Demographic and perioperative data, the incidence and severity of shivering were recorded in the recovery room. Data were analyzed to evaluate the effects of clonidine on the incidence and severity of postoperative shivering. Demographic and perioperative data were not significantly different between the two groups but emergence time was longer in clonidine group (p = 0.04. The incidence of postoperative shivering was 32.5% (13/40 in clonidine and 70% (28/40 in placebo group. The severity of shivering was significantly less frequent in the clonidine compared with placebo group (p<0.001. Oral clonidine in dose of 0.2 mg as premedication 30 min before surgery, reduced the incidence and severity of postoperative shivering but increased emergence time.

  16. Fear of going under general anesthesia: A cross-sectional study

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    M E Ruhaiyem

    2016-01-01

    Results: Among 450 questionnaires that were disturbed, 400 questionnaires were collected and analyzed. Eighty-eight percent experienced preoperative fear. The top three causes of their fears were fear of postoperative pain (77.3%, fear of intraoperative awareness (73.7%, and fear of being sleepy postoperatively (69.5%. Patients are less fearful of drains and needles in the operative theater (48%, of revealing personal issues under general anesthesia (55.2%, and of not waking up after surgery (56.4%. Age and gender were significant predictors of the overall fear among preanesthetic patients. Females are 5 times more likely to experience fear before surgery (P = 0.0009. Patients aged more than 40 years old are also at 75% higher risk of being afraid (P = 0.008. Conclusion: The majority of the patients going for surgery experienced a fear of anesthesia. Mostly females, especially those over 40, were at a higher risk of being afraid. Fear can bring anxiety which, in turn, might affect the patient′s surgery.

  17. Liquid nitrogen cryotherapy of lip mucosa hemangiomas under inhalation general anesthesia with sevoflurane in early infancy.

    Science.gov (United States)

    Chen, Wei-liang; Zhang, Bin; Li, Jin-song; Yang, Zhao-hui; Wang, Yong-jie; Huang, Zhi-quan; Ye, Yu-shan

    2009-02-01

    Mucous membrane hemangiomas of the lip are common benign vascular tumors of infancy. This clinical study evaluated the efficacy and safety of liquid nitrogen cryotherapy of mucous membrane hemangiomas of the lip in early infancy. It was a retrospective review of 127 pediatric patients with hemangiomas involving the lips who underwent liquid nitrogen cryotherapy under inhalation general anesthesia with sevoflurane. Forty-one males and 86 females were treated. The overall median age at diagnosis of the mucous membrane hemangiomas was 3.6 months (range, 7 days to 18 months). The oral mucous membrane hemangioma involved the vermilion of the lower lip in 78 cases (61.4%), the vermilion of the upper lip in 40 cases (31.5%), and both vermilions in 9 cases (7.1%). No complications because of anesthesia occurred. The mean follow-up was 10 months, with a range of 8 to 14 months; 94 lesions (74.0%) were completely involuted, 22 lesions (17.3%) were mostly involuted, 11 lesions (8.7%) were partially involuted, and no lesion showed a small amount of involution. Liquid nitrogen cryotherapy is an effective, simple, and safe treatment for mucous membrane hemangiomas of the lip in early infancy. PMID:19158525

  18. Comparative outcomes of peripheral nerve blocks versus general anesthesia for hip fractures in geriatric Chinese patients

    Directory of Open Access Journals (Sweden)

    Liu JL

    2014-05-01

    Full Text Available Jun Le Liu,1,* Xiao Lin Wang,1,* Mao Wei Gong,1,* Hai Xing Mai,2 Shu Jun Pei,1 Wei Xiu Yuan,1 Hong Zhang11Anesthesia and Operation Center, Chinese People’s Liberation Army General Hospital and Medical School of Chinese People’s Liberation Army, Beijing, People’s Republic of China; 2Department of Urology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China*These authors contributed equally to this workBackground: Geriatric patients undergoing hemiarthroplasty for hip fractures have unacceptably high rates of postoperative complications and mortality. Whether anesthesia type can affect the outcomes has still been inconclusive.Objectives: We compared general anesthesia (GA and peripheral nerve blocks (PNBs on postoperative complications and mortality in elderly patients with femoral neck fractures (FNF undergoing hemiarthroplasty.Materials and methods: This retrospective study involved data collection from an electronic database. Two hundred and seventeen patients underwent hemiarthroplasty for FNF between January 2008 and December 2012 at the Chinese People’s Liberation Army General Hospital. Data on mortality within in-hospital, 30-day, and 1-year, complications, comorbidities, blood loss and transfusion, operative time, postoperative hospital length of stay, intensive care unit admission, and hospital charge were collected and analyzed. Univariate and multivariate Cox regression analyses of all variables were used for 30-day and 1-year mortality.Results: Seventy-two patients receiving GA and 145 receiving PNBs were eventually submitted and analyzed. Mortality was 6.9%, 14.7%, and 23.5% at in-hospital, 30-day, and 1-year, respectively postoperatively, while mortality and cardiovascular complications did not differ between the two anesthetic techniques. Preoperative comorbidities and intraoperative parameters were not statistically different except that patients receiving GA were more likely

  19. Dexmedetomidine for awake intubation and an opioid-free general anesthesia in a superobese patient with suspected difficult intubation

    Directory of Open Access Journals (Sweden)

    Gaszynski T

    2014-07-01

    Full Text Available Tomasz Gaszynski,1 Ewelina Gaszynska,2 Tomasz Szewczyk31Department of Anesthesiology and Intensive Therapy, 2Department of Hygiene and Health Promotion, 3Department of Gastroenterology, Oncology, and General Surgery, Barlicki University Hospital, Medical University of Lodz, PolandAbstract: Super-obese patients (body mass index [BMI] >50 kg/m2 are at a particularly high risk of anesthesia-related complications during postoperative period, eg, critical respiratory events including respiratory arrest, and over-sedation leading to problems with maintaining airway open, hypoxia and hypercapnia. In this paper authors present a case of a 39-year-old super-obese (BMI 62.3 kg/m2 female patient who was admitted for surgical treatment of obesity. Preanesthesia evaluation revealed hypertension and type 2 diabetes mellitus (DM as comorbidities as well as potential for a difficult intubation– neck circumference of 46 cm, reduced neck mobility and DM type 2. Patient was intubated using "awake intubation" method using topical anesthesia and dexmedetomidine infusion. General anesthesia was maintained with sevoflurane and dexmedetomidine infusion instead of opioid administration in "opioid-free anesthesia method".Keywords: morbid obesity, non-opioid anesthesia, dexmedetomidine

  20. [Anaphylactoid Reactions Suspected to Be Caused by Neostigmine in Pediatric Patients under General Anesthesia].

    Science.gov (United States)

    Iwasai, Sayo; Kinoshita, Yoko; Asagoe, Yutaro; Matsuzaki, Takashi; Arai, Minako; Sato, Tetsufumi

    2016-04-01

    Anaphylactoid reaction is a rapid systemic allergic reaction to many kinds of allergen. The peak age of onset is in the forties and there are not many reports on anaphylactoid reactions in pediatric patients. We report two cases of pediatric patients who underwent surgical treatment on retinoblastoma and developed anaphylactoid reaction probably caused by neostigmine. General anesthesia was induced with fentanyl, sevoflurane, dinitrogen monoxide, and rocronium. The procedure was uneventfully completed. Just after the administration of neostigmine to reverse rocronium, the patients showed red flare on the face and chest, and wheezes were heard, but the vital signs were relatively stable. The rapid onset from the administration of neostigmine to the allergic reaction accompanied by skin and respiratory manifestations strongly suggested the anaphylactoid reaction to neostigmine. PMID:27188110

  1. Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia

    International Nuclear Information System (INIS)

    Brachial plexus injury in a patient under general anesthesia (GA) is not uncommon, despite careful positioning and, particularly, awareness of the possibility. The mechanism of injury is stretching and compression of the brachial plexus over a prolonged period. Positioning the patient within the computed tomography (CT) gantry for abdominal or chest procedures can simulate a surgical procedure, particularly when GA is used. The potential for brachial plexus injury is increased if the case is prolonged and the patient's arms are raised above the head to avoid CT image degradation from streak artifacts. We report a case of profound brachial plexus palsy following a CT-guided radiofrequency ablation procedure under GA. Fortunately, the patient recovered completely. We emphasize the mechanism of injury and detail measures to combat this problem, such that radiologists are aware of this potentially serious complication

  2. Peripheral nerve blocks versus general anesthesia for total knee replacement in elderly patients on the postoperative quality of recovery

    Directory of Open Access Journals (Sweden)

    Liu JL

    2014-02-01

    Full Text Available JunLe Liu,1,* WeiXiu Yuan,1,* XiaoLin Wang,1,* Colin F Royse,2,3 MaoWei Gong,1 Ying Zhao,1 Hong Zhang1 1Anesthesia and Operation Center, Chinese People's Liberation Army General Hospital and Medical School of Chinese People's Liberation Army, Beijing, People's Republic of China; 2Anesthesia and Pain Management Unit, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; 3Department of Anesthesia and Pain Management, The Royal Melbourne Hospital, Melbourne, Victoria, Australia *These authors contributed equally to this work Background: Both peripheral nerve blocks with sedation or general anesthesia can be used for total knee replacement surgery. Objectives: We compared these anesthetic techniques on the postoperative quality of recovery early in elderly patients. Materials and methods: In our study, 213 patients who were ≥65 years old and undergoing total knee replacement were randomized to peripheral nerve blocks (PNBs – lumbar plexus and sciatic – with propofol sedation, or general anesthesia with combined propofol and remifentanil. Blocks were performed using nerve stimulation and 0.35% ropivacaine. All patients received postoperative multimodal analgesia. Postoperative recovery was assessed at 15 minutes, 40 minutes, 1 day, 3 days, and 7 days after surgery, with the Postoperative Quality of Recovery Scale, in physiological, nociceptive, emotive, modified activities of daily living, modified cognitive, and overall patient perspective domains. Results: Intraoperative blood pressure and heart rate were more stable with PNBs (P<0.001. The recovery was better with PNBs in physiological (P<0.001, emotive (depression and anxiety (P<0.001, nociceptive (pain and nausea (P<0.001, modified cognitive (P<0.001, and all domains recovery (P<0.001, but not in activities of daily living (P=0.181. Intraoperative drugs and the postoperative sulfentanil requirement of the PNBs group were lower (all P<0.001. Differences were

  3. Anesthesia Awareness

    Science.gov (United States)

    ... and Anesthesia Smoking and Anesthesia Outpatient Surgery Anesthesia Awareness Very rarely – in only one or two out ... become aware or conscious. The condition – called anesthesia awareness – means the patient can recall the surroundings or ...

  4. 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.

  5. Innovation: treatment by protons of a two years old girl under general anesthesia; Innovation: traitement par protons d'une enfant de deux ans sous anesthesie generale

    Energy Technology Data Exchange (ETDEWEB)

    Pechmagre, C.; Oliveres, S.; Helfre, S.; Delacroix, S.; Ferrand, R.; Habrand, J.L.; Lacroix, F. [Institut Curie, Centre de Protontherapie, 91 - Orsay (France); Esteve, M. [Institut Curie, Dept. d' Anesthesie-Reanimation-Douleur, 91 - Orsay (France); Orbach, D. [Institut Curie, Dept. de Pediatrie, 91 - Orsay (France); Rodriguez, J. [Institut Curie, Service de Chirurgie ORL, 91 - Orsay (France)

    2006-11-15

    The proton therapy is a technique known for the treatment of skull tumors, skull base and face. Now it is possible to use it for young children because of the general anesthesia and teams collaboration. This method of treatment offers perspectives because of the number of young children treated. (N.C.)

  6. Blood Glucose Alterations in Spinal versus General anesthesia in those undergoing Cesarean Section Delivery

    OpenAIRE

    Alireza Manafi; Habibollah Zakeri; Fatemeh Salahyan; Marzieh Tavassoli; Fahimeh Shekoohi; Roya Kokabi; Sahar Khazforoosh

    2015-01-01

    Introduction: Major body injury or surgery is associated with reproducible metabolic and hormonal responses. Alteration of blood glucose levels is one of the necessary metabolic changes to surgical stress. Surgical techniques and different methods of anesthesia are factors that can help to control and balance the body’s hormones. One of the most effective ways for decline the endocrine-metabolic response is local anesthesia. We conducted this study to compare the measurement of blood glucose ...

  7. PREVENTION OF PERIOPERATIVE HYPOTHERMIA USING POLYETHYLENE PLASTIC BAGS IN PATIENTS WITH SURGERY UNDER GENERAL ANESTHESIA (IN SPANISH

    Directory of Open Access Journals (Sweden)

    Reales-Osorio Ronald José1

    2014-01-01

    Full Text Available Introduction: perioperative hypothermia is a common finding in the rooms of surgery and it simultaneously is underestimated. The biggest heat loss in patients under general anesthesia is presented importatit factor for the development of postoperative complications for what, preserve the body temperature improves the quality of anesthesia and it is cost-effective. Objetive: to quantify the efficiency and safety of low density polyethylene (LDPE plastic bags to prevent hypothermia in adult patients submitted surgery under general anesthesia. Methods: it is a randomized, prospective, single blind, controlled clinical trial camed out in the Hospital Universitario del Caribe of Cartagena (since june 2012 to may, 2013. 107 patients, scheduled for surgery under general anesthesia, were divided in two groups: [A] Intervention grupo with coverage of 75% of the body surface with low density polyethylene plastic bags, in surgeries that were allowing this coverage. [B] Control group, with conventional management without coverage. In both grups, contirwous measurement of the temperature was done, the proportions of outcome variables between the two groups were compared by means of chi2 and the Mann- Whitney U test. In adittion, the relative risk (RR9 with their confidence intervals of 95% for the use of the intervention in the reduction of the hypothermia was estimated. A p valve <0.05 was considered as statistically significant. Results: the temperature at the end of the surgery was lower in the control group than in the intervention group (p<0.0001. The use of plastic bags had RR=0.48 (CI 0.33- 0.69 for reduction of hypothermia and RR=0.079 (CI 95% 0.011-0.58 for reduction of chills. In the group with plastic bags the appearance of chills and hypothermia was less frequent (p=0.0002. None of the groups presented adverse effects. Conclusion: the adequate coverage of minimum 75% of the body surface with plastic bags, in patients submitted to surgery under

  8. Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants

    Energy Technology Data Exchange (ETDEWEB)

    Windram, Jonathan; Grosse-Wortmann, Lars; Shariat, Masoud; Greer, Mary-Louise; Yoo, Shi-Joon [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Crawford, Mark W. [Hospital for Sick Children, Department of Anesthesia, Toronto (Canada)

    2012-02-15

    MRI in small children generally necessitates the use of general anesthesia. We describe our initial results with a new technique that we name the feed-and-sleep method, whereby an infant can undergo a cardiac MRI without the need for general anesthesia or sedation. The infant is fasted for 4 h prior to the scan and is then fed by his mother prior to the scan. He is then swaddled with 1 to 2 infant sheets before being placed in a vacuum-bag immobilizer. As air is removed from the bag, the immobilizer becomes a rigid cradle that fits the infant's body. We prioritize the sequences according to the purpose of the study and in the order of clinical importance. Between January 2010 and January 2011 a total of 20 infants with the median age 14.5 days (minimum 2 days, maximum 155 days) underwent CMR studies via this method. All were performed successfully with no distress to the infant. The median scan time was 46.5 min (minimum 20, maximum 66). All had complex congenital heart defects and all planned sequences were acquired with sufficient quality to allow accurate diagnosis and to plan appropriate surgery. Using this technique, infants younger than 6 months can complete a cardiovascular MRI without the need for sedation or general anesthesia. We advocate the incorporation of this safe and reliable technique into routine clinical practice. (orig.)

  9. Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants

    International Nuclear Information System (INIS)

    MRI in small children generally necessitates the use of general anesthesia. We describe our initial results with a new technique that we name the feed-and-sleep method, whereby an infant can undergo a cardiac MRI without the need for general anesthesia or sedation. The infant is fasted for 4 h prior to the scan and is then fed by his mother prior to the scan. He is then swaddled with 1 to 2 infant sheets before being placed in a vacuum-bag immobilizer. As air is removed from the bag, the immobilizer becomes a rigid cradle that fits the infant's body. We prioritize the sequences according to the purpose of the study and in the order of clinical importance. Between January 2010 and January 2011 a total of 20 infants with the median age 14.5 days (minimum 2 days, maximum 155 days) underwent CMR studies via this method. All were performed successfully with no distress to the infant. The median scan time was 46.5 min (minimum 20, maximum 66). All had complex congenital heart defects and all planned sequences were acquired with sufficient quality to allow accurate diagnosis and to plan appropriate surgery. Using this technique, infants younger than 6 months can complete a cardiovascular MRI without the need for sedation or general anesthesia. We advocate the incorporation of this safe and reliable technique into routine clinical practice. (orig.)

  10. COMPARISON OF ONDANSETRON IN TWO DIFFERENT DOSES IN THE REDUCTION OF POST ANESTHETIC SHIVERING AFTER GENERAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Umar Qadir

    2015-03-01

    Full Text Available GOALS OF STUDY: Ondansetron, a specific 5 - HT 3 antagonist, conventionally used as an antiemetic may also affect perioperative thermoregulation and Post Anesthetic Shivering (PAS. Therefore, we decided to compare the effect of Ondansetron in 2 different doses (4mg and 8 mg given just before the induction of general anesthesia on the incidence of PAS. METHODS: A double blind, placebo - controlled study was adopted to study 90 patients divided into 3 equal groups receiving general anesthesia for elective general surgeries. Groups – A, B and C received Ondansetron 4 mg, 8mg and Normal Saline 4 ml I/V respectively immediately before anesthetic induction. Core and peripheral temperatures were documented every 10 minutes from baseline to recovery from anaesthesia. After recovery from anaesthesia the occurrence of shivering was documented. Data was entered in excel and statistically important tests were done. P <0.05 was considered as significant. RESULTS: The incidence of PAS was 60% in the Group - C compared with 16.7% in Group - B , and 36.7% in Group - A. PAS was significantly low in the group receiving 8 mg ondansetron. CONCLUSIONS: Ondansetron 8 mg when compared with Ondansetron 4 mg given before the induction of anesthesia, reduces the incidence of PAS in adults significantly, without affecting the core – to - peripheral redistribution of temperature. The incidence of shivering was highest in the control group (60% with an intermediate incidence in the group receiving 4mg Ondansetron (36.7% and a lowest incidence in the group receiving 8mg Ondansetron (16.7%. CONTEXT: Different observations suggest that the serotonergic system has a role in the control of postanesthetic shivering. Ondansetron is a specific 5 - HT 3 antagonist that may affect perioperative thermoregulation and PAS. Therefore, we decided to compare the effect of Ondansetron, in 2 different doses (4mg and 8 mg given just before the induction of general anesthesia, on the

  11. Sevoflurane-Based General Anesthesia Induction via Nasopharyngeal Endotracheal Tube Prior to Definitive Airway Control in Pediatric Oral Tumors

    OpenAIRE

    Singh, Preet Mohinder; S Rajeshwari; Borle, Anuradha; Rangasamy, Valluvan

    2015-01-01

    Airway-related tumors in pediatrics are always challenging for anesthesiologists. We present 2 cases of friable, bleeding large tumors in the oral cavity where conventional methods of securing the airway were not possible. Induction of general anesthesia could potentially lead to complete airway collapse and catastrophic obstruction in such cases. Awake fibrotic intubation is limited in pediatric patients. We describe the innovative use of an endotracheal tube inserted blindly as a nasopharyn...

  12. Capturing Pain in the Cortex during General Anesthesia: Near Infrared Spectroscopy Measures in Patients Undergoing Catheter Ablation of Arrhythmias.

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    Barry D Kussman

    Full Text Available The predictability of pain makes surgery an ideal model for the study of pain and the development of strategies for analgesia and reduction of perioperative pain. As functional near-infrared spectroscopy reproduces the known functional magnetic resonance imaging activations in response to a painful stimulus, we evaluated the feasibility of functional near-infrared spectroscopy to measure cortical responses to noxious stimulation during general anesthesia. A multichannel continuous wave near-infrared imager was used to measure somatosensory and frontal cortical activation in patients undergoing catheter ablation of arrhythmias under general anesthesia. Anesthetic technique was standardized and intraoperative NIRS signals recorded continuously with markers placed in the data set for the timing and duration of each cardiac ablation event. Frontal cortical signals only were suitable for analysis in five of eight patients studied (mean age 14 ± 1 years, weight 66.7 ± 17.6 kg, 2 males. Thirty ablative lesions were recorded for the five patients. Radiofrequency or cryoablation was temporally associated with a hemodynamic response function in the frontal cortex characterized by a significant decrease in oxyhemoglobin concentration (paired t-test, p<0.05 with the nadir occurring in the period 4 to 6 seconds after application of the ablative lesion. Cortical signals produced by catheter ablation of arrhythmias in patients under general anesthesia mirrored those seen with noxious stimulation in awake, healthy volunteers, during sedation for colonoscopy, and functional Magnetic Resonance Imaging activations in response to pain. This study demonstrates the feasibility and potential utility of functional near-infrared spectroscopy as an objective measure of cortical activation under general anesthesia.

  13. Sealing of tracheoesophageal fistula using a Y stent through fiberoptic bronchoscope during general anesthesia under laryngeal mask airway

    OpenAIRE

    Ye, Ling; Yang, Pingliang; Zuo, Yunxia

    2014-01-01

    A 64-yr-old man was admitted because of repeated pneumonia. Both fiberoptic bronchoscopy and esophagoscopy revealed a large tracheoesophageal fistula (15 mm) in the right posterior trachea 1 cm beyond the carina. Coated nickel-titanium shape memory alloy Y shaped stent was planned to seal this fistula under general anesthesia. We took advantage of laryngeal mask airway to insert the fiberoptic bronchoscope to guide the stent placement. Our method of sealing a large tracheoesophageal fistula w...

  14. Dexmedetomidine for awake intubation and an opioid-free general anesthesia in a superobese patient with suspected difficult intubation

    OpenAIRE

    Gaszynski T; Gaszynska E; Szewczyk T

    2014-01-01

    Tomasz Gaszynski,1 Ewelina Gaszynska,2 Tomasz Szewczyk31Department of Anesthesiology and Intensive Therapy, 2Department of Hygiene and Health Promotion, 3Department of Gastroenterology, Oncology, and General Surgery, Barlicki University Hospital, Medical University of Lodz, PolandAbstract: Super-obese patients (body mass index [BMI] >50 kg/m2) are at a particularly high risk of anesthesia-related complications during postoperative period, eg, critical respiratory events including respirato...

  15. Dexmedetomidine for awake intubation and an opioid-free general anesthesia in a superobese patient with suspected difficult intubation

    OpenAIRE

    Gaszynski, Tomasz

    2014-01-01

    Tomasz Gaszynski,1 Ewelina Gaszynska,2 Tomasz Szewczyk31Department of Anesthesiology and Intensive Therapy, 2Department of Hygiene and Health Promotion, 3Department of Gastroenterology, Oncology, and General Surgery, Barlicki University Hospital, Medical University of Lodz, PolandAbstract: Super-obese patients (body mass index [BMI] >50 kg/m2) are at a particularly high risk of anesthesia-related complications during postoperative period, eg, critical respiratory events including respi...

  16. A combination therapy of ethanol injection and radiofrequency ablation under general anesthesia for the treatment of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kazutaka Kurokohchi; Tomohiko Taminato; Shigeki Kuriyama; Seishiro Watanabe; Hirohito Yoneyama; Akihiro Deguchi; Tsutomu Masaki; Takashi Himoto; Hisaaki Miyoshi; Hamdy Saad Mohammad; Akira Kitanaka

    2008-01-01

    AIM: To summarize the effects of laparoscopic ethanol injection and radiofrequency ablation (L-EI-RFA), thora-coscopic (T-EI-RFA) and open-surgery assisted EI-RFA (O-EI-RFA) under general anesthesia for the treatment of hepatocellular carcinoma (HCC).METHODS: Time-lag performance of RFA after ethanol injection (Time-lag PEI-RFA) was performed in all cases. The volume of coagulated necrosis and the applied energy for total and per unit volume coagulated necrosis were examined in the groups treated under general (group G) or local anesthesia (group L).RESULTS: The results showed that the total applied energy and the applied energy per unit volume of whole and marginal, coagulated necrosis were significantly larger in group G than those in the group L, resulting in a larger volume of coagulated necrosis in the group G. The rate of local tumor recurrence within one year was extremely low in group G.CONCLUSION: These results suggest that EI-RFA, under general anesthesia, may be effective for the treatment of HCC because a larger quantity of ethanol and energy could be applied during treatment under pain-free condition for the patients.

  17. A Four-Year Monocentric Study of the Complications of Third Molars Extractions under General Anesthesia: About 2112 Patients

    Directory of Open Access Journals (Sweden)

    A. Guerrouani

    2013-01-01

    Full Text Available Introduction. The aim of this study was to assess the complications resulting from third molar extraction under general anesthesia. Material and Methods. The retrospective study included all patients who underwent impacted third molars extraction from January 2008 until December 2011. 7659 third molars were extracted for 2112 patients. Postoperative complications were retrieved from medical files. Results. No complications were related to general anesthesia. The most frequent postoperative complication was infection (7.15%. Lingual nerve injuries affected 1.8% of the patients. All of them were transient and were not related to tooth section. Inferior alveolar nerve injuries were reported in 0.4% of the cases. 95.8% of these patients were admitted for one-day ambulatory care, and only two patients were readmitted after discharge from hospital. Discussion. This surgical technique offers comfort for both surgeons and patients. Risks are only linked to the surgical procedure as we observed no complication resulting from general anesthesia. One-day hospitalization offers a good balance between comfort, security, and cost. The incidence of complications is in agreement with the literature data, especially regarding pain, edema, and infectious and nervous complications. It is of utmost importance to discuss indications with patients, and to provide them with clear information.

  18. ORAL CLONIDINE VS ORAL DIAZEPAM AS PREMEDITATION: IOP AND HOMODYNAMIC STABILITY AFTER GENERAL ANESTHESIA AND INTUBATIONS

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    H ZAHEDI

    2000-03-01

    Full Text Available Background. In this study, we evaluated the effects of oral clonidine & diazepam on IOP & homodynamic stability after General Anesthesia (GA with scholine & intubation in ECCE & intraocular lens implantation. Methods. In this study 109 patients with ASA 1 to 3 were randomly allocated to two groups. Oral clonidine (3 µg/kg and oral diazepam (0.15 mg/kg were administered to interventional (54 subjects and control (55 subjects groups respectively as premeditation. All of patients under GA has given scholine (1.5 mg/kg, sodium thiopentone (5 mg/kg and fentanyl (2 µg/kg. Heart rate, systolic and diastolic blood pressure and MAP were recorded before and 2hr after premeditation, immediately after intubation and 5th and 10th minute after scholine. IOP before and 2hr after premeditation & 5th and 10th minute after scholine with schiotz tonometer were measured. Findings. In two groups, mean of IOP in 5th & 10th minute after scholine as compared to before scholine demonstrated significant decrease, so reduction was more significant in experimental group. In two groups, mean of MAP, SBP and DBP after intubation as compared to before intubation and gradually decrease. In 5th & 10th minutes after scholine, MAP and SBP has more stability in experimental group. HR has more significant stability in experimental group. Conclusion. Clonidine is an imidazoline derivative and central alpha2 receptor stimulator absorbed almost completely after oral administration. Clonidine has antihypertensive, sedative and analgesic effect. It reduces IOP. Diazepam is a benzodiazepine that reduce BP, IOP and has sedative effect. Our results suggest that oral clonidine as compared to oral diazepam as premeditation is more appropriate for reduction of IOP and homodynamic stability for patients undergoing cataract surgery under GA.

  19. Exposure to general anesthesia and risk of alzheimer's disease: a systematic review and meta-analysis

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    Seitz Dallas P

    2011-12-01

    Full Text Available Abstract Background Alzheimer's disease (AD is common among older adults and leads to significant disability. Volatile anesthetic gases administered during general anesthesia (GA have been hypothesized to be a risk factor for the development of AD. The objective of this study is to systematically review the association between exposure to GA and risk of AD. Methods We searched electronic databases including MEDLINE, Embase, and Google scholar for observational studies examining the association between exposure to GA and risk of AD. We examined study quality using a modified version of the Newcastle-Ottawa risk of bias assessment for observational studies. We used standard meta-analytic techniques to estimate pooled odds ratios (OR and 95% confidence intervals (CI. Subgroup and sensitivity analyses were undertaken to evaluate the robustness of the findings. Results A total of 15 case-control studies were included in the review. No cohort studies were identified that met inclusion criteria. There was variation in the methodological quality of included studies. There was no significant association between any exposure to GA and risk of AD (pooled OR: 1.05; 95% CI: 0.93 - 1.19, Z = 0.80, p = 0.43. There was also no significant association between GA and risk of AD in several subgroup and sensitivity analyses. Conclusions A history of exposure to GA is not associated with an increased risk of AD although there are few high-quality studies in this area. Prospective cohort studies with long-term follow-up or randomized controlled trials are required to further understand the association between GA and AD.

  20. Effect of esmolol infusion on myocardial oxygen consumption during extubation and quality of recovery in elderly patients undergoing general anesthesia: randomized, double blinded, clinical trial

    Directory of Open Access Journals (Sweden)

    Sherif A. ELokda

    2015-04-01

    Conclusions: Esmolol is a safe, effective and well-tolerated drug that can be used in elderly patients undergoing general anesthesia to reduce the myocardial oxygen consumption and improve the quality of recovery.

  1. High Thoracic Epidural Analgesia as an Adjunct to General Anesthesia is Associated with Better Outcome in Low-to-Moderate Risk Cardiac Surgery Patients

    DEFF Research Database (Denmark)

    Stenger, Michael; Fabrin, Anja; Schmidt, Henrik; Greisen, Jacob; Erik Mortensen, Poul; Jakobsen, Carl-Johan

    2013-01-01

    The purpose of this study was to evaluate the addition of high thoracic epidural analgesia (HTEA) to general anesthesia in cardiac surgery patients to enhance the fast-track and improvement in outcome.......The purpose of this study was to evaluate the addition of high thoracic epidural analgesia (HTEA) to general anesthesia in cardiac surgery patients to enhance the fast-track and improvement in outcome....

  2. Anesthesia - what to ask your doctor - adult

    Science.gov (United States)

    ... that I am having? General anesthesia Spinal or epidural anesthesia Conscious sedation When do I need to stop ... to my stomach? If I have spinal or epidural anesthesia, will I have a headache afterwards? What if ...

  3. Anesthesia - what to ask your doctor - child

    Science.gov (United States)

    ... my child is having? General anesthesia Spinal or epidural anesthesia Conscious sedation When does my child need to ... upset stomach? If my child had spinal or epidural anesthesia, will my child have a headache afterwards? What ...

  4. Evaluation of clinical and paraclinical effects of intraosseous vs intravenous administration of propofol on general anesthesia in rabbits

    Directory of Open Access Journals (Sweden)

    Ramin Mazaheri-Khameneh

    2012-06-01

    Full Text Available This prospective study aimed to compare the intraosseous (IO and intravenous (IV effects of propofol on selected blood parameters and physiological variables during general anesthesia in rabbits. Thirty New Zealand White rabbits were studied. Six rabbits received IV propofol (group 1 and another 6 rabbits, were injected propofol intraosseously (Group 2 for 30 minutes (experimental groups. Rabbits of the third and fourth groups received IV and IO normal saline at the same volume given to the experimental groups, respectively. In the fifth group IO cannulation was performed but neither propofol nor normal saline were administered. Blood profiles were assayed before induction and after recovery of anesthesia. Heart and respiratory rates, rectal temperature, saturation of peripheral oxygen and mean arterial blood pressure were recorded. Heart rate increased significantly 1 to 5 minutes after induction of anesthesia in experimental groups (P < 0.05. Although mean arterial blood pressure decreased significantly from baseline, values remained above 60 mm Hg (P < 0.05. Respiratory rate decreased significantly in experimental groups, but remained higher in group 2 (P < 0.05. The lymphocyte count decreased significantly in group 1 (P < 0.05. The concentration of alkaline phosphatase in all rabbits, aspartate aminotransferase and gamma- glutamyl transferase in the first group and gamma-glutamyl transferase in the third group increased significantly (P < 0.05. Total bilirubin decreased significantly in group 2 (P < 0.05. All measured values remained within normal limits. Based on the least significant physiological, hematological and biochemical effects, the IO injection of propofol appears to be safe and suitable method of anesthesia in rabbits with limited vascular access.

  5. The comparison of spinal anesthesia with general anesthesia on the postoperative pain scores and analgesic requirements after elective lower abdominal surgery: A randomized, double-blinded study

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    Khosrou Naghibi

    2013-01-01

    Full Text Available Background: The aim of this study was to compare the postoperative pain scores and morphine requirements between spinal anesthesia (SA with hyperbaric bupivacaine 0.5% and general anesthesia (GA with 1 Minimal alveolar concentration minimal alveolar concentration (MAC of isoflurane in 50% N 2 O and O 2 after elective lower abdominal surgery. Materials and Methods: In this randomized clinical trial, 68 patients with American Society of Anesthesiologists (ASA I or II undergoing lower abdominal surgery were randomly assigned to have elective lower abdominal surgery under SA (n = 34 or GA (n = 34. The SA group received 3 cc of 0.5% hyperbaric bupivacaine (15 mg, at L3-L4 interspace intrathecally and also 2 mic/kg fentanyl and 0.15 mg/kg morphine intravenously for intraoperative analgesia. In the GA group, induction of anesthesia was carried out with Na thiopental 6 mg/kg body weight, fentanyl 2 mic/kg body weight, morphine 0.15 mg/kg, and atracurium 0.6 mg/kg body weight, and then, trachea was intubated. The primary outcome was postoperative pain scores at rest and under stress on a visual analog scale and the secondary outcome was morphine requirement by the patients. Outcome measures were recorded at 2, 4, 6, 12, and 24 h postoperatively. The duration of postanesthesia care unit (PACU and hospital stay were recorded. Intraoperative parameters, postoperative pain scores, complications, recovery time, and the duration of hospital stay at follow up were compared between the two groups. Results: Patients in SA group had significantly lower scores of a postoperative pain at rest (3.4 ± 1.6 and 4.1 ± 1.2 at 2 and 4 h postoperatively vs. 5.2 ± 1.5 and 5.8 ± 0.9 in the GA group with P < 0.05, but there were no significant differences between both groups for scores of postoperative pain at 6, 12, and 24 h. The amount of morphine requirement in 6 h postoperatively was significantly lower in the SA group (10.2 ± 4.3 mg vs. 15.6 ± 5.6 mg in the GA group

  6. Nonanalgesic benefits of combined thoracic epidural analgesia with general anesthesia in high risk elderly off pump coronary artery bypass patients

    Directory of Open Access Journals (Sweden)

    Bhanu Prakash Zawar

    2015-01-01

    Full Text Available Objective: Epidural anesthesia is a central neuraxial block technique with many applications. It is a versatile anesthetic technique, with applications in surgery, obstetrics and pain control. Its versatility means it can be used as an anesthetic, as an analgesic adjuvant to general anesthesia, and for postoperative analgesia. Off pump coronary artery bypass (OPCAB surgery triggers a systemic stress response as seen in coronary artery bypass grafting (CABG. Thoracic epidural anesthesia (TEA, combined with general anesthesia (GA attenuates the stress response to CABG. There is Reduction in levels of Plasma epinephrine, Cortisol and catecholamine surge, tumor necrosis factor-Alpha( TNF ά, interleukin-6 and leucocyte count. Design: A prospective randomised non blind study. Setting: A clinical study in a multi specialty hospital. Participants: Eighty six patients. Material and Methods/intervention: The study was approved by hospital research ethics committee and written informed consent was obtained from all patients. Patients were randomised to receive either GA plus epidural (study group or GA only (control group. Inclusion Criteria (for participants were -Age ≥ 70 years, Patient posted for OPCAB surgery, and patient with comorbidities (diabetes mellitus, chronic obstructive pulmonary disease, cerebrovascular disease, peripheral vascular disease, renal dysfunction. Serum concentration of Interlukin: - 6, TNF ά, cortisol, Troponin - I, CK-MB, and HsCRP (highly sensitive C reactive protein, was compared for both the group and venous blood samples were collected and compared just after induction, at day 2, and day 5 postoperatively. Time to mobilization, extubation, total intensive care unit stay and hospital stay were noted and compared. Independent t test was used for statistical analysis. Primary Outcomes: Postoperative complications, total intensive care unit stay and hospital stay. Secondary Outcome: Stress response. Result: Study group

  7. SPINAL ANESTHESIA A BETTER AND EFFECTIVE ALTERNATIVE TO GENERAL ANEASTHESIA IN SPINE SURGERIES: A PROSPECTIVE OPEN LABEL SINGLE ARM STUDY

    Directory of Open Access Journals (Sweden)

    Kumar Babu

    2014-11-01

    Full Text Available : INTRODUCTION: In all practical purposes various thoraco lumbar and lumbar surgeries like discectomy, laminectomy and spinal fusion procedures are usually performed under general anesthesia (GA. Our aim of this study is to assess whether spinal anesthesia is a better and effective alternative to general anesthesia in terms of economic advantage and functional recovery with both intra and post-operative heamodynamic stability. METHODS: In our study hundred patients with age group 25-45 yrs within the ASA criteria of class I-III were enrolled. All patients were randomly selected based on age, sex, ASS criteria, duration of surgery, heart rate (HR, mean arterial pressure (MAP, blood loss, previous history of risk factors and co morbidities. The severity of postoperative pain based on visual analogue scale (VAS and use of analgesics post operatively, were recorded. RESULTS: There were 41 males and 59 females. The mean age of the patient was 39.28±9.27 yrs. Six patients had hypertension, 11 with diabetes. Patients with ASA Grade I and II and III were 60, 34 and 6 respectively. There were no episodes of air way compromises, 2 patients had spinal aneasthesia failures, no incidence of post dural puncture headache, 3 patients had mean blood pressure fluctuations among them, one patient had post-operative paraperesis due to hematoma treated by immediate decompression, and 13 patients had usage of propofol sedation in terms of comfort. The duration of surgery (range was 77.25±22.44 min (40-120 Severity of postoperative pain after four hours of surgery on VAS was 3.24±0.46. Twenty two patients (22% required analgesics. Two patients had post-operative vomiting. CONCLUSIONS: In our study we have considered that spinal anesthesia for advantages such as less blood loss, intra operative blood pressure and heart rate changes, postoperative pain, quick functional recovery and lower incidence of pulmonary complications. Additionally, during spinal anesthesia

  8. A conundrum: general or neuraxial anesthesia and the use of ROTEM.

    Science.gov (United States)

    Mauritz, A A; Strouch, Z Y; Olufolabi, A J

    2016-08-01

    We report the use of rotational thromboelastometry (ROTEM) to guide the management of a 29-year-old primigravida at 36weeks' gestation with portal hypertension, esophageal varices, suspected pseudocholinesterase deficiency, and steroid refractory thrombocytopenia presenting to labor and delivery with worsening peripheral edema and new-onset hypertension. A multidisciplinary decision for preoperative platelet transfusion and cesarean delivery under spinal anesthesia was made, guided by ROTEM. A successful cesarean delivery was performed with no bleeding complications. PMID:27290967

  9. Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section

    OpenAIRE

    Maheshwari, Darshana; Ismail, Samina

    2015-01-01

    Background and Aims: We aimed to measure the frequency of preoperative anxiety in patients undergoing elective cesarean section (CS) and its impact on patients decision regarding the choice of anesthesia. Material and Methods: This cross-sectional study included 154 consecutive patients, who were scheduled for elective CS. Visual analog scale (VAS) for anxiety was the study tool, and VAS ≥50 was considered as significant anxiety. Enrolled patients were interviewed by the primary investigator ...

  10. The Effect of Peribulbar Block with General Anesthesia for Vitreoretinal Surgery in Premature and Ex-Premature Infants with Retinopathy of Prematurity.

    Science.gov (United States)

    Sinha, Renu; Maitra, Souvik

    2016-01-15

    Safe anesthesia in premature and ex-premature infants remains a challenge for the anesthesiologist. These infants are at risk of postoperative apnea, desaturation, and bradycardia after general anesthesia. We describe our experience of peribulbar block in 24 infants who underwent vitreoretinal surgery for retinopathy of prematurity. None of our patients had postoperative apnea or required neonatal intensive care admission. A possible opioid and muscle relaxant-sparing effect of peribulbar block might have reduced the incidence of postoperative complications. PMID:26556110

  11. Postoperative amnesia in a patient undergoing general anesthesia for electro-physiologic (EP) catheter ablation of an irritable atrial focus.

    Science.gov (United States)

    Sophocles, Aris; Chen, Linda; Lin, David; Liu, Renyu

    2014-10-31

    This case report describes the anesthetic management of a 67-year-old who underwent a catheter based pulmonary vein isolation (PVI) of long-standing, persistent atrial fibrillation. When the patient awoke from the 6.5 hour procedure, he was found to have a transient retrograde and anterograde amnesia that persisted for 18-24 hours postoperatively. This is a unique instance of global amnesia following a cardiac ablation procedure under prolonged general anesthesia. This case study highlights important topics in postoperative cognitive deficits including the differential diagnosis, risk factors, and strategies for optimizing patient outcomes in high risk procedures. PMID:25429367

  12. TORSADES DE POINTES ASSOCIATED WITH TAKOTSUBO CARDIOMYOPATHY IN AN ANOREXIA NERVOSA PATIENT DURING EMERGENCE FROM GENERAL ANESTHESIA.

    Science.gov (United States)

    Kawano, Hiroaki; Kinoshita, Michiko; Kondo, Akio; Yamada, Yasuhito; Inoue, Masaya

    2016-06-01

    Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, is a disease in which the patient exhibits transient, reversible left ventricular dysfunction that is triggered by physical or emotional stress. Prolongation of QT interval, a risk factor for arrhythmia and sudden death, has been reported to be prevalent among patients with Takotsubo cardiomyopathy and is also observed in those with severe anorexia nervosa. In this report, we describe the rare case of a 30-year-old female patient with anorexia nervosa who developed Torsades de Pointes associated with Takotsubo cardiomyopathy during emergence from general anesthesia for emergency exploratory laparotomy. PMID:27487642

  13. Need and Demand for Sedation or General Anesthesia in Dentistry: A National Survey of the Canadian Population

    OpenAIRE

    Chanpong, B; Haas, D A; Locker, D

    2005-01-01

    The aim of this study was to assess the need and demand for sedation or general anesthesia (GA) for dentistry in the Canadian adult population. A national telephone survey of 1101 Canadians found that 9.8% were somewhat afraid of dental treatment, with another 5.5% having a high level of fear. Fear or anxiety was the reason why 7.6% had ever missed, cancelled, or avoided a dental appointment. Of those with high fear, 49.2% had avoided a dental appointment at some point because of fear or anxi...

  14. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

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    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  15. A COMPARATIVE STUDY OF RECOVERY TIME AFTER GENERAL ANESTHESIA AND SUBARCHNOID BLOCK FOR INGUINAL HERNIORRAPHY IN PACU

    Directory of Open Access Journals (Sweden)

    Dipalisingh

    2014-06-01

    Full Text Available BACKGROUND: Inguinal herniorraphy is commonly performed on an outpatient basis under nerve blocks, local, spinal or general anesthesia (GA. We have selected inguinal herniorraphy under general anesthesia and spinal anesthesia (SA. OBJECTIVE: To compare the recovery time, postoperative pain and patient satisfaction in the Post Anesthetic Care Unit (PACU. METHODS: A prospective, single blinded, controlled study involved total 60 patients belonging to American Society of Anesthesiologists (ASA I/II scheduled for elective repair of unilateral inguinal hernia. Randomization was done using computer generated random numbers. GA group received intravenous (IV propofol (2mg/kg, butorphanol (40μg/kg and skeletal muscle relaxation was achieved with vecuronium bromide (0.1 mg/kg. Patient was maintained with nitrous oxide and oxygen (66:33 and sevoflurane. SA group received 2ml of 0.5% of hyperbaric bupivacaine intrathecal in lateral decubitus position with 0.04mg/kg midazolam injection IV for sedation. Modified Aldrete scoring system, Visual Analogue Scale (VAS and modified Bromage score were employed to assess recovery time. When pain score was more than 5, rescue analgesia was given with IV injection ketorolac 30mg. All data were analyzed statistically. RESULTS: Patients in GA group (136.23 ±17.82 minutes showed a statistically significant (p< 0.05 recovery time to get shifted from PACU compared with patients in the SA group (176.00 ± 11.92 minutes. But patients in the SA group had significantly less VAS score pain (1.30±1.76 vs. 3.23±2.88, less number of patient received rescue analgesia (16.7% vs. 50% and satisfaction was higher than GA group. CONCLUSIONS: We conclude that GA group resulted in faster recovery time from PACU but SA group had less post-operative pain and better satisfied

  16. Sex Differences in the Morphine-Sparing Effects of Intraoperative Dexmedetomidine in Patient-Controlled Analgesia Following General Anesthesia

    Science.gov (United States)

    Li, Yuan-Yuan; Ge, Dong-Jian; Li, Jin-Yu; Qi, Bin

    2016-01-01

    Abstract Previous studies have reported that intraoperative dexmedetomidine has morphine-sparing effects in patient-controlled analgesia (PCA). The present study was designed to investigate the possible sex differences in the morphine-sparing effects of intraoperative dexmedetomidine following general anesthesia. A total of 223 patients scheduled for surgeries under general anesthesia were divided into female and male groups. Each group was then subdivided into 2 subgroups that were maintained using propofol/remifentanil/dexmedetomidine (PRD) or propofol/remifentanil/saline (PRS). During the first 24 hours postsurgery, both female and male PRD patients had lower scores on a visual analog scale (VAS) (fPRS vs fPRD, P  0.05) and consumed comparable morphine compared to the male PRD patients (fPRD vs mPRD, P = 0.4238). However, when normalized to body weight, they consumed much more morphine than male PRD patients (fPRD vs mPRD, P < 0.001), and this effect was not seen in the PRS patients. Intraoperative administration of dexmedetomidine appeared to have a stronger morphine-sparing effect in controlling postoperative acute pain in male patients than in female patients. PMID:27149500

  17. Preoperative anxiety induces no clinically relevant effect on intraoperative nociceptive levels during breast surgery under general anesthesia.

    Science.gov (United States)

    Hashimoto, Kazuma; Iwayama, Sachiko; Sano, Yuka; Tatara, Tsuneo; Hirose, Munetaka

    2015-12-01

    Anxiety can affect acute and chronic postoperative pain after breast surgery. Nociceptive response during surgery might also be affected by preoperative anxiety even under unconscious state during general anesthesia. The aim of this retrospective study was to investigate nociceptive responses during breast surgery under general anesthesia in patients with or without preoperative anxiety. Patients (n = 45) were divided into a low-anxiety group (n = 25) and a high-anxiety group (n = 20) in accordance with preoperative scores for the State Trait Anxiety Inventory. We performed discriminant analysis to compare nociception during surgery using three intraoperative averaged values: heart rate; systolic blood pressure; and perfusion index. No significant differences in discriminant score were seen between groups (p = 0.10). Although we performed propensity score-matching to reduce the bias due to confounding variables in this retrospective study, there was also no significant difference in levels of nociceptive response between groups (p = 0.06). In conclusion, the level of nociception during breast surgery is not significantly affected by preoperative anxiety. PMID:25995061

  18. Maternal and neonatal effects of nalbuphine given immediately before induction of general anesthesia for elective cesarean section

    Directory of Open Access Journals (Sweden)

    Sabry M Amin

    2011-01-01

    Full Text Available Background: Although nalbuphine was studied extensively in labour analgesia and was proved to be acceptable analgesics during delivery, its use as premedication before induction of general anesthesia for cesarean section is not studied. The aim of this study was to evaluate the effect of nalbuphine given before induction of general anesthesia for cesarean section on quality of general anesthesia, maternal stress response, and neonatal outcome. Methods: Sixty full term pregnant women scheduled for elective cesarean section, randomly classified into two equal groups, group N received nalbuphine 0.2 mg/kg diluted in 10 ml of normal saline (n=30, and group C placebo (n=30 received 10 ml of normal saline 1 min before the induction of general anesthesia. Maternal heart rate and blood pressure were measured before, after induction, during surgery, and after recovery. Neonates were assisted by using APGAR0 scores, time to sustained respiration, and umbilical cord blood gas analysis. Result: Maternal heart rate showed significant increase in control group than nalbuphine group after intubation (88.2±4.47 versus 80.1±4.23, P<0.0001 and during surgery till delivery of baby (90.8±2.39 versus 82.6±2.60, P<0.0001 and no significant changes between both groups after delivery. MABP increased in control group than nalbuphine group after intubation (100.55±6.29 versus 88.75±6.09, P<0.0001 and during surgery till delivery of baby (98.50±2.01 versus 90.50±2.01, P<0.0001 and no significant changes between both groups after delivery. APGAR score was significantly low at one minute in nalbuphine group than control group (6.75±2.3, 8.5±0.74, respectively, P=0.0002 (27% of nalbuphine group APGAR score ranged between 4-6, while 7% in control group APGAR score ranged between 4-6 at one minute. All neonates at five minutes showed APGAR score ranged between 9-10. Time to sustained respiration was significantly longer in nalbuphine group than control group (81.8

  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. PMID:25886114

  20. Closed-loop control of anesthesia using bispectral index - Performance assessment in patients undergoing major orthopedic surgey under combined general and regional anesthesia

    NARCIS (Netherlands)

    Absalom, AR; Sutcliffe, N; Kenny, GN

    2002-01-01

    Background: The Bispectral Index (BIS) is an electroencephalogram-derived measure of anesthetic depth. A closed-loop anesthesia system was built using BIS as the control variable, a proportional-integral-differential control algorithm, and a propofol target-controlled infusion system as (lie control

  1. Impact of general versus epidural anesthesia on early post-operative cognitive dysfunction following hip and knee surgery

    Directory of Open Access Journals (Sweden)

    Mandal Sripurna

    2011-01-01

    Full Text Available Background : Post-operative cognitive dysfunction is the subtle cerebral complication temporally seen following surgery. The aim of this study was to compare the influence of either general anesthesia (GA or epidural anesthesia (EA on the early post-operative neurocognitive outcome in elderly (>59 years subjects undergoing hip and knee surgery. Methods : A total of 60 patients were recruited in a prospective, randomized, parallel-group study, comparable by age and sex. They were enrolled and randomized to receive either EA (n = 30 or GA (n = 30. All of them were screened using the Mini Mental State Examination (MMSE, with components of the Kolkata Cognitive Screening Battery. The operated patients were re-evaluated 1 week after surgery using the same scale. The data collected were analyzed to assess statistical significance. Results : We observed no statistical difference in cognitive behavior in either group pre-operatively, which were comparable with respect to age, sex and type of surgery. Grossly, a significant difference was seen between the two groups with respect to the perioperative changes in verbal fluency for categories and MMSE scores. However, these differences were not significant after the application of the Bonferroni correction for multiple analyses, except the significant differences observed only in the MMSE scores. Conclusions : We observed a difference in cognitive outcome with GA compared with EA. Certain aspects of the cognition were affected to a greater extent in this group of patients undergoing hip and knee surgery.

  2. Effectiveness of combined regional-general anesthesia for reducing mortality in coronary artery bypass: meta-analysis

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2016-04-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Neuraxial anesthesia (NA has been used in association with general anesthesia (GA for coronary artery bypass; however, anticoagulation during surgery makes us question the viability of benefits by the risk of epidural hematoma. The aim of this study was to perform a meta-analyzes examining the efficacy of NA associated with GA compared to GA alone for coronary artery bypass on mortality reduction. METHODS: Mortality, arrhythmias, cerebrovascular accident (CVA, myocardial infarction (MI, length of hospital stay (LHS, length of ICU stay (ICUS, reoperations, blood transfusion (BT, quality of life, satisfaction degree, and postoperative cognitive dysfunction were analyzed. The weighted mean difference (MD was estimated for continuous variables, and relative risk (RR and risk difference (RD for categorical variables. RESULTS: 17 original articles analyzed. Meta-analysis of mortality (RD = -0.01, 95% CI = -0.03 to 0.01, CVA (RR = 0.79, 95% CI = 0.32-1.95, MI (RR = 0.96, 95% CI = 0.52-1.79 and LHS (MD = -1.94, 95% CI = -3.99 to 0.12 were not statistically significant. Arrhythmia was less frequent with NA (RR = 0.68, 95% CI = 0.50-0.93. ICUS was lower in NA (MD = -2.09, 95% CI = -2.92 to -1.26. CONCLUSION: There was no significant difference in mortality. Combined NA and GA showed lower incidence of arrhythmias and lower ICUS.

  3. Tamsulosin-induced severe hypotension during general anesthesia: a case report

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    Khan Fauzia

    2010-11-01

    Full Text Available Abstract Introduction Tamsulosin, a selective α1-adrenergic receptor (α1-AR antagonist, is a widely prescribed first-line agent for benign prostatic hypertrophy (BPH. Its interaction with anesthetic agents has not been described. Case presentation We report the case of 54-year-old Asian man undergoing elective left thyroid lobectomy. The only medication the patient was taking was tamsulosin 0.4 mg for the past year for BPH. He developed persistent hypotension during the maintenance phase of anesthesia while receiving oxygen, nitrous oxide and 1% isoflurane. The hypotension could have been attributable to a possible interaction between inhalational anesthetic and tamsulosin. Conclusion Vigilance for unexpected hypotension is important in surgical patients who are treated with selective α1-AR blockers. If hypotension occurs, vasopressors that act directly on adrenergic receptors could be more effective.

  4. Comparative study of patients suffering sore throat after general anesthesia using laryngeal mask airway and cuffed pharyngeal tube in adults

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    Hassani V

    2001-09-01

    Full Text Available Post-operative sore throat is one of the most common complications and complaints of patients after general anesthesia especially in operations that need endotracheal intubations. Its causes are: size of endotracheal tube and type of its cuff, inadequate airway humidification, trauma during intubation and suctioning, high flow of inspiratory gases, surgical manipulation of airway and adjacent organs, ect. Use of instruments with less invasion to upper respiratory tract, for example, face mask and airway, LMA or CPT are methods, used for decreasing the rate of post-operative sore throat. This study was performed to compare the rate of sore throat after general anesthesia between Laryngeal Mask Airway (LMA and Cuffed Pharyngeal Tube (CPT. From the patients, 120 ASA: PS-I cases, were selected, who were candidates for elective surgery of Orthopedics, Urology, General surgery and Gynecology in Hazrat Rasool-Akram Hospital Complex in the year 2000. Their operation were performed in supine position and did not need muscle relaxation and the patients had spontaneous breathing. Duration of surgery was less than 2 hours. The patients were randomly allocated into two groups: LMA was used for one group and CPT for others. Immediately after operation, in the recovery room and at 6, 12, 18 and 24 hours after removing the tube, the patients were asked about sore throat and the results were recorded in the related sheets. The results was 31.7 percent of patients in group LMA and 0 percent of patients in group CPT, had sore throat. There were significant difference between groups (LMA and CPT in presentation of sore throat (P<0.001.

  5. Orthopedic Anesthesia in Haiti

    OpenAIRE

    Osteen, Kristie D.

    2011-01-01

    Healthcare practitioners from around the world responded almost immediately in the aftermath of the 2010 earthquake in Haiti. This article reports on the efforts of an orthopedic trauma team in Haiti and its efforts in providing surgery without general anesthesia.

  6. Preoperative peribulbar block in patients undergoing retinal detachment surgery under general anesthesia: a randomized double-blind study.

    Science.gov (United States)

    Morel, Jérôme; Pascal, Jean; Charier, David; De Pasquale, Véronique; Gain, Philippe; Auboyer, Christian; Molliex, Serge

    2006-04-01

    Retinal detachment surgery is frequently associated with significant postoperative pain and emesis in adults. In this randomized, double-blind, controlled study we sought to demonstrate that 1% ropivacaine peribulbar (PB) block in conjunction with general anesthesia (GA) improves operative conditions and postoperative analgesia compared with GA combined with subcutaneous normal saline injection into the inferior eyelid. Thirty-one patients were included in each group. Anesthesia was performed with target-controlled infusion propofol and continuous remifentanil infusion adjusted to maintain bispectral index values between 40 and 50. Postoperative analgesia included fixed-dose IV infusion of propacetamol and IV injection of nefopam via a patient-controlled analgesia device. Tramadol was infused IV as rescue medication. Demographic data were comparable between the groups and bispectral index values were maintained at the objective target. In the PB group, fewer patients presented an oculocardiac reflex (6 versus 17; P < 0.01); bleeding interfering with the surgical field was reduced (1 versus 11 patients; P < 0.01); mean time to first nefopam request was longer (148 +/- 99 versus 46 +/- 58 min; P < 0.01); mean nefopam consumption was diminished during the first 6 h after tracheal extubation (18.9 +/- 13.9 versus 28.5 +/- 14.7 mg; P < 0.05); immediate postoperative pain scores were lower; and fewer patients required rescue medication (5 versus 23; P < 0.01). The two groups were similar with respect to the incidence of postoperative nausea and vomiting. Overall, PB block combined with GA improved operating conditions and postoperative analgesia in retinal detachment surgery. PMID:16551903

  7. "The comparison between effects of two general anesthesia techniques; Intermittent apenic technique and continuous controlled ventilation in upper airway Laser therapy "

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    Khagavy MR "

    2002-11-01

    Full Text Available Introduction: Laser beam due to finest of incision and reduction of postoperative complication, facilitates airway surgery, but at the same time it increases the danger or firing and the airway management and protection becomes difficult during anesthesia. In this study, two general anesthesia methods; (Intermittent Apneic Technique And Continuous Controlled Ventilation With Enveloped Endotracheal Tube have been compared with each other mater. Materials and methods: two groups, each consist of 25 patients 10 to 60 years old, and ASA I-II class and below 100kg weight who have been candidate for laser therapy, were given two mentioned methods of anesthesia. All patients were suffering from subglotic stenosis, vocal cord nodules, papillomatosis and oropharyngeal obstruction. Induction and maintenance of anesthesia, and monitoring during surgery (EGG, PETCO2, SaPo2, BP, PR in both groups were the same. Results: Homodynamic stability in the both groups were the same and there was no hypoxia and dysrhythmia. In apneic technique group, most of the surgeries needed 2-3 time of apnea, and each apnea duration was 2-4 minutes, without any hypercaphic (Peteco 2>47 mmHg and hypoxic (Spo2<90 percent state and duration of laser surgery was about 9-10 minutes. More satisfaction was gained with apneic technique because of having a better surgery filed. All the patients had no recall at the end of anesthesia and patietn's expenses were much lower with no danger of firing. Conclusion: It has been concluded that intermittent apneic technique in upper airway laser therapy is a better technique of anesthesia.

  8. [General Anesthesia Using Remifentanil for Cesarean Section in a Parturient with Marfan Syndrome Associated with Heart Failure due to Severe Mitral Regurgitation].

    Science.gov (United States)

    Fujita, Masahide; Satsumae, Tsuyoshi; Tanaka, Makoto

    2016-05-01

    A 24-year-old woman with Marfan syndrome was scheduled for cesarean section in order to avoid progression of heart failure due to severe mitral regurgitation and aortic dissection during labor. Cesarean section was performed under general anesthesia using remifentanil. Anesthesia was induced and maintained with remifentanil (0.1-0.3 μg x kg(-1) x min(-1)) and continuous administration of propofol (target-controlled infusion, 2-3 ng x ml(-1)). The trachea was intubated without a significant hemodynamic change. The patient's systolic blood pressure was maintained between 90 and 120 mmHg during surgery. Intraoperatively, we conducted a transesophageal echocardiography examination, and no remarkable change was seen in the severity of mitral regurgitation and the size of an ascending aorta. An infant was delivered 6 minutes after anesthesia induction. The Apgar scores were 4 at 1 min, 5 at 5 min and 8 at 10 min. Postoperative course was uneventful. We conclude that remifentanil can be used successfully to manage cesarean section of a parturient with Marfan syndrome associated with heart failure due to severe mitral regurgitation under general anesthesia. PMID:27319100

  9. Intrathecal morphine plus general anesthesia in cardiac surgery: effects on pulmonary function, postoperative analgesia, and plasma morphine concentration

    Directory of Open Access Journals (Sweden)

    Luciana Moraes dos Santos

    2009-04-01

    Full Text Available OBJECTIVES: To evaluate the effects of intrathecal morphine on pulmonary function, analgesia, and morphine plasma concentrations after cardiac surgery. INTRODUCTION: Lung dysfunction increases morbidity and mortality after cardiac surgery. Regional analgesia may improve pulmonary outcomes by reducing pain, but the occurrence of this benefit remains controversial. METHODS: Forty-two patients were randomized for general anesthesia (control group n=22 or 400 µg of intrathecal morphine followed by general anesthesia (morphine group n=20. Postoperative analgesia was accomplished with an intravenous, patient-controlled morphine pump. Blood gas measurements, forced vital capacity (FVC, forced expiratory volume (FEV, and FVC/FEV ratio were obtained preoperatively, as well as on the first and second postoperative days. Pain at rest, profound inspiration, amount of coughing, morphine solicitation, consumption, and plasma morphine concentration were evaluated for 36 hours postoperatively. Statistical analyses were performed using the repeated measures ANOVA or Mann-Whiney tests (*p<0.05. RESULTS: Both groups experienced reduced FVC postoperatively (3.24 L to 1.38 L in control group; 2.72 L to 1.18 L in morphine group, with no significant decreases observed between groups. The two groups also exhibited similar results for FEV1 (p=0.085, FEV1/FVC (p=0.68 and PaO2/FiO2 ratio (p=0.08. The morphine group reported less pain intensity (evaluated using a visual numeric scale, especially when coughing (18 hours postoperatively: control group= 4.73 and morphine group= 1.80, p=0.001. Cumulative morphine consumption was reduced after 18 hours in the morphine group (control group= 20.14 and morphine group= 14.20 mg, p=0.037. The plasma morphine concentration was also reduced in the morphine group 24 hours after surgery (control group= 15.87 ng.mL-1 and morphine group= 4.08 ng.mL-1, p=0.029. CONCLUSIONS: Intrathecal morphine administration did not significantly alter

  10. Effects of intracerebroventricular NMDA and non-NMDA receptor agonists or antagonists on general anesthesia of propofol in mice

    Institute of Scientific and Technical Information of China (English)

    XU Aijun; DUAN Shiming; TIAN Yuke

    2007-01-01

    The efiects of intracerebroventricular(icv)agonists and antagonists of N-methyl-D-aspartate(NMDA)and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors on the general anesthesia of propofol were studied.A tohal of 144 Kunming mice,male and female with body mass of(22±3)g,were used.Part One of the Experiment:a total of 104 Kunming mice,male and female,were randomly divided into 13 groups.Intracerebroventricular artificial cerebral fluid (aCSF)or different doses of NMDA,AMPA,MK-801 or NBOX was iniected immediately after intravenously administered propofol 25 mg/kg and the recovery time following the loss of righting reflex (LORR)was recorded.Part Two of the Experiment:a total of 40 Kunming female mice were divided randomly into 5 groups and iniected with icv aCSF or NMDA.AMPA.MK-801 or NBQX after intraperitoneally administered propofol 50 mg/kg.The pain threshold of the mice was then investigated by hot-plate test(HPPT).NMDA(0.05 or 0.075μg,icv)or AMPA(0.05 μg,icv)exhibited no effects on the LORR,but NMDA(0.1 μg,icv)or AMPA(0.075 or 0.1 μg,icv)prolonged the LORR significantly compared with the aCSF group(P<0.05,P<0.01).The LORR of the 2 μg MK-801 group had no changes,while those of the 4 or 8 μg MK-801 groups were prolonged significantly.The LORR of the 0.5,2 or 4 μg NBQX groups were all prolonged significantly.NMDA 0.05 μg or AMPA 0.05 μg decreased the pain threshold slightly but did not differ in effect compared with the aCSF group;2 μg MK-801 or 0.5 μg NBQX both increased the pain threshold significantly.Our results indicate that propofol produces general anesthesia partly through an interaction with brain NMDA and AMPA receptors in mice.

  11. A randomized clinical trial comparing the efficacy and safety of ramosetron versus ondansetron in patients undergoing abdominal surgery under general anesthesia

    Directory of Open Access Journals (Sweden)

    Sriramamurthy Kaja

    2014-01-01

    Full Text Available Background: Post-operative nausea and vomiting is one of the most common and distressing complications after anesthesia and surgery. It may lead to serious post-operative complications. Ramosetron is a newer 5-HT3 receptor antagonist and has more potent and longer duration of antiemetic effects compared to first generation 5HT3 receptor antagonists. The purpose of this study was to compare the efficacy of Ramosetron for the prevention of post-operative nausea and vomiting with that of Ondansetron in patients undergoing abdominal surgeries under general anesthesia. Methods: In this randomized, double-blind study, 60 patients, 18-60 years of both genders falling under ASA I-II category scheduled for abdominal surgery were included. Group I received I.V ramosetron 0.3 mg while group II received I.V Ondansetron 4 mg at the time of extubation. The standard general anesthetic technique was used throughout. Postoperatively the incidences of nausea, vomiting, and safety assessments were performed at 1, 2, 6, and 24 h during the first 24 h after surgery. Results: There were no differences between groups with respect to patient demographics. The percentage of patients who had complete response (no PONV, and no need for another rescue antiemetic from 0 to 24 h after anesthesia was 56% with ramosetron and 33% with ondansetron. The corresponding rates at 1, 2, 6, and 24 h after anesthesia were 76% and 63%, 76% and 50%, 100 and 83%, 100 and 93%, respectively. Safety profiles of the two drugs were comparable, as no clinically serious adverse effects caused by study drugs were observed in either of the groups. Conclusion: Our study concludes that prophylactic therapy with ramosetron is highly efficacious than ondansetron in preventing PONV in patients undergoing abdominal surgery under general anesthesia.

  12. Short-Term Changes in Postoperative Cognitive Function in Children Aged 5 to 12 Years Undergoing General Anesthesia: A Cohort Study.

    Science.gov (United States)

    Aun, Cindy S T; McBride, Catherine; Lee, Anna; Lau, Angel S C; Chung, Raymond C K; Yeung, Chung Kwong; Lai, Kelly Y C; Gin, Tony

    2016-04-01

    Due to the neurotoxicity effects of general anesthesia (GA) and sedatives found in animal studies, there is a general recommendation to avoid nonurgent surgical procedures requiring anesthesia in children younger than 3 years of age. The aim of this study was to determine the incidence of anesthesia-related postoperative cognitive dysfunction (POCD) on the first day (Day 1) and at 6 weeks after elective noncardiac surgery in school-age children.This was a prospective cohort study of 118 children undergoing GA and 126 age-matched controls of school children aged 5 to 12 years. All children were given a panel of 4 neuropsychological assessments (Hong Kong List Learning for verbal memory, Visual Matching for processing speed, Visual Memory, and General Comprehension Skill from the Hong Kong Wechsler Intelligence Scale for Children). The primary outcome was the incidence of POCD on Day 1 and at 6 weeks after surgery. POCD was defined as when at least 2 of the 4 cognitive function tests showed individual Z-scores ≤-1.96 or a combined Z-score ≤-1.96.Using the combined Z-score definition, the incidence of POCD in the GA group on Day 1 and at 6 weeks were 5.1% (95% confidence interval [CI]: 2.1-10.3) and 3.4% (95% CI: 1.1-8.0), respectively. No POCD was found using the other definition. The incidences of decline and improvement in neuropsychological tests were similar between groups over time except for a higher risk in visual matching impairment in the anesthesia group (11.9%) versus control group (1.6%) on Day 1 (P definitions and relative risk ratio methodology, we found no anesthesia-related POCD per se in school-age children. PMID:27057869

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

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    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.

  14. Relatively light general anesthesia is more effective than fluid expansion in reducing the severity of epinephrine-induced hypotension during functional endoscopic sinus surgery

    Institute of Scientific and Technical Information of China (English)

    LI Wei-yan; ZHOU Zhi-qiang; JI Jun-feng; LI Ze-qing; YANG Jian-jun; SHANG Ruo-jing

    2007-01-01

    Background Epinephrine infiltration of the nasal mucosa causes hypotension during functional endoscopic sinus surgery (FESS) under general anesthesia. A prospective randomized-controlled study was designed to determine whether relatively light general anesthesia is superior to fluid expansion in reducing epinephrine-induced hypotension during FESS.Methods Ninety patients undergoing elective FESS under general anesthesia were randomly assigned to three groups with 30 patients in each. Each patient received local infiltration with adrenaline-containing (5 μg/ml) lidocaine (1%,4 ml) under different conditions. For Group Ⅰ, anesthesia was maintained with propofol 2 μg/ml and rimifentanil 2 ng/ml by TCI. Group Ⅱ (control group) and Group Ⅲ received propofol 4 μg/ml and rimifentanil 4 ng/ml, respectively. In Groups Ⅰ and Ⅱ, fluid expansion was performed with hetastarch 5 mi/kg within 20 minutes; hetastarch 10 ml/kg was used in Group Ⅲ. Mean arterial pressure (MAP) and heart rate (HR) were recorded at 30-second-intervals for 5 minutes after the beginning of local infiltration. Simultaneously, the lowest and the highest MAP were recorded to calculate the mean maximum increase or decrease percent in MAP for all patients in each group. Data analysis was performed by χ2 test,one-way analysis of variance, or one-way analysis of covariance.Results Hemodynamic changes, particularly a decrease in MAP accompanied by an increase in HR at 1.5 minutes(P<0.05), were observed in all groups. The mean maximum decrease in MAP below baseline was 14% in Group Ⅰ, 24% in Group Ⅲ and 26% in Group Ⅱ. There were statistically significant differences between Group Ⅰ and Groups Ⅱ and Ⅲ(P<0.05). The mean maximum increase in MAP above baseline was 9% in Group Ⅰ, 6% in Group Ⅲ and 2% in Group Ⅱ.Conclusion Relatively light general anesthesia can reduce the severity of epinephrine-induced hypotension more effectively than fluid expansion during FESS under general

  15. EEG slow-wave coherence changes in propofol-induced general anesthesia: Experiment and theory

    OpenAIRE

    D Alistair Steyn-Ross

    2014-01-01

    The electroencephalogram (EEG) patterns recorded during general anesthetic-induced coma are closely similar to those seen during slow-wave sleep, the deepest stage of natural sleep; both states show patterns dominated by large amplitude slow waves. Slow oscillations are believed to be important for memory consolidation during natural sleep. Tracking the emergence of slow-wave oscillations during transition to unconsciousness may help us to identify drug-induced alterations of the underlying...

  16. EEG slow-wave coherence changes in propofol-induced general anesthesia: experiment and theory

    OpenAIRE

    Wang, Kaier; Steyn-Ross, Moira L.; Steyn-Ross, D. A.; Wilson, Marcus T.; Sleigh, Jamie W

    2014-01-01

    The electroencephalogram (EEG) patterns recorded during general anesthetic-induced coma are closely similar to those seen during slow-wave sleep, the deepest stage of natural sleep; both states show patterns dominated by large amplitude slow waves. Slow oscillations are believed to be important for memory consolidation during natural sleep. Tracking the emergence of slow-wave oscillations during transition to unconsciousness may help us to identify drug-induced alterations of the underlying b...

  17. Anesthesia Safe for Infants, Toddlers, Study Says

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_159247.html Anesthesia Safe for Infants, Toddlers, Study Says No lingering ... 2016 TUESDAY, June 7, 2016 (HealthDay News) -- General anesthesia doesn't seem to harm young children's mental ...

  18. [Intravenous Sedation and Repeated "the Same Day General Anesthesia" for a School-age Boy with Dandy-Walker Syndrome and Dentinogenesis].

    Science.gov (United States)

    Hitosugi, Takashi; Tsukamoto, Masanori; Fujiwara, Shigeki; Yokoyama, Takeshi

    2016-03-01

    Dandy-Walker syndrome (DWS) is characterized by perfect or partial defect of the cerebellum vermis and cystic dilatation of the posterior fossa communicating with the fourth ventricle. Common clinical signs are mental retardation, cerebellar ataxia, and those of increased intracranial pressure (ICP). Associated congenital anomalies are craniofacial, cardiac, renal, and skeletal abnormalities. We experienced a case of intravenous sedation and six times of "the same day" general anesthesia for a school-aged boy (10-13 years old) with DWS and hypodentinogenesis. The patient underwent an examination and dental treatments. We had to pay attention to airway management tracheal tube selection and control of ICP. In addition, we should prevent tooth injuries through mishaps during tracheal intubations, since all-tooth-hypoplasia with fragile dental crowns was strongly suggested in this case. Detailed postoperative care is also required for general anesthesia afflicted with DWS. PMID:27097514

  19. Comparison of ondansetron and granisetron for antiemetic prophylaxis in maxillofacial surgery patients receiving general anesthesia: a prospective, randomised, and double blind study

    Science.gov (United States)

    2016-01-01

    Objectives To compare the efficacy of intravenous ondansetron (4 mg, 2 mL) and granisetron (2 mg, 2 mL) for preventing postoperative nausea and vomiting (PONV) in patients during oral and maxillofacial surgical procedures under general anesthesia. Materials and Methods A prospective, randomized, and double blind clinical study was carried out with 60 patients undergoing oral and maxillofacial surgical procedures under general anesthesia. Patients were divided into two groups of 30 individuals each. Approximately two minutes before induction of general anesthesia, each patient received either 4 mg (2 mL) ondansetron or 2 mg (2 mL) granisetron intravenously in a double blind manner. Balanced anesthetic technique was used for all patients. Patients were assessed for episodes of nausea, retching, vomiting, and the need for rescue antiemetic at intervals of 0-2, 3, 6, 12, and 24 hours after surgery. Incidence of complete response and adverse effects were assessed at 24 hours postoperatively. Data was tabulated and subjected to statistical analysis using the chi-square test, unpaired t-test, or the Mann-Whitney U-test as appropriate. A P-value less than 0.05 was considered statistically significant. Results There was no statistically significant difference between the two groups for incidence of PONV or the need for rescue antiemetic. Both study drugs were well tolerated with minimum adverse effects; the most common adverse effect was headache. The overall incidence of complete response in the granisetron group (86.7%) was significantly higher than the ondansetron group (60.0%). Conclusion Granisetron at an intravenous dose of 2 mg was found to be safe, well tolerated, and more effective by increasing the incidence of complete response compared to 4 mg intravenous ondansetron when used for antiemetic prophylaxis in maxillofacial surgery patients receiving general anesthesia. Benefits of granisetron include high receptor specificity and high potency, which make it a

  20. A Retrospective Study of Dental Treatment under General Anesthesia of Children with or without A Chronic Illness and/or A Disability

    OpenAIRE

    Chia-Ling Tsai; Yi-Ling Tsai; Yng-Tzer Lin; Yai-Tin Lin

    2006-01-01

    Background: The indications for dental treatment under general anesthesia have beendescribed by various authors as extensive decay, behavioral managementproblems, a medically compromised patient, a handicapped patient, and acombination of these. Few studies have been undertaken to identify the rangeof treatment provided for chronically sick children. The aim of this studywas to identify the characteristics of dental procedures performed under generalanesthesia on children with a chronic illne...

  1. Impending compartment syndrome of the forearm and hand after a pressurized infusion in a patient under general anesthesia -A case report-

    OpenAIRE

    Sung, Chi Yun; Chung, Rack Kyung; Ra, Yoon Suk; Lee, Hee Seung; Lee, Guie Yong

    2011-01-01

    A 74-year-old woman underwent posterior lumbar decompressive fusion at L4-5 for treating spondylolisthesis, with the patient under general anesthesia and she was in the prone position. Following attempts to transfuse blood using a pressurized bag, the intravenous infusion site of the left hand along with the noninvasive blood pressure cuff was changed. Swelling and several bullae on the left forearm and hand were visible. Removal of intravenous catheter, hyaluronidase injection, wet dressing ...

  2. Non-invasive monitoring of blood pressure using the Philips Intellivue MP50 monitor cannot replace invasive blood pressure techniques in surgery patients under general anesthesia

    OpenAIRE

    Meng, Xianghu; ZANG, GUANGHUI; FAN, LONGCHANG; Zheng, Lei; DAI, JINZHEN; WANG, XUEREN; Xia, Wei; Liu, Jihong; ZHANG, CHUANHAN

    2013-01-01

    The Philips Intellivue MP50 monitor provides a method for non-invasive, near-continuous blood pressure (BP) monitoring and is designed to be an alternative to direct intra-arterial BP (IABP) measurement. However, no studies have specifically compared non-invasive and invasive BP measurements using the monitor. The present retrospective study observed 515 patients undergoing surgery with general anesthesia, whose invasive (intra-radial, femoral or dorsalis pedis artery) and non-invasive (oscil...

  3. Demand in Pediatric Dentistry for Sedation and General Anesthesia by Dentist Anesthesiologists: A Survey of Directors of Dentist Anesthesiologist and Pediatric Dentistry Residencies

    OpenAIRE

    Hicks, C. Gray; Jones, James E.; Saxen, Mark A.; Maupome, Gerardo; Sanders, Brian J.; Walker, LaQuia A.; Weddell, James A.; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 1...

  4. Hemodynamic Changes Following Endotracheal Intubation in Patients Undergoing Cesarean Section With General Anesthesia: Application of Glidescope® Videolaryngoscope Versus Direct Laryngoscope

    OpenAIRE

    Amini, Shahram; Shakib, Majid

    2015-01-01

    Background Endotracheal intubation is usually associated with hemodynamic changes, especially in patients undergoing cesarean section by general anesthesia. GlideScope® videolaryngoscope (GVL) is a novel video laryngoscope, which does not need direct exposure of vocal cords and produces lesser hemodynamic changes due to lower degrees of trauma and stimuli to oropharynx than the Macintosh direct laryngoscope (MDL). Objectives The aim of this study was to compare hemodynamic changes following e...

  5. Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery

    OpenAIRE

    Hedenstierna Göran; Binnekade Jan M; Hollmann Markus W; Tschernko Edda M; Hiesmayr Michael; Wrigge Hermann; Canet Jaume; Jaber Samir; Severgnini Paolo; Hemmes Sabrine NT; Putensen Christian; Abreu Marcelo; Pelosi Paolo; Schultz Marcus J

    2011-01-01

    Abstract Background Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP) and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ven...

  6. Sedation/general anesthesia for magnetic resonance imaging in paediatrics patients - special considerations and safety

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) study requires the patient to remain motionless for extended periods of time, which can not be achieved in children without special care or drug-induced sleep. There are various methods for sedation / general anaesthesia (GA) in children with their different advantages and disadvantages. The aim of this study was to report our experience with sedation/GA in children who require MRI/computed-tomography (CT) studies. We performed a retrospective review of the sedation/GA records in 34 children aged from 6 months to 12 years; class ASA I-III, undergoing diagnostic MR/CT study. Demographic data, information regarding diagnosis, type of sedation/GA, use of premedication, time to readiness for the procedure after premedication administration, duration of procedure, and the recovery time were obtained. Any adverse events were noted. Imaging study in most of the patients (61.8%) was performed for neurological diseases (delayed neuropsychological development, epilepsy, and cerebral palsy). Sedation/GA with Propofol was administered in 50% (n=17) of patients, in 26.5% (n=9) - Ketamine plus Midazolam; in 20.6% (n=7) - Midazolam alone, and in 9% (n=1) - Thiopental. The time to readiness for the procedure and the recovery time were statistically significantly shorter for patients receiving Propofol, and the observed adverse respiratory events were mild in severity, when compared with patients receiving sedation/GA with another hypnotic agent (p<0.05).The evaluation of the respiratory system before sedation/GA should be carefully performed, as the respiratory diseases could increase the patients' risk of adverse events occurrence. Sedation/GA with Propofol is a method of choice in children with neurological disorders with seizures, increased intracranial pressure and myopathies, undergoing MR/CT study. Crucial for patients' safety and good clinical results is the medical professionals, delivering sedation/GA, to have the knowledge and practical

  7. Seniors and Anesthesia

    Science.gov (United States)

    ... Media Anesthesia 101 Patient Safety Stories Resources About Home » Patients » Preparing For Surgery » Seniors and Anesthesia Share this Page Preparing For Surgery Effects of Anesthesia Children and Anesthesia Pregnancy, Childbirth and Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia ...

  8. Reverse Trendelenburg’s position vs. supine-horizontal position for induction of general anesthesia in obese neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Stošić Mila

    2006-01-01

    Full Text Available Introduction: The induction of general endotracheal anesthesia (GETA is associated with variable period of apnea. Obese patients have reduced oxygen supply during period of apnea. Hypoxemia and subsequent hypercarbia, during period of apnea, are strong stimuli of cerebral blood flow and intracranial pressure increase. Objective: The objective of our study was to determine the patient position with safe apnea period (SAP, which will minimize the risk of hypoxemia, as an optimal positioning for induction of GETA in obese neurosurgical patients. Method: Obese patients (BMI > 30kg m-2 were randomly placed to one of two positions for induction of GETA: group I (n=20 consisted of patients assuming 30 degree reverse Trendelenburg’s position; group II (n=20 was in supine-horizontal position. After the arterial oxygen saturation of 100% measured by pulse oximetry (SpO2, patients were allowed to remain apneic. The time required for SpO2 to decline from 100% to 94% was recorded as SAP. The lowest SpO2 after restoration of ventilation and recovery time to 98% SpO2 were also recorded. Results: Time needed for SpO2 to decline to 94% was: 196.9 ± 21.53 sec in group I, and 130.65 ± 25.73 sec in group II. There was significant difference between groups (I vs. II; p< 0.05. SpO2 of patients in the reverse Trendelenburg’s position dropped the least and took the shortest time to restore to 98%. The recovery time was much longer in group II, 132.65 ± 33.75 (I vs. II; p < 0.05. Conclusion: 30 degree reverse Trendelenburg’s position provides longer SAP when compared with horizontal-supine positions. This extra time may preclude adverse sequelae resulting from hypoxemia during induction of obese neurosurgical patients.

  9. Anesthesia Basics

    Science.gov (United States)

    ... giving you anesthesia. CRNAs may work under the supervision of a anesthesiologist or on their own — it ... lot over the years, thanks to advances in technology and the extensive training anesthesiologists receive. The more ...

  10. A prospective randomized study comparing short- and intermediate-term perioperative outcome variables after spinal or general anesthesia for lumbar disk and laminectomy surgery.

    Science.gov (United States)

    Jellish, W S; Thalji, Z; Stevenson, K; Shea, J

    1996-09-01

    General or regional anesthesia may be used for lumbar laminectomy. To determine whether one method is superior, 122 patients were randomly assigned to receive either a standard general anesthetic (GA) or spinal anesthesia (SA) supplemented with intravenous (IV) propofol sedation. Data from the intraoperative period through hospital discharge were collected and compared. Demographically, both groups were similar. Total anesthesia (131.0 +/- 4.3 vs 106.6 +/- 3.2 min) and surgical times (81.5 +/- 3.6 vs 67.1 +/- 2.8 min) were longer in the GA group. Intraoperative hemodynamics were similar between groups except that the incidence of increased blood pressure was more frequent with GA (26.2% vs 3.3%). Blood loss was less during SA (133 +/- 18 mL vs 221 +/- 32 mL). Postanesthesia care unit (PACU) heart rates and mean arterial pressures were higher in the GA group. Peak pain scores in the PACU were higher after GA compared with SA (58 +/- 4 vs 22 +/- 3) as were the number of patients who required analgesics. Severe nausea was more common in the GA group both in the PACU and during the 24 h after surgery. Analgesic requirements after discharge from the PACU, urinary retention, and days in the hospital did not differ between groups. This study suggests that SA may be superior to GA both intraoperatively and postoperatively for lumbar spine procedures lasting less than 2 h. PMID:8780281

  11. Anesthesia for radiologic procedures

    International Nuclear Information System (INIS)

    Anesthetic techniques for neurodiagnostic studies and radiation therapy have been recently reviewed, but anesthetic involvement in thoracic and abdominal radiology has received little attention. Patient reactions to radiologic contrast media may be of concern to the anesthesiologist, who is often responsible for injecting these agents during diagnostic procedures, and thus is included in this discussion. Finally, the difficulties of administering anesthesia for magnetic resonance imaging (MRI) scans are outlined, in an effort to help anesthesiologist to anticipate problems with this new technologic development. Although there are very few indications for the use of general anesthesia for diagnostic radiologic studies in adults, most procedures performed with children, the mentally retarded, or the combative adult require either heavy sedation or general anesthesia. In selecting an anesthetic technique for a specific procedure, both the patient's disease process and the requirements of the radiologist must be carefully balanced

  12. General anesthesia recovery period complicated by hysteria%全身麻醉恢复期并发癔症

    Institute of Scientific and Technical Information of China (English)

    陈瑞海; 陈建望; 林日武

    2012-01-01

    The hysteria coma is a kind of pseudo-coma.It's rare during anesthesia,and coma during emergence from anesthesia is usually regarded as an accidental event.Hence,the identification of this event is very important.We reported one case who suffered from coma immediately after awakening from anesthesia.This case was diagnosed as pseudo -coma-hysteria coma.An anesthesiologist should have the ability of identification of each kind of comas.A differential diagnosis program should be initiated once coma occurs during anesthesia.Early diagnosis and treatment are very important for outcomes of patients.%癔症性昏迷属假性昏迷范畴,在麻醉恢复期发作较少见,而恢复期昏迷属麻醉急症与意外,故两者的鉴别显得非常重要.报道1例全麻苏醒后突发昏迷患者,被诊断为假性昏迷——癔症性昏迷.麻醉医师应具备识别各类昏迷的能力,当昏迷发生后迅速启动鉴别诊断程序,早期诊断与治疗对麻醉意外事件转归、缓和紧张医患关系都具有重要意义.

  13. The Effect of Dexmedetomidine-assisted in Improving the General Anesthesia Shivering after General Anesthesia%右美托咪啶辅助在改善全麻病人麻醉后寒战中的作用

    Institute of Scientific and Technical Information of China (English)

    邓巧荣

    2015-01-01

    目的:探讨右美托咪啶辅助在降低全麻病人麻醉后寒战发生率中的作用研究。方法该研究于2013年1月—2013年12月对在该院择期接受腹部外科手术治疗的患者按照数字表法随机分为研究组和对照组,其中研究组在麻醉诱导后给予右美托咪啶,而对照组则给予咪唑安定,比较两组患者术后寒战发生率。结果研究组和对照组患者在麻黄碱、去氧肾上腺素等辅助药物上无明显差异(t=1.02、0.10,P>0.05)。研究组患者的术后寒战发生率(16.67%)明显低于对照组(53.37%),且差异具有统计学意义(c2=8.86,P0.05). Incidence of postoperative shivering in the study group (16.67%) was significantly lower than that of control group(53.37%), and the difference was statistically significant(c2=8.86,P<0.05). Pain VAS score of the study group [(3.42 ± 0.75) points] was significantly lower than that of control group [(4.69 ± 0.88) points], and the difference was statistically significance(t=5.13,P<0.05).Conclusion Dexmedetomidine intravenous injection, not only has a sedative and analgesic effect, but also the occurrence of shivering after general anesthesia is better than midazolam. It is worthy of clinical promotion.

  14. Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up.

    Science.gov (United States)

    Wang, Michael Y; Grossman, Jay

    2016-02-01

    OBJECTIVE One of the principal goals of minimally invasive surgery has been to speed postoperative recovery. In this case series, the authors used an endoscopic technique for interbody fusion combined with percutaneous screw fixation to obviate the need for general anesthesia. METHODS The first 10 consecutive patients treated with a minimum of 1 year's follow-up were included in this series. The patients were all treated using endoscopic access through Kambin's triangle to allow for neural decompression, discectomy, endplate preparation, and interbody fusion. This was followed by percutaneous pedicle screw and connecting rod placement using liposomal bupivacaine for long-acting analgesia. No narcotics or regional anesthetics were used during surgery. RESULTS All patients underwent the procedure successfully without conversion to open surgery. The patients' average age was 62.2 ± 9.0 years (range 52-78 years). All patients had severe disc height collapse, and 60% had a Grade I spondylolisthesis. The mean operative time was 113.5 ± 6.3 minutes (range 105-120 minutes), and blood loss was 65 ± 38 ml (range 30-190 ml). The mean length of hospital stay was 1.4 ± 1.3 nights. There were no intraoperative or postoperative complications. Comparison of preoperative and final clinical metrics demonstrated that the Oswestry Disability Index improved from 42 ± 11.8 to 13.3 ± 15.1; the 36-Item Short Form Health Survey (SF-36) Physical Component Summary improved from 47.6 ± 3.8 to 49.7 ± 5.4; the SF-36 Mental Component Summary decreased from 47 ± 3.9 to 46.7 ± 3.4; and the EQ-5D improved from 10.7 ± 9.5 to 14.2 ± 1.6. There were no cases of nonunion identified radiographically on follow-up imaging. CONCLUSIONS Endoscopic fusion under conscious sedation may represent a feasible alternative to traditional lumbar spine fusion in select patients. Larger clinical series are necessary to validate that clinical improvements are sustained and that arthrodesis rates are

  15. [Condition of patients after surgical wisdom tooth extraction under general anesthesia with different premedication variants--a prospective study based on a post-anesthesia questionnaire].

    Science.gov (United States)

    Markus, H; Schwarz, A

    2001-01-01

    Evaluation of the modified "postanaesthesiological questionnaire" pointed to a subtle influencing of the condition of patients who had undergone 3rd molar surgery in general anaesthesia by using different premedication variants: "Atropine, Pethidine and Midazolam" (group A) and "Atropine, Midazolam and S-Ketamin" (group B). The combination in group B seems to be more suitable. On the one hand, a lower incidence of unwanted side-effects was found and, on the other hand, remarkable positive effects were observed. Of particular significance with this combination was also the more effective suppression of postoperative pain. The Propofol-supplemented general anaesthesia prepared in this way and administered using a nasal intubation technique found the full approval of the patients. Postoperative pain therapy was effective and also inexpensive, costing just 8.20 DM per patient, according to current prices calculated by Magdeburg University Hospital. PMID:11799850

  16. A COMPARATIVE STUDY OF PEDIATRIC CARDIAC CATHETERIZATION PROCEDURE UNDER GENERAL ANESTHESIA WITH OR WITHOUT FEMORAL NERVE BLOCK

    OpenAIRE

    Jigisha; Bhavesh; Parineeta; Tarun

    2016-01-01

    OBJECTIVE Anesthetic management for interventional cardiac procedures/cardiac catheterization in pediatric patients is challenging. Cardiac anomalies vary from simple to complex congenital cardiac anomalies, shunts may be present at multiple levels and patients may be profoundly cyanotic, may be with ventricular dysfunction. They usually require sedation and analgesia to maintain steady stable state. In adults, such type of procedures can be well managed with local anesthesia....

  17. Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey.

    Directory of Open Access Journals (Sweden)

    Jie Yi

    Full Text Available Inadvertent intraoperative hypothermia (core temperature 2 h (OR = 3.44, 95% CI 1.90-6.22,, and intravenous un-warmed fluid (OR = 2.45, 95% CI 1.45-4.12 significantly increased the risk of hypothermia.The incidence of inadvertent intraoperative hypothermia in Beijing is high, and the rate of active warming of patients during operation is low. Concern for the development of intraoperative hypothermia should be especially high in patients undergoing major operations, requiring long periods of anesthesia, and receiving un-warmed intravenous fluids.

  18. 全麻维持方式与术后寒战的关系%Relationship between maintenance types of general anesthesia and postoperative shivering

    Institute of Scientific and Technical Information of China (English)

    康孝荣; 李晓强; 等

    2001-01-01

    Objective To research the effect of different maintenance types of general anesthesia on postoperative shivering.Methods The maintenance types of general anesthesia were randomly used in patients whose anesthetics were totally inhaled,intravenously infused plus inhaled,and totally intravenously infused.The occurrence rate of postoperative shivering,the occurrence time and scores of shivering after operation and the changes of tympanic temperatures were observed.Results There was no significant difference in occurrence rate of shivering among three groups.The occurrence time of shivering in inhaled group was significantly shorter than that in totally intravenously infused group.The highest scores of shivering were not significantly different among three groups.The tympanic temperatures after operation were significantly lower than those at 10 minutes after induction in all three groups,the extent of decrease was most in inhaled group and lowest in intravenous infused group.Conclusions Total intravenous maintenance anesthesia has a significant more advantage than inhaled maintenance anesthesia in prevention of postoperative shivering.%目的 研究不同的全麻维持方式对术后寒战的影响。方法 随机采用全吸入、静吸复合及全静脉维持麻醉,观察三组病人寒战发生率、术后出现寒战的时间及级别、鼓膜温度的变化。结果 三组寒战发生率比较无显著性差异;吸入组出现寒战的时间比静脉组显著缩短,寒战最高级别三组无显著性差异。三组病人术后鼓膜温度都显著低于诱导后10分钟的温度,吸入组降低最多,静脉组降低最少。结论 预防术后寒战,全静脉维持麻醉显著优于全吸入维持麻醉。

  19. Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery

    Directory of Open Access Journals (Sweden)

    Hedenstierna Göran

    2011-05-01

    Full Text Available Abstract Background Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery. Methods The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO" trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH2O with recruitment maneuvers (the lung-protective strategy or mechanical ventilation with the level of PEEP at maximum 2 cmH2O without recruitment maneuvers (the conventional strategy. The primary endpoint is any post-operative pulmonary complication. Discussion The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications. Trial registration ISRCTN: ISRCTN70332574

  20. 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 | ...

  1. 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, ...

  2. Towards optimized anesthesia protocols for stereotactic surgery in rats: Analgesic, stress and general health effects of injectable anesthetics. A comparison of a recommended complete reversal anesthesia with traditional chloral hydrate monoanesthesia.

    Science.gov (United States)

    Hüske, Christin; Sander, Svenja Esther; Hamann, Melanie; Kershaw, Olivia; Richter, Franziska; Richter, Angelika

    2016-07-01

    Although injectable anesthetics are still widely used in laboratory rodents, scientific data concerning pain and distress during and after stereotactic surgery are rare. However, optimal anesthesia protocols have a high impact on the quality of the derived data. We therefore investigated the suitability of recommended injectable anesthesia with a traditionally used monoanesthesia for stereotactic surgery in view of optimization and refinement in rats. The influence of the recommended complete reversal anesthesia (MMF; 0.15mg/kg medetomidine, 2mg/kg midazolam, 0.005mg/kg fentanyl; i.m.) with or without reversal and of chloral hydrate (430mg/kg, 3.6%, i.p.) on various physiological, biochemical and behavioral parameters (before, during, after surgery) was analyzed. Isoflurane was also included in stress parameter analysis. In all groups, depth of anesthesia was sufficient for stereotactic surgery with no animal losses. MMF caused transient exophthalmos, myositis at the injection site and increased early postoperative pain scores. Reversal induced agitation, restlessness and hypothermia. Even the low concentrated chloral hydrate led to peritonitis and multifocal liver necrosis, corresponding to increased stress hormone levels and loss in body weight. Increased stress response was also exerted by isoflurane anesthesia. Pronounced systemic toxicity of chloral hydrate strongly questions its further use in rodent anesthesia. In view of undesired effects of MMF and isoflurane, thorough consideration of anesthesia protocols for particular research projects is indispensable. Reversal should be restricted to emergency situations. Our data support further refinement of the current protocols and the importance of sham operated controls. PMID:27067188

  3. 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.

  4. Awake craniotomy for cortical language mapping and resection of an arteriovenous malformation adjacent to eloquent areas under general anesthesia — A hybrid approach

    Directory of Open Access Journals (Sweden)

    Pree Nimmannitya

    2015-12-01

    Full Text Available Surgery of arteriovenous malformation (AVM is sometimes challenging and carries a high risk of morbidity, especially when the AVM is located in an eloquent area of the brain. Unlike gliomas, awake craniotomy has not been widely used for resection of AVM. The authors present a case of an AVM in the left frontal lobe which was successfully removed with the aid of awake craniotomy with cortical language mapping. In conclusion, awake craniotomy for functional cortical mapping is beneficial for AVM resection, especially when the lesion is located in or adjacent to eloquent areas of the brain. A hybrid approach with functional mapping in the awake condition and AVM resection under general anesthesia may be useful in selected cases. Furthermore, en bloc resection with the nidus embedded in the brain parenchyma may be a useful means of removal to reduce operation time and intraoperative blood loss if there is no apparent functional cortex surrounding the AVM, as in the present case.

  5. Beta-adrenergic antagonists during general anesthesia reduced postoperative pain: a systematic review and a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Härkänen, Lasse; Halonen, Jari; Selander, Tuomas; Kokki, Hannu

    2015-12-01

    We have performed a systematic literature review and a meta-analysis investigating the effect of beta-adrenergic antagonist on perioperative pain in randomized clinical trials (RCTs). The search included the CENTRAL, CINAHL, EMBASE, and MEDLINE databases (from inception to 10 February 2015). From the retrieved full texts, we hand-searched the references and PubMed related citations. A total of 11 RCTs consisting data of 701 adult patients were eligible for this systematic review. Esmolol was evaluated in ten trials and propranolol in one. Esmolol decreased the need for rescue analgesics by 32-50%; p esmolol-treated patients: 52-57 vs. 23-34%, p < 0.05. Adverse effects were rarely reported, and as reported were mostly cardiovascular alterations. In conclusion, intra-operative beta-adrenergic antagonists' administration may decrease postoperative pain and analgesic consumption when given as an adjuvant to general anesthesia. PMID:26160590

  6. Effects of Single Low Dose of Dexamethasone before Noncardiac and Nonneurologic Surgery and General Anesthesia on Postoperative Cognitive Dysfunction—A Phase III Double Blind, Randomized Clinical Trial

    Science.gov (United States)

    Pereira, Valeria Fontenelle Angelim; Pietrobon, Ricardo S.; Schmidt, Andre P.; Oses, Jean P.; Portela, Luis V.; Souza, Diogo O.; Vissoci, João Ricardo Nickenig; da Luz, Vinicius Fernando; Trintoni, Leticia Maria de Araujo de Souza; Nielsen, Karen C.; Carmona, Maria José Carvalho

    2016-01-01

    Postoperative cognitive dysfunction (POCD) is a multifactorial adverse event most frequently in elderly patients. This study evaluated the effect of dexamethasone on POCD incidence after noncardiac and nonneurologic surgery. METHODS: One hundred and forty patients (ASA I-II; age 60–87 years) took part in a prospective phase III, double blind, randomized study involving the administration or not of 8 mg of IV dexamethasone before general anesthesia under bispectral index (BIS) between 35–45 or 46–55. Neuropsychological tests were applied preoperatively and on the 3rd, 7th, 21st, 90th and 180th days after surgery and compared with normative data. S100β was evaluated before and 12 hours after induction of anesthesia. The generalized estimating equations (GEE) method was applied, followed by the posthoc Bonferroni test considering P<0.05 as significant. RESULTS: On the 3rd postoperative day, POCD was diagnosed in 25.2% and 15.3% of patients receiving dexamethasone, BIS 35–45, and BIS 46–55 groups, respectively. Meanwhile, POCD was present in 68.2% and 27.2% of patients without dexamethasone, BIS 35–45 and BIS 46–55 groups (p<0.0001). Neuropsychological tests showed that dexamethasone associated to BIS 46–55 decreased the incidence of POCD, especially memory and executive function. The administration of dexamethasone might have prevented the postoperative increase in S100β serum levels. CONCLUSION: Dexamethasone can reduce the incidence of POCD in elderly patients undergoing surgery, especially when associated with BIS 46–55. The effect of dexamethasone on S100β might be related with some degree of neuroprotection. Trial Registration: www.clinicaltrials.gov NCT01332812 PMID:27152422

  7. Effects of Single Low Dose of Dexamethasone before Noncardiac and Nonneurologic Surgery and General Anesthesia on Postoperative Cognitive Dysfunction-A Phase III Double Blind, Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Livia Stocco Sanches Valentin

    Full Text Available Postoperative cognitive dysfunction (POCD is a multifactorial adverse event most frequently in elderly patients. This study evaluated the effect of dexamethasone on POCD incidence after noncardiac and nonneurologic surgery.One hundred and forty patients (ASA I-II; age 60-87 years took part in a prospective phase III, double blind, randomized study involving the administration or not of 8 mg of IV dexamethasone before general anesthesia under bispectral index (BIS between 35-45 or 46-55. Neuropsychological tests were applied preoperatively and on the 3rd, 7th, 21st, 90th and 180th days after surgery and compared with normative data. S100β was evaluated before and 12 hours after induction of anesthesia. The generalized estimating equations (GEE method was applied, followed by the posthoc Bonferroni test considering P<0.05 as significant.On the 3rd postoperative day, POCD was diagnosed in 25.2% and 15.3% of patients receiving dexamethasone, BIS 35-45, and BIS 46-55 groups, respectively. Meanwhile, POCD was present in 68.2% and 27.2% of patients without dexamethasone, BIS 35-45 and BIS 46-55 groups (p<0.0001. Neuropsychological tests showed that dexamethasone associated to BIS 46-55 decreased the incidence of POCD, especially memory and executive function. The administration of dexamethasone might have prevented the postoperative increase in S100β serum levels.Dexamethasone can reduce the incidence of POCD in elderly patients undergoing surgery, especially when associated with BIS 46-55. The effect of dexamethasone on S100β might be related with some degree of neuroprotection.www.clinicaltrials.gov NCT01332812.

  8. A COMPARATIVE STUDY OF PEDIATRIC CARDIAC CATHETERIZATION PROCEDURE UNDER GENERAL ANESTHESIA WITH OR WITHOUT FEMORAL NERVE BLOCK

    Directory of Open Access Journals (Sweden)

    Jigisha

    2016-02-01

    Full Text Available OBJECTIVE Anesthetic management for interventional cardiac procedures/cardiac catheterization in pediatric patients is challenging. Cardiac anomalies vary from simple to complex congenital cardiac anomalies, shunts may be present at multiple levels and patients may be profoundly cyanotic, may be with ventricular dysfunction. They usually require sedation and analgesia to maintain steady stable state. In adults, such type of procedures can be well managed with local anesthesia. METHODS Fifty patients were included in the study. They were randomly divided into two groups- Group A (n=25 patients received femoral N. block along with IV sedation and analgesia while group B (n=25 patients received only IV sedation and analgesia. Both groups were compared for hemodynamics, pain score and requirement of IV anesthetic agents and any complications if come up. RESULTS Group A patients required IV ketamine 3.24mg/kg (±0.31SD as compared to 5.58mg/kg (±1.6SD in group B, which suggests significantly reduced requirement of IV anesthetic agents in group where femoral nerve block has been given. Hemodynamic parameters remained stable and comparable (no statistically significant variation Pain score was less in group A patients than group B. CONCLUSION It has been observed that Group A patients required less dosages of IV anesthetic agents, with stable hemodynamics and less pain score and sedation score as compared to group B patients.

  9. 全麻期间机械通气对患者心功能的影响%Effect of mechanical ventilation on cardiac function during general anesthesia

    Institute of Scientific and Technical Information of China (English)

    蒋海; 蒋小朴; 林世清; 陈锡辉; 靳三庆

    2008-01-01

    Objective To evaluate the effect of mechanical ventilation on cardiac function during general anesthesia.Methods Fifty-three ASA Ⅰ or Ⅱ patients aged 18-55 yr scheduled for elective tympanic cavity plasty surgery were randomly divided into 2 groups: mechanical ventilation group (group M, n = 28) and spontaneous respiration group (group S, n = 25). Mechanical ventilation was applied in group M after rapid induction and tracheal intuhation, while in group S spontaneous respiration was maintained after slow induction and tracheal intuhation. BIS value was maintaited between 40-60 during anesthesia in both groups. Before induction of anesthesia, the baseline of heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation ( SpO2 ), cardiac output (CO) and stroke volume (SV) were recorded. The parameters including HR and MAP, SpO2, CO, SV ,tidal volume (VT),respiratory rate (RR), partial pressure of carbon dioxide in endexpiratory gas (PET CO2 ) and peak inspiratory pressure (Ppeak) were recorded at 1, 5, 10, 20, 40, 60, 90, 120 and 150 min after intubation. Results There were no statistical differences in CO, SV, HR, MAP between the two groups. SpO2, VT and Ppeak were significantly higher and RR and PETCO2 were significantly lower in group M than in group S, but the values were in the normal range. Conclusion The short-term mechanical ventilation has no adverse effect on cardiac function during general anesthesia in patients with normal heart function.%目的 评价全麻期间机械通气对患者心功能的影响.方法 选择鼓室成形术ASA Ⅰ或Ⅱ级患者53例,随机分为机械通气组(M组,n=28)和自主呼吸组(S组,n=25).M组麻醉诱导气管插管后行机械通气;S组采取麻醉慢诱导气管插管后保留自主呼吸.术中维持BIS 40~60.于气管插管前、气管插管后1、5、10、20、40、60、90、120及150 min时记录心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)、心输出量(CO)及每搏量(SV);

  10. Anesthesia for fetoscopic intervention

    Directory of Open Access Journals (Sweden)

    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.

  11. [Voluntary interruption of pregnancy: anesthesia or sophrology].

    Science.gov (United States)

    Ferragut, E

    1979-10-01

    General anesthesia during induced abortion has the great advantage of eliminating any physical pain; it does not do anything, however, for anxiety, guilt feeling, emotional upheaval, and postoperative depression. This study investigate sophrology, a form of anesthesia without medication, which diminishes psychic tension through comforting and sympathetic words, and corporal tension through relaxation. At the beginning of the study, which observed 7547 patients, general anesthesia was routinely used for all induced abortion patients; after 4 years of observation, general anesthesia was used on about 1.9% of patients. Judging from a questionnaire given to patients after intervention 75% of patients were completely satisfied from an emotional point of view; the same percentage judged the procedure a bit painful, but bearable; only 3.5% of patients regretted not to have opted for general anesthesia. PMID:12158285

  12. Paediatric Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Rakhee Goyal

    2008-01-01

    Full Text Available Paediatric spinal anesthesia is not only a safe alternative to general anaesthesia but often the anaesthesia technique of choice in many lower abdominal and lower limb surgeries in children. The misconception regarding its safety and feasibility is broken and is now found to be even more cost-effective. It is a much preferred technique especially for the common daycase surgeries generally performed in the paediatric age group. There is no require-ment of any additional expensive equipment either and this procedure can be easily performed in peripheral centers. However, greater acceptance and experience is yet desired for this technique to become popular.

  13. Atelectasia pulmonar em cães durante anestesia geral Pulmonary atelectasis in dogs during general anesthesia

    Directory of Open Access Journals (Sweden)

    Patrícia Cristina Ferro Lopes

    2010-02-01

    Full Text Available A pressão intrapleural normalmente é menor que a pressão intrapulmonar. Consequentemente , os pulmões tendem ao colapso e se retraem, afastando-se da parede torácica. No início do século XX, Pasteur descreveu a atelectasia pulmonar, que ocorre com frequência durante a indução anestésica, persiste no período pós-operatório e pode contribuir de maneira significativa para a morbidade e o aumento nos gastos com medicamentos. Em medicina veterinária, no entanto, a atelectasia não é frequentemente diagnosticada, apesar de que isso não implica afirmar que tal afecção não ocorra, visto que existem relatos do desenvolvimento desse quadro em cães e em outras espécies. No contexto da anestesia geral, essa complicação pulmonar pode ser encontrada em animais que respiram 80 a 100% de oxigênio. A partir dessas informações, torna-se necessário que o profissional da anestesiologia veterinária obtenha conhecimentos complementares sobre o tema. Com este trabalho, objetivou-se descrever alguns dos mecanismos da atelectasia e seus pontos relevantes, de modo a familiarizar os profissionais quanto aos pormenores dessa importante, e nem sempre bem compreendida, alteração fisiológica respiratória.Pleural pressure is usually lower than pulmonary pressure. Therefore, the lungs tend to collapse and increase its distance from thoracic walls. At the beginning of 20th century, Pasteur described the pulmonary atelectasis, which develops during induction of anesthesia and persists to the postoperative period. It can contribute significantly to morbidity and to increase the medical expenses. In veterinary medicine, pulmonary atelectasis is not frequently diagnosed, which doesn't rule out the occurrence of this disease, since there are reports of atelectsasis in dogs. This pulmonary complication can be found in animals that breathe 80% to 100% oxygen in anesthetic procedures. Based on this information, the veterinary anesthesiologist is required

  14. Non-invasive monitoring of blood pressure using the Philips Intellivue MP50 monitor cannot replace invasive blood pressure techniques in surgery patients under general anesthesia.

    Science.gov (United States)

    Meng, Xianghu; Zang, Guanghui; Fan, Longchang; Zheng, Lei; Dai, Jinzhen; Wang, Xueren; Xia, Wei; Liu, Jihong; Zhang, Chuanhan

    2013-07-01

    The Philips Intellivue MP50 monitor provides a method for non-invasive, near-continuous blood pressure (BP) monitoring and is designed to be an alternative to direct intra-arterial BP (IABP) measurement. However, no studies have specifically compared non-invasive and invasive BP measurements using the monitor. The present retrospective study observed 515 patients undergoing surgery with general anesthesia, whose invasive (intra-radial, femoral or dorsalis pedis artery) and non-invasive (oscillometric) BP (NIBP) were monitored simultaneously using the monitor. These data were analyzed using correlations, regressions and Bland-Altman plots. The patients were placed in a supine position during surgery. The correlation data for invasive BP and NIBP measurements were: for intra-radial measurements, r(2)=0.51 (bias and precision, 11.04±15.22 and 14.76±11.64 mmHg, respectively) for systolic BP (SBP) and r(2)=0.27 (6.17±11.95 and 9.77±9.25 mmHg, respectively) for diastolic BP (DBP); for intra-femoral measurements: r(2)=0.57 (14.79±14.55 and 17.15±11.68 mmHg, respectively) for SBP and r(2)=0.45 (4.12±9.70 and 7.49±7.40 mmHg, respectively) for DBP; and for intra-dorsalis pedis measurements: r(2)=0.33 (13.00±16.81 and 17.34±12.28 mmHg, respectively) for SBP and r(2)=0.30 (0.17±11.27 and 8.44±7.46 mmHg, respectively) for DBP. According to this data, the NIBP measured by the Philips Intellivue MP50 monitor showed low positive correlations and poor agreement with the IABP, as calculated by Bland-Altman analysis. Therefore, the use of oscillometric BP measured by the monitor in surgery patients under general anesthesia is not generally recommended. PMID:23935710

  15. Efficacy and safety of ramosetron versus ondansetron for postoperative nausea and vomiting after general anesthesia: a meta-analysis of randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Gao CJ

    2015-04-01

    Full Text Available Chengjie Gao, Bo Li, Lufeng Xu, Fubin Lv, Guimao Cao, Huixia Wang, Fei Wang, Guanghan WuDepartment of Anesthesiology, General Hospital of Jinan Military Command, Jinan, People’s Republic of ChinaBackground: Postoperative nausea and vomiting is a common side effect of general anesthesia. In this study, we performed a meta-analysis on the efficacy and safety of ramosetron versus ondansetron in the prevention of postoperative nausea and vomiting using the most recently published randomized controlled clinical studies.Methods: PubMed and EMBASE were searched for randomized controlled clinical trials comparing the efficacy and safety of ramosetron and ondansetron. The meta-analysis was performed using Review Manager version 5.3 (Cochrane Collaboration, Oxford, UK. Dichotomous outcomes are presented as the relative risk (RR with a 95% confidence interval (CI.Results: A total of 898 patients from nine selected studies were treated with antiemetics after surgery, including 450 patients who received ondansetron 4 mg and 448 patients who received ramosetron 0.3 mg. The meta-analysis showed no statistically significant difference between the two groups with regard to prevention of postoperative nausea (PON during different time periods in the 48 hours after surgery. When comparing the efficacy of ramosetron and ondansetron in the prevention of postoperative vomiting (POV, at various time intervals in the 24 hours after surgery, ramosetron was significantly more efficient than ondansetron: 0–6 hours (RR 0.46, 95% CI 0.24–0.92; P=0.03, 0–24 hours (RR 0.72, 95% CI 0.52–1.00; P=0.05, and 6–24 hours (RR 0.51, 95% CI 0.31–0.84; P=0.008. At other time periods between 24 and 48 hours after surgery, ramosetron did not show better efficacy than ondansetron. When comparing the safety profiles of ramosetron and ondansetron, fewer side effects were recorded in the ramosetron group (RR 0.65, 95% CI 0.47–0.91; P=0.01.Conclusion: Our meta

  16. Effects of preoperative psychological state on the results of general anesthesia%术前心理状态对全麻效果的影响

    Institute of Scientific and Technical Information of China (English)

    冯晋潞; 乔阳

    2007-01-01

    Objective To study the effects of preoperative psychological state on calm time、recovery time and the level of pain about female tumer patients with general anesthesia.Methods We selected 105 female tumer patients whose ages were from 39 years to 66 years.They were divided into two groups according to SAS grade.We observed the calm time,recovery time and the VAS about the two groups.Results The calm time and reeovery time in disquieting group was significant longer than that of the normal group.There was a significant difference between group A and group B(P<0.01).Otherwise the grade of VAS after operation was significant greater than that of the normal group.Conclusion The disquieting preoperative psychological state would effect the results of general anesthesia.The anesthetist should pay attention to the visiting patients before operation.%目的 研究术前心理状态对妇科肿瘤切除术患者全麻镇静时间、苏醒时间和术后疼痛的影响.方法 选择年龄在39~66岁,行择期妇科肿瘤切除术的患者105例,按照Zuang焦虑自评量表(SAS)对患者进行焦虑状态自评的分数,将105例患者分为对照组(A组)和焦虑组(B组)两组.观察上述两组全麻镇静时间、苏醒时间和术后视觉模拟(VAS)评分情况.结果 焦虑组全麻镇静时间、苏醒时间均明显长于对照组(P<0.01),焦虑组的术后VAS评分也明显大于正常组(P<0.01).结论 术前患者的焦虑心理状态对全麻效果有一定的影响,麻醉医师应重视术前访视患者.

  17. 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

  18. Effects of essential oils on wake-promoting of general anesthesia in rats%精油对全麻大鼠促醒效应的实验研究

    Institute of Scientific and Technical Information of China (English)

    方文恒; 徐金勇; 任振华; 李光武

    2011-01-01

    Aim To research the effects of essential oils on wake-promoting of general anesthesia. Methods Three kinds of essential oilPM , rosemary, lavender oil and three kinds of anesthetics pentobarbital ( PTB) , propofol ( PRO) , ketamine ( KET) were used in our study. We investigated the effects of PM , rosemary , lavender oil on PTB-induced general anesthesia . whether various concentrations of lavender oil affected PTB-induced general anesthesia and the effects of PM oil on PRO , KET-induced general anesthesia. Results It indicated that PM oil reduced PTB and PRO-induced general anesthesia duration significantly while the anesthesitic KET had no significant effect. In addition , lavender oil had wake-promoting effect in given concentration. Conclusion It coulcl have wake-promoting effect of general anesthesia in rats by inhalation of PM oil and lavender oil in given concentration.%目的 研究精油对全麻的促醒效果.方法 该研究选用了PM、迷迭香、薰衣草精油及三种全麻药戊巴比妥钠、丙泊酚和氯胺酮,通过吸嗅器械分别观察了:吸嗅PM、迷迭香(RM)、薰衣草(LA)精油对戊巴比妥钠全麻大鼠睡眠时间的影响;不同吸嗅浓度的薰衣草精油是否改变戊巴比妥钠(PTB)全麻大鼠的睡眠时间以及吸嗅PM精油分别对丙泊酚(PRO)和氯胺酮(KET)全麻大鼠睡眠时间的影响.结果 PM精油可明显降低戊巴比妥钠和丙泊酚诱导的睡眠时间,而对氯胺酮则无明显效果;薰衣草精油在给定吸嗅浓度下也存在促醒效果.结论 吸嗅PM精油和特定浓度的薰衣草精油对全麻大鼠具有促醒效应.

  19. Impact of dental treatment under general anesthesia on the oral health-related quality of life of adolescents and adults with special needs.

    Science.gov (United States)

    Chang, Juhea; Patton, Lauren L; Kim, Hae-Young

    2014-12-01

    This study aimed to assess the perception of the family's primary caregiver on the oral health-related quality of life (OHRQoL), and the impact on family dynamics, of dental treatment under general anesthesia (GA) in adolescent and adult patients with intellectual and developmental disabilities (IDD) and neurocognitive disorders. Self-administered questionnaires were completed, before dental treatment, by 116 primary family caregivers of patients who received dental treatment under GA, and 102 (88%) of these caregivers completed the same questionnaires within 4 wk after treatment. The Child Oral Health Impact Profile (COHIP) and the Family Impact Scale (FIS) were shortened to a 14-item COHIP (COHIP-14) and a 12-item FIS (FIS-12) based on the limitations of patients' communication. The COHIP-14 and FIS-12 scores and each subscale improved after treatment. The baseline scores varied based on certain characteristics of the patients, such as age, disabilities, medications, caregivers, meal types, cooperation levels, and treatment needs. The postoperative improvement in OHRQoL was significant in the patients who were older than 30 yr of age, originally eating soft meals, displaying no or very low levels of cooperation, or receiving endodontic treatment. Based on the primary caregiver perceptions, the OHRQoL of adolescents and adults with IDD and neurocognitive disorders was improved by dental treatment under GA. PMID:25292335

  20. 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...

  1. Hand Surgery: Anesthesia

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon Hand Surgery Anesthesia Email to a friend * required fields From * To * ... in to name and customize your collection. DESCRIPTION Anesthesia is a way to control pain during a ...

  2. Topical anesthesia in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Saad Waheeb

    2010-01-01

    Conclusion : Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon.

  3. 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...

  4. Dental treatment for handicapped patients; sedation vs general anesthesia and update of dental treatment in patients with different diseases

    OpenAIRE

    Corcuera Flores, José Ramón; Delgado Muñoz, José María; Ruiz Villandiego, José Cruz; Maura Solivellas, Isabel; Machuca Portillo, Guillermo

    2013-01-01

    Dental treatment on Handicapped Patients is often difficult because many people with a wide range of ages (from children to the elderly) with different pathologies that can affect the oral cavity and differ widely are included in this group. This situation creates some controversy, because according to pathology, each patient will be treated differently depending on collaboration, general health status, age or medication used to treat this pathologies. According to this situation we can opt f...

  5. Comparison between general and spinal anesthesia in inguinal hernia repair in Clinical University Hospital "St. Naum Ohridski" - Skopje

    OpenAIRE

    Vukovikj, Makedonka; Angelovska, Bistra; Drakalska, Elena

    2015-01-01

    Most often recommended treatment for inguinal hernia diagnosed patients is surgery. Generally, the surgical treatment includes several components: opening the subcutaneous fat by incision of the abdominal wall, mobilization of cord structures, dissection of weakened tissue and closure of inguinal canal with application of sterile synthetic mesh patch used to repair and decrease the tension in the weakened area of the abdominal wall after mobilization of hernia. Usually, the patient is given g...

  6. Role of butorphanol and ondansetron premedication in reducing postoperative shivering after general and spinal anesthesia: A randomized comparative study from North India

    Science.gov (United States)

    Rai, Sujeet; Verma, Satyajeet; Pandey, H. P.; Yadav, Pramod; Patel, Amit

    2016-01-01

    Background: Postoperative shivering (PAS) is a common problem following general and spinal anesthesia and may lead to multiple complications. This placebo-controlled, randomized study was performed to evaluate the efficacy of Ondansetron and butorphanol premedication reduces shivering after general and spinal anaesthesia. Aims: The aim of this study to highlight the efficacy of Butorphenol and ondosteron in controlling postoperative shivering. Materials and Methods: This clinical trial included 180 patients scheduled for elective general surgery, E.N.T., Ophthamological operations, randomly divided to six groups. Three groups in which General Anaesthesia was used i.e. Group 1-ondansetron 8 mg intravenously(IV).Group 2 butorphanol 2 mg IV and Group 3 – saline 4 ml IV. And three groups where spinal Anaesthesia was used i.e. Group 4-Ondosteron 8 mg IV, Group 5 butorphanol 2 mg IV and Group 6 – saline 4 ml IV 3-5 minutes before anaesthesia. Patients were observed in terms of vital signs, side effects and shivering. Settings and Design: The type of the study was double blind randomized trial. Statistical Analysis Used: Statistical Package for Social Sciences version 13.0 statistical analysis software. Results: Postoperative shivering was observed in 15.5%, 22.2% and 60% in general anaesthesia groups I II and III respectively. The reduction of core and dermal temperature during the anaesthesia and recovery, changes in systolic and diastolic blood pressure and heart rate were similar in all three groups (i.e. Group I,II,III). In spinal anaesthesia groups, PAS occurred 10%, 13.3% and 43.3% in group IV, V, VI respectively. The reduction of core temperature is similar in all three groups of spinal anaesthesia. But heart rate and mean arterial pressure increase were significant in control saline group in post operative recovery time. No complication seen in any of the six groups. Conclusion: This study suggested that use of Butorphanol and Ondansteron both are effective

  7. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... anesthesia services. 415.110 Section 415.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... directed anesthesia services. (a) General payment rule. Medicare pays for the physician's medical direction of anesthesia services for one service or two through four concurrent anesthesia services...

  8. Influence of music therapy for patients’ pain in the recovery period of general anesthesia after abdominal operation%音乐疗法对腹部手术后全麻苏醒期患者疼痛的影响

    Institute of Scientific and Technical Information of China (English)

    洪莲; 尧永华; 黎玉梅; 江涛; 唐春林; 沈翠玲; 符玲

    2015-01-01

    目的:观察运用音乐疗法对腹部手术患者全麻苏醒期疼痛的影响。方法选择择期腹部手术患者250例,按手术日期单、双号分两组(各125例),单号为治疗组,双号为观察组。治疗组患者在术后麻醉苏醒期予以播放镇静安神、宁心催眠、节奏舒缓的音乐(舒伯特小夜曲),观察组按照常规麻醉复苏。结果治疗组在麻醉苏醒期的疼痛程度比观察组低,差异有统计学意义( P<0.001)。结论腹部手术全麻苏醒期应用音乐疗法可减轻患者在麻醉苏醒期的疼痛程度。%Objective To observe the influence of music therapy for patients’ pain in the recovery period of general anesthesia after abdominal operation.Methods 250 patients,according to the operation date of single and double,were randomized to the treatment group aronnd with Schubert's Serenade in the recovery period of general anesthesia and the observing group with usual nursing care.Results The level of patients’ pain in the recovery period of general anesthesia in treatment group was obvious lower than the observing group(P<0.001).Conclusion The ap⁃plication of music therapy can reduce the degree of patients’ pain in the recovery period of general anesthesia after abdominal operation.

  9. Protocol for a systematic review and individual patient data meta-analysis of benefit of so-called lung-protective ventilation settings in patients under general anesthesia for surgery

    OpenAIRE

    Neto, Ary Serpa; Hemmes, Sabrine NT; de Abreu, Marcelo Gama; Pelosi, Paolo; Schultz, Marcus J.

    2014-01-01

    Background Almost all patients under general anesthesia for surgery need mechanical ventilation. The harmful effects of short-term intra-operative ventilation on pulmonary integrity are increasingly recognized. Recent investigations suggest protection against so-called ventilation-associated lung injury with the use of lower tidal volumes and/or the use of higher levels of positive end-expiratory pressure (PEEP). This review and meta-analysis will evaluate the effects of these protective meas...

  10. Anaphylaxis due to thiopental sodium anesthesia.

    OpenAIRE

    Dolovich, J; Evans, S.; Rosenbloom, D; Goodacre, R; Rafajac, F O

    1980-01-01

    Anaphylaxis due to an anesthetic is one type of cardiovascular emergency that can occur during general anesthesia. Anaphylactic reactions to muscle relaxants have been documented. Barbiturates, used as sedatives, are well known to produce cutaneous reactions, but anaphylaxis after their ingestion seems to be rare. Generalized allergic reactions to thiopental sodium during anesthesia are mentioned in the product monograph for Penthothal sodium, and rare case reports of anaphylactic reactions t...

  11. Modeling the dynamical effects of anesthesia on brain circuits

    OpenAIRE

    Ching, ShiNung; Brown, Emery N

    2014-01-01

    General anesthesia is a neurophysiological state that consists of unconsciousness, amnesia, analgesia, and immobility along with maintenance of physiological stability. General anesthesia has been used in the United States for more than 167 years. Now, using systems neuroscience paradigms how anesthetics act in the brain and central nervous system to create the states of general anesthesia is being understood. Propofol is one of the most widely used and the most widely studied anesthetics. Wh...

  12. Back Pain and Neuraxial Anesthesia.

    Science.gov (United States)

    Benzon, Honorio T; Asher, Yogen G; Hartrick, Craig T

    2016-06-01

    The incidence of back pain after neuraxial anesthesia in the adult population is not different from that after general anesthesia. The pain is usually mild, localized in the low back, rarely radiates to the lower extremities, and has a duration of only a few days. The risk factors for development of back pain include the lithotomy position, multiple attempts at block placement, duration of surgery longer than 2.5 hours, body mass index ≥32 kg/m, and a history of back pain. However, there is no permanent worsening of preexisting back pain after neuraxial anesthesia. The back pain has been attributed to tears in the ligaments, fascia, or bone with localized bleeding; immobility of the spine; relaxation of the paraspinal muscles under anesthesia; flattening of the normal lumbar convexity; and stretching and straining of the lumbosacral ligaments and joint capsules. The addition of an anti-inflammatory drug to the local anesthetic used for skin infiltration may decrease the incidence and severity of back pain. The use of spinal or epidural anesthesia in the adult, non-obstetric and obstetric populations should depend on the advantages offered by the technique and not on the occurrence of back pain after the procedure. Additional studies are needed to confirm the efficacy of epidural dexamethasone, or other steroids, or the addition of an anti-inflammatory drug to the local anesthetic infiltration for the prevention of back pain after neuraxial anesthesia. Future studies should involve a physician with expertise in the evaluation of chronic low back pain to help identify the cause of the back pain and institute appropriate treatment(s). PMID:27195644

  13. Effect of ondansetron on prevention of post-induction hypotension in elderly patients undergoing general anesthesia: A randomized, double-blind placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Mohammad Golparvar

    2015-01-01

    Full Text Available Background: Elderly patients are susceptible to post-induction hypotension. Volume loading and vasopressors for prevention of hypotension in elderly patients may increase perioperative cardiovascular risks. Ondansetron by blocking Bezold-Jarisch reflex (BJR through inhibition of serotonin receptors has been effective in the prevention of post-spinal hypotension, and bradycardia. Bradycardia frequently accompanies post-induction hypotension in elderly patients, which signifies a possible preventing role for ondansetron. No previous study has evaluated the prophylactic effects of ondansetron for the prevention of post-induction hypotension. Materials and Methods: In this randomized placebo-controlled clinical trial, ondansetron 4 mg was given intravenously to 65 elderly patients, 20 min before induction of general anesthesia, and the rate of post-induction hypotension defined as 25% or more reduction in mean arterial blood pressure, compared with a placebo groups. Results: A total of 114 patients completed the study (58 in ondansetron and 56 in the placebo group. Proportions of post-induction hypotension were 9 (16% and 25 (45% in ondansetron and placebo groups, respectively, (P = 0.001. Forty-five patients (40% developed bradycardia. Rates of bradycardia were not significantly different between two groups. Conclusions: The results of this study show the effectiveness of intravenous ondansetron for prevention of post-induction hypotension in elderly patients. The mechanism of this effect largely is unknown. Role of ondansetron for prevention of post-induction hypotension may not fully understandable by its interaction with BJR, as has been shown in post-spinal hypotension.

  14. Research progress on awareness and recall during general anesthesia%全身麻醉期间的知晓和回忆研究进展

    Institute of Scientific and Technical Information of China (English)

    徐丽; 田国刚

    2016-01-01

    Intraoperative awareness refers to the presence of consciousness in patients undergoing general anes-thesia during surgery and patients recalling related events after surgery. Patients experiencing intraoperative awareness may develop severe post-traumatic stress disorder, which should not be overlooked. To monitor this phenomenon, new research has been performed. However, current techniques for monitoring and preventing intraoperative awareness, in-cluding those based on electroencephalogram (EEG), are of low credibility. As the absence of a unified standard for intra-operative EEG monitoring brings difficulties for medical works to detect intraoperative awareness, how to prevent intra-operative awareness remains a problem needed to be further explored.%术中知晓指患者在经历全身麻醉的手术过程中存在意识且术后可以回忆起术中发生的相关事件。患者经历术中知晓可能发展为严重的创伤后应激功能障碍,不应该被忽视。为了监测这种现象,新的研究已经进行。然而,包括基于脑电图仪技术去监测和预防术中知晓的测试方法的可信度都不高。术中缺乏统一标准的脑电监测给医务人员察觉术中知晓带来了困扰,如何预防术中知晓还需要继续探索。

  15. Effects of Dental Rehabilitation under General Anesthesia on Children’s Oral-Health-Related Quality of Life: Saudi Arabian Parents’ Perspectives

    Directory of Open Access Journals (Sweden)

    Ziad D. Baghdadi

    2014-12-01

    Full Text Available Aim: To determine whether dental treatment under general anesthesia (GA would improve quality of life for children as reported by Saudi Arabian parents using a Parental-Caregivers Perceptions Questionnaire (P-CPQ and a Family Impact Scale (FIS. Methods: Sixty-six parents completed P-CPQ and FIS scales four to eight weeks after their children (ages three to ten years underwent comprehensive dental treatment under GA. Postoperative data were compared with baseline data gathered before GA using paired t-test at the 0.05 level of significance. The responsiveness of the P-CPQ and the FIS and the magnitude of changes in children’s quality of life as a result of dental treatment were determined by calculating the effect size (ES. Cross-sectional construct validity and internal consistency were also examined using the pretreatment scores of the P-CPQ and the FIS scores. Results: The overall P-CPQ and FIS scores showed a significant decrease following treatment, concomitant with large ES in both scales and all their subscales with the exception of social wellbeing, which showed moderate ES (ES 0.59. The greatest relative changes were seen in the oral symptoms (ES 1.81 and the family activity (ES 1.57 subscales. Conclusion: Dental treatment under GA is associated with considerable improvement in children’s quality of life as perceived by Saudi parents. The P-CPQ and the FIS scales are valid and responsive to changes resulting from dental treatment of young children affected by severe childhood caries.

  16. Anesthesia for cesarean section in pregnancies complicated by placenta previa

    International Nuclear Information System (INIS)

    Objective was to evaluate the factors affecting the choice of anesthetic technique for cesarean section in women with placenta previa. In this retrospective study, the records of the labor Ward Theatre of the University of Benin Teaching Hospital, Benin City, Nigeria were examined from January 2000 to December 2004 to identify all the women who had cesarean section for placenta previa. The patient's socio-demographic characteristics, type of placenta previa, anesthesia technique, estimated blood loss, maternal and fetal outcomes were recorded. One hundred and twenty-six patients had cesarean section for placenta previa, however, only 81 patients 64.3% were available for analysis. General anesthesia was administered to 52/81 patients 64.2% and 29/81 patients 35.8% received spinal anesthesia. A history of antepartum bleeding was recorded in 61.7% n=50. Of 31 patients without antepartum hemorrhage APH, 15/31 had general anesthesia and 16/31 had spinal anesthesia. The patients who had APH, 37/50 had general anesthesia and 1/50 had spinal anesthesia. There was an increased chance of using general anesthesia and if APH were present p=0.03, odds ratio=3.1, 95% confidence interval=1.2-7.7. Spinal anesthesia may useful in patients with placenta previa. The presence of APH may encourage the use of general anesthesia for cesarean delivery. (author)

  17. 178名儿童口腔医生对笑气镇静及全麻的认知调查%Investigation of the cognition of 178 pediatric dentists about nitrous oxide sedation and general anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈静涛; 周志斐; 邬礼政; 王小竞

    2013-01-01

    目的:了解儿童口腔医生对笑气镇静及全麻的认知情况.方法:2012-06对参加第七次全国儿童口腔医学会议的178名医生进行笑气镇静及全麻认知情况问卷调查,并对相关因素进行分析.结果:178名医生中有25人(14%)独立开展过笑气镇静;42人(23.6%)在麻醉医生的合作下开展过全麻技术;38人(21.3%)接受过不同程度的笑气镇静专科培训.医师工作所在省市GDP位于全国前10位的92名医生中有30人(32.6%)在麻醉医师合作下开展全麻技术,位于10位以后的86名医生中仅有12人(13.9%)开展过全麻技术.笑气镇静和全麻的优点,85人(47.8%)选择了避免患儿产生心理阴影;笑气镇静和全麻的缺点,选择医疗费用高,操作难度大,会出现麻醉意外分别为33.7%,29.2%,27.5%;175名(98.3%)医生在以后的工作中会建议病人使用笑气镇静或全麻.结论:目前国内开展笑气镇静及全麻技术的程度较低,可能与国内经济教育发展水平相对不高有关.%AIM: To investigate the general cognition situation of chinese pediatric dentists about the use of nitrous oxide (NO) sedation and general anesthesia. METHODS: In June, 2012 during the 7 th National Congress of Pediatric Dentistry a questionnaire was delivered to delegates on the acceptance level of NO sedation and general anesthesia and effective replies with a sample size of 178 were received. Then the related factors based on the questionnaires were further assessed. RESULTS: 25 out of the 178 investigated pediatric dentists(14% ) had carried out NO sedation independently and 42 (23. 6% ) had taken general anesthesia by anesthesiologists in the treating procedure. 38 (21. 3% ) had received professional training in the field of NO sedation. 30 out of the 92 (32. 6% ) from the provinces or cities ranking top 10 of GDP in China had carried out general anesthesia with the cooperation of anesthesiologists while those from the other

  18. 髋关节置换术中全麻和腰硬联合麻醉的应用效果分析%Effect on the application of general anesthesia and combined spinal-epidural anesthesia used in hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    周晓雪; 孙卫强

    2015-01-01

    Objective To explore the effect of application of general anesthesia and combined spinal - epidural anesthesia in hip arthro-plasty. Methods A total of 92 patients with hip arthroplasty were randomly divided into two groups,46 cases in each group. Patients in control group were given with general anesthesia,and patients in trial group were given with combined spinal - epidural anesthesia. The anesthetic effect, hemodynamic indexes at different time points,postoperative pain and complications were compared between these 2 groups. Results There was no significant difference in excellent rate of anesthesia between these two groups( P 0.05);与对照组相比较,观察组的麻醉药用量、起效时间、阻滞完全时间和术后患者的清醒时间显著缩短,组间比较差异具有统计学意义( P <0.05);与对照组相比较,观察组麻醉诱导后、插管后即刻、切皮时、拔管时的收缩压、舒张压和心率均显著升高,组间比较差异具有统计学意义( P <0.05);观察组术后疼痛程度和术后并发症的发生率均显著低于对照组,差异具有统计学意义( P <0.05)。结论在髋关节置换术中采取联合腰硬联合麻醉,具有起效快、麻醉效果好、患者血流动力学稳定、术后并发症少等特点,值得在临床推广应用。

  19. 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.

  20. Acupuncture assisted local anesthesia for penile surgeries

    OpenAIRE

    Hsu, Geng-Long; Zaid, Uwais X.; Hsieh, Cheng-Hsing; Huang, Sheng-Jean

    2013-01-01

    Although the mechanism of acupuncture for analgesia is not fully elucidated, a combination of acupuncture and several methods of topical blocks for local anesthesia has been effective to patients with indications for penile surgeries on ambulatory basis. We sought to review this unique clinical application since 1998. To summarize practice-based medical literature contingent this unique application and, in contrast, the commonly agreed either general or spinal anesthesia concerning those surg...

  1. Reductions in anesthesia direct costs is not the right way for racionalization of anesthesia costs

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

    Full Text Available Introduction. Anesthesia management is characterized by salary limiting and pressure for decreasing anesthetics and other drug budget. The aim of this paper is to determine the possibility of reducing the direct costs in anesthesia. Materials and methods. This paper is a part of a five-year (2005-2009, academic, pharmaco-economic retrospective- prospective study (phase IV. The study was done according to European Union Directive for Clinical Research. We retrospectively calculated and analyzed all anesthesia direct costs (personnel costs, anesthetics and other drug costs, materials, laboratory analyses, and machines at the Institute For Ane- sthesia and Reanimation, Clinical Center of Serbia in relation to the costs refunded by National Health Insurance in all patients who underwent anesthesia in 2006. Results. Out of 70 195 anesthesia services rendered to 32 267 patients in one-year period, 47% were general anesthesia, 23% were local anesthesia, and 30% were anesthetic procedures. Our results of highly significant association between personnel costs (r = 0.980, p = 0.000 and consumption of anesthetics and drugs (r = 0.885, p = 0.000 with the direct costs do not provide an opportunity for further cost reduction due to disassociation of direct costs and the ”unit price” of National Health Insurance issued in terms of the restricted maximum budget for health. Conclusion. There is no space for direct cost reduction in anesthesia.

  2. Comparison of Fentanyl and Fentanyl Plus Lidocaine on Attenuation of Hemodynamic Responses to Tracheal Intubation in Controlled Hypertensive Patients Undergoing General Anesthesia

    OpenAIRE

    Hassani, Valiallah; Movassaghi, Gholamreza; Goodarzi, Vahid; Safari, Saeid

    2013-01-01

    Background Induction of anesthesia and endotracheal intubation often creates a period of hemodynamic instability in hypertensive patients. Endotracheal intubation of the trachea stimulates laryngeal and tracheal sensory receptors, resulting in a marked increase in the elaboration of sympathetic amines. Objectives This trial aimed to evaluate and compare the efficacy of fentanyl and fentanyl plus lidocaine in attenuating the hemodynamic responses to laryngoscopy and endotracheal intubation in ...

  3. General anesthesia type does not influence serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in video laparoscopic bariatric surgery

    Directory of Open Access Journals (Sweden)

    Adriano Fernandes

    2014-12-01

    Full Text Available OBJECTIVES: Video laparoscopic bariatric surgery is the preferred surgical technique for treating morbid obesity. However, pneumoperitoneum can pose risks to the kidneys by causing a decrease in renal blood flow. Furthermore, as in other surgical procedures, laparoscopic bariatric surgery triggers an acute inflammatory response. Neutrophil gelatinase-associated lipocalin is an early and accurate biomarker of renal injury, as well as of the inflammatory response. Anesthetic drugs could offer some protection for the kidneys and could attenuate the acute inflammatory response from surgical trauma. The objective of this study was to compare the effects of two types of anesthetics, propofol and sevoflurane, on the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery. METHODS: Sixty-four patients scheduled for laparoscopic bariatric surgery were randomized into two anesthesia groups and were administered either total intravenous anesthesia (propofol or inhalation anesthesia (sevoflurane. In the perioperative period, blood samples were collected at three time points (before anesthesia, 6 hours after pneumoperitoneum and 24 hours after pneumoperitoneum and urine output was measured for 24 hours. Acute kidney injuries were evaluated by examining both the clinical and laboratory parameters during the postoperative period. The differences between the groups were compared using non-parametric tests. ReBEC (http://www.ensaiosclinicos.gov.br/rg/recruiting/: RBR-8wt2fy RESULTS: None of the patients developed an acute kidney injury during the study and no significant differences were found between the serum neutrophil gelatinase-associated lipocalin levels of the groups during the perioperative period. CONCLUSION: The choice of anesthetic drug, either propofol or sevoflurane, did not affect the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in

  4. Using a low-cost anesthetic chamber as a didactic tool to explain the basics of general anesthesia to veterinary medicine students

    OpenAIRE

    Gerardo Alberto Isea Fernández; Ilsen Emérita Rodríguez Rodríguez; Ernesto Enrique Isea Morillo; Merilio Antonio Montero Urdaneta

    2008-01-01

    A low-cost glass-assembled and easy to handleanesthetic chamber is presented, easy handlingand cleaning, as a didactic manner to explain,by using mice, the basis of the inhaled generalanesthesia to veterinary medicine students. Thechamber, allows adequate dose administration ofanesthetic, preserves life of animals and decreasesexposure of teachers and students to anestheticsgases. Thus, it’s possible to explain in a didacticfashion the basic concepts of inhaled anesthesia,such as anesthetic c...

  5. Using a low-cost anesthetic chamber as a didactic tool to explain the basics of general anesthesia to veterinary medicine students

    Directory of Open Access Journals (Sweden)

    Gerardo Alberto Isea Fernández

    2008-12-01

    Full Text Available A low-cost glass-assembled and easy to handleanesthetic chamber is presented, easy handlingand cleaning, as a didactic manner to explain,by using mice, the basis of the inhaled generalanesthesia to veterinary medicine students. Thechamber, allows adequate dose administration ofanesthetic, preserves life of animals and decreasesexposure of teachers and students to anestheticsgases. Thus, it’s possible to explain in a didacticfashion the basic concepts of inhaled anesthesia,such as anesthetic concentration and solubility.

  6. Assessment of the Risk Factors for Oro-Dental Injuries to Occur during General Anesthesia and Measures taken by Anesthesiologist to Prevent them

    OpenAIRE

    Darawade, Dattatray Anant; Dubey, Alok; Gondhalekar, Rajashree; Dahapute, Swapnil; Deshmukh, Sonali B; Darawade, Ashish Dattatray

    2015-01-01

    Background and Aim: Anesthesiologist gain access to the airway passage orally with the help of laryngoscope. Dental trauma can occur during different steps in anesthesia. The aim of the study is to evaluate the risk factor for dental trauma perioperatively and to look for the preventive measures mostly employed by the anesthesiologist to prevent dental insult. Materials and Methods: The present study involved 40 anesthetists working in private hospitals using simple random sampling. They were...

  7. Effect of esmolol infusion on myocardial oxygen consumption during extubation and quality of recovery in elderly patients undergoing general anesthesia: randomized, double blinded, clinical trial

    OpenAIRE

    Sherif A. ELokda; Elshamaa, Hossam A.

    2015-01-01

    Background: Upon recovery from anesthesia and during extubation, there will be mechanical stimulation of receptors in the respiratory tract that results in both respiratory and cardiovascular reflex responses. Heart rate plays a major determinant of myocardial oxygen consumption and cardiac workload, so decreasing the heart rate will increase the ischemic threshold and improve the cardiac performance. Objective: To evaluate the effect of esmolol infusion on myocardial oxygen consumption du...

  8. Effects of Anesthesia

    Science.gov (United States)

    ... Regional Anesthesia The potential side effects of regional anesthesia (such as an epidural or spinal block, in which an anesthetic is injected in ... days after the procedure if some of the spinal fluid leaks out. Minor back ... was injected. Serious but rare complications include: Pneumothorax – ...

  9. 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.

  10. Glide Scope视频喉镜在全麻气管插管中的应用%Clinical application of Glide Scope in tracheal intubation under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    邓小强; 高之心; 张雷; 李元海

    2012-01-01

    Objective To observe the feasibility of Glide Scope in tracheal intubation under general anesthesia. Methods Sixty patients scheduled for selective surgery under general anesthsia were randomly divided into two groups of G ( Glide Scope ) and P ( Macintosh laryngoscope ) with 30 cases each. The view of glottic exposure, the times of intubation and intubation time were recorded. HR, SBP and DBP were recorded before operation( Tl ),after induction( T2 ),l( T3 ),3( T4 ) and 5( T5 ) min after intubation. The complications during intubation were recorded as well. Results Cormack and Lehane grade 1 of group G and group P was 30 vs 17, grade 2:0 vs 7, grade 3 : 0 vs 6. Compared with group P, Cormack and Lehane grade was markedly lower in group G( P 0. 05 ). Conclusion Orotracheal intubation using Glide Scope video laryngoscopes is simple to perform and provides a clear view of glottic. It deserves spreading in clinic.%目的 观察Glide Scope视频喉镜在全麻气管插管中应用的可行性.方法 60例择期手术准备行全麻气管插管患者,ASAⅠ~Ⅱ级,随机分为G组和P组,每组30例,术前处理和麻醉诱导相同.G组采用Glide Scope视频喉镜进行气管插管,P组采用普通直接喉镜进行气管插管.观察两组患者声门显露程度、插管次数、插管时间及手术前(T1)、诱导后(T2)、插管后1 min(T3)、3 min(T4)、5 min(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)和插管操作引起的相关并发症.结果 声门显露:G组30例均为1级.P组1级17例,2级7例,3级6例,两者相比差异有显著性(P<0.05).插管时间:G组为(30±13)s,P组为(26±19)s,两组相比差异无显著性.血流动力学的变化两组无差异,但在T3时P组HR上升与术前(T1)相差异有显著性(P<0.05).插管引起的相关并发症两组无差异.结论 应用Glide Scope视频喉镜气管插管操作简单便捷,声门显露容易清晰,对咽喉部的刺激小,值得在临床推广应用.

  11. Effect of dezocine suppressing fentanyl-induced cough during general anesthesia induction%地佐辛抑制全麻诱导期时芬太尼诱发咳嗽反射的效果

    Institute of Scientific and Technical Information of China (English)

    王丽; 高艳; 刘辉; 邢珍; 李福龙; 葛丽萍

    2015-01-01

    目的 探讨地佐辛抑制全麻诱导期时芬太尼诱发咳嗽反射的效果.方法 选择2013年3月—2014年3月本院收治的140例美国麻醉学家学会Ⅰ~Ⅱ级择期行全身麻醉患者,随机分为试验组和对照组各70例.试验组地佐辛0.1 mg/kg加生理盐水稀释成10 ml静脉注射,对照组以同样方法静脉注射等量生理盐水,2组10 min后于5 s内静脉注射芬太尼3 g/kg.在手术切口处进行浸润麻醉.注射芬太尼2 min后记录2组咳嗽发生率.结果 试验组1例患者出现咳嗽,对照组53例出现咳嗽,2组间差异有统计学意义(P<0.05).结论 地佐辛对抑制全麻诱导期时芬太尼诱发咳嗽反射效果良好.%Objective To evaluate the suppressive effect of intravenous dezocine on fentanyl-induced cough during the induction of general anesthesia.Methods 140 patients with induction of general anesthesia at March 2013 to March 2014, American Society of Anesthesiologists physical statusⅠ~Ⅱ, were randomly divided into two groups:experimental group(n=70)and control group(n=70). Experimental group was given intravenous dezocine 0.1 mg/kg and 10 ml matching placebo at 10 min after induction of anesthesia. Control group was given 9% NaCl, 10 ml placebo 10 min after the induction of general anesthesia. The occurrence of cough was recorded 2 min after fentanyl bolus. Results 1 patient in the dezocine group had cough, and 53 patients in the control group had cough. The difference was statistically different between these two groups(P<0.05).Conclusion The results demonstrated that intravenous dezocine was more effective in suppressing fentanyl-induced cough in our patients.

  12. 全麻患儿术后早期少量饮水的可行性%Feasibility of a small mount of water intake at early stage after general anesthesia in children

    Institute of Scientific and Technical Information of China (English)

    殷小容; 谭玲; 廖燕; 刘瑶; 尹燕; 郭利娟

    2012-01-01

    目的 评价全麻患儿术后早期饮水的可行性.方法 全麻术后患儿570例,年龄2月~5岁,性别不限,采用随机数字表法,将患儿随机分为2组:对照组(n=288)和术后早期饮水组(n=282).对照组患儿术后常规禁饮禁食,早期饮水组患儿术后神志清醒,咳嗽吞咽反射恢复时给予少量饮水,于饮水前、饮水后5 min时观察患儿哭闹、呛咳、误吸和低氧血症的发生情况.结果 与对照组比较,术后早期饮水组患儿呛咳发生率差异无统计学意义(P>0.05),患儿哭闹发生率降低(P<0.05);两组患儿均无误吸和低氧血症发生.结论 全麻患儿术后早期少量饮水具有可行性.%Objective To investigate the feasibility of a small amount of water intake at the early stage after general anesthesia in children.Methods Five hundred and seventy children underwent operations under general anesthesia were randomly divided into 2 groups:control group ( n =288) and early postoperative drinking group ( n =282).The children received routine water deprivation after operation in control group.After recovery from anesthesia and recovery of coughing and swallowing reflexes,the children were allowed to drink a small amount of water in early postoperative drinking group.The incidences of crying,bucking,aspiration and hyoxemia were recorded before water intake and at 5 min after water intake.Results Compared with control group,the incidence of crying was significantly decreased and no significant change was found in the incidence of bucking in early postoperative drinking group.No patients exhibited aspiration and hyoxemia in the two groups.Conclusion It is feasible that children drink a small amount of water at the early stage after general anesthesia.

  13. 右美托咪定与曲马多预防全麻妇科腔镜手术后寒战的比较%Comparison of dexmedetomidine and tramadol on shivering following general anesthesia for gynecologic laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    焦妮妮; 刘静

    2015-01-01

    目的:比较右美托咪定与曲马多对全身麻醉下妇科腔镜手术后寒战的影响。方法150例择期全麻手术患者,以数字表法随机分为右旋美托咪啶组、曲马多组和等容生理盐水组3组,每组50例。在全麻成功后手术结束前30 min分别静脉滴注右旋美托咪啶1.0μg/kg,曲马多1.0 mg/kg和等容生理盐水,观察术后1 h内寒战发生率、镇静评分。结果右旋美托咪啶、曲马多两组寒战发生率无差异但均显著低于生理盐水组(P<0.05);右旋美托咪啶组过度镇静率显著低于曲马多组(P<0.05)。结论右美托咪定和曲马多均可预防全麻后寒战,但前者过度镇静发生率低于后者。%Objective To compare dexmedetomidine with tramadol on shivering following general anesthesia for gynecological laparoscopic surgery. Methods One hundred and fifty patients undergoing elective gynecologic surgery under general anesthesia were randomly divided into dexmedetomidine group,tramadol group and normal saline group (n=50). All patients respectively received different drugs by intravenous drip from anesthesia success to 30 min before the end of operation (dexmedetomidine group,dexmedetomidine 1.0 μg/kg;tramadol group,tramadol 1.0 mg/kg;normal saline group,equal volume of normal saline).The prevalence of shivering and sedation score within 1 h after surgery in each group were recorded. Results The shivering rate in dexmedetomidine group and tramadol group were significautly lower than that in normal saline group(P<0.05). The excessive sedation rate in dexmedetomidine group was significantly lower than that in tramadol group(P<0.05). Conclusions Both dexmedetomidine and tramadol can prevent shivering following general anesthesia,but dexmedetomidine provides less excessive sedation than tramadol.

  14. Dorsal Penile Nerve Block With Ropivacaine-Reduced Postoperative Catheter-Related Bladder Discomfort in Male Patients After Emergence of General Anesthesia: A Prospective, Randomized, Controlled Study.

    Science.gov (United States)

    Li, Jing-Yi; Yi, Ming-Liang; Liao, Ren

    2016-04-01

    Catheter-related bladder discomfort (CRBD) is a distressing symptom complex after surgery, especially in male patients who have had urinary catheterization under general anesthesia. In this prospective, randomized, controlled trial, we compared dorsal penile nerve block (DPNB) with 0.33% ropivacaine with intravenous tramadol 1.5 mg kg in prevention of CRBD, as well as the incidences of postoperative side effects.Fifty-eight male patients aged 18 to 50 years, undergoing elective liver surgery and limb surgery with urinary catheterization, were enrolled and divided randomly into 2 groups. In the DPNB group, patients were given dorsal penile nerve block with 15 mL of 0.33% ropivacaine, and in the tramadol intravenous administration (TRAM) group, patients were given 1.5 mg kg tramadol after the completion of surgery before extubation. The primary outcome was the incidence of CRBD, and the secondary outcomes included the severity of CRBD, postoperative side effects, postoperative pain, and the acceptance of urinary catheterization. Patients were evaluated upon arrival to postanesthetic care unit (PACU), at 0.5, 1, 2, 4, and 6 hours after patients' arrival in the PACU for outcomes.The incidence of CRBD was significantly lower in the DPNB group than in the TRAM group, either upon arrival to PACU (10.3% vs 37.9%, P = 0.015), or at 0.5 hours (3.4% vs 34.5%, P = 0.003), 1 hours (3.4% vs 37.9%, P = 0.001), 2 hours (6.9% vs 34.5%, P = 0.010), and 4 hours (6.9% vs 27.6%, P = 0.039) after patients' arrival in PACU. Compared with the TRAM group, the severity of postoperative CRBD upon arrival to PACU (P = 0.011) and at 0.5 hours (P = 0.005), 1 hours (P = 0.002), 2 hours (P = 0.005), 4 hours (P = 0.017), and 6 hours (P = 0.047) after patients' arrival in PACU were all significantly reduced in the DPNB group. The incidences of postoperative nausea, vomiting, dizziness, and sedation were decreased

  15. Efficacy of general anesthesia with SLIPA laryngeal mask airway with tumescent anesthesia in patients abdominal liposuction%SLIPA喉罩下全麻联合局部肿胀麻醉用于脂肪抽吸术的效果观察

    Institute of Scientific and Technical Information of China (English)

    唐华明; 任羿; 陈志兵

    2015-01-01

    Objective To evaluate the efficacy of general anesthesia with SLIPA laryngeal mask airway with tumescent anesthesia in patients abdominal liposuction. Methods 160 ASAⅠ-Ⅱpatients of fe⁃males,aged 20-35years,weighing 56-78 kg,abdominal liposuction under general anesthesia,were randomly divided into 2 groups (n=80 each).Group Ⅰ received combined intravenous-inhalational anesthesia with endotracheal tube.Group Ⅱ received combined intravenous-inhalational anesthesia with SLIPA laryngeal mask airway then undergoing abdominal liposuction with tumescent anesthesia. HR was maintained at 50-100bpm,MAP was maintained at the preoperative baseline level (increase or decrease amplitude <20% of the baseline level) during operation and in postanesthesia care unit (PACIU) and vasoactive drugs (atropine,esmolol,efedrina or urapidil) were given when necessary.The patients received patient-controlled intravenous analgesia with sufentanil (background infusion 1.5 ml/h, bolus dose2 ml,lockout interval 15 min) after operation and VAS score was maintained at≤2.The re⁃quirement for vasoactive drugs during operation and in PACU,PACU stay length,and consumption of analgesics and occurrence of nausea and vomiting within 24h after operation were recorded. Results Compared with groupⅠ,the requirement for all vasoactive drugs during operation and in PACU was significantly reduced,PACU stay length was significantly shortened,and the consumption of analge⁃sics and incidence of nausea and vomiting were significantly reduced in groupⅡ(P<0.05). Conclu⁃sion general anesthesia with SLIPA laryngeal mask airway with tumescent anesthesia provides better efficacy with fewer complications and less consumption of postoperative analgesics than general an⁃esthesia with endotracheal tube in patients abdominal liposuction.%目的:评价SLIPA喉罩下全麻联合局部肿胀麻醉用于脂肪抽吸术的效果。方法:择期行腰腹脂肪抽吸术的患者80例,女性,年龄20

  16. 术中知晓患者术后抑郁/焦虑情况研究%DEPRESSIVE AND/OR ANXIETY DISORDER IN PATIENTS WITH AWARENESS DURING GENERAL ANESTHESIA

    Institute of Scientific and Technical Information of China (English)

    刘旺

    2009-01-01

    目的 研究术中知晓患者术后抑郁/焦虑情况.方法 选取10例全麻术中知晓患者纳入术中知晓组,30例无术中知晓全麻患者为对照组.所有患者术后1个月,利用医院焦虑抑郁量表、Hamilton抑郁量表和/或Hamilton焦虑量表进行调查.结果 术中知晓组与对照组患者年龄、性别、体重以及手术时间等一般情况无显著性差异(p>0.05),但术中知晓组单纯采取全麻方式比率高于对照组(p0.05).术中知晓组与对照组比较,肯定抑郁发生率以及肯定抑郁焦虑总和率差异显著(p0.05).结论 术中知晓患者容易发生抑郁/焦虑等精神障碍.%Objective To reveal the prevalence of depressive and/or anxiety symptom and disorder in patients with awareness during general anesthesia.Methods 10 patients which had the awareness during general anesthesia were selected into AR group (awareness with recall during general anesthesia group).Face-to-face interviews were used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptom screening.Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with HAMA scales and HAMD scales.Results The difference of common general state of patients, such as age, weigh and the time during operation were all insignificant between two groups (p>0.05).The rate of patients received general anesthesia only in AR group was higher than that in control group(p<0.05).The prevalence of depressive symptom, the prevalence of depressive or anxiety symptom and the prevalence of depressive and anxiety symptom in AR group were higher than that in control group(p<0.05).The prevalence of depressive disorder, the prevalence of depressive or anxiety disorder and the prevalence of depressive and anxiety disorder in AR group were higher than that in control group too(p<0.05).Conclusion There was high prevalence of depressive and/or anxiety symptom and disorder in

  17. Pediatric regional anesthesia- A comparison between pediatric spinal and caudal anesthesia

    Directory of Open Access Journals (Sweden)

    Charu Pandya

    2014-01-01

    Full Text Available Regional anesthesia in children was first studied by August Bier in 1899. Since then, spinal anesthesia was known to be practiced for several years with a series of cases published as early as in 1909-1910. (1 In 1900, Bainbridge reported a case of strangulated hernia repair under spinal anesthesia in an infant of three months(2. Thereafter, Tyrell Gray, a British surgeon published a series of 200 cases of lower abdominal surgeries in infants and children under spinal anesthesia in 1909-1910. The appearance of neuromuscular blocking agents and the development of volatile anesthetics in the forties shifted the techniques toward general anesthesia. However, spinal pediatric anesthesia did not disappear. In 1901, Sicard and Cathelin introduced independently the caudal approach in the anesthetic practice. The first publication that mentions this technique in children was written by Campbell in 1933 and the second one by Leigh and Belton in 1951. Subsequently, Fortuna (1963 in Brazil, Melman(10 (1973 in Mexico, Takasaki (1977 in Japan, Ecoffey(7 (1985 in France, and Rash (1995 in USA, introduced these techniques in their countries. The caudal technique is extensively described by Key in 1994. When regional anesthesia is given to older children, some variables such as the intervention site, age, and presence of chronic disease, cooperativeness and parental preferences should be considered. In present study we compared caudal block with spinal block in pediatric patients.

  18. The influence of different adjuvant ventilation modes on CVP in patients during the general anesthesia induction%全麻诱导不同通气方式对中心静脉压的影响

    Institute of Scientific and Technical Information of China (English)

    程芳; 林华赋; 周毅

    2012-01-01

    目的 探讨全身麻醉诱导时低潮气量高频率辅助通气与高潮气量低频率辅助通气对中心静脉压的影响,选出对循环血流动力学影响较小的辅助通气方式.方法 选择2010年3月~2011年7月于江门市中心医院行全身麻醉的患者120例,随机分为两组,每组60例.Ⅰ组在全麻诱导准备插管前采用低潮气量高频率辅助通气,Ⅱ组在全麻诱导准备插管前采用高潮气量低频率辅助通气,全程监测心率、血氧饱和度、平均动脉压、中心静脉压,分别记录患者在全麻诱导前、全麻诱导时、气管插管后的中心静脉压值(CVP),比较两组CVP值的变化.结果 全麻诱导前及气管插管后两组CVP值差异无统计学意义(P > 0.05),全麻诱导时Ⅱ组CVP值明显比Ⅰ组低,差异有统计学意义(P < 0.05).结论 全麻诱导时低潮气量高频率辅助通气对CVP的影响小,较高潮气量低频率辅助通气对CVP的影响较大,但持续时间很短,在气管插管后,这种影响即消失.%Objective To discuss the influence of different adjuvant ventilation modes (low tidal volume with high respiratory rate and high tidal volume with low respiratory rate) on CVP in patients during general anesthesia induction. And to find out a adjuvant ventilation mode which had a less influence on CVP. Methods 120 patients practised general anesthesia in the central hospital of Jiangmen from March 2010 to July 2011 were enrolled for the study. They were randomly divided into two groups. Each group had 60 patients. The patients in group I were practised the adjuvant ventilation mode of low tidal volume with high respiratory rate during the general anesthesia induction, and the patients in group II were practised the adjuvant ventilation mode of high tidal volume with low respiratory rate. All of them were monitored HR, SpO2, MAP, CVP. The CVP of two groups were compared. Results Before general anesthesia and after tracheal intubation, CVP of two

  19. Effects of combining electroacupuncture with general anesthesia induced by sevoflurane in patients undergoing supratentorial craniotomy and improvements in their clinical recovery profile & blood enkephalin.

    Science.gov (United States)

    Yang, Caixia; An, Lixin; Han, Ruquan; Kang, Xixiong; Wang, Baoguo

    2012-01-01

    Drug-induced anesthesia combined with electroacupuncture (EA) in patients has been put into practice in recent years in China. In this study, we showed the effectiveness of EA on the speed of post-operative recovery of patients undergoing supratentorial craniotomy and the potential clinical mechanism of EA. Dual channel electrical stimulator made by HANS Beijing connected the following acupoints respectively: LI4 (Hegu), SJ5 (Waiguan), ST36 (Zusanli), BL63 (Jinmen), LR3 (Taichong), and GB40 (Qiuxu). Disperse-dense and symmetric biphasic pulse waves were selected, frequency of waves (pulse rates) were 2Hz/100Hz, altered/3sec; pulse duration was 0.6ms/0.2ms, 2Hz: 0.6ms, 100Hz: 0.2ms; symmetric biphasic pulse wave. We found that the EA-group required 9.62% less sevoflurane than the sham EA-group (P<0.05). During recovery from anesthesia, the autonomous respiration recovery time, tracheo-tube removal time, eye-opening time, voluntary motor recovery time, orientation force recovery time, and the operating-room departure time of the EA-group were all significantly shortened 35.86%, 27.07%, 38.38%, 30.11%, 34.95%, 28.80% than the corresponding sham EA-group, respectively (P<0.05). The serum enkephalin values were elevated in the EA group versus the sham EA-group. PMID:23156204

  20. A Comparative Study of Cuffed Pharyngeal Tube (CPR with Endotracheal Tube in Airway Management and Ventilation of Spontaneously Breathing Patients Undergoing General Anesthesia

    Directory of Open Access Journals (Sweden)

    F Mir Mohammad Sadeghi

    2002-09-01

    Full Text Available Background: Cuffed pharyngeal tube is a device designed for ventilation of anesthetized patients. CPT has advantages over face mask including: maintaining of face mask can be difficult and boring after several minutes and mobility of the practitioner is reduced due to involvement of hands. Mask pressure can cause soft tissue and nerve damage around the nose. Anesthetic gas leakage from the mask adds to the operation room pollution. In difficult intubation CPT can be life-saving. Materials and Methods: In our study CPT was compared with endotracheal tube (ET in anesthetized patients. A scoring system for evaluating ventilation of patients was designed using symmetric chest wall motion during ventilation with anesthesia bag and sensing lung compliance through it, auscultation of breathing sounds, oscilation of bag with breathing and peripheral oxygen saturation by pulse oxymetry. Respiratory complications (pulmonary aspiration, Iaryngospasm and bronchospasm, nausea and vomiting were looked for during anesthesia. Results: The results showed that CPT was successful as ET in ventilation of spontaneously breathing patients and incidence of respiratory complications with CPT was no more than ET. Airway resistance was significantly greater with CPT than ET (P<0.05. Patients with ET had significantly greater incidence of sore throat than with CPT (P<0.05. Conclusion: Thus we concluded that CPT can be used for ventilation of anesthetized patients not predisposed to pulmonary aspiration and whose peak airway pressure does not exceed 20-25 CmH2O.

  1. NEURAXIAL ANESTHESIA and OBESITY

    OpenAIRE

    Şahin, Aynur; Doğru, Hatice Yılmaz

    2013-01-01

    Obesity is one of the serious condition that commonly effects health in modern age. It was reported that obesity was three-fold increased in the last three decades. According to the statement by World Health Organisation in 2005, 700 million people will be estimated obese in 2015. While neuraxial anesthesia is a commonly used technique in the worldwide, the process may have difficulties in obese patients. In this review, the pathophysiological changes and challenges in neuraxial anesthesia ...

  2. Laparoscopic cholecystectomy under epidural anesthesia: A feasibility study

    Directory of Open Access Journals (Sweden)

    Ranendra Hajong

    2014-01-01

    Full Text Available Background: Laparoscopic cholecystectomy (LC is normally performed under general anesthesia. But of late this operation has been tried under regional anesthesia successfully without any added complications like epidural anesthesia. Aims: The aim of the study was to study the feasibility of performing LC under epidural anesthesia in normal patients so that the benefits could be extended to those high-risk patients having symptomatic gallstone disease and compromised cardio-pulmonary status where general anesthesia is contraindicated. Materials and Methods: In all, 20 patients with the American Society of Anesthesiologist′s class I or II were enrolled in the study. The level of epidural block and satisfaction score, both for the patient and the surgeon, were noted in the study. Results: The LC was performed successfully under epidural anesthesia in all but two patients who had severe shoulder pain in spite of giving adequate analgesia and were converted to general anesthesia. Conclusions: The LC can be performed safely under epidural anesthesia with understanding between patient and surgeon. However, careful assessment of complications in the patients should be done to make the procedure safer.

  3. 电针辅助全身麻醉对老年患者术后认知功能的影响%Effects of Electroacupuncture Assistant General Anesthesia on Postoperative Cognitive Dysfunction of Aged Patients

    Institute of Scientific and Technical Information of China (English)

    高晓秋; 张子银; 马武华

    2012-01-01

    目的 观察电针辅助全身麻醉对老年患者术后认知功能的影响.方法 选择美国麻醉医师学会( American Society of Anesthesiology,ASA)分级Ⅰ~Ⅲ级择期行非心脏手术的老年患者(年龄>65岁)120例,随机分为全身麻醉组(A组)和电针辅助全身麻醉组(B组),每组60例.在麻醉诱导开始前30 min选取百会、合谷、内关、足三里4个穴位对B组患者进行电刺激并维持至术毕.两组患者均在依托咪酯0.2 ~0.3 mg/kg,芬大尼3~5 μg/kg,顺式阿曲库铵0.15 mg/kg诱导下行气管插管,七氟烷吸入及瑞芬太尼持续输入下维持麻醉.手术结束前30 min给予曲马多50 mg.记录两组患者麻醉前1天及术后第2、4、6天简易智力状态检查(mini-mental state examination,MMSE)评分和术后恶心、呕吐情况,比较术后2、4、6天术后认知功能障碍(postoperative cognitive dysfunction,POCD)发生率.结果 B组患者术后第2、4天POCD发生率均明显低于A组同期(分别为40.0%vs66.7%,13.3%vs43.3%),差异有统计学意义(P<0.05).两组患者麻醉前MMSE评分比较,差异无统计学意义(P>0.05);术后2、4天B组MMSE评分高于A组(分别为21.3±3.9vs18.3±3.8,26.4±2.9vs22.9±3.9),差异有统计学意义(P<0.05).与本组麻醉前1天MMSE评分比较,A组患者术后第2、4天(18.3±3.8,22.9±3.9 vs 27.9±2.1)及B组术后第2天(21.3±3.9vs27.5±2.5)差异均有统计学意义(P<0.05).B组患者术后恶心及呕吐的发生率为23.3% (14/60),低于A组(46.7%,28/60),差异有统计学意义(P<0.05).结论 电针辅助全身麻醉可减少老年患者POCD的发生率.%Objective To observe the effects of electroacupuncture (EA) assistant general anesthesia on postoperative cognitive dysfunction (POCD) of aged patients. Methods One hundred and twenty senile American Society of Anesthesiology (ASA) grade I - m patients (more than 65 years old) with non-cardiac surgery were randomly assigned to two groups, Group A

  4. SEVOFLURANE VERSUS HALOTHANE FOR GENERAL ANESTHESIA IN PEDIATRIC PATIENTS – A COMPARATIVE STUDY OF INDUCTION TIME, INTUBATION TIME AND EMERGENCE TIME

    Directory of Open Access Journals (Sweden)

    Santosh K

    2014-03-01

    , diastolic blood pressures, and SpO2. The depth of anesthesia was assessed clinically by evaluation of changes in heart rate, and blood pressure during surgery and these were maintained within 20% of baseline values. RESULTS: Induction time was significantly shorter with Gr S[mean(SD 136.0(19.343secs] than with Gr H [mean (SD 156.09(10.651 secs] (P=0.0001. Intubation time was significantly shorter with Gr S [mean (SD 242.400(9.940 secs] than with Gr H[mean(SD 265.769(12.039 secs] (P<0.0001. Time to emergence was significantly shorter in Gr S [mean(SD 217.667(22.831secs] than with Gr H[mean(SD 450.5(18.407 secs] (P<0.0001. CONCLUSIONS: We found that sevoflurane is an excellent agent for inhalational induction of anesthesia in pediatric patients. It facilitates a rapid induction of anesthesia, found to be 20 seconds faster than halothane in our study. Emergence time is relatively shorter with sevoflurane as compared to halothane

  5. Minimally invasive parathyroidectomy under local anesthesia

    Directory of Open Access Journals (Sweden)

    Ö Karahan

    2013-01-01

    Full Text Available Background: More than 85% of primary hyperparathyroidism (PHPT cases are due to solitary, benign parathyroid adenomas. Recently, the success rate of Tc99m sestamibi scintigraphy in localization has made minimally invasive parathyroidectomy (MIP more prominent. MIP is as effective as conventional bilateral neck exploration. Moreover, it offers lower morbidity, cost effectiveness, and better cosmetics effects. Aim: We aimed to evaluate the success of MIP, which happens only under local anesthesia, in this study. Materials and Methods: Total of 63 patients were operated for PHPT, of which 54 had solitary adenoma. Five patients underwent bilateral neck exploration under general anesthesia for thyroid nodules or unlocalizated adenomas. A total of 49 patients underwent MIP under local anesthesia without any sedation. During MIP, gamma probe was used for all patients. The patients were followed for parathyroid functions. Results: The mean age of 49 patients with MIP (5 male, 44 female was 59 years. The mean follow-up time was 16.4 (±10.1 months (range: 2-36 months. Of the 49 patients, 47 (96% were totally cured. In 2 patients, the procedure was switched to conventional bilateral neck exploration. Temporary hypocalcaemia was noted in 4 patients. Conclusions: If the adenoma is localizated, MIP under only local anesthesia can be performed with a high success rate. Gamma probe-guided MIP under local anesthesia is an effective and safe method. It has the advantage of being minimally invasive and, therefore, it should be preferred over the conventional method.

  6. 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

  7. 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...

  8. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

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

    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...

  9. Intranasal Insulin Prevents Anesthesia-Induced Spatial Learning and Memory Deficit in Mice

    Science.gov (United States)

    Zhang, Yongli; Dai, Chun-ling; Chen, Yanxing; Iqbal, Khalid; Liu, Fei; Gong, Cheng-Xin

    2016-01-01

    Elderly individuals are at increased risk of cognitive decline after anesthesia. General anesthesia is believed to be a risk factor for Alzheimer’s disease (AD). At present, there is no treatment that can prevent anesthesia-induced postoperative cognitive dysfunction. Here, we treated mice with daily intranasal administration of insulin (1.75 U/day) for one week before anesthesia induced by intraperitoneal injection of propofol and maintained by inhalation of sevoflurane for 1 hr. We found that the insulin treatment prevented anesthesia-induced deficit in spatial learning and memory, as measured by Morris water maze task during 1–5 days after exposure to anesthesia. The insulin treatment also attenuated anesthesia-induced hyperphosphorylation of tau and promoted the expression of synaptic proteins and insulin signaling in the brain. These findings show a therapeutic potential of intranasal administration of insulin before surgery to reduce the risk of anesthesia-induced cognitive decline and AD. PMID:26879001

  10. Regional Anesthesia in Trauma Medicine

    OpenAIRE

    Loreto Lollo; Wu, Janice J.; Andreas Grabinsky

    2011-01-01

    Regional anesthesia is an established method to provide analgesia for patients in the operating room and during the postoperative phase. While regional anesthesia offers unique advantages, as shown by the recent military experience, it is not commonly utilized in the prehospital or emergency department setting. Most often, regional anesthesia techniques for traumatized patients are first utilized in the operating room for procedural anesthesia or for postoperative pain control. While infiltra...

  11. Anesthesia for interventional radiology

    International Nuclear Information System (INIS)

    We recognized that the complexity and surgical nature of many interventional radiology procedures dictate essential radiologic involvement into traditional anesthesiologic areas. They reviewed our experience with a variety of interventional procedures to document complications and problems related to anesthetic use (or misuse) and compile recommendations for rational monitoring and control for these procedures. In particular, the authors have studied complications of drug therapies and the treatment of these complications; use of complex anesthesia procedures (e.g., epidural anesthesia, succinylcholine blockage); reasons for choice of drugs (e.g., fentanyl vs meperidine vs morphine); and medico-legal aspects of radiologist performing traditional anesthesiology-type procedures

  12. Local anesthesia for prostate brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To demonstrate the technique and feasibility of prostate brachytherapy performed with local anesthesia only. Methods and Materials: A 5 by 5 cm patch of perineal skin and subcutaneous tissue is anesthetized by local infiltration of 10 cc of 1% lidocaine with epinephrine, using a 25-gauge 5/8-inch needle. Immediately following injection into the subcutaneous tissues, the deeper tissues, including the pelvic floor and prostate apex, are anesthetized by injecting 15 cc lidocaine solution with approximately 8 passes of a 20-gauge 1.0-inch needle. Following subcutaneous and peri-apical lidocaine injections, the patient is brought to the simulator suite and placed in leg stirrups. The transrectal ultrasound (TRUS) probe is positioned to reproduce the planning images and a 3.5- or 6.0-inch, 22-gauge spinal needle is inserted into the peripheral planned needle tracks, monitored by TRUS. When the tips of the needles reach the prostatic base, about 1 cc of lidocaine solution is injected in the intraprostatic track, as the needle is slowly withdrawn, for a total volume of 15 cc. The implants are done with a Mick Applicator, inserting and loading groups of two to four needles, so that a maximum of only about four needles are in the patient at any one time. During the implant procedure, an additional 1 cc of lidocaine solution is injected into one or more needle tracks if the patient experiences substantial discomfort. The total dose of lidocaine is generally limited to 500 mg (50 ml of 1% solution). Results: To date, we have implanted approximately 50 patients in our simulator suite, using local anesthesia. Patients' heart rate and diastolic blood pressure usually showed moderate changes, consistent with some discomfort. The time from first subcutaneous injection and completion of the source insertion ranged from 35 to 90 minutes. Serum lidocaine levels were below or at the low range of therapeutic. There has been only one instance of acute urinary retention in the

  13. Study on clinical application of esmolol in general anesthesia in senile patients with laparoscopic cholecystectomy.%艾司洛尔在老年患者全麻腹腔镜胆囊切除术的临床研究

    Institute of Scientific and Technical Information of China (English)

    施燕飞; 王晓军; 刘如葵; 徐连生; 李雪刚; 汤荣兴; 张努

    2011-01-01

    目的 探讨艾司洛尔对老年患者全麻腹腔镜胆囊切除术的有效性和安全性.方法 选择60例美国麻醉师协会(ASA) I~II全麻腹腔镜胆囊切除术老年患者,麻醉诱导前静脉注射艾司洛尔0.5 mg/kg,然后以25 μg/(kg·min)持续静脉输注,监测麻醉诱导前(T0)、插管前(T1)、插管后(T2)、插管后5 min(T3)、插管后10 min(T4)、拔管前(T5)、拔管后5 min(T6)的收缩压(SBP)、舒张压(DBP)、心率(HR)及术后苏醒情况、麻醉并发症.结果 插管后、插管后5 min、插管后10 min、拔管前、拔管后5 min的收缩压、舒张压、心率与插管前比较差异均无统计学意义(P>0.05);术中无心律失常,术后24 h内随访无麻醉相关并发症.结论 艾司洛尔可安全有效的用于老年患者全麻腹腔镜胆囊切除术,血流动力学稳定,术后苏醒快.%Objective To study the efficacy and safety of esmolol applied in general anesthesia for senile patients with laparoscopic cholecystectomy. Methods The application of loading dosage of esmolol 0.5mg/kg before induction of anaesthesia and followed by infusion of 25 μg/ ( kg · min ) was carried out during the operation, laparoscopic cholecystectomy under ASA Ⅰ to Ⅱ general anesthesia was carried out in 60 senile patients, their systolic blood pressure ( SBP ), diastolic blood pressure ( DBP ) and heart rate ( HR ) were recorded before induction of anaesthesia,immediately after intubation, 5 and 10 minutes after intubation, before and 5 minutes after extubation. At the same time, monitoring postoperative recovery situation and complications at 24 hornrs after anesthesia was also observed. Results There were no statistically significant difference ( P> 0.05 ) observed immediately after intubation, 5 and 10 minutes after intubation, before and 5 minutes after extubation among systolic blood pressure, diastolic blood pressure and heart rate as compared with those before intubation; and there were no arrhythmia and

  14. A rare complication of spinal anesthesia: Intracranial subdural hemorrhage

    Directory of Open Access Journals (Sweden)

    Cengiz Kaplan

    2015-02-01

    Full Text Available Spinal (subarachnoid anesthesia (SA is a widely used general-purpose anesthesia. Postdural Puncture Headaches (PDPHs represent one of the principal complications of spinal anesthesia. A 21-year-old man underwent inguinal herniorrhaphy and orchiectomy using spinal anesthesia. Postoperatively, our patient started to have a headache with nausea. The patient received symptomatic therapy, but the severe headache persisted even in the supine position, with his vital signs and neurological examination being normal. Cranial MRI showed a bilateral subdural hematoma from his frontal to temporal region. A postdural puncture headache is a frequent complication after spinal anesthesia. However, serious complications, such as an intracranial subdural hemorrhage, can rarely occur. [Arch Clin Exp Surg 2015; 4(1.000: 54-56

  15. 喉罩联合无肌松全麻在小儿眼科手术中的应用%The application of LMA combined with general anesthesia without muscle relaxants in the pediatric department of ophthalmology operation

    Institute of Scientific and Technical Information of China (English)

    贺伟忠; 杨义; 范小丽; 李萌

    2014-01-01

    目的:研究无肌松全麻联合喉罩置入对小儿眼科手术围术期应激反应的影响。方法选择全身麻醉下小儿眼科手术患者90例,随机分为A、B两组,每组各45例。 A组使用肌松药插入气管导管,B组采用无肌松药全麻并置入喉罩。对比手术中各时间点的平均动脉压(MAP)、心率(P)、心率收缩压乘积(RPP)、血氧饱和度(SpO2)。观察两组拔管期呛咳、躁动等拔管反应,并记录拔管(喉罩)时间、麻醉药总量。结果A组麻醉诱导及拔管期血流动力学波动高于B组;A组严重呛咳、躁动例数高于B组;A组拔管时间长于B组;A组麻醉药物总量多于B组。结论喉罩联合无肌松全麻应用于小儿眼科手术安全可靠,相较气管插管围术期应激反应更低。%Objective To study without muscle relaxants combined general effect of laryngeal mask insertion on the pe-diatric department of ophthalmology operation perioperative stress responses. Methods Ninety patients with pediatric eye surgery were randomly divided into group A and group B, 45 cases in each group. Group A treated with muscle re-laxants insert the tracheal tube, group B treated with without anesthesia and muscle relaxants into the LMA. Contrast surgery mean arterial pressure at each time point (MAP), heart rate (P), rate pressure product (RPP), oxygen saturation (SpO2). Extubation were observed choking, restlessness, etc. extubation reaction, record extubation (LMA) time, total quantity of using drug. Results A induction of anesthesia and extubation hemodynamic fluctuations was higher than that of group B; Severe cough, agitation of group A were higher than that in B group; The extubation time was longer than that of group B; Drug amount was higher than that of group B. Conclusion LMA Joint no muscle relaxant used in pe-diatric anesthesia eye surgery is safe and reliable, with lower stress response.

  16. 上腹部手术中胸段硬膜外麻醉联合全身麻醉对血流动力学的影响%The hemodynamic effects during thoracic epidural anesthesia combined with general anesthesia In patients undergoing major abdominal operations

    Institute of Scientific and Technical Information of China (English)

    赵薇; 周然; 周丽萍; 李成辉

    2009-01-01

    Objective To investigate the hemedynamic effects between the two established anesthetic managements: thoracic epidural anesthesia combined with general anesthesia (TEA+GA) as well as total intravenous anesthesia (TIVA). Methods Forty-four patients undergoing major abdominal operation were randomized to TEA + GA ( n = 22 ) group or TIVA ( n = 22 ) group. After thoracic epidural catheterization,the anesthesia induction and endotracbeal intubafion was made and a standard anesthesia procedure was administered for both groups. In TEA + GA group, the patients received thoracic epidural anesthesia (TEA) with 0.25% bupivacaine (bolus 0. 5 mg/kg firstly and then infused continuously with 0.2 the same bolus volume and same infusion rate as in TEA + GA group. The parameters monitored were as follows: ECG, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), heart rate(HR) ,central venous pressure, cardiac index (CI), systemic vascular resistance (SVR), pulse oximetry and PetCO2. Blood gas analysis was made as needed. The observation time for both groups was 90 min. Results After epidural infusion of bupicacaine (TEA + GA group) or saline (TIVA group), SAP, DAP, HR and SVR in TEA + GA group were statistically decreased in comparing with the baseline, and SAP, DAP, MAP and SVR were also decreased significantly when compared with those in TIVA group (P≤ 0.05). However, CI and SV in TEA + GA group changed little and showed no statistical differences in comparing with those in TIVA group. Conclusions This study gives evidences that TEA in combination with GA had no negative effects on cardiac functions. The decrease of blood pressure may possibly be caused by the reduction of systemic vascular resistance.%目的 观察胸段硬膜外麻醉联合全身麻醉(TEA+GA)与全凭静脉麻醉(TIVA)这两种麻醉方法在上腹部手术时血流动力学参数的改变.方法 自2007年12月至2008年5月选择44例拟行择期上腹部手术的美国麻醉医师协

  17. Dexmedetomidine Reducing Sufentanil Induced Cough during Children General Anesthesia Induction%右美托咪啶减轻小儿全麻诱导期舒芬太尼呛咳反应的临床观察

    Institute of Scientific and Technical Information of China (English)

    张成; 徐晓燕

    2014-01-01

    目的:评价右美托咪啶减轻小儿全麻诱导期舒芬太尼诱发呛咳反应的临床有效性。方法:选择2011年5月-2013年11月在笔者所在医院行择期手术患儿60例,将其随机分为对照组与试验组,每组30例,麻醉前15 min试验组静脉恒速泵注右美托咪啶,对照组静脉恒速泵注生理盐水,泵注15 min。泵注结束后两组患儿均静脉注射丙泊酚2 mg/kg与舒芬太尼0.5μg/kg和维库溴铵0.1 mg/kg麻醉诱导,术中以丙泊酚和瑞芬太尼维持麻醉。观察静脉注射舒芬太尼后5 min内呛咳反应发生率和程度以及血流动力学的变化。结果:两组血流动力学变化没有显著性差异,试验组呛咳发生率和程度均显著低于对照组(P<0.05)。结论:右美托咪啶可有效抑制全身麻醉诱导期舒芬太尼引发的呛咳反应。%Objective:To observe the effects of Dexmedetomidine in reducing children cough induced by Sufentanil in general anesthesia induction. Method:Our hospital from May 2011 to November 2013,60 children undergoing elective operation,the pediatric patients were randomly divided into control group and experimental group,30 cases in each group.15 min before experimental group constant rate intravenous infusion of Dexmedetomidine,the control group constant rate intravenous infusion of saline infusion pump,15 min.Pump after the end of the two groups were intravenous injection of Propofol 2 mg/kg with Sufentanil 0.5 μg/kg and Vecuronium 0.1 mg/kg anesthesia induction.During the maintenance of anesthesia with Propofol and Remifentanil.Observation of intravenous Sufentanil post to 5 min cough frequency and hemodynamic changes.Result:The hemodynamic changes of two groups were compared,there were no significant differences,but the rate and degree of cough in the experimental group were significantly better than the control group(P<0.05).Conclusion:The induction period of Sufentanil induced cough suppression of Dexmedetomidine

  18. Anestesia geral com propofol em cães pré-tratados com acepromazina e alfentanil General anesthesia with propofol in dogs premedicated with acepromazine and alfentanil

    Directory of Open Access Journals (Sweden)

    Silvia Renata Gaido Cortopassi

    2000-08-01

    /kg, 0,9% NaCI 0,05ml/kg and propofol 6,0mg/kg (Group II; 0,9% NaCI 0,1ml/kg, alfentanil 0,05mg/kg and propofol 6,0mg/kg (Group III. Thirty healthy adult mongrel dogs (10 males and 20 females; mean weight, 14,44 ± 2,72kg were divided in three groups randomiy assigned to one of the associations. Short-term bradicardia was observed in groups I and III immediately after the administration of alfentanil. The heart rate retumed to control values at the end of the evaluation period. AU the anesthetic procedures caused severe alterations in respiratory function with a significant decrease in PaO2, pH and SaO2 and rise of PaCO2. Respiratory depression was more intense when alfentanil was used. Respiratory rate with this drug increased significantiy. In the acepromazine-propofol group, the some alterations could be noticed but not so severe. The induction of anesthesia in all groups was uneventful and excitement free and the intubation was easily performed. Anesthesia recovery was smooth, fast and excitment free. These observations confirm that propofol is in fact an effective and safe induction agent once we did not observe life-threatining cardiovascular depression and undesirable side effects. Both acepromazine alone and acepromazine pius alfentanil are effective premedication agents once they contributed to an uneventful induction and recovery of anesthesia without excitatory fenômeno or myoclonus, with prolongation of the anesthetic time of propofol.

  19. 鼻内镜手术无肌松药全身麻醉可行性探讨%Application of general anesthesia without muscle relaxant in nasal endoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    杨戈雄; 袁杰; 高爽; 李滔; 滕煜; 马军令

    2014-01-01

    /kg maintai-ning muscle relaxation;group Ⅱtracheal intubation after complex full airway surface anesthesia but without muscle relaxants mainte-nance during operation.Blood pressure ( MAP) , heart rate ( HR) , pulse oxygen saturation ( SpO2 ) , end tidal carbon dioxide partial pressure ( PetCO2 ) were recorded in each time point in the two groups before anesthesia ( T0 ) , 2 min after anesthesia induction ( T1 ) , 2 min after endotracheal intubation ( T2 ) , 2 min after the start of operation ( T3 ) , 20 min after the start of operation ( T4 ) , and 5 min after extubation ( T5) .The body movement frequency intraoperation , recovery time from anesthesia and extubation time, adverse reac-tions and complications and intraoperative additional infusion dosage of remifentanil and propofol were compared between the two groups.Results In both groups, T0 ~T4 each observation point,HR, MAP, SpO2 and PetCO2 changes were not significantly different (P>0.05).Breathing the air after 5 min(T5), SPO2 in group Ⅱwere higher than those in groupⅠ, PetCO2 in groupⅡlower than that in groupⅠ, there were significant differences between the two groups (P<0.05).In groupⅡ,anesthesia recovery time and ex-tubation time were significantly shorter than those in group Ⅰ( P <0.01).There were no adverse reaction and complication. Conclusions The effect of nasal endoscopic surgery under tracheal intubation general anesthesia without muscle relaxant is reliable, safe and feasible.

  20. Electroencephalographic Variation during End Maintenance and Emergence from Surgical Anesthesia

    OpenAIRE

    Divya Chander; García, Paul S.; MacColl, Jono N.; Sam Illing; Sleigh, Jamie W

    2014-01-01

    The re-establishment of conscious awareness after discontinuing general anesthesia has often been assumed to be the inverse of loss of consciousness. This is despite the obvious asymmetry in the initiation and termination of natural sleep. In order to characterize the restoration of consciousness after surgery, we recorded frontal electroencephalograph (EEG) from 100 patients in the operating room during maintenance and emergence from general anesthesia. We have defined, for the first time, 4...

  1. Neuropeptide alterations in the tree shrew hypothalamus during volatile anesthesia

    OpenAIRE

    Fouillen, Laetitia; Petruzziello, Filomena; Veit, Julia; Bhattacharyya, Anwesha; Kretz, Robert; Rainer, Gregor; Zhang, Xiaozhe

    2013-01-01

    Neuropeptides are critical signaling molecules, involved in the regulation of diverse physiological processes including energy metabolism, pain perception and brain cognitive state. Prolonged general anesthesia has an impact on many of these processes, but the regulation of peptides by general anesthetics is poorly understood. In this study, we present an in-depth characterization of the hypothalamic neuropeptides of the tree shrew during volatile isoflurane/nitrous oxide anesthesia administe...

  2. 全麻患者静脉输注国产阿芬太尼的药代动力学%Pharmacokinetics of intravenously infused domestic alfentanil in patients undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    杨小娟; 吴超然

    2016-01-01

    目的 探讨全麻患者静脉输注国产阿芬太尼的药代动力学.方法 择期全麻下行甲状腺次全切除术患者12例,年龄18~47岁,体重49~ 86 kg,性别不限,ASA分级Ⅰ或Ⅱ级.静脉注射眯达唑仑0.02 mg/kg、阿芬太尼25 μg/kg、异丙酚1.5 mg/kg和罗库溴铵0.8 mg/kg,气管插管后接呼吸机行机械通气,麻醉维持:吸入0.8% ~2.0%七氟醚,静脉输注阿芬太尼1μg· kg-1·min-1,间断静脉注射罗库溴铵10~20 mg,维持BIS值40 ~ 60,手术结束前10 min时停止输注阿芬太尼.分别于麻醉诱导前、静脉输注阿芬太尼1、3、5、8、10、14、20、35、65、95、125 min及停止输注后5、15、30、60、120、180、240、300和360 min时采集静脉血样4 ml,采用高效液相色谱-质谱联用法测定血浆阿芬太尼浓度.采用DAS 3.0软件分析阿芬太尼药代动力学参数.结果 国产阿芬太尼药代动力学适用二室模型描述,其分布半衰期为(1.8±0.8) min,消除半衰期为(91±22) min;稳态分布容积为(0.38±0.12)L/kg;清除率为(4.3±1.6) ml· kg-1·min-1;国产阿芬太尼的消除符合一级消除动力学.结论 全麻患者静脉输注国产阿芬太尼的分布符合二室模型,其消除符合一级消除动力学.%Objective To investigate the pharmacokinetics of intravenously infused domestic alfentanil in the patients undergoing general anesthesia.Methods Twelve American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 18-47 yr,weighing 49-86 kg,scheduled for elective subtotal thyroidectomy under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.02 mg/kg,alfentanil 25 μg/kg,propofol 1.5 mg/kg and rocuronium 0.8 mg/kg.The patients were endotracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of 0.8%-2.0% sevoflurane,iv infusion of alfentanil 1 μg · kg-1 · min-1,and intermittent iv boluses of rocuronium 10-20 mg

  3. Update on complications in pediatric anesthesia

    Directory of Open Access Journals (Sweden)

    Giovanni de Francisci

    2013-02-01

    Full Text Available Complications in pediatric anesthesia can happen, even in our modern hospitals with the most advanced equipment and skilled anesthesiologists. It is important, albeit in a tranquil and reassuring way, to inform parents of the possibility of complications and, in general, of the anesthetic risks. This is especially imperative when speaking to the parents of children who will be operated on for minor procedures: in our experience, they tend to think that the anesthesia will be a light anesthesia without risks. Often the surgeons tell them that the operation is very simple without stressing the fact that it will be done under general anesthesia which is identical to the one we give for major operations. Different is the scenario for the parents of children who are affected by malignant neoplasms: in these cases they already know that the illness is serious. They have this tremendous burden and we choose not to add another one by discussing anesthetic risks, so we usually go along with the examination of the child without bringing up the possibility of complications, unless there is some specific problem such as a mediastinal mass.

  4. Anesthesia for pediatric external beam radiation therapy

    International Nuclear Information System (INIS)

    -acting barbiturate induction plus inhalation maintenance (36%), and 1 with inhalation alone (9%). Eight of the 11 (73%) received prior chemotherapy. Conclusion: Anesthesia was generally necessary at ≤ 3 years, and rarely required at > 5 years of age. Sepsis associated with frequent use of the central venous access line was seen in 15% of the patients with these lines

  5. Applications of rocuronium pretreatment in general anesthesia tracheal intubation%罗库溴铵预注在全身麻醉气管插管中的应用

    Institute of Scientific and Technical Information of China (English)

    杨松保; 魏素云; 郑立东

    2011-01-01

    Objective :To investigate the effects of rocuronium pretreatment in the patients of general anesthesia tracheal intubation.Methods: Forty-eight ASA Ⅰ - Ⅱ patients undergoing elective surgery under general anesthesia were randomly divided into two groups (24 cases/group) :group rocuronium( group R) and group suxamethonium( group S). Intravenous pretreatment of rocuronium 0.06 mg/kg( 1/5ED95 ) was given to group R while the equivalent volume of nornal saline to group S. After induction of general anesthesia,rocuronium 0.6 mg/kg(2ED95 ) and suxamethonium 1.2 mg/kg(4ED95 ) were injected as a bolus to group R and group S ,respectively.The effective time,the onset time, the T1 Value at one minute and the time of maximal depression of T1 were observed. At the same time, mean arterial pressure ( MAP), heart rate ( HR), hood oxygen satu ration ( SpO2 ) and end tidal carbon dioxide ( PET CO2 ) were observed respectively. Results: There were no significant differences in intubation conditions between the two groups ( P > 0. 05 );Furthermore, the largest extent of inhibition is general similar ( P > 0.05 ) , while the effective time and onset time in group S was significant shorter than that in group R( P < 0.01 ). There was no significant differences in MAP, HR, SpO2 and PET CO2. Conclusions:In our study, intravenous pretreatment of rocuronium 0.06 mg/kg( 1/5ED95 ) plus 0.6 mg/kg intubation dose of rocuronium is effective and safety.%目的:观察罗库溴铵全身麻醉(全麻)诱导预注给药气管插管效果.方法:48例ASA Ⅰ~Ⅱ级择期手术患者,随机分为罗库溴铵组(R组)24例和琥珀胆碱组(S组)24例,R组在全麻诱导前先静脉注射小剂量罗库溴铵0.06 mg/kg(1/5ED95),再静脉注射罗库溴铵0.6 mg/kg(2ED95),预注时间为1 min;S组诱导药同R组,最后静脉注射琥珀胆碱1.2 mg/kg(4ED95).观察作用显效时间、起效时间、1min T1值及T1最大抑制程度和平均动脉压(MAP)、心率(HR

  6. Clinical Anaiysis of Progressive Cephalocele in Cerebral Surgery during General Anesthesia%择期颅脑外科手术全身麻醉期间进行性脑膨出的临床分析

    Institute of Scientific and Technical Information of China (English)

    孟庆涛; 夏中元; 陈向东; 曹晨

    2011-01-01

    0bjective:To retrospextively analyze acute progressive external brain herniation during elective eraniotomy under general anesthesia,its clinical characteristics,etiology and diagnosis,management and prevention.Methods:To analyze case files of elective craniotomy performed under general anesthesia from 2002 to 2008,which resulted in intraoperative complication on the brain bulging out transcalvarially,though the craniotomy site.Data on the characteristics of the herniation,etiological causative factors,methods of management and prognosis were collected.Results:Out of the 8 230 patients undergoing elective craniotomy under general anesthesia between 2002 and 2008,8 of them developed external brain herniation intraoperatively.3 patients were found to have developed epidural hematomas due to the trauma induced by the pins of head holders (Sugita head holder),2 others developed deeply located hematomas,ipsilaterally to the craniotomy sites,1 patients had a hematoma,ipsilateral to the craniotomy site,1 patient during resection of a giant craniopharyngioma,sustained injury to hypothalamus and 1 patient developed external brain herniation due to inappropriate head position,ETT obstructed with secretion leading to hypereapnia.Among these 8 patients,preoperatively ICP was not unusually high.When the dura was open,there was no bulging of the brain and the latter was adequately relaxed.6 patients required emergent CT scan and 1 on the completion of the surgery.Out of these 8 patients,6 of them required emergent decompression craniotomy followed by the originally planned procedures.For 1 of the patients,hematoma drained was performed on completion of the management of the primary pathology,at the same time.Mild hypothermia was initiated and diuretics.6 patients were able to emerge for anesthesia after surgery and 2 passed away due to global brain injury (25%).Using GOS standard,the surviving patients were evaluated 6 months after surgery,1 patient was suffering for severe

  7. Clinical Observation of Spontaneous Breathing under General Anesthesia in Retinal Surgery%眼底手术中全身麻醉保留自主呼吸的临床观察

    Institute of Scientific and Technical Information of China (English)

    纪存良; 李天佐; 孙永兴; 郭玉良

    2014-01-01

    Objective: To observe clinical effects of spontaneous breathing reserved in retinal surgery under general anesthesia. Methods: Retinal surgery 260 cases, 172 cases of male, female 88 cases, aged 18 to 79 years, mean (48±14) years of age. Divided into control breathing intubation group (group A) and spontaneous respiration LMA group (group B). 130 cases of each. A group of patients given propofol, fentanyl and vecuronium drugs, controlled breathing intubation under general anesthesia. Group B received vecuronium, propofol, dexmedetomidine hydrochloride, tramadol ,succinylcholine chloride and lfexible LMA intubated during general anesthesia with spontaneous breathing, which be changed to manual ventilation if necessary(PETCO2>50mmHg). Two groups of patients were given retrobulbar nerve block and inhalation of 2.5%~3.5% sevolfurane, which deactivated in postoperative bandaging head or ten minutes before the bandaging. Patients' blood pressure, oxygen saturation, heart rate,respiration and so on were recorded at the relevant time points during anesthesia, the hemodynamic and respiratory parameters observed, as well as the quality of postoperative recovery, incidence of adverse reactions, etc.Results:Blood pressure and heart rate of group A elevated during endotracheal intubation and extubation while heart rate in group B slowed down while or 15min after intubation, the difference was significant (P0.05), PETCO2 slightly higher in group B than that of group A(P<0.05);Group B was superior to group A as far as extubation time and recovery time after surgery was concerned(P<0.05); Perioperative complications in group B was signiifcantly lower than that in group A (P<0.05).Conclusions:Adult retinal surgery under general anesthesia with spontaneous breathing can effectively reduce the incidence of perioperative complications in patients with rapid recovery, recovery time is short, it is safe and reliable.%目的:观察眼底手术中全身麻醉保留自主呼吸的临

  8. 不同剂量曲马多预防全身麻醉后寒战的对比研究%The comparison of different dose of tramal for preventing shiver after general anesthesia

    Institute of Scientific and Technical Information of China (English)

    刘宇

    2014-01-01

    Objective To observe the effectiveness and adverse reaction after using different dose of tramal for preventing shiver after general anesthesia,and discuss the suitable dose.Methods This study was carried on 120 cases that were undergoing elective uterectomy.All cases was divided into 4 groups,every group contains 30 patients.Every patients were intravenous administration before the end of the operation in 10 minutes:group A used 0.5 mg/kg tramal;group B used 1.0 mg/kg tramal;group C used 2.0 mg/kg tramal;group D used physiological saline.The levels of shiver,recovery time,the presence of respiratory depression,the presence of gastrointestinal reaction were observed in all cases.Results Through the comparison between each group,group D had a highest incidence rate of shiver after general anesthesia,and the difference was statistically significant(P0.05).In gastrointestinal reaction,group C had a highest incidence rate in all groups(P<0.05).Conclusion The dose of 1.0 mg/kg tramal is the suitable dose for preventing shiver after general anesthesia.%目的:通过观察不同剂量曲马多预防全身麻醉术后寒战的效果和不良反应,探讨曲马多预防全身麻醉术后寒战的适宜剂量。方法:研究120例全身麻醉下择期行子宫切除术的患者,随机分为四组,每组30例患者,于手术结束前10分钟静脉推注给药:A组给予曲马多0.5 mg/kg;B组给予曲马多1.0 mg/kg;C组给予曲马多2.0 mg/kg;D组为对照组,给予生理盐水0.05 ml/kg。观察术后寒战分级、苏醒时间、呼吸抑制、恶心、呕吐等指标。结果:通过组间比较,D组术后寒战的发生率最高,差异有统计学意义(P<0.05), B组术后寒战的发生率最低,差异有统计学意义(P<0.05),苏醒时间方面,A组、B组、C组、D组之间比较差异无统计学意义(P>0.05)。各组术后均无呼吸抑制的发生。胃肠道反应方面,C组恶心、呕吐发生率最高

  9. 多沙普仑和哌替啶治疗全麻苏醒期寒战的对比研究%Effect comparison of doxapram and pethidine on postoperative shiver in general anesthesia recovery period

    Institute of Scientific and Technical Information of China (English)

    江烨岚; 梁敏; 郑文美; 周大春

    2014-01-01

    Objective To compare the effect of doxapram and pethidine on postoperative shiver in general anesthesia re-covery period. Methods Fifty-one patients who shivered during recovery from general anesthesia were randomly divided into three groups: doxapram group that received doxapram 1.0mg/kg, pethidine group that received pethidine 0.5 mg/kg and control group that received normal saline. Shiver grade and the rate of shiver stopped were compared. The effect of two drugs on sedation and analgesia and adverse effect incidence were observed. Results At 1, 2.5 and 5 minutes after treat-ment, both doxapram and pethidine groups were significantly effective in reducing postoperative shivering grade comparing with control group (H=18.97,24.96,30.85,P0.05). Con-clusion Both doxapram and pethidine were effective for postoperative shiver while pethidine had higher incidence of post-operative nausea and vomiting. The doxapram and pethidine were unaffected general anesthesia recovery when as to already awake patients.%目的:研究多沙普仑和哌替啶对于全麻后寒战患者的治疗效果及对苏醒质量的影响。方法将全麻苏醒期进入术后恢复室后发生寒战的51例全麻病人随机分三组治疗:多沙普伦针1.0 mg/kg (多沙普仑组)、哌替啶针0.5 mg/kg(哌替啶组)及0.9%氯化钠注射液(对照组),比较三组患者的降低寒战分级、寒战终止率,并观察对镇静、镇痛的影响及不良反应发生率。结果治疗1 min、2.5 min和5 min后多沙普仑组和哌替啶组寒战等级相比对照组均有明显降低,差异均有统计学意义(H分别=18.97、24.96、30.85,P均<0.05)。治疗1 min后,多沙普仑组和哌替啶组寒战终止率明显高于对照组,差异均有统计学意义(χ2=5.04、11.10,P<0.05)。而哌替啶组24 h内恶心、呕吐的发生率明显高于多沙普仑组和对照组,经Fisher精确检验,差异均有统计学意义(P均<0.05)。三

  10. Ablação curativa da fibrilação atrial: comparação entre sedação profunda e anestesia geral Curative ablation of atrial fibrillation: comparison between deep sedation and general anesthesia

    Directory of Open Access Journals (Sweden)

    Elizabeth Bessadas Penna Firme

    2012-12-01

    Full Text Available OBJETIVO: Comparar sedação profunda com anestesia geral para ablação curativa de fibrilação atrial. MÉTODOS: Estudo prospectivo, aleatório, com 32 pacientes, idades entre 18 e 65 anos, ASA 2 e 3, IMC d" 30kg/m², distribuídos em dois grupos: sedação profunda (G1 e anestesia geral (G2. Todos receberam midazolan (0,5mg/kg venoso. O G1 recebeu propofol (1mg/kg e máscara facial de O2, seguido da infusão contínua de propofol (25-50mg/kg/min e remifentanil (0,01-0,05µg/kg/min. O G2 recebeu propofol (2mg/kg e máscara laríngea com tubo de drenagem, seguido da infusão contínua de propofol (60-100mg/kg/min e remifentanil (0,06-0,1µg/kg/min. Foram comparados: frequência cardíaca, pressão arterial invasiva, complicações, recidiva (desfecho em três meses e gasometrias. RESULTADOS: Os pacientes do G1 apresentaram gasometrias arteriais com níveis de PaCO2 maiores e pH menores (p=0,001 e maior incidência de tosse. Ocorreu diminuição da PAM e FC no G2. Exceto a tosse, as complicações e recidivas foram semelhantes em ambos os grupos. CONCLUSÃO: Ambas as técnicas podem ser utilizadas para a ablação curativa da fibrilação atrial. A anestesia geral proporcionou menores alterações respiratórias e maior imobilidade do paciente.OBJECTIVE: To compare deep sedation with general anesthesia for curative ablation of atrial fibrillation. METHODS: We conducted a prospective, randomized study with 32 patients, aged between 18 and 65 years, ASA 2 and 3, BMI d" 30kg/m2, divided into two groups: deep sedation (G1 and general anesthesia (G2. All patients received intravenous midazolam (0.5 mg / kg. G1 received propofol (1mg/kg and O2 by facemask, followed by continuous infusion of propofol (25-50mg/kg/min and remifentanil (0.01-0.05 mg / kg / min. G2 received propofol (2mg/kg and laryngeal mask with built-in drain tube, followed by continuous infusion of propofol (60-100mg/kg/min and remifentanil (0.06 to 0.1g/kg/min. We compared heart rate

  11. Anesthesia and cor triatriatum

    OpenAIRE

    Federica Scavonetto; Tze Yeng Yeoh; Tasha L Welch; Weingarten, Toby N.; Juraj Sprung

    2014-01-01

    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 co...

  12. 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.

  13. 腹部手术硬全联合麻醉术后谵妄的影响因素%The Inlfuencing Factors of Postoperative Delirium in Continuous Epidural Block Combined with General Anesthesia with Tracheal Intubation on Abdominal Operation

    Institute of Scientific and Technical Information of China (English)

    曾晓燕; 李正芬

    2013-01-01

    目的:分析腹部手术硬全联合麻醉患者术后谵妄的影响因素。方法:采用病例对照研究方法,选择腹部手术硬全联合麻醉患者,根据患者术后3天内是否发生谵妄分为病例组和对照组,以单因素分析联合多因素分析方法研究患者术后发生谵妄的影响因素。结果:患者术后谵妄发生率4.95%,患者均在术后24 h内发病;高龄、手术时间>2h、术后疼痛评分>2分、肺部慢性疾病史、饮酒史是患者术后发生谵妄的危险因素。结论:对高龄、既往患有肺部慢性疾病、手术时间长的患者,术后密切监测电解质、血气,防治肺部感染的发生,以降低患者术后谵妄的发生率。%Objective:To analysis the influencing factors of postoperative delirium in continuous epidural block combined with general anesthesia with tracheal intubation on abdominal operation. Methods:The case control study were used, continuous epidural block combined with general anesthesia with tracheal intubation on abdominal operation patients were selected, was divided into case group and control group according to the delirium of patients after 3 days, study the influence factors of postoperative delirium in patients by single factor analysis and multiple factor analysis.Results:The incidence rate of delirium was 4.95%in patients, the patients were onset within 24h;senility, operation time≥2h, postoperative pain score>2, chronic lung disease, drinking history were risk factors of postoperative delirium for patients.Conclusion:In the light of elderly patients, who suffered from chronic lung disease, long operation time of patients, postoperative close monitoring of electrolytes, blood gas analysis, prevention and treatment of pulmonary infection, to reduce the incidence of postoperative delirium in elderly patients .

  14. The effect of anesthesia on the radiographic appearance of the coxofemoral joints

    International Nuclear Information System (INIS)

    The effect of anesthesia on the radiographic appearance of the coxofemoral joints was evaluated by taking pelvic radiographs of thirty dogs. Each dog was radiographed twice, once under general anesthesia and once without anesthesia. The radiographs were submitted to the Orthopedic Foundation for Animals independently of one another to be evaluated for signs of hip dysplasia. Results suggest there was no statistical difference between the two groups of dogs. Twenty five dogs received the same reading. Three dogs received readings that were worse by one grade while under anesthesia and two dogs received readings that were one grade better while under anesthesia. This study failed to demonstrate any changes due to anesthesia on the radiographic appearance of the coxofemoral joints. Anesthesia may, however, be beneficial for proper positioning and to decrease unnecessary patient, and personnel exposure to radiation

  15. Changes of body temperature and threshold of thermoregulatory vasoconstriction under general anesthesia%全身麻醉下吸烟病人体温与体温调节性血管收缩阈值的变化

    Institute of Scientific and Technical Information of China (English)

    刘勇; 王朝忠

    2016-01-01

    and threshold of thermoregulatory vasoconstriction under general an-esthesia and the mechanism.Methods Forty -three adult male patients (ASA 1 ~2)undergoing operation on abdominal region in general anesthesia were randomized into smoking group (S group,n =22)and control group (C group,n =21).Propofol,fentanyl,ve-curonium were used for induction of aneasthesia,isoflurane,remifentanil,vecuronium for maintenance of anesthesia,ventilator for in-termittent positive -pressure ventilation (IPPV).We calculated the gain of threshold of vasoconstriction with weighting least square method,and recorded the temperature,blood pressure and heart rate change before anesthesia (T0 )and every five minutes from the 5th minute to the 180th minutes after induction of aneasthesia.Results Temperature before aneasthesia induction(T0 ),the difference of TES ,TMSE ,temperature head from esophageal temperature to TMSK(TES -MSK )and Tforearm -fingertip were not significant between the two groups.The differences in heart rates at different time and the mean arterial pressure were statistically significant (P 0.05).There was no significant differences between the two groups in the esophageal temperature and the average skin temperature at different time points (P >0.05). There was no interaction between the time and the changes in the esophagus temperature,the average skin temperature,the temperature head between the esophagus and the skin temperature,and the temperature head between the forearm and the fingertip among different populations.The TES -MSK at T30 ,T60 ,T120 ,T150 and T180 in the smoking group were lower than those in the control group,and the Tforearm -fingertip at T120 ,T150 and T180 in the smoking group were lower than those in the control group.The difference was statistically sig-nificant.As for the threshold of vasoconstriction and the gain,the threshold of vasoconstriction in S group (34.89 ±0.20)℃was sig-nificantly lower than that in C group (35.48 ±0.18)℃;the gain in C

  16. Cholecystectomy with local anesthesia as a resource in the elderly

    International Nuclear Information System (INIS)

    In the case of a patient presenting with acute cholescystectomy ideally is to remove the gallbladder. Sometimes there are special situations in malnourished elderlies with deterioration of its general status in whom a lengthy anesthesia intervention, even using not much invasive means as the videosurgery, put at risk the life of patient. In such cases the cholescystectomy with local anesthesia is an alternative that must to be taken into account. (author)

  17. Can Local Anesthesia Prevent the Injury of Brachial Plexus?

    OpenAIRE

    Alaattin Ozturk

    2014-01-01

    Schwannomas (neurilemmomas) are benign tumors arising from peripheral nerve sheaths. They can be seen all over the body, but approximately half of the cases occur in the head and neck region. The schwannoma arising from brachial plexus is a rare cause of neck masses. They are rarely diagnosed preoperatively. The risk of nerve damage after excision is high under general anesthesia. In this article, a case of brachial plexus schwannoma was presented and the excision with local anesthesia was sh...

  18. 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...... 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 in...

  19. Electroencephalographic variation during end maintenance and emergence from surgical anesthesia.

    Science.gov (United States)

    Chander, Divya; García, Paul S; MacColl, Jono N; Illing, Sam; Sleigh, Jamie W

    2014-01-01

    The re-establishment of conscious awareness after discontinuing general anesthesia has often been assumed to be the inverse of loss of consciousness. This is despite the obvious asymmetry in the initiation and termination of natural sleep. In order to characterize the restoration of consciousness after surgery, we recorded frontal electroencephalograph (EEG) from 100 patients in the operating room during maintenance and emergence from general anesthesia. We have defined, for the first time, 4 steady-state patterns of anesthetic maintenance based on the relative EEG power in the slow-wave (awareness after drug discontinuation. Moreover, these emergence patterns could be broadly grouped according to the duration and rapidity of transitions amongst these slow-wave dominated brain states that precede awakening. Most patients progressed gradually from a pattern characterized by strong peaks of delta (0.5-4 Hz) and alpha/spindle (8-14 Hz) power ('Slow-Wave Anesthesia') to a state marked by low delta-spindle power ('Non Slow-Wave Anesthesia') before awakening. However, 31% of patients transitioned abruptly from Slow-Wave Anesthesia to waking; they were also more likely to express pain in the post-operative period. Our results, based on sleep-staging classification, provide the first systematized nomenclature for tracking brain states under general anesthesia from maintenance to emergence, and suggest that these transitions may correlate with post-operative outcomes such as pain. PMID:25264892

  20. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    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

  1. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

    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

  2. Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery

    OpenAIRE

    Kyu-Jin Chung; Kyu-Ho Cha; Jun-Ho Lee; Yong-Ha Kim; Tae-Gon Kim; Il-Guk Kim

    2012-01-01

    Background Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anest...

  3. 术前联合术中保暖避免全麻手术低体温发生%Preoperative combined with intraoperative warming avoids hypothermia during surgery in general anesthesia

    Institute of Scientific and Technical Information of China (English)

    朱帅; 闵昱源; 郑少华; 周艳楠; 张丽娜; 景桂霞

    2013-01-01

    Objective To evaluate the effects of intraoperative warming with and without 1 hour of preoperative warming, in preventing intraoperative and postoperative hypothermia. Methods Thirty ASA physical status I and II female patients scheduled for elective abdominal surgery received standard general anesthesia. In 10 patients, no special precautions were taken ( Gl group ); 10 patients were submitted to preoperative and intraoperative active warming ( G2 group ); 10 patients were only warmed intraoperatively ( G3 group ). Temperatures were recorded at 30 min intervals. Results The patients in G2 had high skin and core temperatures than Gl group during two hours of anesthesia and the core temperatures were higher at 90 and 120 min than G3 group ( P <0.05 ). Patients in G2 and G3 were extubated early and none had shivering. In contrast, patients in Gl had low temperature and five patients shivered. Conclusion One hour of preoperative warning combined with intraoperative warming can prevent intra - or postoperative hypothermia and shivering and offer good conditions for early tracheal extubation.%目的 观察术中保暖联合或不联合术前1 h保暖,对全麻手术患者术中和术后低体温的影响.方法 收集30例美国麻醉师协会(ASA)分级I~Ⅱ级女性择期腹部手术常规全身麻醉患者.10例不给于保暖措施(G1组);10例术前1 h联合术中保暖(G2组);10例仅术中保暖(G3组).各组患者每30 min记录体温一次.结果 G2组患者手术2 h内体表和核心体均温高于G1组,其术中90 min和120 min核心体温高于G3组(P<0.05).G2和G3组术后拔管较早且无寒颤反应;G1组手术结束时体温较低且5例患者发生寒颤.结论 术前1 h联合术中保暖能避免全麻手术术中和术后低体温、寒颤发生,给拔管提供良好条件.

  4. 异病酚静脉全麻下复合氯胺酮或曲马多行纳屈酮快速阿片脱毒的效果比较%The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

    Institute of Scientific and Technical Information of China (English)

    黄位耀; 肖晓山; 刘瑛; 廖秀清; 周代伟; 戴航

    2002-01-01

    Objective To release the heroin addicts' sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia. Method 160 volunteers were divided at random into two groups:Group A were performed under the combined anesthesia with propofol, midazolam and ketamine,Group B were performed under the combined anesthesia with propofol with midazolam and tramadol. The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirst, sleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much difference between group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days. Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious. The tramadol is better than others.

  5. Does regional anesthesia influence early outcome of upper arm arteriovenous fistula?

    International Nuclear Information System (INIS)

    To assess the effect of regional anesthesia on the outcome of elbow arteriovenous fistula (AVF), prospectively studied consecutive patients with end-stage renal disease referred for permanent vascular access to the Vascular Unit of King Fahd University Hospital between September 2004 and September 2007. The patients were divided into 2 groups: Group 1: patients who underwent the construction of the AVF under regional anesthesia and Group 2: patients who were operated under general anesthesia, indicated by their preferences or failure of regional anesthesia. Data including patient characteristics and type of AVF were recorded. The internal diameter of the vein and the artery and intra-operative blood flow were measured. The complications of both types of anesthesia were recorded. The patients were followed up for three months. Eighty four cases were recruited in this study. Complete brachial plexus block was achieved in 57 (68%) patients. Seven patients were converted to general anesthesia and 20 patients had AVF under general anesthesia from the start. There were no significant differences between the 2 groups with regard to basic characteristics or operative data. There were no instances of systemic toxicity, hematomas, or nerve injury from the regional block. No major complications were reported from the general anesthesia. There was no significant difference between both groups regarding early failure of AVF (Group 1, 14% vs. Group2; 11%. P= 0.80). No significant advantage of regional over general anesthesia in terms of early outcome of AVF was seen in this study (Author).

  6. 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.

  7. Anesthesia for bronchoscopy.

    Science.gov (United States)

    Abdelmalak, Basem B; Gildea, Thomas R; Doyle, D John

    2012-01-01

    Bronchoscopic procedures are at times intricate and the patients often very ill. These factors and an airway shared with the pulmonologist present a clear challenge to anesthesiologists. The key to success lies in the understanding of both the underlying pathology and procedure being performed combined with frequent two-way communication between the anesthesiologist and the pulmonologist. Above all, vigilance and preparedness are paramount. Topics discussed in this review include anesthesia for advanced diagnostic procedures as well as for interventional/ therapeutic procedures. The latter includes bronchoscopic tracheal balloon dilation, tracheobronchial stenting, endobronchial electrocautery, bronchoscopic cryotherapy and other techniques. Special situations, such as tracheoesophageal fistula and mediastinal masses, are also considered. PMID:22762465

  8. 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.

  9. The application of HC visual laryngoscopes in endotracheal intubation under general anesthesia%HC可视喉镜在全身麻醉气管插管的应用

    Institute of Scientific and Technical Information of China (English)

    王玉玲; 邱郁群; 黄梅; 陈艳; 何金龙; 陈艾

    2015-01-01

    Objective To investigate the clinical results of HC visual laryngoscope in endotracheal intubation under general anesthesia. Methods 600 cases of general anesthesia patients in our hospital from December 2012 to September 2013 were selected as research subjects, and randomly assigned into two groups according to figures, H group (300 cases) used HC-assisted intubation laryngoscope visualization tube; M group (300 cases) used ordinary assisted intubation laryngoscope, glottis exposure time, total time intubation, once success rate, glottis exposed satisfaction rate, complication rate, blood pressure at different time points, heart rate (HR) and heart rate and systolic blood pressure product (PPR)were compared between the two groups. Results The total exposure time of glottis and intubation in H group were shorter than that in the M group (P 0.05); the hemodynamics parameter in the two groups after induction anesthesia (T1) were lower than that before induction kinetics parameters (T0), it in intubation (T2) was significantly higher than that in T1, the differences were statistically significant (P 0.05). H group each hemodynamic parameter at each time point were lower than that in the M group, but the difference was not statistically significant (P > 0.05). Conclusion HC laryngoscope can clearly expose the glottis department, reducing intubation time and improve the success rate of intubation, the patient will not have hemodynamic indices adversely affect safe for general anesthesia process.%目的:探讨 HC 可视喉镜在全身麻醉气管插管中临床效果。方法选择2012年12月~2013年9月在我院行全身麻醉患者600例作为研究对象,按数字随机表法分为两组,H 组(300例)采用 HC 可视喉镜辅助下气管插管;M 组(300例),采用普通喉镜辅助下气管插管,比较两组声门暴露时间、气管插管总时间、一次成功率、声门暴露满意率及并发症发生率,比较两组患者不同时间

  10. 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

    -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...

  11. Effect of different anesthesia methods on plasma neuropeptides levels during the peri-operative period in surgical patients with hypertension

    International Nuclear Information System (INIS)

    Objective: To explore the effect of different anesthesia methods on the levels of plasma neuropeptides during the peri-operative period in patients with hypertension. Methods: Ninety hypertensive patients undergoing upper abdominal operations were randomly allocated to equal divided epidural anesthesia, general anesthesia and combined Groups. Plasma neuropeptide Y(NPY) concentrations were measured before anesthesia, at 15 min after anesthesia, 20 min after operation and 10 min after completion of the operation. Results: BP, HR and NPY were significantly changed in both E group and G group after anesthesia and operation (compared vs before anesthesia, p<0.01). BP, HR and NPY were significantly changed in C group after operation compared with those in both E and G group (p<0.05) . Conclusion: The combined anesthesia method is effective in inhibits the stress response during upper abdominal operation in the hypertensive patients

  12. Influence of Abdominal Epidural Block Combined with General Anesthesia on Nose Pharynx Temperature of Elderly Patients in Perioperative Period%腹部硬膜外阻滞复合全凭静脉麻醉对老年患者围术期鼻咽温度的影响

    Institute of Scientific and Technical Information of China (English)

    王浩杰; 郭创

    2012-01-01

    [Objective] To study the changing of core temperature on elderly patients during abdominal epidural block combined with general anesthesia. [Methods] Forty ASA Ⅱ ~Ⅲ elderly patients undergoing elective surgery for gastric cancer were randomly divided into two groups. Group I: abdominal epidural block combined with general anesthesia was performed. Epidural block was performed at T11-12. Group Ⅱ:General anesthesia was performed. Nose pharynx temperature was recorded every 30 min from the beginning of anesthesia induction to the end of the operation. [Results] In two groups, nose pharynx temperature at the time of the end of the operation was significantly lower than that at the time of anesthesia induction. The core temperature decreased more progressively in group I (1.87+0.47),℃ than group Ⅱ (1.24±0.3)℃. [Conclusions] Perioperative mild hypothermia developed progressively on elderly patients during abdominal epidural block combined with general anesthesia. The protective measures should be taken actively.%[目的]研究腹部硬膜外阻滞复合全凭静脉麻醉对老年患者围术期鼻咽温度的影响.[方法]选择2009年9月至2011年1月在我院择期行胃癌根治术老年患者40例(>65岁),美国麻醉师协会(ASA)Ⅱ~Ⅲ级,随机分成2组,Ⅰ组采用腹部硬膜外阻滞复合全凭静脉麻醉,Ⅱ组采用全凭静脉麻醉.各组于诱导时开始,每隔30min记录鼻咽温度,直至手术结束.[结果]诱导后两组患者的鼻咽温度呈进行性降低,术毕值与诱导值比较差异显著(P<0.01),Ⅰ组鼻咽温度下降幅度(1.87±0.47)℃明显>Ⅱ组(1.24±0.30)℃(P<0.05).两组的生命体征比较,差异无统计学意义(P>0.05).[结论]腹部硬膜外阻滞复合全凭静脉麻醉过程中老年患者围术期鼻咽温度显著降低,围术期应采取保暖措施.

  13. 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.

  14. Hemodynamic effects of caudal block with bupivacaine and adrenaline in the newborn undergoing elective surgery under general anesthesia%布比卡因混合肾上腺素骶管阻滞对全麻新生儿血液动力学的影响

    Institute of Scientific and Technical Information of China (English)

    邓萌; 王炫; 贺琳; 郑珊

    2008-01-01

    Objective To investigate the effects of caudal block with bupivacaine and adrenaline on the hemodynamics in the newborn undergoing general anesthesia for elective surgery. Methods Thirty ASA Ⅰ or Ⅱ fall-term neonates aged ≤ 28 days weighing ≥ 2 500 g undergoing elective abdominal or genitourinary surgery under general anesthesia were studied. Children with known cardiovascular abnormalities, infections diseases or intestinal obstruction and those with conditions contraindicating caudal block were excluded from the study. The children were randomly allocated into 3 groups (n = 10 each) : group Ⅰ general anesthesia (A) ;group Ⅱ general anesthesia + caudal block (0.2% bupivacaine 1.25 ml/kg) (AP) and group Ⅲ general anesthesia + caudal block (0.2% bupivacaine 1.25 ml/kg + adrenaline 1:200 000) (AE). Anesthesia was induced with propefal 3 mg/kg iv. Tracheal intubation was facilitated with vecuronium 0.15 mg/kg. The patients were mechanically ventilated. PETCO2 Was maintained at 30-35 mm Hg. Anesthesia was maintained with 0.4% sevoflurane + 40% N2O + 60 % O2. Radial artery was cannulated for continuous BP monitoring. HR, cardiac output (CO) and stroke volume (SV) were monitored using noninvasive transthoracic echocardiagraphy and recorded at 5 min before, and 5, 10 and 15 min after performance of caudal block. Systemic vascular resistance (SVR) was calculated (SVR = MAP/CO × 80). Results There were no significant differences in the hemodynamic variables between the 3 groups. Conclusion Caudal block with bupivacaine alone or with adrenaline exerts no significant effects on hemodynamics in the newborn undergoing elective surgery under general anesthesia.%目的 评价布比卡因混合肾上腺素骶管阻滞对全麻新生儿血液动力学的影响.方法 择期或限期行腹部或会阴部手术的足月新生儿30例,性别不限,ASA Ⅰ或Ⅱ级,出生体重≥2 500 g,日龄≤28 d,随机分为3组(n=10):全麻组(A组)、全麻+骶管阻滞(0.2%

  15. 星状神经节阻滞与全麻插管期心血管反应%Effect of Right Stellate Ganglion Block on Cardiovascular Response during the Endotracheal lntubation under the General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈华梅; 廖琪

    2011-01-01

    目的 观察右星状神经节阻滞(R-SGB)对全身麻醉气管内插管期心血管反应的影响.方法 2009年10-12月选取60例美国麻醉医师协会(ASA)Ⅰ、Ⅱ级择期全麻手术患者,随机分为3组.研究组于全麻诱导前15 min用1%利多卡因10 mL经颈6入路行R-SGB,对照组1诱导前同法注射10 mL生理盐水,对照组2诱导前肌注2%利多卡因5 mL.观察气管捕管前后收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)、心率(HR)、心电图(ECG)、氧饱和度(SpO2)和心率收缩压乘积(RPP)的变化.结果 研究组各时点与进入手术室时的基础值比较,仅诱导后SBP、DBP、MBP显著降低,窥喉时HR和RPP显著升高(P<0.01);在插管3 min后已恢复至基础值.对照组1和对照组2诱导后SBP、DBP、MBP显著降低(P<0.01);窥喉时SBP、DBP、MBP、HR、RPP均显著升高(P<0.01),并持续至捕管后5 min.两对照组升高的程度均显著高于研究组(P<0.05或Pgeneral anesthesia.Methods Sixty ASA Ⅰ- Ⅱ patients who underwent general anaesthesia between October to December 2009 were randomly divided into three groups.The patients in the trial group accepted R-SGB by C6 route with 1% lidocaine (10 mL) 15 minutes before induction of general anesthesia;the patients in control group 1 were injected with 10 mL physiological saline in the same way before the induction; the patients in control group 2 underwent the intramuscular injection of 2% lidocaine (5 mL) before the induction.The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hear rate (HR), electrocardiogram (ECG), oxygen saturation (SpO2) and heart rate-systolic blood pressure product (RPP)before and

  16. Modeling the dynamical effects of anesthesia on brain circuits.

    Science.gov (United States)

    Ching, Shinung; Brown, Emery N

    2014-04-01

    General anesthesia is a neurophysiological state that consists of unconsciousness, amnesia, analgesia, and immobility along with maintenance of physiological stability. General anesthesia has been used in the United States for more than 167 years. Now, using systems neuroscience paradigms how anesthetics act in the brain and central nervous system to create the states of general anesthesia is being understood. Propofol is one of the most widely used and the most widely studied anesthetics. When administered for general anesthesia or sedation, the electroencephalogram (EEG) under propofol shows highly structured, rhythmic activity that is strongly associated with changes in the patient's level of arousal. These highly structured oscillations lend themselves readily to mathematical descriptions using dynamical systems models. We review recent model descriptions of the commonly observed EEG patterns associated with propofol: paradoxical excitation, strong frontal alpha oscillations, anteriorization and burst suppression. Our analysis suggests that propofol's actions at GABAergic networks in the cortex, thalamus and brainstem induce profound brain dynamics that are one of the likely mechanisms through which this anesthetic induces altered arousal states from sedation to unconsciousness. Because these dynamical effects are readily observed in the EEG, the mathematical descriptions of how propofol's EEG signatures relate to its mechanisms of action in neural circuits provide anesthesiologists with a neurophysiologically based approach to monitoring the brain states of patients receiving anesthesia care. PMID:24457211

  17. Causes of pulmonary infections under general anesthesia for elderly patients after abdominal surgery%老年患者全身麻醉腹部手术后并发肺部感染的原因分析

    Institute of Scientific and Technical Information of China (English)

    张燕; 刘欢欢; 杨平山

    2012-01-01

    OBJECTIVE To analyze the causes of pulmonary infections under general anesthesia for elderly patients after abdominal surgery, explore measures for prevention of infections so as to reduce the hospital infection rate of the elderly patients. METHODS A total of 16 patients with postoperative pulmonary infections among the 226 cases of elderly patients who underwent abdominal surgery under general anesthesia from Aug 2009 to Jun 2011 were analyzed retrospectively. The causes of the infections, infection rate and pathogenic bacteria were observed. RESULTS Of 226 cases of patients,the postoperative pulmonary infections occurred in 16 cases with the infection rate of 7. 1 %, the main risk factors for infections mainly included the invasive procedures, postoperative pain, the use of antibiotics, and upper respiratory diseases; all of the 16 patients with pulmonary infections underwent tracheal intubation, suffered from postoperative pain, and empirically used antibiotics after operation; the result of the sputum culture for 16 cases of patients with pulmonary infections indicated that there were 16 strains of pathogens cultured, including gram-negative bacteria (56. 3%), gram-positive bacteria (31. 3%), and fungi (12.5%); the main pathogenic bacteria causing infections were Pseudomonas aeruginosa , Escherichia coli, and Staphylococcus aureus. CONCLUSION The operations should be strictly in accordance with procedures, the strict quality control of the steps of the invasive operation should be carried out so as to eliminate various susceptible factors, which is also crucial to the reduction of the pulmonary infections.%目的 分析老年患者全身麻醉腹部手术后并发肺部感染的原因,探讨预防感染的措施,以降低老年患者的医院感染率.方法 医院2009年8月-2011年6月226例全身麻醉腹部手术的老年患者的资料进行回顾性分析,其中16例并发肺部感染,调查发生感染的原因、感染率及感染病原菌.结果 226

  18. Effects of intra-operative end-tidal carbon dioxide levels on the rates of post-operative complications in adults undergoing general anesthesia for percutaneous nephrolithotomy: A clinical trial

    Directory of Open Access Journals (Sweden)

    Mahmoud Saghaei

    2014-01-01

    Full Text Available Background: A retrospective study has shown lesser days of hospital stay in patients with increased levels of intra-operative end-tidal carbon dioxide (ETCO 2 . It is probable that hypercapnia may exert its beneficial effects on patients′ outcome through optimization of global hemodynamic and tissue oxygenation, leading to a lower rate of post-operative complications. This study was designed to test the hypothesis that higher values of intra-operative ETCO 2 decrease the rate of post-operative complications. Materials and Methods: In this randomized, double-blind clinical trial, 78 adult patients scheduled for percutaneous nephrolithotomy (PCNL were prospectively enrolled and randomly divided into three groups. ETCO 2 was set and maintained throughout the procedure at 31-33, 37-39 and 43-45 mmHg in the hypocapnia, normocapnia and hypercapnia groups, respectively. The rates of post-operative complications were compared among the three groups. Results: Seventy-five patients completed the study (52 male and 23 female. Ten (38.5%, four (16% and two (8.3% patients developed post-operative vomiting in the hypocapnia, normocapnia and hypercapnia groups, respectively (P = 0.025. The nausea score was significantly lower in the hypercapnic group compared with the other groups (3.9 ± 1.8, 3.2 ± 2.1 and 1.3 ± 1.8 in the hypocapnia, normocapnia and hypercapnia groups, respectively; P = 0.000. Time to return of spontaneous respiration and awakening were significantly decreased in the hypercapnia group compared with the other groups (P < 0.01. Conclusion: Mild intra-operative hypercapnia has a protecting effect against the development of post-operative nausea and vomiting and decreases the duration of emergence and recovery from general anesthesia.

  19. The Advantages of Continuous Epidural Anesthesia in Spinal Deformity Surgery

    Directory of Open Access Journals (Sweden)

    Ezhevskaya А.А.

    2014-09-01

    Full Text Available The aim of the investigation was to assess the efficacy of epidural anesthesia and analgesia during the integrated anesthetic management in spinal deformity surgery. Materials and Methods. The prospective randomized study involved 350 patients aged from 15 to 65 years, divided into two groups: group 1 (n=205 were given combined anesthesia — epidural and endotracheal anesthesia with sevoflurane and continuous epidural analgesia with ropivacaine, fentanyl and epinephrine after surgery; group 2 (n=145 had general anesthesia with sevoflurane and fentanyl, and systemic administration of opioids after surgery. We assessed systemic hemodynamics parameters (a non-invasive method, pain at rest and activities, parameters of hemostasis and fibrinolysis, plasma levels of stress hormones, cytokine levels at seven stages of the study (before, during and three days after surgery. Results. Patients in group 1 with epidural anesthesia had significantly less pain both at rest and motion. The most blood saving effect (up to 60% of blood loss was also found in group 1. Hemodynamic monitoring demonstrated epidural anesthesia not to lead to the life-threatening events of myocardial contractility, cardiac output, systemic vascular resistance and critical increasing of extravascular lung water. The impact of epidural anesthesia on hemostasis encompassed the activation of both coagulation and fibrinolysis. Furthermore, patients in group 1 compared to group 2 had significantly lower plasma levels of glucose, lactate, С-reactive protein, cortisol, and interleukins IL-1β, IL-6, IL-10. Conclusion. Comprehensive anesthetic protection in spinal deformity surgery based on epidural anesthesia provides adequate antinociceptive effects, inhibition of endocrine and metabolic stress response and correction of hemostasis problems.

  20. Electroencephalographic variation during end maintenance and emergence from surgical anesthesia.

    Directory of Open Access Journals (Sweden)

    Divya Chander

    Full Text Available The re-establishment of conscious awareness after discontinuing general anesthesia has often been assumed to be the inverse of loss of consciousness. This is despite the obvious asymmetry in the initiation and termination of natural sleep. In order to characterize the restoration of consciousness after surgery, we recorded frontal electroencephalograph (EEG from 100 patients in the operating room during maintenance and emergence from general anesthesia. We have defined, for the first time, 4 steady-state patterns of anesthetic maintenance based on the relative EEG power in the slow-wave (<14 Hz frequency bands that dominate sleep and anesthesia. Unlike single-drug experiments performed in healthy volunteers, we found that surgical patients exhibited greater electroencephalographic heterogeneity while re-establishing conscious awareness after drug discontinuation. Moreover, these emergence patterns could be broadly grouped according to the duration and rapidity of transitions amongst these slow-wave dominated brain states that precede awakening. Most patients progressed gradually from a pattern characterized by strong peaks of delta (0.5-4 Hz and alpha/spindle (8-14 Hz power ('Slow-Wave Anesthesia' to a state marked by low delta-spindle power ('Non Slow-Wave Anesthesia' before awakening. However, 31% of patients transitioned abruptly from Slow-Wave Anesthesia to waking; they were also more likely to express pain in the post-operative period. Our results, based on sleep-staging classification, provide the first systematized nomenclature for tracking brain states under general anesthesia from maintenance to emergence, and suggest that these transitions may correlate with post-operative outcomes such as pain.

  1. A comparison among different interventions in treating shivering during general anesthesia recovery%不同干预措施对减少全麻苏醒期寒战的对比研究

    Institute of Scientific and Technical Information of China (English)

    聂玲; 魏宏; 刘萍; 罗晓敏; 吕倩茹

    2014-01-01

    目的:探讨不同干预措施对全麻苏醒期寒战的影响。方法:选择100例妇科腹腔镜手术且在苏醒期发生寒战的患者,随机分为四组,每组25例。寒战发生后,A组给予充气式保温毯保暖;B组给予缓慢静脉注射曲马多1mg/kg ;C组给予充气式保温毯保暖,缓慢静脉注射曲马多1mg/kg ;D组为对照组,给予等量生理盐水静脉注射。观察并记录干预前(T1)、干预后5min(T2)和15min(T3)患者的寒战级别,患者的不良反应(恶心呕吐、头晕等)和返回病房后2h内寒战复发率,以及核心温度(鼓膜温度)的变化。结果:T1时点四组患者寒战程度无显著性差异( P>0.05);T2时点A、B、C组寒战等级低于D组(P<0.05),与A组比较,B、C组寒战疗效更好(P<0.05);T3时点A、B、C组疗效优于D组(P<0.05);A、B、C三组间比较C组疗效最佳(P<0.05)。四组患者各个时间点鼓膜温度无显著性差异(P>0.05)。返回病房后2h内寒战复发率C组明显低于A、B、D组(P<0.05);B、C组不良反应率比较无显著性差异(P>0.05)。结论:充气式保温毯加曲马多,对治疗全麻苏醒期寒战效果显著,不良反应少,且寒战复发率低。%Objective :To examine the effects of different interventions on shivering during general anes-thesia recovery .Methods :100 patients scheduled for elective gynecologic laparo-scopic operations ,were randomly divided into four groups .Group A was received heat protecing blanket after shivering ;Group B intravenous injection tramadol 1mg/kg ;Group C both heat protecing blanket and tramadol ;Group D intravenous injection normul suline (as a control group) .Patients were observed in terms of the degree of shivering at times before intervention (T1 ) ,5 minutes (T2 )and 15 minutes(T3 ) after interventions .The side effects、core temperature and recurrence rate of shive

  2. Flurbiprofen Axetil Injection in Preventing Restlessness During Analepsia from General Anesthesia in Functional Endoscopic Sinus Surgery%氟比洛芬酯预防鼻内镜手术苏醒期躁动的临床研究

    Institute of Scientific and Technical Information of China (English)

    曹金良; 阮骆阳; 郑英文; 许晓梦; 杨作天

    2012-01-01

    目的:评价氟比洛芬酯对鼻内镜手术患者全麻苏醒期躁动的预防作用.方法:42例ASA I-II级择期鼻内镜手术患者,随机分为试验组(麻醉开始前及手术结束前分别静脉给予氟比洛芬酯50mg,n=21);对照组(手术开始前及手术结束前静脉给予相同体积的生理盐水,n=21).观察手术时间、麻醉维持时间、清醒时间及拔管时间;监测苏醒期心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)及躁动评分、镇静评分;术后24 h随访副作用.结果:两组患者性别、年龄、体重、手术时间、拔管时间及苏醒时间差异无统计学意义;与对照组相比,试验组在术毕后各时点的HR、MAP均显著降低(P<0.05);两组患者在各观察时点的SpO2无统计学差异;试验组在各观察时点的躁动评分均显著低于对照组(P<0.05),Ramsay镇静评分均显著高于对照组(P<0.05);两组患者术后24 h内恶心呕吐发生率无明显差异.结论:静注氟比洛芬酯能安全有效预防鼻内镜手术全麻苏醒期躁动,不明显延长苏醒及拔管时间,不增加恶心呕吐发生率.%Objective: To evaluate the preventive effect of flurbiprofen axetil on restlessness during an-alepsia from general anesthesia in functional endoscopic sinus surgery. Method :42 patients with ASA grade Ⅰ-Ⅱ, undergoing selective functional endoscopic sinus surgery were randomly divided into test group and control group ( n = 21 ) : In group I, flurbiprofen axetil ( 50mg ) was administrated before anesthesia and before the end of operation. And in group II was given an equal volume of NS. HR, MAP, SpO2 , Restlessness Score, Ramsay Sedative Score were monitored and assessed during the analepsia. Adverse effects were subsequently visted after operation. Result: There is no difference in gender, age, body weight, duration of operation , time for extubation and analepsia among two groups. HR and MAP in test group were lower than that in control group ( P<0

  3. Effect of general anesthesia on voice

    Directory of Open Access Journals (Sweden)

    Balegh Hamdy

    2016-07-01

    Conclusion: Traumatic manifestations of the laryngeal structures that occur during intubation are the most common causes of postoperative dysphonia, with a tendency toward a regressive course of the resulting dysphonia. As such, it is important to establish an early diagnosis and adopt preventive measures.

  4. 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....

  5. Anesthesia for plastic reconstruction surgery of radiation injury of neck

    International Nuclear Information System (INIS)

    The management of anesthesia used in the plastic reconstruction of 18 cases of radiation injury of neck is reported. 17 cases were malignant tumor patients. After radiotherapy, their general condition was weak. The injury of neck skin and surrounding tissues was severe. Most operations were excision of the focus and repairing the wound using adjacent flap. The choice of anesthesia depended on the general condition, degree of injury and the procedure. Good pre-operative preparation, close monitoring and satisfactory airway control during operation are very important

  6. Estudo comparativo entre anestesia peridural torácica e anestesia geral em mastectomia oncológica Estudio comparativo entre la anestesia epidural torácica y la anestesia general en mastectomia oncológica Comparative study between thoracic epidural block and general anesthesia for oncologic mastectomy

    Directory of Open Access Journals (Sweden)

    Sérgio D. Belzarena

    2008-12-01

    esthetic breast surgeries but reports of its use in mastectomies with axillary exploration are very rare. The present study compared this technique with general anesthesia in oncologic surgeries of the breasts. METHODS: Forty patients were divided in two groups. The epidural group (n = 20 underwent epidural thoracic block with bupivacaine and fentanyl associated with sedation with midazolam. The other group (n = 20 underwent conventional general anesthesia with propofol, atracurium, and fentanyl, and maintenance with O2 and isoflurane. Duration of the surgery, the need for intraoperative complementation of anesthesia or sedation, and intraoperative hemodynamic parameters were recorded. In the postoperative period, length of time until discharge from the recovery room and from the hospital, severity of pain, analgesic consumption, adverse effects, and satisfaction with the anesthetic techniques were recorded. RESULTS: Both groups were similar and differences in the duration of the surgery were not observed. Complementary sedation was necessary in 100% of the patients who underwent epidural block and complementary sedation with infiltration of local anesthetic in the axilla in 15% of the patients in this group. The rate of hypertension was more frequent in the group of patients who underwent general anesthesia, while hypotension was more frequent in the epidural group. Pruritus was observed in 55% of the patients in the epidural group. Nausea (30% and vomiting (45% were more frequent in the general anesthesia group. The quality of postoperative analgesia was better in the epidural group, which also presented lower consumption of analgesics; the length hospitalization in this group was also lower. CONCLUSIONS: Epidural block has some advantages when compared with general anesthesia and can be considered an anesthesia option in oncologic mastectomies with axillary lymph node dissection.

  7. 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.

  8. Anesthesia management in a pediatric patient with Dandy-Walker syndrome

    OpenAIRE

    Çelik, Feyzi; Tüfek, Adnan; Temel, Vildan; Akdemir, Salim; Yıldırım, Zeynep Baysal; Kavak, Gönül Ölmez

    2011-01-01

    General anesthesia management of patients with Dandy-Walker syndrome is important since intubation may be difficult due to concomitant anomalies such as hydrocephalus, micrognathia and cleft palate. It should be considered that these patients may require postoperative intensive care support. In this article, anesthesia management of a patient with Dandy-Walker syndrome underwent persistent ventriculo-peritoneal shunt was presented.

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

    Science.gov (United States)

    Davis, K Rennis; Vadakkan, D Thomas; Krishnakumar, E V; Anas, A Muhammed

    2015-01-01

    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. PMID:25814803

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

    OpenAIRE

    K Rennis Davis; D Thomas Vadakkan; Krishnakumar, E. V.; A Muhammed Anas

    2015-01-01

    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.

  11. 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.

  12. Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery

    Directory of Open Access Journals (Sweden)

    Kyu-Jin Chung

    2012-09-01

    Full Text Available Background Patients have anxiety and fear of complications due to general anesthesia.Through new instruments and local anesthetic drugs, a variety of anesthetic methods havebeen introduced. These methods keep hospital costs down and save time for patients. Inparticular, the target-controlled infusion (TCI system maintains a relatively accurate level ofplasma concentration, so the depth of anesthesia can be adjusted more easily. We conductedthis study to examine whether intravenous anesthesia using the TCI system with propofol andremifentanil would be an effective method of anesthesia in breast augmentation.Methods This study recruited 100 patients who underwent breast augmentation surgeryfrom February to August 2011. Intravenous anesthesia was performed with 10 mg/mLpropofol and 50 μg/mL remifentanil simultaneously administered using two separate modulesof a continuous computer-assisted TCI system. The average target concentration was set at2 μg/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinicaleffect and vital signs. Oxygen saturation, electrocardiography, and respiratory status werecontinuously measured during surgery. Blood pressure was measured at 5-minute intervals.Information collected includes total duration of surgery, dose of drugs administered duringsurgery, memory about surgery, and side effects.Results Intraoperatively, there was transient hypotension in two cases and hypoxia in threecases. However, there were no serious complications due to anesthesia such as respiratorydifficulty, deep vein thrombosis, or malignant hypertension, for which an endotrachealintubation or reversal agent would have been needed. All the patients were discharged on theday of surgery and able to ambulate normally.Conclusions Our results indicate that anesthetic methods, where the TCI of propofol andremifentanil is used, might replace general anesthesia with endotracheal intubation in breastaugmentation surgery.

  13. Combined spinal epidural anesthesia in achondroplastic dwarf for femur surgery

    Directory of Open Access Journals (Sweden)

    Rochana Girish Bakhshi

    2011-11-01

    Full Text Available Achondroplasia is the commonest form of short-limbed dwarfism and occurs in 1:26,000- 40,000 live births. This is an autosomal dominant disorder with abnormal endochondral ossification whereas periosteal and intramembranous ossification are normal. The basic abnormality is a disturbance of cartilage formation mainly at the epiphyseal growth plates and at the base of the skull. The anesthetic management of achondroplastic dwarfs is a challenge to the anesthesiologist. Both regional as well as general anesthesia have their individual risks and consequences. We report a case of an achondroplastic dwarf in whom combined spinal epidural anesthesia was used for fixation of a fractured femur. The patient had undergone previous femur surgery under general anesthesia since he had been informed that spinal anesthesia could be very problematic. There was no technical difficulty encountered during the procedure and an adequate level was achieved with low-dose local anesthetics without any problem. Postoperative pain relief was offered for three consecutive postoperative days using epidural tramadol. We discuss the anesthetic issues and highlight the role of combined spinal epidural anesthesia with low-dose local anesthetics in this patient. This approach also helped in early ambulation and postoperative pain relief.

  14. Delayed recovery from anesthesia: A postgraduate educational review.

    Science.gov (United States)

    Misal, Ullhas Sudhakarrao; Joshi, Suchita Annasaheb; Shaikh, Mudassir Mohd

    2016-01-01

    Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important. Certain underlying metabolic disorders such as hypoglycemia, severe hyperglycemia, and electrolyte imbalance, especially hypernatremia, hypoxia, hypercapnia, central anticholinergic syndrome, chronic hypertension, liver disease, hypoalbuminemia, uremia, and severe hypothyroidism may also be responsible for delayed recovery following anesthesia. Unexpected delayed emergence after general anesthesia may also be due to intraoperative cerebral hypoxia, hemorrhage, embolism, or thrombosis. Accurate diagnosis of the underlying cause is the key for the institution of appropriate therapy, but primary management is to maintain airway, breathing, and circulation. This comprehensive review discusses the risk factors, causes, evaluation and management of delayed recovery based on our clinical experience, and literature search on the internet, supported by the standard textbooks of anesthesiology. PMID:27212741

  15. 右旋美托咪定与瑞芬太尼对全麻患者气管插管血流动力学的影响%Influence of dexmedetomidine and remifentanil on the hemodynamics of patients with tracheal intubation undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    杨文胜

    2014-01-01

    Objective To investigate the influence of dexmedetomidine and remifentanil on the hemodynamics of patients with tracheal intubation undergoing general anesthesia. Methods A total of 90 patients (ASAⅠ~Ⅱ) scheduled for general anesthesia were randomly divided into three groups (n=30), dexmedetomidine group (group D), remifentanil group (group R) and saline group (group S). Anesthesia induction was performed by total intravenous anesthesia, and maintaince was conducted by sevoflurane inhalation anesthesia. Patients in group D and group R were intravenously injected with 1μg/kg of dexmedetomidine or remifentanil 10 min before tracheal intubation respectively, while patients in group S were injected the same volume of saline. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded. Results Compared with group S, the rise ratio of blood pressure in group D and R were significantly lower, and the increase of HR after 1 min of intubation was also obviously lower (P<0.05). Conclusion Dexmedetomidine and remifentanil can stabilize the hemodynamic fluctuations caused by tracheal intubation.%目的:探讨右旋美托咪定与瑞芬太尼对全身麻醉(全麻)患者气管插管血流动力学的影响。方法择期全麻手术患者90例, ASAⅠ~Ⅱ级,随机分为三组,每组30例:右旋美托咪定组(D组)、瑞芬太尼组(R组)及生理盐水组(S组)。麻醉诱导采用全凭静脉麻醉,维持采用七氟醚吸入麻醉。D组及R组患者于插管前10 min分别静脉输注1μg/kg右旋美托咪定及瑞芬太尼, S组则静脉输注等容积生理盐水。记录患者收缩压(SBP)、舒张压(DBP)及心率(HR)。结果与S组相比, D组及R组患者插管后血压上升比率显著减少,且插管后1 min心率上升幅度也显著降低(P<0.05)。结论右旋美托咪定与瑞芬太尼可用于稳定气管插管引起的血流动力学波动。

  16. Anestesia peridural contínua com ropivacaína a 0,2% associada a anestesia geral para cirurgia do abdômen superior em crianças Anestesia peridural contínua con ropivacaína a 0,2% asociada a anestesia general para cirugía del abdomen superior en niños Continuous epidural anesthesia with 0.2% ropivacaine associated to general anesthesia for upper abdominal surgery in children

    Directory of Open Access Journals (Sweden)

    Jyrson Guilherme Klamt

    2003-04-01

    el grupo Propofol, sin embargo, la intensidad y duración de la sedación fueron mayores en ese grupo en relación al grupo Sufentanil. Los escores de recuperación fueron similares en los dos grupos. Después de 3 horas en la SRPA, todos los pacientes habían llegado a los criterios de transferencia para las enfermarías. Hipotensión arterial transitoria fue observada en 2 pacientes del grupo Sufentanil. CONCLUSIONES: La combinación de la anestesia peridural torácica continua con ropivacaína a 0,2% (1,5 ml.kg-1 asociada a la infusión de propofol promueve anestesia efectiva y segura para cirugías abdominales altas en niños. El ritmo de infusión de propofol y el tiempo de sedación fueron reducidos con la adición de sufentanil.BACKGROUND AND OBJECTIVES: Several anesthetic techniques have been proposed for different pediatric surgeries to promote postoperative analgesia, among other advantages. This study aimed at evaluating propofol infusion rate and postanesthetic recovery of children submitted to upper abdominal surgeries under epidural anesthesia with 0.2% ropivacaine associated to general anesthesia with propofol or propofol plus sufentanil. METHODS: Participated in this study 26 children physical status ASA I, II and III, aged 0 to 4 years, were scheduled to upper abdominal surgeries under thoracic epidural anesthesia (T7-T8 with 0.2% ropivacaine (1.5 ml.kg-1. They were randomly distributed in two groups: Propofol (propofol infusion and Sufentanil (propofol infusion plus 1 µg.kg-1 sufentanil. Propofol infusion rates were 20 and 10 mg.kg-1.h-1 for the Propofol and Sufentanil groups, respectively, adjusted to maintain blood pressure in approximately 20% of baseline values and withdrawn 10 to 15 minutes before estimated surgery completion. Postanesthetic recovery was evaluated by a modified Aldrete-Kroulik scale and sedation was evaluated by a 5 grade score. RESULTS: Techical difficulties excluded two children of each group. Infusion rate was significantly

  17. The effect of tetracaine jelly on hemodynamics during extubation period in general anesthesia%丁卡因胶浆对全身麻醉拔管期血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    慕玲霞; 刘斐; 孙鹏

    2014-01-01

    Objective To study the effect of tetracaine jelly on hemodynamics during extubation period in general anesthesia.Methods One hundred patients who performed tracheal cannula and general anesthesia were divided into control group (50 patients) and experiment group (50 patients) by random digits table method.Control group:sterile paraffin oil was applied to the endotracheal tube.Experiment group:tetracaine jelly was applied to the endotracheal tube.The systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate(HR) were measured before the anesthesia induction(T1),5 min after stopping infusion drugs (T2),1 min after tracheal extubation (T3),3 min after tracheal extubation (T4) and 5 min after tracheal extubation (T5) were observed.The resistant effect after waking and the number of sore throat,hoarseness were recorded.Results The level of SBP,DBP,HR at T1 and T2 had no significant difference between two groups (P > 0.05).The level of SBP,DBP,HR at T3-T5 in experiment group were significantly lower than those in control group [SBP:(122.3 ± 11.3),(120.0 ± 9.8),(112.0 ± 6.3) mmHg (1 mmHg =0.133 kPa) vs.(158.3 ± 15.0),(142.5 ± 13.5),(133.0± 14.5) mmHg;DBP:(75.0 ± 13.5),(75.8 ± 10.5),(58.3 ±4.2) mmHg vs.(111.0 ± 20.3),(106.5 ± 12.8),(63.8 ± 15.8) mmHg;HR:(81.9 ± 13.7),(83.6 ± 13.4),(60.7 ± 3.5) times/min vs.(113.5 ± 19.4),(117.5 ± 21.7),(71.8 ± 14.6) times/min](P < 0.05).The total effective rate of tolerance in experiment group was higher than that in control group [96%(48/50) vs.56%(28/50)],the rate of sore throat and hoarseness were lower than those in control group [6% (3/50) vs.48% (24/50),4% (2/50) vs.36% (18/50)],there were significant differences (P < 0.05).Conclusion Tetracaine jelly can reduce the cardiovascular response of tracheal extubation,enhance the tolerance of tracheal tube and decrease the morbidity of sore throat and hoarseness.%目的 研究丁卡因胶浆对全身麻醉拔管期

  18. Comparative Study of Invasive Blood Pressure and Non-invasive Blood Pressure in General Anesthesia%全身麻醉患者无创血压与有创血压的对比研究

    Institute of Scientific and Technical Information of China (English)

    徐鑫; 吴廷丽; 马正良; 顾小萍

    2015-01-01

    Objective To investigate the differences of invasive blood pressure( IBP) and non-invasive blood pressure( NIBP) in general anesthesia.Methods Eighty-two patients undergoing general anesthesia were divided into four groups depending on invasive systolic blood pressure (ISBP):group A, ISBP≤90mmHg;group B,ISBP 90-120 mmHg;group C, ISBP 120-150mmHg;group D, ISBP>150mmHg.Non-invasive blood pressure and arterial blood pressure was monitored at the same time.Bilateral NIBP and IBP val-ues were compared by paired t-test and linear correlation analysis.Results There was no significant difference between bilateral NIBP of four groups.Invasive systolic blood pressure was lower than bilateral non-invasive systolic blood pressure in group A (P0.05).Arterial diastolic blood pressure was sig-nificantly lower than bilateral non-invasive diastolic blood pressure in group B and C.There was significant correlation between arterial systolic blood pressure and bilateral non-invasive systolic blood pressure (r=0.940,P<0.01).There was significant correlation be-tween arterial diastolic blood pressure and bilateral non-invasive diastolic blood pressure (r=0.925,P<0.01).Conclusion There was significant difference and correlation between arterial blood pressure and non-invasive blood pressure.Arterial blood pressure can be estimated by non-invasive blood pressure in certain blood pressure range.%目的:探讨全身麻醉患者双侧肱动脉无创血压( NIBP)与桡动脉有创动脉压( IBP)的关系。方法于全身麻醉下进行手术的患者82例,麻醉诱导前后及术中同步测量双侧无创血压及有创血压,根据有创收缩压值( ISBP)大小分为A组( ISBP≤90mmHg)、B组(90mmHg<ISBP≤120mmHg)、C组(120mmHg<ISBP≤150mmHg)和D组(ISBP>150mmHg)。对各组数值进行差异分析,并对有创血压和无创血压值做线性相关分析。结果4组患者双侧无创血压无统计学差异(P>0.05);A组有创

  19. 双腔支气管插管全麻术后与中医气虚证关系的初步研究%Dual chamber bronchial intubation with TCM deficiency syndrome after general anesthesia relationship verin

    Institute of Scientific and Technical Information of China (English)

    杨航; 杨晶欣

    2011-01-01

    Objective: To observe the clinical manifestations and by related laboratory explore dual chamber bronchial intubation with TCM deficiency syndrome after general anesthesia the relationship between them. Methods: selection dual chamber bronchial intubation general anesthesia operation cases respectively, 30 cases in preoperative and postoperative 1, 4, 7, 14 acquisition peripheral blood lymphocyte subsets, determination, CD3++/CD3 CD4+, CD3+/CD8+, CD4/CD8, CD19, NK, Postoperative daily rounds, record its cough, sputum, pale and pulses situation and duration. Results: Compared with the results of preoperative and postoperative 1 d (T1) patients, 3 d (T2), 7 d (T3), 14 d (T4) achroacyte subgroup are declined obviously (P<0.05),CD19 and NK cells are rising, CD3+, CD3+/CD4+, CD4/CD8, cells in postoperative 7 d than postoperative 3 d, 1 d somewhat increases, this degree basic recovered to preoperative level, postoperative 14 days, CD3++/CD3 CD4+, CD4/CD8 level slightly above preoperative levels, CD3+/CD8+ level did not see increased significantly. Including cough, cough up phlegm, complexion is pale white and pulse, such as low lung qi difficiency loss the clinical manifestations of 14 days after surgery can be obviously improved. Conclusion: double cavity bronchial after the operation, the patient appears cough, sputum, complexion is pale white and pulse, such as low clinical manifestations, similar to the category of TCM deficiency syndrome. TCM holds that "evil shall not, within the auror save dry; evil which gather together, its gas will virtual". Visible modern medicine china-africa specificity immunity may be relegated to traditional Chinese medicine "gas" category. Dual chamber bronchial postoperation patients nonspecific immunity laboratory examination index dropped, and related the patient appears the clinical manifestations of TCM deficiency syndrome may be relegated to the category. Achroacyte subgroup postoperative seven days, the patient lung qi

  20. Permutation auto-mutual information of electroencephalogram in anesthesia

    Science.gov (United States)

    Liang, Zhenhu; Wang, Yinghua; Ouyang, Gaoxiang; Voss, Logan J.; Sleigh, Jamie W.; Li, Xiaoli

    2013-04-01

    Objective. The dynamic change of brain activity in anesthesia is an interesting topic for clinical doctors and drug designers. To explore the dynamical features of brain activity in anesthesia, a permutation auto-mutual information (PAMI) method is proposed to measure the information coupling of electroencephalogram (EEG) time series obtained in anesthesia. Approach. The PAMI is developed and applied on EEG data collected from 19 patients under sevoflurane anesthesia. The results are compared with the traditional auto-mutual information (AMI), SynchFastSlow (SFS, derived from the BIS index), permutation entropy (PE), composite PE (CPE), response entropy (RE) and state entropy (SE). Performance of all indices is assessed by pharmacokinetic/pharmacodynamic (PK/PD) modeling and prediction probability. Main results. The PK/PD modeling and prediction probability analysis show that the PAMI index correlates closely with the anesthetic effect. The coefficient of determination R2 between PAMI values and the sevoflurane effect site concentrations, and the prediction probability Pk are higher in comparison with other indices. The information coupling in EEG series can be applied to indicate the effect of the anesthetic drug sevoflurane on the brain activity as well as other indices. The PAMI of the EEG signals is suggested as a new index to track drug concentration change. Significance. The PAMI is a useful index for analyzing the EEG dynamics during general anesthesia.

  1. High Satisfaction with Problem-Based Learning for Anesthesia.

    Directory of Open Access Journals (Sweden)

    Chia-Hung Chang

    2004-09-01

    Full Text Available Background: The aim of this study was to compare students' satisfaction between problem-based learning (PBL and lecture-based traditional teaching of anesthesia.Methods: One hundred and thirty-seven fifth-year medical students were enrolled in acourse which used a hybrid curriculum for teaching about anesthesia. Thehybrid curriculum included 9 essential lectures and 3 related PBL case discussions.A Linkert 5-point scale was used for to assess students' satisfactionlevels between PBL and lecture-based traditional teaching. Data were collectedthrough a year-end questionnaire over 2 academic years from 2002 to2003. Scores regarding the satisfaction levels between these 2 teaching methodswere analyzed using a 2-sided paired t-test.Results: Most students preferred PBL over the lecture-based traditional teaching inthe following 6 aspects: learning about anesthesia, understanding other medicalknowledge, being interested in and motivated to learn, training for futurework, training of personal abilities, and being confident and satisfied withthe teaching method ( p<0.05. However, traditional teaching was superiorto PBL in enhancing the speed of learning with greater understanding of abasic knowledge of anesthesia, as well as in providing more solid contentwith understanding of a greater number of anesthetic techniques ( p<0.05.Satisfaction levels with this curriculum did not generally differ between studentsenrolled in different classes in 2002 and 2003.Conclusions: Although the assessment tools and content of PBL need to be modified,implementation of PBL for teaching anesthesia showed satisfactory results.

  2. Cortico-cardio-respiratory network interactions during anesthesia.

    Directory of Open Access Journals (Sweden)

    Yuri Shiogai

    Full Text Available General anesthetics are used during medical and surgical procedures to reversibly induce a state of total unconsciousness in patients. Here, we investigate, from a dynamic network perspective, how the cortical and cardiovascular systems behave during anesthesia by applying nonparametric spectral techniques to cortical electroencephalography, electrocardiogram and respiratory signals recorded from anesthetized rats under two drugs, ketamine-xylazine (KX and pentobarbital (PB. We find that the patterns of low-frequency cortico-cardio-respiratory network interactions may undergo significant changes in network activity strengths and in number of network links at different depths of anesthesia dependent upon anesthetics used.

  3. Accidently Discovered Postpartum Pituitary Apoplexy after Epidural Anesthesia

    Directory of Open Access Journals (Sweden)

    Rafik Sedra

    2014-11-01

    Full Text Available Anesthetic consideration of obstetric patients with pituitary disorders is an important topic to deal with. Few cases were reported with accidently discovered pituitary tumor complications especially in the postpartum period. A 26 years old primigravida lady with 39 weeks gestational period was reported to have severe headache and sudden loss of conscious after normal vaginal delivery with lumbar epidural anesthesia. Accidently discovered pituitary adenoma was proved after neurology, endocrine and ophthalmology consultations. Hence, undiagnosed pituitary adenomas should be taken in to consideration with unexplained postpartum generalized weakness and loss of conscious especially after exclusion of epidural anesthesia complications.

  4. 足部穴位艾灸对妇科全麻患者术后寒战和足温恢复的影响%Effects of Foot Moxibustion on Recovery of Shivering and Foot Skin Temperature Following General Anesthesia in Gynecological Patients

    Institute of Scientific and Technical Information of China (English)

    陈改平; 杨郁文; 汪永坚; 韩淼

    2014-01-01

    [目的]探讨艾灸足部穴位促进妇科全麻患者术后寒战和足背皮肤温度恢复的效果。[方法]将86例妇科全麻术后低体温和足部皮肤低温的患者,随机分为对照组与观察组。对照组采用常规保暖,观察组在常规保暖的基础上,给予艾灸。观察记录足温及寒战变化情况。[结果]与对照组比较,观察组患者术后足温恢复及寒战缓解所需时间均明显缩短(P<0.01)。[结论]艾灸足部穴位能有效地促进妇科全麻患者术后足温恢复及寒战缓解。%Objective]To study any possible effects of foot moxibustion on recovery of shivering and foot skin temperature fol owing general anesthesia in gynecological patients. [Methods]86 gynecological patients with postoperative hypothermia and low foot skin temperature fol owing general anesthesia were randomly divided into control group and experimental group. Patients in control group received conventional thermal treatment. The experimental group received foot moxibustion in addition to conventional thermal. Any changes in foot skin temperature and shivering were observed and recorded. [Results] Compared with the control group, significantly shortened foot skin temperature recovery and shivering remission time( P<0.01) were obtained in experimental group. [Conclusion]Foot moxibustion can effectively promote the recovery of foot skin temperature and al eviation of shivering in gynecological patients undergone general anesthesia.

  5. 76 FR 16796 - Pediatric Anesthesia Safety Initiative (PASI)

    Science.gov (United States)

    2011-03-25

    ... population databases for cognitive developmental effects where exposure to general anesthesia before the age... regarding the effects of anesthetics and sedatives in the pediatric population. The output from PASI will.... Therefore, numerous non-clinical and clinical studies are needed to assess the effect of anesthetics...

  6. 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. PMID:11217462

  7. 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...... 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 by...

  8. Anesthesia for Children Having Eye Surgery

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Anesthesia for Children Having Eye Surgery En Español Read in Chinese What kinds of anesthesia are available for children having eye surgery? There ...

  9. Anesthesia for Adults Having Eye Surgery

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Anesthesia for Adults Having Eye Surgery En Español What kinds of anesthesia are available for adults having eye surgery? A “ ...

  10. Comparison of dexmedetomidine versus lidocaine for suppression of fentanyl-induced coughing during induction of general anesthesia%右美托咪定与利多卡因抑制芬太尼诱发全麻诱导期患者呛咳反应效果的比较

    Institute of Scientific and Technical Information of China (English)

    戴东升; 邱良诚; 吴晓丹; 陈彦青

    2013-01-01

    Objective To compare dexmedetomidine versus lidocaine for suppression of fentanyl-induced coughing during induction of general anesthesia in patients.Methods Two hundred ASA physical status Ⅰ or Ⅱ patients,aged 36-50 yr,undergoing elective gynecological operations under total intravenous anesthesia,were randomized into 2 groups (n =100 each):dexmedetomidine group (group D) and lidocaine group (group L).Dexmedetomidine 0.5 μg/kg was intravenously infused over 10 min at a rate of 0.05 μg· kg-1· min-1 starting from 20 min before induction of anesthesia in group D.Lidocaine 0.5 mg/kg was injected intravenously at 1 min before induction of anesthesia in group L.For induction of anesthesia,fentanyl was given first,and 2 min later the other drugs were given.The development and degree of coughing were recorded within 1 min after fentanyl injection.The occurrence of adverse events was recorded.Results The incidence of coughing was significantly higher and the degree of coughing was severer in group L than in group D (P < 0.05).There was no signihicant difference in the incidences of hypotension and severe sinus bradycardia between groups D and L (P > 0.05).Conclusion Dexmedetomidine 0.5 μg/kg injected before induction of anesthesia has better suppressive effect on fentanyl-induced coughing during induction of general anesthesia than lidocaine 0.5 mg/kg in patients.%目的 比较右美托咪定与利多卡因抑制芬太尼诱发全麻诱导期患者呛咳反应的效果.方法 择期妇科手术患者200例,ASA分级Ⅰ或Ⅱ级,年龄36 ~ 50岁,均采用全凭静脉麻醉,采用随机数字表法,将其分为2组(n=100):右美托咪定组(D组)和利多卡因组(L组).D组于麻醉诱导前20min静脉输注右美托咪定0.5 μg/kg,输注速率0.05 μg·kg-1· min-1,L组于麻醉诱导前1 min缓慢静脉注射利多卡因0.5 mg/kg.麻醉诱导最先使用芬太尼,2 min后给予其他诱导药物,记录注射芬太尼后1 min内呛咳反应的发生情况

  11. Caudal anesthesia in a patient with peritonitis: Is it safe??

    Science.gov (United States)

    Kako, H; Hakim, M; Kundu, A; Tobias, T D

    2016-01-01

    Neuraxial anesthesia combined with general anesthesia has become a widely accepted method of providing effective postoperative analgesia and decreasing intraoperative anesthetic needs in the pediatric population. In clinical practice, there still appears to be hesitancy for the use of a neuraxial technique (spinal or epidural) in patients at risk for bacteremia or with an on-going systemic infection. However, evidence-based medicine lacks any data to support an increase in the risk of infectious complications following neuraxial anesthesia. We present two pediatric patients with intra-abdominal infectious processes who received caudal epidural blockade for postoperative operative analgesia. The use of neuraxial techniques in patients at risk for bacteremia is reviewed, evidence-based medicine regarding the risks of infection discussed, and the potential favorable effects of neuraxial blockade on the neurohumoral response to sepsis and the systemic inflammatory responses presented. PMID:27051378

  12. 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

  13. 21 CFR 868.6700 - Anesthesia stool.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia stool. 868.6700 Section 868.6700 Food... DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6700 Anesthesia stool. (a) Identification. An anesthesia stool is a device intended for use as a stool for the anesthesiologist in the operating room....

  14. GESTATIONAL OBESITY AS A DETERMINANT OF GENERAL ANESTHESIA TECHNIQUE FOR CAESAREAN DELIVERY: A CASE REPORT Obesidad en la gestación como determinante de técnica anestésica general para cesárea: reporte de caso

    Directory of Open Access Journals (Sweden)

    José Ricardo Navarro-Vargas

    2009-01-01

    Full Text Available Background. The incidence of obesity has undergone a dramatic increase around the world during the last few years. Such epidemic behavior has been associated with obstetric patient’s frequent presentation of different stages of obesity when undergoing anesthetic procedure. Obesity in pregnant women involves the risk of adverse maternal and fetal outcomes. Hypertension and preeclampsia, diabetes, fetal macrosomia, caesarean delivery, difficult airway management and neuroaxial techniques are more likely to be performed in this group of patients. Materials and methods. This is a case report of a morbid obese patient scheduled for caesarean delivery and tubal ligation. Regional, spinal and epidural techniques were attempted for surgery with unsuccessful results; this entails general anesthesia for surgery. The literature on complications due to obesity during pregnancy was reviewed, emphasising relevance for the anesthesiologist. Conclusion.Obesity, especially morbid obesity in pregnant women, represents a challenge for anesthesia management. Updated knowledge of physiology and the conditions related to obesity in pregnancy is necessary; medical services must be prepared to provide optimum and safe obstetric anesthesia, analgesia and post-operation care.Antecedentes. La incidencia de obesidad ha tenido un incremento importante en los últimos años a nivel global. Este comportamiento epidémico ha llevado a la presentación cada vez más frecuente de pacientes obstétricas con diversos grados de obesidad para procedimientos anestésicos. La obesidad en la paciente gestante tiene asociación con desenlaces adversos maternos y fetales, incremento en el riesgo de hipertensión y trastornos hipertensivos, diabetes, macrosomía fetal, nacimiento por cesárea, además de dificultad para realizar técnicas neuroaxiales y para el manejo de la vía aérea. Material y métodos.Este es un reporte de caso de una paciente obesa extrema programada para ces

  15. Required propofol dose for anesthesia and time to emerge are affected by the use of antiepileptics: prospective cohort study

    OpenAIRE

    OUCHI, Kentaro; SUGIYAMA, Kazuna

    2015-01-01

    Background We investigated the impact of the type of neurological disorder on the required propofol dose for anesthesia and the time to emerge from anesthesia during dental treatment in patients with autism (AU), cerebral palsy (CP), and intellectual disability (ID), some of whom also had epilepsy. Methods We studied 224 patients with a neurological disorder who underwent dental treatment under intravenous general anesthesia. Patients were categorized according to neurological disorder (AU, C...

  16. Efeito da anestesia geral na cognição e na memória do idoso Efecto de la anestesia general en la cognición y memoria del paciente de edad avanzada Effects of general anesthesia in elderly patients’ memory and cognition

    Directory of Open Access Journals (Sweden)

    Régis Borges Aquino

    2004-10-01

    en el post operatorio de paciente com edad 60 a 80 años de ambos los sexos, sometidos a la anestesia general con duración de 3 a 7 horas.BACKGROUND AND OBJECTIVES: General anesthesia and mental function have been subject to studies and considerations, especially for the feeling that, especially in the elderly, it could induce changes in cognition and memory. This study aimed at evaluating the effects of general anesthesia in cognition and memory of elderly patients, correlating them to gender, age and anesthesia duration. METHODS: This is a cohort, controlled study with patients divided in two observation groups: a - anesthetic; b - clinical (control. Outcome variables studied were Mini-mental test, Verbal Fluency test and Numeric Remembrance test scores; general anesthesia with halothane, isoflurane, sevoflurane, thiopental, propofol, etomidate, fentanyl, alfentanil, succinylcholine, atracurium and pancuronium; intraoperative period with PaCO2 30 to 45 mmHg, hemoglobin saturation above 90% and blood pressure tolerance with up to 20% decrease as compared to baseline. Patients presenting any intra and postoperative adverse event were excluded from the study. Chi-square test was used for categorical data. Student’s t test for independent samples was used for initial comparison between groups at baseline moment (preanesthetic. Analysis of variance (ANOVA for repeated measures was used to evaluate anesthetic process effects along time. RESULTS: Groups were similar in the Mini-Mental test with increased scores along time. Both groups had virtually unchanged Verbal Fluency test scores. Both groups were very similar in Numeric Remembrance test with increased scores in both groups. CONCLUSIONS: No postoperative cognition or memory decline has been observed in patients of both genders, aged 60 to 80 years, submitted to general anesthesia lasting 3 to 7 hours.

  17. Intestinal circulation during inhalation anesthesia

    International Nuclear Information System (INIS)

    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 86Rb and 9-microns spheres labeled with 141Ce 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 (AVDO2) 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

  18. Periocular Anesthesia in Aesthetic Surgery

    OpenAIRE

    Skibell, Bentley C.; Soparkar, Charles N.S.; Tower, Robert N.; Patrinely, James R.

    2007-01-01

    This article focuses on the administration of anesthesia for periocular aesthetic procedures. Special emphasis is given to office-based procedures, most often without any systemic sedation, highlighting the importance of open communication with patients. Finally, attention is given to potential pitfalls including anesthetic systemic toxicity, ocular injuries, and orbicularis myotoxicity.

  19. The comparison of Alfentanil and Remifentanil infusion during anesthesia on post-anesthesia recovery

    Directory of Open Access Journals (Sweden)

    Masood Entezariasl

    2012-01-01

    Full Text Available Background and Objective: With consideration the daily increased development of outpatient surgeries and high rate of these surgeries in elderly patients, rapid and safe recovery of patients is necessary. In this clinical trial study, recovery time and nausea and vomiting after the use of two rapid-onset narcotics, Alfentanil and Remifentanil, in elderly patients were evaluated. Methods: In this double-blind prospective clinical trial, 40 elderly patients (age above 65 years candidate to cataract surgery with general anesthesia were studied. The patients were divided randomly into two groups and for first group, 10 μg/kg of Alfentanil was injected and for second group Remifentanil 0.5 μg/kg was injected intravenously during 30 seconds one minute before induction. Both two groups were under general anesthesia with same method and during the anesthesia, first group took infusion of Alfentanil 1 μg/kg/min and second group took Remifentanil 0.1 μg/kg/min. In the end of surgery, the time intervals between end of anesthesia drug administration and spontaneous respiration, eyes opening with stimulation, verbal response and discharge of recovery room, also the incidence of complications related to narcotic drugs, especially nausea and vomiting, was recorded. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test and chi square test. Results: The time of spontaneous respiration in Alfentanil group was 2 minutes and in Remifentanil group was 3.3 minutes, the difference was not statistically significant (P=0.08. The time of eyes opening with stimulation, verbal response, and discharge of recovery room were not significantly different. During recovery, incidence of nausea and vomiting in Remifentanil group (30% of patients was significantly more than Alfentanil group (5% of patients (P=0.045. Conclusions: Recovery time between Alfentanil and Remifentanil group was not significantly different, but incidence of

  20. History of anesthesia in Germany.

    Science.gov (United States)

    Wawersik, J

    1991-01-01

    The first ether anesthetic was administered in Germany by J.F. Heyfelder (1798-1869) at the Erlangen University Hospital on January 24, 1847. Thereafter, famous discoveries occurred in the field of pharmacology. Albert Niemann isolated cocaine from the coca shrub in 1860; Emil Fischer synthesized the first barbiturate, Veronal, in 1902; and Helmut Weese promoted the first ultra-short-acting barbiturate, hexobarbital (Evipan), in 1932. The local anesthetic effect of cocaine was reported by Koller at the Congress of the German Society for Ophthalmology on September 15, 1884, in Heidelberg. Many new techniques were tried first in German hospitals. Friedrich Trendelenburg carried out, by tracheotomy, the first operation with endotracheal intubation in 1869, and Franz Kuhn promoted and clinically practiced endotracheal intubation in Heidelberg beginning in 1900. August Bier performed the first operation under spinal anesthesia at the Kiel University Hospital on August 16, 1898. Carl Ludwig Schleich (1859-1922) standardized the methods of infiltration anesthesia by using a cocaine solution in sufficient dilution. The development of anesthesia machines was greatly influenced by Heinrich Dräger (1847-1917) and his son Bernhard Dräger (1870-1928). The Dräger Company in Lübeck built the first anesthesia machine with a carbon dioxide (CO2) absorber and circle system in 1925. Paul Sudeck and Helmut Schmidt worked with this system at the Hamburg University Hospital and reported their results in 1926. The first Dräger anesthesia machine was produced in 1902 and introduced into clinical use by Otto Roth (1863-1944) in Lübeck. Before the Second World War, three universities in Germany carried out research in the field of anesthesia: the University of Freiburg with H. Killian, the University of Hamburg with P. Sudeck and H. Schmidt, and the University of Würzburg with C.G. Gauss. Killian and Gauss established the first journals, Der Schmerz and Narkose und Anaesthesie, in

  1. 不同全麻对非心脏手术患者术后认知功能影响的比较%Comparison of effects of different methods of general anesthesia on postoperative cognitive function in patients undergoing non-cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    方开云; 朱焱; 尚杰

    2014-01-01

    Objective To compare the effects of different methods of general anesthesia on postoperative cognitive function in patients undergoing non-cardiac surgery.Methods One thousand ASA Ⅰ or Ⅱ patients,aged 18-60 years and undergoing non-cardiac surgery,were randomly divided into five groups (n=200 each):isoflurane + propofol + fentanyl group (group IPF),isoflurane + remifentanil group (group IR),sevoflurane + propofol + fentanyl group (group SPF),sevoflurane + remifentanil group (group SR),and propofol + remifentanil group (group PR).Two hundred patients receiving non-operative treatment served as control group (group C).In groups IPF and SPF,anesthesia was maintained with inhalation of 1.68% isoflurane or 1.71% sevoflurane,target controlled infusion (TCI) of propofol with the target plasma concentration of 2-5 μg/ml,and intermittent intravenous boluses of fentanyl.In groups IR,SR and PR,anesthesia was maintained with inhalation of 1.68% isoflurane or 1.71 % sevoflurane,or TCI of propofol with the target plasma concentration of 2-5 μg/ml,and TCI of remifentanil with the target plasma concentration of 2-6 ng/ml.The patients' cognitive function was assessed with minimental state examination (MMSE) 1 day before operation,when leaving the post-anesthetic care unit (PACU),and 1 and 3 days after operation,respectively.Z score was used to identify the cognitive dysfunction as recommended by Moiler when leaving the PACU,and 1 and 3 days after operation.Results Compared with group C,the MMSE score was significantly decreased when leaving the PACU,and the incidence of cognitive dysfunction increased when leaving the PACU and 1 day after operation in the other groups (P < 0.05).Compared with groups IPF,IR,SPF and PR,the incidence of cognitive dysfunction was significantly increased in group SR (P<0.05).Conclusion General anesthesia with sevoflurane combined remifentanil exerts fewer effects on the postoperative cognitive function in patients undergoing non

  2. 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.

  3. Inverse zombies, anesthesia awareness, and the hard problem of unconsciousness.

    Science.gov (United States)

    Mashour, George A; LaRock, Eric

    2008-12-01

    Philosophical (p-) zombies are constructs that possess all of the behavioral features and responses of a sentient human being, yet are not conscious. P-zombies are intimately linked to the hard problem of consciousness and have been invoked as arguments against physicalist approaches. But what if we were to invert the characteristics of p-zombies? Such an inverse (i-) zombie would possess all of the behavioral features and responses of an insensate being, yet would nonetheless be conscious. While p-zombies are logically possible but naturally improbable, an approximation of i-zombies actually exists: individuals experiencing what is referred to as "anesthesia awareness." Patients under general anesthesia may be intubated (preventing speech), paralyzed (preventing movement), and narcotized (minimizing response to nociceptive stimuli). Thus, they appear--and typically are--unconscious. In 1-2 cases/1000, however, patients may be aware of intraoperative events, sometimes without any objective indices. Furthermore, a much higher percentage of patients (22% in a recent study) may have the subjective experience of dreaming during general anesthesia. P-zombies confront us with the hard problem of consciousness--how do we explain the presence of qualia? I-zombies present a more practical problem--how do we detect the presence of qualia? The current investigation compares p-zombies to i-zombies and explores the "hard problem" of unconsciousness with a focus on anesthesia awareness. PMID:18635380

  4. 婴幼儿时期麻醉手术对儿童智力和感觉统合能力的远期影响%Long-term effects of early exposure to general anesthesia and surgery on children' s development of intelligence and sensory integration function

    Institute of Scientific and Technical Information of China (English)

    李纯青; 王东信; 马旭波; 朱赛楠

    2012-01-01

    [Objective]To investigate the long-term effects of early exposure to general anesthesia and surgery on children' s development of intelligence and sensory integration function.[Methods] This was a 1 ∶ 1matched case-control study.Children who lived in Beijing urban area,underwent non-cardiac/non-neurosurgical surgery under general anesthesia before 3 years of age,aged 6 to 8 years at the time of assessment were enrolled as anesthesia group.Children,who lived in the same area but did not undergo general anesthesia and surgery before 3years of age,were matched according to children's age,sex,educational level,as well as parents' educational background,occupation,socioeconomic status and enrolled in the control group.The Wechsler Intelligence Scale for Children-fourth edition( Chinese version)and the Child Sensory Integration Check List were used to evaluate the intelligence and sensory integration function of the two groups of children.Resnlts There were no significant differences between two groups with respect to full scale Intelligence Quotient( 113.6 ± 10.4 vs.114.6 ±9.9,P=0.524 ) as well as Verbal Comprehension Index( 111.0 ± 11.3 vs.112.7 ± 10.3,P=0.320),Perceptual Reasoning Index(113.4 ±12.1 vs.114.3 ±10.4,P=0.631),Working Memory Index(109.6 ± 13.6 vs.109.4 ±10.1,P=0.896),Processing Speed Index( 105.9 ± 9.7 vs.107.7 ± 10.5,P=0.199 ),General Ability Index ( 114.4 ± 11.3vs.115.3 ±11.3,P=0.852)and Cognitive Productive Index(110.1 ± 10.9 vs.110.4 ±9.2,P=0.882).In terms of intelligence structure,the incidence of clinically meaningful difference between indexes of Working Memory and Verbal Comprehension was significantly higher in the anesthesia group than in the control group(7.4% vs.0,P=0.038 ).There was no significant difference in the incidence of sensory integration dysfunction between two groups (46.9% vs.45.7%,P=0.875 ).However,among children in the anesthesia group,the incidence of vestibule balance dysfunction was significantly

  5. 全身麻醉联合7%的利多卡因气雾剂在支撑喉镜下声带手术中的应用%The application of 7% lidocaine aerosol in general anesthesia of laryngoscope vocal surgery

    Institute of Scientific and Technical Information of China (English)

    刘静; 杨春艳; 李婷

    2015-01-01

    Objective To observed the effection of 7% lidocaine aerosol in general anesthesia of laryngoscope vocal surgery.MethodsSixty ASAⅠ-Ⅱ male patients whos age 40 to 75 undergoing surgery of vocal cord were randomly divided into two groups: Grope A (n=30) the general group.Grope B (n=30)the 7% lidocaine aerosol combin with general anesthesia.Recorded the SBP、DBP、HR before induction of anesthesia(T1).After intubation before into the laryngoscope(T2).Into the laryngoscope immediately(T3) Extubation(T4).5 minites after extubation(T5)and the spontaneous brething,eye opening,extubation time of the end of surgery and the doses used foanaesthesia.Results SBP、DBP、HR in GropeA were significantly more than before induction of anesthesia than insert the laryngoscope immediately and before intubation(P<0.05); Grope A were significantly more than Grope B of the anesthetics (P<0.05)Grope B were significantly less than Grope B of the time extubation and recoveration.Conclution The method of 7% lidocaine aerosol in general anesthesia of laryngoscope vocal surgery is simple.It can significantly relieve of cardiovascular effect.It had highly quality of waking.%目的 观察全身麻醉复合7%的利多卡因气雾剂在支撑喉镜下声带手术中的效果.方法 选择60例择期在支撑喉镜下行声带手术的患者,年龄40~75岁,ASAⅠ~Ⅱ.随机分为全身麻醉组(A组),全身麻醉复合7%的利多卡因气雾剂组(B组)各30例.记录诱导前(T1)、插管后上镜前(T2)、上镜后即刻(T3)、拔管时(T4)、拔管后5min(T5)SBP、DBP、HR,以及手术结束后首次自主呼吸出现时间、睁眼时间、气管导管拔除时间、全麻药用量.结果 A组的SBP、DBP、HR在插管后,置入支撑喉镜时,拔管前都明显高于诱导前(P<0.05);术中全麻药用量A组明显多于B组(P<0.05);B组术毕的拔管时间、苏醒时间明显短于A组(P<0.05).结论 全身麻醉联合7%的利多卡因气雾剂用于支撑喉镜下声带手术方法

  6. 舒芬太尼联合曲马多对全麻苏醒期躁动与寒战的预防作用%Preventive Effects of Sufentanil Combined with Tramadol on Agitation and Shivering of Patients with General Anesthesia during Recovery Period

    Institute of Scientific and Technical Information of China (English)

    许先成; 冯慧; 柯昌斌

    2011-01-01

    Objective To observe the preventive effects of sufentanil combined with tramadol on agitation and shivering of patients with general anesthesia during recovery period. Methods One hundred and twenty patients underwent general anesthesia with the same way were randomly divided into sufentanil group (group S), sufentanil combined with tramadol group (group ST) ,tramadol group(group T) and control group(group C) ,n =30. The four groups were given intravenous injection with sufentanil (0. 15 μg · kg - 1 ), sufentanil ( 0. 1 μg · kg - 1 ) combined tramadol ( 1 mg· kg - 1 ), tramadol ( 2 mg·kg-1) ,equal volum of physiological saline at 30 min before operation termination,respectively. The incidence of agitation and shivering in patients were recorded during recovery from general anesthesia by a single blind method. Results Compared with group C,the incidence of agitation and shivering in the other three groups were decreased as well as the pain score. The agitation and shivering incidences in group ST were correspondingly lower than that of group S and that of group T,and the pain score in gorup ST were lower than both group S and group T. Conclusion Pretreated with low dose of sufentanil and tramadol could alleviate the post-operation pain and prevent the agitation and shivering effectively during recovery from general anesthesia, and make the anesthesia recovery more stable.%目的:观察舒芬太尼联合曲马多对全麻苏醒期躁动与寒战的预防作用.方法:全麻下择期开腹手术患者120例随机均分为:舒芬太尼组、联合组、曲马多组及对照组,各组均采用相同的麻醉方案,分别于手术结束前3min静注舒芬太尼0.15μg·kg-1、舒芬太尼0.1μg·kg-1+曲马多1mg·kg-1、曲马多2 mg·kg-1、等量0.9%氯化钠溶液.盲法记录患者苏醒期躁动与寒战情况.结果:与对照组比较,舒芬太尼组、联合组、曲马多组苏醒期躁动与寒战发生数均显著减少,疼痛评分明显降

  7. Avaliação comparativa entre a anestesia geral com halotano e isoflurano sobre a pressão arterial em cães Comparartive evaluation of the general anesthesia with halothane and isoflurane on the arterial pressure in dogs

    Directory of Open Access Journals (Sweden)

    Cláudio Corrêa Natalini

    2000-06-01

    isoflurane in group II. In both groups, nitrous oxide and oxygen in a 2:1 ratio was used as diluent for the inhalant. After 15 minutes of inhalation anesthesia, arterial blood pressures were recorded with a noninvasive blood pressure monitor in 15 minutes intervals for 90 minutes. Statistical analyses showed that there was a significant difference in systolic and diastolic pressures after 45 minutes. Differences in heart rate were not significant. In dos, general anesthesia with isoflurane maintained higher arterial blood pressures than those anesthetized with halothane which produced arterial hipotension from 45 to 75 minutes of anesthesia.

  8. Psychological aspects of pediatric anesthesia

    Directory of Open Access Journals (Sweden)

    Drašković Biljana

    2015-01-01

    Full Text Available Surgery and anesthesia cause a significant emotional stress in both parents and children. Since the consequences of this stress develop immediately after surgery and can last even when the hospital treatment is over, the role of the anesthesiologist is to ensure psychological as well as physiological well-being of the patient. In order to reduce emotional stress induced by anesthesia and operation, the anesthesiologist has to understand certain developmental phases that children go through and to identify situations which a child could potentially see as a danger or a threat. This can usually be achieved by careful preoperative assessment and by administering preoperative sedation. During the preoperative visit to the patient, the anesthesiologist can evaluate the levels of anxiety of both parents and children as well as assess the child’s medical condition.

  9. Awake nasotracheal fiberoptic intubation and self-positioning followed by anesthesia induction in prone patients: A pilot observational study.

    Science.gov (United States)

    Heng, Lei; Wang, Ming-Yu; Sun, Hou-Liang; Zhu, Shan-Shan

    2016-08-01

    Anesthesia followed by placement in the prone position takes time and may result in complications. This study aimed to evaluate the feasibility of awake nasotracheal fiberoptic intubation and self-positioning followed by anesthesia induction in prone-positioned patients under general anesthesia.Sixty-two patients (ASA physical status I-II) scheduled for awake nasotracheal fiberoptic intubation and prone self-positioning before surgery under general anesthesia were selected. Patient preparation began with detailed preoperative counseling regarding the procedure. Premedication with sedative and antisialagogue was followed by airway anesthesia with topical lidocaine; then, awake nasotracheal fiberoptic intubation was carried out. The patients then positioned themselves comfortably before induction of general anesthesia. The changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), incidence of coughing or gagging, and rate pressure product (RPP) were assessed. Statistical analysis was performed with repeated-measures one-way analysis of variance.Fifty-eight of the 62 patients completed prone self-positioning smoothly. Compared with values before intubation, SBP, DBP, HR, and RPP were slightly increased after intubation, although the difference was not statistically significant (P > 0.05). One patient had moderate coughing and 1 patient had gagging during prone self-positioning, which were tolerable.These findings indicated that awake nasotracheal fiberoptic intubation and self-positioning followed by induction of anesthesia is safe and feasible alternative to routine prone positioning after induction of general anesthesia. PMID:27512858

  10. 不同剂量右美托咪定预防腹腔镜患者全身麻醉苏醒期躁动及寒战临床评价%Different Doses of Dexmedetomidine for Preventing Agitation and Shivering of Patients during Recovery Period of General Anesthesia in Gynecological Laparoscopy

    Institute of Scientific and Technical Information of China (English)

    吴静; 杨帆

    2016-01-01

    Objective To analyze clinical efficacy of different doses of dexmedetomidine on shivering and agitation of laparoscopic patients with given anesthesia. Methods 60 cases of laparoscopic patients from March 2015 to February 2016 were divided into into group A, B, C, D according to random number table method, 15 cases in each group. Before induction of anesthesia, groups A, B, C were given dexmedetomidine infusion of 0. 5 μg/kg, 0. 75 μg/kg, 1. 0 μg/kg, group D received isovolumetric saline infusion. The occurrence rates of agitation and shivering were compared between the 4 groups. Results The incidence rates of agitation after general anesthesia in groups A, B, C were 26. 67%, 6. 67%, 20. 00%, which were all significantly lower than 53. 33% in group D, and group B ( 6. 67%) was significantly lower than group A ( 26. 67%) ( P < 0. 05 ) . The incidence rates of shivering after general anesthesia in groups A, B, C were 40. 00%, 73. 33%, 46. 67%, which were all significantly higher than 26. 67% in group D, and group B had the most significant preventive efficacy on shivering with statistically significant difference ( P < 0. 05 ) . Conclusion Dexmedetomidine has good good clinical efficacy on preventing agitation and shivering in laparoscopic patients with general anesthesia, and the dose of 0. 75 μg/kg of dexmedetomidine has the best preventive effect with good recovery.%目的:探讨腹腔镜患者采用不同剂量右美托咪定预防全身麻醉(简称全麻)苏醒期躁动及寒战的临床疗效。方法将2015年3月至2016年2月收治的60例腹腔镜患者采用随机数字表法分成A,B,C,D 4组,各15例;A,B,C组在麻醉诱导前均给予右美托咪定泵注,给予剂量分别为0.5,0.75,1.0μg/kg,D组给予等容生理盐水泵注。比较4组患者术后全麻苏醒期躁动及寒颤的发生情况。结果 A,B,C 3组患者全麻苏醒期躁动发生率(26.67%,6.67%,20.00%)均明显低于D组(53.33%)

  11. Complicações respiratórias em pacientes com paralisia cerebral submetidos à anestesia geral Complicaciones respiratorias en pacientes con parálisis cerebral sometidos a la anestesia general Respiratory complications in patients with cerebral palsy undergoing general anesthesia

    Directory of Open Access Journals (Sweden)

    Sérgio Silva de Mello

    2007-10-01

    álisis cerebral (PC puede representar un desafío para el anestesiólogo. Este estudio prospectivo tuvo como objetivo determinar la prevalencia y el riesgo de complicaciones respiratorias en niños con PC sometidos a anestesia general inhalatoria para tomografía computadorizada. MÉTODO: Participaron del estudio pacientes con edades entre 1 y 17 años, estado físico ASA I a III, sometidos a AGI con sevoflurano y máscara laríngea para TC en el período de junio/2002 a junio/ 2003, divididos en 3 grupos: PC tetraplégicos (PCT, Otros tipos de PC (PCO, y paciente sin PC (NPC. Los padres o responsables respondieron a un cuestionario con preguntas sobre el historial médico de los pacientes, infección de vías aéreas superiores (IVAS, asma, convulsión, no coordinación oro faríngea, reflujo gastroesofágico, etc. Datos sobre la incidencia y la gravedad de las complicaciones respiratorias fueron recolectados proscpectivamente (tos, bronco espasmo, laringo espasmo, hipoxemia, aspiración. La muestra fue calculada para una incidencia esperada de 5% en el grupo NPC, con una diferencia de 15% entre los grupos (alfa = 0,05 y beta = 0,1, utilizando los tests del Chi-cuadrado, exacto de Fisher y t de Student. RESULTADOS: Conformaron la muestra 290 pacientes divididos en los grupos de la siguiente forma: PCT - 100, PCO - 79 y NPC- 111. No hubo diferencia en la prevalencia de complicaciones respiratorias entre los grupos PCT (4%, PCO (8,9% y NPC (7,3%. Hubo una asociación entre la presencia de IVAS y la incidencia de complicaciones (riesgo relativo 10,71. CONCLUSIONES: Niños con parálisis cerebral tipo tetraplegia espástica no parecen correr riesgo aumentado de complicaciones respiratorias durante la anestesia general inhalatoria con sevoflurano y máscara laríngea. El estudio confirma IVAS como factor de riesgo para la incidencia de esas complicaciones.BACKGROUND AND OBJETIVES: Anesthesia in patients with cerebral palsy (CP poses a challenge for the anesthesiologist. The objective

  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. Avaliação de alterações timpanométricas em pacientes submetidos à anestesia geral com óxido nitroso Evaluation of tympanometric alterations in patients subject to general anesthesia with nitrous oxide

    Directory of Open Access Journals (Sweden)

    Fernanda Mossumez Fernandes Teixeira

    2005-06-01

    during the anesthetic act and cause negative pressure after it is discontinued, mainly in patients with Eustachian tube dysfunction. These pressure variations may come up with clinical implications such as tympanic membrane rupture, ossicular system disarticulation, haemotympanum, barotraumas, prosthesis displacement stapaedotomy and tympanic graft lateralization after tympanoplasty, in addition to serous fluid entrance into the middle ear during the negative pressure phase. AIM: To evaluate the nitrous oxide influence on the middle ear pressure in a population without tube malfunction performing pre and postoperative tympanometry. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: A prospective study was carried out with Universitário Clementino Fraga Filho Hospital- UFRJ inpatients submitted to general anesthesia with the use of 50% nitrous oxide from April to June 2003. It was also evaluated whether the duration of surgery, associated anesthetics, presence of allergic rhinitis and nasal septal deviation could contribute to the onset of intratympanic pressure alteration. RESULTS: The sample was made up of 50 patients and in almost half of them (48%, postoperative tympanometry alterations (type C curve were found when comparing to preoperative tympanometric control (type A curve. Neither gender nor age interfered in the onset of postoperative tympanometry alterations, similarly to surgery duration. The associated volatile anesthetic type, nasal septal deviation and allergic rhinitis were not able to influence postoperative middle ear pressure. CONCLUSION: Nitrous oxide modifies intratympanic pressure during the anesthetic act and after its discontinuation.

  14. 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.

  15. Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane Estudo eletrocardiográfico em cães geriátricos submetidos à anestesia geral com isofluorano

    Directory of Open Access Journals (Sweden)

    Andreza Conti-Patara

    2009-04-01

    Full Text Available The purpose of this study was to clarify the degree of influence of anesthetic agents commonly used during anesthesia on the heart conduction systems of geriatric dogs, with or without the presence of electrocardiographic changes in the pre-anesthetic electrocardiogram and also to determine the possible causes of ST-segment and T-wave changes during anesthesia, by monitoring ventilation and oxygenation. 36 geriatric dogs were evaluated. In addition to electrocardiographic evaluation, the pre-anesthetic study included serum levels of urea, creatinine, total protein, albumin and electrolytes. The pre-anesthetic medication consisted of acepromazine (0.05mg kg-1 in association with meperidine (3.0mg kg-1 by IM injection. Anesthesia was induced with propofol (3.0 to 5.0mg kg-1 by IV injection and maintained with isoflurane in 100% oxygen. During the anesthesia, the animals were monitored by continued computerized electrocardiogram. Systemic blood pressure, heart rate, respiratory rate, end-tidal carbon dioxide, partial pressure of carbon dioxide in arterial blood, arterial oxygen saturation, partial pressure of arterial oxygen and oxygen saturation of hemoglobin were closely monitored. During maintenance anesthesia, normal sinus rhythm was more common (78%. ST-segment and T-wave changes during the anesthetic procedure were quite common and were related to hypoventilation. The use of isoflurane did not result in arrhythmia, being therefore a good choice for this type of animal; Electrocardiographic findings of ST-segment and T-wave changes during the maintenance anesthesia were evident in animals with hypercapnia, a disorder that should be promptly corrected with assisted or controlled ventilation to prevent complicated arrhythmias.Os objetivos deste estudo foram esclarecer a influência dos agentes anestésicos comumente utilizados durante a anestesia no sistema de condução cardíaco em cães idosos, com ou sem alterações eletrocardiográficas pr

  16. Survey of international regional anesthesia fellowship directors

    OpenAIRE

    Lansdown AK; McHardy PG; Patel SC; Nix CM; McCartney CJL

    2013-01-01

    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 ...

  17. Hypotensive Anesthesia versus Normotensive Anesthesia during Major Maxillofacial Surgery: A Review of the Literature

    OpenAIRE

    2015-01-01

    Steady blood pressure within normal limits during surgery is one of the markers of the ideal and skillful anesthesia. Yet, reduced blood pressure is advantageous in some settings because it can contribute to a reduction in overall blood loss and improve the surgical field conditions. Controlled hypotension during anesthesia or hypotensive anesthesia is often used in major maxillofacial operations. Since hypotensive anesthesia carries the risk of hypoperfusion to important organs and tissues, ...

  18. 术中保温对全麻患者术后苏醒延迟及寒战的影响%Clinical observation on the effects of intraoperative warming for postoperative delayed recovery and shivering in patients after general anesthesia

    Institute of Scientific and Technical Information of China (English)

    许娜

    2011-01-01

    Objective: To investigate the effects of intraoperative warming for postoperative delayed recovery and preserva -tion of shivering after general anesthesia in patients undergoing abdominal surgery. Methods: 120 female abdominal hysterectomy patients who were ASA Ⅰ - Ⅱ grade and 50 to 60 years old were divided into two groups randomly. Group A (60 cases) did not have any insulation measures in surgery, group B (60 cases) were performed intraoperative infusion of hot air blanket and heating apparatus during opertion. These two sets of delayed recovery after general anesthesia and the inci -dence and causes chills were retrospective analysed. Results: Group A of patients with postoperative recovery time was (8.7±1.9) min, and the incidence of shivering were 31.7%. Group B patients with postoperative recovery time was (5.3 ±1.1) min, and the incidence of shivering rate was 6.7%. Conclusion: Intraoperative warming is the simple and effective method to prevente the postoperative shivering, and promote recovery from general anesthesia. Sufficient intraoperative warming is an important part to ensure successful operation and directly affect the prognosis.%目的:探讨全身麻醉下行开腹手术患者术中保温对术后苏醒延迟及寒战的影响.方法:选择择期ASAⅠ~Ⅱ级50~60岁开腹子宫全切术女性患者120例,随机分为两组:A组(60例)术中未进行任何保温措施,B组(60例)术中使用热风毯与加温输液仪.回顾性分析这两组患者全麻后苏醒延迟及寒战的发生率及原因.结果:A组患者发生术后苏醒时间为(8.7±1.9)min,寒战发生率为31.7%;B组术后苏醒苏醒时间为(5.3±1.1)min,寒战发生率为6.7%.结论:术中保温是一种预防术后寒战、促进全麻苏醒的简捷有效的方法.充分的术中保温是保证手术成功的重要环节,并直接影响疾病的预后.

  19. In vivo metabolic activity of hamster suprachiasmatic nuclei: use of anesthesia

    International Nuclear Information System (INIS)

    In vivo glucose utilization was measured in the suprachiasmatic nuclei (SCN) of Golden hamsters using the 14C-labeled deoxyglucose technique. A circadian rhythm of SCN metabolic activity could be measured in this species, but only during pentobarbital sodium anesthesia when the surrounding background activity of adjacent hypothalamus was suppressed. Both the SCN's metabolic oscillation and its time-keeping ability are resistant to general anesthesia

  20. Anesthesia management in a pediatric patient with Dandy-Walker syndrome

    OpenAIRE

    Zeynep Baysal Yıldırım; Salim Akdemir; Vildan Temel; Adnan Tüfek; Feyzi Çelik; Gönül Ölmez Kavak

    2011-01-01

    General anesthesia management of patients with Dandy-Walker syndrome is important since intubation may be difficult due to concomitant anomalies such as hydrocephalus, micrognathia and cleft palate. It should be considered that these patients may require postoperative intensive care support. In this article, anesthesia management of a patient with Dandy-Walker syndrome underwent persistent ventriculo-peritoneal shunt was presented. J Clin Exp Invest 2011; 2 (3): 327-329.

  1. [Changes in the cerebral hemodynamics during Rohypnol anesthesia in neurosurgical patients].

    Science.gov (United States)

    Gribkov, A V; Bakunin, L M; Rufova, N Iu

    1994-01-01

    Intracranial pressure, cerebral perfusion pressure, and intracerebral blood volume changes were observed in 43 patients with volumetric intracranial processes (intracranial hematomas, tumors) during general rohypnol anesthesia. Intracranial and cerebral perfusion pressures were found to correlate with intracerebral blood volume. Rohypnol anesthesia decreased intracranial pressure by 25% due to reduced arterial blood influx into the head, mechanisms responsible for autoregulation of cerebral circulation being intact. PMID:8209591

  2. A psychoeducational intervention reduces the need for anesthesia during radiotherapy for young childhood cancer patients

    International Nuclear Information System (INIS)

    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. 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. 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. 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

  3. 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.

  4. Sonographic guidance for infant hip reduction under anesthesia

    International Nuclear Information System (INIS)

    An initial attempt to reduce a hip dislocation in a 15-month-old by palpation under general anesthesia led to the subsequent discovery of a posterior subluxation by CT. During the second attempt, sonographic guidance in the operating room was used to show concentric reduction both before and after the application of a spica cast. Successful reduction was later confirmed by CT. Imaging by real-time sonography can be useful in monitoring infant hip reduction. (orig.)

  5. Combination of spinal anesthesia and peripheral nerve block: Case report

    OpenAIRE

    Vildan Temel; Sedat Kaya; Gönül Ölmez Kavak; Haktan Karaman; Adnan Tüfek; Feyzi Çelik

    2010-01-01

    Regional anaesthesia has advantages such as, control of postoperative pain, early mobilization, and does not affect respiratory function. In recent years, regional anaesthesia had improved by the application of the peripheral nerve stimulator and ultrasound guided blocks, new local anaesthetic drugs with the use of additional adjunctive agents. Especially in emergency conditions, combination of regional anaesthesia may avoid the complications of general anesthesia in patients with chronic dis...

  6. Combination of spinal anesthesia and peripheral nerve block: Case report

    OpenAIRE

    Çelik, Feyzi; Tüfek, Adnan; Temel, Vildan; Karaman, Haktan; Kaya, Sedat; Kavak, Gönül Ölmez

    2010-01-01

    Regional anaesthesia has advantages such as, control of postoperative pain, early mobilization, and does not af­fect respiratory function. In recent years, regional anaes­thesia had improved by the application of the peripheral nerve stimulator and ultrasound guided blocks, new local anaesthetic drugs with the use of additional adjunctive agents. Especially in emergency conditions, combination of regional anaesthesia may avoid the complications of general anesthesia in patient...

  7. Oxygenation status of cervical carcinomas before and during spinal anesthesia for application of brachytherapy

    International Nuclear Information System (INIS)

    Background and Purpose: To date, no information is available concerning the impact of spinal anesthesia on the oxygenation status of carcinomas of the uterine cervix. The aim of this study was therefore to determine the influence of spinal anesthesia on the oxygenation status of cervical carcinomas. Patients and Methods: In ten patients with cervical carcinoma who received spinal anesthesia for a first application of brachytherapy, intratumoral pO2 measurements (pO2 histography system, Eppendorf-Netheler-Hinz, Hamburg, Germany) were performed. Systemic parameters were documented prior to and during spinal anesthesia. Patients breathed room air spontaneously. For further evaluation, all intratumoral pO2 values were pooled, and overall median pO2 values and fractions of hypoxic pO2 values ≤ 5 mm Hg were calculated. Overall median pO2 values in the subcutis were also calculated. Results: There were no significant changes of systemic parameters, median subcutaneous pO2 values, median intratumoral pO2 values, and the fractions of hypoxic pO2 values ≤ 5 mm Hg in the tumor upon administration of spinal anesthesia. The variability of measured pO2 values increased during spinal anesthesia, although substantial changes in the oxygenation status were only seen in individual cases (n = 2). Conclusion: This study shows for the first time that the oxygenation status of cervical carcinomas, in general, is not influenced by spinal anesthesia prior to application of brachytherapy. To conclude, the data presented suggest that reliable pO2 measurements can be performed under spinal anesthesia. At the same time, since no substantial changes in tumor oxygenation were observed, spinal anesthesia should not affect the O2-related efficacy of high-dose-rate brachytherapy. (orig.)

  8. Oxygenation status of cervical carcinomas before and during spinal anesthesia for application of brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Weitmann, H.D.; Knocke, T.H.; Poetter, R. [Dept. of Radiotherapy and Radiobiology, Univ. of Vienna, General Hospital of Vienna (Austria); Gustorff, B. [Dept. of Anesthesia and General Intensive Care B, Univ. of Vienna, General Hospital of Vienna (Austria); Vaupel, P. [Inst. of Physiology and Pathophysiology, Univ. of Mainz (Germany)

    2003-09-01

    Background and Purpose: To date, no information is available concerning the impact of spinal anesthesia on the oxygenation status of carcinomas of the uterine cervix. The aim of this study was therefore to determine the influence of spinal anesthesia on the oxygenation status of cervical carcinomas. Patients and Methods: In ten patients with cervical carcinoma who received spinal anesthesia for a first application of brachytherapy, intratumoral pO{sub 2} measurements (pO{sub 2} histography system, Eppendorf-Netheler-Hinz, Hamburg, Germany) were performed. Systemic parameters were documented prior to and during spinal anesthesia. Patients breathed room air spontaneously. For further evaluation, all intratumoral pO{sub 2} values were pooled, and overall median pO{sub 2} values and fractions of hypoxic pO{sub 2} values {<=} 5 mm Hg were calculated. Overall median pO{sub 2} values in the subcutis were also calculated. Results: There were no significant changes of systemic parameters, median subcutaneous pO{sub 2} values, median intratumoral pO{sub 2} values, and the fractions of hypoxic pO{sub 2} values {<=} 5 mm Hg in the tumor upon administration of spinal anesthesia. The variability of measured pO{sub 2} values increased during spinal anesthesia, although substantial changes in the oxygenation status were only seen in individual cases (n = 2). Conclusion: This study shows for the first time that the oxygenation status of cervical carcinomas, in general, is not influenced by spinal anesthesia prior to application of brachytherapy. To conclude, the data presented suggest that reliable pO{sub 2} measurements can be performed under spinal anesthesia. At the same time, since no substantial changes in tumor oxygenation were observed, spinal anesthesia should not affect the O{sub 2}-related efficacy of high-dose-rate brachytherapy. (orig.)

  9. 右美托咪定对高血压患者全麻插管期血儿茶酚胺及血流动力学的影响%Effects of dexmedetomidine on the plasma catecholamine and hemodynamic performance of hypertension patients under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    张新花; 佟飞; 王亚丽; 刘燕冰

    2015-01-01

    目的:探讨右美托咪定对高血压患者全麻插管期血儿茶酚胺水平及血流动力学的影响。方法随机选择30例行全身麻醉的高血压患者,随机分为右美托咪定组( A组)和对照组( B组),每组15例。2组患者均不服用术前药物。其中A组患者在气管插管诱导前20 min静脉注射1μg/kg右美托咪定,15 min注完。 B组则注射相同容积生理盐水。分别记录2组插管前1 min( T1),插管即刻( T2),插管后1 min( T3)以及插管后5 min( T4)时的心率,平均动脉压以及肾上腺素和去甲肾上腺素水平。结果 A组患者各时点血肾上腺素,去甲肾上腺素水平、心率、平均动脉压与B组相比明显降低(P<0.05)。结论高血压患者使用右美托咪定能有效减轻全麻气管插管时的应激反应,抑制血中肾上腺素和去甲肾上腺素等儿茶酚胺类物质的释放,从而维持血流动力学的平稳。%Objective To investigate the effects of dexmedetomidine on the plasma catecholamine and hemodynamic performance of hypertension patients under general anesthesia.Methods A total of 30 hypertension patients receiving general anesthesia were randomly divided into two groups (n=15):a dexmedetomidine group (Group A) and a control group ( Group B) .All patients were not administrated with medications before surgery.Then, 20 min before induction of general endotracheal anesthesia, patients in Group A were intravenously injected with 1 g/kg dexmedetomidine within 15 min.Those in Group B were injected with the same volume of normal saline.Heart rate ( HR) , mean arterial pressure ( MAP) , the concentration of adrenaline and noradrenaline were recorded 1 min before intubation ( T1 ) , and immediately ( T2 ) , 1 min ( T3 ) , 5 min ( T4 ) after intubation.Results Group A showed remarkably reduced HR, MAP, and levels of adrenaline and noradrenaline compared with Group B (P<0.05).Conclusion Dexmedetomidine can

  10. The Influence Factors and Nursing Interventions on the Compliance of Horizontal Position without Pillow after General Anesthesia in Thoracolumbar Disease Patients%胸腰椎疾病患者全麻术后去枕平卧位依从性的影响因素与护理干预

    Institute of Scientific and Technical Information of China (English)

    吕曼

    2013-01-01

    目的探讨胸腰椎疾病患者全麻术后去枕平卧位依从性的影响因素和干预措施。方法回顾性分析我科2012年8月~12月胸腰椎疾病全麻术后去枕平卧位依从性的影响因素,根据结果进行护理干预。结果胸腰椎疾病并行全麻手术患者术后6h内不能坚持体位指导152例。其中,因麻醉状态导致依从性差65例,占42.8%,医学相关知识缺乏20例,占13.2%,患者想急迫恢复健康15例,占9.9%,对医务人员信任度差17例,占11.2%,不舒适感23例,占15.1%,家属不配合12例,占7.9%。结论通过加强护患沟通,与患者及家属建立良好的医患关系;加强麻醉未清醒期间的安全管理和心理护理;落实责任制护理,重视健康教育等方式能提高胸腰椎疾病患者全麻术后去枕平卧位依从性。%Objective To summarize the influence factors and nursing interventions on the compliance of horizontal posi-tion without pillow after general anesthesia in thoracolumbar disease patients .Methods The influence factors on the compli-ance of horizontal position without pillow after general anesthesia in thoracolumbar disease were reviewed retrospectively , based on which the nursing interventions were given to the patients .Results 152 after -general-anesthesia thoracolumbar disease patients who couldn't adhere to horizontal position were reviewed .65 cases were due to narcotism (42 .8% );20 cases were due to lack of related medical knowledge (13 .2% );15 cases were due to the urgence for recovery (9 .9% );17 cases were due to their low confidence degree with medical staff (11 .2% );23 cases were due to discomfort (15 .1% );12 cases were due to family members'non-compliance (7 .9% ) .Con-clusions Strengthening nurse-patient communication ,establishing good relationships with patients and their family mem-bers ,strengthening the safety management and the psychological nursing before anaesthesia clear

  11. Neonatal anesthesia with limited resources.

    Science.gov (United States)

    Bösenberg, Adrian T

    2014-01-01

    Neonates are the most vulnerable age group in terms of anesthetic risk and perioperative mortality, especially in the developing world. Prematurity, malnutrition, delays in presentation, and sepsis contribute to this risk. Lack of healthcare workers, poorly maintained equipment, limited drug supplies, absence of postoperative intensive care, unreliable water supplies, or electricity are further contributory factors. Trained anesthesiologists with the skills required for pediatric and neonatal anesthesia as well as basic monitoring equipment such as pulse oximetry will go a long way to improve the unacceptably high anesthetic mortality. PMID:24251423

  12. TO EVALUATE EFFECT OF IV ESMOLOL (1MG/KG COMPARED TO I.V. LABETALOL (0.5MG/KG IN ATTENUATING PRESSOR RESPONSE DURING LARYNGOSCOPY & INTUBATION IN GENERAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Sowbhagya Lakshmi

    2014-08-01

    Full Text Available BACKGROUND: Laryngoscopy and endotracheal intubation is invariable in G.A. and is associated with increased sympathomimetic response. The present study compared the efficacy of esmolol and labetalol in low doses for attenuation of pressor response. MATERIALS & METHODS: This is a Prospective, randomized, placebo controlled study in which 75 ASA Grade I and II patients aged 18-45 yrs. undergoing elective surgical procedures, requiring G.A. and orotracheal intubation were taken up for the study. Patients were allocated to any of the three groups of (25 each. Group C (Control received 10ml of 0.9% saline IV, Group E (Esmolol were given 1mg/kg of drug diluted with 0.9% saline 10ml IV, Group L (Labetalol were given 0.5mg/kg of the drug diluted with 0.9% saline 10ml IV. All the patients were subjected to the same anesthesia technique. HR, SBP, DBP were recorded prior to intubation, then 1 minute, 3 min, 5 min and upto 10min post intubation. RESULTS: Compared to placebo, esmolol and labetalol significantly attenuated HR, SBP, DBP during laryngoscopy and intubation. CONCLUSION: In lower doses, labetalol is a better agent than esmolol in attenuating the sympathomimetic response to laryngoscopy and intubation

  13. 应用韦氏智力量表评估全身麻醉下牙齿治疗对儿童的影响%Children’s intelligence quotient following general anesthesia for dental care:a clini-cal observation by Chinese Wechsler young children scale of intelligence

    Institute of Scientific and Technical Information of China (English)

    夏斌; 王建红; 肖雨萌; 刘克英; 杨旭东; 葛立宏

    2016-01-01

    Objective:It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models.However,for the limitation that the animal models can-not fully mimic the dose and duration in clinical settings especially for dental general anesthesia,the cli-nical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore,we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia comparing to that before surgery.We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia compared with that before surgery.Methods:Thirty two patients,ASA Ⅰ, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology,aged 4 to 6.5 years,were enrolled in this prospective study.Patients with severe learning difficulties or communication disorders were excluded.Written and informed consent was obtained from each patients’family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version)before and 2 weeks after dental anesthesia.They were treated by experienced pediatric dentists and the sevoflurane,propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extrac-tion.The examiners and scorers for IQ had technical training in the test administration.All the patients were tested by the same examiner and with standardized guide language.Each subtest was scored accor-ding to the tool review.Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS

  14. 国产UE可视喉镜在全麻甲状腺手术患者气管插管中的临床观察%Clinical observation of domestic UE visual laryngoscope used in tracheal intubation for patients with general anesthe-sia in the thyroid surgical

    Institute of Scientific and Technical Information of China (English)

    陈伟; 胡北

    2015-01-01

    目的:比较 UE 可视喉镜和 Macintosh 直接喉镜在全麻甲状腺手术患者气管插管中的临床应用效果。方法:收治甲状腺手术全麻患者60例,随机分为可视喉镜组(A 组)和直接喉镜组(B 组),每组30例。比较两组麻醉插管前(T0)、插管即刻(T1)、插管完成后5 min(T2)时的平均动脉压和心率,比较两组声门暴露程度、插管所用时间、一次插管成功率及并发症发生情况。结果:B组插管即刻(T1)MAP、HR明显高于A组,差异有统计学意义(P<0.05)。A组插管时间缩短,声门暴露程度优,一次性插管成功率高,插管相关并发症少,两组比较,差异均有统计学意义(P<0.05)。结论:国产UE可视喉镜在全麻甲状腺手术患者气管插管中对血流动力学影响更小,且快捷、安全。%Objective:To compare the clinical application effect of UE visual laryngoscope and Macintosh direct laryngoscope used in tracheal intubation for patients with general anesthesia in the thyroid surgical.Methods:60 cases of patients with general anesthesia in the thyroid surgical were randomly divided into the visual laryngoscope group(group A) and the direct laryngoscope group(group B),with 30 cases in each group.The mean arterial pressure and heart rate of the two groups before anesthesia intubation(T0),immediate intubation(T1),5 min after intubation(T2) were compared.The glottis exposure,intubation time,once successful intubation rate and complications of the two groups were compared.Results:The MAP and HR of the Group B immediate intubation(T1) were significantly higher than those of group A,and the differences were statistically significant(P<0.05). Group A had shorter intubation time,better glottis exposure,higher once successful intubation rate and less complications caused by intubation,and the differences between the two groups had statistical significance(P<0.05).Conclusion:Domestic UE visual laryngoscope used in tracheal

  15. Laparoscopic Cholecystectomy Under Spinal Anesthesia with Low-Pressure Pneumoperitoneum - Prospective Study of 150 Cases

    Directory of Open Access Journals (Sweden)

    Sunder Goyal

    2012-08-01

    Materials and Methods: In a private rural medical college, 150 patients were selected prospectively for laparoscopic cholecystectomy, under low-pressure (8mmHg pneumoperitoneum and under spinal anesthesia over a span of one and a half years. Injection bupivacaine (0.5% was used for spinal anesthesia. All ports were made in a head-down position to avoid hypotension. Shoulder pain was managed by reassurance as well as by diverting the attention and sedation in a few cases. Results: We successfully performed the operations in 145 patients without major complications. Spinal anesthesia was converted to general anesthesia in five patients due to severe shoulder pain. Age varied between 21 and 75 years. Duration of operation time (skin to skin was between 40 and 80 minutes. Twenty-nine patients complained of right shoulder pain. Most of them were managed by reassurance from the anesthetist and a few needed an injection of fentanyl along with midazolam. Conclusion: Laparoscopic cholecystectomy with low-pressure CO2 pneumoperitoneum is feasible and safe under spinal anesthesia. Incidence of postoperative shoulder pain and complications are comparable with laparoscopic cholecystectomy under general anesthesia. [Arch Clin Exp Surg 2012; 1(4.000: 224-228

  16. The Clinical Effect and Safety of Applying Non-general Anesthesia with Tracheal Intubation with Ketamine Combined to Sevoflurane in Pediatric Surgeries%儿科手术中应用氯胺酮复合七氟醚行非气管插管全麻的临床效果及安全性探讨

    Institute of Scientific and Technical Information of China (English)

    苏文婷; 黄庆; 廖燕凌

    2015-01-01

    Objectives:To find out the application value and safety of applying non-general anesthesia with tracheal intubation with Ketamine combined to sevoflurane in pediatric surgeries. Methods:120 cases of children who suited the conditions to non-general anesthesia with tracheal intubation accepted by our hospital during February 2012 to February 2014 were selected as the research objects. They were divided into two groups with the draw method, each group has 60 cases of children. In which the control group adopted pure ketamine intravenous anesthesia method, while the observation group took ketamine intravenous anesthesia compound sevoflurane anesthesia. Everyone’s mean arterial pressure, heart rate and arterial blood oxygen saturation in the period of anesthesia induction, surgical biopsy and awakening were recorded and compared. The drug adverse symptoms of each group were also compared in order to find out the safety of each method. Results:Anesthesia induction period mean arterial pressure and heart rate in observation group were significantly lower than the control group, the difference showde statistically significant (P<0.05). In the observation group, there was a total of 6 cases of adverse symptoms, including 2 cases of respiratory secretions increase, 1 cases of respiratory inhibition, 2 cases of awakening period agitation, delayed awakening in 1 case, the adverse reactions occur at a rate of 10%. While in the observation group, there were 10 cases of respiratory secretions increase, 4 cases of respiratory depression;awakening period of agitation in 7 cases, delays in 8 cases, the adverse reaction rate was 48.33%. The rate of adverse symptoms in observation group was obviously lower than that of the control group, the difference showed statistically significant (P<0.05). Conclusions:Ketamine combined with sevoflurane used in pediatric surgery can ensure children with hemodynamic stability, suppress the occurrence of adverse reactions. It has good

  17. 单次骶管阻滞联合气管插管全麻在婴幼儿先天性巨结肠Soave手术中的应用%Application of caudal block combined with general anesthesia for Soave radical operation on children with hirschsprung's disease

    Institute of Scientific and Technical Information of China (English)

    刘亚涛; 冷玉芳; 刘永强; 万占海

    2011-01-01

    Objective To research the anesthesia effects of caudal block combined with general anesthesia for Soave radical operation on children with hirschsprung's disease. Methods Forty children were divided into two groups: group A was given caudal block combined with general anesthesia while group B was given general anesthesia. Heart rate and mean blood pressure were recorded before inducement, after changing body into operation position, expanded anus, separated colon, 5 min after extubation, 15 min after extubation. The rate-pressure product was calculated and recorded at time points mentioned above. The dosage of fentanyl and muscle relaxant, the grade of anus laxity, patients awaking time, operation time, and postoperative intensity of pain were recorded and compared between the two groups. Results Group A showed a smoothly perioperative hemodyamic state in perioperation. But in group B, heart rate, mean blood pressure and rate-pressure product were significantly higher at the times of expanded anus, separated colon, post-extubation 5 min, post-extubation 15 min than those before inducement (P <0.05). Compared with group B, group A showed better anus muscle relaxation(P <0.01), shorter operation time and awaking time(F <0.05), lower antelgic score at postoperative 3 h and 5 h(P <0.01). Group A didn't need fentanyl and muscle relaxant after intubation. Conclusion For Soave radical operation on children with hirschsprung's disease, caudal block combined with general anesthesia is much better than general anesthesia used alone and there is no significant side effect.%目的 探讨单次骶管阻滞联合气管插管全麻用于婴幼儿先天性巨结肠Soave手术的麻醉效果.方法将40例择期进行先天性巨结肠Soave手术的婴幼儿随机分为A、B组,A组全麻诱导气管插管后进行单次骶管阻滞,B组进行单纯气管插管全麻,分别观察诱导前、摆手术体位后、扩张肛门、游离肠管、拔管后5、15 min患儿心率和平均

  18. Anesthesia

    Science.gov (United States)

    ... of external growths. Although alcohol, opium or other botanicals sometimes helped alleviate the agony, most surgical patients ... of the population, such as the elderly or cancer survivors, will reveal whether certain anesthetics are better ...

  19. 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...

  20. 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.

  1. Regional anesthesia in patients with pregnancy induced hypertension

    Directory of Open Access Journals (Sweden)

    Saravanan P Ankichetty

    2013-01-01

    Full Text Available Pregnancy induced hypertension is a hypertensive disorder, which occurs in 5% to 7% of all pregnancies. These parturients present to the labour and delivery unit ranging from gestational hypertension to HELLP syndrome. It is essential to understand the various clinical conditions that may mimic preeclampsia and the urgency of cesarean delivery, which may improve perinatal outcome. The administration of general anesthesia (GA increases morbidity and mortality in both mother and baby. The provision of regional anesthesia when possible maintains uteroplacental blood flow, avoids the complications with GA, improves maternal and neonatal outcome. The use of ultrasound may increase the success rate. This review emphasizes on the regional anesthetic considerations when such parturients present to the labor and delivery unit.

  2. Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report

    Directory of Open Access Journals (Sweden)

    Hagino Tetsuo

    2012-03-01

    Full Text Available Abstract Introduction Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur. Case presentation We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery. Conclusion This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia.

  3. Butorphanol significantly suppresses fentanyl-induced cough during general anesthesia induction%布托菲诺显著抑制全麻诱导时芬太尼诱发的咳嗽

    Institute of Scientific and Technical Information of China (English)

    张军; 周伟; 徐振东; 丁晓楠; 梁伟民

    2011-01-01

    Objective To evaluate the effects of pre-induction butorphanol administration on fentanyl-induced cough during anesthesia induction. Methods This was a random, double-blind study. One hundred and sixty elective surgical patients were equally and randomly assigned to one of the following groups in which butorphnol or equal volume normal saline (control) was injected through peripheral cannula 1 minute prior to intravenous administration of 3 μg/kg fentanyl in 3 seconds. The grade of cough and hemodynamics during the procedure were recorded. Results Only 2 (2.50 % )patients had mild to moderate cough in pre-treatment butorphanol group, while 23 (28.75 % )patients in control group coughed after giving fentanyl intravenously, in which there were 5 mild cases (6.25%), 14 moderate (17.5%) ,and 7 severe (8.75 % ). Compared with the control group, pre-induction butorphanol did not influenced heart rate(HR) and mean arterial pressure (MAP) before tracheal intubation, but significantly suppressed increase of HR and MAP caused by intubation. Conclusions Butorphanol pre-treatment significantly suppresses 3 μg/kg fentanyl-induced cough during anesthesia induction.%目的 评价在麻醉诱导前预注布托菲诺对全麻诱导时芬太尼诱发咳嗽的抑制效应.方法 本试验为随机双盲研究.160例患者随机分为2组(每组80例):麻醉诱导前预注布托菲诺组或等量生理盐水组(对照组).观察外周静脉快速注射3 μg/kg芬太尼(3 s内)所诱发的咳嗽发生情况以及实验过程中的血流动力学变化即心率(HR)和平均动脉压(MAP).结果 布托菲诺组仅有2位患者出现轻中度咳嗽(2.5%),而生理盐水组则有26位(32.5%)患者出现不同程度的咳嗽,其中轻度为5例(6.25%),中度为14例(17.5%),重度为7例(8.75%).与对照组相比,诱导前预注布托菲诺不影响插管前HR和MAP,但可以降低气管插管后HR和MAP的升高.结论 布托菲诺显著降低全麻诱导时注射3 μg/kg芬太尼所诱发的咳嗽反应.

  4. 欧普乐喉罩在小儿全麻手术中应用的探讨%The performance and safety of Oro-Pharyngeal airway cap during general anesthesia for children's surgeries

    Institute of Scientific and Technical Information of China (English)

    范从海; 张奉超; 单成静; 文成

    2015-01-01

    Objective:To explore the safety and reliability of Oro-Pharyngeal airway cap( OPLAC) in pediatric anesthesia .Methods:One hundred ASAⅠorⅡchildren scheduled for surgery were randomized to OPLAC group (O group) and tracheal intubation group(T group) with 50 cases each.Heat rate(HR), mean blood pressure ( MAP) , systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) , tidal volume ( VT ) , pulse oxygen saturation( SpO2 ) and end expiratory carbon dioxide pressure ( PET CO2 ) were recorded before intubation ( T0 ) , immediate after intubation(T1), 5 min after intubation(T2), before extubation(T3), immediate after extubation ( T4) , and 5 min after extubation ( T5 ) .The Success rate of insertion and ventilation satisfaction was also recorded.Results:Children with intubation success rate in O group was less than that in T group, there was no significantly difference(P>0.05).Set aside after the oral endotracheal tube in children with blood pressure in T group were significantly higher than those in O group, with significantly difference(P<0.05).Conclusion:OPLAC provides effective airway with less stress reaction compared with tradition tracheal intubation in anesthesia of children.%目的:探讨欧普乐喉罩( OPLAC)在小儿麻醉中应用的可行性和安全性。方法:择期外科手术患儿100例,随机均分为欧普乐喉罩组( O组)和气管插管组( T组),各50例。经静脉麻醉诱导后,记录围麻醉期不同时间点的心率(HR)、舒张压(DBP)、收缩压(SBP)、脉搏血氧饱和度(SpO2)、潮气量(VT)、呼气末二氧化碳分压( PET CO2)。记录两组置入喉罩(插管)成功率、置入时间以及拔除喉罩(插管)后有无低氧血症、喉痉挛、呛咳等并发症。结果:O组在插入和拔除喉罩时HR、SBP、DBP波动明显低于T组( P<0.05);两组的SpO2、VT、PETCO2比较差异无统计学意义(P>0.05)。 O组

  5. 依托咪酯复合骶管麻醉对小儿皮质醇的影响%Effects of Etomidate on Pedo-adrenal Cortex Function in General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    朱平增; 焦岩; 韩雪萍

    2012-01-01

    Objective:To study the effects of Etomidate on pedo-adrenal cortex function.Metheods:60 children scheduled for hypospadia-neoplasty,aged 5~6, ASA I ~ II, randomly arranged into etomidate group(group A),propofol group (group B) with 30 exaples in either group. After intravenous injiection ketamine 2 mg/kg ,all children were did caudal anesthesia. Anesthesia was maintained with etomidate (22~25) μ g/kg·min injection in group A orpropofol (8~10) mg/kg·h in Group B. Blood sample were taken before induction ( I ), immediately after 30 minutes pump-injected of Etomidate/Propofol(II) immediately, after operation(III) , 12hr (IV),24hr(V) and 48 hr(VI) after operation to measure plasma concentration of cortisol.Results:The concentration of cortisol of group B was significant higher than group B(P<0.05) at II ~-V, and restored to preoperative level in both groups at VI. Conclusion: Etomidate has some certain inhabit effects to adrenal cortex,it can be restored to baseline level at 48 hr after operation. Continuous infusion of etomidate was effective and safefor pedo-hypospadia neoplasty.%目的:观察持续输注依托咪酯复合骶管麻醉对小儿血清皮质醇浓度的影响.方法:60例择期行尿道下裂修补术患儿,年龄5~6岁,ASAⅠ~Ⅱ级,随机分为依托咪酯组(A组),丙泊酚组(B组),各30例.入室后均静脉注射氯胺酮2 mg/kg,入睡后常规骶管阻滞,术中麻醉维持:A组泵注依托咪酯脂肪乳(22~25)μg/kg·min,B组泵注丙泊酚(8~10)mg/kg·h.分别在麻醉前(Ⅰ)、泵注依托咪酯脂肪乳/丙泊酚30min(Ⅱ)、术后即刻(Ⅲ)、术后12h(Ⅳ)、术后24h(Ⅴ)、术后48h(Ⅵ)抽静脉血,测量血清皮质醇水平.结果:Ⅱ、Ⅲ、Ⅳ、Ⅴ时点A组血清皮质醇浓度低于B组(P<0.05),两组血清皮质醇浓度于Ⅵ时点均恢复至麻醉前水平.结论:依托咪酯脂肪乳对小儿肾上腺皮质功能的抑制作用短暂,术后48h恢复至麻醉前水平,可以应用于小儿静脉麻醉维持.

  6. 全麻术后ICU患者并发焦虑的相关因素分析%Analysis of Related Factors of ICU Patients Complicated With Anxiety After General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    王筱君; 王晓静; 郝雪梅; 胡小灵

    2014-01-01

    目的:了解影响全麻术后患者入 ICU 病房后并发焦虑心理状态的相关因素。方法采用《医院焦虑和抑郁量表》对62例术后入ICU 病房的患者进行调查。结果 ICU 患者术后发生焦虑率为38.7%。患者术后对疾病和手术知晓程度及疼痛有明显相关性。结论护士有针对性地适时进行健康教育,采取一些可行的措施,如音乐疗法或访视制度,加强与患者及其家属的沟通,使用有效的镇痛手段,可以达到充分减少患者术后的焦虑情绪的目的,有利于患者康复。%Objective To understand the postoperative anesthesia-related factors in ICU ward and psychological state of anxiety. Methods Used"Hospital Anxiety and Depression Scale" on 62 cases of postoperative patients in the ICU ward for investigation. Results The occurrence rate of anxiety in ICU patients was 38.7%. Patients’ aware of the extent of the disease and surgery was significantly correlated with pain. Conclusion Timely targeted health education, some practical measures, such as music therapy or visits system, enhancement of communication with patients and their families, the use of effective analgesia means can sufficiently reduce anxiety in patients.

  7. Regressão da anestesia geral em pacientes com paralisia cerebral: estudo comparativo utilizando o índice bispectral Regresión de la anestesia general en pacientes con parálisis cerebral: estudio comparativo utilizando el índice bispectral Regression of general anesthesia in patients with cerebral palsy: a comparative study using the bispectral index

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    Verônica Vieira da Costa

    2006-10-01

    pacientes del grupo control estaba en el estadio III de regresión anestésica, versus 29% del grupo con parálisis cerebral. A los treinta minutos, el 72% de los pacientes del grupo control estaba apto para recibir el alta, estadio IV de regresión anestésica, versus 41,9% de los pacientes con PC. CONCLUSIONES: Los pacientes con parálisis cerebral presentaron un regreso más lento de la conciencia en comparación con el grupo control.BACKGROUND AND OBJECTIVES: It has been said that patients with cerebral palsy (CP present a higher sensitivity to anesthetic agents, which may affect adversely the awakening from anesthesia. The objective of this study was to evaluate the recovery of patients with CP compared with patients without CNS disease. METHODS: The study population was composed of children ages 5 to 15, divided in two groups: those with a diagnosis of cerebral palsy and those without CNS disease. All of them underwent general anesthesia with sevoflurane associated with nitrous oxide and 50% oxygen. Besides the parameters commonly monitored, they also underwent EEG-BIS monitoring. Regression of general anesthesia during awakening from anesthesia, tracheal extubation, and the immediate postanesthetic period were evaluated according to the criteria adopted by Saraiva. The speed of elimination of the anesthetic agents was also evaluated, correlating it with the EEG-BIS values, and comparing the two groups of patients. Statistical analysis was done through exploratory analysis of the data and statistical testing comparing the means. The statistical difference was considered significant for values of p smaller or equal to 5%. RESULTS: Fifty-six patients were evaluated: 31 with CP and 25 without CNS disease. Both groups were homogenous regarding age and gender. Baseline EEG-BIS values for CP patients were smaller than those for the control group, and this difference was statistically significant (p = 0.04. During the first five minutes after discontinuation of sevoflurane

  8. Severe tracheobronchial compression in a patient with Turner's syndrome undergoing repair of a complex aorto-subclavian aneurysm: anesthesia perspectives.

    Science.gov (United States)

    Hudson, Christopher C C; Stewart, Jeremie; Dennie, Carole; Malas, Tarek; Boodhwani, Munir

    2014-01-01

    We present a case of severe tracheobronchial compression from a complex aorto-subclavian aneurysm in a patient with Turner's syndrome undergoing open surgical repair. Significant airway compression is a challenging situation and requires careful preoperative preparation, maintenance of spontaneous breathing when possible, and consideration of having an alternative source of oxygenation and circulation established prior to induction of general anesthesia. Cardiopulmonary monitoring is essential for safe general anesthesia and diagnosis of unexpected intraoperative events. PMID:25281630

  9. 髂筋膜间隙阻滞联合全身麻醉在全髋关节置换术中的应用%The efficacy of fascia iliaca compartment block combined with general anesthesia for total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    陈跃; 林仙菊

    2015-01-01

    Objective To investigate the efficacy of fascia iliaca compartment block combined with general anesthesia for total hip arthroplasty.Methods Fifty patients underwent total hip arthroplasty were divided into trial group or control group by random digits table method with 25 cases each.Preoperatively,both groups were given fascia iliaca compartment block with the trial group receiving 60 ml 0.25% ropivacaine and the control group receiving 60 ml 0.9% sodium chloride.Both groups received general anesthesia.The consumption of general anesthetics and intraoperative hemodynamic variation in the 2 groups were recorded.The recovery time,extubation time,observer's assessment of alertness/sedation score (modified OAA/S) at 15 and 30 min postoperative and visual analog score (VAS) at postoperative instantly were compared between the 2 groups.Results The consumptions of propofol and remifentanil during maintenance of anesthesia in trial group were significantly lower than those in control group,and there were statistical differences:(250 ± 40) mg vs.(420 ± 85) mg and (300 ± 50) μ g vs.(600 ± 150) μ g,P < 0.01.The recovery time and extubation time in trial group were significantly shorter than those in control group,and there were statistical differences:(7.2 ± 4.5) min vs.(16.2 ± 7.1) min and (8.0 ± 2.8) min vs.(20.0 ± 8.3) min,P < 0.01.The modified OAA/S at 15 and 30 min postoperative in trial group were significantly higher than those in control group,and there were statistical differences:(4.3 ± 0.3) scores vs.(3.0 ± 1.2) scores and (4.6 ± 0.2) scores vs.(3.9 ± 0.8) scores,P < 0.01.The VAS at postopcrative instantly in trial group was significantly lower than that in control group,there was statistical difference:(1.6 ± 0.9) scores vs.(4.5 ± 0.8)scores,P < 0.01.The degree of satisfaction in trial group was better than that in control group,and there was statistical difference (P < 0.05).Conclusion Compared with general anesthesia alone for

  10. Comparison of unilateral spinal and continous spinal anesthesia for hip surgery in elderly patients

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    Leyla T Kilinc

    2013-01-01

    Full Text Available Background: Continous spinal anesthesia (CSA and frequently unilateral spinal anesthesia (USpA are usually preferred for lower extremity surgeries. In this study, we aimed to compare the effects of these anesthetic techniques, on hemodynamic parameters, quality of anesthesia and complications in elderly patients undergoing hip surgeries. Methods: Forty patients aged 65 years and older, assigned to receive either CSA or USpA with 7.5 mg (1.5 cc 0.5% hyperbaric bupivacaine initially. In CSA group, additional doses of 2.5 mg bupivacaine were applied until sensory block reach to T 10 . Maximum sensorial block level, time to reach the level of T 10 (defined as onset time and to regress to T 12 , hemodynamic parameters and ephedrine requirements were recorded peroperatively and during 2 h postoperatively. Results: Hemodynamic parameters, ephedrine requirements and regression of sensory block by two levels were similar in two groups. The onset time of anesthesia was significantly longer in USpA group than CSA group. Neuraxial anesthesia had to be converted to general anesthesia in 5 patients (25% in CSA group and 1 patient (5% in USpA group. Conclusions: We conclude that both USpA and CSA techniques have similar effects in elderly high risk patients. On the other hand, USpA is more preferable for surgeries with shorter durations due to its low cost and high success rate.

  11. 达克罗宁胶浆对老年高血压患者在气管插管全身麻醉拔管期的影响%The Effect of Dyclonine Mucilage in Elderly Hypertensive Patients Extubation in General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    谢薇; 陈钫; 汤昆蓉; 石庭伟

    2016-01-01

    .ResultsAccidents of cough and restlessness in group A was lower than group B (P<0.05).at one minutes before extubation, during extubation, and at 5 minutes after extubation was lower than the group B (P<0.05).ConclusionDyclonine can effectively inhibit general anesthesia extubation response in the elderly hypertensive patients, help maintaining hemodynamic stability, and ensure operation safety in elderly hypertensive patients.

  12. Supplemental pulpal anesthesia for mandibular teeth

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    Thangavel Boopathi

    2013-01-01

    Full Text Available Clinical pulpal anesthesia is dependent on the interaction of three major factors. (1 the dentist (2 the patient and (3 local anesthesia. Many patients fear endodontic treatment due to a concern about pain. Although pain treatment is well managed in many endodontic patients, there exists a group of patients who do not receive adequate local anesthesia. The purpose of this review article is to discuss the possible reasons for pulpal anesthetic failures and also to focus on the measures for developing effective approaches for the same.

  13. To study the feasibility of cerebral state index for monitoring the depth of general anesthesla for the eldery with laryngeal mask anesthesia%应用麻醉深度指数复合喉罩技术对老年患者下腹部手术静脉复合全麻监测的可行性研究

    Institute of Scientific and Technical Information of China (English)

    李忠兴; 陈方基

    2013-01-01

    objective:To study the feasibility of cerebral state index(CSI)modulating the depth of general anesthesia in the elderly with laryngeal mask anesthesia. Methods:48 ASA physical status of II-IIIpatients undergoing selective lower abdominal sutrery were divided two groups with 24 cases. The anesthesia was induced by sufentanil.propofuland mwintained with TCL propofol. The depth of unesthesia was modulated by CSI index in group I or by hemodynamics in group II. HR.SBP.SDP.MAP and CSI were recorded. The time of awakening form anesthesia(the time when OAA/S reached 4 score after the drawal of propofol)and the dosage of propofol and fentanyl were recored.Results:The time of awakening from anesthesia was 164min in rgoupII, which was significantly longer than that in group I(P<0.05). The total dosage of propofol in group I was significantly lower than used to predict the depth of anesthesis. Conclusion:CSI is Valuable in assessment of anesthetic depth during general anesthesis with laryngeal mask anesthesia in the elderly.%目的:研究麻醉深度指数(CSI)复合喉罩技术用于老年患者下腹部手术静脉复合全麻的可行性。方法:择期选取经膀胱前列腺电切的老年患者48例,随机分为研究组和观察组,研究组通过维持CSI值于40-60左右来调节异丙酚的靶浓度值;观察组仅凭临床经验来调节异丙酚的浓度值。观察记录诱导前(To)、诱导后喉罩置入前(T1)、喉罩置入时(T2)、电切镜置入时(T3)、手术进行30min时(T4)、术终患者改良镇静清醒评分(OAA/S)≥4分时(T5)6个时间点的心率(HR)、收缩期压(SBP)、舒张压(DBP)、平均动脉压(MAP)和 CSI。记录异丙酚和舒芬太尼的用量以及麻醉清醒时间,即停用异丙酚至术终患者改良镇静清醒评分(OAA/S)达4分时的时间。结果:研究组平均清醒时间为(9±2)min,观察组平均清醒时间为(15±5)min,两组间比

  14. 小剂量氯胺酮对全凭静脉麻醉术中梦境的影响%Effect of small dose of ketamine on dreaming during general anesthesia

    Institute of Scientific and Technical Information of China (English)

    吴进; 金仁琴; 戴甫成; 邵东华

    2012-01-01

    Objective To explore the effect of small dose of ketamine (0.3 mg/kg) on dreaming during total intravenous anesthesia (TIVA). Methods Two hundred female patients scheduled for the excision of benign breast lesions under TIVA were randomly divided into ketamine group and control group (n = 100). All the patients were interviewed on the incidence and nature of their dreams. The nature of dreams included the mood, memory, scene, emotional experience and strangeness of the dream. Results The proportion of dreamers was 8% (8/100) in ketamine group and 13% (13/100) in control group, respectively. There was no significant difference in the dream incidence between the two groups ( P = 0.249). Neither were there differences in the five aspects of the nature of dreams (P>0. 05). Conclusion Small dose of ketamine has no significant influence on the incidence and nature of dream during TIVA. (Shanghai Med J, 2012, 35: 668-670)%目的 探讨小剂量氯胺酮(0.3 mg/kg)对全凭静脉麻醉术中梦境发生的影响.方法 选择在全凭静脉麻醉下行乳房良性病变切除术的女性患者200例,随机分为氯胺酮组和对照组,每组100例.患者术后清醒时记录其麻醉中有无梦境发生,并对梦境的5个方面进行评分:梦境中的情绪、对梦境的记忆、梦境中的场景、梦境中的情感体验及对梦境的陌生感.结果 氯胺酮组和对照组全身麻醉中梦境的发生率分别为8%(8/100)和13%(13/100),两组间差异无统计学意义(P=0.249).两组间梦境的5个方面评分的差异均无统计学意义(P值均>0.05).结论 小剂量氯胺酮对全凭静脉麻醉中梦境的发生和性质无显著影响.

  15. 全麻诱导不同通气方式对冠心病患者中心静脉压的影响%Influence of different adjuvant ventilation modes on central venous pressure in patients with coronary heart disease during the general anesthesia induction

    Institute of Scientific and Technical Information of China (English)

    程芳; 林华赋; 周毅; 元春梅

    2012-01-01

    Objective To explore the influence of different adjuvant ventilation modes (low tidal volume with high respiratory rate and high tidal volume with low respiratory rate) on central venous pressure (CVP) in patients with coronary heart disease during general anesthesia induction.And to find out an adjuvant ventilation mode which has a less influence on CVP.Methods 41 patients with coronary heart disease practised with general anesthesia in Jiangmen Central Hospital from March 2010 to July 2011 were enrolled for the study.They were randomly divided into two sets.The patients in set Ⅰ were practised the adjuvant ventilation mode of low tidal volume with high respiratory rate during the general anesthesia induction,and the patients in set Ⅱ were practised the adjuvant ventilation mode of high tidal volume with low respiratory rate.All of them were monitored HR,SpO2.MAP,CVP.The CVP of two sets were compared.Results Before general anesthesia,CVP of set Ⅰ was (8.98 ± 2.65) cmH2O,CVP of set Ⅱ was (8.86 ± 2.91) cmH2O.CVP of two sets had no significant difference (P> 0.05).During the general anesthesia induction,CVP of set Ⅰ was (7.45 ± 3.15) cmH2O、CVP of set Ⅱ was (5.86 ± 3.89) cmH2O.CVP of set Ⅱ was obviously lower than that of set Ⅰ( P< 0.05 ).After tracheal intubatiou,CVP of set Ⅰ was (7.99 ± 2.74) cmH2O,CVP of set Ⅱ was (6.09 ± 2.89) cmH2O.CVP of set Ⅱ was obviously lower than that of set Ⅰ( P< 0.05 ).Conclusion By comparing with two ventilation modes,the ventilation mode of high tidal volume with low respiratory rate has a larger influence on CVP.%目的 比较全身麻醉诱导时低潮气量高频率辅助通气与高潮气量低频率辅助通气对冠心病患者中心静脉压(CVP)的影响,选出对循环血流动力学影响较小的辅助通气方式.方法 选择2010年3月-2011年7月于我院行全身麻醉的41例冠心病患者随机分为两组,Ⅰ组在全麻诱导准备插管前低潮气量高频率辅助通气,Ⅱ

  16. ROLE OF DEXMEDETOMIDINE IN ANESTHESIA AND CRITICAL CARE

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    Baljit Singh

    2014-09-01

    Full Text Available The potential uses of dexmedetomidine (DEX, a highly selective α2- adrenoceptor agonist are very diverse 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 a 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 manage morbidly obese patients and patients with a compromised airway; without causing any cardiorespiratory depression. It is near ideal hypotensive agent used for controlled hypotension. Availability of an antidote (Atipamezole with similar elimination half-life is taking the drug into new frontiers .The aim of this review is to present the most recent topics regarding the advantages in using dexmedetomidine in clinical anesthesia and in critical care, while discussing the controversial issues of its harmful effects.

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

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    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.

  18. 小潮气量机械通气对全麻患儿术中肺功能的影响%Influence of small tidal volume mechanical ventilation to lung function of children in general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李体忠; 刘亚玲; 罗炜; 马源

    2012-01-01

    Objective To study the effect of low tidal volume mechanical ventilation on the lung protection of children in intraoperative anesthesia. Methods 48 cases of children with intestinal obstruction laparotomy were selected and randomly divided into A and B groups. The two groups were treated with low tidal volume and high tidal volume mechanical ventilation separately. Their peripheral blood were collected before intubation, after intubation 1 h and at the end of surgery, using enzyme-linked immunosorbent assay (ELISA) to test patients' plasma interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentration and to analyze arterial blood gas at the same time. Results The two groups in plasma IL-6 levels in tracheal intubation had no significant difference before. In group A there was no significant difference in IL-6 levels. Group B's plasma levels of IL-6 1 h after intubation and at the end of surgery was significantly higher (P <0.05) compared with before intubation. Two groups' plasma levels of TNF-α before intubation had no significant difference and group B's levels were significantly higher (P <0.05) than those 1 h after intubation and at the end of surgery compared with before intubation. Conclusion Tidal volume ventilation can cause increase of plasma IL-6 and TNF-α level in children, which may be one of the reasons to result in mechanical ventilation-induced lung injury. The low tidal volume ventilation used for children in the maintenance of anesthesia in ventilation can contribute to the protection of lung function.%目的 探讨小潮气量机械通气对全麻患儿术中肺功能的影响.方法 选取48例行肠梗阻剖腹探查术的患儿,随机分为A、B两组,术中分别采用小潮气量和大潮气量机械通气,于插管前、插管后1h和手术结束时分别采集外周血,用酶联免疫法检测患儿血浆中白介素-6(IL-6)和肿瘤坏死因子-α (TNF-α)的浓度,同时抽取动脉血行血气分析.结果 A组其他时点

  19. A quest to increase safety of anesthetics by advancements in anesthesia monitoring: scientometric analysis

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    Vlassakov KV

    2015-05-01

    Full Text Available Kamen V Vlassakov, Igor Kissin Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Abstract: The aim of this study was to assess progress in the field of anesthesia monitoring over the past 40 years using scientometric analysis. The following scientometric indexes were used: popularity indexes (general and specific, representing the proportion of articles on either a topic relative to all articles in the field of anesthetics (general popularity index, GPI or the subfield of anesthesia monitoring (specific popularity index, SPI; index of change (IC, representing the degree of growth in publications on a topic from one period to the next; and index of expectations (IE, representing the ratio of the number of articles on a topic in the top 20 journals relative to the number of articles in all (>5,000 biomedical journals covered by PubMed. Publications on 33 anesthesia-monitoring topics were assessed. Our analysis showed that over the past 40 years, the rate of rise in the number of articles on anesthesia monitoring was exponential, with an increase of more than eleven-fold, from 296 articles over the 5-year period 1974–1978 to 3,394 articles for 2009–2013. This rise profoundly exceeded the rate of rise of the number of articles on general anesthetics. The difference was especially evident with the comparison of the related GPIs: stable growth of the GPI for anesthesia monitoring vs constant decline in the GPI for general anesthetics. By the 2009–2013 period, among specific monitoring topics introduced after 1980, the SPI index had a meaningful magnitude (≥1.5 in 9 of 24 topics: Bispectral Index (7.8, Transesophageal Echocardiography (4.2, Electromyo­graphy (2.8, Pulse Oximetry (2.4, Entropy (2.3, Train-of-four (2.3, Capnography (1.9, Pulse Contour (1.9, and Electrical Nerve Stimulation for neuromuscular monitoring (1.6. Only one of these topics (Pulse

  20. Thoracic epidural anesthesia attenuates hemorrhagic-induced splanchnic hypo-perfusion in post-resuscitation experimental hemorrhagic shock

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    Amir S Madjid

    2008-06-01

    Full Text Available The purpose of present study was to assess the effects of thoracic epidural anesthesia on splanchnic perfusion, bacterial translocation and histopathologic changes in experimental hemorrhagic shock in short-tailed macaques (Macaca nemestrina. Sixteen Macaca nemestrinas were randomly assigned to one of two groups i.e. the lidocaine group (n = 8, receiving general anesthesia plus lidocaine thoracic epidural anesthesia; and the saline group (n = 8, receiving general anesthesia alone as control. Hemorrhagic shock was induced by withdrawing blood gradually to a mean arterial pressure (MAP of 40 mm Hg, and maintained for 60 minutes. Animals were then resuscitated with their own blood and ringer lactate solution (RL. After resuscitation, epidural lidocaine 2% was given in the lidocaine group and saline in the control group. Resuscitation that was performed after one hour hemorrhagic shock, with hemodynamic variables and urine output returned to normal, revealed there was no improvement of splanchnic perfusion. PgCO2, P(g-aCO2, and pHi remained in critical value and tended to deteriorate in the saline group. Contrast to saline group, splanchnic perfusion in lidocaine group tended to improve. This condition was supported by the finding of less bacterial translocation and better histopathologic changes in lidocaine thoracic epidural anesthesia group than in saline group. This study concludes that lidocaine thoracic epidural anesthesia attenuates splachnic hypoperfusion in post-resuscitation hemorrhagic shock in Macaca nemestrina. (Med J Indones 2008; 17: 73-81Keywords: thoracic epidural anesthesia, lidocaine, hemorrhagic shock, splanchnic hypoperfusion, bacterial translocation

  1. Clinical efficacy and safety of sacral block combined with general anesthesia in pediatric laparoscopic operation: A meta-analysis%骶管阻滞复合全麻在小儿腹腔镜手术中的临床效果和不良反应的Meta分析

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    沈孜颖; 夏中元; 赵博; 冷燕; 刘敏; 侯家保

    2015-01-01

    Objective To evaluate the clinical effects and adverse reactions of sacral block combined with general anesthesia in pediatric laparoscopic operation. Methods Articles have been retrieved in PubMed, Embase, Cochrane Library, Chinese HowNet database, VIP, from database built to October 2014, and handled in inclusion and exclusion criteria for data extraction and quality assessment, using RevMan 5.1.5 software for Meta-analysis. Results A total of 9 randomized controlled trials were included, with a total of 528 patients. Compared with general anesthesia, heart rate in sacral block combined tracheal intubation was more stable, with statistically significant differ-ence between the two groups before tracheal intubation, 15 min after pneumoperitoneum and after extubation. The par-tial pressure of end-tidal carbon dioxide (PETCO2) in sacral block combined tracheal intubation was more stable, with significant difference 15 min after pneumoperitoneum; The induction time, wake-up time and extubation time were shorter, with statistically significant difference. The postoperative adverse reactions were significantly less, with signif-icant difference in restlessness, nausea, vomiting and balderdash. Conclusion In pediatric laparoscopic operation, sacral block combined with tracheal intubation results in more stable circular and respiratory function, shorter time of induction, wake-up and extubation, and lower incidence of adverse reactions, compared with simple general anesthesia.%目的 采用Meta分析的方法系统评价骶管阻滞复合气管插管全麻在小儿腹腔镜手术中的临床效果和不良反应.方法 计算机检索PubMed、Embase、Cochrane Library、中国知网、维普、万方数据库从建库至2014年10月的文献,对符合纳入与排除标准的研究进行资料提取和文献质量评价,并采用RevMan 5.1.5软件进行Meta分析.结果 最终纳入9个随机对照实验,共计患者528例.Meta分析结果显示,与单纯全麻比较,骶

  2. 复方利多卡因乳膏对喉罩插入不良反应的抑制作用%Surface anesthetic effect of compound lidocaine cream-coated laryngeal mask airway in patients undergoing modified radical mastectomy under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    张锦英; 沈途

    2011-01-01

    目的 观察复方利多卡因乳膏乳癌改良根治术中喉罩插入时不良反应的抑制作用.方法 择期行全麻乳癌改良根治术的患者80例,ASA Ⅰ~Ⅲ级,随机均分为复方利多卡因乳膏喉罩组(A组)和石蜡油喉罩组(B组),将复方利多卡因乳膏和石蜡油涂抹于喉罩表面.麻醉诱导后插入喉罩,记录麻醉诱导前、喉罩插入前、喉罩插入即刻及喉罩插人后3 min患者SBP、DBP、HR,以及术后咽痛或咽部不适的发生率.结果 与喉罩插入前和A组比较,B组喉罩插入即刻和喉罩插入后3min时SBP、DBP明显升高,HR明显增快(P<0.01).A组患者术中呛咳和术后咽痛、咽部不适感发生率明显低于B组(P<0.05).结论 复方利多卡因乳膏能有效抑制全麻乳癌改良根治术中喉罩插人所引起的咽反射和术后咽痛.%Objective To evaluate the surface anesthetic effect of compound lidocaine crearcoated laryngeal mask airway (LMA) in patients undergoing modified radical mastectomy under general anesthesia. Methods Eighty ASA Ⅰ-Ⅲ patients undergoing modified radical mastectomy under general anesthesia received insertion of LMA coated with either compound lidocaine cream (group A, n = 40) or paraffin oil (group B, n = 40). Systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR)were measured during LMA insertion. Incidence of irritating cough and sore throat was recorded after operation. Results Compared with group B, not only SBP, DBP or HR at 0 min, 3 min after LMA insertion were lower, but the incidence of irritating cough and sore throat was significantly also lower in group A (P<0. 01). SBP, DBP and HR at 0 min, 3 min after LMA insertion was higher than that before LMA insertion in B group ( P< 0. 01 ). Conclusion Compound lidocaine cream-coated LMA can inhibit the pharyngeal reaction and reduce the incidence of sore throat in patients undergoing modified radical mastectomy under general anesthesia.

  3. 复方利多卡因乳膏在喉罩全麻腹腔镜胆囊切除术中的应用%Surface anesthetic effect of compound lidocaine cream-coated laryngeal mask airway in patients undergoing laparoscopic cholecystectomy and general anesthesia

    Institute of Scientific and Technical Information of China (English)

    卢静; 兰志勋

    2009-01-01

    目的 观察复方利多卡因在喉罩全麻腹腔镜胆囊切除术中抑制咽反射和术后咽喉痛的效果.方法 将120例ASA Ⅰ~Ⅲ级择期行全麻腹腔镜胆囊切除术的患者随机分为试验组(A组,n=60)和对照组(B组,n=60),分别将复方利多卡因乳膏和石蜡油涂抹于喉罩表面,在麻醉诱导后王入喉罩,记录麻醉诱导前、喉罩置入前、喉罩置入即刻及喉罩置入后3min患者收缩压(SBP)、舒张压(DBP)、心率(HR)以及术后咽痛或咽部不适的发生率.结果 与置入喉罩前相比,A组患者置入喉罩后即刻和置入喉罩后3min时SBP、DBP、HR差异无统计学意义(P>0.05);B组患者上述指标则明显升高,差异有统计学意义(P<0.01).组间比较,A组置入喉罩后的SBP、DBP、HR均低于B组,差异有统计学意义(P<0.01).A组患者术中呛咳和术后咽痛、咽部不适感发生率明显低于B组(P<0.05).结论 复方利多卡因乳膏能有效抑制喉罩全麻胆囊切除术所引起的咽反射和术后咽痛.%Objective To evaluate the surface anesthetic effect of compound lidocaine cream-coated laryngeal mask air-way (LMA) in patients undergoing laparoscopic cholecystectomy (LC) and general anesthesia. Methods 120 ASA Ⅰ~Ⅲ pa-tients undergoing LC and general anesthesia received insertion of LMA coated with either compound lidocaine cream ( A group, n=60) or paraffin oil (B group, n=60). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured during LMA insertion. Irritating cough, sore throat were recorded after operation. Results Compared with B group, not only SBP, DBP and HR at 0min,3min after LMA insertion but also the incidence of irritating cough and sore throat was significantly lower in A group (P<0.01). No difference was observed in SBP, DBP and HR before LMA insertion, at 0min, 3min after LMA insertion in A group but SBP, DBP and HR at Omin,3min after LMA insertion was higher than that before LMA insertion

  4. Observation on curative effect of vocal cord surgical treatment with a suspension micro-laryngoscope under general anesthesia: a report of 320 cases%全麻显微支撑喉镜下声带手术320例临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    薛煜文

    2014-01-01

    目的 探讨全麻显微支撑喉镜下进行声带息肉、声带小结、声带囊肿、声带白斑切除术的治疗效果.方法 2008年3月至2013年3月我院收治了320例需进行声带手术的患者,如声带息肉、声带小结、声带囊肿、声带白斑患者,分别在全麻显微支撑喉镜下进行手术.观察手术后患者的声嘶情况、病变部位、声带色泽、声带闭合情况等来评价治疗效果.结果 320例声带手术患者中,治愈280例,好转30例,无效10例,有效治疗率为96.9%.手术后半年随访调查,经过喉镜复查确定完全地清除了声带病灶,没有残留.所有病例在出院时其发音均有明显好转,手术后1周~3个月患者的发音逐渐恢复.随访半年至2年,无复发.结论 全麻显微支撑喉镜下手术对于声带息肉等良性病变切除彻底,治疗效果好,复发率低,值得临床推广应用.%Objective To investigate curative effect of the suspension micro-laryngoscope under general anesthesia in treatment of vocal cysts,vocal cord polyps,vocal nodules.Methods 320 cases of vocal cord surgery were treated in our hospital from March 2008 to March 2013 and 320 patients of vocal cysts,vocal cord polyps,vocal nodules were all given suspension micro-laryngoscope under general anesthesia.Patients with hoarseness conditions,the lesion,vocal color,vocal closing conditions were observed to evaluate the therapeutic effect.Results In 320 cases,280 cases were cured,30 cases were improved and 10 cases were invalid.The effective rate was 96.9%.After operation,a 6-month-long follow-up study was conducted and it exactly cleared vocal cord lesions and no residue by laryngoscope.All patients in the hospital were significantly improved in their pronunciation 1 week to 3 months after operation,pronunciation of patients was gradually restored.Follow-up of six months to two years showed no recurrence.Conclusion The suspension microlaryngoscope under general anesthesia could

  5. 自制气囊对俯卧位全麻手术患者头面部皮肤状况的影响%Effect of self-made gasbag head and face skin in patients with prone positional operation after general ;anesthesia

    Institute of Scientific and Technical Information of China (English)

    罗建英; 冯星梅

    2015-01-01

    目的:探讨自制气囊在俯卧位全麻手术患者头面部压疮预防中的作用。方法选择2014年1—12月于上海交通大学附属第六人民医院南院施行全身麻醉后俯卧位手术的患者60例,随机分成观察组和对照组各30例。两组患者行全身麻醉后,对照组直接将患者头面部固定于敷有软垫的传统马蹄形支架上;观察组在此基础上在支架上方及两侧增加气囊应用。比较两组患者术中1h、2h、3h头面部皮肤红斑、压痕情况,以及术后1h头面部疼痛不适感。结果术中1h、2h、3h,观察组患者皮肤压痕、红斑发生率及术后1 h疼痛不适感均低于对照组(P均﹤0.05)。结论输液袋自制气囊对俯卧位全身麻醉手术患者头面部压疮预防有显著作用。%Objective To analyze the effect of gasbag made of infusionbag head and face skin in the patients with prone positional operation after general anesthesia. Methods From January to December 2014,a total of 60 patients undergoing prone positional operation after general anesthesia were chosen from South Campus of Shanghai Sixth Peopleˊs Hospital, Shanghai Jiao Tong University. They were randomly divided into the experimental group and control group(30 cases in each group). The traditional horseshoe-shaped cushion was used to fix head and face in the control group. The gasbag made of infusionbag was added to the top and two sides of the bracket in the experimental group. The patients'skin indentation and redness at 1 h,2 h and 3 h during operation and pain at 1 h after operation were recorded. Results Compared with the control group,the experimental group had less skin indentation and redness at 1 h,2 h and 3 h during operation,and less pain at 1 h after operation( P ﹤0 . 05 ). Conclusion The gasbag made of infusionbag can effectively prevent the pressure ulcer of head and face in the patients with prone positional operation after general anesthesia,which has applicative

  6. Effects of ephedrine and propofol on fentanyl-induced cough during induction of general anesthesia%麻黄碱联合丙泊酚抑制芬太尼咳嗽反射的临床研究

    Institute of Scientific and Technical Information of China (English)

    张志永; 谢彬; 虞雪融; 黄宇光

    2012-01-01

    AIM: To evaluate the effectiveness of ephdrine, propofol and ephedrine combined with propofol on fentanyl induced cough during anesthesia induction. METHODS: 320 patients with ASAⅠor Ⅱ for elective procedures were randomly assigned into four groups and the following medications were administered intravenously: patients in Group Ⅰ ( control group) received normal saline 2 raL, Group Ⅱ (ephedrine group) received ephedrine 6 mg, Group Ⅲ (propofol group) received propofol 0. 8 mg/kg and Group Ⅳ (ephedrine plus propofol group) received ephedrine 6 mg plus propofol 0. 8 mg/kg . At one minute after the study med-ication, fentanyl 2. 0 p.g/kg was given intravenously within two seconds. The occurrence of cough and vital sign profiles were recorded within one minutes after fentanyl bolus. RESULTS: The incidence of FIC was 42.5% in group Ⅰ, 18.8% in group Ⅱ , 20.0% in group Ⅲ, and 2.5% in group Ⅳ, respectively. Lower incidence and less severity of cough were observed in groups Ⅱ ,Ⅲ, and Ⅳ than those in groupⅠ (P<0. 05). Groups IV had a lower incidence and less severity of cough than those in groupⅡand groupⅢ(P<0. 05). Hemodynamics was more stable in group IV than that in other groups. CONCLUSION : Intravenous ephedrine 6 mg plus propofol 0. 8 mg/kg could prevent fent-anyl-induced cough effectively. It is a convenient method to suppress fentanyl-induced cough with stable hemodynamics in this setting.%目的:研究麻黄碱联合丙泊酚对芬太尼咳嗽反射(fentanyl-induced cough,FIC)的抑制作用.方法:选择320例择期手术接受全麻的患者,根据计算机随机数字表随机进入4组:Ⅰ组(对照组)静脉注射2 mL生理盐水;Ⅱ组(麻黄碱组)静脉注射6 mg麻黄碱;Ⅲ组(丙泊酚组)静脉注射0.8 mg/kg丙泊酚;Ⅳ组(丙泊酚联合麻黄碱组)静脉注射0.8 mg/kg丙泊酚加6 mg麻黄碱.给予治疗药物2 min后,经外周静脉快速注射2 μg/kg芬太尼.观察并记录患者的血压、心率、脉

  7. 盐酸多沙普仑对右旋美托咪定全麻恢复期催醒效果临床观察%Clinical Observation of Wakening Effect of Doxapram in Recovery Stage under General Anesthesia with Dexmedetomidine

    Institute of Scientific and Technical Information of China (English)

    周爱国

    2011-01-01

    [Objective]To observe the wakening effect and adverse reaction of doxapram(DOX) in patients at peri anesthetic stage under general anesthesia with dexmedetomidine(DEX). [Methods] Forty adult patients undergoing bone surgery under general anesthesia were randomly divided into two groups with 20 cases in each. Group △ was given DEX and DOX. Group B was given DEX and normal saline. After 5min induction,both groups were given DOX lμg/kg with loading dose, and then were maintained by pump administration of 0.6~0. 8μg/(kg o min), and drugs were stopped at 10 min before surgery. At the moment of extubation,group A was given DOX lmng/kg, and group B was given isovolumic normal saline. Systolic blood pressure (SBP), diastolic blood pressure(DBP) and heart rate(HR) at 5min before induction(To), 5min after intuba tion(T1 ), drug withdrawal(T2), intubation(T3) and 5min after intubation(T4) were observed in two groups.Riker sedation agitation scale(SAS) and adverse reactions during peri anesthesia before operation(T0), intuba tion(T1) and 10min after intubation(T2) were also observed. [Results]The demography data in two groups had comparability( P >0.05). There was no significance in SBP, DBP and HR at every point between two groups( P >0.05). The SAS score at T2 in group A was higher than that in group B, and there was signifi cant difference between two groups( P <0.05). There was no significant difference in the incidence of extuba tion reaction score, nausea and vomiting, shivering and intraoperative awareness between two groups( P >0.05). [Conclusion] DEX used in the maintenance of anesthesia can provide stable hemodynamics, good sedation and more stable during recovering period of general anesthesia. DOX for the consciousness recovery after anes thesia with DEX is effective, and has little changes of hemodynamics and low incidence of adverse reactions.%[目的]观察盐酸多沙普仑用于右旋美托咪定全麻患者围麻醉期的催醒效果及不良

  8. 电针对高血糖冠心病老年患者全麻手术围手术期心肌损伤的影响%Effects of Electro-acupuncture Combined General Anesthesia on Myocardial Injury of High Blood Sugar Patients with Coronary Heart Disease in the Perioperative Phase

    Institute of Scientific and Technical Information of China (English)

    沈华; 陈轶菁

    2012-01-01

    Objective To investigate the effects of electro-acupuncture (EA) combined general anesthesia on myocardial injury of high blood sugar patients with coronary heart disease (CHD) in the perioperative phase. Methods Recruited were 40 senile patients with glycosylated hemoglobin ( HbA1c) more than 6. 5%. They were more than 60 years old. They received post-traumatic fracture reduction surgery of four limbs. They were randomly assigned to two groups, Group N (treated by general intravenous anesthesia) and Group D (treated by EA combined with general intravenous anesthesia), 20 in each group. All patients were maintained anesthesia by propofol, fentanyl, and vecuronium. Prior to the induction of anesthesia, patients in Group D received induction of EA at Neiguan (PC6) and Baihui (DU20) for 20 min, which lasted to the end of the surgery. At before intubation (T0), immediately after intubation (T0), 5 min (T2) , immediately after extubation (T3), 5 min (T4), 60 min (T5), 180 min (T6), the fast blood glucose (FBG), plasma vasoactive substance TXB2 and 6-K-prostacycline (6-K-PGF1α) were detected in the two groups. The glucose coefficient of variation (GluCV) and the ratio of TXB2/6-K-PGF1α were calculated. The changes of ST-segment elevation ( mV, sampling 1 min after each time point, and the mean calculated) was recorded. Results There was no statistical difference in all the tested values between the two groups at T0(P>0. 05). The FBG, ST elevation, and the ratio of TXB2/6-K-PGF1α were significantly higher at each time point than at T0 in Group N (P <0. 05), while there was no statistical difference in Group D (P>0. 05). The ratio of TXB2/6-K-PGF1α and ST elevation were significantly higher in Group N than in Group D (P <0. 01). The TXB2 and 6-K-PGF1α were significantly higher at each time point than at T0 in the two groups (P <0. 05). The increment of TXB2 was obviously lower in Group D than in Group N (P<0. 05) , but the increment of 6-K-PGF1α was

  9. 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.

  10. Changes of Body Temperature and Oxygen Consumption of Shivering or Non-shivering Patients in Postoperative Forepart after General Anesthesia%全麻术后早期寒颤与非寒颤病人体温和耗氧量变化

    Institute of Scientific and Technical Information of China (English)

    康孝荣; 李晓强; 王恩真

    2001-01-01

    探讨全麻术后早期寒颤与非寒颤病人体温恢复和耗氧量变化的关系。方法:随机对21例寒颤和29例非寒颤病人的鼓膜温度和耗氧量进行监测,比较两组病人手术结束到术后40分鼓膜温度和耗氧量的变化,并对寒颤前后耗氧量进行比较。结果:两组病人的鼓膜温度均无显著升高,升高程度两组间也无显著性差异。术后40分的耗氧量都高于手术结束时,寒颤病人耗氧量增加显著,寒颤后耗氧量高于寒颤前。结论:寒颤对全麻术后早期病人体温恢复没有显著影响,相反增加耗氧量。%To probe into the relationship between the recoveries of body temperature and the changes of oxygen consumption of shivering or non-shivering patients in the postoperative forepart after general anesthesia. Methods:The tympanic temperatures and oxygen consumptions were randomly observed in 21 shivering and 29 non-shivering patients. The changes of tympanic temperatures and oxygen consumptions from the end of operation to 40 minutes after operation were compared between the two group patients,and the oxygen consumptions between before and after shivering were also compared. Results: The tympanic temperatures of all the two group patients did not significantly increase, and there was no significant difference in the increase degree between the two groups. All the oxygen consumptions at 40 minutes after operation were very significantly higher than those at the end of operation, the increase of oxygen consumptions in shivering patients markedly more than that in non-shivering patients, and the oxygen consumptions after shivering was very significantly higher than those before shivering. Conclusion:Shivering has no significant effect on the recovery of body temperature in the postoperative forepart after general anesthesia and increases the oxygen consumptions contrarily.

  11. 预注右美托咪定的镇静效应及其对全麻患者气管插管反应的影响%The influence of pre-injection with dexmedetomidine on sedation and tracheal intubation responses in general anesthesia

    Institute of Scientific and Technical Information of China (English)

    马立靖; 马璨; 李冬梅; 林长赋; 李文志

    2012-01-01

    目的 观察预注右美托咪定对镇静及气管插管反应的影响.方法 择期全凭静脉麻醉下行甲状腺次全切除术患者42例,ASA Ⅰ或Ⅱ级,年龄18~60岁,体重指数18~30 kg/m2,随机均分为两组:右美托咪定组(D组)和对照组(C组).D组患者于麻醉诱导前15 min静脉泵注右美托咪定0.6 μg/kg(10 min内泵注完毕),C组患者以同样方式泵注等量生理盐水;观察5 min后开始麻醉诱导,两组患者麻醉诱导方法相同,当BIS≤45时行气管插管.记录给药前(T0)、给药完毕即刻(T1)、给药后5 min(T2)、插管前即刻(T3)、插管成功后即刻(T4)、插管成功后1 min(T5)、3 min(T6)、5 min(T7)患者的MAP、HR、SpO2、BIS、Ramsay镇静评分;记录患者意识消失时间和BIS降至45的时间;观察并记录麻醉诱导期间的不良反应.结果 与C组比较,D组患者意识消失时间和BIS降至45的时间缩短(P<0.05);与T0时比较,T1~T7时D组患者MAP、BIS均降低,HR减慢,Ramsay镇静评分升高(P<0.05);T3~T7时C组MAP、BIS均降低,Ramsay镇静评分升高;T3、T6和T7时C组HR减慢(P<0.05);与T3时比较,T6时D组MAP降低,T4、T5时C组MAP均升高,HR增快(P<0.05).结论 右美托咪定0.6 μg/kg预注可产生明显的镇静作用,缩短麻醉诱导时间,有效抑制气管插管所引起的心血管反应.%Objective To observe the influence of pre-injection of dexmedetomidine on sedation and tracheal intubation responses in patients with general anesthesia Methods Forty-two ASA Ⅰ or Ⅱ patients, aged 18-60yr, with body mass index of 18-30 kg/m2, scheduled for elective subtotal thyroidectomy under total intravenous anesthesia were randomly divided into two groups: dexmedetomidine group (group D) and control group (group C). Dexmedetomidine 0. 6 μg/kg was infused intravenously 15 min prior to anesthesia induction in group D(with in 10 min), while equal volume of normal saline was infused in group C. All the patients received the

  12. Clinical observation of flurbiprofen preemptive analgesia to prevent general anesthesia emergence agitation of lobectomy%氟比洛芬酯超前镇痛预防肺叶切除术全身麻醉苏醒期躁动的临床观察

    Institute of Scientific and Technical Information of China (English)

    栗村瑞; 王玉洁; 王运灵; 王冬婷; 杨天德

    2014-01-01

    Objective To discuss the clinical effects and safety of lfurbiprofen preemptive analgesia to prevent general anesthesia emergence agitation of lobectomy. Method 60 cases of patients underwent lobectomy were randomly divided into observation group and control group, 30 cases in each group, all underwent conventional induction anesthesia, surgery patients were given remifentanil, propofol, vecuronium infusion to maintain anesthesia, observation group patients before 30 minutes disposable intravenous injection of lfurbiprofen 1 mg/kg, patients in control group intravenous injection of 5 ml of physiological saline. Two groups of patients were observed with restless score, bleeding time, extubation time, the time of anesthesia and the incidence of adverse reactions. Result Observation group patients restlessness score was (0.88±0.34) points, signiifcantly lower than that of control group [(1.89±0.53) points], the difference was signiifcant (P0.05). Observation group after operation dizziness headache was 3 cases (10%), nausea and vomiting was 9 cases (30.00%), chills and fever was 1 case (3.33%), heart palpitations was 3 cases (10%), somnolence was 2 cases (6.67%), control group of patients with dizziness headache was 5 cases (16.67%), nausea and vomiting was 11 cases (36.67%), chills and fever was 2 cases (6.67%), heart palpitations was 1 case (3.33%), somnolence was 4 cases (13.33%), the incidence of adverse reactions in two groups were not signiifcant (P > 0.05). Conclusion Flurbiprofen injection for prevention of general anesthesia emergence agitation of lobectomy is effective, and does not increase the adverse reaction of patients, worthy of clinical application.%目的:探讨氟比洛芬酯超前镇痛预防肺叶切除术全身麻醉苏醒期躁动的临床效果及安全性。方法将60例肺叶切除术患者随机分为观察组和对照组,每组各30例,均行常规诱导全身麻醉气管插管,术中给予患者瑞芬太尼、丙泊酚、维

  13. REGIONAL ANESTHESIA CONTINUOUS BRACHIAL PLEXUS BLOCK WITH ULTRASONOGRAPHY GUIDANCE

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    T. G. A. Senapathi

    2015-03-01

    Full Text Available Background: Regional anesthesia has an anti-inflammatory effect that blockade the C-fiber hence reduced cytokine production and blocked the activity of the sympathetic nerve fibers. Postoperative pain caused primarily by tissue inflammation and activity of the C-fibers in the manner of reduced the production of cytokines, regional anesthesia may limit the inflammatory response after surgery and severity of postoperative pain. Methods: This study is a clinical experimental study with randomized pre and post test control group design. A total of 24 samples were recruited in this study divided into two groups each consisting of 12 samples. The first group was given regional anesthesia method of continuous brachial plexus block with ultrasound guidance and the second group with general anesthesia method. T-test or Mann-Whitney continued multivariate linear regression analysis was performed to analyze the differences in treatment and not because of differences in the initial values with significance level of p<0.05. Results: This study reports that the mean decreased levels of IL-6 postoperatively in 1stgroup is 29.8 lower than in 2ndgroup and it is statistically significant p< 0.05. There was an increase of IL-10 mean levels from preoperative to postoperatively with significance level of p<0.05 in both groups. Declined in the mean levels of PAF postoperatively in 1st group 1.3 lower than 2nd group and it was statistically significant p<0.05. The declined of  postoperative VAS in 1st group is 3.1 lower than 2nd group and it is statistically significant p< 0.05, and it also contained the pure effect of PAF levels against value of VAS that any increased 1ng/ml levels of PAF then an increase in the value of 0.18 cm VAS and this was statistically significant p<0.05. Selection of this anesthesia technique in orthopedic antebrachii surgery provides better inflammatory response and improved clinical outcomes.

  14. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

    OpenAIRE

    Asma Abdus Salam; Gauhar Afshan

    2016-01-01

    Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by eld...

  15. Audiovisual distraction as a useful adjunct to epidural anesthesia and sedation for prolonged lower limb microvascular orthoplastic surgery.

    Science.gov (United States)

    Athanassoglou, Vassilis; Wallis, Anna; Galitzine, Svetlana

    2015-11-01

    Lower limb orthopedic operations are frequently performed under regional anesthesia, which allows avoidance of potential side effects and complications of general anesthesia and sedation. Often though, patients feel anxious about being awake during operations. To decrease intraoperative anxiety, we use multimedia equipment consisting of a tablet device, noise-canceling headphones, and a makeshift frame, where patients can listen to music, watch movies, or occupy themselves in numerous ways. These techniques have been extensively studies in minimally invasive, short, or minor procedures but not in prolonged orthoplastic operations. We report 2 cases where audiovisual distraction was successfully applied to 9.5-hour procedures, proved to be a very useful adjunct to epidural anesthesia + sedation, and made an important contribution to positive patients' outcomes and overall patients' experience with regional anesthesia for complex limb reconstructive surgery. In the era when not only patients' safety and clinical outcomes but also patients' positive experiences are of paramount importance, audiovisual distraction may provide a simple tool to help improve experience of appropriately informed patients undergoing suitable procedures under regional anesthesia. The anesthetic technique received a very positive appraisal by both patients and encouraged us to study further the impact of modern audiovisual technology on anxiolysis for major surgery under regional anesthesia. The duration of surgery per se is not a contraindication to the use of audiovisual distraction. The absolute proviso of successful application of this technique to major surgery is effective regional anesthesia and good teamwork between the clinicians and the patients. PMID:26272621

  16. 静吸复合全麻时机械通气与自主呼吸对鼓室成形术患者肺功能的影响%Effects of mechanical ventilation and controlled spontaneous respiration on pulmonary function during short duration of general anesthesia with tracheal intubation

    Institute of Scientific and Technical Information of China (English)

    蒋海; 靳三庆; 林世清; 蒋小朴; 陈锡辉

    2009-01-01

    Objective To evaluate the effects of mechanical ventilation on pulmonary function during short duration of general anesthesia with tracheal intubation, and assess the safety of controlled spontaneous respiration during general anesthesia. Methods Fifty-three adult patients (aged 18-55 years, ASA physical status Ⅰ-Ⅱ) scheduled for elective unilateral tympanoplasty were randomly assigned into mechanical ventilation group (group M, n=28) and spontaneous respiration group (group S, n=25). Anesthesia induction was performed in group M with intravenous propofol (2 mg/kg), fentanyl (3 μg/kg) and vecuronium (0.1 mg/kg), while with propofol (2 mg/kg), fentanyl (3 μg/kg) and sufficient superficial anesthesia on upper airway mucous membrane in group S. After tracheal intubation, mechanical ventilation began with VT 8 ml/kg and RR 10-12 bpm in group M, and spontaneous respiration was maintained in group S. Anesthesia was maintained by 0.7%-0.8% isoflurane and 60%-70% N_2O at the end respiratory concentration to control MAC between 1.2-1.3. During the surgery, BIS values were controlled between 40-60, and propofol was administered when necessary. Vecuronium (1-2 mg) was given intermittently to maintain muscle relaxation and neostigmine (1 mg) with atropine 0.5 mg was administered intravenously before extubation in group M. No relaxant was used in group S. The parameters including heart rate (HR), mean blood pressure (MAP), pulse oxygen saturation (SpO_2), and thoracic fluid content (TFC) were recorded before the induction and at 1, 5, 10, 20, 40, 60, 90, 120, and 150 min after intubation. Arterial blood was drawn immediately and 150 min after intubation for blood gases analysis and Alveolar-arterial oxygen gradient (P(A-a)DO_2), and the respiratory index (RI) and dead volume/tidal volume (VD/VT) were calculated. The incidences of moving, bucking, swallowing, and status of awareness during surgery procedures were also recorded. Results A total of 43 patients (group M, n=23

  17. Combination of spinal anesthesia and peripheral nerve block: Case report

    Directory of Open Access Journals (Sweden)

    Vildan Temel

    2010-12-01

    Full Text Available Regional anaesthesia has advantages such as, control of postoperative pain, early mobilization, and does not affect respiratory function. In recent years, regional anaesthesia had improved by the application of the peripheral nerve stimulator and ultrasound guided blocks, new local anaesthetic drugs with the use of additional adjunctive agents. Especially in emergency conditions, combination of regional anaesthesia may avoid the complications of general anesthesia in patients with chronic disease who suffer from upper and lower extremity injuries. In this paper, we present two cases who underwent combined regional anaesthesia techniques for the lower and upper extremity surgery.

  18. Peribulbar anesthesia for the repair of orbital floor fractures.

    Science.gov (United States)

    Kezirian, G M; Hill, F D; Hill, F J

    1991-10-01

    Four patients underwent successful repair of an isolated orbital floor fracture under local anesthesia. The surgical approach was by antero-inferior orbitotomy, with placement of a Nylamid plate (S Jackson Inc, Washington, DC). The anesthetic technique used was a peribulbar and infratrochlear nerve block with local supplementation. Digital control of the globe was maintained during the peribulbar injection to prevent ocular perforation. We conclude that local anesthetic for this procedure in carefully selected cases is safe and efficacious, avoiding the morbidity of a general anesthetic. PMID:1961618

  19. Anesthesia for hemicolectomy in a known porphyric with cecal malignancy

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    B K Naithani

    2015-01-01

    Full Text Available Intraoperative management of a known acute intermittent porphyria patient is a challenge requiring awareness of factors, which trigger an acute crisis, clinical features of a porphyric attack, knowledge of safe pharmacologic intervention, and preparedness for reintubation and ventilatory support. The classical signs of a porphyric crisis such as pain abdomen, vomiting and neuropsychiatric symptoms are masked under general anesthesia and can be confused with postoperative pain and vomiting and postoperative cognitive dysfunction, especially for intra-abdominal surgeries. Eternal vigilance for onset of an acute crisis is imperative. After a crisis of acute intermittent porphyria, residual paresis may persist for years in the absence of further attacks.

  20. Clinical effect of radio-frequency and marsupialization under self-retaining laryngoscope combined with electronic laryngoscope in general anesthesia in the treatment of epiglottic cyst%全麻支撑喉镜联合电子喉镜行射频揭盖术治疗会厌囊肿30例

    Institute of Scientific and Technical Information of China (English)

    薛远琼; 阮奕劲; 朱怀文

    2015-01-01

    目的:观察全麻支撑喉镜联合电子喉镜行射频揭盖术治疗会厌囊肿的疗效。方法选取我院耳鼻喉科收治的会厌囊肿患者60例,随机分为观察组和对照组,每组30例。对照组在全麻下行支撑喉镜下圈套器圈套治疗,观察组行全麻支撑喉镜联合电子喉镜行射频揭盖术治疗。记录两组患者的手术时间和术中出血量。术后采用门诊随访的形式,随访12个月以上,观察患者术后治疗效果。结果观察组和对照组手术时间分别为(12.8±3.2) min和(46.5±8.6) min,术中出血量分别为(2.2±0.3) ml和(10.4±2.6) ml,观察组手术时间和术中出血量显著低于对照组,差异均有显著统计学意义(P<0.01)。随访6个月时,观察组和对照组总有效率分别为96.67%和86.67%,复发率分别为3.33%和13.33%;随访12个月时,观察组和对照组总有效率分别为93.33%和76.67%,复发率分别为6.67%和23.33%;观察组总有效率明显高于对照组,复发率显著低于对照组,差异均有统计学意义(P<0.05或P<0.01)。结论全麻支撑喉镜联合电子喉镜行射频揭盖术治疗会厌囊肿疗效好,且具有手术时间短、出血量少的特点。%Objective To investigate the clinical effect of radio-frequency and marsupialization under self-re-taining laryngoscope combined with electronic laryngoscope in general anesthesia in the treatment of epiglottic cyst. Methods Sixty patients with epiglottic cyst in our hospital were randomly divided into observation group and control group, with 30 cases in each group. Patients in control group were treated with snare trap treatment under self-retaining laryngoscope in general anesthesia, while patients in observation group were treated with radio-frequency and marsupial-ization under self-retaining laryngoscope combined with electronic laryngoscope in general anesthesia. Operation dura-tion and blood loss were recorded. A postoperative follow-up of

  1. 长期糖皮质激素用药对老年患者全麻手术中顺阿曲库铵肌松效应的影响%Effects of long-term glucocorticoid administration on neuromuscular block of cisatracurium in elderly pa-tients undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    朱小兵; 吴论; 王根保; 戚志超; 夏莹; 彭学强

    2016-01-01

    目的:探讨长期糖皮质激素用药对老年全麻手术患者顺阿曲库铵肌松效应的影响。方法择期老年全麻手术患者40例,男28例,女12例,年龄≥65岁,BMI 18~22 kg/m2,ASA 分级Ⅱ或Ⅲ级,根据患者是否长期糖皮质激素用药分为两组(n =20):对照组(非激素组,C 组)和激素组(J 组)。静脉注射咪达唑仑0.03 mg/kg,面罩吸入8%七氟醚,氧流量为8 L,每30 s 递减2%,直至4%,睫毛反射消失后,静脉注射顺阿曲库铵0.15 mg/kg,经1 min 静脉注射瑞芬太尼2μg/kg,30 s后停止吸入七氟醚,气管插管后行机械通气,靶控输注丙泊酚和瑞芬太尼维持麻醉,采用 TOF-Watch SX 加速度仪监测肌松程度,记录顺阿曲库铵起效时间、肌颤搐最大抑制程度、临床作用时间、恢复指数。结果与 C 组比较,J 组顺阿曲库铵起效时间明显延长,肌颤搐最大抑制程度明显降低,临床作用时间明显缩短,恢复指数明显减小(P <0.05)。结论长期糖皮质激素用药可减弱老年全麻手术患者顺阿曲库铵肌松效应。%Objective To investigate the effects of long-term glucocorticoid administration on neuromuscular block of cisatracurium in elderly patients undergoing general anesthesia. Methods Forty ASA Ⅱ or Ⅲ patients,aged≥65 yr,with BMI of 18-24 kg/m2 ,scheduled for elec-tive operation were studied.According to the history of using or not long-term glucocorticoid,patients were assigned into two groups (n = 20 each):control group(group C),glucocorticoid group(group J).Midazolam 0.03 mg/kg was injected,mask inhalation of 8% sevoflurane and flow rate of oxygen 8L,every 30 s decline 2%,until the 4%.After the disappearance of eyelash reflex,cisatracurium 0.1 5 mg/kg was injected intravenously.After 1 min intravenous injection of remifentanil 2 g/kg and 30 s after stop of sevoflurane inhalation anesthesia, endotracheal intubation for mechanical ventilation,target controlled infusion of propofol and remifentanil anesthesia

  2. Anestesia peridural lombar ou bloqueio do plexo lombar combinados à anestesia geral: eficácia e efeitos hemodinâmicos na artroplastia total do quadril Anestesia epidural lumbar o bloqueo del plexo lumbar combinados con la anestesia general: eficacia y efectos hemodinámicos en la artroplastia total de la cadera Epidural lumbar block or lumbar plexus block combined with general anesthesia: efficacy and hemodynamic effects on total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Leonardo Teixeira Domingues Duarte

    2009-12-01

    avanzada y de las enfermedades asociadas a los pacientes. El objetivo del estudio, fue evaluar si el bloqueo del plexo lumbar combinado con la anestesia general, equivale a la anestesia epidural lumbar en cuanto a la eficacia del bloqueo nociceptivo, efectos hemodinámicos secundarios, dificultad en su ejecución e influencia en el sangramiento operatorio en pacientes sometidos a la ATC. MÉTODO: Pacientes estado físico ASA I a III que fueron ubicados aleatoriamente en los grupos Epidural y Lumbar. En el grupo Epidural, se realizó la anestesia epidural lumbar continua con la ropivacaína a 0,5% 10 a 15 mL. En el grupo Lumbar, fue realizado el bloqueo del plexo lumbar por la vía posterior con ropivacaína a 0,5% 0,4 mL.kg-1. Todos los pacientes fueron sometidos a la anestesia general. Se estudiaron: la dificultad en la ejecución de los bloqueos, su eficacia y los efectos hemodinámicos secundarios. RESULTADOS: Cuarenta y un pacientes fueron incluidos en el estudio. El tiempo para la ejecución del bloqueo epidural fue menor, pero el número de intentos en colocar la aguja fue similar en los dos grupos. El bloqueo epidural fue más eficaz. En el grupo Lumbar, se registró un aumento de la presión arterial diastólica y media (PAM y en el doble producto. Después de la incisión, el consumo anestésico durante la operación fue mayor. Posteriormente al bloqueo, la PAM fue menor en los 50, 60 y 70 minutos después de la realización del bloqueo epidural. El sangramiento fue parecido en los dos grupos. CONCLUSIONES: La técnica epidural promovió un bloqueo nociceptivo más eficaz sin asociarse a la inestabilidad hemodinámica, cuando se le combinó con la anestesia general. El bloqueo del plexo lumbar fue una técnica útil en combinación con la anestesia general cuando la anestesia epidural estuvo contraindicada.BACKGROUND AND OBJECTIVES: Anesthesia for total hip arthroplasty (THA is a challenge due to the advanced age and associated diseases of patients. The objective

  3. 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

  4. [Rapid opiate detoxification under anesthesia (RODA)].

    Science.gov (United States)

    Dubols, N; Hallet, C; Luppens, D; Ansseau, M; Charlier, C

    2013-01-01

    Rapid Opiate Detoxification under Anesthesia (RODA) involves the use of opiate antagonists combined with anesthesia and pharmacotherapy to reduce withdrawal symptoms. The aim of our study was to measure the plasma concentrations of heroin metabolites and methadone during anesthesia and patient stay at the hospital in order to assess the amount of active substances at each protocol step. Plasma concentrations of antagonists were also quantified and compared to the recommended target values. Blood samples were drawn in 10 patients undergoing RODA at different times of the procedure (during anesthesia, in post-anesthesia care unit and in psychiatry unit). The plasma concentrations of heroin metabolites, methadone and antagonists were measured using a previously described method. Heroin active metabolites were no longer detected in the patient blood when helshe left the hospital; by contrast, methadone was still present at significant concentrations 3 days after the beginning of the detoxification procedure. Naltrexone analysis allowed us to adjust doses to insure opiate receptor blockade during acute withdrawal, which is a critical period. PMID:23888580

  5. Anestesia geral após falha da raquianestesia para procedimento de urgência em paciente com mucopolissacaridose: relato de caso Anestesia general después de la falla de la anestesia raquidea para procedimiento de urgencia en paciente con mucopolisacaridosis: relato de caso General anesthesia after failed spinal block for emergency surgery in a patient with mucopolysaccharidosis: case report

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2007-12-01

    in the sitting position. After identifying failure of the spinal block it was changed to general anesthesia. Anesthetic induction consisted of intravenous clonidine, fentanyl and propofol, followed by endotracheal intubation without intercurrences. After a 45-minute surgery, the patient was extubated and transferred to the postanesthetic care unit where he remained under observation for 12 hours, being discharged to the regular ward without intercurrences. CONCLUSIONS: In the case presented here we did not have any difficulties handling the airways. However, this is the main problem in this group of patients and it is up to the anesthesiologist to choose the better technique to guarantee adequate handling of the airways.

  6. THORACIC EPIDURAL ANESTHESIA FOR MODIFIED RADICAL MASTECTOMY-IN TYPE2 DIABETES MELLITUS PATIENT

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    Vishwanath R

    2014-12-01

    Full Text Available Modified radical mastectomy (MRM, the standard oncologic surgical procedure of the carcinoma of breast is routinely performed under general anesthesia. Carcinoma breast patients are considered to be at high risk for anesthesia due to high possibility of perioperative complications and mortality when associated with long standing type 2 Diabetes Mellitus (DM with other co morbidities. Cardiac complications due to macro vascular and micro vascular involvement can pose a real threat. Here we present a case report of successful perioperative management of modified radical mastectomy only with thoracic epidural anesthesia (TEA in a case of carcinoma breast with long standing type 2 DM and hypertension. A 71year old female, a known case of DM since 7years with co morbidity; hypertension having a carcinoma breast was scheduled for modified radical mastectomy. Continuous epidural anesthesia was administered at T4-5 level. Local anesthetic supplementation titrated as per the demands of surgery and good postoperative analgesia maintained for 48 hours. Long standing DM with hypertension can lead to perioperative morbidity and mortality due to cardiac complications. However, Thoracic epidural anesthesia (TEA reduces cardiac and sympathetic activity and thereby improves perioperative function of vital organs and reduces postoperative morbidity and mortality. The procedure can lead to prompt recovery with additional benefit of prolonged post-operative analgesia. TEA proved to be an excellent anesthetic technique for MRM in patient with long standing DM.

  7. Importance of transesophageal echocardiography in peripartum cardiomyopathy undergoing lower section cesarean section under regional anesthesia

    OpenAIRE

    Kapoor, Poonam Malhotra; Goyal, Sameer; Irpachi, Kalpana; Smita, Barya

    2014-01-01

    Peripartum cardiomyopathy is a relatively rare but life threatening disease. The etiology and pathogenesis of peripartum cardiomyopathy is generally centered upon viral and autoimmune mechanism. This case report describes the anesthetic management of a patient with term pregnancy suffering from dilated peripartum cardiomyopathy planned for cesarean section, successfully managed with epidural anesthesia after precipitate labour.

  8. Transient Neurological Symptoms after Spinal Anesthesia

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    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

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

    Science.gov (United States)

    ... after—an anesthetic is given. Before anesthesia, a preoperative interview with your anesthesia professional supplies valuable information ... to your mental state as well. Moreover, the anxiety that frequently accompanies important decisions is to be ...

  10. Sedation and Anesthesia Options for Pediatric Patients in the Radiation Oncology Suite

    Directory of Open Access Journals (Sweden)

    Eric A. Harris

    2010-01-01

    Full Text Available External beam radiation therapy (XRT has become one of the cornerstones in the management of pediatric oncology cases. While the procedure itself is painless, the anxiety it causes may necessitate the provision of sedation or anesthesia for the patient. This review paper will briefly review the XRT procedure itself so that the anesthesia provider has an understanding of what is occurring during the simulation and treatment phases. We will then examine several currently used regimens for the provision of pediatric sedation in the XRT suite as well as a discussion of when and how general anesthesia should be performed if deemed necessary. Standards of care with respect to patient monitoring will be addressed. We will conclude with a survey of the developing field of radiation-based therapy administered outside of the XRT suite.

  11. Cardiorespiratory effects of outpatient anesthesia for oral surgery: trichloroethylene-halothane.

    Science.gov (United States)

    Allen, G D; Everett, G B; Haines, M

    1976-12-01

    The cardiorespiratory effects of trichloroethylene supplementation of nitrous oxide-oxygen anesthesia, with simultaneous use of halothane at induction as needed, were studied in outpatient oral surgery patients undergoing dental extractions under general anesthesia. The technique produced no deleterious cardiovascular effects that could be attributed to the combined use of these agents. Elevations of blood pressure, stroke volume, and peripheral resistance indicated light anesthesia. The versatility of halothane combined with the absence of nephrotoxic and hepatotoxic breakdown products of trichloroethylene provides a satisfactory technique for outpatient oral surgery. The agents appear pharmacologically complimentary in that halothane lacks analgesic properties and postoperative shivering occurs, while induction with trichloroethylene is slow and tachypnea is a problem. PMID:1069107

  12. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Kehlet, H

    2001-01-01

    To evaluate the feasibility and safety of unmonitored local anesthesia (ULA) for elective open inguinal hernia repair, we made a prospective, consecutive data collection from 1000 operations on primary and recurrent hernias. Follow-up consisted of a questionnaire 1 mo after surgery and retrieval...... from the electronic patient data management system. In 921 ASA Group I and II and 79 ASA Group III and IV patients, the median age was 60 yr (range, 18-95 yr). ULA was converted to general anesthesia in 5 of 1000 cases, and 961 patients were discharged on the day of surgery after 95 min (median...... anesthesia, day-case setup, or both, primarily because of intraoperative pain (n = 74; 7.8%). We conclude that open inguinal hernia repair can be conducted under ULA, regardless of comorbidity, with a small rate of deviation from day-case setup and minimal morbidity. It provides a safe alternative to other...

  13. 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. PMID:27003489

  14. Convulsions during cataract surgery under peribulbar anesthesia: a case report

    OpenAIRE

    Bensghir, Mustapha; Badou, Najlae; Houba, Abdelhafid; Balkhi, Hicham; Haimeur, Charki; Azendour, Hicham

    2014-01-01

    Introduction Locoregional anesthesia techniques are increasingly used for cataract surgery. From these techniques, peribulbar anesthesia has been very successful over the retrobulbar anesthesia seen its effectiveness and safety. However, peribulbar anesthesia is not without risk. Case presentation A 70-year-old African man was scheduled for cataract surgery and lens implant for his right eye. His medical history included hypertension, diabetes mellitus and gall bladder surgery. There were no ...

  15. The effects of two dosages of midazolam on short-duration anesthesia in the harp seal (Phoca groenlandica).

    Science.gov (United States)

    Pang, Daniel S J; Rondenay, Yves; Measures, Lena; Lair, Stéphane

    2006-03-01

    The purpose of this study was to provide safe anesthesia for bronchoalveolar lavage and assess the utility of premedication with i.m. midazolam for short-duration anesthesia with isoflurane in harp seals (Phoca groenlandica). Fourteen yearling harp seal pups were anesthetized three times each as part of a prospective, cross-over, blinded study. Each animal received i.m. premedication with saline, low-dose, or high-dose midazolam (respectively 0.1 and 0.2 mg/ kg). Following premedication, anesthesia was induced with 4% isoflurane in oxygen delivered through a mask and connected to a Bain non-rebreathing system. A significantly longer time was taken from the end of general anesthesia to head movement in the high-dose group compared with the saline group (P = 0.002). A significantly longer time was taken from the end of general anesthesia to ambulation in the high-dose group compared with the saline group (P = 0.006). There were no significant differences between groups in the subjective assessment of anesthetic quality or ease of intubation. Premedication with i.m. midazolam at the dosages used did prolong recovery from anesthesia, although to a degree unlikely to be significant clinically. PMID:17312808

  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. 21 CFR 868.5170 - Laryngotracheal topical anesthesia applicator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laryngotracheal topical anesthesia applicator. 868... topical anesthesia applicator. (a) Identification. A laryngotracheal topical anesthesia applicator is a device used to apply topical anesthetics to a patient's laryngotracheal area. (b) Classification....

  18. 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…

  19. 21 CFR 868.5140 - Anesthesia conduction kit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction kit. 868.5140 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a) Identification. An anesthesia conduction kit is a device used to administer to a patient conduction, regional,...

  20. 21 CFR 868.5130 - Anesthesia conduction filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction filter. 868.5130 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5130 Anesthesia conduction filter. (a) Identification. An anesthesia conduction filter is a microporous filter used while administering to a...

  1. 21 CFR 868.5150 - Anesthesia conduction needle.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction needle. 868.5150 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a) Identification. An anesthesia conduction needle is a device used to inject local anesthetics into a patient...

  2. 21 CFR 868.5120 - Anesthesia conduction catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction catheter. 868.5120 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5120 Anesthesia conduction catheter. (a) Identification. An anesthesia conduction catheter is a flexible tubular device used to...

  3. 21 CFR 884.5100 - Obstetric anesthesia set.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric anesthesia set. 884.5100 Section 884.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5100 Obstetric anesthesia set. (a) Identification. An obstetric anesthesia set is an assembly...

  4. Can children undergoing ophthalmologic examinations under anesthesia be safely anesthetized without using an IV line?

    Directory of Open Access Journals (Sweden)

    Vigoda M

    2011-04-01

    Full Text Available Michael M Vigoda, Azeema Latiff, Timothy G Murray, Jacqueline L Tutiven, Audina M Berrocal, Steven GayerBascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To document that with proper patient and procedure selection, children undergoing general inhalational anesthesia for ophthalmologic exams (with or without photos, ultrasound, laser treatment, peri-ocular injection of chemotherapy, suture removal, and/or replacement of ocular prosthesis can be safely anesthetized without the use of an intravenous (IV line. Children are rarely anesthetized without IV access placement. We performed a retrospective study to determine our incidence of IV access placement during examinations under anesthesia (EUA and the incidence of adverse events that required intraoperative IV access placement.Methods: Data collected from our operating room (OR information system includes but is not limited to diagnosis, anesthesiologist, surgeon, and location of IV catheter (if applicable, patient’s date of birth, actual procedure, and anesthesia/procedure times. We reviewed the OR and anesthetic records of children (>1 month and <10 years who underwent EUAs between January 1, 2003 and May 31, 2009. We determined the percentage of children who were anesthetized without IV access placement, as well as the incidence of any adverse events that required IV access placement, intraoperatively.Results: We analyzed data from 3196 procedures performed during a 77-month period. Patients’ ages ranged from 1 month to 9 years. Overall, 92% of procedures were performed without IV access placement. Procedure duration ranged from 1–39 minutes. Reasons for IV access placement included parental preference for antinausea medication and/or attending preference for IV access placement. No child who underwent anesthesia without an IV line had an intraoperative adverse event requiring insertion of an IV line.Conclusion: Our data suggest that for

  5. The observation of hemodynamics and ST segment changes during middle-up abdominal surgery under general anesthesia combined with thoracice pidural block in elder patients%老年患者全麻联合硬膜外阻滞下中上腹部手术期间血液动力学变化及缺血性心肌改善的观察

    Institute of Scientific and Technical Information of China (English)

    郭乃良; 许迎华; 杨旅军

    2012-01-01

    Objective To observe the change of hemodynamics and ST segment in elderly patients during middle-up abdominal surgery under general anesthesia combined with thoracic epidural block. Methods 35 elderly patients scheduled for middle-up abdominal surgery were studied. The changes of their hemodynamic parameters from Flotrac/Vigileosystem (Edwards Lifesciences, USA) such as cardiac index (CI), stroke volume variations (SW), systemic vascular resistance (SVR), center venous pressure (CVP), heart rate (HR), invasive blood pressure (IBP) and ST segment changes were recorded before anesthesia, induction, incision, exploration, finishing of operation, after extubation. Results The IBP, CVP, SVR were lower than that at the point of before anesthesia, induction, incision (P0.05). Conclusions Thoracic epidural block could ameliorated myocardialischemia. CI could decrease after thoracic epidural block, induction and even recovered to the level of that before anesthesia after extubation. General anesthesia combined with thoracic epidural block could be beneficial for middle-up operation in the aged.%目的 观察老年患者全麻联合硬膜外阻滞下中上腹部手术期间血液动力血改变及缺血性心肌改善.方法 择期中上腹部手术老年患者35例,年龄70 ~ 85岁,平均(76±5)岁,ASAⅠ~Ⅲ级,监测HR、NIBP、ECG、SPO2,Flotrac传感器至Vigileo监测仪上得到血流动力学的监测指标,心排指数(CI)、每搏量变异度(SW)、外周血管阻力(SVR)等血液动力学指标,并连接至OhmedaS/5型监护仪得到动脉压力波直接得到有创动脉(IBP)以及心电图ST段改变分析;并记录在麻醉前,胸段硬膜外阻滞后15 min,全麻诱导后插管时,切皮时,探查时,术毕,拔管后等各时期的指标.结果 麻醉前,全麻诱导时,切皮时,探查时,术毕时,IBP,CVP,SVR显著下降(P<0.01);在硬膜外阻滞后以及全麻诱导时ST段压低改善(P<0.01);胸段硬膜外阻

  6. [Comparative assessment of inhalation anesthesia with sevofluran and intravenous anesthesia with propofol for carotid endarterectomy].

    Science.gov (United States)

    Neĭmark, M I; Shmelev, V V; Simagin, V Iu

    2009-01-01

    Total intravenous anesthesia with propofol and inhalation sevofluran was assessed in 130 patients with carotid endarterectomy. The parameters of brain blood circulation, brain damage markers were studied. It was shown that sevofluran anesthesia caused less depression of the hemodynamic parameters, supported more optimum level of brain blood flow that limited ischemic and reperfusion damage of the brain and was accompanied by a fewer number of postoperative complications. PMID:20209996

  7. 42 CFR 415.178 - Anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Anesthesia services. 415.178 Section 415.178 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING...

  8. 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.

  9. [Anesthesia in the Signal Processing Methods].

    Science.gov (United States)

    Gu, Jiajun; Huang, Yan; Ye, Jilun; Wang, Kaijun; Zhang, Meimei

    2015-09-01

    Anesthesia plays an essential role in clinical operations. Guiding anesthesia by EEG signals is one of the most promising methods at present and it has obtained good results. The analysis and process of the EEG signals in anesthesia can provide clean signal for further research. This paper used variance threshold method to remove the mutation fast and large interfering signals; and used notch filter to remove frequency interference, smoothing filter to remove baseline drift and Butterworth low-pass filter to remove high frequency noise at the same time. In addition to this, the translation invariant wavelet method to remove interference noise on the signals which was after the classical filter and retained non-stationary characteristics was used to evaluate parameter calculation. By comparing the calculated parameters from treated signal using this paper's methods and untreated signal and standard signal, the standard deviation and correlation has been improved, particularly the major parameters BetaR, which provides better signal for integration of multi-parameter to evaluate depth of anesthesia index for the latter. PMID:26904870

  10. 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.

  11. Respiratory Monitoring for Anesthesia and Sedation

    OpenAIRE

    Anderson, Jay A.

    1987-01-01

    This article reviews the theory and practice of routine respiratory monitoring during anesthesia and sedation. Oxygen monitoring and capnography methods are reviewed. The current ventilation monitoring system of choice is considered a combination of the pulse oximeter and capnography. Guidelines are provided for monitoring standards.

  12. 西安市1002名家长对儿童牙科全身麻醉技术认知及接受度调查%Investigation on cognition and acceptance level on dental general anesthesia of 1002 parents in the city of Xi'an

    Institute of Scientific and Technical Information of China (English)

    刘芬; 周志斐; 邬礼政; 葛鑫; 李巧凤; 王小竞

    2013-01-01

    Objective: To investigate parental cognition and acceptability on dental general anesthesia (DGA) applied in pediatric dentistry and raise some possible affected factors to better serve the clinical work. Method: During November 2011 to March 2012,1002 parents who took their children to the department of pediatric dentistry, School of Stomatology, Fourth Military Medical University were investigated. One clinical worker was assigned to explain the DGA technique and parent then filled the questionnaire. SPSS 11.0 software was used for statistical analysis. Cognition and acceptance level of parents was expressed by the way of relative number while x2 test was used to make it clear which factor would further affect parents' acceptance. Result: DGA in pediatric dentistry had the least familiar level by parents and only 6.69 % of them had heard of it and knew something about the technique. Only 20.76 % of the parents would accept this technique when clinical dentists recommended and among the investigated samples 61.98 % of them worried about the side effects of anesthetic. More than 33.33 % of the parents respectively believe that children's physical and brain development would be hurt under DGA. Monthly income of a family,the educational level of parents and geological factors were the statistically significant affected factors on parents' acceptance of DGA. Conclusion: DGA is a newly developing behavior management technique in pediatric dentistry in recent years. Parents have a low cognition and acceptance level of it. Pediatric dentists should do a better explain work in clinical work.%目的:了解家长对儿童牙科全身麻醉技术(dental general anesthesia,DGA)的认知和接受程度并分析其可能的影响因素.方法:向2011年11月~2012年3月间前来第四军医大学口腔医学院儿童口腔科就诊的1002名初、复诊患儿家长解释DGA后由家长完成调查问卷,数据采用SPSS 11.0软件行统计学分析.家长对DGA的接受度

  13. Effects of different doses of dexmedetomidine on cognitive function in elderly patients in general anesthesia operation%不同剂量右美托咪定对老年全麻手术患者术后认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    马志军; 王清涛; 臧颖卓

    2015-01-01

    Objective Comparison of different doses of dexmedetomidine on general anesthesia in the elderly patients with postoperative cognitive dysfunction (POCD) effect.Methods 105 old aged patients,ASA gardeⅠ-Ⅱ,were randomly allocated to three groups, Dex(0. 5μg/kg) group(A group),Dex(0. 8μg/kg) group(B group)and control group,with 35 cases each. MAP, HR were observed and recorded in 10min before extubation and 30min after extubation, The simple mental state scale (MMSE) score and postoperative cognitive dysfunction (POCD) were compared between the three groups.Results Compared with the control group, the MAP and HR of A group and B group were significantly lower than that in control group in 10min before extubation and 30min after extubation ,MMSE score of A group and B group after surgery recovered rapidly and the incidence of POCD rate is low. there was no significant difference in MAP and HR in 10min before extubation and 30min after extubation ,MMSE score and POCD between A group and B group.Conclusion Dexmedetomidine can maintain stable hemodynamics in elderly patients during general anesthesia ,it could accelerate the recovery of elderly patients with postoperative mental state and reduce occurrence of elderly surgical patients of early POCD. There was no obvious correlation between the effect and the dosage of chemicals.%目的:比较不同剂量右美托咪定对老年全麻患者术后认知功能障碍(POCD)的影响。方法选择美国麻醉医师协会分级(ASA)Ⅰ-Ⅱ级的老年患者105例,随机分为三组:右美托咪定(0.5μg/kg)组(A组),右美托咪定(0.8μg/kg)组(B组),对照组,每组35例,观察并记录术前10min,拔管前10min,拔管后30min的MAP、HR。比较三组术后简易精神状态量表( MMSE)评分和术后认知功能障碍( POCD)发生率。结果与对照组相比,拔管前10min,拔管后30min,A组和B组MAP明显降低,HR明显变慢,A组和B组术后 MMSE评分恢复较快

  14. 丁卡因胶浆对喉罩通气全麻苏醒期患者血流动力学的影响%Effect of tetracaine mucilage on hemodynamics of patients with laryngeal mask airway during recovery period of general anesthesia

    Institute of Scientific and Technical Information of China (English)

    慕玲霞; 孙玉川; 刘斐

    2014-01-01

    目的:观察丁卡因胶浆涂抹喉罩对全麻患者血流动力学和咽部不适的影响。方法选择择期ASAⅠ~Ⅱ手术患者80例,随机分为观察组和对照组。观察组在一次性喉罩的前端和背面均匀涂抹盐酸丁卡因胶浆,对照组在相应位置涂抹石蜡油。观察并记录手术结束时( T1)及拔出喉罩1 min( T2)、3 min( T3)和5 min( T4)各时点的收缩压( SBP)、舒张压( DBP)、心率( HR)的变化。并记录术后咽喉部不适、疼痛、声音嘶哑等并发症的发生率。结果两组在T1时刻HR、SBP和DBP水平比较差异无统计学意义(P﹥0.05)。与A组相比,B组在T2、T3、T4时刻SBP和DBP明显升高,HR增快(P﹤0.05)。A组术后咽喉部不适、疼痛、声音嘶哑的发生率明显低于B组(P﹤0.05)。结论应用丁卡因胶浆涂抹喉罩可以维持全麻苏醒期患者血流动力学的稳定,减轻咽喉部不适。%Objective To observe the effects of tetracaine mucilage coated laryngeal mask on hemodynamics and throat discomfort of patients with general anesthesia. Methods Eighty ASAⅠ-Ⅱ patients were randomly divided into observation group and control group. The patients in observation group were given tetracaine mucilage coated on the front and back of the laryngeal mask,and the patients in the control group were given sterile paraffin oil coated on the front and back of the laryngeal mask. The changes of SBP,DBP and HR were recorded at the end of the operation,1 minute,3 mi-nutes and 5 minutes after the removal of the laryngeal mask. The incidences of complications such as post-operative throat discomfort,pain and hoarseness were recorded. Results There were no significant differences in levels of SBP,DBP and HR between the two groups at T1(P﹥0. 05). The levels of SBP,DBP and HR were higher in group B than those in group A at T2,T3 and T4(P﹤0. 05). The incidences of postoperative throat discomfort,pain and

  15. 全麻诱导期药物应用对颅脑外伤所致脑损伤患者脑血流动力学的影响%Effects of cerebral hemodynamics for patients with craniocerebral trauma cured by different drugs in general anesthesia induction period

    Institute of Scientific and Technical Information of China (English)

    张生茂; 李娜; 韩亚升; 包娜日素

    2015-01-01

    Objective To investigate effects of cerebral hemodynamics for patients with craniocerebral trauma cured by dif‐ferent drugs in general anesthesia induction period.Methods 64 patients with craniocerebral trauma in recent 1 year in our hos‐pital were divided into two groups randomly ,the control group was given alfentanil in the period of general anesthesia induction , while the observation group was given remifentanil.We detected the relative parameters of cerebral hemodynamics in 5 different periods by TCD.Results After the application of the two drugs ,the cerebrovascular velocity ,mean arterial pressure and heart rate were significantly decreased than induction period(P0.05).Velocity ,pulsatility index and resistance index increased significantly(P0.05).Conclusion In the same drug concentration of alfentanil ,the effect of remifentanil on hemodynamics is more obvious.%目的:观察全麻诱导期药物应用对颅脑外伤所致脑损伤患者脑血流动力学的影响。方法入选近1a就诊于我院的颅脑外伤所致脑损伤患者64例,随机分为2组,对照组在全麻诱导期给予阿芬太尼,观察组给予瑞芬太尼,采用 T CD在不同时期分别检测患者脑血流动力学相关参数。结果2组输注药物后脑血管流速、平均动脉压和心率均较诱导期前明显降低,P<0.05;搏动指数和阻抗指数明显提高(P<0.05);气管插管前后平均动脉压和心率无明显变化(P>0.05);流速明显加快(P<0.05);搏动指数和阻抗指数明显升高(P<0.05)。应用瑞芬太尼较阿芬太尼血流速度在药物输注后和气管插管后下降更为显著(P<0.05);搏动指数和阻抗指数提高更为显著(P<0.05);但平均动脉压和心率组间差异无统计学意义(P>0.05)。结论在同等药物浓度情况下,瑞芬太尼对血流动力学的影响较为显著,阿芬太尼影响程度相对较小。

  16. 右美托咪定与哌替啶预防全麻患者术后寒战效果的比较%A comparison of efficacy of dexmedetomidine and pethidine for prevention of postoperative shivering in patients requiring general anesthesia

    Institute of Scientific and Technical Information of China (English)

    沈社良; 王文元; 胡双飞

    2012-01-01

    Objective To compare the efficacy of dexmedetomidine and pethidine for prevention of postoperative shivering in patients requiring general anesthesia.Methods Sixty ASA Ⅰ-Ⅲ patients of both sexes,aged 18-75 yr,weighing 40-85 kg,were randomly divided into 2 groups (n =30 each) ∶ pethidine group (group P) and dexmedetomidine group (group D).At the end of pneumoperitoneum,pethidine 0.5 mg/kg and dexmedetomidine 1 μg/kg were infused intravenously over 10 min in groups P and D,respectively.The shivering,respiratory depression,somnolence,nausea and vomiting,bradycardia and hypotension were recorded within 1 h after operation.Results There were no significant differences in the incidence and degree of shivering between group D and group P (P > 0.05).The incidences of respiratory depression and nausea and vomiting were significantly lower,and the incidence of bradycardia was significantly higher in group D than in group P(P < 0.05).Conclusion The efficacy of dexmedetomidine for prevention of postoperative shivering is better than pethidine in patients requiring general anesthesia.%目的 比较右美托咪定与哌替啶预防全麻患者术后寒战的效果.方法 择期行腹腔镜胆囊切除术患者60例,年龄18 ~ 75岁,体重40 ~ 85 kg,性别不限,ASA分级Ⅰ~Ⅲ级.按年龄进行分层,采用分层随机法,将患者随机分为2组(n=30)∶哌替啶组(P组)和右美托咪定组(D组).停止气腹时P组和D组分别经10 min静脉输注哌替啶0.5 mg/kg和右美托咪定1 μg/kg.记录术后1h内寒战、呼吸抑制、嗜睡、恶心呕吐、心动过缓和低血压的发生情况.结果 与P组比较,D组寒战发生率及程度差异无统计学意义(P> 0.05),呼吸抑制及恶心呕吐发生率降低,心动过缓发生率升高(P<0.05).结论 右美托咪定预防全麻患者术后寒战发生的效果优于哌替啶.

  17. 右美托咪啶用于妇科腹腔镜手术全麻后寒战的效果:前瞻性、随机、单盲、临床对比研究%Effect of dexmedetomidine in preventing shivering after general anesthesia for laparoscopic surgery: a randomized, single-blinded, and placebo-controlled trial

    Institute of Scientific and Technical Information of China (English)

    吴涯雯; 黄鸿晖; 曾静贤; 李步龙; 雷学恒; 陈友权

    2013-01-01

    目的 探讨右美托咪啶在预防妇科腹腔镜手术全麻后寒战的有效性.方法 将80例择期行妇科腹腔镜手术随机分为两组,每组40例.D组:在手术结束前30 min静脉缓慢注射右美托咪啶1.0 μg/kg(注射时间超过10 min).N组:右美托咪啶改为生理盐水.记录术前、术后10 min患者心率、平均动脉压、血氧饱和度数值,观察寒战的发生情况.同时观察、记录并处理有关不良反应.结果 N组的寒战发生率是37.5%,D组是7.5%,两组差异有统计学意义(P<0.05).D组术后心率、平均动脉压与N组比较,差异有统计学意义(P<0.05).D组镇静程度评分和口干发生率与N组比较,差异有统计学意义(P<0.05),而N组恶心和呕吐的发生率高于D组(P<0.05).结论 1.0 μg/kg右美托咪啶用于妇科腹腔镜手术有一定的抗寒战作用,并且可以降低全麻后寒战的发生率.%Objective To evaluate efficacy of dexmedetomidine in preventing shivering after general anesthesia in women undergoing laparoscopic surgery. Methods Eighty patients scheduled for laparoscopic gynecological surgery were randomized into dexmedetomidine group (n=40) and control group (n=40) to receive 1.0 μg/kg dexmedetomidine or an equal volume of saline slowly injected (for over 10 min) at 30 min before the anticipated completion of surgery. The postoperative incidences of shivering and the side effects were recorded. Results The patients in the control group showed a significantly higher postoperative incidence of shivering (37.5%) than those in dexmedetomidine group (P0.05). Heart rate and mean arterial pressure showed significant variations postoperatively in dexmedetomidine group (P0.05), which had a significantly greater sedation score (P<0.05), a higher incidence of dry mouth (P=0.000), but a significantly lower incidence of nausea and vomiting than the control group (P<0.05). Conclusion Dexmedetomidine can lower the incidence of shivering after general

  18. 全身麻醉下顺式阿曲库铵对大鼠坐骨神经复合肌肉动作电位的影响%Effects of cisatracurium on compound muscle action potential of sciatic nerve in rats under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    臧光辉; 孟祥虎; 樊龙昌; 李新华; 刘继红; 张传汉; 罗爱林; 田玉科

    2013-01-01

    目的:研究水合氯醛全麻状态下顺式阿曲库铵对大鼠坐骨神经复合肌肉动作电位(CMAP)的影响.方法:60只SD大鼠随机分为2组,7%水合氯醛腹腔注射麻醉后,实验组腹腔注射顺式阿曲库铵(0.93 mg/kg),对照组腹腔注射等体积生理盐水,立即刺激坐骨神经,记录大鼠腓肠肌CMAP变化,刺激间隔5 min.结果:麻醉生效后18 ~ 48 min 2组间峰峰值及潜伏期差异有统计学意义(P<0.05).实验组CMAP变化分3个阶段:诱导期,表现为峰峰值逐步下降,潜伏期延长,持续约10 min;抑制期,表现为峰峰值进一步降低,潜伏期进一步延长,之后有恢复趋势,持续约30 min;恢复期,表现为峰峰值、潜伏期恢复至用药前水平.对照组CMAP峰峰值与潜伏期均无显著变化(均P>0.05).结论:顺式阿曲库铵对大鼠腓肠肌CMAP有显著影响,而且呈阶段性变化,准确了解这种变化趋势,有助于术中及时为术者反馈信息,减少神经损伤.%Objective: To study the effects of cisatracurium on compound muscle action potential (CMAP) of sciatic nerve in rats under general anesthesia by chloral hydrate. Methods: A total of 60 SD rats were divided into two groups randomly. Cisatracurium (0. 93mg/kg) was injected intraperitoneally into the rats of the experimental group, and isotonic saline of the same volume in the control group after anesthetized by 7% chloral hydrate, respectively. Sciatic nerve was stimulated after injection at 5 minutes'intervals, and recorded the changes of CMAPs of gastrocnemius muscle. Results: Significant differences existed in peak-to-peak values and latencies between two groups 18-48 minutes after general anesthesia (P0. 05). Conclusions: The CMAPs of gastrocnemius muscles can be significantly impacted by cisatracurium, and present phase changes. Accurate understanding the trend of variation of CMAPs conduces to gather feedback information for operater during surgery, and thus may reduce nerve injury.

  19. 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

  20. Effect research of psychological nursing intervention applied for non-general anesthesia patients in operating room%心理护理干预应用于手术室非全身麻醉患者的效果研究

    Institute of Scientific and Technical Information of China (English)

    张云凤; 李飞芳; 宋思贤; 蔡云亮

    2015-01-01

    目的:探索分析针对手术室非全身麻醉患者进行心理护理干预的临床效果。方法190例非全身麻醉患者随机分为对照组和研究组,各95例。对照组予以常规护理,研究组予以心理护理干预。将两组患者手术前后的相关指标变化情况进行对比。结果两组患者治疗前血压以及心率比较,差异无统计学意义(P>0.05);治疗后均显著优于治疗前,且研究组显著优于对照组,差异有统计学意义(P0.05). The indicators were all improved after treatment, and the research group had better improvement than the control group, and their difference had statistical significance (P<0.05). The research group had much lower visual analogue scale (VAS) and self-rating anxiety scale (SAS) scores than the control group, and their difference had statistical significance (P<0.05). The research group had obviously higher nursing satisfaction degree as 95.79% than 78.95% of the control group (P<0.05).Conclusion Implement of psychological nursing intervention applied for non-general anesthesia patients in operating room can effectively improve heart rate and blood pressure, and relieve postoperative anxiety and pain. This method is benefit for prognosis, and it contains huge value for promotion and application.