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Sample records for anesthesia general

  1. Adenotomy under general anesthesia.

    Science.gov (United States)

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

    1989-01-01

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

  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. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

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

  5. Double balloon enteroscopy examinations in general anesthesia

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  6. 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

  7. [Electronographic changes in general anesthesia].

    Science.gov (United States)

    Mircea, N; Jianu, E; Mănescu, M

    1982-01-01

    Using the electronograph, a special device which is capable to record luminous effects of the Corona and Kirlian types, the authors investigated 9 patients (6 males and 3 females) both before and during anesthetic sleep, and after arousal from anesthesia. In all the patients the studies were made on black-and-white, as well as on colour films. PMID:6220435

  8. 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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    LaQuia A. Vinson

    2016-08-01

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

  12. 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

  13. 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.

  14. 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)

  15. 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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  18. 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...

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. Fetal heart rate changes associated with general anesthesia.

    Science.gov (United States)

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

    1989-07-01

    Decreased fetal heart rate variability was noted 90 seconds after the induction of general anesthesia with sodium thiopentone and fentanyl in a patient undergoing basket extraction of a renal calculus at 30 weeks' gestation. The fetal sleep pattern lasted for 105 minutes after the anesthetic was discontinued, 45 minutes after the mother was fully awake. PMID:2730732

  4. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Sheng-Yong Liang

    2015-01-01

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

  6. 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.

  7. [Epidural analgesia in combination with general anesthesia].

    Science.gov (United States)

    Gottschalk, Antje; Poepping, Daniel M

    2015-07-01

    Epidural anaesthesia is a widely used and accepted technique for perioperative analgesia in different kinds of surgery. Apart from analgetic effect and due to wide positve effects on patients outcome epidural analgesia is often used with general anaesthesia. It represents a reliable and reversible neural deafferentation technique that effectively contributes to a reduction of the surgical stress response with subsequent positive effects on cardiopulmonary, gastrointestinal, and immune function. Animal studies suggest that the use of epidural anaesthesia may be beneficial for cancer surgery because of less tumour recurrence. Further, a benefit is expected in patient's mortality. This article summarizes and critically discusses the current knowledge on the effects of epidural anaesthesia on pain management, cardiopulmonary as well as gastrointestinal functions and patient's outcome.

  8. 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...

  9. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia

    OpenAIRE

    Haruka Nakanishi; Tetsuya Tono; Shoichiro Ibusuki

    2015-01-01

    Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the...

  10. 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

  11. 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...

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2002-01-01

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

  14. Dental management of PHACE syndrome under general anesthesia

    Directory of Open Access Journals (Sweden)

    S Fernandes

    2011-01-01

    Full Text Available PHACE syndrome was first described by Dr. Ilonia Frieden and colleagues in 1996. It is an under-recognized rather than a very rare condition among patients with large facial hemangiomas. It is challenging as it has significant neurological, vascular and airway implications. Vascular malformations compromising cerebral blood flow predispose the patient to strokes and seizures. Subglottic hemangiomas, if present, could bleed during intubation. Meticulous neurological monitoring is mandatory in those undergoing repair of the great vessels. We describe the perioperative management of a child with PHACE syndrome subjected to dental treatment under general anesthesia.

  15. Butorphanol suppresses fentanyl-induced cough during general anesthesia induction

    Science.gov (United States)

    Cheng, Xiao-Yan; Lun, Xiao-Qin; Li, Hong-Bo; Zhang, Zhi-Jie

    2016-01-01

    Abstract Fentanyl-induced cough (FIC) is unwanted in the patients requiring stable induction of general anesthesia. This study was designed to evaluate the suppressive effects of butorphanol pretreatment on the incidence and severity of FIC during the induction of general anesthesia. A total of 315 patients of American Society of Anesthesiologists physical status I and II, scheduled for elective surgery under general anesthesia were randomized into 3 equally sized groups (n = 0105). Two minutes before fentanyl bolus, group I received intravenously 5 mL normal saline, groups II and III received butorphanol 0.015 and 0.03 mg/kg (diluted with saline to 5 mL), respectively. Patients were then administrated with fentanyl 2.5 μg/kg within 5 s. The incidence and severity of FIC was recorded for 2 minutes after fentanyl bolus. During experimental period, the mean arterial pressure, heart rate, and peripheral capillary oxygen saturation (SpO2) were recorded before the administration of butorphanol or normal saline (T0), 2 minutes (T1) after butorphanol injection, and 2 minutes (T2) after fentanyl injection. The incidence of FIC was 31.4% in group I, 11.4% in group II, and 3.8% in group III. Group III had a lowest incidence of FIC among 3 groups (P < 0.001, vs group I; P < 0.05, vs group II). The severe FIC was not observed in groups II and III, but was recoded from 6 patients in group I. At 2 minutes after fentanyl injection (T2), the mean arterial pressure was significantly higher in group I than that in groups II and III (P < 0.01, vs group II; P < 0.05, vs group III), but the values remained within safe limits. In conclusion, pretreatment with butorphanol could effectively and safely suppress FIC during anesthesia induction. PMID:27367987

  16. 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...

  17. 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...

  18. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia.

    Science.gov (United States)

    Nakanishi, Haruka; Tono, Tetsuya; Ibusuki, Shoichiro

    2015-01-01

    Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the submandibular gland worsened and he required emergent reintubation due to airway compromise. The cause of submandibular gland swelling seemed to be an obstruction of the salivary duct due to surgical positioning. Conclusion. Once submandibular swelling and edematous change around the submandibular gland occur, they can worsen and compromise the air way within several hours after operation. Adequate precaution must be taken for any predisposing skull-base surgery that requires strong cervical rotation and flexion. PMID:26697254

  19. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Haruka Nakanishi

    2015-01-01

    Full Text Available Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the submandibular gland worsened and he required emergent reintubation due to airway compromise. The cause of submandibular gland swelling seemed to be an obstruction of the salivary duct due to surgical positioning. Conclusion. Once submandibular swelling and edematous change around the submandibular gland occur, they can worsen and compromise the air way within several hours after operation. Adequate precaution must be taken for any predisposing skull-base surgery that requires strong cervical rotation and flexion.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  1. 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.

  2. 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.

  3. Quantifying cortical activity during general anesthesia using wavelet analysis.

    Science.gov (United States)

    Zikov, Tatjana; Bibian, Stéphane; Dumont, Guy A; Huzmezan, Mihai; Ries, Craig R

    2006-04-01

    This paper reports on a novel method for quantifying the cortical activity of a patient during general anesthesia as a surrogate measure of the patient's level of consciousness. The proposed technique is based on the analysis of a single-channel (frontal) electroencephalogram (EEG) signal using stationary wavelet transform (SWT). The wavelet coefficients calculated from the EEG are pooled into a statistical representation, which is then compared to two well-defined states: the awake state with normal EEG activity, and the isoelectric state with maximal cortical depression. The resulting index, referred to as the wavelet-based anesthetic value for central nervous system monitoring (WAV(CNS)), quantifies the depth of consciousness between these two extremes. To validate the proposed technique, we present a clinical study which explores the advantages of the WAV(CNS) in comparison with the BIS monitor (Aspect Medical Systems, MA), currently a reference in consciousness monitoring. Results show that the WAV(CNS) and BIS are well correlated (r = 0.969) during periods of steady-state despite fundamental algorithmic differences. However, in terms of dynamic behavior, the WAV(CNS) offers faster tracking of transitory changes at induction and emergence, with an average lead of 15-30 s. Furthermore, and conversely to the BIS, the WAV(CNS) regains its preinduction baseline value when patients are responding to verbal command after emergence from anesthesia. We conclude that the proposed analysis technique is an attractive alternative to BIS monitoring. In addition, we show that the WAV(CNS) dynamics can be modeled as a linear time invariant transfer function. This index is, therefore, well suited for use as a feedback sensor in advisory systems, closed-loop control schemes, and for the identification of the pharmacodynamic models of anesthetic drugs.

  4. 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

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

    Science.gov (United States)

    Moiseev, V N

    1983-02-01

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

  6. 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.

  7. Postoperative Pain in Children After Dentistry Under General Anesthesia.

    Science.gov (United States)

    Wong, Michelle; Copp, Peter E; Haas, Daniel A

    2015-01-01

    The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R ≥ 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P < .001, Wilcoxon matched pairs signed rank test). Moderately good correlation between the 2 pain measures existed 2 and 12 hours from discharge (Spearman rhos correlation coefficients of 0.604 and 0.603, P < .005). In conclusion, children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics.

  8. [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

  9. 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.

  10. Prevalence and specifications of postoperative sore throat following general endotracheal anesthesia in patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Zeynab Maghsood-Taleghani

    2007-01-01

    Full Text Available Introduction: Tracheal intubation is a standard technique for the performance of general anesthesia which might lead to stress in patient. This study has been done to evaluate prevalence and specifications of postoperative sore throat following general endotracheal anesthesia in patients undergoing open reduction surgery of extremity limbs fractures.Methods and Materials: In this cross-sectional study a number of 78 patients with 15-65 year old undergoing open reduction surgery of extremity limbs fractures were selected upon to researcher characteristics and in un-randomized sampling. Sensory, affective, intensity and general condition of pain were assessed in 1 and 24 hour after general anesthesia and extubation by using McGill Pain Questionnaire-Short Form (MPQ-SF questionnaire. Results: Upon to result, average age was 29 year and base on McGill Pain Questionnaire-Short Form (MPQ-SF questionnaire results, average score of sensory components of sore throat, 1 and 24 hour after general anesthesia was 3.42 and 1.2 respectively, and average score of affective components of sore throat 1 and 24 hour after general anesthesia was 1.14 and.46 respectively, and average score of sore throat intensity, 1 and 24 hour after general anesthesia was 3.51 and 1.18, respectively. 75.6% of patients had sore throat 1 hour after general anesthesia and 24 hour after decrease to 29.5%. In general, the majority of patients (33.3% said that their sore throat intensity is discomforting. Pair t test revealed a significant difference between sensory and affective components and also intensity of sore throat in 1 and 24 hour after general anesthesia. Average score of sore throat intensity in females was greater than males. Pearson correlation test revealed a significant difference between age and sore throat intensity in 24 hour after general anesthesia.Conclusion: According to results of this study, awareness to complication following general endotracheal anesthesia and

  11. 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.

  12. 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/...

  13. 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.

  14. Regional or general anesthesia for fast-track hip and knee replacement - what is the evidence?

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Aasvang, Eske Kvanner

    2015-01-01

    Regional anesthesia for knee and hip arthroplasty may have favorable outcome effects compared with general anesthesia by effectively blocking afferent input, providing initial postoperative analgesia, reducing endocrine metabolic responses, and providing sympathetic blockade with reduced bleeding...... and less risk of thromboembolic complications but with undesirable effects on lower limb motor and urinary bladder function. Old randomized studies supported the use of regional anesthesia with fewer postoperative pulmonary and thromboembolic complications, and this has been supported by recent large non......-randomized epidemiological database cohort studies. In contrast, the data from newer randomized trials are conflicting, and recent studies using modern general anesthetic techniques may potentially support the use of general versus spinal anesthesia. In summary, the lack of properly designed large randomized controlled...

  15. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

    Directory of Open Access Journals (Sweden)

    Aysun Postaci

    2012-01-01

    Full Text Available Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  16. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia.

    Science.gov (United States)

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-07-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  17. 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

  18. 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

  19. [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

  20. Tourniquet-induced cardiovascular responses in anterior cruciate ligament reconstruction surgery under general anesthesia: Effect of preoperative oral amantadine

    Directory of Open Access Journals (Sweden)

    Ashraf Abd Elmawgood

    2015-01-01

    Conclusion: Preoperative oral amantadine reduced tourniquet induced hypertension and postoperative analgesic requirements in anterior cruciate ligament reconstruction surgery under general anesthesia.

  1. Chronic alcoholism and general anesthesia%慢性酗酒与全身麻醉

    Institute of Scientific and Technical Information of China (English)

    王维维; 王常松; 李恩有

    2015-01-01

    Background With the increasing proportion of chronic alcoholism in surgical patients, anesthesiologists should pay attention to the treatment of alcoholism with general anesthesia.Objective To investigate the effects of chronic alcoholism on general anesthesia and provide theories for clinical application.Content Review the impacts of chronic alcoholism on the body systems and general anesthesia treatment of alcoholism.Trend A more secure and reliable general anesthesia method for chronic alcoholism should be searched.%背景 随着外科手术中慢性酗酒患者比例的增加,酗酒患者的全身麻醉管理受到麻醉医师的关注. 目的 探讨慢性酗酒对全身麻醉的影响,为临床工作提供依据. 内容 综述慢性酗酒对全身系统的影响和酗酒患者的全身麻醉管理. 趋向 寻找安全、可靠的慢性酗酒者的全身麻醉方法.

  2. 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.

  3. 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...

  4. 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.

  5. 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.)

  6. Paraplegia after thoracotomy under combined general and epidural anesthesia in a child.

    NARCIS (Netherlands)

    Allison, C.E.; Aronson, D.C.; Geukers, V.G.; Berg, R. van den; Schlack, W.S.; Hollmann, M.W.

    2008-01-01

    A 9-year-old boy underwent a thoracotomy for excision of his right third rib under combined general and epidural anesthesia for a Ewings sarcoma. Postoperatively, he was found to have a complete T2-3 paraplegia. Permanent paraplegia was described as a rare complication of thoracotomy in adults, and

  7. Inflammatory profile of awake function-controlled craniotomy and craniotomy under general anesthesia

    NARCIS (Netherlands)

    M. Klimek (Markus); J.W. Hol (Jaap Willem); S.C.A. Wens (Stephan); C. Heijmans-Antonissen (Claudia); S.P. Niehof (Sjoerd); A.J. Vincent (Arnaud); J. Klein (Jan); F.J. Zijlstra (Freek)

    2009-01-01

    textabstractBackground. Surgical stress triggers an inflammatory response and releases mediators into human plasma such as interleukins (ILs). Awake craniotomy and craniotomy performed under general anesthesia may be associated with different levels of stress. Our aim was to investigate whether thos

  8. 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…

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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. 

  11. 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;

    2014-01-01

    BACKGROUND: The purpose of this study was to determine whether anesthesia affects graft patency after lower extremity arterial in situ bypass surgery. METHODS: This investigation was a retrospective study using a national database on vascular surgical patients at a single medical institution. We...... 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...

  12. 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…

  13. Direct Modulation of Microtubule Stability Contributes to Anthracene General Anesthesia

    Science.gov (United States)

    Emerson, Daniel J.; Weiser, Brian P.; Psonis, John; Liao, Zhengzheng; Taratula, Olena; Fiamengo, Ashley; Wang, Xiaozhao; Sugasawa, Keizo; Smith, Amos B.; Eckenhoff, Roderic G; Dmochowski, Ivan J.

    2013-01-01

    Recently, we identified 1-aminoanthracene as a fluorescent general anesthetic. To investigate the mechanism of action, a photoactive analogue, 1-azidoanthracene, was synthesized. Administration of 1-azidoanthracene to albino stage 40–47 tadpoles was found to immobilize animals upon near-UV irradiation of the forebrain region. The immobilization was often reversible, but it was characterized by a longer duration consistent with covalent attachment of the ligand to functionally important targets. IEF/SDS-PAGE examination of irradiated tadpole brain homogenate revealed labeled protein, identified by mass spectrometry as β-tubulin. In vitro assays with aminoanthracene-cross-linked tubulin indicated inhibition of microtubule polymerization, similar to colchicine. Tandem mass spectrometry confirmed anthracene binding near the colchicine site. Stage 40–47 tadpoles were also incubated 1 h with microtubule stabilizing agents, epothilone D or discodermolide, followed by dosing with 1-aminoanthracene. The effective concentration of 1-aminoanthracene required to immobilize the tadpoles was significantly increased in the presence of either microtubule stabilizing agent. Epothilone D similarly mitigated the effects of a clinical neurosteroid general anesthetic, allopregnanolone, believed to occupy the colchicine site in tubulin. We conclude that neuronal microtubules are “on-pathway” targets for anthracene general anesthetics and may also represent functional targets for some neurosteroid general anesthetics. PMID:23484901

  14. 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

  15. 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.

  16. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. [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

  5. 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

  6. 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)

  7. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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

  11. 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.

  12. CLINICAL APPLICATION OF ACUPUNCTURE ON ALLEVIATION OF STRESS REACTION INDUCED BY TRACHEAL INTUBATION IN GENERAL ANESTHESIA

    Institute of Scientific and Technical Information of China (English)

    SHI Jin-hua

    2006-01-01

    By summarizing the formation of stress reaction induced by tracheal intubation and method of medicinal control, the recognition of Chinese medicine in treatment of cardiac arrhythmia and hypertension with acupuncture and the clinical application of acupuncture on stress reaction induced by tracheal intubation,it is concluded that the side effects of tracheal intubation are inevitable, even though there are many methods presented for the prevention and treatment for it. In recent years, the functions of acupuncture in anesthesia,especially in regulation of circulatory properties have been developed gradually and have been applied by many physicians in controlling the stress reaction induced by tracheal intubation in general anesthesia. Being a kind of dual-directional and positive regulation and stimulation, acupuncture provides definite and safe effects on controlling the stress reaction induced by tracheal intubation.

  13. 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...

  14. 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

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

    Directory of Open Access Journals (Sweden)

    Rogério Luizari Guedes

    2015-08-01

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

  16. 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

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

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    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.

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

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    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.

  19. 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

  20. 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.

  1. Comparison of recovery profiles of propofol AND sevoflurane anesthesia with bispectral index monitoring (BIS in general anesthesia

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    Mukesh Somvanshi

    2015-03-01

    Method: Fifty ASA physical status I-II patients of either sex, aged between 18 and 60 years were randomly divided into two groups to receive either propofol infusion (group P, n=25 or sevoflurane (group S, n=25. Cardiovascular parameters, SpO2 and bispectral index (BIS scores were recorded. Time to eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9 and the incidence of complications were noted. Results: Early recovery times [eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9] were significantly longer in group P (P 0.05. The incidence of post-operative nausea and vomiting was significantly higher in group S. Conclusions: The present study which adjusted propofol infusion rate and sevoflurane concentration according to BIS scores revealed that maintenance of anesthesia with sevoflurane is associated with faster recovery than anesthesia with propofol. Propofol resulted in a significantly lower incidence of postoperative nausea and vomiting. [Natl J Med Res 2015; 5(1.000: 52-56

  2. Regional versus General Anesthesia for Percutaneous Nephrolithotomy: A Meta-Analysis.

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    Henglong Hu

    Full Text Available To compare the effectiveness and safety of regional anesthesia (RA and general anesthesia (GA for percutaneous nephrolithotomy (PNL.PubMed, EMBASE, The Cochrane Library, and the Web of Knowledge databases were systematically searched to identify relevant studies. After literature screening and data extraction, a meta-analysis was performed using the RevMan 5.3 software.Eight randomized controlled trials (RCTs and six non-randomized controlled trials (nRCTs involving 2270 patients were included. Patients receiving RA were associated with shorter operative time (-6.22 min; 95%CI, -9.70 to -2.75; p = 0.0005, lower visual analgesic score on the first and third postoperative day (WMD, -2.62; 95%CI, -3.04 to -2.19; p < 0.00001 WMD, -0.38; 95%CI, -0.58 to -0.18; p = 0.0002, less analgesic requirements (WMD, -59.40 mg; 95%CI, -78.39 to -40.40; p<0.00001, shorter hospitalization (WMD, -0.36d; 95%CI, -0.66 to -0.05; p = 0.02, less blood transfusion (RR, 0.61; 95%CI, 0.41 to 0.93; p = 0.02, fewer modified Clavion-Dindo Grade II (RR, 0.56; 95%CI, 0.37 to 0.83; p = 0.005, Grade III or above postoperative complications (RR, 0.51; 95%CI, 0.33 to 0.77; p = 0.001, and potential benefits of less fever (RR, 0.79; 95%CI, 0.61 to 1.02; p = 0.07, nausea or vomiting (RR, 0.54; 95%CI, 0.20 to 1.46; p = 0.23, whereas more intraoperative hypotension (RR, 3.13; 95%CI, 1.76 to 5.59; p = 0.0001 when compared with patients receiving GA. When nRCTs were excluded, most of the results were stable but the significant differences were no longer detectable in blood transfusion, Grade II and more severe complications. No significant difference in the total postoperative complications and stone-free rate were found.Current evidence suggests that both RA and GA can provide safe and effective anesthesia for PNL in carefully evaluated and selected patients. Each anesthesia technique has its own advantages but some aspects still remain unclear and need to be explored in future studies.

  3. 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

  4. 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.

  5. 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

  6. Evaluation of "no touch" extubation technique on airway-related complications during emergence from general anesthesia

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    Saad A Sheta

    2011-01-01

    Full Text Available Background and Objectives: Awake "no touch" extubation requires performing extubations only when the patient spontaneously wakes up without any kind of stimulation during emergence from general anesthesia. The aim of this study was to evaluate absolutely awake extubation "no touch" technique in adult patients, scheduled for elective nasal and paranasal sinus surgeries under general anesthesia as regard to emergence airway complications. Methods: A total of 60 adult patients were randomly allocated into one of two equal groups according to the method of extubation: Group I: Standard fully awake, Group II: Absolutely "no touch" awake extubation (absolutely no stimulation "no touch" was allowed until patients were able to open their eyes. The incidence of laryngospasm and its grade according to a four-point scale was reported. Occurrence of airway events (excessive secretions, breath-holding, coughing, hoarseness, biting, as well as the number and severity of any desaturation episodes, oozing from the wound, and postoperative sore throat were also recorded. The heart rate (HR, systolic (SBP and diastolic (DBP blood pressure measured at the end of surgery served as baseline values, and subsequent measurements were taken within 30 minutes after the end of surgery. Results: There was absolutely no case of laryngeal spasm or episode of desaturation among patients who were extubated with the "no touch" technique. On the other hand, there were 3 cases of laryngeal spasm in standard fully awake group. Severity of coughing, excessive secretions and breath holding, hoarseness, biting, and occurrence of non-purposeful movements of the limbs were significantly less in the absolutely "no touch" awake technique. The changes in HR, SBP, and DBP during emergence extubation were significantly less in "no touch" technique group. However, oozing from the wound was significantly higher with standard fully awake extubation. However, there were no significant

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

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    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

  8. [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

  9. Near-death experience in a boy undergoing uneventful elective surgery under general anesthesia.

    Science.gov (United States)

    Lopez, Ursula; Forster, Alain; Annoni, Jean-Marie; Habre, Walid; Iselin-Chaves, Irène A

    2006-01-01

    Near-death experience (NDE) is a complex subjective experience, which may include affective elements such as a sense of peacefulness, paranormal components such as a sensation of floating out of the body, and a perception of being in a dark tunnel and seeing a brilliant light. It is usually reported to occur in association with a wide range of life-threatening situations, as for instance, cardiopulmonary resuscitation. We report on an episode of NDE that occurred in a 12-year-old boy who underwent a general anesthesia for an elective uncomplicated surgery. To our knowledge, this is the first case of NDE in a child that has been reported in this context.

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

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    Nasser Kaviani

    2014-09-01

    Full Text Available 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 clinical trial study, 62 healthy non-cooperative children, candidate for dental treatment under general anesthesia, were randomly divided into study and control groups. The children received 20ml orange juice, 20 minutes before starting the anesthesia. The juice of the test group contained 0.5mg/kg of midazolam and that of the control group included no medication. The induction and the maintenance process of anesthesia were similar in both groups. The manner of subjects when separated from parents, their cooperation during intravenous catheterization, and recalling the pre-anesthetic events were recorded. Data were analyzed by adopting chi-square and Mann-Whitney tests. Results: Most of the children in the test group had a comfortable separation from parents, restful IV catheterization and 90% of the subjects did not recall the pre-anesthetic events. Conclusion: Under the circumstances of this study, it could be concluded that 0.5mg/kg oral midazolam premedication is effective for comfortable separation of children from parents and restful IV catheterization and also forgetting the pre-anesthetic events.

  11. Laser-Assisted Periodontal Management of Drug-Induced Gingival Overgrowth under General Anesthesia: A Viable Option.

    Science.gov (United States)

    Muralikrishna, Tupili; Kalakonda, Butchibabu; Gunupati, Sumanth; Koppolu, Pradeep

    2013-01-01

    Gingival overgrowth/hyperplasia can be attributed to several causes, but drug-induced gingival overgrowth/hyperplasia arises secondarily to prolonged use of antihypertensive drugs, anticonvulsants and immunosuppressants. The management is complex in nature considering the multitude of factors involved such as substitution of drug strict plaque control along with excision of the tissue to be performed under local anesthesia as outpatient. In the recent times, the patient's psychological fear of the treatment with the use of surgical blade and multiple visits has developed the concept of single visit treatment under general anesthesia incorporating a laser as viable option. The present case highlights the new method of management of gingival overgrowth.

  12. Regional anesthesia as compared to general anesthesia for surgery in geriatric patients with hip fracture: Does it decrease morbidity, mortality and healthcare costs? Results of a single-centered study

    Science.gov (United States)

    Le-Wendling, Linda; Bihorac, Azra; Baslanti, Tezcan Ozrazgat; Lucas, Stephen; Sadasivan, Kalia; Heyman, James; Wendling, Adam; Heyman, H. James; Boezaart, Andre

    2013-01-01

    Introduction Hip fracture in geriatric patients has a substantial economic impact and represents a major cause of morbidity and mortality in this population. At our institution, a regional anesthesia program was instituted for patients undergoing surgery for hip fracture. This retrospective cohort review examines the effects of regional anesthesia (from mainly after July 2007) versus general anesthesia (mainly prior to July 2007) on morbidity, mortality and hospitalization costs. Methods This retrospective cohort study involved data collection from electronic and paper charts of 308 patients who underwent surgery for hip fracture from September 2006 to December 2008. Data on postoperative morbidity, in-patient mortality, and cost of hospitalization (as estimated from data on hospital charges) were collected and analyzed. Seventy-three patients received regional anesthesia and 235 patients received general anesthesia. During July 2007, approximately halfway through the study period, a regional anesthesia and analgesia program was introduced. Results The average cost of hospitalization in patients who receive surgery for hip fracture was no different between patients who receive regional or general anesthesia ($16,789 + 631 v. $16,815 + 643, respectively, p = 0.9557). Delay in surgery and intensive care unit admission resulted in significantly higher hospitalization costs. Age, male gender, African-American race and intensive care unit admission were associated with increased in-hospital mortality. In-hospital mortality and rates of readmission are not statistically different between the two anesthesia groups. Conclusions There is no difference in postoperative morbidity, rates of re-hospitalization, in-patient mortality or hospitalization costs in geriatric patients undergoing regional or general anesthesia for repair of hip fracture. Delay in surgery beyond 3 days and intensive care unit admission both increase cost of hospitalization. PMID:22758782

  13. Cerebral oxygenation and processed EEG response to clamping and shunting during carotid endarterectomy under general anesthesia.

    Science.gov (United States)

    Perez, William; Dukatz, Christopher; El-Dalati, Sami; Duncan, James; Abdel-Rasoul, Mahmoud; Springer, Andrew; Go, Michael R; Dzwonczyk, Roger

    2015-12-01

    Clamping and shunting during carotid endarterectomy (CEA) surgery causes changes in cerebral blood flow. The purpose of this study was to assess and compare, side by side, the cerebral oxygenation (rSO2) and processed electroencephalogram (EEG) response bilaterally to carotid artery clamping and shunting in patients undergoing CEA under general anesthesia. With institutional approval and written informed consent, patients undergoing CEA under general anesthesia and routine carotid artery shunting were recorded bilaterally, simultaneously and continuously with an rSO2 and processed EEG monitor. The response of the monitors during carotid artery clamping and shunting were assessed and compared between monitors and bilaterally within each monitor. Sixty-nine patients were included in the study. At clamping the surgical-side and contralateral-side rSO2 dropped significantly below the baseline incision value (-17.6 and -9.4% respectively). After shunting, the contralateral-side rSO2 returned to baseline while the surgical-side rSO2 remained significantly below baseline (-9.0%) until the shunt was removed following surgery. At clamping the surgical-side and contralateral-side processed EEG also dropped below baseline (-19.9 and -20.6% respectively). However, following shunt activation, the processed EEG returned bilaterally to baseline. During the course of this research, we found the rSO2 monitor to be clinically more robust (4.4% failure rate) than the processed EEG monitor (20.0% failure rate). There was no correlation between the rSO2 or processed EEG changes that occurred immediately after clamping and the degree of surgical side stenosis measured pre-operatively. Both rSO2 and processed EEG respond to clamping and shunting during CEA. Cerebral oximetry discriminates between the surgical and contralateral side during surgery. The rSO2 monitor is more reliable in the real-world clinical setting. Future studies should focus on developing algorithms based on these

  14. 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 ...

  15. 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.

  16. 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;

    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...... dizygotic same-sex twin pairs who were discordant for anesthesia and major surgery exposure. For this analysis, the proportion of pairs in which the co-twin who had been exposed to anesthesia and major surgery and also had the lowest composite cognitive score was calculated. This proportion was compared...

  17. 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 ...

  18. 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

  19. 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.)

  20. 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.)

  1. 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

  2. Breath isoprene concentrations in persons undergoing general anesthesia and in healthy volunteers.

    Science.gov (United States)

    Hornuss, Cyrill; Zagler, Armin; Dolch, Michael E; Wiepcke, Dirk; Praun, Siegfried; Boulesteix, Anne-Laure; Weis, Florian; Apfel, Christian C; Schelling, Gustav

    2012-12-01

    Human breath contains an abundance of volatile organic compounds (VOCs). Analysis of breath VOC may be used for diagnosis of various diseases or for on-line monitoring in anesthesia and intensive care. However, VOC concentrations largely depend on the breath sampling method and have a large inter-individual variability. For the development of breath tests, the influence of breath sampling methods and study subject characteristics on VOC concentrations has to be known. Therefore, we investigated the VOC isoprene in 62 study subjects during anesthesia and 16 spontaneously breathing healthy volunteers to determine (a) the influence of artificial and spontaneous ventilation and (b) the influence of study subject characteristics on breath isoprene concentrations. We used ion molecule reaction mass spectrometry for high-resolution breath-by-breath analysis of isoprene. We found that persons during anesthesia had significantly increased inspiratory and end-expiratory isoprene breath concentrations. Measured isoprene concentrations (median [first quartile-third quartile]) were in the anesthesia group: 54 [40-79] ppb (inspiratory) and 224 [171-309] ppb (end-expiratory), volunteer group: 14 [11-17] ppb (inspiratory) and 174 [124-202] ppb (end-expiratory). Higher end-tidal CO(2) concentrations in ventilated subjects were associated with higher expiratory isoprene levels. Furthermore, inspiratory and end-expiratory isoprene concentrations were correlated during anesthesia (r = 0.603, p < 0.001). Multivariate analysis showed that men had significantly higher end-expiratory isoprene concentrations than women. Rebreathing of isoprene from the anesthesia machine possibly accounts for the observed increase in isoprene in the anesthesia group.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Hemodynamic Effect of 2% Lidocaine with 1:80,000 Epinephrine Infiltration in Maxillofacial Surgeries under General Anesthesia

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    Baratollah Shaban

    2013-01-01

    Full Text Available Introduction: Epinephrine-containing lidocaine is the most used anestheic drug in dentistry. The aim of this study was to investigate the hemodynamic changes following local infiltration of 2%lidocaine with 1:80,000 epinephrine in subjects undergoing orthognatic surgery under general anesthesia. Methods: Twenty five patients without any systemic disease participated. After general anesthesia, two cartridges of 2% lidocaine + 1:80,000 epinephrine were infiltrated around the surgery site. Systolic (SBP and diastolic (DBP blood pressure, mean arterial blood pressure (MAP, heart rate (HR, and blood sugar (BS were measured in three stages: before the injection (M1, at the end of injection (M2, and 10 min after injection (M3. Results: No significant difference observed in SBP, DBP, and MAP at the end of injection and 10 min later. HR was increased significantly after injection and remained significantly higher than baseline after 10 min. BS increased slightly at the end of injection and continued to increase after 10 min. However, changes in BS were not significant. Conclusion: Using two cartridges of epinephrine-containing lidocaine have slight systemic changes in healthy subjects; as a result, this dosage could be used in patients with cardiovascular complications undergoing general anesthesia.

  5. Hemodynamic Effect of 2% Lidocaine with 1:80,000 Epinephrine Infiltration in Maxillofacial Surgeries under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Baratollah Shaban

    2013-12-01

    Full Text Available Introduction: Epinephrine-containing lidocaine is the most used anestheic drug in dentistry. The aim of this study was to investigate the hemodynamic changes following local infiltration of 2% lidocaine with 1:80,000 epinephrine in subjects undergoing orthognatic surgery under general anesthesia. Methods: Twenty five patients without any systemic disease participated. After general anesthesia, two cartridges of 2% lidocaine + 1:80,000 epinephrine were infiltrated around the surgery site. Systolic (SBP and diastolic (DBP blood pressure, mean arterial blood pressure (MAP, heart rate (HR, and blood sugar (BS were measured in three stages: before the injection (M1, at the end of injection (M2, and 10 min after injection (M3. Results: No significant difference observed in SBP, DBP, and MAP at the end of injection and 10 min later. HR was increased significantly after injection and remained significantly higher than baseline after 10 min. BS increased slightly at the end of injection and continued to increase after 10 min. However, changes in BS were not significant. Conclusion: Using two cartridges of epinephrine-containing lidocaine have slight systemic changes in healthy subjects; as a result, this dosage could be used in patients with cardiovascular complications undergoing general anesthesia.

  6. 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.

  7. 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.

  8. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia

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    Almushayt Abdullah

    2009-02-01

    Full Text Available Abstract Background Review of post-operative morbidity reports for pediatric dental care under general anesthesia (GA show great variations. Until now, no morbidity data has been available to estimate the safety of pediatric patients under GA for dental rehabilitation in Saudi Arabia. The purposes of this study were to (1 investigate post-operative complications associated with dental care under GA and (2 correlate morbidity reports with patient's characteristics, dental procedures, and hospital protocol. Methods Study sample included 90 children attending GA for dental treatment at major governmental hospitals in Jeddah. Data were collected from every patient on three occasions, intra-operatively at the operating room, and post-operatively via phone calls in the first and third days after operation. Results Results showed that 99% of the children had one or more complaints in the first day in contrast to only 33% in the third day. Inability to eat (86%, sleepiness (71%, and pain (48% were the most common complaints in the first day, followed by bleeding (40%, drowsiness (39%, sore throat (34%, vomiting (26%, psychological changes (24%, fever (21%, cough (12%, and nausea (8%. A great significant complaints reduction was reported by the third post-operative day. Age, gender, admission type of the patients and GA duration were the factors that showed a significant relationship with post-operative complaints. Conclusion Post-operative morbidity was common, but mostly of mild severity and limited to the first day. Hospital staff efforts should be directed to control commonly reported postoperative complaints.

  9. 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.

  10. Laser-Assisted Periodontal Management of Drug-Induced Gingival Overgrowth under General Anesthesia: A Viable Option

    Directory of Open Access Journals (Sweden)

    Tupili Muralikrishna

    2013-01-01

    Full Text Available Gingival overgrowth/hyperplasia can be attributed to several causes, but drug-induced gingival overgrowth/hyperplasia arises secondarily to prolonged use of antihypertensive drugs, anticonvulsants and immunosuppressants. The management is complex in nature considering the multitude of factors involved such as substitution of drug strict plaque control along with excision of the tissue to be performed under local anesthesia as outpatient. In the recent times, the patient’s psychological fear of the treatment with the use of surgical blade and multiple visits has developed the concept of single visit treatment under general anesthesia incorporating a laser as viable option. The present case highlights the new method of management of gingival overgrowth.

  11. 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;

    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....

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

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    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.

  13. Cognitive function correlations with apolipoprotein Eε4 single nucleotide polymorphism in 1 000 elderly patients following general anesthesia A randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    Yingmin Cai; Haitao Hu; Rongliang Xue; Pengbin Liu; Gaifeng Feng; Weijiang Dong; Bin Yu; Minggang Zhao

    2009-01-01

    BACKGROUND: Cognitive dysfunction occurs in elderly patients following general anesthesia, and this might be associated with genetics. Studies have shown that theε4 allele gene is closely associated with senile dementia.OBJECTIVE: To compare and analyze the correlations between cognitive dysfunction and single nucleotide polymorphism of apolipoprotein E (ApoE) following inhaJation or intravenous anesthesia.DESIGN, TIME AND SETTING: A randomized, controlled study was performed. The patients were recruited from the Department of Anesthesia, Second Affiliated Hospital, Medical College, Xi'an Jiaotong University, China between May 2005 and December 2008. Genetic analyses were conducted at the Departments of Neuroanatomy and Forensic Medicine, Medical College, Xi'an Jiaotong University, China.PARTICIPANTS: A total of 1 000 patients of ASA Ⅰ-Ⅱ grade, without genetic connection, were enrolled in this study, comprising 520 males and 480 females, aged (70.1±4.6) years and weighing (57.3±7.5) kg. No patients suffered from cognitive dysfunction.METHODS: The patients were equally and randomly divided into intravenous anesthesia and gas anesthesia groups. Total intravenous anesthesia and inhaled anesthesia were used. Genomic DNA from whole blood was extracted. The ApoE gene was amplified by PCR. Restriction fragment length polymorphism of ApoE gene was analyzed. Cognitive function was evaluated by Mini-Mental State Examination (MMSE). Patients scoring 0.05).CONCLUSION: Results demonstrated a correlation between cognitive dysfunction and ApoE single nucleotide polymorphism in elderly patients after gas anesthesia. However, no relationship between cognitive dysfunction and ApoE single nucleotide polymorphism was determined in elderly patients following intravenous anesthesia. Therefore, elderly patients, especially those expressing the ApoEε4 gene, should be cautiously exposed to gas anesthesia.

  14. 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

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

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    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

  16. 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

  17. 全麻对剖宫产胎儿影响的临床研究%Clinical study of the influence of general anesthesia on cesarean delivery fetus

    Institute of Scientific and Technical Information of China (English)

    李莉; 苏利

    2014-01-01

    Objective To compare the influence of general anesthesia and combined spinal-epidural anesthesia on neonatal Apgar score. Methods A total of 65 cases of single pregnancy to full term undergone cesarean section were taken as study subjects. There were 32 cases in the general anesthesia group received general anesthesia due to intraspinal anesthesia taboo, and the other 33 cases in the combined spinal-epidural anesthesia group received combined spinal-epidural anesthesia. The fetal childbirth time, birth weight, and apgar score at 1 min and 5 min were recorded. Results Apgar score at 1 min of general anesthesia group and combined spinal-epidural anesthesia group were (9.5±0.8) points and (9.8±0.6) points respectively, and there was no significant difference between the two groups (P>0.05). Apgar scores at 5 min were all 10 points in the two groups. Conclusion General anesthesia and combined spinal-epidural anesthesia have no obviously variant influences on fetus.%目的:比较剖宫产施行全身麻醉(全麻)和腰硬联合麻醉对新生儿Apgar评分的影响。方法选择足月单胎妊娠行择期剖宫产的产妇65例,椎管内麻醉禁忌而需使用全麻的剖宫产为全麻组32例,其余33例行腰硬联合麻醉作为腰硬联合麻醉组。记录胎儿娩出时间,新生儿体重和1、5 min的Apgar评分。结果全麻组和腰硬联合麻醉组新生儿1 min的Apgar评分分别为(9.5±0.8)分、(9.8±0.6)分,两组差异无统计学意义(P>0.05)。5 min Apgar评分均为10分。结论全麻和硬联合麻醉对胎儿的影响没有明显差异。

  18. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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

  1. Butorphanol suppresses fentanyl-induced cough during general anesthesia induction: A randomized, double-blinded, placebo-controlled clinical trial.

    Science.gov (United States)

    Cheng, Xiao-Yan; Lun, Xiao-Qin; Li, Hong-Bo; Zhang, Zhi-Jie

    2016-06-01

    Fentanyl-induced cough (FIC) is unwanted in the patients requiring stable induction of general anesthesia. This study was designed to evaluate the suppressive effects of butorphanol pretreatment on the incidence and severity of FIC during the induction of general anesthesia. A total of 315 patients of American Society of Anesthesiologists physical status I and II, scheduled for elective surgery under general anesthesia were randomized into 3 equally sized groups (n = 0105). Two minutes before fentanyl bolus, group I received intravenously 5 mL normal saline, groups II and III received butorphanol 0.015 and 0.03 mg/kg (diluted with saline to 5 mL), respectively. Patients were then administrated with fentanyl 2.5 μg/kg within 5 s. The incidence and severity of FIC was recorded for 2 minutes after fentanyl bolus. During experimental period, the mean arterial pressure, heart rate, and peripheral capillary oxygen saturation (SpO2) were recorded before the administration of butorphanol or normal saline (T0), 2 minutes (T1) after butorphanol injection, and 2 minutes (T2) after fentanyl injection. The incidence of FIC was 31.4% in group I, 11.4% in group II, and 3.8% in group III. Group III had a lowest incidence of FIC among 3 groups (P < 0.001, vs group I; P < 0.05, vs group II). The severe FIC was not observed in groups II and III, but was recoded from 6 patients in group I. At 2 minutes after fentanyl injection (T2), the mean arterial pressure was significantly higher in group I than that in groups II and III (P < 0.01, vs group II; P < 0.05, vs group III), but the values remained within safe limits. In conclusion, pretreatment with butorphanol could effectively and safely suppress FIC during anesthesia induction. PMID:27367987

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

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    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

  3. 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

  4. 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.

  5. 不同麻醉方法用于剖宫产术的成本分析%Cost of continuous epidural anesthesia and general anesthesia for caesarean section

    Institute of Scientific and Technical Information of China (English)

    许敏; 魏昕; 柴小青; 潘建辉

    2014-01-01

    目的:比较分析剖宫产中应用椎管内麻醉或全身麻醉的成本消耗,为医疗成本运作和医疗政策制定提供临床参考数据。方法回顾我院择期行子宫下段剖宫产术的患者(212例),按其接受的麻醉方法分为椎管内麻醉组(连续硬膜外麻醉,SA组,106例)及全身麻醉组(喉罩下全麻,GA组,106例),对麻醉的直接成本进行了评估。从麻醉数据库中统计麻醉中使用的药品及耗材,根据麻醉相关时间及麻醉人员薪酬计算人员成本,并计算相关比例。结果剖宫产中应用全身麻醉直接麻醉成本及非人员麻醉成本均高于连续硬膜外麻醉(P<0.05),人员成本则是连续硬膜外麻醉高于全身麻醉(P<0.05),全身麻醉的药品及耗材成本明显高于连续硬膜外麻醉(P<0.05),连续硬膜外麻醉的诱导时间及持续时间较长(P<0.05),两组患者术后住院天数差异无统计学意义(P>0.05)。结论椎管内麻醉的直接成本较低,但是人员成本相对较高。麻醉方法的选择并不影响患者术后住院天数。%Objective To analyze the costs of continuous epidural anesthesia and general anesthesia for caesarean section and pro-vide clinical reference data for health behaviors and health policy makers.Methods The clinical data of 212 patients (aged 22~35 years) who received elective cesarean section surgery from to July to December in 2012 in our hospital were retrospectively analysed.The patients were divided into the spinal anesthesia group(continuous epidural anesthesia,SA group,n=106)and the general anesthesia group(LMA un-der general anesthesia,GA group,n=106 )according to their method of anesthesia.Direct costs were measured on detailed data of the re-sources used during anaesthetic procedures from the anesthesia record.Costs related to anaesthetic staff work were calculated based on per ca-pita remuneration and duration of

  6. Comparison of palanosetron with ondansetron for postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia

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    Jyoti Bhalla

    2015-01-01

    Full Text Available Background: Post-operative nausea and vomiting (PONV is a ′big little′ problem especially after laparoscopic surgeries. Palanosetron is a new potent 5 hydroxy tryptamine 3 antagonists. In this randomized double blind clinical study we compared the effects of i.v. ondansetron and palanosetron administered at the end of surgery in preventing post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia. Materials and Methods: A total of 100 subjects between 18-60 years with Apfel score ≥2, were randomly assigned into one of the two groups, containing 50 patients each. Group A received ondansetron 4 mg i.v. and Group B received palanosetron 0.07 5mg i.v. both as bolus before induction. The incidence of nausea, retching and vomiting, incidence of total PONV, requirement of rescue antiemetics and adverse effects were evaluated during the first 24 h following end of surgery. Results: The incidence of nausea was significantly lower in patients who had received palanosetron (16% as compared to ondansetron (24%. Need of rescue antiemetics was significantly higher in patients receiving ondansetron (32% as compared to palanosetron (16%. The incidence of total PONV was also significantly lower in group receiving palanosetron (20% as compared to ondansetron (50%. Among the side effects, headache was noted significantly higher with ondansetron (20% as compared to palanosetron (6%. Conclusion: Palanosetron has got better anti-nausea effect, less need of rescue antiemetics, favourable side effect profile and a decrease in the incidence of total PONV as compared to ondansetron in 24 h post operative period in patients undergoing laproscopic cholecystectomy under general anesthesia.

  7. Comparison of the effects of intravenous premedication: Midazolam, Ketamine, and combination of both on reducing anxiety in pediatric patients before general anesthesia

    Science.gov (United States)

    Sajedi, Parvin; Habibi, Bashir

    2015-01-01

    Objective: In some medical circumstances, pediatric patients may need premedication for transferring to the operating room. In these situations, using intravenous premedication is preferred. We assessed the efficacy and safety of intravenous midazolam, intravenous ketamine, and combination of both to reduce the anxiety and improve behavior in children undergoing general anesthesia. Methods: In a double-blind randomized clinical trial, 90 pediatric patients aged 6 months to 6 years with American Society of Anesthesiologist grade I or II were enrolled. Before anesthesia, children were randomly divided into three groups to receive intravenous midazolam 0.1 mg/kg, or intravenous ketamine 1 mg/kg, or combination of half doses of both. Behavior types and sedation scores were recorded before premedication, after premedication, before anesthesia, and after anesthesia in the postanesthesia care unit. Anesthesia time, recovery duration, blood pressure, and heart rate were also recorded. For comparing distribution of behavior types and sedation scores among three groups, we used Kruskal–Wallis test, and for comparing mean and standard deviation of blood pressure and heart rates, we used analysis of variance. Findings: After premedication, children's behavior was significantly better in the combination group (P ketamine as premedication produced more deep sedation and more desirable behavior in children compared with each midazolam 0.1 mg/kg or ketamine 1 mg/kg. PMID:26645024

  8. 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

  9. Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies.

    Science.gov (United States)

    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 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.

  10. [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

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

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    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

  12. 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.

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

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    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.

  14. What does pain signify? A hypothesis concerning pain, the immune system and unconscious pain experience under general anesthesia.

    Science.gov (United States)

    Neuman, Yair

    2004-01-01

    In this paper, I present a case-study that initiates a discussion about the meaning of pain. The case-study concerns a person who was under deep sedation during colonoscopy. The person did not experience pain from a first-person perspective, although pain was evident to the medical team from a second-person perspective. The divergence of pain perspectives raises an interesting quandary. If the body communicates pain while pain consciousness is blocked by the sedation procedure, our conclusion should be that the intersubjective aspect of pain precedes the "subjective," first-person experience of pain. This conclusion is not consistent with the common representational conception of pain that places the intrasubjective point of view prior to the intersubjective point of view. The solution I offer to this quandary is the quasi-paradoxical idea that pain can be experienced unconsciously through the immune system. Following this suggestion, I hypothesize that post-traumatic stress disorders following general anesthesia may result from this unconscious pain experience. If this idea is scientifically grounded, then physicians should: (1) consider ways of blocking the unconscious pain experience produced by the immune system without interfering with the immune response, and (2) study pain as a complex cognitive and unconscious system by drawing an analogy with the immune system, which follows similar logic.

  15. Combined general-epidural anesthesia with continuous postoperative epidural analgesia preserves sigmoid colon perfusion in elective infrarenal aortic aneurysm repair

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    Venetiana Panaretou

    2012-01-01

    Full Text Available Background: In elective open infrarenal aortic aneurysm repair the use of epidural anesthesia and analgesia may preserve splanchnic perfusion. The aim of this study was to investigate the effects of epidural anesthesia on gut perfusion with gastrointestinal tonometry in patients undergoing aortic reconstructive surgery. Methods: Thirty patients, scheduled to undergo an elective infrarenal abdominal aortic reconstructive procedure were randomized in two groups: the epidural anesthesia group (Group A, n=16 and the control group (Group B, n=14. After induction of anesthesia, a transanally inserted sigmoid tonometer was placed for the measurement of sigmoid and gastric intramucosal CO 2 levels and the calculation of regional-arterial CO 2 difference (ΔPCO 2 . Additional measurements included mean arterial pressure (MAP, cardiac output (CO, systemic vascular resistance (SVR, and arterial lactate levels. Results: There were no significant intra- and inter-group differences for MAP, CO, SVR, and arterial lactate levels. Sigmoid pH and PCO 2 increased in both the groups, but this increase was significantly higher in Group B, 20 min after aortic clamping and 10 min after aortic declamping. Conclusions: Patients receiving epidural anesthesia during abdominal aortic reconstruction appear to have less severe disturbances of sigmoid perfusion compared with patients not receiving epidural anesthesia. Further studies are needed to verify these results.

  16. 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

  17. 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.

  18. 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...

  19. Perioperative respiratory adverse events in children with active upper respiratory tract infection who received general anesthesia through an orotracheal tube and inhalation agents

    OpenAIRE

    Kim, So Yeon; Kim, Jeong Min; Lee, Jae Hoon; Kang, Young Ran; Jeong, Seung Ho; Koo, Bon-Nyeo

    2013-01-01

    Background Active upper respiratory tract infection (URI), orotracheal intubation and use of inhalation anesthetics are known risk factors for perioperative respiratory adverse events (RAE). This study investigated the risk factors of perioperative RAE in children with these risk factors. Methods The records of 159 children who underwent general anesthesia with an orotracheal tube and inhalation were reviewed. These patients also had at least one of the following URI symptoms on the day of su...

  20. 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...

  1. 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...

  2. 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

  3. Anesthesia of the geriatric equine

    Directory of Open Access Journals (Sweden)

    Doherty TJ

    2012-08-01

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

  4. 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 ...

  5. Comparison of end-tidal CO2 measured by transportable capnometer (EMMA™ capnograph) and arterial pCO2 in general anesthesia.

    Science.gov (United States)

    Kim, Kyung Woo; Choi, Hey Ran; Bang, Si Ra; Lee, Jeong-Wook

    2016-10-01

    An end-tidal CO2 monitor (capnometer) is used most often as a noninvasive substitute for PaCO2 in anesthesia, anesthetic recovery, and intensive care. Additionally, the wide spread on-site use of portable capnometers in emergency and trauma situations is now observed. This study was conducted to compare PaCO2 measurement between the EMMA™ portable-capnometer and sidestream capnometry. End-tidal CO2 (portable capnometer: EMMA™ capnograph, side stream capnometry module: Datex-Ohmeda S5 Anesthesia Monitor) levels were recorded at the time of arterial blood gas sampling of patients undergoing general anesthesia. Data were compared using the Bland and Altman method, and by evaluating the clinical significance performed by calculating the percent error (%). A total of 100 data were obtained from 35 patients. The bias of PaCO2 and portable capnometer was 6.0 mmHg, where the upper and lower limits of the agreement were 11.8 and 0.3 mmHg, respectively. The percent error was 18.0 %. The bias of side stream capnometry and portable capnometer was 2.2 mmHg, where the upper and the lower limits of the agreement were 6.0 and -1.6 mmHg, respectively. The percent error was 13.0 %. Significant differences between the PETCO2 and PaCO2 values of the EMMA™ portable-capnometer were not observed for patients undergoing general anesthesia. ClinicalTrials.gov identifier NCT02184728. PMID:26264607

  6. Fully Automated Anesthesia, Analgesia and Fluid Management

    Science.gov (United States)

    2016-09-05

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

  7. 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.

  8. 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.

  9. 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

  10. [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.

  11. [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

  12. Laser-Assisted Periodontal Management of Drug-Induced Gingival Overgrowth under General Anesthesia: A Viable Option

    OpenAIRE

    Tupili Muralikrishna; Butchibabu Kalakonda; Sumanth Gunupati; Pradeep Koppolu

    2013-01-01

    Gingival overgrowth/hyperplasia can be attributed to several causes, but drug-induced gingival overgrowth/hyperplasia arises secondarily to prolonged use of antihypertensive drugs, anticonvulsants and immunosuppressants. The management is complex in nature considering the multitude of factors involved such as substitution of drug strict plaque control along with excision of the tissue to be performed under local anesthesia as outpatient. In the recent times, the patient’s psychological fear o...

  13. 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....

  14. Comparing the preventive effect of 2 percent Topical Lidocaine and Intravenous Atropine on oculocardiac reflex in Ophthalmological Surgeries under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Parvin Sajedi

    2013-01-01

    Full Text Available Background: The current study aimed to determine preventive effect of 2 percent topical xylocaine on oculocardiac reflex in ophthalmological surgeries except strabismus, including retinal detachment and vitrectomy with scleral buckling under general anesthesia. Methods: A randomized controlled clinical trial was carried out on 150 patients aged 18-90 years undergoing ophthalmological surgeries under general anesthesia. Samples randomly divided into the experimental group (received four drops of 2 percent topical xylocaine instilled in desired eye and control group (received 0.5 mg atropine sulfate injection. Systolic, diastolic and mean arterial blood pressure of patients and baseline heart rate were recorded. They were compared regarding the incidence of bradycardia, heart rate less than 60 beats/minute, hypotension and blood pressure less than 90 mm/Hg. Data were analyzed by Statistical Package for the Social Sciences software version 20 using Chi-square and ANOVA. Results: The difference between two groups was not statistically significant regarding demographic and basic variables. The incidence of bradycardia in both groups was respectively (90.7 percent vs. 17.3 percent, heart rate less than 60 beats/minute (40 percent vs. 13.3 percent, hypotension (76 percent vs. 32 percent and blood pressure less than 90 mmHg was (28 percent vs. 8 percent. Accordingly, the differences between both groups were statistically significant (P > 0.001. Conclusions: The preventive impact of topical xylocaine upon oculocardiac reflex in ophthalmological surgeries such as retinal detachment and vitrectomy with scleral buckling under general anesthesia was less effective than that of atropine injection. Therefore, to avoid this reflex in high-risk patients, injecting atropine would be safer.

  15. 全麻术后意识恢复呼吸抑制原因探讨%Respiratory depression reasons discussion of regaining consciousness after general anesthesia

    Institute of Scientific and Technical Information of China (English)

    代宇; 杨许莲; 李昌菊

    2014-01-01

    目的:探讨择期手术全身麻醉术后患者经麻醉医师评估后拔除人工气道,在麻醉恢复监测过程中出现呼吸抑制重建人工气道的原因,提出预防与处理措施。方法回顾2012年3月~2014年3月由麻醉科送入重症医学科的择期全身麻醉术后患者2209例,对其中6例已拔除人工气道患者在入住重症医学科后5~20min内出现呼吸抑制并重建人工气道患者的原因进行分析。结果全麻术后患者意识恢复拔除人工气道后,出现呼吸抑制及气道梗阻与患者年龄、体重指数、手术时间短、全麻药及肌松药残留、气道高反应性等因素相关。结论全麻术后意识恢复不是拔除人工气道的主要指征;气道高危患者可适当延迟拔除人工气道;术后适当应用拮抗剂可减少全麻术后呼吸抑制并发症。%Objective To discuss the reasons of the patients with respiratory depression and artificial airway reconstruction in the process of anesthesia recovery monitoring, the patients were unplugged the artificial airway after elective surgery under general anesthesia surgery and assessed by anesthesiologists, to propose prevention and treatment measures. Methods 2209 cases with elective general anesthesia surgery who were sent to critical care medicine by anesthesiology department from March 2012 to March 2014 were reviewed. of all the cases,there were 6 patients with artificial airway unplugged appeared respiratory depression and artificial airway reconstruction after the arrival of critical care medicine 5-20min, analyzed the reasons. Results The patients who were unplugged artificial airway after general anesthesia and recovery of consciousness,respiratory depression and airway obstruction were associated with age, body mass index, shorter operative time, anesthetics and muscle relaxants residues, airway hyperresponsiveness and other related factors. Conclusion Recovery of consciousness after general anesthesia

  16. Triple Therapy with Scopolamine, Ondansetron and Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Moderate to High Risk Patients Undergoing Craniotomy Under General Anesthesia: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Sergio Daniel Bergese

    2015-06-01

    Full Text Available Introduction: Postoperative nausea and vomiting is one of the most common complaints from patients and clinicians after a surgical procedure. According to the current Society of Ambulatory Anesthesia Consensus Guidelines, the general incidence of vomiting and nausea is around 30% and 50% respectively; and up to 80% in high risk patients. In previous studies, the reported incidence of PONV at 24 hours after craniotomy was 43%-70%. The transdermal scopolamine delivery system contains a 1.5 mg drug reservoir, which is designed to deliver a continuous slow release of scopolamine through intact skin during the first 72 hours of patch application. Therefore, we designed this single arm, non-randomized, pilot study to assess the efficacy and safety of triple therapy with scopolamine, ondansetron and dexamethasone to prevent PONV.Materials and methods: In the preoperative area, subjects received an active TDS 1.5 mg that was applied to a hairless patch of skin in the mastoid area approximately 2 hours prior to the operation. Immediately after anesthesia induction, all patients received a single 4 mg dose of ondansetron IV and a single 10 mg dose of dexamethasone IV. Patients that experienced nausea and/or vomiting received ondansetron 4 mg IV as the initial rescue medication. Results: A total of 36 subjects were analyzed. The overall incidence of PONV during the first 24 hours after neurological surgery was 33% (n=12. The incidence of nausea and emesis during the first 24 hours after surgery was recorded as 33% (n=12 and 16% (n=6 respectively. Conclusion: Our data also showed that this triple therapy regimen may be an efficient alternative regimen for PONV prophylaxis in patients undergoing neurological surgery with general anesthesia. Further studies using regimens affecting different receptor pathways should be performed to better prove the efficacy in preventing PONV or delayed PONV.

  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. Effects of dexmedetomidine on depth of anesthesia and sore throat after general anesthesia%右美托咪定对全麻麻醉深度和术后咽喉痛的影响

    Institute of Scientific and Technical Information of China (English)

    张辉; 邵东华; 吴进; 张维; 王华

    2015-01-01

    目的:探讨右美托咪定对麻醉深度及对全麻术后咽喉痛的影响。方法:选择择期行甲状腺肿瘤切除术患者40例,随机分为右美托咪定组和对照组,每组20例;在全麻下手术开始后10 min,右美托咪定组给予右美托咪定0.6μg/kg 泵注10 min,继以0.2μg·kg -1·h -1维持泵注;对照组以相同方式输注生理盐水。监测并记录两组患者用药前即刻(T0)、用药后5 min(T1)、10 min(T2)、15 min(T3)、20 min(T4)、25 min(T5)、30 min(T6)的 Narcotrend 指数(NTI)、平均动脉压(MAP)、心率。比较两组患者在麻醉恢复室拔管时间、苏醒时间、镇痛药总用量及术后24 h 咽喉痛发生率。结果:与对照组相比,右美托咪定组心率在 T1~T6时间点明显降低(P <0.05),NTI 在 T3~T6时间点明显降低(P <0.05),T1~T6时间点 MAP 差异无统计学意义(P >0.05);两组患者拔管时间及苏醒时间差异无统计学意义(P >0.05);右美托咪定组术中镇痛药总用量和术后24 h 咽喉痛发生率明显低于对照组(P <0.05)。结论:全麻患者术中静脉输注小剂量右美托咪定可增加麻醉镇静深度,并可有效预防全麻术后咽喉痛的发生。%Objective:To explore the effects of dexmedetomidine on depth of anesthesia and sore throat after general anesthesia.Methods:Forty ASA Ⅰ/Ⅱ patients undergoing thyroidectomy operation were ran-domly assigned into two groups:dexmedetomidine group (n =20)and control group (n =20).Ten minutes after the start of the operation,under general anesthesia,patients in the dexmedetomidine group received intravenous injection of dexmedetomidine 0.6 μg/kg for 10 min and followed by 0.2 μg·kg -1 ·h -1 for maintenance.Saline was applied in the same way in the control group.Monitored and recorded the NTI, MAP,heart rate before(T0)and 5 min(T1),10 min(T2),15 min(T3),20 min(T4),25 min

  19. 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。

  20. Pediatric Ophthalmic Surgery under General Anesthesia Post-resuscitation and Care%全麻下小儿眼科手术后复苏和护理

    Institute of Scientific and Technical Information of China (English)

    刘小玲

    2013-01-01

    Objective: to analyze and study under the general anesthesia recovery nursing after operation in pediatric department of ophthalmology. Methods: in our hospital with general anesthesia for Department of ophthalmology operation 39 cases of children were summarized, and a retrospective analysis. Results: 1 patients had no complications, were cured and discharged. Conclusion:the nursing staf should be strict observation of condition changes, to take ef ective nursing measures, that children can safely through the recovery period.%目的:分析和研究全麻下小儿眼科手术后复苏护理方法。方法选取我院采用全身麻醉方式进行眼科手术的患儿39例,进行回顾性的分析与总结。结果没有1例患儿发生术后并发症,均治愈出院。结论护理人员应严密观察小儿的病情变化情况,采取有效护理措施,使患儿能够安全的渡过复苏期。

  1. 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

  2. Application of Dexmedetomidine in General Anesthesia for Heroin Addicts%右美托咪啶施用于海洛因依赖者全身麻醉

    Institute of Scientific and Technical Information of China (English)

    柳培雨; 田毅; 林晓; 王玥; 符永思

    2012-01-01

    海洛因吸食者的行为失控常会引起创伤.对此类患者实施全身麻醉时,毒品所至的病理生理学改变应给予综合评估,同时海洛因与全身麻醉药和阿片类镇痛药物的相互作用需要引起重视和动态调整.α2肾上腺素能受体激动剂对于此类麻醉具有良好的辅助作用.%The behavior of heroin abusers often cause trauma. Pathophysiological changes for heroin should be given a comprehensive assessment, and interactions of heroin and general anesthetics together with opioid analgesic drugs in general anesthesia need attention and dynamic adjustment. Α2 adrenergic receptors agonists shows favourable effects in those kind of anesthetics.

  3. A short period of fasting before surgery conserves basal metabolism and suppresses catabolism according to indirect calorimetry performed under general anesthesia.

    Science.gov (United States)

    Yoshimura, Shinichiro; Fujita, Yoshihito; Hirate, Hiroyuki; Kusama, Nobuyoshi; Azami, Takafumi; Sobue, Kazuya

    2015-06-01

    It is recommended that the period of fasting before elective surgery should be shortened to facilitate a rapid recovery by preventing catabolism. We examined the effects of a short period of fasting on metabolism by performing indirect calorimetry (IC) under general anesthesia. A prospective observational study involving 26 consecutive patients who underwent elective surgery and whose metabolism was evaluated using IC during anesthesia was conducted. The patients were divided into two groups, those who fasted for 10 h (group L). Oxygen consumption, the volume of carbon dioxide emissions (VCO2), the respiratory quotient (RQ), resting energy expenditure (REE), and basal energy expenditure (BEE) were compared. The REE, VCO2, and RQ of group L (17.7 ± 2.3 kcal/kg/day, 118.5 ± 20.8 ml/min, and 0.71 ± 0.12, respectively) were significantly lower than those of group S (19.7 ± 2.3 kcal/kg/day, 143.6 ± 30.9 ml/min, and 0.81 ± 0.09, respectively) (P metabolism.

  4. 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, ...

  5. 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

  6. 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.

  7. 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

  8. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... Webinars Publications & Resources Clinical Practice Guidelines SAMBA Link Digital ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ...

  9. 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.

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

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    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.

  11. Transverse myelitis following spinal anesthesia

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    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.

  12. 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);

  13. Pre-emptive analgesia using intravenous fentanyl plus low-dose ketamine for radical prostatectomy under general anesthesia does not produce short-term or long-term reductions in pain or analgesic use.

    NARCIS (Netherlands)

    Katz, J.; Schmid, R.L.; Snijdelaar, D.G.; Coderre, T.J.; McCartney, C.J.; Wowk, A.

    2004-01-01

    The aim of the study was to evaluate post-operative pain and analgesic use after pre-operative or post-incisional i.v. fentanyl plus low dose i.v. ketamine vs. a standard treatment receiving i.v. fentanyl but not ketamine. Men undergoing radical prostatectomy under general anesthesia were randomly a

  14. Magnesium sulphate suppresses fentanyl-induced cough during general anesthesia induction: a double-blind, randomized, and placebo-controlled study

    Science.gov (United States)

    Liu, Hai-Lin; An, Li-Jun; Su, Zhen; Zhang, Yang; Gui, Bo

    2015-01-01

    Fentanyl-induced cough is a common phenomenon during anesthesia induction. Magnesium sulphate (MgSO4) is reported to have a powerful relaxation of airway smooth muscle. This study is to investigate the effects of prophylactic MgSO4 on the incidence and severity of fentanyl-induced cough. A total of 120 patients, scheduled for elective surgery under general anesthesia, were randomly allocated into three groups (n = 40, each group) and injected with 50 ml normal saline, 30 mg/kg and 50 mg/kg of MgSO4 (diluted with normal saline into 50 ml) in groups I, II and III, respectively. One minute later all patients were injected with 5.0 μg/kg of fentanyl within 5 s. The incidence and severity of cough were recorded 30 s after fentanyl injection. Hemodynamic parameters and plasma magnesium concentration of the patients were also noted. Three patients dropped off the study due to obvious burning sense during injection of 50 mg/kg of MgSO4. Injection with 50 mg/kg of MgSO4 increased plasma magnesium level at the end of its infusion, but the latter still remained within therapeutic range (2-4 mmol/L). The incidence of cough in group I was much higher than those in groups II and III (45.0% vs. 15.0% and 8.1%, P < 0.05). Compared with the group I, both the groups II and III had lower incidence of moderate cough (P < 0.05). There were no differences in the hemodynamic data at three timepoints among the three groups. In conclusion, fentanyl-induced cough may be suppressed effectively and safely by prophylactic 30 mg/kg of MgSO4 during anesthetic induction. PMID:26379945

  15. 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.

  16. 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

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

    Science.gov (United States)

    Dai, Xiaotan; Song, Pingping; Zhang, Baijiang

    2016-05-20

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

  18. 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

  19. 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

  20. 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.

  1. 全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响%Effects of general anesthesia and epidural anesthesia on the short-term cognitive function in the elderly patients after orthopedics surgery

    Institute of Scientific and Technical Information of China (English)

    夏燕飞; 黄浩; 周嘉莉; 罗妙妙

    2012-01-01

    Objective To study the influence of general anesthesia and epidural anesthesia on postoperative short-term cognitive function in the elderly patients undergoing orthopedics surgery.Methods 120 patients with hip joint displacement or internal fixation after femur fracture and American Society of Anesthesiology Ⅰ and Ⅱ were randomly divided into general anesthesia and epidural anesthesia groups(n=60 for each group).Artery blood pressure(ABP)and heart rate were recorded before operation,pre-operation after anesthesia,during 30 min operation,during main operation and at operation end.Cognitive function was detected by mini-mental state(MMS)before induction of anesthesia and 6 h,12 h,24 h and 72 h after anesthesia.Results There were no differences in ABP and heart rate during operation between the two groups(P>0.05).The scores of MMS in general anesthesia group at 6 h(26.5±0.5),12 h(25.4±0.7)and 24 h(27.4±0.3)were decreased as compared with pre-induction of anesthesia(29.5 ± 0.3)(P< 0.05),while no difference was found at 72 h(29.3±0.3).The scores of MMS in epidural anesthesia group at 6 h(26.6±0.4)and 12 h(25.6±0.8)were lower(P<0.05),while had no difference at 24 h(29.1±0.4)and 72 h (29.5±0.4)(P>0.05)as compared with pre-induction of anesthesia(29.4±0.4).At 24 h after anesthesia,the MMS scores were higher in epidural anesthesia group(29.1±0.4)than in general anesthesia group(27.4±0.3)(P<0.01).Conclusions General anesthesia may contribute to more obvious influences on cognitive function than epidural anaesthesias within 12h after operation in the elderly patients undergoing orthopedics surgery.%目的 观察全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响. 方法 选择全髋关节置换或股骨骨折切复内固定手术患者120例,美国麻醉医师协会(ASA)病情分级Ⅰ、Ⅱ级,数字抽签随机分为全身麻醉组和硬膜外麻醉组各60例.记录术前、麻醉后手术前、手术30 min、主

  2. Anesthesia for adult rigid bronchoscopy.

    Science.gov (United States)

    Dincq, A S; Gourdin, M; Collard, E; Ocak, S; D'Odémont, J P; Dahlqvist, C; Lacrosse, D; Putz, L

    2014-01-01

    Rigid bronchoscopy under general anesthesia enables performing diagnostic and/or therapeutic procedures in the tracheobronchial tree. This technique is characterized by specific technical problems, insofar as the anesthesiologist and the operators share the same space, namely the airway. Several potential complications (hemorrhage inside the airway, threat to ventilation ...) may arise. These challenges render the ability to use the variable available techniques essential, as well as knowledge of the complications they could entail, and the ability to rapidly solve them. General anesthesia is usually total intravenous anesthesia, using short acting agents. Ventilation can be spontaneous, but more often insured using high-frequency jet ventilation. The hospital infrastructure and staff must have the expertise to perform this particular procedure, in order to limit the complication rate. PMID:25508517

  3. Comparison of risk of tumor invasion and metastasis under paravertebral block combined with general anesthesia versus general anesthesia in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope:plasma VEGF and M%椎旁神经阻滞联合全麻与全麻下胸腔镜肺癌根治术病人肿瘤侵袭和转移风险的比较:VEGF和MMP-9血浓度

    Institute of Scientific and Technical Information of China (English)

    陈冀衡; 范志毅; 张云霄; 金云玉; 李萍

    2015-01-01

    Objective To compare the risk of tumor invasion and metastasis under paravertebral block (PVB) combined with general anesthesia versus general anesthesia in the patients undergoing radical resection for lung cancer performed via video-assisted thoracoscope in terms of plasma concentrations of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9).Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 30-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective radical resection for lung cancer performed via video-assisted thoracoscope,were randomly divided into 2 groups (n =20 each) using a random number table:general anesthesia group (group G) and PVB combined with general anesthesia (group PG).PVB of T4-7 was performed successfully with local injection of 0.375% ropivacaine 5 ml before induction of anesthesia.Double-lumen endotracheal tube was placed after induction of anesthesia,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 1%-2%),and intravenous infusion of remifentanil 0.2-0.3 μg · kg-1 · min-1,and intermittent intravenous boluses of atracurium.Before anesthesia and at 24 h after surgery,the venous blood samples were collected for measurement of plasma concentrations of VEGF and MMP-9.Results The plasma VEGF and MMP-9 concentrations were significantly lower after surgery in group PG than in group G.Conclusion PVB combined with general anesthesia significantly decreases the risk of tumor invasion and metastasis in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope in comparison to general anesthesia.%目的 采用血管内皮生长因子(VEGF)和基质金属蛋白酶-9(MMP-9)血浓度,比较椎旁神经阻滞联合全麻与全麻下胸腔镜肺癌根治术病人肿瘤侵袭和转移风险.方法 择期行胸腔镜肺癌根治术病人40例,年龄30 ~ 64岁,性别不限,BMI 18

  4. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    OpenAIRE

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

    2012-01-01

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

  5. 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.

  6. Spinal morphine anesthesia and urinary retention.

    Science.gov (United States)

    Mahan, K T; Wang, J

    1993-11-01

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

  7. Risk factors for and circumstances of needlestick and sharps injuries of doctors in operating rooms: A study focusing on surgeries using general anesthesia at Kurume University Hospital, Japan.

    Science.gov (United States)

    Yonezawa, Yuko; Yahara, Koji; Miura, Miho; Hieda, Fumiyo; Yamakawa, Ryoji; Masunaga, Kenji; Mishima, Yasunori; Watanabe, Hiroshi

    2015-12-01

    Healthcare workers are exposed to serious infectious diseases via needlestick and sharps injuries. The operating room is a particularly important environment in which the risk for needlestick injuries is increased for surgical doctors. According to national surveillance studies, the proportion of needlestick and sharps injuries in operating rooms has been increasing for unknown reasons. In this study, we examined risk factors for and circumstances of injuries in operating rooms by combining and analyzing incidence reports and electronic records of every surgery in Kurume University Hospital (Kurume, Japan). The annual injury rate (reflecting the reporting rate) rose continuously from fiscal years 2007-2012. We conducted analyses focusing on surgeries that used general anesthesia, which accounted for 88.1% of the injuries. An analysis of the time of injury found that the number of injuries increased toward the end of the surgical procedure. A comparative analysis of surgeries by doctors who had experienced injury revealed risk for the injury increased when a procedure ended after 20:00. In addition, a comparative analysis of doctors with and without injury experience who had similar level of operating time per year revealed that the number of working years was not lower in the injured doctors. Although the data analyzed in this study were confined to one university hospital, our approach and these results will form a basis on which to consider more effective measures to prevent injury in operating rooms.

  8. [Regional anesthesia in geriatric surgery. Possibilities and limitations: (author's transl)].

    Science.gov (United States)

    Sehhati, G; Sarvestani, M

    1976-10-01

    Modern anesthetic techniques are superior to regional anesthesia for most operative procedures. Yet because of new advances in techniques and methods and sound pathophysiological knowledge, there are some operations for which regional anesthesia has distinct advantages over general anesthesia. This is the case, for example, in geriatric surgery. Here, the technical simplicity and short amount of time required give spinal anesthesia marked advantages over general anesthesia. Post-spinal headaches and slight falls in blood pressure have become rarer due to technical innovations and can reasonably be accepted. PMID:825724

  9. 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...

  10. 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

  11. 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...

  12. 全麻术后声带麻痹相关危险因素及治疗%Related Risk Factors and Treatment of Vocal Cord Paralysis After General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    韦应晖

    2015-01-01

    Objective To explore the risk factors and causes of vocal cord paralysis after general anesthesia, causing reasons, and puts forward suggestions for its prevention. Methods 6482 patients who underwent general anesthesia in our hospital during March 2000 and January 2015 were retrospectively analyzed, and the impact of their gender, age, types of operation, size, and anesthesia management on vocal cord paralysis were observed. Results A total of 58 patients were confirmed with vocal cord paralysis, be-tween whom and the other patients, there were statistically significant differences in terms of indwelling catheter time, size, and anesthesia management, difficulty level, general anesthesia times, P < 0.05. Conclusion Recurrent laryngeal nerve injury is the main cause of vocal cord paralysis after general anesthesia which has many kinds of risk factors that can always lead to mild and moderate damage. We can reduce its incidence by fully understanding the preoperative condition, strengthening intraoperative monitoring and mastering the indications for extubation.%目的:探讨全麻术后声带麻痹的危险因素、引发原因,提出预防意见。方法回顾分析该院自2000年3月-2015年1月收治经全麻手术患者6482例,观察性别、年龄、手术类型、体型、麻醉管理等对全麻术后声带麻痹患者的影响。结果共确诊声带麻痹患者58例。留管时间(χ2=6.78)、体型(χ2=4.43)、麻醉管理(χ2=8.38)、插管难易度(χ2=11.71)、全麻次数(χ2=4.43)差异有统计学意义(P<0.05)。结论全麻术后声带麻痹引发原因以喉返神经损伤为主,危险因素较多,多为轻、中度损伤。充分了解患者术前情况、术中监护预防及掌握术后拔管指征及注意事项,可降低发生率。

  13. 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.

  14. 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...

  15. Evaluation of Combined General Epidural Anesthesia in 62 Cases of Gynecological Laparoscopic Operation Anesthesia%硬膜外复合全麻在62例妇科腹腔镜手术中的麻醉效果评价

    Institute of Scientific and Technical Information of China (English)

    李英杰

    2014-01-01

    Objective To study anaesthesia effect of the combined general epidural anesthesia in gynecological laparoscopic operation. Methods From 2010 October to 2014 April, 102 cases in our hospital for gynecological laparoscopic operation were divided randomly into the control group (40 cases) and observation group (62 cases). The control group were used conventional general anesthesia, the observation group were treated by general anesthesia combined with epidural anesthesia, comparing and analyzing hemodynamic changes in patients in the two group, postoperative the recovery time and the excellent and good rate of uterine relaxation degree. Results The two groups were observed before and after induction, mean arterial pressure and heart rate fiuctuation, recovery time and uterine relaxation rate in patients in observation was significantly better than the control group, P<0.05, the difference was statistically significant. Conclusion Through general epidural anesthesia in gynecological laparoscopic operation, intraoperative mean arterial pressure and heart rate are stable, uterine relaxation degree is good, and have faster postoperative recovery.%目的:研究硬膜外复合全麻在妇科腹腔镜手术中…的麻醉效果。方法选取2010年10月~2014年4月于本院进行妇科腹腔镜手术治疗的102例患者,分为对照组40例和观察组62例,对照组患者采用普通全麻进行麻醉,观察组患者采用硬膜外复合全麻进行麻醉,观察两组患者术中…血流动力学变化,术后苏醒时间及子宫松弛度优良率,对比并分析两组患者的麻醉效果。结果两组比较,观察组患者诱导前后的平…均动脉压和心率波动较小,苏醒时间和子宫松弛良好率明…显优于对照组,P <0.05,差异具有统计学意义。结论硬膜外复合全麻在妇科腹腔镜手术中…的麻醉效果较好,术中…平…均动脉压和心率均较平…稳,子宫松弛度良好,术后苏醒快。

  16. 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...

  17. 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.

  18. 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。

  19. 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.

  20. 日间门诊全麻下拔牙的临床应用及评价%Tooth Extraction Under General Anesthesia in Outpatient Department: A Retrospective Study with 18 Cases

    Institute of Scientific and Technical Information of China (English)

    张智勇; 张晓; 王德蕙; 高巍; 陈全; 刘文曙; 姜霞

    2012-01-01

    目的:回顾性分析日间门诊全麻下拔牙的病例资料,总结日间门诊全麻下拔牙的麻醉特点、诊疗规范、手术特点和安全性.方法:收集日间门诊全麻下拔牙病例,总结选择全麻的原因、拔除牙位、离院评价得分,分析日间门诊全麻下拔牙的麻醉特点、手术特点.根据术中情况和术后复查分析该方法的安全性.结果:共收集18个病例,男11例,女7例,年龄7~50岁.选择全麻的原因包括:无法配合手术的儿童、智障、癫痫、咽部敏感、局麻药物过敏和有紧张晕厥病史.拔除牙位主要是阻生智齿和埋伏多生牙,均采用气管内插管静吸复合麻醉.所有病例手术顺利并安全离院,离院标准评分均在13分以上.结论:严格遵从诊疗规范的情况下,日间门诊全麻下拔牙对因各种原因无法配合局麻下手术的患者是一种安全有效的治疗方法.%Objective: To evaluate the indication and security of tooth extraction under general anesthesia in outpatient department. Methods: The patients accepted tooth extractions under general anesthesia in outpatient department were included in this study. The following information were recorded and summed, including: the reason for choosing general anesthesia, the position of the teeth removed and the score of postanesthetic discharge scoring system. Results: 18 cases were collected in this study. There were 11 male and 7 females, and the range of the age was from 7 to 50 years. The reasons for choosing general anesthesia including: children cannot corporate, falling sickness, mentally challenged, pharynx sensitivity, allergenic to local anesthesia drug and patients have swoon history because of overmuch nervous in dentistry treatment. The major positions of the teeth extracted were impacted teeth and supernumerary teeth. All patients accepted endotracheal intubation intravenous -inhalation combined anesthesia. All the operations were performed successfully and all

  1. Current clinical evidence on the effect of general anesthesia on neurodevelopment in children: an updated systematic review with meta-regression.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available BACKGROUND: Several epidemiological studies have been conducted to address the later effect of anesthesia on neurodevelopment in children. However, the results are still inconclusive. METHODS: We here conducted a systematic review and meta-analysis to summarize the currently available clinical and epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children by searching PubMed, EMBASE, and Web of Science database (from January-1 2000 to February-1, 2013. The evaluation of neurodevelopment includes language and learning disabilities, cognition, behavioral development, and academic performance. Both retrospective and prospective studies were included. Data were abstracted from seven eligible studies. We estimated the synthesized hazard ratios (HR and 95% confidence interval (CI according to inter-study heterogeneity. RESULTS: The pooled HR for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.25 (95% CI, 1.13-1.38, P<0.001; random-effects model in children undergoing the first anesthesia before the age of 4-year. Then we analyzed the factors for this association using meta-regression method. It showed that it was the number of times of exposure (HR = 1.75, 95% CI 1.31-2.33; P<0.001 rather than the time at exposure before 4-year (HR = 1.08, 95% CI 0.87-1.34 for the effect of per 1-year early exposure; P = 0.47 is a risk factor for neurodevelopmental impairment. CONCLUSION: The current clinical evidence suggests modestly elevated risk of adverse neurodevelopmental outcomes in children who were exposed to anesthesia/surgery during early childhood, especially for those with multiple times of exposure. Due to limitation of retrospective studies, prospective investigations are needed to determine whether anesthesia/surgery is causative.

  2. Application of oxycodone hydrochloride in the induction of general anesthesia%羟考酮在全身麻醉诱导中的临床应用

    Institute of Scientific and Technical Information of China (English)

    朱文智; 王东信

    2016-01-01

    目的:探讨羟考酮行全麻诱导的有效性与安全性。方法择期行结直肠癌手术患者60例,年龄35~75岁,随机分为两组,每组30例。F 组静脉注射芬太尼2μg/kg、丙泊酚2 mg/kg与顺式阿曲库铵0.15 mg/kg 行全麻诱导;O 组静脉注射羟考酮0.2 mg/kg、丙泊酚2 mg/kg 与顺式阿曲库铵0.15 mg/kg 行全麻诱导。记录诱导前(T0)、插管前1 min(T1)、插管后即刻(T2)、插管后1 min(T3)、5 min(T4)的 MAP 和 HR;记录手术时间、苏醒时间、拔管时间及不良反应情况。结果与T0时比较,T1时两组 MAP 均明显降低,T2时明显升高(P <0.05),且 T1时 F 组明显低于 O 组(P<0.05);T1时 F 组 HR 明显减慢(P <0.05);T2、T3时两组 HR 均明显增快(P <0.05)。插管期间两组 HR 差异无统计学意义。两组手术时间、苏醒时间、拔管时间差异无统计学意义。F 组咳嗽发生率明显高于 O 组(P <0.05)。结论羟考酮可以安全有效地用于临床全身麻醉气管插管的诱导。%Objective To explore the clinical effect and safety of oxycodone hydrochloride in the induction of genenral anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 35-75 years,sched-uled for colorectal surgery,undergoing general aneasthesia were randomly divided into two groups with 30 cases in each group:fentanyl group (group F)and oxycodone hydrochloride group (group O).Fentanyl 2 μg/kg+propofol 2 mg/kg+cisatracurium 0.1 5 mg/kg (group F)or oxycodone 0.2 mg/kg+propofol 2 mg/kg + cisatracurium 0.1 5 mg/kg (group O)was administered intravenously for general anesthesia induction.MAP and HR were monitored and recorded before the induction (T0 ),1 min before intubation (T1 ),at the time of intubation (T2 ),1 min after intubation (T3 )and 5 min after intubation (T4 ).Side-effect incidence of each group,operation time,wakening time,extuba-tion time and visual analogue scale (VAS)were recorded.Results Compared with group F,MAP in group O were lower than that of group F at

  3. 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

  4. 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

  5. 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。

  6. 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.

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

    Institute of Scientific and Technical Information of China (English)

    秦必光; 胡北喜; 等

    2002-01-01

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

  8. 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...

  9. 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...

  10. 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...

  11. 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.

  12. 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.

  13. 全身麻醉下气管支架植入术治疗恶性气管狭窄%Under general anesthesia endotracheal stenting for the treatment of malignant tracheal stenosis

    Institute of Scientific and Technical Information of China (English)

    孙陵; 吕朋华; 王立富; 王书祥; 王福安; 黄文诺; 耿素萍; 蔡明玉

    2012-01-01

    Objective To assess the curative effect of under general anesthesia endotracheal stenting for the treatment of malignant tracheal stenosis. Methods Seventeen patients with malignant tumors and moderate and severe dyspnea caused by tracheal stenosis were collected and underwent endotracheal stenting under general anesthesia. Nickel-titanium shape memory alloy stents were implanted through tracheal tube to the stenosis under DSA fluoroscopy. Results Technical success was achieved in all patients. The dyspnea was improved immediately after stent placement. Following-up for 3-24 months showed that there was no stent displacement, no obstruction of the airway, nor obvious pain and foreign body sensation in all cases. Conclusion Under general anesthesia tracheal stent implantation is safe, fast, effective and little pain for the treatment of malignant tracheal stenosis, which contributes to subsequent treatment.%目的 评价全身麻醉下气管支架植入术治疗恶性气管狭窄的疗效.方法 选择因恶性肿瘤致气管狭窄、中、重度呼吸困难患者17例,行全身麻醉及气管插管,于DSA监视下经气管套管植入镍钛记忆合金支架.结果 全部病例均成功植入支架,呼吸困难症状立即得到改善.随访3~24个月,支架无移位,气管通畅,患者无明显疼痛及异物感.结论 全身麻醉下气管支架植入术治疗恶性气管狭窄安全、快捷、有效,患者痛苦小,可为后续治疗提供条件.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

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

    Science.gov (United States)

    Gemperlé, M

    1977-02-01

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

  20. 地佐辛对小儿耳鼻喉手术全身麻醉苏醒期躁动的影响%Effect of Dezocine General Anesthesia in Pediatric ENT Surgery Restlessness

    Institute of Scientific and Technical Information of China (English)

    曾春红

    2015-01-01

    目的:探讨地佐辛对减轻小儿耳鼻喉手术全身麻醉苏醒期躁动的作用。方法:选取我院收治的行全身麻醉耳鼻喉手术的小儿患者作为研究对象,并随机分为对照组和观察组,所有患者术前接受相同的治疗,使用东莨菪碱、芬太尼、异丙酚和罗库溴铵诱导麻醉,微量泵入异丙酚、瑞芬太尼维持麻醉。手术结束前观察组静脉滴注地佐辛,对照组滴注生理盐水。结果:两组小儿患者手术时间、麻醉时间及拔管时间差异无统计学意义(P>0.05),拔管后15min时,观察组患者的平均动脉压(79.0±6.9) mmHg和心率(98.0±15.5)次/min均低于对照组的平均动脉压(94.2±8.3)mmHg和心率(115.1±17.2)次/min,差异有统计学意义(P<0.05);观察组小儿患者躁动情况控制率显著(80.0%)高于对照组(26.7%),且观察组平均躁得分(0.67±0.11)低于对照组(1.96±0.46),差异有统计学意义(P<0.05)。结论:地佐辛对减轻小儿耳鼻喉手术全身麻醉苏醒期躁动效果显著。%Objective: To investigate the Dezocine pediatric ENT surgery to relieve restlessness general anesthesia role. Methods:Our hospital ENT surgery under general anesthesia in pediatric patients for the study and randomly divided into control group and observation group,all patients received the same treatment,the use of scopolamine,fontanel,protocol and rocuronium-induced anesthesia,micro-pump protocol remifentanil anesthesia was maintained.Before the end of surgery,intravenous Dezocine observation group and control group with normal saline infusion.Results:The two groups of pediatric patients operative time,anesthesia time and estuation time was no significant difference (P>0.05),15min after estuation,observe the group of patients with mean arterial pressure (79.0±6.9)mmHg and heart rate (98.0±15.5)times / min were lower than the control group, mean arterial pressure (94.2±8.3)mmHg and heart rate (115.1±17.2)times

  1. Pulmonary infections caused by tracheal intubation general anesthesia for esophageal neoplasms%食管肿瘤行气管插管全麻术后肺部感染临床分析

    Institute of Scientific and Technical Information of China (English)

    吴炜

    2012-01-01

    目的 探讨食管肿瘤行气管插管全麻术后造成肺部感染的影响因素,为临床防治提供依据.方法 将医院2006年2月-2011年1月收治的5938例食管肿瘤行气管插管全麻患者临床资料进行总结,分别对患者的既往、术前状况、麻醉及气管导管类型、痰培养结果进行分析.结果 入选病例共5938例,术后肺部感染共786例,占13.24%;组间比较年龄、麻醉时间、导管类型差异有统计学意义;观察组患者经细菌学检查分离病原菌128株,依次为鲍氏不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌、非发酵菌分别占37.5%、18.8%、14.8%、12.5%、7.0%、9.4%.结论 食管肿瘤行气管插管全麻术后肺部感染发生率较高,影响因素与年龄、麻醉时间、气管导管类型有关,对患者术后合理应用抗菌药物、慎重选择气管导管及侵入性操作对预防其发生肺部感染有重要意义.%OBJECTIVE To explore the related factors for the pulmonary infections caused by tracheal intabation general anesthesia for esophageal neoplasms so as to provide-bases for clinical prevention. METHODS The clinical data of 5938 esophageal tumor patients who underwent tracheal intubation general anesthesia from Feb 2006 to Jan 2006 were summarized, the previous status, preoperative status, the type of anesthesia and endotracheal tube, and the sputum culture were observed. RESULTS A total of 5938 patients were enrolled the case study, postoperative pulmonary infections occurred in 786 cases (13. 24%); the difference in the age, duration of anesthesia, and the type of catheter was statistically significant; totally 128 strains of pathogens were isolated from the patients in the observation group by bacteriological examination, among which Acinetobacter baumannii, Pseudomonas aerugino-sa , Staphylococcus aureus , Klebsiella pneumonia , and Escherichia coli accounted for 37. 5% ,18. 75% ,14. 84

  2. 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

  3. 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

  4. The Effect of a Combination Treatment Using Palonosetron, Promethazine, and Dexamethasone on the Prophylaxis of Postoperative Nausea and Vomiting and QTC interval duration in Patients Undergoing Craniotomy Under General Anesthesia: A pilot Study

    Directory of Open Access Journals (Sweden)

    Sergio Daniel Bergese

    2016-02-01

    Full Text Available Introduction: Postoperative nausea and vomiting (PONV is a displeasing experience that distresses surgical patients during the first 24 hours after a surgical procedure. The incidence of postoperative nausea occurs in about 50%, the incidence of postoperative vomiting is about 30%, and in high-risk patients, the PONV rate could be as high as 80%. Therefore, the study design of this single arm, non-randomized, pilot study assessed the efficacy and safety profile of a triple therapy combination with palonosetron, dexamethasone and promethazine to prevent PONV in patients undergoing craniotomies under general anesthesia.Methods: The research protocol was approved by the institutional review board and 40 subjects were provided written informed. At induction of anesthesia, a triple therapy of palonosetron 0.075 mg IV, dexamethasone 10 mg IV and promethazine 25 mg IV was given as PONV prophylaxis. After surgery, subjects were transferred to the surgical intensive care unit (SICU or post anesthesia care unit as clinically indicated. Ondansetron 4 mg IV was administered as primary rescue medication to subjects with PONV symptoms. PONV was assessed and collected every 24 hours for 5 days via direct interview and/or medical charts review.Results: The overall incidence of PONV during the first 24 hours after surgery was 30% (n=12. The incidence of nausea and emesis 24 hours after surgery was 30% (n=12 and 7.5% (n=3 respectively. The mean time to first emetic episode, first rescue, and first significant nausea was 31.3 (±33.6 15.1 (±25.8 and 21.1 (±25.4 hours, respectively . The overall incidence of nausea and vomiting after 24-120 hours period after surgery was 30% (n=12. The percentage of subjects without emesis episodes over 24-120 h postoperatively was 70% (n=28. No subjects presented a prolonged QTC interval ≥500 msec before and/or after surgery.Conclusion: Our data demonstrated that this triple therapy regimen may be an adequate alternative

  5. [Anesthesia for ambulatory patients].

    Science.gov (United States)

    Landauer, B

    1975-11-13

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

  6. 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

  7. 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

  8. Gasless retroperitoneal laparoscopic unroofing of renal cysts under non-general anesthesia%免气腹非全身麻醉后腹腔镜下肾囊肿去顶术

    Institute of Scientific and Technical Information of China (English)

    瞿兆奎; 祁薇; 杨岗林; 吉剑波; 吴大庆; 许少波

    2011-01-01

    目的 探讨在免气腹非全麻后腹腔镜下行肾囊肿去顶减压术的可行性.方法 86例均来自该院2006年6月~2010年8月住院患者,被随机分为实验组与对照组,两组在性别、年龄等方面差异无显著性(P>0.05).实验组41例用可折叠软柄撑开器行免气腹非全麻后腹腔镜手术.同期对照组45例开展普通后腹腔镜手术.每例手术患者均记录手术时间、术中出血量、术中术后高碳酸血症和恶心呕吐并发症的发生.结果 两组手术均获成功,手术时间、术中出血量差异均无显著性(P>0.05);但实验组与对照组相比显著减少了手术时气腹、全麻可能引起的高碳酸血症和恶心呕吐并发症(P<0.05).结论 借助可折叠软柄撑开器开展免气腹非全麻后腹腔镜手术与普通后腹腔镜手术相比同样微创,患者痛苦小、恢复快、易于接受.且显著减少了原后腹腔镜手术时气腹、全麻可能引起的高碳酸血症和恶心呕吐并发症.%[ Objective ] To discuss the feasibility of the gasless retroperitoneal laparoscopic unroofing of renal cysts under non-general anesthesia. [Methods] All 86 inpatients of the department from June 2006 to August 2010 were randomly divided into experimental group and control group, in which there were no significant gender and age differences (P >0.05). 41 cases of experiment group were treated by gasless non-general anesthesia retroperitoneal laparoscopy using the collapsible distraction device with soft-handle. During the same period 45 cases of control group were treated by traditional retroperitoneal laparoscopy. The medical data of all the patients including operation time, amount of blood loss and complications such as hypercapnia, nausea and vomiting were recorded. (Results] Both the two groups had been operated successfully. There were no significant differences in operation time and blood loss (P >0.05), but the occurrence of possible complications such as

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

    Science.gov (United States)

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

    2007-01-01

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

  10. 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.

  11. 七氟烷和丙泊酚麻醉下阻塞性黄疸患者术后恢复的比较%The difference on anesthesia recovery period in obstructive jaundice patients under general anesthesia with sevoflurane of intravenous propofol

    Institute of Scientific and Technical Information of China (English)

    李廷坤; 卢锡华; 吕帅国; 章云飞; 王根生; 冯艳平

    2008-01-01

    Objective To investigate the effect of general anesthesia with sevoflurane or intravenous propofol on anesthesia recovery period in obstructive jaundice patients. Methods Thirty ASA Ⅰ or Ⅱ and Child A obstructive jaundice patients were randomly divided into two equal groups (n=15 each). The patients in group S received inhalation anesthesia with sevoflurane and those in group P intravenous anesthesia with propofol during operation for obstructive jaundice. The patients were premedicated with intramuscular phenobarbital 100mg and atropine 0.5mg, anesthesia was induced with midazolam 0.05mg/kg, atracurium 0.5mg/kg, propofol 1.5-2.5mg/kg and fentanyl 4μg/kg. Maintained with TCI of propofol (target plasmaconcentration was set at 3.5mg/L) or sevoflurane inhalation (end-tidal sevoflurane concentration was 2%-3%) and intermittent i. v. boluses of fentanyl. EGG, HR, MAP, SpO and end-tidal sevoflurane concentration were continuously monitored during operation. Duration of anesthesia, the volume of infusion and fentanyl were recorded, awaking time, extubation and regained consciousness after operation were recorded. Results There were no significant differences between the two groups in average age, sex, body-weight, duration of anesthesia, the parameters of MAP and HR (P>0.05). The awaking time was (7.9±1.5) minutes in group S and (26.1±8.8) minutes in group P. The extubation time was (8.5±2.5) minutes in group S and (27.8±11.2) minutes in group P. The regained consciousness time was (13.1±4.4) minutes in group S and (33.7±12.5) minutes in group P. The incidence of lethargy, fidget were higher in group P than those in group S. Conclusion Both sevoflurane and propofol can provide satisfactory anesthesia for the operation of obstructive jaundice, but the recovery of influence caused by sevoflurane is faster and more steady than that caused by propofol.%目的 比较阻塞性黄疽患者在七氟烷和丙泊酚麻醉后恢复的差异.方法 择期

  12. Countermeasure and Clinical Analysis of Intraoperative Awareness of Patients Undergoing General Anesthesia%全身麻醉患者发生术中知晓的临床特征和对策

    Institute of Scientific and Technical Information of China (English)

    刘珍珍; 夏中元; 姚瑶; 杜立

    2012-01-01

    Objective:To analyze the Incidence, risk factors and characteristics intraoperative awareness of patients undergoing general anesthesia and explore the prevention and control measures. Methods:28 cases of intraoperative awareness undergoing general anesthesia were analyzed retrospectively in our hospital from 2005 to 2010.Results:The incidence of intraoperative awareness was 0.07%; The characteristics of the group of patients:①The prevalence was greater in men than in women;②More common in anesthesia in less than lh of the "short operation";③Awareness during intravenous anesthesia was higher than that of other ways, but also case of all did not use benzodiazepine drugs; ④It was higher in the patients with long-term drinking and using diazepam for a long time, and intraoperative monitoring of brain function is not implemented; ⑤Postoperative period were with serious psychological and mental disorders, But the treatment was obviously effective. Conclusion:Awareness of patients undergoing general anesthesia during surgery in patients can cause severe psychological and mental disorders; We should strengthen the preoperative evaluation and prevention of high-risk patients such as men, short operation and long-term using diazepam for a long time ,and especially preventive use of benzodiazepines drugs.BIS monitoring should be implemented; Pay attention to the return visit and timely psychological and drug treatment.%目的:分析全身麻醉患者发生术中知晓的发生率、高危因素及特征,探讨其防治措施.方法:回顾性分析我院2005年-2010年全身麻醉患者中发生术中知晓的28例病例.结果:全身麻醉患者术中知晓的发生率为0.07%;该组病例特征为:①男性的发生率大于女性;②多见于麻醉手术时间小于1h的"短小手术";③麻醉方式主要表现在静脉复合麻醉中,但均未使用苯二氮卓类药;④长期口服"安眠药"和长期饮酒的患者发生率高,且术中未实施脑功能监

  13. 舒芬太尼预防全麻术后躁动和咽喉疼痛的临床观察%Clinical observation of preventive effects of sufentanil on restlessness and sore throat after surgery under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    姚猛飞; 何丽云

    2011-01-01

    Objective To observe preventive effects of intravenous injection of sufentanil by the end of surgery under general anesthesia on restless during awakening and sore throat within postoperative 24 h. Methods 122 patients who would undergo selective operation under general anesthesia were randomly divided into group A and group B( n= 61 ). Both groups received anesthesia induction with midazolam, atracurium, fentanil and propofol,then maintenance anesthesia with propofol + remifentanil + isoflurane. B group was intravenously injected with sufentanil at 0.25 - 0.5 μg/kg 30 - 40 min before the anesthetic withdrawal ,while in group A no drug was administered by the end of surgery The recovery time of spontaneous breathing, eye opening time, incidence of restless during postanaesthetic recovery and incidence of sore throat within postoperative 24 h were recorded in the two groups. Results The recovery time of spontaneous breathing and eye opening time were not significantly different between the two groups( P > 0.05 ). However, the incidences of restless and sore throat in group B were significantly lower than those in group A( P < 0.05 ). Conclusion Low - dose sufentanil administration before awakening from general anesthesia can not only prevent restless during postanaesthetic recovery, but also prevent sore throat within postoperative 24 h.%目的 观察术毕前静脉注射舒芬太尼预防全麻术后苏醒期躁动和术后24 h咽喉疼痛的效果.方法 随机将122例需要全麻的择期手术患者分为A组和B组,每组61例,两组均以咪唑安定、阿曲库铵、芬太尼、丙泊酚诱导,丙泊酚+瑞芬太尼+异氟醚维持麻醉.B组于手术结束麻醉停药前30~40 min给予舒芬太尼0.25~0.5 μg/kg;A组手术结束前不给药.分别纪录两组患者的自主呼吸恢复时间、呼之睁眼时间及苏醒期患者的躁动发生率、术后24 h咽喉疼痛发生率.结果 两组患者手术结束后,自主呼吸恢复时间、呼

  14. The risk factors for delirium in older orthopedic surgery patients in post-anesthesia care unit after general anesthesia%麻醉后恢复室老年骨科全麻患者谵妄的危险因素

    Institute of Scientific and Technical Information of China (English)

    杨许丽; 刘玥; 郑旭; 孙玉娥; 王杨; 李新梅; 江澜; 王江; 王玲

    2014-01-01

    Objective To investigate the risk factors for delirium incidence in older orthopedic surgery patients in postanesthesia care unit (PACU) following general anesthesia.Methods Sixty-seven cases of elderly patients exposed to orthopedics surgery with general anesthesia were enrolled in the PACU.Delirium was evaluated with the intensive care delirium screening checklist (ICDSC) after extubation for 5 min.We also recorded relevant data for statistical analysis such as intraoperative fluid intake and output,positive reaction for catheterization as well as patient's age,sex,weight,body height and education time.Results Postoperative delirium was observed in 19 patients (5 males and 14 females),accounting for 28.34%.The average age in delirium group(group Z) was (77±7),while non-delirium group (group NZ) was (72±6).Furthermore,the average education time in group Z was(4.6±2.4),which was much lower compared with (6.5±3:1) group NZ,and exhibited statistically significant differences between the two groups (P<0.05).We also revealed that age may serve as a potential risk factor for delirium via logistic regression analysis for variables observed statistically significant in comparisons between groups (P=0.005,OR=1.231).Conclusions Age may increase the risk of delirium in older orthopedic patients in PACU following general anesthesia.%目的 探讨麻醉后恢复室(post-anesthesia care unit,PACU)老年骨科全麻患者谵妄发生的危险因素. 方法 观察67例接受骨科手术入PACU的老年全麻患者,拔管后5 min采用重症监护谵妄筛查检查表(the intensive care delirium screening checklist,ICDSC)评估谵妄.记录术中出入量,是否有尿管反应,患者的年龄、性别、体重、身高、受教育年限等一般资料,进行统计分析. 结果 19例患者(男5例,女14例)发生术后谵妄,占28.34%.谵妄组(Z组)平均年龄(77±7)岁,高于无谵妄组(NZ组)(72±6)岁;谵妄组(Z组)患者平均受教育年限(4.6±2.4)

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  16. Application of Non-intubated Anesthesia in VATS

    Directory of Open Access Journals (Sweden)

    Xiaotan DAI

    2016-05-01

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

  17. 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

  18. 右旋美托咪定(Dex)用于全身麻醉效果安全性分析%Dexmedetomidine (Dex) is used to analyze the security effect of general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李宏开

    2013-01-01

    Objective to analyze and discuss dexmedetomidine given the clinical effects and safety of general anesthesia applications. Methods 72 patients according to the use of narcotic drugs which are divided into a different group will adopt a given dexmedetomidine (deX) were anesthetized and injected only with saline group B comparison. deX is used to observe the effect of general anesthesia and their safety. Results 72 patients under general anesthesia for surgery were successfully completed, and no arrhythmia, dizziness, fever and other adverse reactions. Which, given the use of dexmedetomidine group A patient's blood pressure, heart rate, SpO2 and other indicators are better than group B (P <0.05), while, ramsay score was also significantly better than group B. Compared with group B, the amount of anesthetic agent A group (such as remifentanil, propofol, etc.) is also small. Conclusion deX not only for general anesthesia with sedation, analgesia, anti-sympathetic effect, but also to reduce the use of fentanyl and propofol and other narcotic drugs, blood circulation stable, safe and reliable.%目的:分析并讨论右旋美托咪定在全身麻醉应用中的临床效果及其安全性。方法72例患者据所使用麻醉药物的不同将其均分为采用右旋美托咪定(deX)进行麻醉的 a 组,与仅注射等量生理盐水的 B 组进行对比。观察 deX 用于全身麻醉的效果与其安全性。结果72例进行全身麻醉的患者手术均顺利完成,且没出现心律失常、头晕、发热等不良反应。其中,采用右旋美托咪定 a 组患者的血压、心率、spo2等指标均优于 B 组(P<0.05),同时,ramsay 评分也明显优于 B 组。与 B 组相比,a 组的麻醉剂用量(如瑞芬太尼、异丙酚等)也较少。结论 deX 用于全身麻醉不仅具有镇静、镇痛、抗交感的效果,而且能够减少芬太尼和异丙酚等麻醉药物的使用,稳定血液循环等,安全可靠。

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

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-01-01

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

  20. 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.

  1. 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

  2. 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...

  3. 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

  4. 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.

  5. 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

  6. 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

  7. The efficacy of dexmedetomidine hydrochloride on prevention of agitation and sore throat after surgery with general anesthesia%右美托咪定预防全麻术后躁动和咽喉疼痛的作用

    Institute of Scientific and Technical Information of China (English)

    刘晶; 廖信芳; 胡祖荣; 贾杰; 黄希照; 邓恋

    2012-01-01

    目的 探讨右美托咪定(Dex)对患者全麻术后躁动和咽喉疼痛的预防作用.方法 将200例择期腹腔镜妇科手术患者分为观察组和对照组,每组100例,两组均以咪达唑仑、维库溴铵、舒芬太尼、丙泊酚诱导,丙泊酚、瑞芬太尼和七氟醚维持麻醉.手术结束前30 min观察组用Dex 0.6 μg/kg 10 min泵入,对照组相同量生理盐水10 min泵入.观察记录两组患者的自主呼吸恢复时间、呼之睁眼时间、拔管时间及苏醒期患者的躁动评级、身体舒适度评分(BCS)、术后24 h咽喉疼痛评级.结果 两组患者手术结束后,自主呼吸恢复时间、呼之睁眼时间及拔管时间差异无统计学意义(P>0.05),而躁动和咽喉痛发生率观察组比对照组明显降低(P<0.05),观察组BCS明显高于对照组(P<0.05).结论 Dex可有效预防全麻术后躁动和咽喉疼痛的发生.%Objective To study preventive efficacy of dexmedetomidine on agitation and sore throat after surgery with general anesthesia. Methods Two hundred patients with selective celoscopic gynecological operation were randomized two groups (n = 100) : Group A and B. Midazolam, vecuronium bromide, sufentanil and propofol were applied for anesthesia induction, as propofol, remifentanil and sevoflurane were applied for maintenance of anesthesia in the both groups. However, intravenous dexmedetomidine (0. 6 μg/kg) was given to the participants in Group A 30 min before the end of the operation, whereas the substituted physiological saline was given in Group B. The recovery time of spontaneous breathing, eye opening time, extubation time, agitation grading, body comfort score (BCS) and sore throat grade within the 24 h after operation were recorded. Results There was no significant difference in recovery time of spontaneous breathing, eye opening time or extubation time between the two groups ( P > 0. 05 ) . However, there was significant reduction of incidences of agitation and sore throat

  8. Tramadol with Flurbiprofen Axetil reduces recovery restlessness after general anesthesia%曲马朵联合氟比洛芬酯预防全麻苏醒期躁动

    Institute of Scientific and Technical Information of China (English)

    谢阳; 方志源

    2011-01-01

    Objective To observe the effect of t lurbiproten Axetu and Tramadol on treating the recovery restlessness after general anesthesia. Methods Sixty patients of LC surgery were divided into 3 groups randomly, each with 20 cases. Group A was given Flurbiprofen (1 mg/kg) before induction of anesthesia, Group B was given Tramadol (2 mg/kg) 20 minutes before finishing the surge and Group C was given Flurbiprofen (1 mg/kg) before induction of anesthesia, then was given Tramadol (2 mg/kg) 20 minutes before finishing the surge. Agitation score, the time from withdrawal to recovery and side effects were observed. Results Emergence agitation score at each time point: Group A>Group B>Group C with P0. 05. Conclusion Flurbiprofen Axetil with Tramadol can degrade the level of recovery restlessness after general anesthesia with less side reactions.%目的 观察曲马朵联合氟比洛芬酯用于预防全麻手术苏醒期躁动的效果及安全性.方法 择期腹腔镜胆囊切除手术60例,随机分为3组,每组20例.A组:于麻醉诱导开始前给予氟比洛芬酯注射液1 mg/kg;B组:于手术停止前20 min给予曲马朵注射液2 mg/kg;C组:于麻醉诱导开始前给予氟比洛芬酯注射液1mg/kg,手术停止前20 min给予曲马朵注射液2 mg/kg.观察:每组患者拔管即刻(0min),拔管后5min,10 min,15 min的躁动评分;从停药到患者清醒的时间;是否发生呼吸抑制、恶心呕吐、皮肤瘙痒等不良反应.结果 各时间点躁动分级:A组明显高于B组和C组,B组明显高于C组(P<0.01).B、C组各有1例恶心、呕吐发生,3组无呼吸抑制、凝血功能异常、瘙痒等不良反应,3组之间差异无显著性意义.结论 术中应用曲马朵联合氟比洛芬酯对预防全麻苏醒期躁动具有良好的效果,并能降低不良反应发生率.

  9. 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.

  10. A comparison of the end-expired concentrations of sevoflurane at the same anesthesia depth among patients with different ages undergoing general anesthesia%不同年龄患者在同一麻醉深度下呼气末七氟烷浓度的比较

    Institute of Scientific and Technical Information of China (English)

    张旭东; 张可贤; 陈一丁; 于涛; 唐育民

    2013-01-01

    Objective:To investigate the difference of the end-expired concentrations of sevoflurane in patients with different ages undergoing general surgery with remifentanil .Methods: One hundred and twenty-five ASAⅠ-Ⅱpatients undergoing general surgery were allocated into 5 groups ( 25 cases in each group ) , group 1:1-4 yrs;group 2:5-18 yrs;group 3:19-40 yrs;group 4:41-65 yrs;and group 5:66-86 yrs.After inducing ,anesthesia was maintained with sevoflurane and remifentanil ( 0.1 μg · kg -1 · min-1 ) .The concentration of sevoflurane was adjusted to maintain Narcotrend index (NI) at 64.BP,HR and expired concentration of sevoflurane were measured and recorded at these three time points:before anesthesia , the time when NI maintaining 64 and 85.Results:There were no recovering delay ,respiration dysfunction or intraoperative awareness in each group .The values of end-expired concentration of sevoflurane among the 5 groups had significant differences ( P <0.05 ) .At the same anesthesia depth, the value of end-expired concentration of sevoflurane in group 3 was lowest among the 5 groups.Conclusion:The end-expired concentrations of sevoflurane in different ages at the same anesthesia depth undergoing general surgery with remifentanil were significantly different (P<0.05).And the end-expired concentration of sevoflurane should be adjusted according to the age of the patient for the proper depth of sevoflurane anesthesia .%目的:观察不同年龄的全麻普通外科手术患者复合雷米芬太尼麻醉在同一麻醉深度下呼气末七氟烷浓度的区别。方法:125例行腹部手术的患者, ASA分级Ⅰ~Ⅱ,按年龄分为5组:组1为1~4岁,组2为5~18岁,组3为19~40岁,组4为41~65岁,组5为66~86岁,每组25例。静脉诱导后雷米芬太尼维持输注速度为0.1μg · kg -1· min-1和吸入七氟烷维持麻醉,调节七氟烷浓度使Narcotrend指数( Narcotrend index,NI)值稳定在64水平。手术结束后

  11. 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.

  12. The Develoment of Anesthesia.

    Science.gov (United States)

    Davis, Audrey B.

    1982-01-01

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

  13. Local anesthesia: a review.

    Science.gov (United States)

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

    1992-01-01

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

  14. 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

  15. 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...

  16. 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...

  17. Comparison of the Effects of General Anesthesia and Epidural Combined Anesthesia on Postoperative Early Cognitive Function in Elderly Patients with Postoperative Epidural Analgesia%全身麻醉与硬膜外复合麻醉继以术后硬膜外镇痛对老年患者非心脏手术后早期认知功能的影响比较

    Institute of Scientific and Technical Information of China (English)

    隋金玲; 邓蓉蓉

    2015-01-01

    Objective To probe into the effect of general anesthesia and epidural combined anesthesia on postoperative early cognitive function in elderly patients with postoperative epidural analgesia. Methods 115 patients who accepted heart operation treatments in our hospital from January, 2011 to December, 2014 and these patients were randomly divided into the control group and the observation group.In the observation group of 60 patients were received general anesthesia and epidural combined anesthesia and postoperative epidural analgesia while in the control group of 55 patients were received general anesthesia and intravenous analgesia after surgery. Then, the postoperative neurological and mental function and other indicators of two groups of patients were observed and the early postoperative cognitive function of patients was comparative analyzed.Results The incidence of cognitive dysfunction seven days after surgery in the observation group and control group was 51.67% (31/60) and 49.09% (27/55).Conclusion After non cardiac surgery, the elderly patient wil have some early cognitive dysfunction due to surgical operation and education, while the effect of epidural anesthesia and epidural anesthesia on early cognitive function in elderly patients is not obvious.%目的:探讨全身麻醉与硬膜外复合麻醉继以术后硬膜外镇痛对老年患者非心脏手术后早期认知功能的影响。方法选择2011年01月~2014年12月在我院进行非心脏手术的老年患者115例分为对照组和观察组,观察组60例患者接受全身麻醉与硬膜外复合麻醉和术后硬膜外镇痛,对照组55例患者仅接受全身麻醉和术后静脉镇痛。观察两组患者术后神经及精神功能等各项指标,就患者术后早期认知功能情况作对比分析。结果观察组和对照组患者在术后七天的认知功能障碍发生率为51.67%(31/60)、49.09%(27/55)。结论在进行非心脏手术后,老年患者会因外科手

  18. 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.

  19. 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

  20. Risk factors of postoperative respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia%全身麻醉患者术后呼吸道感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李宁; 张义龙; 赵国军; 宋有鑫; 任磊; 李建玲

    2016-01-01

    目的 探讨气管插管全身麻醉下行腰椎手术患者术后发生呼吸道感染的原因,为其临床预防治疗提供参考依据.方法 连续收集2012年9月-2014年9月住院拟行气管插管全身麻醉下腰椎后路切开减压内固定椎间融合术的患者300例作为研究对象,记录其基本信息及相关病史,分析术后呼吸道感染的原因,采用SPSS 17.0软件进行数据统计分析,对危险因素应用logistic回归模型分析.结果 300例患者中发生呼吸道感染34例,发生率11.33%;多因素分析结果 表明,年龄、吸烟史、既往有呼吸系统慢性感染、糖尿病、无口腔护理等因素与术后呼吸道感染有关(P<0.05).结论 气管插管全身麻醉下行腰椎手术患者,如为高龄、吸烟者,既往有慢性呼吸道感染及糖尿病史,术后发生呼吸道感染危险明显增高;术前规范进行口腔护理可以降低术后发生呼吸道感染的风险.%OBJECTIVE To explore the causes for respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia in order to guide the clinical prevention and treatment .METHODS The continuous clinical data of 300 patients who needed lumbar vertebra surgery under general anesthesia from Sep .2012 to Sep . 2014 were collected and their general information and the relative medical history were recorded ,then the patients who had respiratory tract infections postoperatively were recorded and analyzed .The software SPSS 17 .0 was used for statistical analysis and the risk factors were analyzed by logistic regression model .RESULTS Of 300 pa-tients with complete data ,respiratory tract infections occurred in 34 cases with the incidence rate of 11 .33% .The multivariate analysis indicated that age ,smoking history ,history of chronic respiratory tract infections or diabetes mellitus ,and absence of oral care were correlated with postoperative respiratory tract infections .CONCLUSION The risk of getting respiratory

  1. Risk factor analysis of postoperative respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia%腰椎手术患者全麻术后呼吸道感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李宁; 张义龙; 赵国军; 宋有鑫; 任磊; 李建玲

    2016-01-01

    目的:探讨气管置管全身麻醉下行腰椎手术患者术后发生呼吸道感染的相关因素,为其临床预防治疗提供参考依据。方法收集2012年9月-2014年9月在医院住院拟行气管置管全身麻醉下腰椎后路切开减压内固定椎间融合术的患者303例作为研究对象,记录其基本信息及相关病史,分析术后呼吸道感染的相关因素,研究数据采用SPSS 17.0软件进行统计处理。结果300例患者中发生呼吸道感染34例,感染率为11.33%;多因素分析结果显示,年龄、吸烟史、既往有呼吸系统慢性感染、糖尿病、无口腔护理等因素与术后呼吸道感染有关,差异有统计学意义(P<0.05)。结论气管置管全身麻醉下行腰椎手术患者,如为高龄、吸烟者,既往有慢性呼吸道感染及糖尿病史,术后发生呼吸道感染危险因素明显增高;术前进行规范口腔护理可以降低术后发生呼吸道感染的风险。%OBJECTIVE To explore the related factors for respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia in order to guide the clinical prevention and treatment .METHODS The consecutive clinical data of 300 patients who needed lumbar vertebra surgery under general anesthesia from Sep . 2012 to Sep .2014 were collected and the general information and the relative medical history were recorded .The related factors for postoperative respiratory tract infection were analyzed .The data were statistically analyzed by software SPSS 17 .0 .RESULTS Of 300 patients with complete data ,respiratory tract infection occurred in 34 cases with the incidence rate of 11 .33% .The multivariate analysis indicated that age ,smoking history ,history of chro-nic respiratory tract infection or diabetes mellitus ,and oral care were correlated with postoperative respiratory tract infections ,with significant difference (P<0 .05) .CONCLUSION The risk factors of

  2. 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

  3. Effect of dexmedetomidine on blood lfow dynamics in elderly patients undergoing general anesthesia%右美托咪啶对全麻老年患者血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    徐永生

    2016-01-01

    目的:探讨右美托咪啶用于全麻老年高血压患者对心钠素(ANP)、内皮素(ET)及血流动力学的影响,分析右美托咪啶在全麻老年高血压患者的应用效果。方法随机选择2015年4月至2016年1月哈尔滨市第五医院拟行气管插管全麻的开腹手术老年原发性高血压患者40例。所选患者随机分为两组,即右美托咪啶组(D组)和对照组(C组),每组20例。分别于麻醉前(即基础值)(Tl)、插管前(T2)、插管后(T3)、手术开始切皮时(T4)、手术30min(T5)、手术结束拔管时(T6),六个时点抽取静脉血,采用放免法测定血浆中ET、ANP的含量。所有患者围术期连续监测心电图(ECG)、心率(HR)、血氧饱和度(SPO2)、收缩压(SBP)、舒张压(DBP)、尿量并对这些指标定时记录。结果在SBP、DBP、HR中显示D组与C组比较,除T1以外T2-T6均有差异(P<0.05)。在监测血浆内皮素和心钠素的浓度中发现,D组与C组间比较除麻醉前以外,T2-T6各个时间点比较有显著差异(P<0.05)。结论右美托咪啶用于全麻老年高血压患者能有效减少手术过程中ET、ANP的释放和保持围手术期血流动力学稳。%Objective To evaluate the Dexmedetomidine Injection used for general anesthesia in the elderly patients with high blood pressure and blood flow to ET, ANP dynamics influence, so as to analyze the Dexmedetomidine Injection in the elderly patients with high blood pressure of general application effect, to provide reference for clinical medication.Methods Random selection in April 2015 to January 2016 he fifth hospital of Harbin plans to do tracheal intubation of general anesthesia open surgery patients with essential hypertension 40 cases, The selected patients were randomly divided into two groups, and Each group of 20 cases. Dexmedetomidine(D group) and the control group(group C). Difference in anesthesia

  4. 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

  5. Effect of general anesthesia for children on their intelligence and sensory integration capability%儿童行全身麻醉手术对其智力和感觉统合能力的影响

    Institute of Scientific and Technical Information of China (English)

    朱明; 王璐

    2015-01-01

    Objective To study the effect of general anesthesia on children's intelligence and sensory integra-tion capability. Methods Children aged 7~9 who had gone through general anesthesia during the age from 1 to 3 but not for cardiac surgery or neurosurgery were selected as the experimental group (n=72). Children aged 7~9 who re-ceived no general anesthesia during the age from 1 to 3 were selected as the control group (n=72) based on the 1:1 principle correspondent with sex, age, and education, education levels, occupation of their parents of the experimental group. The Wechsler Intelligence Scale and Children Sensory Integration Capability Development Rating were used to assess the children's intelligence and capability of sensory integration. Results The two groups of children showed no statistically significant difference in the total index of intelligence and cognitive ability (P>0.05). In terms of the in-ternal structure of intelligence, the proportion of patients in the experimental group who were with difference between perceptual reasoning index and processing speed index was 16.7%(12/72), and that in the control group was 1.4%(1/72). Proportion of patients in the experimental group who were with difference between working memory and the verbal comprehension index was 20.8%(15/72), and that of the control group was 2.8%(2/72). Both the above com-parisons showed statistically significant differences (P0.05)。在智力内部结构方面,实验组儿童的言语理解-加工速度指数存在差异者为16.7%(12/72),而对照组为1.4%(1/72),实验组的知觉推理-加工速度指数差异者为20.8%,(15/72),对照组为2.8%(2/72),两组指数比较差异均具有统计学意义(P<0.05);实验组儿童前庭功能失衡发生率为25.0%(18/72),明显高于对照组儿童的1.4%(1/72),差异具有统计学意义(P<0.05)。结论总体来看,儿童在1~3岁期间进行全麻手术后对其后期的智力、感觉统合能力无显著影响,

  6. 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

  7. 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

  8. 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

  9. 氟马西尼用于脑瘫患儿全麻催醒的临床研究%CLINICAL STUDY ON FLUMAZENIL USING FOR ANALEPSIA OF CHILDREN WITH CEREBRAL PALSY AFTER GENERAL ANESTHESIA

    Institute of Scientific and Technical Information of China (English)

    张科; 叶章文; 余学英; 齐磊

    2011-01-01

    目的 探讨氟马西尼用于脑瘫患儿全麻术后催醒的有效性和安全性.方法 40例行脑瘫手术的患儿,随机分为氟马西尼组(I组)和生理盐水组(II组).前者在手术结束后经留置针注射氟马西尼0.006mg/kg,60s内清醒程度未达到要求再追加半量.II组注射相同剂量的生理盐水.观察记录注射药物后5min患儿清醒率、注射药物时和注射药物后5min患儿的脑电双频指数(bispectral index,BIS)值以及清醒后30min内躁动和恶心、呕吐发生率.结果 氟马西尼组注射药物后5min清醒率及BIS值均高于生理盐水组(P<0.05),2组患儿的躁动和恶心、呕吐发生率差异无统计学意义(P>0.05).结论 氟马西尼可以安全有效的用于脑瘫患儿的全麻术后催醒.%Objective To determine the analeptic effectiveness and safety of flumazenil in child patients with cerebral palsy for recovery from general anesthesia. Methods Forty operated child patients with cerebral palsy were randomly divided into two groups ( n = 20 each ) . The patients in group I received flumazenil (0. 006mg/kg, intravenous injection) after surgery, and patients in group II received normal saline. When patients could not be awakened in 60 seconds, they were given a half of the first dose once more. The alertness score and the bispectral index (BIS) value in 5min before and after the injection were assessed, and adverse reactions such as nausea ,vomiting and psychomotor agitation of all patients were also recorded. Results The alertness rate and BIS value were significantly higher in group I than those in group II. However, there were no significant difference in nausea, vomiting and psychomotor agitation found between two groups. Conclusion Flumazenil can be effectively and safely used for analepsia of children with cerebral palsy after general anesthesia.

  10. 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 .

  11. Screening of postoperative delirium in elderly diabetic patients after general anesthesia%老年糖尿病患者全麻术后谵妄筛查的研究

    Institute of Scientific and Technical Information of China (English)

    钱彦; 吴红英; 吴悦; 徐文斌; 卢伟良

    2014-01-01

    Objective To investigate the incidence of postoperative delirium in elderly diabetic patients after general anesthesia. Methods The incidence of postoperative delirium in 140 elderly diabetic patients after general anesthesia was screened with Intensive Care Delirium Screening Scale (ICDSC). With DSM- IV as the gold standard for diagnosis of delirium, the validity of ICDSC was evaluated. Results The incidence of delirium was 23.8%in 140 postoperative elderly patients with dia-betes. The sensitivity, specificity, positive predictive value and negative predictive value of ICDSC in diagnosis of delirium were 0.935, 0.889, 0.725 and 0.978, respectively; and the kappa consistency coefficient was 0.750. Conclusion The incidence of postoperative delirium in elderly patients with diabetes is relatively high, and ICDSC can be used effectively in screening of deliri-um for postoperative patients.%目的:探讨老年糖尿病患者全麻术后谵妄发生率和谵妄筛查量表的筛查效度。方法以DSM- IV诊断作为金标准,调查140例老年糖尿病患者术后谵妄发生率,评价重症监护谵妄筛查量表(ICDSC)的筛查效果。结果老年糖尿病患者全麻术后谵妄发生率为23.8%;ICDSC筛查敏感度0.935,特异度0.889,阳性预测值0.725,阴性预测值0.978,一致性Kappa系数为0.750。结论老年糖尿病患者全麻术后谵妄应引起高度关注,可使用有效筛查工具ICDSC进行常规筛查,提前预防和干预,减少术后并发症,降低病死率。

  12. 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...

  13. 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.

  14. 连续无创血压监测系统在全身麻醉中的应用%Efficacy of a continuous non -invasive arterial pressure monitor system during general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李晶; 周婷; 田丽平; 徐世元; 张鸿飞

    2016-01-01

    目的:评价TL_300 tensymeter系统(TL_300)所测的连续无创血压(NIBP)在全身麻醉中的有效性及安全性。方法选择全身麻醉下行择期仰卧位手术的成年患者20例,ASAⅠ~Ⅲ级。麻醉诱导后无菌操作下左侧桡动脉穿刺置入动脉导管进行连续有创血压( IBP)监测,右侧手臂连接TL_300进行NIBP监测,稳定5 min后,同时测量IBP和NIBP,间隔3 min分别记录IBP监测及相应时点NIBP监测的收缩压、舒张压和平均压。术后监测与两种血压监测相关的并发症如肢体缺血、坏死、感觉异常。结果 NIBP监测与IBP监测所测收缩压、舒张压和平均压差值分别为(-0.086±9.59)、(3.203±7.11)、(2.60±6.76) mmHg,两种血压监测方法的收缩压、舒张压和平均压的决定系数分别为0.711、0.565和0.729,P值均小于0.001。所有患者均未发生肢体缺血、坏死、感觉异常。结论与IBP监测相比,NIBP监测在全身麻醉成年手术患者中,可提供连续、无创、准确、安全的血压监测。%Objective To investigate the accuracy, precision and safety of continuous non-invasive blood pres-sure( NIBP) monitoring delivered by TL_300 tensymeter system.Methods Twenty ASA classification of Ⅰ-Ⅲadult patients undergoing elective surgeries in a supine position under general anesthesia were included in the study.A catheter was placed into the left radial artery under local anesthesia before induction, with the TL_300 tensymeter system connected to the right arm.Continuous invasive blood pressure ( IBP) monitoring was derived from the invasive artery catheter while the NIBP was from TL_300 tensymeter system.Systolic, diastolic and mean arterial pressure were recorded every 3 mi-nutes simultaneously for both IBP and NIBP from 5 min after monitoring to the end of surgery.Complications associated with both pressure monitors including limb ischemia, necrosis and paresthesia were recorded

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

    Science.gov (United States)

    Ishii, Yoshiki

    2007-07-01

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

  16. Outpatient varicocelectomy performed under local anesthesia

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  17. The role of dexmedetomidinein immune function of patients with breast cancer via sevoflurane inhalation general anesthesia during perioperative radical mastectomy%右美托咪定对七氟烷全麻乳腺癌根治术围术期免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    徐勇民; 傅艳师; 郑艳萍; 陈琳; 杨新明; 周艳; 陈俊; 王万平

    2016-01-01

    Objects To evaluate the immune protective effect of dexmedetomidine on breast cancer dur-ing perioperative radical mastectomy via sevoflurane inhalation general anesthesia. To explore reasonable anesthet-ic strategyfor breast cancer radical mastectomy. Methods Patients were divided into two groups. Patients in ex-perimental group receivedgeneral anesthesia with dexmedetomidine and sevoflurane. Control group means general anesthesia with sevoflurane only. In both groups, the level of cortisol, IL-6, IL-8 and of TNF-αin serum were measured at 5 time points , 30 minutes before anesthesia , after cutting skin , after surgery , 24 h after surgery and 72 h after surgery. Results The amount of anesthetic used to induce general anesthesia in the experimen-talgroup were lower than that of the control group.There is no obvious difference of cortisol , IL-6, IL-8 and of TNF-αin serumat the time of 30 min before anesthesia between two groups.Concentrations ofseveral markersin-creasedafter anesthesia, of which experimentalgroup were lower than that of the control group. Conclusions Dexmedetomidine could be immunoprotective for patient with breast cancer during perioperative radical mastecto-my via sevoflurane inhalationgeneralanesthesia. This study recommends usingmultiple anestheticdrugs to anes-thetize patients of breast cancer when performing radical mastectomy.%目的:评价右美托咪定对七氟烷吸入全麻乳腺癌根治围术期免疫保护作用,探讨乳腺癌根治术合理麻醉用药。方法:比较右美托咪定联合七氟烷全麻(实验)组和单纯七氟烷全麻(对照)组,在麻醉前30 min、切皮后、术毕、术后24 h,术后72 h不同时点血清皮质醇(cor)、IL-6、IL-8、TNF-α浓度。结果:实验组麻醉剂用量较对照组降低。麻醉前30 min各指标浓度没有差异,麻醉后各指标浓度均上升,每个时间点实验组浓度均低于对照组。结论:右美托咪定对七氟烷全麻乳腺

  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 safe conduct of pediatric anesthesia. This initiative aims to provide guidance on markers of quality anesthesia care. The introduction and implementation of national regulations of 'who, where, when and how' are required and will result in an improved perioperative outcome in vulnerable children....... The improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps...

  19. 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.

  20. 硫酸镁对全麻术后疼痛和并发症影响的Meta分析%Effects of Magnesium Sulfate on Postoperative Pain and Complications after General Anesthesia: A Meta-Analysis

    Institute of Scientific and Technical Information of China (English)

    尹秀茹; 裴凌

    2012-01-01

    Objective To systematically evaluate the effects of magnesium sulfate on postoperative pain and complications after general anesthesia. Methods A literature search was conducted in following databases as The Cochrane Library, Embase, PubMed, EBSCO, Springer, Ovid, CNKI and CBM from the date of establishment to September 2011 to identify randomized controlled trials (RCTs) about intravenous infusion of magnesium sulfate during general anesthesia. All included RCTs were assessed and the data were extracted according to the standard of Cochrane systematic review. The homogenous studies were pooled using RevMan 5.1 software. Results A total of 11 RCTs involving 905 patients were included. The results of meta-analyses showed that compared with the control group, intravenous infusion of magnesium sulfate during general anesthesia significantly reduced the visual analog scale (VAS) scores at the time-points of 2, 4, 6, 8,16, and 24 hours, respectively, after surgery, the postoperative 24 hours morphine requirements, and the incidents of postoperative nausea and vomiting (RR=0.61, 95%CI 0.40 to 0.91, P=0.02) and chilling (RR=0.29, 95%CI 0.14 to 0.59, P=0.000 7). Although the incidents of bradycardia (RR=1.93, 95%CI 1.05 to 3.53, P=0.03) increased, there were no adverse events or significant differences in the incidents of hypotension and serum concentration changes of magnesium. Conclusion Intravenous infusion of magnesium sulfate during general anesthesia may obviously decrease the pain intensity, and the incidents of nausea and vomiting and chilling after surgery, without increasing cardiovascular adverse events and risk of hypermagnesemia. The results still need to be confirmed by more high-quality and large-sample RCTs.%目的 系统评价硫酸镁对全麻术后疼痛和并发症的影响.方法 计算机检索Cochrane图书馆、EMbase、PubMed、EBSCO、Springer、Ovid、CNKI、CBM等数据库,收集从建库至2011年9月间关于全身麻醉中静脉应用硫酸

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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

  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 and bodybuilding].

    Science.gov (United States)

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

    2008-05-01

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

  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. Anesthesia for geriatric patients.

    Science.gov (United States)

    Deiner, S; Silverstein, J H

    2011-02-01

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

  10. 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.

  11. 麻醉诱导期Slipa喉罩和气管导管对眼的影响%Comparison the effect of supralaryngeal airway and endotracheal catheter on the eye during induction of general anesthesia

    Institute of Scientific and Technical Information of China (English)

    邢娜; 卫新; 杜英英; 常琰子; 张卫

    2014-01-01

    Objective To compare the effect of supralaryngeal airway (Slipa) and endotracheal catheter on the eye during induction of general anesthesia.Methods Fifty patients aged 20 ~50 years old with weight 45 ~70 kg and intraocular pressure (IOP) 12 ~18 mmⅡg received elective benign breast neoplasm resection surgery and were randomly divided into 2 groups:S group (Slipa) and C group (endotracheal catheter).Anesthesia was induced with intravenous propofol and remifentanil until loss of the eyelash reflex.Cisatracurium was then administered.When the jaw was flabby,Slipa was inserted to trachea and the intubation was performed with mechanical ventilation.The IOP,mean arterial pressure (MAP),and heart rate (HR) were measured and recorded before anesthesia induction(T0),before intubation(T1),after intubation immediately(T2),at 1 min(T3),2 min(T4),5 min(T5) after intubation.Results Compared with TO,the IOP,MAP and HR were significantly lower than those at T1.Compared with T1 in group S,the IOP,MAP and HR in T2 ~ T5 were more stable.In group C,the IOP,MAP and HR significantly increased at T2,T3,T4.Compared with group S,the IOP,MAP and HR in group C were significantly higher at T2,T3,T4.The MAP was positively correlated with the IOP in group S and group C (r =0.832 and 0.829,respectively).Conclusion Supralaryngeal airway is better than endotracheal catheter in preventing the increase of IOP and keeping stable hemodynamic responses during induction of general anesthesia.%目的 比较麻醉诱导期Slipa喉罩和气管导管对患者眼的影响.方法 乳腺良性病变切除术50例,年龄20 ~ 50岁,体质量45 ~ 70 kg,眼压(IOP) 12~ 18 mmHg(1 mmHg =0.133 kPa),按照随机数字表法平均分为两组:Slipa喉罩组(S组)和气管导管组(C组).两组均静脉注射丙泊酚、瑞芬太尼、顺苯磺阿曲库铵行麻醉诱导,待下颌松弛后S组置入Slipa喉罩,C组插入气管插管后行机械通气.于诱导前(基础值T0)、插管或置喉罩前(T1)

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

    Science.gov (United States)

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

    2014-01-01

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

  13. 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. Effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. A randomized, placebo controlled pilot study.

    Science.gov (United States)

    García-Navia, Jusset Teresa; Tornero López, Javier; Egea-Guerrero, Juan José; Vilches Arenas, Angel; Vázquez Gutiérrez, Tiburcio

    2016-01-01

    Introducción y objetivos del estudio: existe evidencia de que la administracion perioperatoria de ketamina y lidocaina intravenosa reduce el dolor y el consumo de opioides postoperatorio, acorta la estancia hospitalaria y acelera la recuperacion de la funcion intestinal. Sin embargo, no se han estudiado los efectos beneficiosos en el periodo intraoperatorio. El objetivo de este estudio fue evaluar el efecto de una unica dosis de lidocaina y ketamina sobre el consumo intraoperatorio de opioides en pacientes sometidas a cirugia ginecologica electiva bajo anestesia general. Material y métodos: estudio prospectivo, aleatorizado, doble ciego, controlado con placebo en un solo centro. Se incluyeron 33 pacientes (11 en el grupo ketamina, 11 en el grupo lidocaina y 11 en el grupo placebo). Para la analgesia postoperatoria se utilizo una bomba PCA (Analgesia Controlada por el Paciente ) de morfina. Los pacientes fueron asignados al azar a uno de los tres grupos de estudio: 1,5 mg/kg de lidocaina al 2%, 0,5 mg/kg de ketamina al 5% o solucion salina 0.9%. La variable principal del estudio fue el consumo de opioides durante la cirugia. Las variables secundarias fueron: tiempo de educcion de la anestesia, intensidad del dolor, consumo de opioides en las 24 horas posteriores a la cirugia y efectos adversos. Resultados: se observo una disminucion del consumo intraoperatorio de opioides en los grupos ketamina (402,3 } 106,3) y lidocaina (397,7 } 107,5) frente al grupo placebo (561,4 } 97,1); p = 0,001. Se encontro una correlacion positiva entre el consumo intraoperatorio de opioides y el tiempo de despertar (r = 0,864, p.

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

    Directory of Open Access Journals (Sweden)

    Abdi S

    2005-07-01

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

  16. 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%

  17. 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

  18. 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

  19. 地佐辛对上腹部全麻手术后拔管的效果评估%Effect of dezocine on removal of tracheal catheter after epigastric operation under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    洪道先; 郑孝振

    2012-01-01

    Objective To observe the effect of dezocine on tracheal catheter removal after epigastic operation under general anesthesia, including stress, consciousness, and recovery of respiration. Methods Eighty patients undergoing epigastric operation were randomly divided into dezocine group(group D) and control group(group C), 40 in each group. Etomidate and remifentanil were withdrawn from the patients in group D 15 and 3min respectively before operation, who were then infused with dezocine (5mg) through the vein 15min by the end of operation. Patients in group C were infused with 5ml 0.9% sodium chloride solution. Their SBP, DBP, MAP, and HR were measured before operation (T0), 1 minute after operation (T1), 3 minutes after operation (T2) and 5 minutes after operation (T3). Their RPP was calculated. Blood sample was collected from internal jugular vein. Blood glucose and cortisol levels were measured by glucose-oxidase and radioimmunoassay. Wakeup and tracheal catheter removal time, and dysphoria during tracheal catheter removal were recorded. Results The MAP, HR and RPP were significantly lower in group C than in group D at T1-T3 (P0.05). Conclusion Intraveinous injection of dezocine can inhibit stress to tracheal catheter removal under general anesthesia without affecting the wakeup and respiration recovery of patients.%目的 观察地佐辛抑制上腹部全麻患者术后气管拔管应激反应的效果和对患者意识,呼吸恢复的影响.方法 80 例择期上腹部手术患者随机分为地佐辛组(D 组) 和对照组(C 组) 各40 例,术毕前15min 停用依托咪酯,前3min 停用瑞芬太尼,术毕前15min D 组静注地佐辛5mg,C 组静注0.9% 氯化钠注射液5ml.分别于入室后诱导前(T0)、拔管后1min(T1)、3min(T2)、5min(T3) 记录收缩压、舒张压、平均动脉压、心率,计算心率与收缩压乘积,并于各时点采集颈内静脉血,采用葡萄糖氧化酶法测定血糖,放射免疫法检测皮质醇浓度,记录患者清

  20. 依托咪酯不同输注速度对全麻诱导期肌阵挛的影响%Effects of different infusion rates of etomidate on myoclonus during general anesthe-sia induction period

    Institute of Scientific and Technical Information of China (English)

    魏宇; 董有静

    2014-01-01

    目的:研究依托咪酯不同输注速度对全麻患者肌阵挛的影响。方法选取妇科全麻手术的患者90例,平均分成3组,每组30例,记录患者的入室平均动脉压( MAP)、心率( HR)。开通静脉后,在诱导期以不同的速度静脉输注总量为0.3 mg/kg的依托咪酯。输注速度:A组0.9 mg/(kg·min),B组0.45 mg/(kg·min),C组0.23 mg/( kg·min)。患者入睡后,记录肌阵挛的发生情况,然后给予0.1 mg芬太尼,0.15 mg/kg顺苯,并吸入6%七氟醚,2 min后给予插管。记录输注依托咪酯结束后1、5、8 min的MAP、HR。结果 B组肌阵挛的发生率低于A组,但B组与C组比较差异无统计学意义,其中B组发生肌阵挛的程度以1、2级为主,而A组和C组均以2、3级为主。给药后5 min,三组患者MAP升高,给药后8 min有所下降。三组心率比较差异无统计学意义。结论依托咪酯以一定的速度推注,可以减少肌阵挛的发生率并减轻其发生程度,本实验的最适速度是0.45 mg/( kg·min)。%Objective To study the effect of different infusion rates of etomidate on myoclonus during general anesthesia. Methods 90 patients with general anesthesia gynecological surgery were divided into three groups. The mean arterial pressure (MAP),heart rate (HR) were recorded. After opening veins,patients of the three groups re-ceived intravenous infusion of 0. 3 mg/kg etomidate by different speeds. The infusion speed of group A,group B and group C were 0. 9 mg/( kg·min) ,0. 45 mg/( kg·min) and 0. 23 mg/( kg·min) . The patients′ myoclonus occurrences were recorded after falling asleep,then 0. 1 mg fentanyl and 0. 15 mg/kg cis-atracurium was injected,and 6%sevoflu-rane was inhaled. The intubation was done after 2 min. The blood pressure,mean arterial pressure ( MAP) and heart rate ( HR) at 1 min,5 min,8 min after injecting etomidate were recorded. Results The incidence of myoclonus in group B was lower than that of group A,no significant

  1. Distribution of pathogens causing postoperative infections in acute intracerebral hemorrhage patients undergoing general anesthesia%急性脑出血全麻患者术后感染病原菌分析

    Institute of Scientific and Technical Information of China (English)

    陈洁; 王光磊; 王云; 张智卿; 白延仓

    2016-01-01

    OBJECTIVE To analyze the pathogen distribution and its effect on recognition function in acute intrace‐rebral hemorrhage patients with general anesthesia ,so as to provide reference for clinical treatment .METHODS A total of 170 cases of patients got infections after general anesthesia operation for the acute intracerebral hemorrhage in our hospital from Sep .2012 to Sep .2014 were enrolled as infected group .Another 170 cases of healthy subjects at the same period in our hospital were taken as control group .And another 170 cases of uninfected patients after general anesthesia operation for acute intracerebral hemorrhage were taken as uninfected group .The changes of recognition function , serum fibroblast growth factor and inflammatory factors were compared in these three groups .RESULTS A total of 170 strains of pathogens were isolated from the 170 cases of patients ,including 77 (45 .3% ) strains of gram‐positive bacteria ,mainly Staphylococcus aureus 18 (10 .6% ) strains , Staphylococcus saprophyticus 12(7 .1% ) strains ,and Enterococcus f aecalis 11(6 .5% ) strains .There were 93 (54 .7% ) strains of gram‐negative bacteria ,including Pseudomonas aeruginosa 18 (10 .6% ) strains , Enterobacter aerogenes 17 (10 .0% ) strains ,and Neisseria meningitides 16(9 .4% ) strains .The MMSE scores of infected patients were de‐creased obviously ,and catalase and superoxide dismutase in serum were lower than control group and uninfected group obviously ,but MDA ,IL2 ,IL10 and TNF‐α were increased significantly compared with control and unin‐fected groups (P<0 .05) .CONCLUSION There is big chance for acute intracerebral hemorrhage patients got infec‐ted ,and which could influence the cognition function of patients .%目的:研究急性脑出血全麻患者术后感染病原菌分布及对患者认知功能的影响,为临床治疗提供参考。方法选取医院2012年9月-2014年9月诊治的170例急性脑出血全麻术后感

  2. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  3. Under General Anesthesia%右美托咪定与地佐辛对全身麻醉患者苏醒期躁动及血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    廖琼; 张红

    2015-01-01

    Objective: To compare the effect of dexmedetomidine , dezocine and coadministration of them on the hemodynamics and restlessness in the stage of analepsia in patients under general anesthesia , and to provide foundations for clinical rational administration .Method:Ninety eligible patients were selected and randomly divided into group A , group B and group C , with 30 patients in each group; group A used dexmedetomidine , group B used dezocine , and group C used dexmedetomidine and dezocine; the systolic blood pressures (SBP), diastolic blood pressures (DBP) and heart rates (HR) before anesthesia (T0), 5min after tracheal extubation ( T1 ) and at 10min after tracheal extubation ( T2 ) and the restlessness in the stage of analepsia in the patients of the three groups were observed and recorded .Result:The patients of the three groups had similar operative time , intra-operative blood loss , and intra-operative volume of fluid in-fused, and the differences were statistically insignificant ( P>0.05).The patients of the three groups had similar SBP , DBP and HR at T0, and the differences were statistically insignificant ( P>0.05) .The patients of the group A and the group B had similar SBP , DBP and HR at T1 and T2, and the differences were statis-tically insignificant (P>0.05).The patients of the group C had more stable SBP , DBP and HR at T1 and T2 than the patients of the group A and the group B , and the differences were statistically significant ( P0.05) , and the restlessness incidence in the patients of the group C was significantly lower than that of the group B and the group C ( P<0.05) .Conclusion:Coadministration of dexmedetomidine and dezocine can stabilize the blood pressure and heart rate in the stage of analepsia more effectively , and decrease the incidence of restlessness in patients under general anesthesia , and consequently is worthy of clinical application .%目的:比较右美托咪定、地佐辛及其二者联合对全身麻醉患者苏醒

  4. 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

  5. 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

  6. 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.

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

    DEFF Research Database (Denmark)

    Bülow, J; Henriksen, O; Amtorp, Ole

    1984-01-01

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

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. 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....

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

    DEFF Research Database (Denmark)

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

    1989-01-01

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

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. Possibilities of creating meaningful encounters in anesthesia nursing

    DEFF Research Database (Denmark)

    Aagaard, Karin

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

  2. Outcomes of ventilation with laryngeal mask in patients undergoing radical mastectomy under general anesthesia%喉罩通气在全麻下乳腺癌根治术的应用效果

    Institute of Scientific and Technical Information of China (English)

    余小玉; 徐汝玺

    2011-01-01

    目的 探讨喉罩通气应用于全身麻醉下乳腺癌根治术的效果.方法 择期乳腺癌根治术患者40例,随机均分为喉罩(IL)组和气管插管(T)组.观察插管(罩)前后血压(BP)、心率(HR)的变化以及术后胃胀、咽喉疼痛等不良反应.结果 L组插入喉罩后BP、HR没有明显变化;T组导管插入后的BP、HR均较插入前明显升(P<0.01).气管插管组咽痛等并发症发生率及疼痛程度明显高于喉罩组.结论 喉罩通气较气管插管对患者循环功能影响较小,并发症少.%Objective Toinvestigate the outcomes of ventilation with laryngeal mask in the patients undergoing radical mastectomy under general anesthesia. Methods Fourty patients with breast cancer undergoing selective mastectomy were randomly divided into two grups with 20 cases each. The patients in group L were ventilated with laryngeal mask and those in group T were given conventional tracheal intubation as the controls. The changes of blood pressure(BP) and heart rate (HR) were recorded during laryngeal mask placement or tuble insertion. The adverse responses to the procedures after operation were compared between two groups. Results BP and HR were not significantly changed after laryngeal mask placement compared to those before, which in group T were remarkably increased after intubation and higher than those in group L(P<0. 01). The incidence of sore throat after surgery was more and severer in group T than that in group L. Conclusion Ventilated with laryngeal mask is better than conventioal intubation in keeping circulation function stable and reducing sore throat.

  3. 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

  4. 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。

  5. 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

  6. 电针复合药物全麻对围术期腹腔镜胆囊切除术患者血流动力学及内啡肽的影响%Effects of Acupuncture Combined General Anesthesia on Endorphin and Hemodynamics of Laparoscopic Cholecystectomy Patients in the Perioperative Phase

    Institute of Scientific and Technical Information of China (English)

    丁依红; 顾陈怿; 沈利荣; 吴凉森; 施征; 陈跃来

    2013-01-01

    Objective To observe the effects of different anesthesia ways on endorphin and hemodynamics of laparoscopic cholecystectomy patients in the perioperative phase.Methods A total of 90 laparoscopic cholecystectomy patients,29 to 80 years old,were randomly assigned to Group A (treated with electroacupuncture at acupoints combined general anesthesia),Group B (treated with electroacupuncture at non-acupoints combined general anesthesia),and Group C (treated with general anesthesia) according to American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ,30 cases in each group.All patients were induced by 3 μg/kg Fentanyl (Fen),2 mg/kg Propofol (Pro),and 0.1 mg/kg Vecuronium (Vcr).Bispectral index (BIS),being 40-65,indicated the state of general anesthesia.The anesthesia was maintained by intravenous injecting Pro,interruptedly intravenous injecting Fen and Vcr.Each patient recieved patient controlled intravenous analgesia (PCIA) after operation.On these bases,patients in Group A received electrical acupuncture at bilateral Hegu (LI4),Neiguan (PC6),Quchi (LI11),Zusanli (ST36),and Yanglingquan (GB34).Patients in Group B received electrical acupuncture at the points beside acupoints.The electroacupuncture was lasted from 15-30 min before anesthesia induction to the end of the operation in Group A and B.The heart rate (HR),mean arterial pressure (MAP),cardiac index (CI),cardiac output (CO),systemic vascular resistance index (SVRI),and acceleration index (ACI) were recorded before anesthesia induction,immediate before pneumoperitoneum,5 min after pneumoperitoneum,excision of gallbladder,and at the end of operation.The time consumption from discontinuation to spontaneously breathing recovery,analepsia,and extubation were recorded.The blood samples (3 mL each time) were collected from the peripheral vein before anesthesia induction,2 h after operation,the 1st day after operation,and the 3rd day after operation to detect the β-endorphin (β3-EP) level.The visual analogue scale (VAS

  7. 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

  8. Study on significance of application of dexmedetomidine in reducing agitation and throat pain in patients after general anesthesia%右美托咪定预防全麻术后躁动和咽喉疼痛的作用

    Institute of Scientific and Technical Information of China (English)

    钟剑平; 何绍旋

    2014-01-01

    目的:探讨右美托咪啶在预防全麻术后躁动和咽喉疼痛方面的应用价值,以提高全身麻醉的安全性。方法选取接受全麻手术治疗的患者114例,通过随机数字表法将其分为观察组和对照组各57例。两组均采用相同的药物进行全身麻醉,观察组在手术结束前半个小时静脉泵入右美托咪啶,对照组则静脉泵入相同体积的0.9%氯化钠注射液。对比两组患者恢复自主呼吸的时间和拔除气管插管时间以及术后躁动和咽喉疼痛的发生率。结果两组患者恢复自主呼吸时间、拔除气管插管时间的对比,差异无统计学意义( P ﹥0.05)。在术后躁动方面,观察组0级的有53例,躁动率为7.02%;对照组0级的有34例,躁动率为40.35%。观察组躁动率显著低于对照组( P ﹤0.05)。在术后咽喉疼痛方面,观察组0级的有46例,咽喉疼痛率为19.30%;对照组0级的有30例,咽喉疼痛率为47.37%。观察组咽喉疼痛率显著低于对照组( P ﹤0.05)。结论右美托咪啶对全麻术后躁动和咽喉疼痛具有良好的预防作用,同时不会增加呼吸抑制的风险,值得在临床上推广应用。%Objective Toexploretheapplicationvalueofdexmedetomidineinreducingagitationandthroatpainaftergeneralanesthesia, inordertoimprovethesafetyofanesthesia.Methods Atotalof114patientsunderwentgeneralanesthesiaforoperationinthishospitalwerese-lected for this study,they were divided by random number table method into observation group and control group,each with 57 cases. Patients in these two groups were used with same drug for general anesthesia,patients in observation group were given with intravenous infusion of dexmedeto-midine at half hour before the end of operation,while patients in control group were administrated with intravenous infusion of same volume of 0. 9% sodium chloride solution. The incidence rates of agitation,spontaneous breathing recovery

  9. 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

  10. 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.

  11. 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

  12. 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.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  14. 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

  15. 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.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

    Epley, J M

    1977-06-01

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

  18. 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

  19. EEG entropy measures in anesthesia

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    Zhenhu eLiang

    2015-02-01

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

  20. 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

  1. 右美托咪啶对正颌手术全麻苏醒期的影响%Effect of dexmedetomidine on the recovery of patients after general anesthesia in orthognathic surgery

    Institute of Scientific and Technical Information of China (English)

    王晓东; 纪志农

    2013-01-01

    目的:了解右美托咪啶对正颌手术全麻苏醒期的影响.方法:40例ASA Ⅰ-Ⅱ级择期行颌面外科正颌手术患者,随机分为右美托咪啶组(D组)和生理盐水组(C组).D组患者术毕前30 rmin给予右美托咪啶0.6 μg/kg,泵注10 min后以0.4μg(kgh)持续泵入.C组患者以相同速率输注生理盐水.在患者清醒(T1),拔管(T2),拔管后20 rmin(T3)行Ramsay评分;在T2记录2组躁动率;在T3行全麻后舒适度(BCS)评分.结果:与C组相比,D组在T1、T2、T3的Ramsay评分明显增加(P<0.05);2组在T2躁动率有明显差异(P<0.05);D组BCS评分明显高于C组(P<0.05).结论:术毕前泵入右美托咪啶可明显减少正颌手术患者拔管期躁动程度,并且提高患者带管耐受性.%Objective:To study the effect of dexmedetomidine on the recovery of patients after general anesthesia in orthognathic surgery.Methods:40 patients with ASA Ⅰ-Ⅱ degree jaw deformity undergoing orthognathic surgery were randomly divided into dexmedetomidine group (D) and normal saline group (C) with 20 cases in each.In group D,dexmedetomidine was administered intravenously at 0.4 μg(kg · h) after a bolus infusion at 0.6 μg/kg for 10 min before ending operation.Nornial saline was given by the same way in group C.Ramsay sedation scores were monitored at the time of awaken(T1),immediately after extubation(T2),20 rain after extubation(T3) ;the restlessness assessment was recorded at T2 and the bruggrmann comfort scale(BCS) assessment was recorded at T3.Results:Ramsay sedation scores were higher at T4,T2 and T3 in group D than those in group C (P < 0.05) ; the restlessness in group D was less than in group C at T2 (P < 0.05) ; the BCS was significantly higher in group D than in group C.Conclusion:Dexmedetomidine given before ending operation may decrease the restlessness in patients undergoing orthognathic surgery and improve the tolerance of retaining tracheal catheter.

  2. Effects of general anesthesia with sevoflurane on learning and memory of children%吸入麻醉药七氟醚对儿童学习记忆的影响

    Institute of Scientific and Technical Information of China (English)

    朱贵芹; 朱霞; 郑闽江; 王丽华; 李加凯; 邱燕林; 杨爱兴; 张文明; 李小民

    2011-01-01

    目的 观察研究吸入麻醉药七氟醚对儿童高级神经活动学习、记忆功能的影响.方法 选择7~10岁男生择期下腹部手术33例,分为七氟醚组(20例)和对照组(13例).采用“韦氏记忆量表”进行学习记忆能力的测试,测试术前、术后1d、术后1周长时记忆、短时记忆及瞬时记忆的量表得分.结果 ①七氟醚组和对照组2组术后1d与术前、术后1周相比,短时记忆量表得分均显著下降,差异有显著性(P<0.05);②术后1周2组患儿的短时记忆量表得分均已经接近原来的水平;③术后1d短时记忆量表得分七氟醚组与对照组量表得分相近,差异没有显著性意义.结论 ①手术患儿学习记忆能力的改变,术后1d在短时记忆的分测验中有明显的下降,而对长时记忆和瞬时记忆没有明显改变;②未能提示吸入麻醉药七氟醚对儿童学习\\记忆能力的影响是一个独立的风险因素.%Objective To investigate the possible effects of general anesthesia with sevoflu-rane on learning and memory of children. Methods The ability of learning and memory was evaluated with Wechsler Memory Scale before operation, one day and seven days after operation. Thirty three boys aged 7-10 years old undergoing elective hypogastric surgery were enrolled, of which 20 cases were treated with sevoflurane and 13 were put in control group. The long - term, short - term and instantaneous memory were measured. Results ① Comparing results one day after operation to results before operation and seven days after operation, short - term memory scale scores decreased significantly in both sevoflurane and control groups one day after operation, and the difference was significant (P<0. 05); ② The short - term memory scale scores of both two groups of children were close to the original level one week after operation. ? One day after operation the short- term memory scale scores of sevoflurane group and control group were similar

  3. 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.

  4. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2009-01-01

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

  5. 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

  6. 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

  7. 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

  8. 氟比洛芬酯和帕瑞昔布预防丙泊酚复合瑞芬太尼麻醉下苏醒期躁动的临床对比%Comparision of Flurbiprofen Axetil and Parecoxib on restlessness during the stage of analepsia after general anesthesia with Propofol combined with Remifentanil

    Institute of Scientific and Technical Information of China (English)

    熊涛; 钟世雄; 廖敏

    2011-01-01

    Objective To compare the effects of Flurbiprofen Axetil and Parecoxib injected before anesthesia induction on the restlessness during the stage of analepsia after general anesthesia with propofol combined with remifentanil. Methods Totally 84 patients with undergoing cholecystectomy by laparoscopic surgery who visited the department of hepatobiliary surgery of our hospital between January 2010 and December 2010 were randomly divided into Flurbiprofen Axetil group,Parecoxib group and control group(28 cases in each group). All patients received combined anesthesia of propofol combined with remifentanil. Patients in Flurbiprofen Axetil group and Parecoxib group respectively received 50mg of Flurbiprofen Axetil and 40mg of Parecoxib injected before anesthesia induction, and patients in control group only received normal saline. Visual analogue scale, restless scale and Ramesay scale were evaluated before and at removal of airway tube,and 15min,30min and 45min after removal of airway tube. Results Visual analogue scale, restless scale and ramesay scale in Flurbiprofen Axetil group or Parecoxib group decreased significantly compared to those in control group ( P < 0. 05 or P < 0. 01). Visual analogue scale(VAS),restless scale and Ramesay scale in Parecoxib group decreased significantly compared to those in Flurbiprofen Axetil group (P < 0. 01 ). Conclusions Parecoxib injected before anesthesia induction on the restlessness during the stage of analepsia after general anesthesia with propofol combined with remifentanil can more effectively prevent restlessness during the stage of analepsia than Flurbiprofen Axetil.%目的 观察麻醉诱导前静脉注射氟比洛芬酯和帕瑞昔布预防丙泊酚复合瑞芬太尼麻醉苏醒期躁动的效果.方法 2010年1月-2010年12月重庆市綦江县中医院肝胆外科择期行腹腔镜胆囊切除术患者84例随机分为氟比洛芬酯组、帕瑞昔布组和对照组,每组28例.所有患者均以丙泊酚、瑞芬

  9. Impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function in patients with abdominal surgery%硬膜外复合全麻对腹部手术患者血液循环及免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    马海燕

    2013-01-01

    目的 探讨硬膜外复合全麻对腹部外科手术患者血流循环及免疫功能的影响.方法 将90例行腹部手术患者随机分成实验组(应用硬膜外复合全麻)和对照组(单纯应用全身麻醉),每组45例.记录并比较2组的血流动力学及免疫功能的变化情况.结果 实验组术毕时、术后12h及术后1、2d的SBP、DBP、HR、SpO2波动幅度均明显小于对照组(P<0.05);实验组术后6h及术后1、3、5、7d的CD3+、CD4+、CD4+/CD8+水平下降幅度均明显小于对照组(P<0.05).结论 硬膜外复合全麻较单纯全麻对患者的血流循环及免疫功能的影响更小,临床应用于腹部外科手术麻醉的前景良好.%Objective To investigate the impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function in patients with abdominal surgery.Methods Ninety patients with abdominal surgery were randomly divided into two groups,treatment group (n =45) and control group (n =45).The control group was given general anesthesia only,and the treatment group was given epidural anaesthesia combined with general anesthesia.The changes of hemodynamic and the immune function in both groups were observed and compared.Results The fluctuation range of SBP,DBP,HR,SpO2 in the end of operation,12 hours after operation,ld and 2ds after operation in the treatment group were significantly less than the control group (P < 0.05).The decline of CD3+,CD4+,CD4+/CD8+ 6 hours after operation,1d,3 ds,5 ds and 7 ds after operation in the treatment group were significantly less than the control group (P < 0.05).Conclusion The impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function is significantly smaller in patients with abdominal surgery,and the epidural anaesthesia combined with general anesthesia has good prospects in abdominal surgery.

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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

  16. Preemptive analgesia effects of flurbiprofen axetil or tramadol in patients undergoing sevoflurane general anesthesia%氟比洛芬酯和曲马多超前镇痛应用于七氟醚麻醉的比较

    Institute of Scientific and Technical Information of China (English)

    王琦; 余永华; 姚尚龙

    2013-01-01

    (the flurbiprofen axetil group,20 cases) or 2 mg/kg tramadol(the tramadol group,20 cases) or 10 ml normal saline (the normal saline group,20 cases),10 min before the surgery.The heart rate (HR),mean arterial blood pressure (MAP) and pulse oxygen saturation (SpO2) before induction of anesthesia and peri-extubation,the moment of eyes opening and extubation,and the degree of postoperative agitation were recorded.Results The MAP、HR in the flurbiprofen axetil group and the tramadol group were significantly lower than that of the normal saline group peri-extubation(P<0.05 or P<0.01),SpO2 was not significantly different in all groups.The time of eye opening and extubation in the flurbiprofen axetil group [(11 ±4),(13±3) min] were significantly shorter than that of the tramadol group [(15±4),(18±5) min] (P<0.05).The emergence of postoperative agitation in the flurbiprofen axetil group(0) and the tramadol group(20%) were significantly better than that of the normal saline group(55%)(P<0.05 or P<0.01),and the visual analogue score in the flurbiprofen axetil group[(2.2±0.6),(2.1±0.8)] and the tramadol group[(3.0±1.1),(2.6±1.0)] after the operation finished 0.5 h and 2 h were significantly better than that of the normal saline group [(4.1 ±0.7),(3.9±0.6)] (P<0.05).Conclusions Applying of flurbiprofen axetil and tramadol in sevoflurane general anasthesia can provide a good effect of preemptive analgesia and prevent postoperative agitation.But tramadol would prolong the waking time of patients.

  17. 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.

  18. 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%)

  19. Effects of transcutaneous electrical stimulation of acupuncture points on target effect-site concentration of propofol TCI and mount of fentanyl consumed in patients undergoing general anesthesia%经皮穴位电刺激对全麻患者异丙酚效应室靶浓度和芬太尼用量的影响

    Institute of Scientific and Technical Information of China (English)

    王明山; 陈怀龙; 毕燕琳; 时飞

    2008-01-01

    Objective To investigate the effects of transcutaneous electrical stimulation of acupuncture points(TEAS)on the target effect-site concentration(CT)of propofol and amount of fentanyl consumed in patients undergoing general anesthesia.Methods Forty ASA Ⅰor Ⅱ patients aged 38-64 yr weighing 50-90 kg undergoing upper abdominal surgery under general anesthesia were randomly divided into 2 groups(n=20 each):group Ⅰpropofol(P)and group Ⅱ TEAS+pmpofol(EP).The patients were predemicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg.Anesthesia was induced with midazolam 0.03 mg/kg.fentanyl 1.5 μg/kg and TCI of propofol(the initial CT=2.5 μg/ml).As soon as the patients lost consciousness,vecuronium 0.12 mg/kg was given iv.The patients were mechanically ventilated after tracheal intubation.PET CO2 was maintained at 30-35 mm Hg.Anesthesia was maintained with TCI of propofol and intermittent iv boluses of fentanyl and vecuronium.CT of propofol was adjusted to maintain BIS at 45-55 during operation.In EP group transcutaneons electrical stimulation of bilateral Neiguan and Zusardi points was performed at 30 min before induction of general anesthesia and maintained until the end of surgery with alternative stimulation at frequency of 2 Hz and 100 Hz and intensity of 8-12 mA.HR and MAP were recorded before induction of anesthesia(To,baseline),before(T1)and after tracheal intubation(T2),before(T3)and after skin incision(T4),during surgical exploration(T5)and at the end of operation(T6).The CT of propofol and amount of fontanyl consumed were also recorded at T1-6.Blood samples were taken at 30 min of TEAS before induction of anesthesia and at T4-6 for determination of serum concentrations of angiotensin Ⅱ and cortisol by radioimmuno assay.ResultsCT of propofol and the amount of fentanyl consumed were significantly lower in group EP than in group P(P<0.01).There were no significant differences in the serum concentrations of angiotensinⅡand cortisol at

  20. 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

  1. 达克罗宁胶浆在全麻手术经口气管插管中的应用效果%Dyclonine mortar in the application of the breath tube intubation on general anesthesia surgery

    Institute of Scientific and Technical Information of China (English)

    陈平

    2015-01-01

    Objective To study the clinical effect of dyclonine mortar as a lubricant for the breath tube intubation in critical care patients .Methods According to the random number table method, 86 patients with the breath tube intubation anesthesia were divided into observation group and control group, 43 cases in each group. After anesthesia induction, patients in observation group were with 1% dyclonine mortar as a lubricant evenly 15~20 cm in front of the endotracheal tube for endotracheal intubation, and the control group were used routinely paraffin oil lubricating oil endotracheal tube . The visual analogue scale method(visual analog score, VAS)(0~10) was used for patients' cough, sore throat and hoarseness symptoms assessment; WHO mucosa reaction classification method(0 - Ⅳ degree 0 to 4 points, has been recorded in the sum of total score for the pharyngeal and laryngeal score) on patients with pharyngeal and laryngeal mucosa reaction rate.Results Postoperative cough VAS score between the two groups had no statistical difference(P>0.05); The patients' postoperative sore throat, hoarseness VAS score in observation group were less than those in the control group, and the differences were statistically significant(P0.05);术后两组患者咽痛、声嘶VAS评分观察组小于对照组,差异有统计学意义(P<0.05);术后两组患者咽喉部黏膜反应评分观察组小于对照组,差异有统计学意义(P<0.05).结论 应用达克罗宁胶浆在气管插管中作为润滑剂,能有效地减少神经冲动刺激咽喉壁,减少患者的痛苦,提高患者的依从性,且操作简单.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. The modifying effect of anesthetic technique on the metabolic and endocrine responses to anesthesia and surgery

    DEFF Research Database (Denmark)

    Kehlet, H

    1988-01-01

    and the widespread use of the term "stress free anesthesia" in surgery is therefore not valid. However, continuous administration of local anesthetic agents in the epidural space is the most effective technique in so far as reduction of the stress response is concerned. The clinical implication of a variable...... reduction in the stress response to surgery by different anesthetic techniques remains largely unsettled, since only few controlled studies have been published on the clinical effects of pain relief and general anesthesia. However, a vast amount of data exist from controlled studies comparing regional...... anesthesia with local anesthetics and general anesthesia. The cumulative experience from these studies have demonstrated an advantageous effect on postoperative morbidity parameters such as blood loss, postoperative thromboembolic complications, pulmonary infective complications, gastrointestinal motility...

  7. 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.

  8. 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 ...

  9. [Drug dosage during balanced anesthesia in children with urinary tract diseases].

    Science.gov (United States)

    Katkovskiĭ, D G; Stepanova, N A

    1990-01-01

    To determine principles of choosing individual fentanyl and ketamin doses the data on the course of general anesthesia in 120 children were processed by regression analysis. It has been established that individual anesthetic dose titration should take into consideration the child's age, efficacy of premedication, renal function and circulatory pattern The infusion rate is determined with regard to anesthesia-induced circulatory changes. Regression analysis made it possible to work out formulas which enable individual dose titration and determination of the infusion rate.

  10. 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

  11. 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.

  12. Articaine and lidocaine for maxillary infiltration anesthesia.

    Science.gov (United States)

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

    1993-01-01

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

  13. 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

  14. 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

  15. Costs of anesthetics and other drugs in anesthesia

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

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

  16. 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

  17. Comparison on the influence of different anesthesia methods for oxygen metabolism and hemodynamics of patients with infective shock

    Institute of Scientific and Technical Information of China (English)

    Ma Jie

    2016-01-01

    Objective:To observe and compare the influence state of general anesthesia and general anesthesia combined with epidural anesthesia for the oxygen metabolism and hemodynamics of patients with infective shock, in order to provide evidence for the selection of anesthesia methods of the patients with infective shock.Methods:A total of 42 patients with infective shock in hospital from April 2013 to December 2015 were randomly divided into control group and observation group by the principle of random allocation, 21 cases in control group were with general anesthesia, 21 cases in observation group were with general anesthesia integrated with epidural anesthesia, then the oxygen metabolism and hemodynamics indexes of two groups before the anesthesia and at 20min during the operation, at 10min after the operation were compared.Results: The oxygen metabolism parameters including SvO2, CjvO2 and VO2 were respectively (64.81±5.99)%, (94.24±5.32) mL/L, (136.16±8.32) mL/min•m2 and (67.20±6.08)%, (95.10±5.40) mL/L, (133.15±8.17) mL/min•m2, and they were all better than (60.11±5.81)%, (90.11±5.04) mL/L, (145.15±9.38) mL/min•m2 and (63.24±5.95)%, (92.23±5.18) mL/L, (142.24±9.11) mL/min•m2 of control group, the hemodynamics indexes were all better than those of control group.Conclusion: The influence state of general anesthesia integrated with epidural anesthesia or the oxygen metabolism and hemodynamics of patients with infective shock are better than those of general anesthesia, so the application value of general anesthesia integrated with epidural anesthesia in the patients are relatively higher.

  18. 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

  19. 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

  20. 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

  1. Partial intravenous anesthesia in cats and dogs.

    Science.gov (United States)

    Duke, Tanya

    2013-03-01

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

  2. 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

  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. 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.

  5. 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

  6. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency

    Directory of Open Access Journals (Sweden)

    Mehta N

    2015-12-01

    Full Text Available Nandita Mehta, Sunana Gupta, Atul Sharma, Mohd Reidwan Dar Department of Anesthesiology and Intensive Care, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India Abstract: Older people undergoing any surgery have a higher incidence of morbidity and mortality, resulting from a decline in physiological reserves, associated comorbidities, polypharmacy, cognitive dysfunction, and frailty. Most of the clinical trials comparing regional versus general anesthesia in elderly have failed to establish superiority of any single technique. However, the ideal approach in elderly is to be least invasive, thus minimizing alterations in homeostasis. The goal of anesthetic management in laparoscopic procedures includes management of pneumoperitoneum, achieving an adequate level of sensory blockade without any respiratory compromise, management of shoulder tip pain, provision of adequate postoperative pain relief, and early ambulation. Regional anesthesia fulfills all the aforementioned criteria and aids in quick recovery and thus has been suggested to be a suitable alternative to general anesthesia for laparoscopic surgeries, particularly in patients who are at high risk while under general anesthesia or for patients unwilling to undergo general anesthesia. In conclusion, we report results of successful management with thoracic combined spinal epidural for laparoscopic cholecystectomy of a geriatric patient with ischemic heart disease with chronic obstructive pulmonary disease and renal insufficiency. Keywords: geriatric anesthesia, bupivacaine, segmental anesthesia, laparoscopic surgery

  7. 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.

  8. Comparison of influence of visual endoscope and general laryngoscope under general anesthesia on postopera-tive sore throat%全身麻醉术可视内窥镜与普通喉镜插管对术后咽喉疼痛的影响比较

    Institute of Scientific and Technical Information of China (English)

    罗洪亮

    2014-01-01

    目的:探讨全身麻醉术中可视内窥镜与普通喉镜插管对术后咽喉疼痛的影响,为临床选择术式提供参考。方法选择320例实施全麻非颈部、非咽喉手术患者,按随机数表法分为对照组和观察组,各160例。两组实施相同插管方式,对照组患者辅助普通喉镜手术,观察组辅助可视内窥镜手术。对比两组患者手术指标及术后疼痛感。结果观察组气囊压力、麻醉时间、手术时间与对照组相近,差异无统计学意义(t=0.834、0.943、1.034,均P>0.05);观察组术后2 h、24 h、48 h、96 h VAS评分分别为(11.93±2.04)分、(17.44±3.27)分、(3.88±0.83)分、(1.12±0.31)分,96 h 内咽喉出血7.50%,均明显低于对照组的(18.43±3.21)分、(22.55±4.19)分、(6.33±0.64)分、(3.29±0.58)分、17.50%,差异均有统计学意义(t=7.493、5.773、4.834、7.231,χ2=8.221,均P<0.05)。结论可视内窥镜辅助插管可有效改善术后咽喉疼痛,临床可优先考虑使用此术式。%Objective To compare the influence of visual endoscope and general laryngoscope under general anesthesia on postoperative sore throat , in order to provide reference for clinical surgery .Methods 320 patients under non-neck and non-throat surgeries were selected .They were randomly divided into the control group and obser-vation group,160 cases in each group.Same intubation was used in both the two groups ,general laryngoscope was used in the control group and visual endoscope was used in the observation group .Clinical indicators and pain score after surgery were compared between the two groups .Results The air pressure,time of anesthesia and operation time in the observation group were similar with the control group ,the differences were not significant (t =0.834,0.943, 1.034,all P>0.05); 2h,24h,48h,96h after surgery,the VAS scores in the

  9. 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 ...

  10. 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...

  11. 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.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2013-01-01

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

  15. 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

  16. Simplified local anesthesia technique for external dacryocystorhinostomy without nasal packing: a new technique and pilot study outcome

    Directory of Open Access Journals (Sweden)

    Tawfik HA

    2013-11-01

    Full Text Available Hatem A Tawfik,1 Osama R Youssef21Department of Ophthalmology, 2Department of Anesthesiology, Ain Shams University, Cairo, EgyptBackground: The purpose of this paper is to describe a simplified local anesthesia technique for external dacryocystorhinostomy (EXT-DCR.Methods: In this pilot, retrospective, noncomparative, interventional case series, 448 patients (480 eyes underwent EXT-DCR using a simplified local anesthesia technique. Nasal mucosal anesthesia was achieved using combined application of 6 mL of oxymetazoline 0.025% nasal spray and lidocaine 1% in the same spray bottle, without any packing of the nose with either pledgets or ribbon gauze. Local infiltration anesthesia consisted of subcutaneous injection of a 7 mL mixture of 2% lidocaine with 1:100,000 epinephrine injected on the flat side of the nose beneath the incision site, in addition to a second medial peribulbar injection (3 mL, 2% lidocaine without epinephrine.Results: Successful unilateral or bilateral EXT-DCR was achieved in 432/448 patients (96.4%. Four patients could not tolerate the procedure under local anesthesia and were converted to general anesthesia. Four patients required additional local anesthetic injections because of intolerable pain. Heavy sedation was essential in eight uncooperative patients because surgical manipulation was impossible. The remaining patients tolerated the procedure well. The intraoperative bleeding rate was very low except in one patient. Mean operative time was 16 minutes. Severe postoperative epistaxis was observed in four patients. Temporary anosmia developed in one patient.Conclusion: Our simplified local anesthesia approach of EXT-DCR is convenient for the patient because it avoids unnecessary nasal packing. It is also safe and effective, as evidenced by the high rate of successful completion of the procedure without conversion to general anesthesia or the need for supplemental local anesthesia.Keywords: local anesthesia, external

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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

  3. Supplemental pulpal anesthesia for mandibular teeth

    Directory of Open Access Journals (Sweden)

    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.

  4. Clinical observation of preinjecting Tramadol in the contain of adverse re actions during awakening period of general anesthesia%预注曲马多用于抑制全麻患者苏醒期不良反应的临床观察

    Institute of Scientific and Technical Information of China (English)

    邵兆军; 王迎虎; 何伟

    2011-01-01

    目的:观察曲马多抑制全麻患者苏醒期不良反应的效果.方法:将100例患者随机分为A、B两组,每组50例,A组(观察组),在手术结束前预注曲马多2mg/kg,B组(对照组),在手术结束前不做任何处理.观察两组患者在苏醒前和苏醒期的收缩压(SBP)、舒张压(DBP)、心率(HR)的变化及两组患者在苏醒期寒战、躁动的发生率.结果:与B组苏醒前和A组相比,B组患者苏醒期SBP、DBP、HR变化差异有统计学意义(P<0.05),A组患者苏醒前与苏醒期SBP、DBP、HR变化比较差异无统计学意义(P>0.05),A组患者苏醒期寒战、躁动的发生率明显少于B组(P<0.05).结论:全麻患者在苏醒前预注2mg/kg曲马多可有效地预防苏醒期不良反应的发生.%Objective: To investigate the preventive effect of preinjecting Tramadol on the adverse reactions in general anesthesia during awakening period.Methods: lOO cases undergoing general surgery were randomly divided into group A (observation group) and group B (control group) with 50 cases in each group.Tramadol 2 mg/kg was administered intravenously to the patients in the obseration group, but no medicine was given to the control group.SBP, DBP and HR of two groups before and during awakening period and the incidence rate of cold shivers and agitate during awaking period were observed.Results: SBP, DBP and HR during awaking period of group B increased significantly than those of group A and before group B awaking period (P<0.05).SBP, DBP and HR during awaking period of the group A had no significant change than that of group B before awaking period (P>0.05).The incidence rate of cold shivers and agitate during awaking period in group A obviously lower than those in Group B (P<0.05).Conclusion: The preinjecting Tramadol with.2 mg/kg can effectively prevent the adverse reactions in general anesthesia during awakening period.

  5. Differential Postoperative Effects of Volatile Anesthesia and Intraoperative Remifentanil Infusion in 7511 Thyroidectomy Patients

    Science.gov (United States)

    Jo, Jun-Young; Choi, Seong-Soo; Yi, Jung Min; Joo, Eun Young; Kim, Ji Hyun; Park, Se Ung; Sim, Ji-Hoon; Karm, Myong-Hwan; Ku, Seungwoo

    2016-01-01

    Abstract Although remifentanil is used widely by many clinicians during general anesthesia, there are recent evidences of opioid-induced hyperalgesia as an adverse effect. This study aimed to determine if intraoperative remifentanil infusion caused increased pain during the postoperative period in patients who underwent a thyroidectomy. A total of 7511 patients aged ≥ 20 years, who underwent thyroidectomy between January 2009 and December 2013 at the Asan Medical Center were retrospectively analyzed. Enrolled patients were divided into 2 groups: group N (no intraoperative remifentanil and only volatile maintenance anesthesia) and group R (intraoperative remifentanil infusion including total intravenous anesthesia and balanced anesthesia). Following propensity score matching analysis, 2582 patients were included in each group. Pain scores based on numeric rating scales (NRS) were compared between the 2 groups at the postoperative anesthetic care unit and at the ward until 3 days postoperation. Incidences of postoperative complications, such as nausea, itching, and shivering were also compared. The estimated NRS pain score on the day of surgery was 5.08 (95% confidence interval [CI] 4.97–5.19) in group N patients and 6.73 (95% CI 6.65–6.80) in group R patients (P < 0.001). There were no statistically significant differences in NRS scores on postoperative days 1, 2, and 3 between the 2 groups. Postoperative nausea was less frequent in group R (31.4%) than in group N (53.5%) (P < 0.001). However, the incidence of itching was higher in group R (4.3%) than in group N (0.7%) (P < 0.001). Continuous infusion of remifentanil during general anesthesia can cause higher intensity of postoperative pain and more frequent itching than general anesthesia without remifentanil infusion immediately after thyroidectomy. Considering the advantages and disadvantages of continuous remifentanil infusion, volatile anesthesia without opioid may be a good choice for minor

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

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

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

  7. ROLE OF DEXMEDETOMIDINE IN ANESTHESIA AND CRITICAL CARE

    Directory of Open Access Journals (Sweden)

    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.

  8. Preadministration of Low-dose Ketamine Reduces Tourniquet-induced Adverse Effects in Orthopedic Patients Under Gener-al Anesthesia%小剂量氯胺酮预防全身麻醉下止血带不良反应的发生

    Institute of Scientific and Technical Information of China (English)

    杨丽; 薛刚; 陈虹烨; 韩洪涛

    2013-01-01

    Objective :In this study ,we assesses the effects of preadministration of low-dose ketamin on blood pressure and heart rate during tourniquet inflation under general anesthesia .Methods :Thirty patients of ASA class Ⅰ or Ⅱ , scheduled for lower limb surgery ,were randomly divided into two groups .In group 1 underwent general anesthesia with preadministration of low-dose ketamine 0 .1mg/kg ,and in group 2 also underwent general anesthesia with the same volume of saline .The changes of MAP and HR were measured before tourniquet inflation ,after skin incision , 30min and 60min after inflation .Results :Comparing group 2 with group 1 ,there were significant increases before tour-niquet inflation to 30min and 60min after inflation in MAP and HR in group 2 (P< 0 .05) .What is more ,all of the pa-tients have tachycardia in group 2 on 60min after inflation.Conclusion :The results demonstrate that patients who re-ceived preadministration of low-dose ketamin showed less increase in MAP and HR during tourniquet inflation .%目的:观察小剂量氯胺酮预防下肢手术时止血带充气期所致不良反应的临床效果。方法:下肢手术的患者30例(ASA Ⅰ~Ⅱ级),随机分为两组,每组15例。两组均在全身麻醉下手术,组1在止血带充气前15min 静脉注射氯胺酮0.1mg/kg ,组2为空白对照组,记录止血带充气前、手术开始切皮时、止血带充气后30min 、止血带充气后60min 四个时间段的 MAP(Mean artery pressure ,平均动脉压)和 HR(Heart rate ,心率)。结果:两组手术开始切皮后 MAP 和HR 较止血带充气前均无统计学差异,但组2在止血带充气后30min 和60min 的 MAP 和 HR 均比充气前显著升高,加深麻醉亦不能奏效,必须加用血管活性药物,甚至停止止血带使用。结论:小剂量氯胺酮预防下肢手术时止血带充气所致的血压升高和心率增快,安全有效,无不良副作用。

  9. 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

  10. 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.

  11. 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

  12. Effects of different doses of dexmedetomidine on agitation and extubation reactions in emergence period after general anesthesia in elderly patients%不同剂量右旋美托咪啶对老年患者全麻苏醒期躁动及气管拔管反应的影响

    Institute of Scientific and Technical Information of China (English)

    刘焕仪; 张欢欢; 许学兵; 许立新

    2011-01-01

    Objective To observe the effects of different doses of dexmedetomidine on agitation and extubation reactions in emergence period after general anesthesia in elderly patients. Methods Eighty patients aged 65 - 95 years undergoing elective abdominal operation under general anesthesia were studied and divided into 4 groups, with 20 patients in each group. The control group received intravenous injection of 20 ml saline, and the other 3 groups were given intravenous injection of different doses of dexmedetomidine 0. 2, 0. 3, 0. 4 μg/kg respectively. Results Compared with the dexmedetomidine-treating groups, the fluctuations of arterial blood pressure (MAP) and heart rate (HR) in the saline-treating group were more significant; the incidence rates of agitation and endo-tracheal-tube-associated cough showed significant differences among the 4 groups (P<0. 05 for all). The group treated with dexmedetomidine of 0. 4 fig/kg had longer emergence period than the other groups (P<0. 05). Conclusion The incidence of agitation and extubation reactions can be reduced by injecting 0. 3 fig/kg dexmedetomidine in emergence period after general anesthesia in elderly patients without prolonging extubation time.%目的 观察不同剂量右旋美托咪啶对老年患者苏醒期躁动及气管拔管反应的影响。方法选择择期上腹部手术老年患者80例,随机分为对照组,右旋美托咪啶干预D1、D2和D3组各20例。手术结束前5 min对照组静脉注射0.9%氯化钠注射液20 ml;D1、D2和D3组分别单次缓慢静脉注射右旋美托咪啶0.2 μg/kg、0.3μg/kg、0.4 μg/kg。结果对照组苏醒拔管期间平均动脉压、心率波动显著,D1、D2、D3组较平稳;四组躁动、呛咳发生率比较,差异有统计学意义(均P<0. 05);D3组苏醒时间显著长于其他三组(均P<0. 05)。结论单次静脉注射右旋美托咪啶0.3 μg/kg可有效降低腹部手术老年患者麻醉苏醒期躁动发生率,减少气管拔

  13. 全麻诱导时不同静脉给药顺序对芬太尼诱发咳嗽的影响%Effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia

    Institute of Scientific and Technical Information of China (English)

    高卉; 桑诺尔; 张秀华; 黄宇光; 罗爱伦

    2014-01-01

    Objective To evaluate the effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia.Methods One hundred patients of both sexes,aged 18-70 yr,weighing 42-88 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to 2 groups using a random number table:fentanyl-propofol group (group FP) and propofol-fentanyl group (group PF).In FP group,fentanyl 3 μg/kg was injected intravenously over 3 s,and then propofol 1.5 mg/kg was injected intravenously.In PF group,propofol 1.5 mg/kg was injected intravenously,and then fentanyl 3μg/kg was injected intravenously over 3 s.The development,intensity and onset time of cough were recorded within 1 min after fentanyl injection.Results Compared with FP group,the incidence of cough was significantly decreased,and no significant change was found in the intensity and onset time of cough in PF group.Conclusion Administration in the propofol-fentanyl sequence can reduce the development of fentanyl-induced cough as compared with that in the fentanyl-propofol sequence during induction of general anesthesia.%目的 评价全麻诱导时不同静脉给药顺序对芬太尼诱发咳嗽的影响.方法 全麻下择期手术患者100例,性别不限,年龄18 ~ 70岁,体重42 ~ 88 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其分为2组(n=50):芬太尼-异丙酚组(FP组)静脉注射芬太尼3μg/kg,3 s注射完毕,随后静脉注射异丙酚1.5 mg/kg;异丙酚-芬太尼组(PF组)先静脉注射异丙酚1.5 mg/kg,随后静脉注射芬太尼3μg/kg,3 s注射完毕.记录注射芬太尼后1 min内咳嗽的发生情况、程度和出现时间.结果 与FP组比较,PF组咳嗽发生率降低(P<0.05),咳嗽出现时间和程度差异无统计学意义(P>0.05).结论 与芬太尼-异丙酚给药比较,异丙酚-芬太尼给药可减少全麻诱导时芬太尼诱发的咳嗽.

  14. Analysis of the Effects of Different Intravenous Drug Delivery Order on the Induction of Cough Induced by Fentanyl During General Anesthesia%全麻诱导时不同静脉给药顺序对芬太尼诱发咳嗽的影响分析

    Institute of Scientific and Technical Information of China (English)

    孙宁

    2015-01-01

    Objective Effects of analgesia effect of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia. Methods A retrospective analysis of 120 cases, aged 19~71 yr, weighing 41~89 kg, of ASA physical status ⅠorⅡ, scheduled for elective surgery under general anesthesia, were equally randomized to 2 groups using a random number table: fentanyl-propofol group (group FP) and propofol- fentanyl group (group PF), in FP group. fentanyl 3μg/kg was injected intravenously over 3 s, and then propofol1.5 mg/kg was injected intravenously, in PF group, propofol 1.5 mg/kg was injected intravenously, and then fentanyl 3μg/kg was injected intravenously over 3 s. The development, Intensity and onset time of cough were record within 1 min after fentanyl injection. Results Compared with FP group, the incidence of cough was signiifcantly decreased (P0.05).Conclusion Administration in the propofol-fentanyl sequence can reduce the development of fentanyl-propofol cough as compred with that in the fentanyl-propofol sequence during induction of general anesthesia.%目的:分析评价全麻诱导时不同静脉给药顺序对芬太尼诱发咳嗽的影响。方法回顾性分析我科全麻下择期手术患者120例,年龄19~71岁,体重41~89 kg,ASA分级Ⅰ或Ⅱ级,随机均分为芬太尼-异丙酚组(FP组)和异丙酚-芬太尼组(PF组),每组患者均为60例, FP组静脉注射芬太尼3μg/kg,在3 s内注射完,随后静脉注射异丙酚1.5 mg/kg,PF组静脉注射异丙酚1.5 mg/kg,随后静脉注射芬太尼3μg/kg,在3 s内注射完,记录注射芬太尼后1 min内咳嗽的发生情况和出现时间。结果与FP组比较,PF组咳嗽发生率降低(P<0.05),咳嗽出现时间差异无统计学意义(P>0.05)。结论与芬太尼-异丙酚给药比较,异丙酚-芬太尼给药可减少全麻诱导时芬太尼诱发的咳嗽。

  15. 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

    Institute of Scientific and Technical Information of China (English)

    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

  16. 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

  17. 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

  18. 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.

  19. A quest to increase safety of anesthetics by advancements in anesthesia monitoring: scientometric analysis

    Directory of Open Access Journals (Sweden)

    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. 多模式镇痛用于小儿唇腭裂修补术全麻苏醒期的镇痛镇静效果%Analgesic and sedative effects of muitimodal analgesia in stage of emergence after general anesthesia for cleft lip and/or palate prosthesis

    Institute of Scientific and Technical Information of China (English)

    唐岩峰; 陈芳; 王本福; 李海飞; Gennadiy Fuzaylov; 李军; 连庆泉

    2009-01-01

    目的 观察联合应用芬太尼、对乙酰氨基酚栓剂及局部浸润麻醉对唇腭裂修补术小儿全麻苏醒期镇静镇痛的效果.方法 择期行唇腭裂修补术的患儿54例,随机分为2组,对照组(C组,n=28)和多模式镇痛组(M组,n=26).均采用全身麻醉气管插管的方法,七氟烷麻醉诱导与维持.手术开始前由术者对两组患儿行局部浸润麻醉;M组患儿气管插管后即予对乙酰氨基酚栓剂塞肛;手术结束前10 min,静脉注射静脉注射芬太尼0.5μg/kg,C组不给药.观察两组患儿停止吸入七氟烷至拔除气管导管的时间、PACU内镇静镇痛评分、PACU的滞留时间及不良反应的发生情况.结果 两组患儿从停止吸入麻醉药至拔除气管导管时间无明显差异;PACU滞留时间M组[(25 ±4)min]较C组[(32±3)min]短(t=7.426,P<0.01);与C组比较,M组患儿镇痛满意(F=4.840,P=0.028),发生严重疼痛(F=5.333,P=0.021)及躁动(F=4.571,P=0.033)的例数少,差异具有统计学意义;两组患儿无一例发生呼吸抑制及瘙痒,过度镇静和恶心呕吐的发生率,两组间差异无统计学意义.结论 联合应用芬太尼、对乙酰氨基酚栓剂及局部浸润麻醉的多模式镇痛方法在苏醒期可为唇腭裂修补术小儿提供良好的镇痛镇静,减少躁动的发生率,加快PACU患者的转运速度,有利于苏醒期安全.%Objective To investigate the effects of multimodal analgesia on analgesia and sedation during emergence of general anesthesia for cleft lip and/or palate surgery pediatric patients. Methods Fifty-four pediatric patients with ASA Ⅰ and Ⅱ cleft lip and/or palate, aged 2 - 7, undergoing prosthesis were randomly allocated into 2 groups: control group (Group C, n = 28) inhaling nitrous oxide/oxygen (50%: 50%) and sevoflurane(5%) for general anesthesia, and multimodal group (Group M, n =26), injected intravenously with fentanyl and atracurium in addition to inhalation of nitrous oxide/oxygen (50%: 50%) and

  1. 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

  2. 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

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

    Science.gov (United States)

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

    1998-06-01

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

  4. 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.

  5. Anesthesia and analgesia for geriatric veterinary patients.

    Science.gov (United States)

    Baetge, Courtney L; Matthews, Nora S

    2012-07-01

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

  6. About Forum of Anesthesia and Monitoring

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

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

  7. About Forum of Anesthesia and Monitoring

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

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

  8. Educational experiences and preparedness in dental anesthesia: five-year outcome assessment and conclusions.

    Science.gov (United States)

    Moore, Paul A; Boynes, Sean G; Cuddy, Michael A; Giovannitti, Joseph A; Zovko, Jayme

    2009-12-01

    A mail survey of 2003-07 dental school graduates was undertaken by the Department of Anesthesiology at the University of Pittsburgh School of Dental Medicine to assess the strengths and weaknesses of the predoctoral curriculum in anesthesia and to determine the preparedness of practicing dentists to provide anesthesia services for their dental patients. Subsets of the survey responses were created to specifically evaluate the effectiveness of an advanced selective program in sedation offered to approximately twenty third- and fourth-year predoctoral students. This fourteen-month Anesthesia Selective Program provides advanced didactic instruction and clinical experiences needed to establish competence in minimal to moderate sedation. Overall, graduates reported being best prepared in assessment of medical histories, physiology, and pharmacology, while being least prepared in oral sedation, intravenous sedation, and general anesthesia. For graduates currently in general practice, those who had participated in the Anesthesia Selective Program reported being better prepared in most subjects relating to anesthesia and patient care. Participants in the selective were also more likely to treat special needs patients in their private practices. Respondents' written comments indicated a desire for a greater number of clinical experiences involving sedation procedures within the predoctoral curriculum. This outcome assessment indicated that a greater emphasis should be placed on instruction and training experiences for enteral sedation within the predoctoral dental curriculum. Advanced training and increased clinical experiences in anesthesia may also be an effective means to better prepare graduates to assess medical histories, to manage medical emergencies, and to be willing to treat medically complex patients as well as patients with special health care needs. PMID:20007493

  9. Transcending intractable conflict in health care: an exploratory study of communication and conflict management among anesthesia providers.

    Science.gov (United States)

    Jameson, Jessica Katz

    2003-01-01

    This paper explores the contrast between the longstanding, intractable conflict between two anesthesia providers and the cooperation of many individual nurse anesthetists and anesthesiologists working side-by-side to provide safe, effective anesthesia. Analysis of interview transcripts reveals that communication among anesthesia nurses and anesthesiologists may enact or transcend the conflict. This article proposes recommendations for improving communication between anesthesiologists and certified registered nurse anesthetists in particular and de-escalating intractable conflict in general. It also contributes to communication theory in intractable conflict by examining how individual, interpersonal conflict management interactions lead to either transcendence or enactment of the larger group conflict.

  10. 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.

  11. Twelve-lead ECG observation and analysis on acute brain injury patients during surgical gen-eral anesthesia and after operation%急性脑外伤患者全麻手术期间及术后12导联心电图观察分析

    Institute of Scientific and Technical Information of China (English)

    陈军; 董伦; 薛静

    2015-01-01

    目的:观察急性脑外伤患者全麻手术期间及术后心电图变化情况。方法186例成人急诊颅脑手术过程中及术后描记12导联电图,进行心电监护并记录。结果186例脑外伤患者麻醉手术期间有157例出现不同程度心电图异常改变(占84.4%)。窦性心动过缓、ST-T改变、心肌缺血最常见,其他异常主要有早搏、心律不齐、传导阻滞、异常 Q 波、Q-T 间期延长等改变。心电图的改变主要发生在脑部病变的急性期及开颅手术的一周内,且与病情严重程度密切相关。结论脑外伤患者急性期脑水肿颅内压增高、缺血缺氧、电解质紊乱等导致大多数患者有心电图异常,且变化复杂,一般为应激反应,是暂时的、可逆的,可随病情的减轻而好转或消失;麻醉及手术操作刺激对患者的心血管系统也造成一定的影响。通过监测分析心电图可发现潜在危险,特别是对有器质性心脏疾病者更应提高警惕。%Objective To observe the ECG changes of acute brain injury patients during surgical general anesthesia and after operation.Methods Twelve-lead ECGs of 186 adult patients were traced during the process of emergency craniocerebral trauma operation and after operation,and ECG monitoring was carried out and recorded.Results Among the 186 cases,there were 157 ca-ses showing various degrees of ECG abnormal changes (accounting for 84.4%),during anesthesia surgery.The ECG abnormalities were commonly sinus bradycardia,ST-T changes,and myocardial ischemia while others mainly included premature beat,arrhythmia,conduction block,abnormal Q waves,and so on.The changes of ECG mainly happened in the acute stage of brain lesions and within one week after craniotomy,and closely related to the severity of the disease.Conclusion Various factors such as cerebral edema,intracranial hypertension,ischemia /hypoxia and electrolyte imbalance can cause ECG abnormalities among a

  12. 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

  13. 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

  14. 右美托咪定预防妇科腹腔镜全身麻醉苏醒期躁动及对认知功能的影响%Dexmedetomidine Prevention of Restlessness in Recovery Period of General Anesthesia for Laparos-copy and Its Effect on Cognitive Function

    Institute of Scientific and Technical Information of China (English)

    李敏

    2016-01-01

    目的:探讨右美托咪定预防妇科腹腔镜患者全身麻醉苏醒期躁动及对认知功能的影响。方法选择2014年1月至2015年3月大连市妇女儿童医疗中心收治的行妇科腹腔镜手术的女性患者80例作为研究对象,依据抽签法随机分为试验组和对照组,各40例。对照组患者给予常规的麻醉,试验组患者在此基础上于手术结束前30 min 静脉泵注0.5μg/kg 右美托咪定,15 min 内完成。比较两组患者麻醉苏醒期间的镇静评分、躁动评分、寒战评分、不良反应及认知功能。结果试验组镇静评分、躁动评分、寒战评分均高于对照组[(3.73±0.13)分比(1.48±0.10)分,(92.1±2.3)分比(79.6±2.4)分,(93.2±2.4)分比(79.8±1.3)分],差异有统计学意义(P<0.01)。术后,试验组简易精神状态评价量表评分低于对照组[(25.4±1.0)分比(27.5±0.7)分],差异有统计学意义(P<0.01)。试验组总不良反应发生率低于照组[7.5%(3/40)比35.0%(14/40)],差异有统计学意义( P<0.05)。结论右美托咪定预防妇科腹腔镜患者全身麻醉苏醒期躁动及寒战具有显著的临床效果,对认知功能影响小,值得推广。%Objective To explore dexmedetomidine prevention of restlessness in recovery period of gen-eral anesthesia for gynecological laparoscopy restlessness and its effect on cognitive function .Methods Total of 80 female patients admitted to Women and Children Health Care Center of Dalian from Jan .2014 to Mar. 2015 were selected as the research objects,all the patients were randomly assigned to the trial group and the control group according to lottery method,40 patients each.The control group was treated with routine anes-thesia treatment,while the trial group was given dexmedetomidine by 0.5 μg/kg half an hour before the end of surgery,administered within 15 min.The anesthesia sedation score,agitation score

  15. Perioperative outcomes and type of anesthesia in hip surgical patients: An evidence based review

    Science.gov (United States)

    Opperer, Mathias; Danninger, Thomas; Stundner, Ottokar; Memtsoudis, Stavros G

    2014-01-01

    Over the last decades the demand for hip surgery, be it elective or in a traumatic setting, has greatly increased and is projected to expand even further. Concurrent with demographic changes the affected population is burdened by an increase in average comorbidity and serious complications. It has been suggested that the choice of anesthesia not only affects the surgery setting but also the perioperative outcome as a whole. Therefore different approaches and anesthetic techniques have been developed to offer individual anesthetic and analgesic care to hip surgery patients. Recent studies on comparative effectiveness utilizing population based data have given us a novel insight on anesthetic practice and outcome, showing favorable results in the usage of regional vs general anesthesia. In this review we aim to give an overview of anesthetic techniques in use for hip surgery and their impact on perioperative outcome. While there still remains a scarcity of data investigating perioperative outcomes and anesthesia, most studies concur on a positive outcome in overall mortality, thromboembolic events, blood loss and transfusion requirements when comparing regional to general anesthesia. Much of the currently available evidence suggests that a comprehensive medical approach with emphasis on regional anesthesia can prove beneficial to patients and the health care system. PMID:25035837

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

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

  18. 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

  19. 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

  20. REGIONAL ANESTHESIA CONTINUOUS BRACHIAL PLEXUS BLOCK WITH ULTRASONOGRAPHY GUIDANCE

    Directory of Open Access Journals (Sweden)

    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.