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Sample records for anesthesia recovery period

  1. Applying healthcare failure mode and effect analysis to patient pain management in the anesthesia recovery period

    Institute of Scientific and Technical Information of China (English)

    Zhao-Ping Xue; Hong-Yan Li; Rui-Tong Guan; Si Chen

    2016-01-01

    Objective: To standardize pain management in the anesthesia recovery period and improve the effects of analgesia on acute postoperative pain. Methods: Using healthcare failure mode and effect analysis (HFMEA), we analyzed the primary cause of patients' pain and subsequently determined the process and risk priority number (RPN). Results: Actions were taken to improve patients' pain. After using HFMEA, the experimental group's visual analog scale (VAS) scores were lower than those of the control group at 1 h and at discharge from the post-anesthetic intensive care unit (PAICU). The differences were statistically significant (P Conclusions: The application of failure mode and effect analysis can relieve pain and improve the quality of nursing.

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

    Science.gov (United States)

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

    1989-01-01

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

  3. Lidocaine-prilocaine cream reduces catheter-related bladder discomfort in male patients during the general anesthesia recovery period: A prospective, randomized, case-control STROBE study.

    Science.gov (United States)

    Mu, Li; Geng, Li-Cheng; Xu, Hui; Luo, Man; Geng, Jing-Miao; Li, Li

    2017-04-01

    Urethral catheterization is a predictor of agitation during the general anesthesia recovery period. The aim of this study was to determine the effect of intraurethral 5% lidocaine and 25 mg/g prilocaine cream in reducing catheter-related bladder discomfort (CRBD) in male patients during the general anesthesia recovery period. Adult male patients undergoing elective operations that required urinary catheterization under general anesthesia were enrolled and assigned randomly to 2 groups. In the lidocaine-prilocaine cream group (n = 72), approximately 5 g of topical cream was spread in the preputial sac, the glans, the meatus, and on the urinary catheter surface before urinary catheterization. In the control group (n = 74), the urinary catheter was lubricated with lidocaine gel. The incidence and severity of CRBD were assessed 15, 30, 45, and 60 minutes postoperatively. We found that the incidence of CRBD in the lidocaine-prilocaine cream group was significantly lower than in the control group. Multivariate logistic regression analysis showed that lidocaine-prilocaine cream applications reduced moderate or severe CRBD. Thirty minutes postoperation was the most frequent time point for the incidence of CRBD. Application of lidocaine-prilocaine cream on the surface of the urinary catheter is an efficient and safe method to reduce the incidence and severity of CRBD.

  4. 腹腔镜下胆囊切除术全麻复苏期甲状腺危象的护理体会%Nursing experience of laparoscopic cholecystectomy under general anesthesia recovery period of thyroid crisis

    Institute of Scientific and Technical Information of China (English)

    高家芝

    2014-01-01

    目的:探讨非甲亢手术全麻复苏期发生甲状腺危象病人的护理方法。方法:回顾性分析救治的1例腹腔镜下胆囊切除术全麻复苏期发生甲状腺危象病人的护理资料。结果:护理方法有效,术后3小时病情逐渐好转,1周后出院。结论:非甲亢手术病人全麻复苏期发生甲状腺危象,及时发现,及时有效的救治与护理,可有效提高患者生存率,降低死亡率。%Objective:To explore the nursing methods of patients with hyperthyroidism thyroid crisis occurred in non operation anesthesia recovery period.Methods:To review the nursing data of patients with thyroid crisis operation under general anesthesia recovery period resection in 1 case of laparoscopic treatment of gal bladder analysis.Result:The ef ective nursing method,3 hours after the operation condition improved gradual y,1 week later discharge from hospital.Conclusion:Non hyperthyroidism operation patients during general anesthesia recovery period of thyroid crisis occurred,the timely disG covery,timely and ef ective treatment and nursing,can ef ectively improve the survival rate of patients,reduce the mortality rate.

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

    Directory of Open Access Journals (Sweden)

    Munevera Hadžimešić

    2013-12-01

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

  6. 双腔气管插管手术患者麻醉复苏期的气道管理探讨%Airway Management of Patients With Double Lumen Endotracheal Intubation During Anesthesia Recovery Period

    Institute of Scientific and Technical Information of China (English)

    刘海军; 覃林基

    2016-01-01

    Nowadays, mechanical ventilation has been widely used in clinic, has become an important measure for treatment of critically ill patients. In intrathoracic surgery, double lumen endotracheal intubation (DLT) is an important means to ensure one lung ventilation, in order to ensure ventilation and endotracheal intubation and extubation process smoothly, do double lumen airway management during the recovery period of anesthesia tracheal intubation in patients with surgery is very important. Based on this, the necessity and speciifc methods of airway management of double lumen intubation surgery patients anesthesia recovery period were discussed.%现如今,机械通气已经被广泛应用到临床上,成为了抢救危重症患者的重要措施。在胸腔内手术中,双腔气管插管(DLT)是确保单侧肺通气的一项重要手段,而为了确保插管、拔管以及通气过程的顺利,做好双腔气管插管手术患者麻醉复苏期的气道管理十分重要。基于此,本文对双腔气管插管手术患者麻醉复苏期的气道管理必要性及具体方法进行了探讨。

  7. Application Analysis of Comprehensive Nursing Intervention in General Anesthesia Operation Patients During Recovery Period%综合护理干预在全麻手术患者苏醒期的应用分析

    Institute of Scientific and Technical Information of China (English)

    徐冬霞; 邵正霞

    2015-01-01

    Objective To discuss the application method and effect of comprehensive nursing intervention in general anesthesia operation patients during recovery period.Methods500 cases of general anesthesia operation patients in recovery period were selected and randomly divided into treatment group and control group with 250 cases each. The former received regular nursing combined with comprehensive nursing intervention while the latter received regular nursing.Results The incidence of restlessness of treatment group was lower than control group (P<0.05) and the severity was also slighter (P<0.05). At discharge, the physiological, psychological, social and environmental scores in the treatment group were higher than those in the control group (P<0.05).Conclusion Comprehensive nursing intervention can reduce the incidence of restlessness and alleviate the severity, which is favorable for improving the overall life quality.%目的:探讨综合护理干预在全麻手术患者苏醒期的应用方法与效果。方法选择全麻手术进入苏醒期患者500例,随机分为治疗组与对照组各250例,治疗组在苏醒期给予常规护理联合综合护理干预,对照组在苏醒期给予常规护理。结果治疗组的躁动发生例数少于对照组(P<0.05),且发生程度轻于对照组(P<0.05)。出院时进行调查,治疗组的生理、心理、社会与环境领域得分都高于对照组(P<0.05)。结论综合护理干预在全麻手术患者苏醒期的应用能减少躁动的发生,减轻躁动发生程度,有利于患者总体生活质量的改善。

  8. 围术期保温措施对经尿道前列腺电切术患者麻醉恢复期的影响%On Effects of Perioperative Warming on TURP Patients in Anesthesia Recovery Period

    Institute of Scientific and Technical Information of China (English)

    吴昉; 施惠

    2014-01-01

    目的:探讨围术期保温措施对经尿道前列腺电切术(TURP)患者麻醉恢复期的影响。方法选择60例行TURP患者,按随机数字表法分为研究组和对照组,每组30例。两组患者均给予标准的全麻诱导、维持程序。研究组采用围术期综合保温措施,对照组采用常规保温方法。对比两组患者不同时间点的体温以及患者入麻醉恢复室(PACU)时的平均动脉压(MAP)、Steward苏醒评分、视觉模拟评分(VAS)、脉搏血氧饱和度(SpO2)。结果两组患者在术前、术中及入PACU 后60分时体温差异均无统计学意义(P﹥0.05);对照组在入PACU时、入PACU 30分时的体温均低于研究组(P<0.05);两组患者在入PACU时,MAP、SpO2差异无统计学意义(P﹥0.05),对照组的Steward苏醒评分低于研究组而VAS评分高于研究组(P<0.05)。结论围术期保温措施可有助于维持TURP患者麻醉恢复期体温平稳,降低其疼痛程度,防止患者的苏醒延迟。%Objective to study the effects of perioperative warming on TURP patients in anesthesia recovery period. Methods 60 cases of TURP patients are divided into experimental group and control group at random, 30 cases in each group, both of which are given the same standard induction and maintenance of general anesthesia. The experimental group takes the perioperative warming while the other group takes the traditional warming. Comparisons and contrasts have been made between the two groups on temperatures at different time, MAP of patients in PACU, Steward scores, VAS and SpO2. Results The temperature differences of the two groups before operation, during operation, and after 60 minutes in PACU show no statistical significance(P﹥0.05). The temperature of control group is lower than experimental group at the entry of PACU and after 30 minutes in PACU(P<0.05). Both groups show no statistical significance(P﹥0.05) on MAP and SpO2 when they enter PACU. Besides

  9. 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

  10. 地佐辛超前镇痛对面肌痉挛术后麻醉苏醒期的影响%The effect of dezocine preemptive analgesia on hemifacial spasm postoperative anesthesia recovery period

    Institute of Scientific and Technical Information of China (English)

    王长明; 蔡长华; 张静; 刘辉; 庞庆贵; 王嵘巍; 刘艳芳; 尹美华; 马逸

    2014-01-01

    Objective To explore effect of dezocine preemptive analgesia on microvascular decompression (MVD) for hemifacial spasm in anesthesia recovery period.Methods Thirty-two patients,who underwent the MVD for hemifacial spasm,were randomly divided into experimental group (group Ⅰ) and control group (group Ⅱ) with 16 patients per group.In group Ⅰ,patients received intravenous injection of dezocine 5 mg/2 ml 30 min before the end of the surgery.While in group Ⅱ,patients received intravenous injection of saline 2 ml 30 min before the end of the surgery.Postoperative recovery time,pain visual analogue scale (VAS) 10 min after extubation and pulling out laryngeal mask immediately riker agitation-sedation scale (RSS) were assessed.Mean arterial pressure (MAP),heart rate (HR) and pulse oxygen saturation(SpO2) were observed before anesthesia (T0,baseline),5 min before pulling out the laryngeal mask (T1),extracting the laryngeal mask immediately (T2) and 10 min after pulling out the laryngeal mask(T3).Results There was no significant difference in postoperative recovery time and Ramsay sedation score between group Ⅰ and group Ⅱ (P>0.05).Significant difference between group Ⅰ and group Ⅱ in RSS score at T2 [(0.6±0.1),(2.8±0.2) points] and VAS score at T3 [(1.0±0.2),(3.3±0.4) points] were observed.There was no significant difference in MAP and HR at T0 and T1 between group Ⅰ and group Ⅱ (P>0.05).From our results,it showed significant differences between group Ⅰ in MAP[(96.6±1.1),(94.7±1.1) mmHg(1 mmHg=0.133 kPa)],HR[(81.4±1.7),(78.0±1.2) bpm] and group Ⅱ in MAP[(104.9±1.5),(100.9±1.2) mmHg],HR[(87.7±2.0),(85.0±1.9) bpm] at T2 and T3.The MAP[(95.5±2.0) mmHg] and HR[(81.8±2.6) bpm] at T0 were compared with T2 and T3 in MAP[(104.9±1.5),(100.9±1.2) mmHg],HR[(87.7±2.0),(85.0±1.9) bpm] in group Ⅱ,which showed significant difference (P<0.05).There was no significant difference in SpO2 (P>0.05).No differences were observed in the

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

    Science.gov (United States)

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

    1996-06-01

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

  12. Influence of parecoxib Na on anesthesia recovery period of patients under the fast track anesthesia with remifentanil%帕瑞昔布钠对瑞芬太尼快通道麻醉患者术后苏醒期影响的效果分析

    Institute of Scientific and Technical Information of China (English)

    周孝道; 龚红君; 马驰波

    2015-01-01

    目的:探讨麻醉诱导前用帕瑞昔布钠对瑞芬太尼快通道麻醉患者术后苏醒期的影响。方法将105例腹腔镜胆囊切除术患者随机分为3组,每组35例。 A组在麻醉诱导之前20 min静脉输注帕瑞昔布钠40 mg+0.9%氯化钠10 mL,B组在术毕前20 min静脉输注帕瑞昔布钠40 mg+0.9%氯化钠10 mL,C组在麻醉诱导前20 min静脉注射0.9%氯化钠10 mL。记录并比较不同时间点3组患者平均动脉压、心率、血氧饱和度以及口述描述痛觉评分、躁动评分、镇静评分和舒适度评分等。结果 T2至T4时间段,A组和B组平均动脉压、心率、躁动评分均显著低于 C 组,A 组平均动脉压、心率、躁动评分显著低于 B 组(P<0.05)。A组和B组镇静评分均显著高于C组,A组镇静评分显著高于B组(P<0.05)。不同时间点口述描述痛觉评分比较,A组B组均显著低于C组,A组显著低于B组( P<0.05)。 A组和B组术后舒适度评分显著高于C组,A组术后舒适度评分显著高于B组( P<0.05)。结论术前用帕瑞昔布钠能够明显减轻瑞芬太尼快通道麻醉患者的急性疼痛,有效抑制痛觉过敏,减少患者的苏醒期躁动。%Objective To investigate the effects of preoperative use of parecoxib Na during anesthesia recovery period on the fast track anesthe-sia with remifentanil.Methods A total of 105 cases who received lapa-roscopic cholecystectomy were randomly divided into three groups with 35 cases in each group.Patients in group A received parecoxib Na 40 mg dissolved in normal saline 10 mL through injection 20 min before induc-tion of anesthesia.Patients in group B received parecoxib Na 40 mg dis-solved in normal saline10 mL through injection 20 min before the end of surgery.Patients in group C received normal saline 10 mL through injec-tion 20 min before induction of anesthesia.The data of mean arterial pressure(MAP), heart rate (HR) and oxygen saturation

  13. 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.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    Science.gov (United States)

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

  17. 帕金森病患者脑深部电刺激术后麻醉恢复期常见并发症分析%Analysis on common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease

    Institute of Scientific and Technical Information of China (English)

    王会文; 张雪梅; 侯春梅; 房辉; 吕玉梅; 韩如泉

    2016-01-01

    Objective To investigate the common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease. Methods The complications during anesthesia recovery period after deep brain stimulation in 869 patients with Parkinson disease were retrospectively analyzed. Results The median recovery time during anesthesia recovery period was 15 (0 - 30) min. The complications of 869 patients with Parkinson disease were hypertension in 133 cases (15.3%), arrhythmia in 99 cases (11.4%), agitation in recovery period in 76 cases (8.7%), respiratory obstruction in 24 cases (2.8%), postoperative nausea and vomiting (PONV) in 18 cases (2.1%), hypoxemia in 17 cases (2.0%), pain in 10 cases (1.2%), delayed emergence in 10 cases (1.2%), shivering in 3 cases (0.3%), and hypotension in 1 case (0.1%). The incidence of 1 complication was 26.8%(233/869), the incidence of ≥ 2 complications was 9.9% (86/869), and the total incidence of complications was 36. 7% (319/869). In the 869 patients, the modified Aldrete score ≥ 9 scores when patients were removed away from the anesthesia recovery room was in 849 cases (97.7%), and≤8 scores was in 20 cases (2.3%). Conclusions The common complications during anesthesia recovery period after deep brain stimulation in patients with Parkinson disease are special. To maintain a stable circulation, preventing respiratory complications and aspiration are important to reduce the incidence and improve the prognosis.%目的:探讨帕金森病患者脑深部电刺激术后麻醉恢复期常见并发症的发生情况。方法对869例帕金森病行脑深部电刺激术的患者麻醉恢复期并发症发生情况进行回顾性分析。结果患者麻醉恢复期的中位苏醒时间为15(0~30)min。869例帕金森病患者并发症发生情况:高血压133例(15.3%),心律失常99例(11.4%),苏醒期躁动76例(8.7%),呼吸道梗阻24例(2.8%),术后恶心呕吐(PONV)18

  18. Changes in effective connectivity of sensorimotor rhythms in thalamocortical circuits during the induction and recovery of anesthesia in mice.

    Science.gov (United States)

    Kang, Jae-Hwan; Choi, Jee Hyun; Hwang, Eunjin; Kim, Sung-Phil

    2016-10-15

    The thalamocortical network serves a role in both consciousness and sensorimotor processing. However, little is known regarding how changes in conscious states, via induction of and recovery from anesthesia, affect the processing of sensorimotor information in the thalamocortical network. To address this, we investigated the dynamics of causal interactions among sensorimotor rhythms (SMR; frequency range of 3-12Hz) across the thalamocortical network during transitions into and out of ketamine-induced unconsciousness. Two local field potentials from the ventral lateral and ventrobasal thalamic nuclei, as well as two intracranial electroencephalography signals from the primary sensory and primary motor regions, were recorded in 10 mice. Spectral Granger causality analysis revealed two distinct frequency-specific patterns in sensorimotor rhythms. For the low-frequency (3-6.5Hz) SMR, loss of consciousness evoked causal influences directed from the cortex to the thalamus. For the high-frequency (6.5-12Hz) SMR, causal influences from the primary sensory cortex to other regions during the conscious period were abruptly altered by loss of consciousness and gradually regenerated following recovery of consciousness. The results of the present study indicate that anesthesia alters the flow of sensorimotor information in the thalamocortical network and may provide evidence of the neural basis of loss and recovery of sensorimotor function associated with anesthesia.

  19. Effects of Sevoflurane and Desflurane Anesthesia on Recovery and Agitation in Children Undergoing Strabismus Surgery

    Directory of Open Access Journals (Sweden)

    Meziyet Sarac Ahrazoglu

    2012-08-01

    Full Text Available Purpose: We aimed to compared the effects of sevoflurane and desflurane anesthesia on recovery and early agitation in children undergoing strabismus surgery in our study. Method: Totally 42 patients undergoing elective strabismus surgery who between the ages of 2-10, ASA I-II were included this study. The patients were classified into two groups randomly. Induction of anesthesia was provided with 50% nitrous oxide, 50% oxygen and 6-8% sevoflurane in both groups. Maintenance of anesthesia was provided with sevoflurane 1-2% in Group I and desflurane 4-6% in Group II. The operation time, extubation, eye opening, obeying the verbal commands and orientation times and nausea-vomiting, laryngospasm and other adverse affects were recorded. Postoperative recovery (Modified Aldrete Emergence Score and agitation (Pediatric Anesthesia Delirium Scale and Watcha Behaviour Scale situation were recorded. Results: Patient’s demographic data and hemodynamic parameters were similar between the groups. Extubation, eye opening, obeying the verbal commands, orientation times were shorter in desflurane group than sevoflurane group(p< 0.05. Postoperative recovery and agitation scores were similar in two groups. Conclusion: In children, it was concluded that desflurane anesthesia may be preferred to sevoflurane because of shorter extubation, eye-opening, obeying the verbal commands and orientation times, but it did not reduce postoperative agitation. [Cukurova Med J 2012; 37(4.000: 186-192

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

    Directory of Open Access Journals (Sweden)

    Mukesh Somvanshi

    2015-03-01

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

  1. 心脏病人行非心脏手术麻醉恢复期肌松拮抗剂使用安全性评估%Safety of muscle relaxant antagonism for patients with heart disease and non-heart operation during post-anesthesia recovery period

    Institute of Scientific and Technical Information of China (English)

    刘小男; 陈其彬; 闵苏; 朱儒红

    2013-01-01

    Objective:To study the efficacy and safety of using neostigmine antagonism vecuronium bromide for patients with heart disease undergoing non-heart operation under general anesthesia in post-anesthesia recovery room(PACU).Methods:Totally 180 patients of American Society of Anesthesiologists (ASA) Ⅱ-Ⅲ level,19-65 year-old,complicated with hypertensive cardiopathy,coronary heart disease,rheumatic heart disease and pulmonary heart disease,undergoing non-heart operation under general anesthesia were randomly selected.After entering PACU,patients were randomly divided into 3 groups:control group(C group),using no muscle loose antagonistic drugs during anesthesia recovery period until recovery,neostigmine single medication group(N group) intravenous injection of neostigmine 40 μg and atropine 20 μg when train of four(TOF) reaching 25%,neostigmine twice to medicine group(M group),intravenous injection of neostigmine 20 μg/kg and atropine 10 μg/kg when TOF reaching 25% and 75% respectively.Vital signs were monitored in three groups.Extubation time from TOF 25% to 90% and PACU discharging time when Aldrete score reaching 9 were recoded.Hypotension,hypertension,cardiac arrhythmia,arterial blood gas analysis,reintubation rate,incidence of nausea and vomiting and delirium were recorded in three groups during the periods mentioned above.Results:Extubation time was significantly shortened in N and M groups than in group C(P<0.01) without significant differences in complication rate between groups.Conclusions:Reasonable application of muscle relaxant antagonism for patients with heart disease undergoing non-heart operation in PACU can promote muscle contraction function recovery,shorter extubation time under general anesthesia without inducing adverse events,therefore is safe and feasible.%目的:研究探讨心脏病人接受全身麻醉下的非心脏手术后在麻醉恢复室(postanesthesia care unit,PACU)内使用新斯的明拮抗维库溴铵的有效性

  2. 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

  3. Phentolamine mesylate for accelerating recovery from lip and tongue anesthesia.

    Science.gov (United States)

    Hersh, Elliot V; Lindemeyer, Rochelle G

    2010-10-01

    Phentolamine mesylate, at dosages from 0.4 to 0.8 mg in adults and adolescents and at dosages from 0.2 to 0.4 mg in children aged 4 to 11 years, has been proven to be safe and effective for the reversal of soft tissue anesthesia (lip and tongue numbness) and the associated functional deficits resulting from a local dental anesthetic injection containing a vasoconstrictor. Its ability to block a-adrenergic receptors on blood vessels induces vasodilation and enhances the redistribution of the local anesthetic away from the injection site. The low dosages administered for dental local anesthetic reversal in all likelihood accounts for the lack of significant cardiovascular effects that are associated with the medical use of the drug for hypertensive conditions associated with catecholamine excess.

  4. Influencing factors for restlessness during anesthesia recovery period after gynecologic laparoscopic surgery under general anesthesia%妇科全麻腹腔镜手术患者术后麻醉恢复期躁动的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    孙明

    2012-01-01

    目的 分析妇科全麻腹腔镜手术患者术后全麻苏醒期躁动(EA)的影响因素.方法 回顾性分析268例行妇科全麻腹腔镜手术患者的临床资料.结果 年龄大、高血压病史、糖尿病病史、诱导后放置导尿管、术前血小板计数高是妇科全麻腹腔镜手术患者术后EA的危险因素,术后镇痛、SPO2高是保护因素.结论 医务人员应针对EA发生的危险因素进行相应干预措施,防止EA的发生.%Objective To explore the influencing factors of emergence agitation (EA) in patients after gynecologic laparoscopic surgery under general anesthesia. Methods The clinical data of 268 patients undergoing gynecologic laparoscopic surgery under general anesthesia were retrospectively reviewed. Results Advanced age, hypertension history, diabetes history, catheter placement after induction, preoperative high platelet count were dangerous factors of EA after general anesthesia laparoscopic surgery. Postoperative analgesia and high level of SP2 were protective factors. Conclusion Medical personnel should take related intervention measures aiming directly at dangerous factors to prevent the occurrence of EA.

  5. Effect of chest physical therapy on the pulmonary ventilation in recovery period after general anesthesia in patients with thoracoscopic surgery for lung cancer%胸部物理治疗对胸腔镜下肺癌手术患者全麻复苏期通气的影响

    Institute of Scientific and Technical Information of China (English)

    刘青云

    2015-01-01

    目的:探讨胸部物理治疗对胸腔镜下肺癌手术患者全麻复苏期通气的影响。方法:将60例胸腔镜下手术治疗的肺癌患者随机分为观察组和对照组各30例,对照组给予常规护理,观察组在常规护理基础上给予术前访视,指导患者掌握有效咳嗽和主动呼吸周期锻炼,麻醉复苏期给予胸部物理治疗。比较两组患者麻醉复苏期胸部物理治疗有效率和不同时间点血气分析结果。结果:观察组麻醉复苏期胸部物理治疗有效率显著高于对照组( P <0.05)。拔管前两组患者血气分析无差异,予胸部物理治疗后,两组患者血气分析结果优于治疗前;拔管后30 min、1 h、2 h 观察组血气分析结果明显优于对照组(P <0.05)。拔除气管导管后30 min、1 h、2 h 观察组血气分析合格率显著高于对照组(P <0.05)。结论:胸部物理治疗能提高患者术后麻醉苏醒期患者治疗的有效性,有助于改善患者麻醉复苏期的肺通气功能。%Objective:To explore the effect of chest physical therapy on the pulmonary ventilation in recovery period after general anes-thesia in patients with thoracoscopic surgery for lung cancer. Methods:60 lung cancer patients undergoing thoracoscopic surgery were ran-domly divided into the observation group and the control group(30 cases in each group). The patients in the control group were given rou-tine nursing care and the patients in the observation group were given preoperative visit and the guidance on how to effectively cough and to take active breathing,and chest physical therapy was provided for the patients in the recovery period after general anesthesia. The effective rate of chest physical therapy and the results of blood gas analysis at different time points were compared between the two groups. Results:The effective rate of chest physical therapy in the observation group was significantly higher than that in the control

  6. The Effects of Single-Dose Rectal Midazolam Application on Postoperative Recovery, Sedation, and Analgesia in Children Given Caudal Anesthesia Plus Bupivacaine

    Directory of Open Access Journals (Sweden)

    Sedat Saylan

    2014-01-01

    Full Text Available Background. This study aimed to compare the effects of rectal midazolam addition after applying bupivacaine and caudal anesthesia on postoperative analgesia time, the need for additional analgesics, postoperative recovery, and sedation and to find out its adverse effects in children having lower abdominal surgery. Methods. 40 children between 2 and 10 years of ASA I-II were randomized, and they received caudal anesthesia under general anesthesia. Patients underwent the application of caudal block in addition to saline and 1 mL/kg bupivacaine 0.25%. In the postoperative period, Group C (n = 20 was given 5 mL saline, and Group M (n = 20 was given 0.30 mg/kg rectal midazolam diluted with 5 mL saline. Sedation scale and postoperative pain scale (CHIPPS of the patients were evaluated. The patients were observed for their analgesic need, first analgesic time, and adverse effects for 24 hours. Results. Demographic and hemodynamic data of the two groups did not differ. Postoperative sedation scores in both groups were significantly lower compared with the preoperative period. There was no significant difference between the groups in terms of sedation and sufficient analgesia. Conclusions. We conclude that caudal anesthesia provided sufficient analgesia in peroperative and postoperative periods, and rectal midazolam addition did not create any differences. This trial is registered with ClinicalTrials.gov NCT02127489.

  7. 气管内注射和静脉泵注右美托咪定在小儿全身麻醉苏醒期的应用%Intravenous and endotracheal application of dexmedetomidine during recovery period of pediatric general anesthesia

    Institute of Scientific and Technical Information of China (English)

    余高锋; 金尚怡; 陈景晖; 赵玉萍; 汪自欣; 宋兴荣

    2016-01-01

    group V(P <0.05 ).② Compared with control group, recovery time of group V and group T were prolonged, and the differences were significant, respectively (P <0.05).Significant difference was found in recovery time between group V and group T (P <0.05).Extubation time in group V was longer than that of control group (P <0.05).③ The bucking score of group V and group T were significantly lower than that of control group, respectively,and the differences were significant (P < 0.01 ).Conclusions The intravenous and endotracheal application of dexmedetomidine were helpful to maintain circulation stabilization.They could alleviate bucking response during recovery period of pediatric general anesthesia.The recovery time and extubation time were prolonged when dexmedetomidine was administered intravenously. Dexmedetomidine injected intratracheally did not affect extubation time,but prolonged the recovery time.

  8. Influence of serial electrical stimulations of perifornical and posterior hypothalamic orexin-containing neurons on regulation of sleep homeostasis and sleep-wakefulness cycle recovery from experimental comatose state and anesthesia-induced deep sleep.

    Science.gov (United States)

    Chijavadze, E; Chkhartishvili, E; Babilodze, M; Maglakelidze, N; Nachkebia, N

    2013-11-01

    The work was aimed for the ascertainment of following question - whether Orexin-containing neurons of dorsal and lateral hypothalamic, and brain Orexinergic system in general, are those cellular targets which can speed up recovery of disturbed sleep homeostasis and accelerate restoration of sleep-wakefulness cycle phases during some pathological conditions - experimental comatose state and/or deep anesthesia-induced sleep. Study was carried out on white rats. Modeling of experimental comatose state was made by midbrain cytotoxic lesions at intra-collicular level.Animals were under artificial respiration and special care. Different doses of Sodium Ethaminal were used for deep anesthesia. 30 min after comatose state and/or deep anesthesia induced sleep serial electrical stimulations of posterior and/or perifornical hypothalamus were started. Stimulation period lasted for 1 hour with the 5 min intervals between subsequent stimulations applied by turn to the left and right side hypothalamic parts.EEG registration of cortical and hippocampal electrical activity was started immediately after experimental comatose state and deep anesthesia induced sleep and continued continuously during 72 hour. According to obtained new evidences, serial electrical stimulations of posterior and perifornical hypothalamic Orexin-containing neurons significantly accelerate recovery of sleep homeostasis, disturbed because of comatose state and/or deep anesthesia induced sleep. Speed up recovery of sleep homeostasis was manifested in acceleration of coming out from comatose state and deep anesthesia induced sleep and significant early restoration of sleep-wakefulness cycle behavioral states.

  9. Premedication with clonidine versus fentanyl for intraoperative hemodynamic stability and recovery outcome during laparoscopic cholecystectomy under general anesthesia

    OpenAIRE

    Gupta, Kumkum; Lakhanpal, Mahima; Prashant K.Gupta; Krishan, Atul; Rastogi, Bhawna; Tiwari, Vaibhav

    2013-01-01

    Background: Laparoscopic cholecystectomy under general anesthesia induced intraoperative hemodynamic responses which should be attenuated by appropriate premedication. The present study was aimed to compare the clinical efficacy of clonidine and fentanyl premedication during laparoscopic cholecystectomy for attenuation of hemodynamic responses with postoperative recovery outcome. Subjects and Methods: In this prospective randomized double blind study 64 adult consented patients of either sex ...

  10. National Weatherization Assistance Program Characterization Describing the Recovery Act Period

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, Bruce Edward [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rose, Erin M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hawkins, Beth A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-10-01

    This report characterizes the U.S. Department of Energy s Weatherization Assistance Program (WAP) during the American Recovery and Reinvestment Act of 2009 (Recovery Act) period. This research was one component of the Recovery Act evaluation of WAP. The report presents the results of surveys administered to Grantees (i.e., state weatherization offices) and Subgrantees (i.e., local weatherization agencies). The report also documents the ramp up and ramp down of weatherization production and direct employment during the Recovery Act period and other challenges faced by the Grantees and Subgrantees during this period. Program operations during the Recovery Act (Program Year 2010) are compared to operations during the year previous to the Recovery Act (Program Year 2008).

  11. Periodic Lateralized Epileptiform Discharges can Survive Anesthesia and Result in Asymmetric Drug-induced Burst Suppression

    Science.gov (United States)

    Mader, Edward C.; Cannizzaro, Louis A.; Williams, Frank J.; Lalan, Saurabh; Olejniczak, Piotr W.

    2017-01-01

    Drug-induced burst suppression (DIBS) is bihemispheric and bisymmetric in adults and older children. However, asymmetric DIBS may occur if a pathological process is affecting one hemisphere only or both hemispheres disproportionately. The usual suspect is a destructive lesion; an irritative or epileptogenic lesion is usually not invoked to explain DIBS asymmetry. We report the case of a 66-year-old woman with new-onset seizures who was found to have a hemorrhagic cavernoma and periodic lateralized epileptiform discharges (PLEDs) in the right temporal region. After levetiracetam and before anesthetic antiepileptic drugs (AEDs) were administered, the electroencephalogram (EEG) showed continuous PLEDs over the right hemisphere with maximum voltage in the posterior temporal region. Focal electrographic seizures also occurred occasionally in the same location. Propofol resulted in bihemispheric, but not in bisymmetric, DIBS. Remnants or fragments of PLEDs that survived anesthesia increased the amplitude and complexity of the bursts in the right hemisphere leading to asymmetric DIBS. Phenytoin, lacosamide, ketamine, midazolam, and topiramate were administered at various times in the course of EEG monitoring, resulting in suppression of seizures but not of PLEDs. Ketamine and midazolam reduced the rate, amplitude, and complexity of PLEDs but only after producing substantial attenuation of all burst components. When all anesthetics were discontinued, the EEG reverted to the original preanesthesia pattern with continuous non-fragmented PLEDs. The fact that PLEDs can survive anesthesia and affect DIBS symmetry is a testament to the robustness of the neurodynamic processes underlying PLEDs. PMID:28286626

  12. 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.

  13. Effects of combined midazolam and propofol in anesthesia induction and recovery of cats undergoing ovariohisterectomy

    Directory of Open Access Journals (Sweden)

    Diogo Gorayeb de Castro

    2015-12-01

    Full Text Available The objective of this study was to determine the effects of propofol and midazolam on induction of anesthesia in cats undergoing ovariohysterectomy, measured in terms of the quality of tracheal intubation, anesthesia induction, cardiorespiratory effects, and recuperation period. Thirty healthy adult cats were pretreated with acepromazine and morphine. After 30 min, they were divided into three groups: PG (n = 10, in which induction was performed with only intravenous propofol at doses required for intubation; MPG (n = 8, in which animals received intravenous midazolam (0.3 mg kg-1 administered over 30 s, followed by administration of propofol as in PG; and PMG (n = 9, in which propofol was first administered at a rate of 4 mg kg-1 min-1, after which midazolam was administered (0.3 mg/kg, followed by re-administration of propofol. In order to perform a blinded study, the PG and PMG received a 0.9% NaCl solution volume similar to the midazolam dose before induction (0.06 mL/kg. Similar to the other groups, the PG and MPG received (0.06 mL kg-1 saline 30 s after administration of propofol. In order to mimic the administration of midazolam, the saline solution was administered for 30s. The PG received 11.0 ± 1.38 mg kg-1 propofol, a greater dose than that administered to the PMG (p < 0.001 and MPG (p < 0.01, which received 7.9 ± 1.92 and 9.1 ± 2.20 mg kg-1, respectively. There were no differences in the intubation scores between groups. Previous use of midazolam did not affect agitation or excitement in cats; both sequences of propofol-midazolam administration are feasible, but the propofol-midazolam sequence was superior due to the lower propofol dose.

  14. 小儿氯胺酮麻醉术后复苏的护理研究%Nursing Care of Postoperative Recovery of Ketamine Anesthesia in Children

    Institute of Scientific and Technical Information of China (English)

    叶红艳

    2014-01-01

    Objective To investigate the nursing experience of children ketamine anesthesia recovery.Methods A total of 196 cases in anesthesia recovery ketamine anesthesia children take careful y ef ective protection Measures, such as strengthening the condition monitoring and safety management.Results 196 cases of children with ketamine anesthesia safety through anesthesia recovery, the effect is bet er.Conclusion For children with ketamine anesthesia and ef ective nursing is beneficial to the safety of anesthesia recovery.%目的探讨小儿氯胺酮麻醉复苏期的护理体会。方法对我院196例处于麻醉复苏期的氯胺酮麻醉患儿采取精心有效的护理措施,如加强病情监测和安全防范的管理。结果196例氯胺酮麻醉患儿安全度过麻醉复苏期,效果较好。结论对氯胺酮麻醉患儿采取精心有效的护理有利于安全度过麻醉复苏期。

  15. Effect of parecoxib sodium on propofol combined with fentanyl anesthesia effect and postoperative recovery in elderly patients with laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Jin-E Du

    2016-01-01

    Objective:To study the effect of parecoxib sodium on propofol combined with fentanyl anesthesia effect and postoperative recovery in elderly patients with laparoscopic surgery. Methods:A total of 80 cases of elderly patients who received laparoscopic surgery in our hospital from May 2013 to December 2015 were selected for study and randomly divided into observation group who received parecoxib sodium + propofol combined with fentanyl anesthesia and control group who received propofol combined with fentanyl anesthesia, and then pain threshold and serum indicators of two groups were compared.Results: 2 h, 4 h, 6 h, 8 h, 10 h and 12 h after surgery, pain threshold EI50 of observation group was significantly higher than that of control group; serum Glu, PS, histamine, 5-HT, MCP-1, CCR2, JAK2, STAT3, p38MAPK, PX1, Orexin, IRAK1, TRAF6 and FcγRI contents of observation group were significantly lower than those of control group; serum GABA andβ-EP contents of observation group were significantly higher than those of control group.Conclusion:Parecoxib sodium has inhibiting effect on the pain perception of propofol combined with fentanyl anesthesia for elderly patients with laparoscopic surgery and can reduce the synthesis of pain neurotransmitters, inflammatory factors and related molecules.

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

    Directory of Open Access Journals (Sweden)

    Dipalisingh

    2014-06-01

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

  17. Effect of sevoflurane versus propofol-based anesthesia on the hemodynamic response and recovery characteristics in patients undergoing microlaryngeal surgery

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    Neerja Bharti

    2012-01-01

    Full Text Available Background: This randomized study was conducted to compare the hemodynamic changes and emergence characteristics of sevoflurane versus propofol anesthesia for microlaryngeal surgery. Methods: Forty adult patients undergoing microlaryngoscopy were randomly allocated into two groups. In propofol group, anesthesia was induced with 2-3 mg/kg propofol and maintained with propofol infusion 50-200 μg/kg/h. In sevoflurane group induction was carried out with 5-8% sevoflurane and maintained with sevoflurane in nitrous oxide and oxygen. The propofol and sevoflurane concentrations were adjusted to maintain the bispectral index of 40-60. All patients received fentanyl 2 μg/kg before induction and succinylcholine 2 mg/kg to facilitate tracheal intubation. The hemodynamic changes during induction and suspension laryngoscopy were compared. In addition, the emergence time, time to extubation, and recovery were assessed. Results: The changes in heart rate were comparable. The mean arterial pressure was significantly lower after induction and higher at insertion of operating laryngoscope in propofol group as compared to sevoflurane group. More patients in propofol group had episodes of hypotension and hypertension than sevoflurane group. The emergence time, extubation times, and recovery time were similar in both groups. Conclusion: We found that sevoflurane showed advantage over propofol in respect of intraoperative cardiovascular stability without increasing recovery time.

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

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    Dana Tahririan

    2016-01-01

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

  19. Evaluation of latent period of temperature sensitivity in traditional and unilateral spinal anesthesia

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    Lakhin R.E.

    2015-09-01

    Full Text Available Objective: evaluation of the differences in the level of temperature, sensory and motor blockade during the various techniques of spinal anesthesia. Materials and Methods. Prospectively the randomized study included 70 patients. In the group with conventional spinal anesthesia (n=35 15mg of bupivacaine injected quickly. In the group with unilateral spinal anesthesia (n=35 7.5mg of bupivacaine administered slowly, at a rate of 1 ml per minute. We studied the level of temperature and time, sensory and motor blockade. The data are statistically processed. Results. Reduced thermal sensitivity recorded in an average of 48 seconds as a unilateral spinal anesthesia group and the control group. Subarachnoid administration of 7.5 mg of hyperbaric bupivacaine resulted in the development of a complete motor blockade underlying lower extremity in only 16 patients (45.7%. Conclusion. Using lower dosages of bupivacaine for unilateral spinal anesthesia lowers the threshold concentration of the local anesthetic in the subarachnoid space, resulting in slower motor neuron blockade and it is not total in more than 50% of cases.

  20. Hexavalent Americium Recovery Using Copper(III) Periodate

    Energy Technology Data Exchange (ETDEWEB)

    McCann, Kevin; Brigham, Derek M.; Morrison, Samuel; Braley, Jenifer C.

    2016-11-21

    Separation of americium from the lanthanides is considered one of the most difficult separation steps in closing the nuclear fuel cycle. One approach to this separation could involve oxidizing americium to the hexavalent state to form a linear dioxo cation while the lanthanides remain as trivalent ions. This work considers aqueous soluble Cu3+ periodate as an oxidant under molar nitric acid conditions to separate hexavalent Am with diamyl amylphosphonate (DAAP) in n-dodecane. Initial studies assessed the kinetics of Cu3+ periodate auto-reduction in acidic media to aid in development of the solvent extraction system. Following characterization of the Cu3+ periodate oxidant, solvent extraction studies optimized the recovery of Am from varied nitric acid media and in the presence of other fission product, or fission product surrogate, species. Short aqueous/organic contact times encouraged successful recovery of Am (distribution values as high as 2) from nitric acid media in the absence of redox active fission products. In the presence of a post-PUREX simulant aqueous feed, precipitation of tetravalent species (Ce, Ru, Zr) occurred and the distribution values of 241Am were suppressed, suggesting some oxidizing capacity of the Cu3+ periodate is significantly consumed by other redox active metals in the simulant. The manuscript demonstrates Cu3+ periodate as a potentially viable oxidant for Am oxidation and recovery and notes the consumption of oxidizing capacity observed in the presence of the post-PUREX simulant feed will need to be addressed for any approach seeking to oxidize Am for separations relevant to the nuclear fuel cycle.

  1. 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 < 0.05). In group L, the relationship between REE and BEE was weaker (r(2) = 0.501) and the BEE-REE slope was less steep (REE = 0.419BEE + 509.477) than those seen in group S (r(2) = 0.749 and REE = 1.113BEE - 376.111, respectively). Our findings suggest that a short period of fasting (<8 h) before surgery is more strongly associated with the conservation of basal metabolism.

  2. A pharmacodynamic analysis of factors affecting recovery from anesthesia with propofol-remifentanil target controlled infusion

    Institute of Scientific and Technical Information of China (English)

    Bon-nyeo KOO; Jeong-rim LEE; Gyu-jeong NOH; Jae-hoon LEE; Young-ran KANG; Dong-woo HAN

    2012-01-01

    Aim:To examine individual patient's demographic parameters and clinical variables related to return of consciousness (ROC) and the pharmacodynamic relationship between propofol effect-site concentration (Ce) and ROC from propofol-remifentanil anesthesia.Methods:Ninety-four patients received propofol-remifentanil anesthesia using the effect-site target-controlled infusion (TCI) system.All clinical events were noted,and variables possibly related to propofol Ce at ROC were examined using linear correlation analyses.Pharmacodynamic modeling incorporating covariates was performed using NONMEM (Nonlinear Mixed Effects Modeling) Ⅶ software.Results:The Ce values of propofol at loss of consciousness (LOC) and ROC were 4.4±1.1 μg/mL and 1.1±0.3 μg/mL respectively.Age was negatively correlated with propofol Ce at ROC (r=-0.48,P<0.01).Including age as a covariate in Ce50 (the effect-site concentration associated with 50% probability of return of consciousness) and λ (the steepness of the concentration-versus-response relationship) significantly improved the performance of the basic model based on the likelihood ratio test,with a significant decrease in the minimum value of the objective function.The Ce50 in 25-,50-,and 75-year-old patients was predicted to be 1.38,1.06,and 0.74 Iμg/mL,respectively.The λ,in 25-,50-,and 75-year-old patients was predicted to be 12.23,8.70,and 5.18,respectively.Conclusion:Age significantly affects the relationship between propofol Ce and ROC,and pharmacodynamic modeling including age could lead to better predictions of ROC during emergence from propofol-remifentanil anesthesia.

  3. Quality of Recovery after Anesthesia: Validation of the Portuguese Version of the 'Quality of Recovery 15' Questionnaire.

    Science.gov (United States)

    Sá, Ana Carolina; Sousa, Gabriela; Santos, Alice; Santos, Cristina; Abelha, Fernando José

    2015-01-01

    Introdução: O questionário "Quality of Recovery 15" tem sido utilizado para o estudo da qualidade de recuperação após anestesia. O objetivo deste estudo foi validar a versão Portuguesa do questionário "Quality of Recovery 15". Material e Métodos: Após aprovação pela Comissão de ética institucional, foi realizado um estudo de coorte prospectivo em doentes submetidos a cirurgia eletiva de junho a agosto de 2013. A versão portuguesa do "Quality of Recovery 15" foi aplicada antes da cirurgia (T0) e 24 h após a cirurgia (T1) em 170 doentes. Os doentes incapazes de dar consentimento informado ou com comprometimento cognitivo foram excluídos. Má qualidade de recuperação foi definida para pontuações de "Quality of Recovery 15" em T1 inferiores à média das pontuações de "Quality of Recovery 15" menos 1 desvio padrão. Confiabilidade e discordãncia entre observadores foram avaliadas por meio da correlação intraclasse. Testes não-paramétricos foram utilizados para comparações. Resultados: Observou-se uma correlação negativa entre pontuações de "Quality of Recovery 15" e tempo de internamento na Unidade Pós-Anestésica (p = -0,264, p = 0,004) e tempo de internamento hospitalar (p = -0,274, p = 0,004). Trinta e dois doentes (19%) tiveram má qualidade de recuperação. Os doentes com má qualidade de recuperação tinham mais frequentemente diabetes mellitus e hipertensão arterial e estavam medicados com antidepressivos com mais frequência. Os doentes com má qualidade de recuperação foram mais frequentemente submetidos a anestesia combinada e menos frequente a anestesia geral e locorregional (p = 0,008). O questionário teve boa consistência interna; a confiabilidade do teste-reteste foi boa. Discussão: A versão portuguesa do "Quality of Recovery 15" mostrou boa correlação com a versão original. Conclusão: Este questionário parece ser uma avaliação precisa e confiável para a qualidade de recuperação.

  4. 七氟醚复合不同浓度氧化亚氮全凭吸入麻醉对小儿苏醒期的影响%Effect of sevoflurane with different concentrations of nitrous oxide inhalation anes-thesia on the recovery period of children

    Institute of Scientific and Technical Information of China (English)

    赵越; 陈宏志; 白璐; 从雪

    2015-01-01

    Objective To compare the effects of sevoflurane combined with different concentrations of nitrous oxide on emergence agitation after anesthesia. Methods Forty-five ASA Ⅰ children underwent cleft lip repair surgery were randomly divided into group S,group N1 and group N2 with 15 cases in each group. Children were respectively given sevoflurane combined with pure oxygen ( group S ) , sevoflurane combined with nitrous oxide ( 50%) ( group N1),sevoflurane combined with nitrous oxide (66%) (group N2) induction and maintenance. After operation,the children did not receive the pure oxygen (group S),50% nitrous oxide in oxygen (group N1),66% nitrous oxide in oxygen (group N2) till 2 min after sevoflurane inhalation stopped. The time from the beginning of drug injection to the loss of eyelash reflex and the intubation time were recorded. The HR,MAP,SpO2 ,BIS value,MAC value were recor-ded before operation,at the time points of intubation,extubation and 5 min after extubation. The degree of agitation was evaluated to record the score. The PAED score was used to evaluate the agitation of children in PACU. The periopera-tive adverse reactions were observed. Results The time from the beginning of drug injection to the loss of eyelash re-flex and the intubation time in group N2 were less than those of group S and group N1 ( P <0.05 ) . The immediate postoperation agitation score and the PAED score of children in PACU in group N2 were less than those of the other groups ( P <0.05 ) . Conclusion Compared with sevoflurane and sevoflurane combined with 50% nitrous oxide, sevofluranecombined with 66% nitrous oxide can shorten the intubation time,effectively reduce the degree of agitation more significantly,and it is safe for anesthesia of children.%目的 比较七氟醚复合不同浓度氧化亚氮对麻醉苏醒期躁动的影响. 方法 将择期行全麻下唇裂修补术的45例患儿随机分为S组、N1组、N2组,每组15 例,ASA分级Ⅰ级. 分

  5. Paravertebral blocks provide superior same-day recovery over general anesthesia for patients undergoing inguinal hernia repair.

    Science.gov (United States)

    Hadzic, Admir; Kerimoglu, Beklen; Loreio, Dan; Karaca, Pelin Emine; Claudio, Richard E; Yufa, Marina; Wedderburn, Ray; Santos, Alan C; Thys, Daniel M

    2006-04-01

    Inguinal herniorrhaphy is commonly performed on an outpatient basis under nerve blocks or local or general anesthesia (GA). Our hypothesis is that use of paravertebral blocks (PVB) as the sole anesthetic technique will result in shorter time to achieve home readiness and improved same-day recovery over a 'fast-track' GA. Fifty patients were randomly assigned to receive either PVB or GA under standardized protocols (PVB = 0.75% ropivacaine, followed by propofol sedation; GA = dolasetron 12.5 mg, propofol induction, rocuronium, endotracheal intubation; desflurane; bupivacaine 0.25% for field block). Eligibility for postanesthetic care unit (PACU) bypass and data on time-to-postoperative pain, ambulation, home readiness, and incidence of adverse events were collected. More patients in the PVB group (71%) met the criteria to bypass the postanesthetic care unit compared with patients in the GA group (8%; P local anesthetic (P = 0.005). Patients in the PVB group were able to ambulate earlier (102 +/- 55 minutes) than those in the GA group (213 +/- 108 minutes; P inguinal herniorrhaphy, PVB resulted in faster time to home readiness and was associated with fewer adverse events and better analgesia before discharge than GA.

  6. Psychogenic non-epileptic seizures in the post-anesthesia recovery unit

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    Juan A. Ramos

    2016-08-01

    Full Text Available Abstract Introduction: Psychogenic non-epileptic seizures (PNES or “pseudoseizures” remain an obscure topic in the peri-operative setting. They are sudden and time-limited motor and cognitive disturbances, which mimic epileptic seizures, but are psychogenically mediated. Pseudoseizures occur more frequently than epilepsy in the peri-operative setting. Early diagnosis and management may prevent iatrogenic injury. Case: 48 year-old female with a history of depression and “seizures” presented for gynecologic surgery. She described her seizure history as “controlled” without anticonvulsant therapy. The patient underwent uneventful general anesthesia and recovered neurologically intact. During the first two postoperative hours, the patient experienced 3 episodes of seizure-like activity with generalized shaking of extremities and pelvic thrusting; her eyes were firmly closed. No tongue biting or incontinence was noted. The episodes lasted approximately 3 min each, one of which resolved spontaneously and the other two following intravenous lorazepam. During these episodes, the patient had stable hemodynamics and adequate ventilation such that endotracheal intubation was deemed unwarranted. Post-ictally, the patient was neurologically intact. Computed axial tomography of the head, metabolic assay, and electroencephalogram showed no abnormalities. A presumptive diagnosis of PNES was made. Discussion: Psychogenic non-epileptic seizures mimic shivering, and should be considered early in the differential diagnosis of postoperative shaking, as they may be more likely than epilepsy in this setting. Pseudoseizure patterns include asynchronous convulsive episodes lasting more than 90 s, forced eye closure with resistance to opening, and retained pupillary responses. Autonomic manifestations such as tachycardia, cyanosis and incontinence are usually absent. A psychiatric background is common. Knowledge and correct diagnosis of pseudoseizures is of

  7. A comparison of desflurane and sevoflurane in the recovery of cognitive function after general anesthesia in elderly patients

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    Pandurang Kondiba Jadhav

    2015-11-01

    Full Text Available Background: The postoperative cognitive dysfunction (POCD or psychomotor function disorder is known to be associated with the anesthetic agents, as well as the physiological changes resulting from the anesthesia. The known risk factors are old age, preexisting cerebral cardiac or vascular disease, alcohol abuse, intra and post-operative complications. Methods: 50 patients above 65 years of age falling into ASA Grade 1, 2, or 3 were catagrzed into 2 groups, one (Group A wherein sevoflurane was given as the anesthetic agent and the other (Group B where desflurane was administered. All had undergone physical and regular blood examination. MMSE score was taken for all patients for cognitive recognition before surgery and 1, 3, and 6 hours after surgery. Results: Of the 50 patients, the MMSE score was above 27 for all before surgery, while, post-surgery it was below 27 after I hour in 100% of the cases. After 3 hours, in Group A, the mean MMSE was above 27 while it was still below 27 in Group B while it was above 27 in both the Groups after 6 hours post-surgery. There was only 1 cases of POCD after 6 hours in Group A and none in Group B. The recovery time was faster in Group B as compared to Group A. Conclusions: Desflurane was marginally a better anesthetic agent in terms or recovery to sevoflurane and sevoflurane was slightly better than the former when it came to cognitive recognition Therefore, we conclude that both the drugs are equally good anesthetic agents. [Int J Res Med Sci 2015; 3(11.000: 3278-3282

  8. Evaluation of cardiopulmonary parameters and recovery from anesthesia in cougars (Puma concolor anesthetized with detomidine/ketamine and isoflurane or sevoflurane

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    Verônica B. Albuquerque

    2016-01-01

    Full Text Available Abstract: The aim of this study was to assess the cardiopulmonary effects, the onset time after the administration of a detomidine/ketamine combination, and the recovery from anesthesia of cougars (Puma concolor anesthetized with detomidine/ketamine and isoflurane or sevoflurane for abdominal ultrasound imaging. Fourteen animals were randomly allocated into two experimental groups: GISO (n=7 and GSEVO (n=7. Chemical restraint was performed using 0.15mg/kg detomidine combined with 5mg/kg ketamine intramuscularly; anesthesia induction was achieved using 2mg/kg propofol intravenously and maintenance with isoflurane (GISO or sevoflurane (GSEVO. The following parameters were assessed: heart rate, respiratory rate, systolic and diastolic arterial blood pressure, mean arterial blood pressure, oxyhemoglobin saturation, rectal temperature, central venous pressure, and end-tidal carbon dioxide. The time to sternal recumbency (TSR and time to standing position (TSP were also determined. There was not statistically significant difference for the cardiopulmonary variables or TSP whereas TSR was significantly shorter in GSEVO. The time to onset of anesthesia was 11.1±1.2 minutes and 11.3±1.8 minutes for GISO and GSEVO, respectively. The anesthesia of cougars with detomidine/ketamine and isoflurane or sevoflurane was conducted with safety, cardiopulmonary stability, and increased time to sternal recumbency in the GISO group.

  9. Comparison of the efficacy of dexmedetomidine and esmolol in the treatment of increased hemodynamic response during the recovery period

    Directory of Open Access Journals (Sweden)

    Ayşe Neslihan Bebek

    2012-03-01

    Full Text Available Objectives: Our aim was to compare effectiveness of esmololand dexmedetomidine in the treatment of increasedhemodynamic response during anesthesia recovery period.Materials and methods: 60 ASA I-II patients whomscheduled for elective surgery with endotracheal intubationwere randomized before extubation according to theirhemodynamic parameters that were increased 20% oftheir baseline values in order to receive 1mg/kg esmolol(Group Esmolol, n= 30 or 0.5 μg/kg dexmedetomidine(Group Dexmedetomidine, n= 30. Heart rate (HR, systolicand diastolic blood pressures (SBP,DBP, peripheral oxygensaturation (SpO2, end tidal carbon dioxide (ETCO2values, extubation time, recovery time were recorded. Theduration till having pain requiring analgesic was recordedand cognitive functions were evaluated with short memoryorientation concentration test at 20th and 50th minutes.Results: After drug, HR reductions were significant at allperiods in group Dexmedetomidine (Z2-Z10: p<0.001,Z11:p=0.001, Z12, p=0.006. In group DexmedetomidineSBP value was high at 3rd min after drug (p<0.001, andSBP values were lower in all periods before and after extubation(Z6- Z10: p<0.001, Z11: p=0.02, Z12: p=0.04.In group Dexmedetomidine DBP value was higher at 1stmin after drug (p=0.001, DBP values were lower at 10thmin after drug and before extubation (p= 0.045, p=0.001.The duration of pain requiring analgesic and recoveryperiod were longer in dexmedetomidine group (p<0.001,p<0.001.Conclusions: Although esmolol and dexmedetotimidineattenuated hemodynamic response during recovery period,dexmedetotimidine was more effective in hemodynamicstabilization and the duration of pain requiring analgesicwas longer. Esmolol provided faster recovery time. JClin Exp Invest 2012; 3(1: 53-60

  10. Brain Networks Maintain a Scale-Free Organization across Consciousness, Anesthesia, and Recovery: Evidence for Adaptive Reconfiguration

    Science.gov (United States)

    Lee, UnCheol; Oh, GabJin; Kim, Seunghwan; Noh, GyuJung; Choi, ByungMoon

    2010-01-01

    Background Loss of consciousness is an essential feature of general anesthesia. Although alterations of neural networks during anesthesia have been identified in the spatial domain, there has been relatively little study of temporal organization. Methods Ten normal male volunteers were anesthetized with an induction dose of propofol on two separate occasions. The duration of network connections in the brain was analyzed by multichannel electroencephalography and the minimum spanning tree method. Entropy of the connections was calculated based on Shannon entropy. The global temporal configuration of networks was investigated by constructing the cumulative distribution function of connection times in different frequency bands and different states of consciousness. Results General anesthesia was associated with a significant reduction in the number of network connections, as well as significant alterations of their duration. These changes were most prominent in the delta bandwidth and were also associated with a significant reduction in entropy of the connection matrix. Despite these and other changes, a global “scale-free” organization was consistently preserved across multiple subjects, multiple anesthetic exposures, multiple states of consciousness and multiple frequencies of the electroencephalogram. Conclusions Our data suggest a fundamental principle of temporal organization of network connectivity that is maintained during both consciousness and anesthesia, despite local changes. These findings are consistent with a process of adaptive reconfiguration during general anesthesia. PMID:20881595

  11. Transient Neurological Symptoms after Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Zehra Hatipoglu

    2013-02-01

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

  12. Regional anesthesia techniques for ambulatory orthopedic surgery.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2012-02-03

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

  13. [The importance of communication during the postoperative recovery period].

    Science.gov (United States)

    Razera, Ana Paula Ribeiro; Braga, Eliana Mara

    2011-06-01

    The objective of this study was to learn about the importance of communication when the nursing team gives postoperative orientations to patients and/or relatives at a private institution, and learn their perception about those orientations. This cross-sectional, descriptive study was performed using a qualitative approach, having Interpersonal Communication and Content Analysis as the theoretical and methodological frameworks, respectively. Participants were 16 patients interviewed in the postoperative period. Results showed that the nursing team focused the orientations on the instrumental techniques of the professions and did not approach the individuals in a holistic manner. It was also observed that when the nurse stands away from the patient and/or does not provide appropriate information, it generates feelings of anxiety, fear, insecurity and a sensation of lack of care in the patients. On the other hand, when the nursing team is present and provides coherent information, patients reported high satisfaction and a feeling of being well cared for.

  14. [The perioperative period in cancer surgery: a critical moment! Is there a role for regional anesthesia in preventing cancer recurrence?].

    Science.gov (United States)

    Beloeil, H; Nouette-Gaulain, K

    2012-06-01

    Surgical treatment of cancer is usually necessary but it can paradoxically aggravate the patient outcome by increasing the risk of recurrence. Many perioperative factors have been shown to contribute to the dissemination of the tumor: surgery itself, stress, inflammation, pain, anaesthetic drugs, blood transfusion, etc. The type of anaesthesia chosen in the cancer patient could then be crucial and influence the evolution of the disease. Experimental, preclinical and retrospective studies have suggested that a regional anesthesia associated or not with a general anesthesia for carcinologic surgery might reduce the risk of cancer recurrence. This text reviews the factors promoting the recurrence of tumors after carcinologic surgery and the potential possibilities of protection associated with the type of anaesthesia chosen.

  15. CT findings suggesting anastomotic leak and predicting the recovery period following gastric surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Ho; Kim, Jung Hoon; Shin, Cheong-Il; Kim, Se Hyung; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology, Institute of Radiation Medicine, Jongno-gu, Seoul (Korea, Republic of)

    2015-07-15

    To assess diagnostic performance of routine CT for detecting anastomotic leak after gastric surgery, and analyse the relationship between recovery period and CT findings. We included 179 patients who underwent immediate CT and fluoroscopy after gastric surgery. Two reviewers retrospectively rated the possibility of leak on CT using a five-point scale focused on predefined CT findings. They also evaluated CT findings. Patients were categorised as: Group I, leak on fluoroscopy; Group II, possible leak on CT but negative on fluoroscopy; Group III, no leak. We analysed the relationship between recovery period and group. Area under the curve for detecting leak on CT was 0.886 in R1 and 0.668 in R2 with moderate agreement (k = 0.482). Statistically common CT findings for leak included discontinuity, large amount of air-fluid and wall thickening at anastomosis site (p < 0.05). Discontinuity at anastomosis site and a large air-fluid collection were independently associated with leak (p < 0.05). The recovery period including hospitalisation and postoperative fasting period was longer in Group I than Group II or III (p < 0.05). Group II showed a longer recovery period than Group III (p < 0.05). Postoperative routine CT was useful for predicting anastomotic leak using specific findings, and for predicting length of recovery period. (orig.)

  16. Design and scheduling for periodic concurrent error detection and recovery in processor arrays

    Science.gov (United States)

    Wang, Yi-Min; Chung, Pi-Yu; Fuchs, W. Kent

    1992-01-01

    Periodic application of time-redundant error checking provides the trade-off between error detection latency and performance degradation. The goal is to achieve high error coverage while satisfying performance requirements. We derive the optimal scheduling of checking patterns in order to uniformly distribute the available checking capability and maximize the error coverage. Synchronous buffering designs using data forwarding and dynamic reconfiguration are described. Efficient single-cycle diagnosis is implemented by error pattern analysis and direct-mapped recovery cache. A rollback recovery scheme using start-up control for local recovery is also presented.

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

    Science.gov (United States)

    Motsch, J; Must, W; Hutschenreuter, K

    1988-09-01

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

  18. Effects of preoperative anxiety on early postoperative pain and anesthesia recovery in total knee arthroplasty%全膝关节置换术前焦虑对术后疼痛及麻醉恢复的影响

    Institute of Scientific and Technical Information of China (English)

    李林涛; 符培亮; 袁帅; 周义钦; 吴宇黎; 吴海山

    2015-01-01

    目的:探讨初次全膝关节置换术( TKA)患者术前焦虑状态对术后镇痛效果及麻醉恢复情况的影响。方法纳入长征医院骨科2012年9月至2013年9月间84例行TKA手术的住院患者进行前瞻性队列研究,通过术前贝克焦虑量表( BAI )将患者分为高焦虑组( A组)和低焦虑组( B组)。对比两组的一般资料、手术时间、麻醉时间、拔管时间及麻醉后副反应,分别于术后1、2、4、8、12、24 h进行视觉模拟量表( VAS)评分并记录12、24 h的曲马多用量。结果共有38(45.24%)的患者术前处于高焦虑状态,两组间的一般资料、手术及麻醉时间没有统计学差异,但B组拔管时间、麻醉后副反应少于A组,术后2、4、8、12 h的VAS评分低于A组,术后曲马多用量少于A组,结果有统计学意义( P<0.05)。结论 TKA患者术后疼痛程度与术前焦虑情绪有关。高焦虑状态会影响麻醉恢复及镇痛效果,增加药物用量。%Objective To evaluate the impacts of preoperative anxiety on postoperative pain and recovery from anesthesia in the patients undergoing total knee arthroplasty (TKA).Methods A total of 84 patients with osteoarthritis who underwent unilateral TKA between September 2012 and September 2013 were separated into two groups according to Beck′s anxiety inventory ( BAI):the patients with anxiety were enrolled in the high-anxious patient group (group A) and the patients without anxiety were enrolled in the low-anxious group ( group B ) .During the perioperative period , all the patients received patient-controlled analgesia (PCA) for 24h postoperatively.General information, duration of surgery, duration of anesthesia, extubation time, adverse effects, drug dosage for 12 and 24h, and Visual analog score ( VAS) were assessed and compared between the two groups .Results Among all the patients, 38 patients (45.24%) had preoperative anxiety according to the

  19. Analysis of deaths related to anesthesia in the period 1996-2004 from closed claims registered by the Danish Patient Insurance Association

    DEFF Research Database (Denmark)

    Hove, Lars Dahlgaard; Steinmetz, Jacob; Christoffersen, Jens Krogh

    2007-01-01

    Anesthesia is associated with complications, and some of them may be fatal. The authors investigated the circumstances under which deaths were associated with anesthesia. In Denmark, the specialty anesthesiology encompasses emergency medicine, chronic and acute pain medicine, anesthetic procedure...

  20. Anesthesia for a Patient with Myotonic Dystrophy

    Directory of Open Access Journals (Sweden)

    Dilek Kalaycı

    2016-09-01

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

  1. Comparison of the variability of the onset and recovery from neuromuscular blockade with cisatracurium versus rocuronium in elderly patients under total intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    Feng Xiaobo

    2012-07-01

    Full Text Available This study was designed to compare the variability of the onset and offset of the effect of two neuromuscular blocking drugs with different elimination pathways in adult and elderly patients during total intravenous anesthesia (TIVA. After Ethics Committee approval and patients’ informed consent, the drugs were compared in 40 adult and 40 elderly patients scheduled for elective surgery under TIVA with tracheal intubation who were randomized to receive a single bolus dose of 0.15 mg/kg cisatracurium or 0.9 mg/kg rocuronium. The time of onset of maximum depression, duration of action, and recovery index time were measured and recorded for each patient and variability is reported as means ± standard deviation. Time of onset was significantly shorter for rocuronium than cisatracurium for the adult and elderly groups (P = 0.000, but the variability of cisatracurium was significantly greater compared with rocuronium for the same age groups (93.25 vs 37.01 s in the adult group and 64.56 vs 33.75 s in the elderly group; P = 0.000. The duration of the effect in the elderly group receiving rocuronium was significantly longer than in the elderly group receiving cisatracurium, and the variability of the duration was significantly greater in the rocuronium group than in the cisatracurium group. Mean time of recovery was significantly longer for the elderly group receiving rocuronium than for the elderly group receiving cisatracurium (P = 0.022, and variability was also greater (P = 0.002. Both drugs favored good intubating conditions. In conclusion, cisatracurium showed less variability in these parameters than rocuronium, especially in the elderly, a fact that may be of particular clinical interest.

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

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    Nancheva Jasminka

    2016-07-01

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

  3. Sensitive periods for language and recovery from stroke: conceptual and practical parallels.

    Science.gov (United States)

    Zevin, Jason D; Datta, Hia; Skipper, Jeremy I

    2012-04-01

    In this review, we consider the literature on sensitive periods for language acquisition from the perspective of the stroke recovery literature treated in this Special Issue. Conceptually, the two areas of study are linked in a number of ways. For example, the fact that learning itself can set the stage for future failures to learn (in second language learning) or to remediate (as described in constraint therapy) is an important insight in both areas, as is the increasing awareness that limits on learning can be overcome by creating the appropriate environmental context. Similar practical issues, such as distinguishing native-like language acquisition or recovery of function from compensatory mechanisms, arise in both areas as well.

  4. Recovery of partial differential operators on classes of periodic functions with mixed smoothness

    Science.gov (United States)

    Balgimbayeva, Sholpan

    2016-08-01

    We consider the problem of optimal linear recovery for mixed partial differential operator A on the unit ball SBpθ r(Tn) of the Nikol'skii-Besov space of periodic functions with mixed smoothness. We find error bounds sharp in order for optimal linear recovery of operator A on class SBpθ r(Tn) . As information IMδ(f ) about the functions f from class SBpθ r(Tn) we shall use Fourier coefficients with numbers from step "hyperbolic" cross. As the linear method using the information about Fourier coefficients, we shall consider action of the mixed partial differential operator A on the special "private" sum of decomposition on system (type as wavelets) trigonometric polynomials.

  5. Effect of mild hypothermia on recovery from cisatracurium blockade during recovery from anesthesia%浅低温对麻醉恢复期患者顺式阿曲库铵肌松恢复的影响

    Institute of Scientific and Technical Information of China (English)

    周一; 张欢; 杨拔贤

    2014-01-01

    Objective To evaluate the effect of mild hypothermia on the recovery from cisatracurium blockade during the recovery from anesthesia in patients .Methods Thirty ASA physical status Ⅰ or Ⅱ patients , aged 18-64 yr , with body mass index 18-25 kg/m2 , scheduled for elective abdominal surgery under general anesthesia ,were enrolled in the study .The patients were divided into 2 groups according to the body temperature recorded when cisatracurium infusion was stopped at the end of surgery .The body temperature 36.0-36.9 ℃served as normothermia group (group N , n=14 ) and 34.0-35.9 ℃ served as mild hypothermia group (group H , n= 16 ) . The body temperature was measured by a thermocouple placed in the nasopharynx . Neuromuscular function was monitored by measuring the evoked mechanical response of the adductor pollicis muscle to supramaximal train-of-four (TOF) stimulation (frequency 2 Hz ,wave length 0.2 ms ,intensity 50 mA ,interval 15 s) of the ulnar nerve at the wrist using TOF-Watch SX® .Cisatracurium was intravenously infused at 1-3μg·kg-1 ·min-1 during surgery to maintain neuromuscular block with 1% recovery index (time for T1 to recover from 25% to 75% ) ,time for T1 to recover from 10% to 75% ,and time for T1 to recover from 10% to T4/T1 ratio of 0.9 were recorded . Results Compared with group N ,the recovery index ,time for T1 to recover from 10% to 75% ,and time for T1 to recover from 10% to T4/T1 ratio of 0.9 were significantly prolonged in group H ( P<0.05) .Conclusion Mild hypothermia can inhibit the recovery from cisatracurium blockade during the recovery from anesthesia in patients .%目的:评价浅低温对麻醉恢复期患者顺式阿曲库铵肌松恢复的影响。方法择期全麻下行开腹手术患者30例,性别不限,年龄18~64岁,体重指数18~25 kg/m2,ASA分级Ⅰ或Ⅱ级。根据术毕停止输注顺式阿曲

  6. Effects of intravenous anesthesia maintained by etomidate on recovery quality in breast cancer patients undergoing radical mastectomy%依托咪酯静脉维持麻醉对乳腺癌手术患者术后苏醒质量的影响

    Institute of Scientific and Technical Information of China (English)

    何欣; 赵洪伟; 李锦成

    2016-01-01

    Objective To evaluate the effects of etomidate used for maintenance of intravenous anesthesia on recovery quality in breast can-cer patients undergoing radical mastectomy. Methods Sixty breast cancer patients scheduled to receive radical mastectomy were randomly divi-ded into treatment group and control group, 30 patients in each group.Anesthesia was maintained by continuous infusion of etomidate 10-15 μg・ kg -1・ min-1 in treatment group, or propofol 6 -8 mg・ kg-1・ h-1 in control group.In two groups, open eyes time, extuba-tion time and orientation recovery time were observed.The hemodynamics indexes during extubation period and adverse drug reactions such as nau-sea, vomiting were also recorded.Results There were no statistical differences about open eyes time and extubation time in all patients of the two groups ( P >0.05 ) .During extubation period of anesthesia, treat-ment group could keep relatively stable hemodynamics, but the diffe-rences had no statistically significant between two groups.In treatment group, the incidence of nausea and vomiting was significantly higher than that of control group ( P<0.05).Conclusion In radical mastectomy of breast cancer patients, application of etomidate combined with remifen-tanil for anesthesia maintenance has shorter extubation time, hemodyna-mic stability and satisfactory recovery quality from intravenous anesthesia.It proves that intravenous anesthesia maintained by etomidate in short-time surgery is safe and feasible.%目的:观察依托咪酯用于乳腺癌手术患者的静脉麻醉维持对患者术后苏醒质量的影响。方法将60例拟在全身麻醉下进行乳腺癌根治术的患者随机分为试验组30例和对照组30例。试验组术中麻醉维持为持续静脉输注依托咪酯10~15μg・ kg-1・ min-1;对照组术中持续输注丙泊酚6~8 mg・ kg-1・ h-1。记录2组患者睁眼时间、拔管时间、定向力恢复时间,观察患者拔管期血流动力学变

  7. Aerobic Interval Exercise Training Induces Greater Reduction in Cardiac Workload in the Recovery Period in Rats

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Juliana Pereira, E-mail: julipborges@gmail.com; Masson, Gustavo Santos; Tibiriçá, Eduardo; Lessa, Marcos Adriano [Instituto Oswaldo Cruz - FIOCRUZ, Rio de Janeiro, RJ (Brazil)

    2014-01-15

    Aerobic interval exercise training has greater benefits on cardiovascular function as compared with aerobic continuous exercise training. The present study aimed at analyzing the effects of both exercise modalities on acute and subacute hemodynamic responses of healthy rats. Thirty male rats were randomly assigned into three groups as follows: continuous exercise (CE, n = 10); interval exercise (IE, n = 10); and control (C, n = 10). Both IE and CE groups performed a 30-minute exercise session. The IE group session consisted of three successive 4-minute periods at 60% of maximal velocity (Max Vel), with 4-minute recovery intervals at 40% of Max Vel. The CE group ran continuously at 50% of Max Vel. Heart rate (HR), blood pressure(BP), and rate pressure product (RPP) were measured before, during and after the exercise session. The CE and IE groups showed an increase in systolic BP and RPP during exercise as compared with the baseline values. After the end of exercise, the CE group showed a lower response of systolic BP and RPP as compared with the baseline values, while the IE group showed lower systolic BP and mean BP values. However, only the IE group had a lower response of HR and RPP during recovery. In healthy rats, one interval exercise session, as compared with continuous exercise, induced similar hemodynamic responses during exercise. However, during recovery, the interval exercise caused greater reductions in cardiac workload than the continuous exercise.

  8. [Regional anesthesia and cancer immunology].

    Science.gov (United States)

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

    2013-09-01

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

  9. HORMONAL RESPONSES IN HEAVY TRAINING AND RECOVERY PERIODS IN AN ELITE MALE WEIGHTLIFTER

    Directory of Open Access Journals (Sweden)

    Ching-Lin Wu

    2008-12-01

    Full Text Available The endocrine system has been suggested as a useful indicator for training stress (Kraemer and Ratamess, 2005. An equilibrium between anabolic and catabolic states in athletes is often represented by testosterone-to-cortisol ratio (TCR. Changes in TCR have been positively related to weight training performance (Hakkinen, et al., 1987. The decreased TCR has been used as an indicator for overtraining (Roberts, et al., 1993, Vervoorn, et al., 1991 and insufficient recovery (Passelergue and Lac, 1999. Elite weightlifters undergo year-round training with various overreaching and recovery periods. Previous investigations have not established the detailed time course of the hormonal responses in these periods mostly due to insufficient sampling frequencies.We investigated the changes in serum levels of total and free testosterone and cortisol, free testosterone-to-free cortisol ratio (FTFCR, insulin-like growth factor-1 (IGF-1, and free triiodothyronine (FT3 and thyroxine (FT4 every 2 weeks for 21 weeks in an elite male weightlifter. This study was performed from August, 2003 to January, 2004, including the preparation, taper, and recovery periods for the World Championship in November, 2003.The 27-year-old male weightlifter holds the national records of Taiwan (Chinese Taipei in 56 and 62 kg categories. The subject had ranked top 5 in the world for several years prior to this study and ranked first in the world in 2005 in 56 kg category. His height was 1.58 m and body weight ranged from 55.8 to 59.6 kg during the 21-week study period. The subject has no history of using anabolic steroid or other banned substances. Venous blood samples were collected after overnight fast every 2 weeks between 7 and 8 am. The first blood sample after the World Championship was collected in week 15. Serum concentrations of total and free testosterone and cortisol were measured with enzyme immunoassay and IGF-1 were measured with enzyme-linked immunosorbent assay kits

  10. Is Period3 Genotype Associated With Sleep and Recovery in Patients With Disorders of Consciousness?

    Science.gov (United States)

    Bedini, Gloria; Bersano, Anna; Sebastiano, Davide Rossi; Sattin, Davide; Ciaraffa, Francesca; Tosetti, Valentina; Brenna, Greta; Franceschetti, Silvana; Ciusani, Emilio; Leonardi, Matilde; Vela-Gomez, Jesus; Boncoraglio, Giorgio B; Parati, Eugenio A

    2016-06-01

    Background Sleep evaluation is increasingly being used as prognostic tool in patients with disorders of consciousness, but, surprisingly, the role of Period3 (Per3) gene polymorphism has never been evaluated. Objective The aim of this study was to investigate the contribution of Per3 genotype on sleep quantity and consciousness recovery level in patients with disorders of consciousness (DOC). Methods In this observational study, we evaluated 71 patients with DOC classified as vegetative state/unresponsive wakefulness syndrome or minimally conscious state. Demographic and clinical data were collected and a standardised diagnostic workup, including a polysomnographic record, was applied. After informed consent provided by proxy, genomic DNA was obtained and Per3 polymorphism was analysed by polymerase chain reaction to identify 5/5, 4/5, or 4/4 genotype. Results Per3(5/5) genotype was found in 12.7% of our DOC patients. The median total Coma Recovery Scale-revised score in Per3(5/5) carriers was significantly higher than 4/4 genotype (10, range 5-16 vs 7, range 4-11; post hoc P = .036). Moreover, total sleep time seemed to be higher in 5/5 genotype (5/5, 221 minutes, range 88-515 minutes; 4/4, 151.5 minutes, range 36-477 minutes; and 4/5, 188 minutes, range 44-422 minutes). Conclusion For the first time we have shown a possible association between Per3 polymorphism and consciousness recovery level in DOC patients. Even though the exact molecular mechanism has not been defined, we speculate that its effect is mediated by higher total sleep time and slow wave sleep, which would improve the preservation of main cerebral connections.

  11. Effects of Varying Recovery Periods on Muscle Enzymes, Soreness, and Performance in Baseball Pitchers

    Science.gov (United States)

    Potteiger, Jeffrey A.; Blessing, Daniel L.; Wilson, G. Dennis

    1992-01-01

    In this study we examined the effects of varied recovery time on serum creatine kinase (CK), serum lactate dehydrogenase (LDH), muscle soreness, and pitch velocity in baseball pitchers. Ten males who had pitching experience participated in the study. After an 18-day training period, subjects pitched three simulated games. Game A and Game B were separated by four days of rest, while Game B and Game C were separated by two days of rest. CK, LDH, and muscle soreness were evaluated at the following times: before and immediately after exercise, and six, 24, 48, and 72 hours after exercise. Muscle performance was evaluated by measuring pitch velocity during the games. The CK level was elevated after each game (Game A - 249 U/l; Game B - 243 U/l; and Game C - 240 U/l); then it dropped toward baseline (p≤0.01). CK post-exercise values were not different among games A, B, and C. LDH displayed a response similar to CK; however, there was a reduction over the span of the games (p≤0.05). Muscle soreness was significantly elevated immediately after exercise (p≤0.01) compared to all other measurement times. Pitch velocity was not different among games A, B, and C. Results indicate that muscle damage, as evidenced by CK release, occurs in response to baseball pitching. However CK values, muscle soreness, and pitch velocity are not significantly affected by changes in the amount of recovery time typically scheduled between games. PMID:16558126

  12. Postoperative Complications and Related Risk Factors in Neurosurgery Patients during Anesthesia Recovery%神经外科患者麻醉恢复期常见并发症及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王云霞; 王会文; 侯春梅; 彭宇明; 菅敏钰; 张雪梅; 房辉; 韩如泉

    2016-01-01

    Objective To investigate the characteristics of postoperative complications and related risk factors in neurosurgery patients. Methods A retrospective study was carried out in neurosurgery patients during anesthesia recovery period from March, 2009 to November, 2013. The recorded complications included respiratory and circulatory system complications, pain, shivering, nausea and vomiting, agitation and delaying recovery. Multivariate logistic regression analysis was performed to screen the risk factors for these complications. Results Da-ta of 13,495 patients were available for analysis. The general incidence was 48.8%. Post-operative complications included post-operative nausea and vomiting (PONV) (14.5%), agitation (13.5%), hypertension (13.4%), arrhythmia (9.3%), shivering (8.9%), pain (5.9%), hypox-emia (2.5%), delayed recovery (1.9%), airway obstruction (1.7%) and hypotension (0.3%). Regression analysis showed that the risk factors for hypoxemia included male,<59 years old and infratentorial tumor (P<0.05);the risk factors for PONV included male, supratentorial tu-mor, infratentorial tumor, cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and tramadol (P<0.05);and the risk factors for postoperative restlessness included male, infratentorial tumor and cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and no use of patient-controlled analgesia (PCA) pump (P<0.05). Conclusion Patients with different neuro-logical diseases showed different post-operative complications and exhibited different risk factors for these complications. Anesthesiologists should closely monitor patients receiving various neurosurgery and provide timely treatment.%目的:探讨神经外科患者麻醉恢复期常见并发症的发生情况及其相关危险因素。方法回顾性分析2010年3月~2014年11月期间麻醉恢复室神经外科全麻术后的患者,患者信息和并发症情况按统一标准由

  13. REPEATED SPRINT ABILITY AND RECOVERY PERIOD: COMPARISON OF TRAINED AND UNTRAINED INDIVIDUALS

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    Sultan

    2016-04-01

    Full Text Available The purpose of the study was to investigate the effects of training both in repeated sprint ability (RSA and during the recovery after sprint. Soccer players playing in regional amateur league (n=14, age: 21.86±2.35 years, height: 180.14±4.54 cm, body mass: 72.57±5.03 kg, training age: 8.71±1.86 years and students from faculty of sport sciences that played soccer in the past (n=13, age: 23.77±2.65 years, height: 178.54±4.67 cm, body mass: 74.54±10.52 kg participated in this study as trained and untrained group, respectively. The groups were tested using Yo-Yo intermittent recovery test level 1 (YIRT1 and maximum oxygen uptake (VO2max was calculated using a formula from distance covered in YIRT1. Groups performed a repeated sprint ability (RSA, 6x6 s of Wingate test protocol + 30 s of rest test after 48 h. Blood lactate level and heart rate of groups were recorded at rest, immediately, 5, 15, and 30 min after RSA test. The absolute peak power and relative mean power in repeated sprints and the VO2max values were significantly higher in trained group than in untrained group (p<0.05. The absolute values of mean power was also significantly higher in trained group compared to that of the untrained group, except for the first sprint (p<0.05. On the other hand, it was observed that blood lactate level at 30 min and heart rate at 15 and 30 min of the recovery after testing was significantly lower in trained group than those of untrained group (p<0.05. The performance and metabolic results showed that VO2max level would be effective both in maintaining repeated sprint ability performance and for the acceleration of the recovery period.

  14. Anesthesia for outpatient female sterilization.

    Science.gov (United States)

    Fishburne, J I

    1983-04-01

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

  15. Spinal and epidural anesthesia

    Science.gov (United States)

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

  16. 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, ...

  17. Society for Ambulatory Anesthesia

    Science.gov (United States)

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

  18. 七氟醚复合瑞芬太尼麻醉时长对全麻苏醒质量的影响%Effect of duration of combined anesthesia with sevoflurane-remifentanil on the recovery quality after general anesthesia

    Institute of Scientific and Technical Information of China (English)

    梁小丽; 郑雪; 张鸿磊; 张秋英; 朱昭琼

    2014-01-01

    目的:评价七氟醚复合瑞芬太尼麻醉持续时间对患者术后苏醒质量的影响。方法ASAⅠ~Ⅱ级择期腹腔镜胆囊手术患者97例,根据吸入麻醉时间不同分为<90 min组(n=61)与≥90 min组(n=36)。观察苏醒期呼气末七氟醚浓度、苏醒时间、血流动力学变化,比较不良反应发生情况及术后24 h患者麻醉满意度。结果两组麻醉时间分别为(70.0±13.2)min和(120.4±27.5)min(P<0.05);自主呼吸恢复、呼唤睁眼时及拔管时间差异无统计学意义(P>0.05);手术结束时、自主呼吸恢复时、呼唤睁眼时及拔管时四个时间点的血流动力学变化、呼吸末七氟醚浓度比较差异无统计学意义(P>0.05);术后患者麻醉满意度评分及不良反应发生率比较差异亦无统计学意义(P>0.05)。结论七氟醚复合瑞芬太尼麻醉用于不同时长麻醉维持,具有较好的可控性,可有效避免麻醉时间延长导致的药物蓄积、苏醒延迟和血压波动,获得满意的苏醒质量。%Objective To evaluate the effect of the sevoflurane-remifentanli anesthesia duration on the postoperative recovery quality .Methods 97 patients with ASAⅠ ~ Ⅱ ,who have undergone laparo-scopic cholecystectomy ,were assigned to group 0 .05) .Likewise ,there were no statistical significantly differences between two groups in the changes of hemodynamics ,end-tidal concentration of sevoflurane patients’ satisfaction ratings to anes-thesia and the incidence of adverse effects at the four points including end of surgery , recovery of spontaneous breathing ,eyes opening and extubation(P>0 .05) .Conclusion Combined anesthesia with sevoflurane and remifentanil can be used in anesthesia maintenance with different duration to prevent drug accumulation ,delayed recovery and fluctuation in blood pressure due to long anesthesia duration , by which satisfactory recovery quality can be also

  19. Activities of the Oil Implementation Task Force, reporting period March--August 1991; Contracts for field projects and supporting research on enhanced oil recovery, reporting period October--December 1990

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    Activities of DOE's Oil Implementation Task Force for the period March--August 1991 are reviewed. Contracts for fields projects and supporting research on enhanced oil recovery are discussed, with a list of related publications given. Enhanced recovery processes covered include chemical flooding, gas displacement, thermal recovery, and microbial recovery.

  20. A Multiband Generalization of the Analysis of Variance Period Estimation Algorithm and the Effect of Inter-band Observing Cadence on Period Recovery Rate

    CERN Document Server

    Mondrik, Nicholas; Marshall, Jennifer L

    2015-01-01

    We present a new method of extending the single band Analysis of Variance period estimation algorithm to multiple bands. We use SDSS Stripe 82 RR Lyrae to show that in the case of low number of observations per band and non-simultaneous observations, improvements in period recovery rates of up to $\\approx$60\\% are observed. We also investigate the effect of inter-band observing cadence on period recovery rates. We find that using non-simultaneous observation times between bands is ideal for the multiband method, and using simultaneous multiband data is only marginally better than using single band data. These results will be particularly useful in planning observing cadences for wide-field astronomical imaging surveys such as LSST. They also have the potential to improve the extraction of transient data from surveys with few ($\\lesssim 30$) observations per band across several bands, such as the Dark Energy Survey.

  1. 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.

  2. Neurometabolic therapy in the recovery period of ischemic stroke: impact on quality of life and cognitive functions

    Directory of Open Access Journals (Sweden)

    V. V. Zakharov

    2016-01-01

    Full Text Available Some recovery of impaired neurological functions (a stroke recovery period is almost always observed within the first 6–24 months after ischemic stroke (IS. The paper discusses the mechanisms responsible for this process (neurogenesis, neuroplasticity, and readaptation and possible approaches to the drug support of cerebral reparative processes. It presents data on the rate and etiology of poststroke cognitive impairments (CI that are one of the important factors that negatively influence the outcome of rehabilitation measures. The results obtained from a recent study of the efficacy of the neurometabolic agent citicoline in the recovery period of IS are given. The use of citicoline is shown to cause a significant regression of CI and to improve quality of life in patients who have sustained IS for the first time. 

  3. Topical anesthesia

    Directory of Open Access Journals (Sweden)

    Mritunjay Kumar

    2015-01-01

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

  4. Unconventional gas recovery program. Semi-annual report for the period ending September 30, 1979

    Energy Technology Data Exchange (ETDEWEB)

    Manilla, R.D. (ed.)

    1980-04-01

    This document is the third semi-annual report describing the technical progress of the US DOE projects directed at gas recovery from unconventional sources. Currently the program includes Methane Recovery from Coalbeds Project, Eastern Gas Shales Project, Western Gas Sands Project, and Geopressured Aquifers Project.

  5. 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.

  6. 小儿全身麻醉苏醒期呼吸道并发症发生的影响因素分析%Risk Factors Analysis of the Occurrence of Airway Adverse Events in Pediatric General Anesthesia Awakening Period

    Institute of Scientific and Technical Information of China (English)

    杨琰

    2014-01-01

    named ETT-A group(A certain depth of anesthesia pul-ling the endotracheal tube,25 cases) ,LMA-A group( A certain depth of anesthesia removing laryngeal mask , 25 cases),ETT-W group(removal of the endotracheal tube under consciousness,25 cases) and LMA-W group(clear out the laryngeal mask under consciousness,25 cases).The number of times of intubation, awakeningtime and waking period respiratory complications ( respiratory secretions increase, cough,nausea, laryngospasm etc.) were observed and recorded,and the multi-factor Logistic regression analysis was done. Results Awakening time of ETT-W group was significantly less than that of ETT-A group,LMA-A group, and LMA-W group with statistically significant difference(P<0.05); the respiratory complication rate dur-ing recovery period of ETT-W group were higher than ETT-A group,LMA-A group and LMA-W group( P<0.05).Multivariate Logistic regression analysis showed:ventilation device selection was a hazard factor,age and anesthesia state during extubation (laryngeal mask removal)were protective factors.Conclusion Choo-sing the endotracheal tube as ventilation device is more dangerous for inducing respiratory complications in pediatric anesthesia awakening period,and preoperative and postoperative monitoring should be strengthened to actively prevent and reduce the complications,so as to improve the perioperative anesthesia safety.

  7. Determining the Optimum Exposure and Recovery Periods for Efficient Operation of a QCM Based Elemental Mercury Vapor Sensor

    Directory of Open Access Journals (Sweden)

    K. M. Mohibul Kabir

    2015-01-01

    Full Text Available In recent years, mass based transducers such as quartz crystal microbalance (QCM have gained huge interest as potential sensors for online detection of elemental mercury (Hg0 vapor from anthropogenic sources due to their high portability and robust nature enabling them to withstand harsh industrial environments. In this study, we determined the optimal Hg0 exposure and recovery times of a QCM based sensor for ensuring its efficient operation while monitoring low concentrations of Hg0 vapor (<400 ppbv. The developed sensor was based on an AT-cut quartz substrate and utilized two gold (Au films on either side of the substrate which functions as the electrodes and selective layer simultaneously. Given the temporal response mechanisms associated with mass based mercury sensors, the experiments involved the variation of Hg0 vapor exposure periods while keeping the recovery time constant following each exposure and vice versa. The results indicated that an optimum exposure and recovery periods of 30 and 90 minutes, respectively, can be utilized to acquire the highest response magnitudes and recovery rate towards a certain concentration of Hg0 vapor whilst keeping the time it takes to report an accurate reading by the sensor to a minimum level as required in real-world applications.

  8. Physical health problems experienced in the early postoperative recovery period following total knee replacement

    DEFF Research Database (Denmark)

    Szötz, Kirsten; Pedersen, Preben Ulrich; Hørdam, Britta

    2015-01-01

    BACKGROUND: The length of stay in hospital following total knee replacement is markedly shortened due to fast-track programmes. Patients have to be responsible for their recovery at a very early stage. The aim of this study was to investigate the prevalence of physical health problems and the level...

  9. 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.

  10. Graded defragmentation of cortical neuronal firing during recovery of consciousness in rats.

    Science.gov (United States)

    Vizuete, J A; Pillay, S; Ropella, K M; Hudetz, A G

    2014-09-05

    State-dependent neuronal firing patterns reflect changes in ongoing information processing and cortical function. A disruption of neuronal coordination has been suggested as the neural correlate of anesthesia. Here, we studied the temporal correlation patterns of ongoing spike activity, during a stepwise reduction of the volatile anesthetic desflurane, in the cerebral cortex of freely moving rats. We hypothesized that the recovery of consciousness from general anesthesia is accompanied by specific changes in the spatiotemporal pattern and correlation of neuronal activity. Sixty-four contact microelectrode arrays were chronically implanted in the primary visual cortex (contacts spanning 1.4-mm depth and 1.4-mm width) for recording of extracellular unit activity at four steady-state levels of anesthesia (8-2% desflurane) and wakefulness. Recovery of consciousness was defined as the regaining of the righting reflex (near 4%). High-intensity firing (HI) periods were segmented using a threshold (200-ms) representing the minimum in the neurons' bimodal interspike interval histogram under anesthesia. We found that the HI periods were highly fragmented in deep anesthesia and gradually transformed to a near-continuous firing pattern at wakefulness. As the anesthetic was withdrawn, HI periods became longer and increasingly correlated among the units both locally and across remote recording sites. Paradoxically, in 4 of 8 animals, HI correlation was also high at the deepest level of anesthesia (8%) when local field potentials (LFP) were burst-suppressed. We conclude that recovery from desflurane anesthesia is accompanied by a graded defragmentation of neuronal activity in the cerebral cortex. Hypersynchrony during deep anesthesia is an exception that occurs only with LFP burst suppression.

  11. 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...

  12. [Automated anesthesia record system].

    Science.gov (United States)

    Zhu, Tao; Liu, Jin

    2005-12-01

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

  13. Analysis of Thermal and Chemical Effets on Negative Valve Overlap Period Energy Recovery for Low-Temperature Gasoline Combustion

    Energy Technology Data Exchange (ETDEWEB)

    Ekoto, Dr Isaac [Sandia National Laboratories (SNL); Peterson, Dr. Brian [University of Edinburgh; Szybist, James P [ORNL; Northrop, Dr. William [University of Minnesota

    2015-01-01

    A central challenge for efficient auto-ignition controlled low-temperature gasoline combustion (LTGC) engines has been achieving the combustion phasing needed to reach stable performance over a wide operating regime. The negative valve overlap (NVO) strategy has been explored as a way to improve combustion stability through a combination of charge heating and altered reactivity via a recompression stroke with a pilot fuel injection. The study objective was to analyze the thermal and chemical effects on NVO-period energy recovery. The analysis leveraged experimental gas sampling results obtained from a single-cylinder LTGC engine along with cylinder pressure measurements and custom data reduction methods used to estimate period thermodynamic properties. The engine was fueled by either iso-octane or ethanol, and operated under sweeps of NVO-period oxygen concentration, injection timing, and fueling rate. Gas sampling at the end of the NVO period was performed via a custom dump-valve apparatus, with detailed sample speciation by in-house gas chromatography. The balance of NVO-period input and output energy flows was calculated in terms of fuel energy, work, heat loss, and change in sensible energy. Experiment results were complemented by detailed chemistry single-zone reactor simulations performed at relevant mixing and thermodynamic conditions, with results used to evaluate ignition behavior and expected energy recovery yields. For the intermediate bulk-gas temperatures present during the NVO period (900-1100 K), weak negative temperature coefficient behavior with iso-octane fueling significantly lengthened ignition delays relative to similar ethanol fueled conditions. Faster ethanol ignition chemistry led to lower recovered fuel intermediate yields relative to similar iso-octane fueled conditions due to more complete fuel oxidation. From the energy analysis it was found that increased NVO-period global equivalence ratio, either from lower NVOperiod oxygen

  14. Optimizing anesthesia techniques in the ambulatory setting

    NARCIS (Netherlands)

    E. Galvin

    2007-01-01

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

  15. 脑电双频指数监测在老年患者麻醉苏醒中的作用%Bispectral index monitoring improves early recovery of elderly patients under sevoflurane anesthesia

    Institute of Scientific and Technical Information of China (English)

    周惠丹; 方军; 付霜; 连燕虹

    2011-01-01

    目的 研究脑电双频指数(BIS)指导七氟醚吸入对老年患者麻醉苏醒的影响.方法 择期行下腹部手术的老年患者44例,ASAⅠ~Ⅱ级,随机数字表法分为BIS组(B组)和对照组(D组),每组22例.D组由麻醉医生根据临床经验调节术中七氟醚的吸入浓度;B组术中维持BIS值在45~55,术毕前10min维持在56~70.记录麻醉诱导前、手术期间和拔管时的BIS值、七氟醚设定浓度和呼气末浓度;苏醒时间、拔管时间、OAA /S评分达到5分的时间.结果 与D组相比,B组术中七氟醚用量减少20%,手术期间的BIS升高、呼气末七氟醚浓度降低,手术结束时呼气末七氟醚浓度降低,苏醒时间、拔管时间、OAA /S评分达到5分的时间缩短.结论 BIS指导吸入七氟醚能加快老年患者腹部手术的麻醉苏醒,提高苏醒质量,并可减少术中七氟醚的用量.%Objective To evaluate the application of BIS monitoring during sevoflurane anesthesia in elderly patients undergoing intra- abdominal surgery. Methods Forty- four ASA Ⅰ or Ⅱ patients aged over 60 undergoing intra- abdominal surgery were randomized dMded into two groups with 22 cases each: BIS group and control group. In BIS group sevoflurane was titrated to keep BIS values 45- 55 during operation; and the BIS value was increased to 56- 70 at 10 min before the end of operation. In control group the depth of anesthesia was maintained based on the clinical experience of anesthesiologist. The BIS values and the end- tidal sevoflurane concentration before and during anesthesia and at extubation, recovery time, extubation time and the time OAA/S score to 5 were recorded and compared between the two groups. The mini- mental state examination (MMSE) was used before and at 1,2,12 and 24h affer surgery. Results The total amount of sevoflurane consumed was 20% less, the average BIS value s were higher and end- tidal sevoflurane concentration was lower in BIS group than those in control group. The

  16. Mortality in anesthesia: a systematic review

    Directory of Open Access Journals (Sweden)

    Leandro Gobbo Braz

    2009-01-01

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

  17. Sensitive Period for the Recovery of the Response Rate of the Wind-Evoked Escape Behavior of Unilaterally Cercus-Ablated Crickets (Gryllus bimaculatus).

    Science.gov (United States)

    Takuwa, Hiroyuki; Kanou, Masamichi

    2015-04-01

    We examined the compensational recovery of the response rate (relative occurrence) of the wind-evoked escape behavior in unilaterally cercus-ablated crickets (Gryllus bimaculatus) and elucidated the existence of a sensitive period for such recovery by rearing the crickets under different conditions. In one experiment, each cricket was reared in an apparatus called a walking inducer (WI) to increase the sensory input to the remaining cercus, i.e., the self-generated wind caused by walking. In another experiment, each cricket was reared in a small plastic case separate from the outside atmosphere (wind-free: WF). In this rearing condition, the cricket did not experience self-generated wind as walking was prohibited. During the recovery period after the unilateral cercus ablation, the crickets were reared under either the WI or WF condition to investigate the role of the sensory inputs on the compensational recovery of the response rate. The compensational recovery of the response rate occurred only in the crickets reared under the WI condition during the early period after the ablation. In particular, WI rearing during the first three days after the ablation resulted in the largest compensational recovery in the response rate. In contrast, no compensational recovery was observed in the crickets reared under the WF condition during the first three days. These results suggest that a sensitive period exists in which sensory inputs from the remaining cercus affect the compensational recovery of the response rate more effectively than during other periods.

  18. An adequate interset rest period for strength recovery during a common isokinetic test.

    Science.gov (United States)

    Blazquez, Ivan N; Warren, Barbara L; O'Hanlon, Ann M; Silvestri, Lynette R

    2013-07-01

    Isokinetic testing is used in rehabilitation settings on a regular basis; yet, there is a lack of consistency in rest period usage among protocols. Furthermore, the allotment of rest periods has been arbitrary (e.g., 30, 60, 90 seconds or more). This investigation examines the work:rest ratio as an effective method of standardizing rest periods in isokinetic testing. The purpose of this study was to establish an adequate rest period that would allow reproducibility of strength during a common isokinetic strength test. Twenty-seven healthy college-aged men (age, 23 ± 3.8 years; body weight, 79.54 ± 11.09 kg) were tested on 5 separate occasions: 2 familiarization sessions and 3 experimental sessions. Each subject performed a knee extension/flexion isokinetic strength protocol (Cybex NORM; Lumex, Inc., Ronkonkoma, NY, USA) to determine peak torque by performing 5 maximal reciprocal repetitions at each ascending velocity of 60, 180, and 300°·s. Work:rest ratios of 1:3, 1:8, and 1:12 were counterbalanced between sets. A 3 × 3 repeated measures analysis of variance was used to analyze the data. A significance level of α ≤ 0.05 was used for all tests. There was no significant difference in either knee extension or knee flexion peak torque when comparing work:rest ratios. These findings suggest that a 1:3 work:rest ratio is sufficient during a common isokinetic strength test.

  19. 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.

  20. Recovery of systems with a linear filter and nonlinear delay feedback in periodic regimes.

    Science.gov (United States)

    Ponomarenko, V I; Prokhorov, M D

    2008-12-01

    We propose a set of methods for the estimation of the parameters of time-delay systems with a linear filter and nonlinear delay feedback performing periodic oscillations. The methods are based on an analysis of the system response to regular external perturbations and are valid only for systems whose dynamics can be perturbed. The efficiency of the methods is illustrated using both numerical and experimental data.

  1. 不同麻醉方案对幕上肿瘤切除术后患者麻醉复苏的影响%Effect of different anaesthetic methods on the anesthesia recovery of patients after supratentorial tumor resction

    Institute of Scientific and Technical Information of China (English)

    孙燕; 谢先丰; 徐勇; 张璟瑜

    2016-01-01

    目的::比较2种不同麻醉方案对幕上肿瘤切除术患者麻醉复苏的影响。方法:66例患者随机分为2组,分别在脑电双频指数( BIS)指导下使用丙泊酚-瑞芬太尼麻醉( PR组)和七氟烷-舒芬太尼麻醉( SS组)。评估患者术后自主呼吸恢复时间、拔管时间和对简单指令有反应的时间。同时记录患者改良镇静评分≤1分、格拉斯哥昏迷评分=15分、疼痛VAS评分0.05)。 SS组患者术后Aldrete评分=10分、简易精神状态量表=30分和格拉斯哥昏迷评分=15分时间均早于PR组患者(P0.05)。结论:在BIS指导下,行幕上肿瘤切除术患者使用七氟烷-舒芬太尼麻醉和丙泊酚-瑞芬太尼麻醉后苏醒时间无明显不同,七氟烷-舒芬太尼麻醉有加快此类患者神经功能恢复的趋势。%Objective:To compare the effects of two different anaesthetic methods on the anesthesia recovery of patients after supratentorial tumor resction. Methods:Sixty-six patients were randomly divided into the propofol-remifentanil ( PR group ) and sevoflurane-sufentanil( SS group) . The PR group and SS group were anaesthetized using propofol-remifentanil and sevoflurane-sufentanil under the bispectral index( BIS) monitor,respectively. The time of the spontanous breathing recovering,extubation and response in two groups were evaluated after operation. The time at Simplified Sedation Score(SSS) less than or equal to 1,Glasgow Coma Scale(GCS) equal to 15,Pain Visual Analogue Scale(PVAS) less than 4,Mini-mENTAL sTATE(MMS) equal to 30 and Aldrete Score(AS) equal to 10 in two groups were recorded. Results:The differences of the spontanous breathing recovering time,extubation time and response time between two group were not statistically significant(P>0. 05). The time at the postoperative AS equal to 10,MMS equal to 30 and GCS equal to 15 in SS group was sooner than those in PR group(P0. 05). Conclusions:The anesthesia recovery time between the propofol

  2. [Character and speed of recovery of psychophysiological functions after application of various kinds of anesthesia in conditions of a "one-day" stationary].

    Science.gov (United States)

    Polinchuk, I S

    2009-09-01

    The frequency of operative interventions, performed according to the "one-day" stationary technology is raising every day. The patients are choosed in accordance with conventional methods, while somatic state of a patient and the further operation volume playing the leading role. But in 30% of patients in the early postoperative period and in 10.4% in the late postopeartive period the high psychic functions disorders occur, which are called postoperative cognitive dysfunction. The investigation is devoted to studying of character and speed of restoration of psychophysiologic functions after application of various general anaesthesy in conditions of the "one-day" stationary. There was proved, that apart of general anaesthesy scheme applied, in all the patients the cognitive functions defect was noted in postoperative period. These functions are restored most quickly in application of propofol in the scheme and most slower in mononarcosis with ketamin.

  3. Anesthesia care for the professional singer.

    Science.gov (United States)

    Meacham, Ryan K; Schindler, Joshua

    2015-06-01

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  5. Effect of anesthesia induction with parents' accompanying on psychological intervention on children patients in the perioperative period%陪护下麻醉诱导对围术期患儿心理干预的影响

    Institute of Scientific and Technical Information of China (English)

    张改英

    2012-01-01

    Objective:To explore the effect of anesthesia induction with parents'accompanying on psychological intervention on children patients in the perioperative period. Methods: 104 children patients who would receive operation were randomly divided into an experimental group and a control group ( 52 cases in each group ). The children patients in the experimental group were given anesthesia induction with the accompanying of their parents and the children patients in the control group received anesthesia induction without accompanying. Results : Heart rate and blood pressure of the children patients had no significant change after the induction in the experimental group, compared with those before the induction; in the control group, heart rate and blood pressure of the children patients were faster and higher before the induction than those after the induction and than the experimental group ( P <0. 05 );the anxiety scores of the children patients were significantly lower in the experimental group than the control group in the different time ( before operation, entering the anesthesia induction room or operation room,anesthesia induction by venous puncture,6 hours after operation ) ( P <0. 05 );the coordination scores and anxiety scores of the children patients were significantly lower when their parents left in the experimental group than the control group ( P <0.05 ); the cases of postoperative behavioral change were significantly fewer in the experimental group than the control group ( P < 0. 05 );the anesthesia induction effect was better in the experimental group than the control group ( P <0. 05 ). Conclusion:The anesthesia induction with parents' accompanying in the induction room is conducive to easing children's preoperative fear, lightening the mood of anxiety and improving the anesthetic effect,and it is also helpful for postoperative rehabilitation of the children patients.%目的:探讨在父母陪护下进行麻醉诱导对患儿

  6. 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.

  7. 耳穴磁贴辅助全麻对妇科手术患者术后恢复的影响%Effect of assisted anesthesia of auricular point magnetic sticking on postoperative recovery of gynecological surgery

    Institute of Scientific and Technical Information of China (English)

    李万山; 万赖思琪; 刘晓静; 李万瑶; 肖建斌; 招伟贤

    2013-01-01

    Objective To explore an optimum method on postoperative recovery of general-anesthesia gynecological laparoscopic surgery.Methods One hundred and twenty cases of gynecological laparoscopic surgery were randomly divided into three groups,40 cases in each one.The sensitive points of bilateral Shenmen (TF4),Zigong (TF2),Wei (CO4),Dachang (CO7) and so on were selected in all three groups one night before the surgery.The sticking with magnetic beads was applied in the group A.The magnetic beads were in-pair stuck at front-back corresponding location of both ears in the group B.The same-appearance plaster was put at the corresponding acupoints in the group C.The intubation anesthesia was applied in all three groups and postoperative recovery of gynecological laparoscopic surgery was observed.Results The postoperative visual analogue scale (VAS) was (1.77+1.65) in the group A and (1.80+1.96) in the group B,which was both lower than (2.62+1.46) in the group C (both P<0.01).The occurrence rate of nausea and vomiting was 25.0% (9/36) in the group A and 20.0% (8/40) in the group B,which was both lower than 50.0% (19/38) in the group C (both P<0.01).The recovery of borborygmus on postoperative 1st and 3rd day in the group A and B was faster than that in the group C (both P<0.05),while time of fart and defecation in the group A and B was earlier than that in the group C (both P<0.05).The score of state-trait anxiety inventory in the group A and B was lower than that in the group C (both P<0.05),but the differences of each item between the group A and B were not obvious (both P>0.05).Conclusion The auricular point sticking could support analgesia of general-anesthesia gynecological laparoscopic surgery,which could relieve anxiety mood,reduce occurrence of nausea and vomiting and improve function of stomach and intestine to benefit postoperative recovery.However,the effect of in-pair sticking of auricular point with magnetic beads at front-back acupoints was not

  8. Six-month low level chlorine dioxide gas inhalation toxicity study with two-week recovery period in rats

    Science.gov (United States)

    2012-01-01

    Background Chlorine dioxide (CD) gas has a potent antimicrobial activity at extremely low concentration and may serve as a new tool for infection control occupationally as well as publicly. However, it remains unknown whether the chronic exposure of CD gas concentration effective against microbes is safe. Therefore, long-term, low concentration CD gas inhalation toxicity was studied in rats as a six-month continuous whole-body exposure followed by a two-week recovery period, so as to prove that the CD gas exposed up to 0.1 ppm (volume ratio) is judged as safe on the basis of a battery of toxicological examinations. Methods CD gas at 0.05 ppm or 0.1 ppm for 24 hours/day and 7 days/week was exposed to rats for 6 months under an unrestrained condition with free access to chow and water in a chamber so as to simulate the ordinary lifestyle in human. The control animals were exposed to air only. During the study period, the body weight as well as the food and water consumptions were recorded. After the 6-month exposure and the 2-week recovery period, animals were sacrificed and a battery of toxicological examinations, including biochemistry, hematology, necropsy, organ weights and histopathology, were performed. Results Well regulated levels of CD gas were exposed throughout the chamber over the entire study period. No CD gas-related toxicity sign was observed during the whole study period. No significant difference was observed in body weight gain, food and water consumptions, and relative organ weight. In biochemistry and hematology examinations, changes did not appear to be related to CD gas toxicity. In necropsy and histopathology, no CD gas-related toxicity was observed even in expected target respiratory organs. Conclusions CD gas up to 0.1 ppm, exceeding the level effective against microbes, exposed to whole body in rats continuously for six months was not toxic, under a condition simulating the conventional lifestyle in human. PMID:22348507

  9. Six-month low level chlorine dioxide gas inhalation toxicity study with two-week recovery period in rats

    Directory of Open Access Journals (Sweden)

    Akamatsu Akinori

    2012-02-01

    Full Text Available Abstract Background Chlorine dioxide (CD gas has a potent antimicrobial activity at extremely low concentration and may serve as a new tool for infection control occupationally as well as publicly. However, it remains unknown whether the chronic exposure of CD gas concentration effective against microbes is safe. Therefore, long-term, low concentration CD gas inhalation toxicity was studied in rats as a six-month continuous whole-body exposure followed by a two-week recovery period, so as to prove that the CD gas exposed up to 0.1 ppm (volume ratio is judged as safe on the basis of a battery of toxicological examinations. Methods CD gas at 0.05 ppm or 0.1 ppm for 24 hours/day and 7 days/week was exposed to rats for 6 months under an unrestrained condition with free access to chow and water in a chamber so as to simulate the ordinary lifestyle in human. The control animals were exposed to air only. During the study period, the body weight as well as the food and water consumptions were recorded. After the 6-month exposure and the 2-week recovery period, animals were sacrificed and a battery of toxicological examinations, including biochemistry, hematology, necropsy, organ weights and histopathology, were performed. Results Well regulated levels of CD gas were exposed throughout the chamber over the entire study period. No CD gas-related toxicity sign was observed during the whole study period. No significant difference was observed in body weight gain, food and water consumptions, and relative organ weight. In biochemistry and hematology examinations, changes did not appear to be related to CD gas toxicity. In necropsy and histopathology, no CD gas-related toxicity was observed even in expected target respiratory organs. Conclusions CD gas up to 0.1 ppm, exceeding the level effective against microbes, exposed to whole body in rats continuously for six months was not toxic, under a condition simulating the conventional lifestyle in human.

  10. Investigations on Health Conditions of Chernobyl Nuclear Power Plant Accident Recovery Workers from Latvia in Late Period after Disaster

    Directory of Open Access Journals (Sweden)

    Reste Jeļena

    2016-10-01

    Full Text Available The paper summarises the main findings on Chernobyl Nuclear Power Plant (CNPP accident recovery workers from Latvia and their health disturbances, which have been studied by the authors during the last two decades. Approximately 6000 persons from Latvia participated in CNPP clean-up works in 1986–1991. During their work period in Chernobyl they were exposed to external as well as to internal irradiation, but since their return to Latvia they were living in a relatively uncontaminated area. Regular careful medical examinations and clinical studies of CNPP clean-up workers have been conducted during the 25 years after disaster, gathering knowledge on radiation late effects. The aim of the present review is to summarise the most important information about Latvian CNPP clean-up worker health revealed by thorough follow-up and research conducted in the period of 25 years after the accident. This paper reviews data of the Latvian State Register of Persons Exposed to Radiation due to CNPP Accident and gives insight in main health effects found by the researchers from the Centre of Occupational and Radiological Medicine (Pauls Stradiņš Clinical University Hospital and Rīga Stradiņš University in a number of epidemiological, clinical, biochemical, immunological, and physiological studies. Latvian research data on health condition of CNPP clean-up workers in the late period after disaster indicate that ionising radiation might cause premature ageing and severe polymorbidity in humans.

  11. Comparison of cardiomyocyte apoptosis and early postoperative recovery between propofol-and midazolam-combined anesthesia in patients undergoing cardiac valve replacement%异丙酚或咪达唑仑复合麻醉下心脏手术患者心肌细胞凋亡及术后早期恢复的比较

    Institute of Scientific and Technical Information of China (English)

    诸绍君; 周燕丰; 祝胜美

    2010-01-01

    Objective To compare the cardiomyocyte apoptosis and early postoperative recovery in patients undergoing cardiac valve replacement under propofol-or midazolam-combined anesthesia.Methods Forty NYHA class Ⅱ or Ⅲ patients (aged 48-64 yr and weighing 45-78 kg) undergoing cardiac valve replacement with cardiopulmonary bypass (CPB) were randomly divided into midazolam group (Group M) and propofol group (Group P) (n=20each). The patients were premedicated with morphine 0.1 mg/kg i.v. and scopolamine 0.3 mg i.v. Anesthesia was induced with midazolam 0.2 mg/kg (in Group M) or propofol 2 mg/kg (in Group P) combined with fentanyl 10 μg/kg and vecuronium 0.1 mg/kg, and maintained with propofol 5 mg. kg-1·h-1 (in Group P) or midazolam 0.1 mg·kg-1·h-1(in Group M) and intermittent i.v. boluses of fentanyl and vecuronium after tracheal intubation. The patients were mechanically ventilated with PETCO2 maintained at 35-45 mm Hg. Myocardial tissues were obtained from the right atrium before and after CPB for determination of apoptosis in cardiomyocytes (by TUNEL). The apoptotic index was calculated. The expression of caspase-3 and caspase-9 was determined by immunohistochemical avidin-biotin-peroxidase complex (ABC) technique staining. The mean airway pressure (MAP) and heart rate (HR) were monitored. Aortic cross-clamping time, surgical and CPB times, spontaneous recovery of normal heart beat, emergence from anesthesia, extubation time and duration of ICU stay were recorded and compared between the two groups.Results The percentage of spontaneous recovery of normal heart beat after release of aortic cross clamp was significantly higher and the need for dobutamine support was significantly less in Group P than in Group M ( P < 0.05). The emergence from anesthesia was significantly more rapid, the extubation time and the ICU stay were significantly shorter in Group P than in Group M (P<0.05). There were no significant differences in apoptosis index and expression of

  12. The effect of sugammadex on postoperative cognitive function and recovery

    OpenAIRE

    Özcan Pişkin; Gamze Küçükosman; Deniz Utku Altun; Murat Çimencan; Banu Özen; Bengü Gülhan Aydın; Rahşan Dilek Okyay; Hilal Ayoğlu; Işıl Özkoçak Turan

    2016-01-01

    Abstract Background and objective: Sugammadex is the first selective relaxant binding agent. When compared with neostigmine, following sugammadex administration patients wake earlier and have shorter recovery times. In this study, we hypothesized that fast and clear awakening in patients undergoing general anesthesia has positive effects on cognitive functions in the early period after operation. Methods: Approved by the local ethical committee, 128 patients were enrolled in this randomized...

  13. [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.

  14. Effects of carbohydrate, branched-chain amino acids, and arginine in recovery period on the subsequent performance in wrestlers

    Directory of Open Access Journals (Sweden)

    Jang Tsong-Rong

    2011-11-01

    Full Text Available Abstract Many athletes need to participate in multiple events in a single day. The efficient post-exercise glycogen recovery may be critical for the performance in subsequent exercise. This study examined whether post-exercise carbohydrate supplementation could restore the performance in the subsequent simulated wrestling match. The effect of branched-chain amino acids and arginine on glucose disposal and performance was also investigated. Nine well-trained male wrestlers participated in 3 trials in a random order. Each trial contained 3 matches with a 1-hr rest between match 1 and 2, and a 2-hr rest between match 2 and 3. Each match contained 3 exercise periods interspersed with 1-min rests. The subjects alternated 10-s all-out sprints and 20-s rests in each exercise period. At the end of match 2, 3 different supplementations were consumed: 1.2 g/kg glucose (CHO trial, 1 g/kg glucose + 0.1 g/kg Arg + 0.1 g/kg BCAA (CHO+AA trial, or water (placebo trial. The peak and average power in the 3 matches was similar in the 3 trials. After the supplementation, CHO and CHO+AA trial showed significantly higher glucose and insulin, and lower glycerol and non-esterified fatty acid concentrations than the placebo trial. There was no significant difference in these biochemical parameters between the CHO and CHO+AA trials. Supplementation of carbohydrate with or without BCAA and arginine during the post-match period had no effect on the performance in the following simulated match in wrestlers. In addition, BCAA and arginine did not provide additional insulinemic effect.

  15. 认知行为干预对全麻后导尿病人疼痛耐受力的影响%Effect of Cognitive Behavioral Intervention on Pain Tolerance of Patients with Urinary Catheter after General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    刘永宁; 金嵩; 王晓庆

    2016-01-01

    目的:通过术前认知干预缓解患者因手术麻醉后留置导尿引起的疼痛及麻醉恢复期躁动。方法对150例全麻后导尿的手术患者随机分成认知干预组和对照组,对照组常规麻醉诱导后导尿,干预组术前给予麻醉后导尿的认知辅导,对全麻恢复期尿管刺激疼痛强度及躁动情况比较。结果两组患者术后现有疼痛强度评定P<0.05有统计学意义;术后麻醉恢复躁动差异显著P<0.01。结论通过建立全麻手术患者对麻醉后导尿的认知及认知评价,可以提高手术患者术后及麻醉恢复期对尿管刺激疼痛的耐受力,减少术后躁动。%Objective to releive urinary catheter pains and dysphoria at anesthesia recovery period after operation general anesthesia of patients through preoperative cognitive intervention.Methods 150 patients with urinary catheter after general anesthesia were randomly divided into cognitive intervention and control group. Control group was treated with catheterization of routine anesthesia induction, and intervention group with preoperative cognition instruction of urinary catheterization after anesthesia. Compare catheter stimulation pain intensity and dysphoria during recovery period of general anesthesia.Results postoperative pain intensity assessment of two groups showedP<0.05 with statistical significance; postoperative anesthesia recovery dysphoria showed significant difference P<0.01.Conclusion: establishing patients’ cognition and evaluation for catheterization after general anesthesia can improve catheter stimulation pain tolerance after surgery during anesthesia recovery period, and reduce postoperative dysphoria.

  16. Anesthesia & Down Syndrome

    Science.gov (United States)

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

  17. [Carotid endarterectomy under local anesthesia].

    Science.gov (United States)

    Kuz'min, A L; Belov, Iu V

    2001-01-01

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

  18. Presbycusis: reversible with anesthesia drugs?

    Science.gov (United States)

    Kocher, Carl A

    2009-02-01

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

  19. Monitoring training load, recovery-stress state, immune-endocrine responses, and physical performance in elite female basketball players during a periodized training program.

    Science.gov (United States)

    Nunes, João A; Moreira, Alexandre; Crewther, Blair T; Nosaka, Ken; Viveiros, Luis; Aoki, Marcelo S

    2014-10-01

    This study investigated the effect of a periodized training program on internal training load (ITL), recovery-stress state, immune-endocrine responses, and physical performance in 19 elite female basketball players. The participants were monitored across a 12-week period before an international championship, which included 2 overloading and tapering phases. The first overloading phase (fourth to sixth week) was followed by a 1-week tapering, and the second overloading phase (eighth to 10th week) was followed by a 2-week tapering. ITL (session rating of perceived exertion method) and recovery-stress state (RESTQ-76 Sport questionnaire) were assessed weekly and bi-weekly, respectively. Pretraining and posttraining assessments included measures of salivary IgA, testosterone and cortisol concentrations, strength, jumping power, running endurance, and agility. Internal training load increased across all weeks from 2 to 11 (p ≤ 0.05). After the first tapering period (week 7), a further increase in ITL was observed during the second overloading phase (p ≤ 0.05). After the second tapering period, a decrease in ITL was detected (p ≤ 0.05). A disturbance in athlete stress-recovery state was noted during the second overloading period (p ≤ 0.05), before returning to baseline level in end of the second tapering period. The training program led to significant improvements in the physical performance parameters evaluated. The salivary measures did not change despite the fluctuations in ITL. In conclusion, a periodized training program evoked changes in ITL in elite female basketball players, which appeared to influence their recovery-stress state. The training plan was effective in preparing participants for competition, as indicated by improvements in recovery-stress state and physical performance after tapering.

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

    Directory of Open Access Journals (Sweden)

    Donmez T

    2016-10-01

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

  1. The Effect of Active versus Passive Recovery Periods during High Intensity Intermittent Exercise on Local Tissue Oxygenation in 18 – 30 Year Old Sedentary Men

    Science.gov (United States)

    Kerhervé, Hugo A.; Askew, Christopher D.; Solomon, Colin

    2016-01-01

    Purpose High intensity interval training (HIIT) has been proposed as a time-efficient format of exercise to reduce the chronic disease burden associated with sedentary behaviour. Changes in oxygen utilisation at the local tissue level during an acute session of HIIT could be the primary stimulus for the health benefits associated with this format of exercise. The recovery periods of HIIT effect the physiological responses that occur during the session. It was hypothesised that in sedentary individuals, local and systemic oxygen utilisation would be higher during HIIT interspersed with active recovery periods, when compared to passive recovery periods. Methods Twelve sedentary males (mean ± SD; age 23 ± 3 yr) completed three conditions on a cycle ergometer: 1) HIIT with passive recovery periods between four bouts (HIITPASS) 2) HIIT with active recovery periods between four bouts (HIITACT) 3) HIITACT with four HIIT bouts replaced with passive periods (REC). Deoxygenated haemoglobin (HHb) in the vastus lateralis (VL) and gastrocnemius (GN) muscles and the pre-frontal cortex (FH), oxygen consumption (VO2), power output and heart rate (HR) were measured continuously during the three conditions. Results There was a significant increase in HHb at VL during bouts 2 (p = 0.017), 3 (p = 0.035) and 4 (p = 0.035) in HIITACT, compared to HIITPASS. Mean power output was significantly lower in HIITACT, compared to HIITPASS (p < 0.001). There was a significant main effect for site in both HIITPASS (p = 0.029) and HIITACT (p = 0.005). There were no significant differences in VO2 and HR between HIITPASS and HIITACT. Conclusions The increase in HHb at VL and the lower mean power output during HIITACT could indicate that a higher level of deoxygenation contributes to decreased mechanical power in sedentary participants. The significant differences in HHb between sites indicates the specificity of oxygen utilisation. PMID:27677081

  2. 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

  3. Discrimination of auditory stimuli during isoflurane anesthesia.

    Science.gov (United States)

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

    2008-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Lucía Vizcaíno-Martínez

    2014-01-01

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

  5. Risk management in anesthesia.

    Science.gov (United States)

    Cabrini, L; Levati, A

    2009-11-01

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

  6. Comparison of the Direct Costs, Length of Recovery, and Incidence of Post Operative Anti-Emetic use After Anesthesia Induction with Propofol or a 1:1 Mixture of Thiopental and Propofol

    Science.gov (United States)

    1999-10-01

    1997). Propofol causes burning upon IV injection but that burning is reduced by previous injection of lidocaine (Stolting, 1991). It is associated...improve care in providing anesthesia. Understanding the underlying pharmacodynamics of induction agents will help the provider to make informed choices

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

    Science.gov (United States)

    Herminghaus, A; Löser, S; Wilhelm, W

    2012-04-01

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

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

    OpenAIRE

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

    2009-01-01

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

  9. The effect of propofol and sevoflurane on the quality of patient recovery from anesthesia with laparoscopic placement of peritoneal dialysis catheter%异丙酚和七氟醚麻醉用于腹腔镜腹膜透析置管术患者苏醒质量研究

    Institute of Scientific and Technical Information of China (English)

    李进; 龚昭; 丰新民; 熊飞

    2011-01-01

    [Objective] To observe the effects of propofol and sevoflurane on the quality of patient recovery from anesthesia with laparoscopic placement of peritoneal dialysis catheter. [Methods] One hundred patients with end-stage renal disease scheduled for elective laparoscopic placement of peritoneal dialysis catheter were randomly divided into two groups. The propofol group (n =50) were given fentanyl, atracurium, and propofol for tracheal intubation and given propofol and remifentanil for anesthesia maintenance. The sevoflurane group (n =50) were given fentanyl, atracurium, and sevoflurane for tracheal intubation and given sevoflurane for anesthesia maintenance. The hemody-namics during perioperative, the time to recovery from anesthesia, the pain and vomiting score were observed. [Results] The blood pressure and HR rised in both groups in intubation (P 0.05). [Conclusions] Using sevoflurane for intubation and anesthesia maintenance can obtain more stable hemodynamics and soon recovery from anesthesia for the patients underwent laparoscopic placement of peritoneal dialysis catheter.%目的 探讨异丙酚和七氟醚麻醉对腹腔镜腹膜透析置管术患者麻醉后苏醒质量的影响.方法 选择择期行腹腔镜腹膜透析置管术的终末期肾病患者100例,随机分成两组:异丙酚组(n=50),给予芬太尼、阿曲库铵、异丙酚行麻醉诱导,异丙酚、瑞芬太尼维持麻醉;七氟醚组(n=50):给予芬太尼、阿曲库铵、七氟醚行麻醉诱导,七氟醚维持麻醉.观察围手术期患者的血液动力学状态,术后麻醉恢复时间,疼痛、呕吐评分.结果 两组患者在气管插管时,血压、心率均升高(P<0.05),七氟醚组较异丙酚组升高较低(P<0.05);七氟醚组麻醉后苏醒时间较异丙酚组快(P<0.05),两组疼痛、呕吐评分差异无显著性(P>0.05).结论 七氟醚用于腹腔镜腹膜透析置管术麻醉诱导和维持,具有血液动力学平稳,苏醒快速的优点.

  10. 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.

  11. Intraoperative patient information handover between anesthesia providers

    Science.gov (United States)

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

    2014-01-01

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

  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. Comparison of Propofol and Desflurane Anesthesia Combined with Remifentanyl in Breast Surgery

    Directory of Open Access Journals (Sweden)

    Ertan Piri

    2014-03-01

    Full Text Available Aim: In this study, we aimed to compare the effects of propofol and desfluran anesthesia combined with remifentanil anesthesia on the various systems in short-term breast surgery. Material and Method: A prospective, randomized, controlled study design established for the short-term breast surgery planned, 40, ASA I- II patients aged 18-60 year-old. Group P (n=20 was named for the patients administered remifentanil and propofol and Group D (n=20 was named for the patients administered remifentanil and desflurane. For induction therapy, remifentanil of 1µg/kg dosage and Propofol of 2mg/kg dosage was adjusted for Group P and remifentanil of 1µg/kg dosage and % 3 end expiratory desflurane was adjusted for Group D. LMA applied for all of the patients. Maintenance treatment of remifentanil infusion with the dose of 0,25 µg/kg/min were used for both groups and Group P was also administered to 90 µg/kg/min infusion of Propofol. Tenoksikam with the dose of 20mg was used intravenously for all the patients 10min before the surgery finalized. Data of operation time, total anesthesia time, LMA extubation time, eye opening time, the time achievement of Aldrete score of 9 in postoperative period, VAS results and total remifentanil consumption were recorded. Blood samples were collected for ACTH and Cortizol levels 10min. before induction, 15 min after initial surgical incision and at 15th min of recovery period. Results: Hemodynamic stability maintained for both groups and no hemodynamic response occurred after surgical incisions. Wake-up time and recovery time were decreased in group D. We detected that ACTH and Cortizol levels were decreased in both groups although surgical stress was increased. Discussion: We suggest that desflurane-remifentanil drug combination can be used successfully as an alternative to TIVA for outpatient surgery.

  15. 右美托咪定、咪达唑仑对腹腔镜胆囊切除术全麻患者气管插管拔管期心血管应激反应的影响%Effects of dexmedetomidine and midazolam on cardiovascular response of general anesthesia patients undergoing laproscopic cholecystectomy during decannulation period

    Institute of Scientific and Technical Information of China (English)

    杨晓玲; 周述芝

    2013-01-01

    目的 观察右美托咪定与咪达唑仑对腹腔镜胆囊术全麻患者气管插管拔管期心血管应激反应的影响.方法 100例合并高血压行腹腔镜胆囊切除患者随机分为两组,两组患者均采用相同全麻诱导和维持,右美托咪定组诱导前10 min内静脉泵注1μg/kg右美托咪定,咪达唑仑组同速度同容量静射0.05 mg/kg咪达唑仑.观察两组诱导前、拔管时及拔管后1、5、10 min时的SBP、DBP、HR、心率和收缩压的乘积(RPP).结果 与咪达唑仑组比较,右美托咪定组拔管时、拔管后1 min的SBP、DBP、HR、RPP降低,拔管后5 min的RPP亦降低(P均<0.05);与同组诱导前比较,咪达唑仑组拔管时、拔管后1 min的SBP、DBP、HR、RPP升高,拔管后5 min的RPP亦升高(P均<0.05).结论 相对于咪达唑仑,右美托咪定能有效减轻腹腔镜胆囊切术全麻患者气管插管拔管期心血管应激反应,增加拔管时的安全性.%Objective To investigate the effects of dexmedetomidine and midazolam on cardiovascular response of general anesthesia patients undergoing laproscopic cholecystectomy ( LC) during decannulation period. Methods One hundred patients with hypertension underwent LC were randomly divided into two groups. The scheme of induction and maintenance of anesthesia of the two groups were identical. However, patients in dexmedetomidine group were administered with dexmedetomidine 1 μg/kg over 10 mins and midazolam 0. 05 mg/kg over 10 mins in midazolam group. Before induction, at the time of extubation and 1 min post extubation, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , heart rate ( HR) , the recovery time, extubation time and adverse effects were recorded, RPP were also calculated. Results SBP, DBP, HR, RPP in dexmedetomidine group at the time of extubation and 1 min post extubation were significantly lower than those in midazolam group. And even 5 min post extubation, RPP value in dexmedetomidine group was still

  16. Propofol and sevoflurane in children with general anesthesia on hemodynamics, postoperative recovery Quality of comparative study%丙泊酚和七氟烷在患儿全身麻醉中对血流动力学、术后苏醒质量的影响对比研究

    Institute of Scientific and Technical Information of China (English)

    陈炜; 罗会红; 龙宏杰

    2016-01-01

    Objective: To evaluate the propofol and sevoflurane in children with general anesthesia applications. Methods: Our hospital 180 cases of children with inguinal hernia elective surgery were randomly divided into propofol group and sevoflurane anesthesia group, 90 cases. Continuous monitoring of children with systolic blood pressure(SBP), heart rate(HR), electrocardiogram(ECG), diastolic blood pressure(DBP), the depth of anesthesia(BIS), oxygen saturation(SpO2), PETCO2. Record children after induction of anesthesia (T1), before induction (T0), endotracheal intubation (T2), 3min (T3), when the procedure is complete (T4), when the eyes open (T5), fully awake after intubation (T6) of SBP, HR, DBP, BIS. Results: The two groups were compared in the index, systolic and diastolic blood pressure significantly decreased compared with the induced (P<0.05), sevoflurane group of children surgery extubation time and postoperative recovery time after the completion of induction of anesthesia compared with propofol group was significantly shorter(P<0.05). Conclusion:propofol and sevoflurane anesthesia can effectively lower blood pressure, heart rate stability, to maintain a considerable depth of anesthesia, sevoflurane awake but better quality.%目的:评价丙泊酚与七氟烷在患儿全身麻醉中的应用效果。方法:选择我院择期手术的180例腹股沟斜疝患儿,随机分为丙泊酚麻醉组和七氟烷麻醉组各90例。连续监测患儿收缩压(SBP)、心率(HR)、心电图(ECG)、舒张压(DBP)、麻醉深度(BIS)、血氧饱和度(SpO2)、PETCO2。记录患儿麻醉诱导后(T1)、诱导前(T0)、气管插管即刻(T2)、插管后3min(T3)、手术完成时(T4)、睁眼时(T5)、完全清醒时(T6)的SBP、HR、DBP、BIS。结果:两组患儿组内各指标相比,麻醉诱导后收缩压和舒张压与诱导前比较明显下降(P<0.05),七氟烷组患儿手术完

  17. Study on appHcatlon of complex psychological intervention in patients during recovery from general anesthesia%复合心理疏导在全麻苏醒期患者中的应用研究

    Institute of Scientific and Technical Information of China (English)

    张芝颖; 王欣然; 韩斌如

    2008-01-01

    Objective To explore the mode of clinical psychological intervention of operative patients,pmbe into the value of music therapy in clinical application,and slart the new application fields.Methods 60 Datients were divided into the experiment group and the control group.Patients in the two groups accepted the pre-operative psychological intervention 1 d before the operation.Afier the operation.the complex psychological intervention was given to the patients during recovery from general anesthesia in the experiment group.While the patients in the control group were waken only by means of music.The heart rate(HR),pulse oximetry (SpO2),mean arterial pressure(MAP) and the objective indexes of Hamilton Anxiety Scale(HAMA)were assessed between the two groups.Results MAP in the experiment group and the control group were(79.80 4±7.76)mm Hg,(82.33±6.42)mm Hg(1 mm Hg=0.133 kPa),respectively,There was no statistical meaning in MAP and SpO2 between the two groups(P>0.05).HR were(80.76±13.92),(85.82±13.39) times/minute.respectively.The difference of HR had statistical meaning(P<0.05).The anxiety degree (9.78 4±2.32)in the experiment group was obviously poor than that(11.08±2.97)in the control group,and the difference had a statistical meaning(P<0.01).Conclusions The complex psychological intervention is a combination of preoperative psychological intervention,postoperative music awakening,and psychological guidance assisted under the music during the stepwise recovery of consciousness.It provides the whole process,timely,individual and pertinent help and psychological guidance,having active effect in reducing the patients' anxiety degree.%目的 探讨手术患者的临床心理干预模式,探索音乐疗法在临床应用中的价值,并开创新的应用领域.方法 60例患者分为实验组与对照组,2组患者于手术前1 d均接受术前心理干预,手术后,实验组患者在全麻苏醒期给予复合心理疏导,对照组患者术后

  18. Effects of different periods of paradoxical sleep deprivation and sleep recovery on lipid and glucose metabolism and appetite hormones in rats.

    Science.gov (United States)

    Brianza-Padilla, Malinalli; Bonilla-Jaime, Herlinda; Almanza-Pérez, Julio César; López-López, Ana Laura; Sánchez-Muñoz, Fausto; Vázquez-Palacios, Gonzalo

    2016-03-01

    Sleep has a fundamental role in the regulation of energy balance, and it is an essential and natural process whose precise impacts on health and disease have not yet been fully elucidated. The aim of this study was to assess the consequences of different periods of paradoxical sleep deprivation (PSD) and recovery from PSD on lipid profile, oral glucose tolerance test (OGTT) results, and changes in insulin, corticosterone, ghrelin, and leptin concentrations. Three-month-old male Wistar rats weighing 250-350 g were submitted to 24, 96, or 192 h of PSD or 192 h of PSD with 480 h of recovery. The PSD was induced by the multiple platforms method. Subsequently, the animals were submitted to an OGTT. One day later, the animals were killed and the levels of triglycerides, total cholesterol, lipoproteins (low-density lipoprotein, very-low-density lipoprotein, and high-density lipoprotein), insulin, ghrelin, leptin, and corticosterone in plasma were quantified. There was a progressive decrease in body weight with increasing duration of PSD. The PSD induced basal hypoglycemia over all time periods evaluated. Evaluation of areas under the curve revealed progressive hypoglycemia only after 96 and 192 h of PSD. There was an increase in corticosterone levels after 192 h of PSD. We conclude that PSD induces alterations in metabolism that are reversed after a recovery period of 20 days.

  19. Effects of music therapy under general anesthesia in patients undergoing abdominal surgery

    Science.gov (United States)

    Kahloul, Mohamed; Mhamdi, Salah; Nakhli, Mohamed Said; Sfeyhi, Ahmed Nadhir; Azzaza, Mohamed; Chaouch, Ajmi; Naija, Walid

    2017-01-01

    ABSTRACT Background: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. Methods: This is a prospective, randomized, double-blind study conducted in the operating theatre of visceral surgery at Sahloul Teaching Hospital over a period of 4 months. Patients aged more than 18 undergoing a scheduled surgery under general anesthesia were included. Patients undergoing urgent surgery or presenting hearing or cognitive disorders were excluded. Before induction, patients wore headphones linked to an MP3 player. They were randomly allocated into 2 groups: Group M (with music during surgery) and group C (without music). Hemodynamic parameters, quality of arousal, pain experienced, patient’s satisfaction, and awareness incidence during anesthesia were recorded. Results: One hundred and forty patients were included and allocated into 2 groups that were comparable in demographic characteristics, surgical intervention type and anesthesia duration. Comparison of these two groups regarding the hemodynamic profile found more stability in group M for systolic arterial blood pressure. A calm recovery was more often noted in group M (77.1% versus 44%, p < 10–3). The average Visual Analog Scale (VAS) score was lower in the intervention group (33.8 ± 13.63 versus 45.1 ± 16.2; p < 10–3). The satisfaction rate was significantly higher among the experimental group (81.4% versus 51.4%; p < 10–3). The incidence of intraoperative awareness was higher in group C (8 cases versus 3 cases) but the difference was not statistically significant. Conclusion: Music therapy is a non-pharmacological, inexpensive, and non-invasive technique that can significantly enhance patient satisfaction and decrease patients’ embarrassing experiences related

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Effect of estradiol, vitamin A, E and selenium treatment with varying sexual rest period on recovery rate in cross-bred cows with chronic endometritis

    Directory of Open Access Journals (Sweden)

    Dipyaman Sengupta

    2013-04-01

    Full Text Available Aim:This work was done to study the effect of vitamin A, E and Se with varying sexual rest period in cross-bred cows with chronic endometritis. Materials and Methods: Cross-bred cows (n=396 from different villages of West Bengal with purulent or muco-purulent discharge with a history of infertility and repeat breeding for 3 to 6 months were chosen for the present study. These cows received uterine wash with lugol's iodine, intra-uterine and parenteral antibiotics and de-worming as general treatment. They were then divided into six groups viz. SR12 × EV (n=59, SR12 × Control (n=67, SR21 × EV (n=65, SR21 × Control (n=70, SR24 × EV (n=66, SR24 × Control (n=69 receiving sexual rest of 12 (SR12, 21 (SR21 and 24 (SR24 days with (EV group or without (control estradiol + vitamin A, E and Se. Results: The results indicate that the recovery rate of EV and control group was 76.27 % and 37.31 % respectively (P<0.01 in SR 12, 72.31 % and 47.14 % respectively (P<0.01 in SR 21 and 92.41 % and 63.77 % respectively (P<0.01 in SR 24. SR 24 showed significantly better (P<0.01 recovery rate compared to SR 12 and SR 21. Lowest recovery and conception rate of EV and control group in SR 12 might be due to insufficient time for the recovery of endometrium. Conclusion: The results indicate that parenteral and intra-uterine antibiotics had synergistic effect with estradiol, vitamin A, E and Se treatment in recovery from endometritis, though a minimum time interval is required for complete recovery of the endometrium for best conception rate. [Vet World 2013; 6(2.000: 106-108

  3. Anesthesia for thoracoscopic surgery

    OpenAIRE

    Conacher I

    2007-01-01

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

  4. 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.

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

    Directory of Open Access Journals (Sweden)

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

    2011-04-01

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

  6. 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...

  7. Impact of parental presence during induction of anesthesia on anxiety level among pediatric patients and their parents: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Sadeghi A

    2017-02-01

    Full Text Available Afsaneh Sadeghi, Ahmad Khaleghnejad Tabari, Alireza Mahdavi, Sara Salarian, Seyed Sajjad Razavi Department of Anesthesiology, Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Introduction: Anesthesia induction is a stressful event for children and their parents, and may have potentially harmful consequences on the patient’s physiological and mental situation. Stressful anesthesia induction has psychological adverse effects that recur with repeated anesthesia, can lead to increased pediatric discomfort during the recovery period, and may even induce reactionary postoperative behavior. A randomized controlled trial was performed to assess the impact of parental presence during induction of anesthesia (PPIA on preoperative anxiety of pediatric patients and their parents at three different times, cooperation of child with anesthesiologist at induction of anesthesia, and parental satisfaction.Patients and methods: A total of 96 pediatric patients undergoing elective minor surgery (ASA 1–2 were randomly divided into two groups. Both groups received oral midazolam (0.5 mg/kg at least 20 minutes before surgery, but in the PPIA group, the parents were also present in the operating room until loss of consciousness of child at anesthesia induction. Anxiety in the patients (as measured by the modified Yale Preoperative Anxiety Scale [mYPAS] and parents (as measured by the State and Trait Anxiety Inventory [STAI], the Induction Compliance Checklist (ICC, and parental satisfaction (as measured by visual analog scale were assessed. Results: There was no significant difference in the mean anxiety scores (mYPAS of participants in the control and PPIA groups at ward T0 and upon arrival to operating room T1 (P>0.05. However, between the PPIA and control groups, mean mYPAS score was different at the time of induction of anesthesia T2 (35.5±16.6 vs 59.8±22.4; P<0.001. The ICC scores showed that perfect score was

  8. Acute Paraplegia After General Anesthesia

    Directory of Open Access Journals (Sweden)

    Gholam Hossein Ghaedi

    2011-08-01

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

  9. 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

  10. Skeletal muscle glycogen content and particle size of distinct subcellular localizations in the recovery period after a high-level soccer match

    DEFF Research Database (Denmark)

    Nielsen, Joachim; Krustrup, Peter; Nybo, Lars

    2012-01-01

    Whole muscle glycogen levels remain low for a prolonged period following a soccer match. The present study was conducted to investigate how this relates to glycogen content and particle size in distinct subcellular localizations. Seven high-level male soccer players had a vastus lateralis muscle...... biopsy collected immediately after and 24, 48, 72 and 120 h after a competitive soccer match. Transmission electron microscopy was used to estimate the subcellular distribution of glycogen and individual particle size. During the first day of recovery, glycogen content increased by ~60% in all...... subcellular localizations, but during the subsequent second day of recovery glycogen content located within the myofibrils (Intramyofibrillar glycogen, a minor deposition constituting 10-15% of total glycogen) did not increase further compared with an increase in subsarcolemmal glycogen (-7 vs. +25...

  11. Anesthesia for Adults Having Eye Surgery

    Science.gov (United States)

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

  12. Efficacy of alfaxalone for intravascular anesthesia and euthanasia in blue crabs (Callinectes sapidus).

    Science.gov (United States)

    Minter, Larry J; Harms, Craig A; Archibald, Kate E; Broadhurst, Heather; Bailey, Kate M; Christiansen, Emily F; Lewbart, Gregory A; Posner, Lysa P

    2013-09-01

    The objective of this study was to characterize the behavioral effects and changes in heart rate of four doses of alfaxalone delivered by intravascular injection to blue crabs (Callinectes sapidus). Thirty (male, n = 27; female, n = 3) blue crabs were randomly assigned to one of four treatment groups of alfaxalone: eight animals were assigned to each of the 5-, 10-, and 15-mg/kg treatment groups, and the remaining six animals were assigned to the 100-mg/kg group. Times for anesthetic induction and recovery periods were recorded. Righting reflex, defensive posturing, and heart rate were evaluated before, during, and after the anesthetic trial. Anesthesia was induced in all 14 animals consolidated into the high-dosage group (15 mg/kg [n = 8] and 100 mg/kg [n = 6]), which was significantly greater than 8 of 16 animals in the low-dosage group (5 mg/kg [n = 2] and 10 mg/kg [n = 6]). Median anesthesia induction time for all crabs was 0.4 min, with no significant difference in induction time between groups observed. Median recovery time was 9.4 min (n = 2), 6.1 min (n = 5), 11.3 min (n = 8), and 66.1 min (n = 5) for the 5-, 10-, 15-, and 100-mg/kg groups, respectively. Recovery times were significantly longer for crabs exposed to an induction dose of 100 mg/kg compared with the 10- and 15-mg/kg induction doses. A significant decrease in the median heart rate was observed between the baseline value and that observed at both induction and 5 min postinjection in the 100-mg/kg dose trial. Two mortalities were observed during the anesthesia trials (n = 1, 10 mg/kg; n = 1, 100 mg/kg), both associated with the autotomization of limbs. In summary, the intravascular administration of alfaxalone at 15 mg/kg provided rapid and reliable sedation, whereas alfaxalone administered at 100 mg/kg produced rapid and long lasting anesthesia.

  13. Sex-specific responses to self-paced, high-intensity interval training with variable recovery periods.

    Science.gov (United States)

    Laurent, C Matthew; Vervaecke, Lauren S; Kutz, Matthew R; Green, J Matthew

    2014-04-01

    This study examined sex-specific responses during self-paced, high-intensity interval training (HIIT). Sixteen (8 men and 8 women) individuals completed a peak oxygen uptake test and 3 treadmill HIIT sessions on separate days. The HIIT sessions consisted of six 4-minute intervals performed at the highest self-selected intensity individuals felt they could maintain. Recovery between intervals was counterbalanced and consisted of 1-, 2-, or 4-minute recovery during each trial. Relative measures of intensity, including percentage of velocity at VO2peak (vVO2peak), %VO2peak, %HRmax, and blood lactate concentration ([La]), were observed during the trials. Perceived readiness was recorded immediately before and ratings of perceived exertion (RPE) were recorded at the end of each interval with session RPE recorded after each trial. Results revealed a significant effect of sex on %vVO2peak (p high-intensity exercise, as they will self-select intensities resulting in greater cardiovascular strain. Moreover, results confirm previous findings suggesting that a 2:1 work-to-rest ratio is optimal during HIIT for both men and women.

  14. Influência da concentração de benzocaína e do comprimento dos peixes na anestesia e na recuperação de tilápias-do-nilo Effect of benzocaine concentration and fish size on anesthesia and recovery in Nile tilapia

    Directory of Open Access Journals (Sweden)

    Daniel Okamura

    2010-05-01

    Full Text Available Com o objetivo de avaliar a influência da concentração de benzocaína na indução e recuperação da anestesia em tilápias-do-nilo (Oreochromis niloticus de diferentes comprimentos, desenvolveu-se um experimento em blocos casualizados, em esquema fatorial 4 × 4, composto de quatro comprimentos de peixes (6; 10; 14 e 18 cm de comprimento total e quatro concentrações de benzocaína (60; 120; 180 e 240 mg por litro de água. A indução e a recuperação da anestesia foram divididas em três estágios, de acordo com o comportamento dos peixes sob efeito do anestésico, registrando-se o tempo de permanência em cada estágio. As diferenças de comprimento não influenciaram de forma significativa os tempos de anestesia e recuperação. Regressões lineares com plateau foram geradas para estimar o ponto em que o aumento da dose deixou de ter efeito. Durante a indução à anestesia, o plateau ocorreu na concentração de 132 mg/L e o tempo estimado para atingir a sedação total (estágio 3 foi de 86 segundos. Para permanência do peixe sob sedação total, é necessária concentração de benzocaína de 190 mg/L e o tempo estimado de permanência neste estágio é de 91,1 segundos. Concentrações superiores a 190 mg de benzocaína por litro de água não produzem efeitos que justifiquem seu emprego.To evaluate the influence of benzocaine concentration on the induction and recovery from anesthesia in different sized Nile tilapia (Oreochromis niloticus, it was developed a random block experiment design in 4 × 4 factorial consisted of four fish lengths (6; 10; 14 and 18 cm total lenght and four benzocaine concentrations (60; 120; 180 and 240 mg of benzocaine per liter of water. The induction and the recovery from anesthesia were divided in three stages based on the behavior of the fishes under anesthetic effect. The time spent in each stage was recorded. Differences in length did not affect significantly the anesthesia and recovery time

  15. Delayed emergence after anesthesia.

    Science.gov (United States)

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

    2015-06-01

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

  16. Nurse anesthesia and multiculturalism.

    Science.gov (United States)

    Horton, B J; Waugaman, W R

    1996-01-01

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

  17. 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.

  18. Anesthesia and pulmonary hypertension.

    Science.gov (United States)

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

    2012-01-01

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

  19. 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.

  20. [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.

  1. Differential effects of controlled hypotension on gastric intramucosal pH and post-operational gastrointestinal functional under two different anesthesia methods

    Institute of Scientific and Technical Information of China (English)

    Guanglei Wang; Junli Cao; Gongjian Liu

    2008-01-01

    Objective: To observe the effects of controlled hypotension on gastric intramucosal pH and post-operational gastrointestinal functions using two specific anesthesia methods. Methods: Thirty patients(ASA Ⅱ)scheduled for ectomy of hepatocarcinoma, were randomly assigned to two groups: epidural block combined with intravenous anesthesia group(E group) and inhalation anesthesia group(G group). Gastric PgCO2 and pHi were monitored at different time points, before theintravenous induction of controlled hypotension, after 1 h and 2 h, and 1 h after the termination of controlled hypotension. In the meanwhile, the artery blood gas was analyzed. Results: There was no significant difference in blood gas indexes between E group and G group. However, pHi decreased significantly after 1 h and 2 h of controlled hypotension(P<0.05), and during the same periods PgCO2 increased significantly(P<0.05 or P<0.01), the time of bowel movement and defecating deferred significantly shorter in G group patients, when compared with E group patients. Conclusion: Epidural block in combination with general anesthesia can improve gastrointestinal blood flow during controlled hypotension and facilitates post-operational recovery of gastrointestinal functions.

  2. Histological Evaluation of Prostate Tissue Response to Image-Guided Transurethral Thermal Therapy After a 48h Recovery Period

    Science.gov (United States)

    Boyes, Aaron; Tang, Kee; Chopra, Rajiv; Bronskill, Michael

    2009-04-01

    Image-guided transurethral ultrasound thermal therapy shows strong potential for sparing of critical adjacent structures during prostate cancer treatment. Preclinical experiments were conducted to provide further information on the extent of the treatment margin. Four experiments were carried out in a canine model to investigate the pathology of this margin during the early stages of recovery and were compared to previous results obtained immediately post-treatment. Sedated animals were placed in a 1.5T clinical MRI, and the heating device was positioned accurately within the prostatic urethra with image guidance. Using an MRI-compatible system, the ultrasound device was rotated 365° treating a prescribed volume contained within the gland. Quantitative temperature maps were acquired throughout the treatment, providing feedback information for device control. Animals were allowed to recover and, after 48h, an imaging protocol including T2 and contrast enhanced (CE) MRI was repeated before the animals were sacrificed. Prostate sections were stained with H&E. Careful slice alignment methods during histological procedures and image registration were employed to ensure good correspondence between MR images and microscopy. Although T2 MRI revealed no lesion acutely, a hypo-intense region was clearly visible 2 days post-treatment. The lesion volume defined by CE-MRI increased appreciably during this time. Whole-mount H&E sections showed that the margin between coagulated and normal-appearing cells narrowed during recovery, typically to a width of under 1mm compared to 3mm acutely. These results illustrate the high level of precision achievable with transurethral thermal therapy and suggest methods to monitor the physiological response non-invasively.

  3. Recovery of ordered periodic orbits with increasing wavelength for sound propagation in a range-dependent waveguide

    CERN Document Server

    Kon'kov, L E; Sosedko, E V; Uleysky, M Yu

    2014-01-01

    We consider sound wave propagation in a range-periodic acoustic waveguide in the deep ocean. It is demonstrated that vertical oscillations of a sound-speed perturbation, induced by ocean internal waves, influence near-axial rays in a resonant way, producing ray chaos and forming a wide chaotic sea in the underlying phase space. We study interplay between chaotic ray dynamics and wave motion with signal frequencies of 50-100 Hz. The Floquet modes of the waveguide are calculated and visualized by means of the Husimi plots. Despite of irregular phase space distribution of periodic orbits, the Husimi plots display the presence of ordered peaks within the chaotic sea. These peaks, not being supported by certain periodic orbits, draw the specific "chainlike" pattern, reminiscent of KAM resonance. The link between the peaks and KAM resonance is confirmed by ray calculations with lower amplitude of the sound-speed perturbation, when the periodic orbits are well-ordered. We associate occurrence of the peaks with the r...

  4. 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.

  5. Optimal effect-site concentration of remifentanil for preventing cough during removal of the double-lumen endotracheal tube from sevoflurane-remifentanil anesthesia: A prospective clinical trial.

    Science.gov (United States)

    Lee, Sook Young; Yoo, Ji Young; Kim, Jong Yeop; Kim, Dae Hee; Lee, Jung Dong; Rho, Go Un; Park, Hyungbae; Park, Sung Yong

    2016-06-01

    Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled. The effective effect-site concentration (Ce) of remifentanil for 50% and 95% of patients (EC50 and EC95) for preventing cough was determined using the isotonic regression method with a bootstrapping approach, following the Dixon up-and-down method. Recovery profiles and hemodynamic values after anesthesia were compared between patients with cough and patients without cough.EC50 and EC95 of remifentanil was 1.670 ng/mL [95% confidence interval (95% CI) 1.393-1.806] and 2.275 ng/mL (95% CI 1.950-2.263), respectively. There were no differences in recovery profiles and hemodynamic values after anesthesia between patients with/without cough. No patients suffered respiratory complications during the emergence period.Remifentanil can be a safe and reliable method of cough prevention during emergence from sevoflurane anesthesia after thoracic surgery requiring DLT. EC50 and EC95 of remifentanil that suppresses coughing is 1.670 and 2.275 ng/mL, respectively.

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

    Directory of Open Access Journals (Sweden)

    Subash Kennedy Sivasubramaniam

    2014-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Mariana Correia

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Eng MR

    2015-07-01

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

  10. Comparative study on early period of recovery between minimally invasive surgery total knee arthroplasty and minimally invasive surgery-quadriceps sparing total knee arthroplasty in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    YU Jia-kuo; YU Chang-long; AO Ying-fang; GONG Xi; WANG Yong-jian; WANG Shu; XING Xie; CHEN Lian-xu; JU Xiao-dong

    2008-01-01

    Background Different kinds of minimally invasive surgery (MIS) procedures have now been used in total knee arthroplasty (TKA). Compared with traditional TKA procedure with a long skin incision, clinical studies showed MIS procedures had some advantages. Quadriceps sparing (QS) procedures are the most minimally invasive MIS procedure until now. This study was aimed to find the insertion types for Chinese patients' vastus medialis and if the QS procedure had some advantages in patients' early recovery.Methods Between February 2006 and May 2007, 120 consecutive patients underwent unilateral primary TKA under general anesthesia, among whom 14 patients were lost to follow-up, the remaining 106 cases were enrolled in this study. Among the 106 cases there were 85 right knees, 21 left knees (15 men and 91 women, with a mean age of 65.1±7.4 years); osteoarthritis in 97 patients (91.5%) and rheumatoid arthritis in 9 patients (8.5%). MIS TKA was performed in 49 cases (MIS TKA group), while MIS-QS TKA in 57 cases (MIS-QS TKA group). During the operation, the type Ⅰ, Ⅱ and Ⅲ insertions of the vastus medialis for all patients were recorded. Each knee was rated post-operatively according to the Hospital of Special Surgery (HSS) scoring system. Clinical follow-up was undertaken at 1 week, 2, 6, 12 and 24 weeks. Operating time and complications were recorded.Results There was no statistically significant difference between the two groups for gender distribution, age, left or right knee incidence, pre-operative diagnosis, incidence of varus or valgus deformity. Of the 106 cases there was 1 (0.9%) case with a type Ⅰ insertion of the vastus medialis, 4 (3.8%) cases with type Ⅱ insertions, 101 (95.3%) cases with type Ⅲ insertions. The HSS scoring was significantly different between the MIS-QS TKA group and MIS TKA group within the first two weeks post operation. From 2 weeks later to 24 weeks, no significant difference was found. The average operating time was (53.3±12

  11. Hemoptysis during general anesthesia in a diabetic patient with healed tuberculosis: a case report

    Science.gov (United States)

    Chung, Mee Young; Jeong, Hyeon-Do; Kim, Seul-Gi

    2017-01-01

    Hemoptysis is a common complication of pulmonary tuberculosis. Most of the cases of hemoptysis originate from hypertrophied bronchial arteries. Also, diabetes induces pulmonary vascular abnormalities such as endothelial dysfunction, inflammatory infiltration and pulmonary vascular remodeling. A 27-year-old male, with diabetes and a history of tuberculosis, underwent the procedure of pars plana vitrectomy under general anesthesia. After an uneventful intra-operative period, he had hemoptysis prior to extubation. Emergency fiberoptic bronchscopy showed blood plugs and spotted fresh blood at the right upper lobar bronchus. After successful embolization of the bronchial artery, the patient made a recovery and was discharged without experiencing any complication. Predisposing factors of hemoptysis in this case are presumed to be tuberculosis and diabetes. The bleeding might had been caused by the rupture of a weakened artery within the cavity in the right upper lobe, through expansion of the lung during manual ventilation by positive pressure. PMID:28184273

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

    Directory of Open Access Journals (Sweden)

    Ashish

    2014-09-01

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

  13. Recovery from Age-Related Infertility under Environmental Light-Dark Cycles Adjusted to the Intrinsic Circadian Period

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    Nana N. Takasu

    2015-09-01

    Full Text Available Female reproductive function changes during aging with the estrous cycle becoming more irregular during the transition to menopause. We found that intermittent shifts of the light-dark cycle disrupted regularity of estrous cycles in middle-aged female mice, whose estrous cycles were regular under unperturbed 24-hr light-dark cycles. Although female mice deficient in Cry1 or Cry2, the core components of the molecular circadian clock, exhibited regular estrous cycles during youth, they showed accelerated senescence characterized by irregular and unstable estrous cycles and resultant infertility in middle age. Notably, tuning the period length of the environmental light-dark cycles closely to the endogenous one inherent in the Cry-deficient females restored the regularity of the estrous cycles and, consequently, improved fertility in middle age. These results suggest that reproductive potential can be strongly influenced by age-related changes in the circadian system and normal reproductive functioning can be rescued by the manipulation of environmental timing signals.

  14. Recovery from Age-Related Infertility under Environmental Light-Dark Cycles Adjusted to the Intrinsic Circadian Period.

    Science.gov (United States)

    Takasu, Nana N; Nakamura, Takahiro J; Tokuda, Isao T; Todo, Takeshi; Block, Gene D; Nakamura, Wataru

    2015-09-01

    Female reproductive function changes during aging with the estrous cycle becoming more irregular during the transition to menopause. We found that intermittent shifts of the light-dark cycle disrupted regularity of estrous cycles in middle-aged female mice, whose estrous cycles were regular under unperturbed 24-hr light-dark cycles. Although female mice deficient in Cry1 or Cry2, the core components of the molecular circadian clock, exhibited regular estrous cycles during youth, they showed accelerated senescence characterized by irregular and unstable estrous cycles and resultant infertility in middle age. Notably, tuning the period length of the environmental light-dark cycles closely to the endogenous one inherent in the Cry-deficient females restored the regularity of the estrous cycles and, consequently, improved fertility in middle age. These results suggest that reproductive potential can be strongly influenced by age-related changes in the circadian system and normal reproductive functioning can be rescued by the manipulation of environmental timing signals.

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

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    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

  16. Transverse myelitis following spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Jha Sanjeev

    2006-01-01

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

  17. 瑞芬太尼、芬太尼在肥胖患者麻醉中的应用观察%Observation of application of remifentanil and fentanyl in obese patients during anesthesia period

    Institute of Scientific and Technical Information of China (English)

    韦克; 邓军; 黄仕英

    2014-01-01

    Objective To explore the efficacy and safety of remifentanil and fentanyl in obese patients.Methods 96 obese patients applied general anesthesia in our hospital from October 2012 to October 2013 were randomly equally divided into three groups by hidden numbers.They were used remifentanil,fentanyl,remifentanil fentanyl fentanyl anesthesia.The hemodynamics was compared in the three groups,using the visual analogue scale (VAS)and sedation /alertness score (OAA /S).Results Before induction,the difference was not significant in intubation MAP of three groups (P >0.05).MAP significantly increased after intubation in fentanyl group, compared with the combined group and remifentanil group .The difference was significant . (P <0.05).Compared with the fentanyl group,MAP in extubation remifentanil group signifi-cantly increased.joint group difference was significant (P <0.05).VAS score in Remifentanil group was significantly higher than that in the fentanyl group,OAA /S score in combined group and the fentanyl group was significantly lower than that in remifentanil group.The difference was significant with the comparison of different groups.(P <0.05).Conclusion The efficacy and safety of remifentanil and fentanyl anesthesia in obese patients have greater advantages.%目的:观察瑞芬太尼、芬太尼在肥胖患者麻醉中的有效性和安全性。方法选择本院2012年10月-2013年10月拟全身麻醉手术的肥胖患者96例,采用隐藏数字随机法分为3组,每组32例,分别采用瑞芬太尼、芬太尼、瑞芬太尼复合芬太尼麻醉,比较3组血流动力学,采用视觉模拟评分(VAS)和镇静/警觉评分(OAA /S)。结果诱导前、插管前3组患者MAP 比较差异无统计学意义(P >0.05)。插管后芬太尼 MAP 明显升高,与瑞芬太尼组、联合组比较差异有统计学意义(P <0.05),拔管时瑞芬太尼组 MAP 明显升高,与芬太尼组、联合组比较差异有统计学意义(P <0

  18. 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....

  19. Influence of arbuscular mycorrhizal fungi and treated wastewater on water relations and leaf structure alterations of Viburnum tinus L. plants during both saline and recovery periods.

    Science.gov (United States)

    Gómez-Bellot, María José; Nortes, Pedro Antonio; Ortuño, María Fernanda; Romero, Cristina; Fernández-García, Nieves; Sánchez-Blanco, María Jesús

    2015-09-01

    Nowadays, irrigation with low quality water is becoming an alternative to satisfy the needs of crops. However, some plant species have to deal with high salinity of reclaimed water, by adapting their physiological behaviour during both saline and recovery periods and developing morphological changes in their leaves. The application of arbuscular mycorrhizal fungi (AMF) could also be a suitable option to mitigate the negative effects of this kind of water, although the effectiveness of plant-AMF association is influenced by many factors. In this work, during forty weeks, the combined effect of Glomus iranicum var. tenuihypharum and two types of water: control, C, EC<0.9 dS m(-1) and reclaimed water, RW (with EC: 4 dS m(-1) during a first saline period and EC: 6 dS m(-1) during a second saline period) was evaluated for laurustinus plants (Viburnum tinus L.) transplanted in soil. This was followed by a recovery period of eight weeks, when all the plants were irrigated in the control irrigation conditions. Seasonal and daily changes in stem water potential (Ψstem), stomatal conductance (gs), photosynthesis (Pn) and leaf internal CO2 concentration (Ci) of laurustinus plants were evaluated. Leaf structure alterations, nutrient imbalance, height and leaf hydraulic conductivity (Kleaf) were also determined. Due to the high difficulty of absorbing water from the soil, RW plants showed a high volumetric water content (θv) in soil. The stem water potential and the stomatal conductance (gs) values were reduced in RW plants throughout the second saline period. These decreases were also found during the day. Leaf Ca(2+)/Na(+) and K(+)/Na(+) ratios diminished in RW plants respect to the C plants due to the Na(+) accumulation, although height and chlorophyll content values did not show statistical differences. Leaves from RW plants showed a significantly thicker mesophyll than Control leaves as a consequence of high EC. The area of palisade parenchyma (PP) increased while the

  20. Isoflurane anesthesia initiated at the onset of reperfusion attenuates oxidative and hypoxic-ischemic brain injury.

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    Sergey A Sosunov

    Full Text Available This study demonstrates that in mice subjected to hypoxia-ischemia (HI brain injury isoflurane anesthesia initiated upon reperfusion limits a release of mitochondrial oxidative radicals by inhibiting a recovery of complex-I dependent mitochondrial respiration. This significantly attenuates an oxidative stress and reduces the extent of HI brain injury. Neonatal mice were subjected to HI, and at the initiation of reperfusion were exposed to isoflurane with or without mechanical ventilation. At the end of HI and isoflurane exposure cerebral mitochondrial respiration, H2O2 emission rates were measured followed by an assessment of cerebral oxidative damage and infarct volumes. At 8 weeks after HI navigational memory and brain atrophy were assessed. In vitro, direct effect of isoflurane on mitochondrial H2O2 emission was compared to that of complex-I inhibitor, rotenone. Compared to controls, 15 minutes of isoflurane anesthesia inhibited recovery of the compex I-dependent mitochondrial respiration and decreased H2O2 production in mitochondria supported with succinate. This was associated with reduced oxidative brain injury, superior navigational memory and decreased cerebral atrophy compared to the vehicle-treated HI-mice. Extended isoflurane anesthesia was associated with sluggish recovery of cerebral blood flow (CBF and the neuroprotection was lost. However, when isoflurane anesthesia was supported with mechanical ventilation the CBF recovery improved, the event associated with further reduction of infarct volume compared to HI-mice exposed to isoflurane without respiratory support. Thus, in neonatal mice brief isoflurane anesthesia initiated at the onset of reperfusion limits mitochondrial release of oxidative radicals and attenuates an oxidative stress. This novel mechanism contributes to neuroprotective action of isoflurane. The use of mechanical ventilation during isoflurane anesthesia counterbalances negative effect of isoflurane anesthesia on

  1. Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study

    Directory of Open Access Journals (Sweden)

    Mefkur Bakan

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting. METHODS: 80 Anesthesiologists I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF. All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver IV fentanyl for 6 h after surgery. The primary outcome variable was postoperative fentanyl consumption. RESULTS: Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF, which were 75 ± 59 µg and 120 ± 94 µg respectively, while it was comparable at postoperative 6th hour. During anesthesia, there were more hypotensive events in Group RF, while there were more hypertensive events in Group DL, which were both statistically significant. Despite higher recovery times, Group DL had significantly lower pain scores, rescue analgesic and ondansetron need. CONCLUSION: Opioid-free anesthesia with dexmedetomidine, lidocaine and propofol infusions may be an alternative technique for laparoscopic cholecystectomy especially in patients with high risk for postoperative nausea and vomiting.

  2. 围手术麻醉期患者睡眠质量与心理健康状态的相关性分析%Correlation analysis of sleep quality and mental health status in patients with Perioperative anesthesia period

    Institute of Scientific and Technical Information of China (English)

    李鹏

    2011-01-01

    Objective: To evaluate the relationship between sleep quality and mental health status in patients with Perioperative anesthesia period. Methods: The Pittsburgh sleep quality index questionnaire (PSQI), depression self rating scale (SDS) and anxiety self-evaluation questionnaire (SAS) were assessed and analysized in SO patients with Perioperative anesthesia period (case group) and 40 normal subjects (normal group). Results: The rates of sleep disorder, anxiety and depression are 26%, 24% and 56% respectively in case group.The abnormal rate of score of PSQI,SAS and SDS in two groups comparativly P is <0.05. Difference was statistically significant. The total score of PSQI, PSQI sub-projects sleep efficiency and sleep disorders, standard score of SDS, SDS four sub-projects mental and emotional disorders.body sexual failure.spiritual motility disorders, depression of psychological barriersand and standard score of SAS in two groups comparativly P is <0.05. Difference was statistically significant. Correlation analysis showed that PSQI scores negatively correlated with mental health scores. Conclusion: There were existed the sleep disorders, anxiety depression of psychological barriers of emotional in patientswith Perioperative anesthesia period and the sleep quality scores was related to mental health status scores in patients with Perioperative anesthesia period.%目的:了解围手术麻醉期患者的睡眠质量与心理健康状态的关系.方法:对50例备行手术麻醉患者(试验组)及40名正常人(对照组)行匹兹堡睡眠质量指数问卷(PSQI)评定、抑郁自评量表(SDS)及焦虑自评量(SAS)评定,对上述量表结果进行分析.结果:试验组睡眠紊乱率、焦虑及抑郁发生率分别为:26%、24%及 56%,两组PSQI、SAS及SDS评分异常率比较P<0.05,差异有统计学意义.两组患者的PSQI总分、PSQI子项目睡眠效率及睡眠障碍、SDS标准分、SDS 4个子项目精神性情感症状、躯体性障碍、

  3. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

  5. The effect of midazolam on the recovery quality, recovery time and the minimum alveolar concentration for extubation in the isoflurane-anesthetized pig.

    Science.gov (United States)

    Kleine, S A; Quandt, J E; Hofmeister, E H; Peroni, J

    2015-04-01

    There are no reported studies evaluating the effect of midazolam on recovery quality, recovery time or minimum alveolar concentration (MAC) at which extubation occurs (MAC extubation). Our hypotheses were that midazolam administered prior to recovery would decrease MAC extubation, prolong recovery time but provide a smoother recovery. Sixteen Yorkshire pigs were anesthetized with isoflurane for approximately 5 h. The end-tidal isoflurane concentration was then stabilized at 1.4% for 20 min. Pigs were randomly assigned to receive midazolam or saline. The vaporizer was decreased by 10% every 10 min until extubation. Pigs were declared awake by a blinded observer and were assigned a recovery score by the same observer. Mean MAC extubation was not significantly different for pigs receiving saline prior to recovery compared with those pigs receiving midazolam. The overall mean MAC extubation for both groups was 0.6 ± 0.4 vol%. Time to extubation was not significantly longer with midazolam (124 ± 36 min) compared with the saline group (96 ± 61 min; P = 0.09). Recovery score was not significantly different between groups (midazolam, 0.86 ± 1.1; saline 0.5 ± 0.5; P = 0.26). In conclusion, midazolam did not affect MAC extubation. There was no advantage of administering midazolam in the recovery period when performing step-down titration of isoflurane anesthesia.

  6. 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.

  7. 潜伏期行椎管内阻滞麻醉分娩镇痛对孕妇妊娠结局与新生儿预后的影响%The Effect of Incubation Period Line Block Anesthesia Intra-Spinal Canal Labor Analgesia on Pregnant Women Pregnancy Outcome and Neonatal Prognosis

    Institute of Scientific and Technical Information of China (English)

    贾利红; 王文凯; 陈艳丽

    2015-01-01

    目的:潜伏期行椎管内阻滞麻醉分娩镇痛对孕妇妊娠结局与新生儿预后的影响。方法:选取2013年1月-2014年3月本院通过麻醉分娩镇痛的孕妇174例,依据随机分配原则分为潜伏组和对照组,两组孕妇均给予常规椎管内阻滞麻醉分娩镇痛治疗,对照组孕妇在宫口开大高于3 cm时给予实施,潜伏组孕妇在宫口扩张1~2 cm时给予实施,在孕妇宫口开始扩张时应用视觉模拟疼痛评分法(VAS)对孕妇进行疼痛评估,统计分析所有孕妇产程时间、疼痛情况、分娩结局和围产儿结局。结果:潜伏组产妇第一、第二产程时间明显短于对照组,宫口扩张60 min内各时点VAS评分明显低于对照组,差异均有统计学意义(P<0.05);潜伏组产妇分娩结局明显优于对照组,差异有统计学意义(P<0.05);潜伏组产妇产后围产儿结局明显优于对照组,差异有统计学意义(P<0.05)。结论:潜伏期行椎管内阻滞麻醉分娩镇痛方式可有效缩短产妇产程时间,快速缓解产妇疼痛,有助于实现产程无痛分娩,增强产妇自然分娩的信心,对降低剖宫产率有积极作用。同时改善孕妇妊娠结局和围产儿结局,有利于提高新生儿预后水平,值得临床作进一步推广。%Objective:To discuss the effect of incubation period line block anesthesia intra-spinal canal labor analgesia on pregnant women pregnancy outcome and neonatal prognosis.Method:174 pregnant women with incubation period line block anesthesia intra-spinal canal labor analgesia were selected from January 2013 to March 2014 in our hospital, according to the random distribution, all patients were divided into latent group and the control group. Two groups of pregnant women were given the conventional block anesthesia labor analgesia intra-spinal canal treatment, the control group of pregnant women in the palace mouth up higher than 3 cm given

  8. Anesthesia for off-pump coronary artery bypass surgery

    Directory of Open Access Journals (Sweden)

    Thomas M Hemmerling

    2013-01-01

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

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

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    Antonio Abramo

    2010-01-01

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

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

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    Shoeibi G

    2004-07-01

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

  11. The Effect of Ondansetron and Dexamethasone on Nausea and Vomiting under Spinal Anesthesia

    Science.gov (United States)

    Kalani, Navid; Zabetian, Hasan; Sanie, Mohammad Sadegh; Deylami, Mansour; Radmehr, Mohammad; Sahraei, Reza; Kargar Jahromi, Hossein; Kooti, Wesam

    2017-01-01

    BACKGROUND During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors. This study compared the effects of ondansetron and dexamethasone on nausea and vomiting under spinal anesthesia. METHODS One hundred and twenty patients of 15 to 35 years old with ASA class I and II were enrolled. Before administering either ondansetron or dexamethasone, blood pressure and heart rate of the patients were recorded. The patients received 70 mg of 5% lidocaine for spinal anesthesia. Patients who received 6 mg of ondansetron were considered as group A, while group B received 8 mg of dexamethasone. The level of nausea and vomiting, blood pressure, heart rate and respiratory rate of each patient was measured at 1, 5, 10, 15 and 30 minutes after spinal anesthesia and during recovery (every 5 minutes). RESULTS There was a significant difference between nausea and vomiting between the two groups after spinal anesthesia within the first and fifth minutes. There was no significant difference between nausea and vomiting between the two groups within 10, 15 and 30 minutes and during recovery at 5, 10, 15 and 30 minutes. CONCLUSION Dexamethasone and ondansetron were shown to equally reduce the incidence of nausea and vomiting under spinal anesthesia and can be recommended as a good choice for prevention of nausea and vomiting during surgeries. PMID:28289619

  12. Elevation of a patient's trunk and legs does not influence length of stay in the post-anesthesia care unit

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    Otávio Omati

    Full Text Available CONTEXT: Patient recovery time after anesthesia depends on problem-oriented monitoring and individual assessment. OBJECTIVE: To investigate the influence of patient positioning on post-anesthesia recovery time. TYPE OF STUDY: Retrospective. SETTING: Post-anesthesia care unit, Hospital das Clínicas, São Paulo. METHODS: Data were obtained from patients recovering from anesthesia in a supine horizontal position or with their trunk and legs elevated at 30 degrees. Data were recorded every 30 minutes. The start time was considered to be the admission to the unit, and the final measurement was taken when the patient reached an Aldrete-Kroulik index of 10. The length of time until discharge was recorded. RESULTS: 442 patients recovering after general (n = 274 or regional anesthesia (n = 168 were assigned to be kept in a supine position or with their trunk and legs elevated. There was no difference in the medians for non-parametric results, between supine position (75 min, n = 229 and trunk and legs elevated (70 min, n = 213; p = 0.729. Patients recovered faster from regional anesthesia with trunk and legs elevated (70 min than in the supine position (84.5 min, although not significantly (p = 0.097. There was no difference between patients recovering from general anesthesia, no matter the positioning (70 min; p = 0.493. DISCUSSION: Elevated legs may supposedly improve venous return and cardiac output since spinal anesthesia blocks sympathetic system and considering leg-raising has been shown to improve cardiac output from hipovolemia. Our findings did not support this hypothesis. Some limitations included a retrospective collection of data that did not allow randomization for recovery position and the unregistered duration of the exposure to the anesthetic drugs. CONCLUSIONS: There was no difference in anesthesia recovery time in relation to positioning patients supinely or with trunk and legs elevated.

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

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    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.

  14. Quality control and assurance in anesthesia: A necessity of the modern times.

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Jindal, Ravi

    2014-01-01

    The advent of newer developments in anesthesia techniques and current clinical scenario has necessitated assurance of quality anesthesia services delivery. Numerous factors including availability of newer drugs, availability of newer advanced monitoring gadgets, increased awareness among the patient population, implementation of newer medico-legal laws and professional competitiveness has mandated a quality control and assurance in anesthesia. These domains of quality control are adapted from public health and are being incorporated into daily anesthesia practice in a gradual and phased manner. Quality control and assurance can be assessed and measured with certain quality indicators, which are also helpful in determining the perioperative outcome in anesthesia and surgical practice. Patient's perception about various anesthetic procedures, drug effects and recovery state are the prime underlying basis for assessing the quality assurance and control. At the same time, a positive impact of feedback mechanism cannot be under-emphasized while aiming for improvement in delivery of quality anesthesia services. The current review is aimed at highlighting the important aspects associated with quality assurance and quality control in anesthesia practice.

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

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    Hockel Konstantin

    2012-03-01

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

  16. 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...

  17. 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.

  18. 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.

  19. Comparison of Intravenous Dexmedetomidine and Midazolam for Bispectral Index-Guided Sedation During Spinal Anesthesia.

    Science.gov (United States)

    Jo, Youn Yi; Lee, Dongchul; Jung, Wol Seon; Cho, Noo Ree; Kwak, Hyun Jeong

    2016-10-04

    BACKGROUND Despite the high frequency of hypotension during spinal anesthesia with proper sedation, no previous report has compared the hemodynamic effects of dexmedetomidine and midazolam sedation during spinal anesthesia. We compared the effects of bispectral index (BIS)-guided intravenous sedation using midazolam or dexmedetomidine on hemodynamics and recovery profiles in patients who underwent spinal anesthesia. MATERIAL AND METHODS One hundred and sixteen adult patients were randomly assigned to receive either midazolam (midazolam group; n=58) or dexmedetomidine (dexmedetomidine group; n=58) during spinal anesthesia. Systolic, diastolic, and mean arterial pressures; heart rates; peripheral oxygen saturations; and bispectral index scores were recorded during surgery, and Ramsay sedation scores and postanesthesia care unit (PACU) stay were monitored. RESULTS Hypotension occurred more frequently in the midazolam group (Pmidazolam sedation.

  20. Total intravenous anesthesia without muscle relaxant in a patient with amyotrophic lateral sclerosis.

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    Lee, Dongchul; Lee, Kyung Cheon; Kim, Ji Young; Park, Yeon Soo; Chang, Young Jin

    2008-01-01

    A 63-year-old woman with amyotrophic lateral sclerosis (ALS) was scheduled for open reduction and internal fixation of the right tibia. Total intravenous anesthesia using propofol and remifentanil without muscle relaxant was selected as the anesthetic method, in order to avoid the possible occurrence of ventilatory depression due to abnormal responses to muscle relaxants and exacerbation of the motor neuron disease. After standard and neuromuscular monitoring devices were applied, anesthesia was induced and maintained with target controlled infusion of propofol and remifentanil in the range of 2.5-5.0 microg x ml(-1) and 2.5-5.0 ng x ml(-1), respectively. To avoid delayed neuromuscular recovery, we did not use any muscle relaxant at all. Intubation was successful and there were no remarkable events during anesthesia, except for three brief hypotensive events; there was no exacerbation of ALS itself during or after the anesthesia. She was discharged on postoperative day 3, without any discomfort.

  1. 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...

  2. Comparative efficacy of Diazepam, Ketamine, and Diazepam-Ketamine combination for sedation or anesthesia in cockerel chickens

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    Muhammad Abdullahi Mahmud

    2014-09-01

    Full Text Available The comparative efficacy of Diazepam, Ketamine, and Ketamine-Diazepam combination was assessed in adult chickens. The chickens (n=30 were divided into three equal groups (G-1, G-2 and G-3, and were administered with Diazepam dosed at 0.5 mg/kg body weight (b.wt., Ketamine HCL dosed at 20 mg/kg b.wt., and Ketamine HCL (dosed at 10 mg/kg b.wt. combined with Diazepam (dosed at 2 mg/kg b.wt. through intramuscular (IM route. The means of induction period, duration of sedation or anesthesia, full recovery period and duration of analgesia were significantly (p≤0.05 differed among the groups. Also, the clinical and hematological parameters measured before and after the sedation or anesthesia within the groups were found to be differed significantly (p≤0.05 from each other. It was concluded that Diazepam dosed at 0.5 mg/kg b.wt. (IM can be used in cockerels. However, combination of Ketamine (at 10 mg/kg IM-Diazepam (at 2 mg/kg b.wt. IM is preferably recommended as this combination is comparatively safer, and minimizes the pains elicited from the surgical procedure of using Diazepam alone.

  3. 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.

  4. Comparison Of The Direct Costs, Length Of Recovery, And Incidence Of Post Operative Anti Emetic Use After Anesthesia Induction With Propofol Or A 1:1 Mixture Of Thiopental And Propofol

    Science.gov (United States)

    1999-10-01

    by previous injection of lidocaine (Stolting, 1991). It is associated with a period of apnea when first administered that quickly resolves. Apnea... pharmacodynamics of induction agents will help the provider to make informed choices when using these agents. Barbiturates such as thiopental have been shown to

  5. Effects of active and passive training apparatus combined with rehabilitation training on lower limb function of stroke patients during recovery period

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Stroke patients always spontaneously do some learning and training of motor functions;however, learning and training are not prompt and right, while patients do not have enough activity amounts.Active and passive motor training apparatus is aimed directly at lower limb training so as to stimulate nerve function through stimulating muscular movement. Based on motor mileage, motor time, various power supplies and velocity of active and passive training apparatus, we can understand the training condition and adjust training program.OBJECTIVE: To observe the effects of grade-III rehabilitation training combining with active and passive training apparatus on lower limb function, muscle strength and activity of daily living (ADL) in stroke patients during recovery period.DESIGN: Contrast observation.SETTING: Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine.PARTICIPANTS: A total of 80 patients with stroke-induced hemiplegia after stabilizing vital signs for 2 weeks were selected from Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine from January to June 2007. There were 47 males and 33 females, and their ages ranged from 41 to 75 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Disease Academic Meeting in 1995 and were diagnosed as cerebral hemorrhage or cerebral infarction through CT or MRI examinations in clinic. Patients and their parents provided the confirmed consent. Based on therapeutic orders of hospitalization, patients were randomly divided into treatment group and control group with 40 patients in each group.METHODS: Patients in the control group received physical therapy and occupational therapy combining with rehabilitative treatment based on grade-Ⅲ rehabilitative treatment program, which was set by the National Cerebrovascular Disease Topic Group. In addition, patients in the treatment group were trained with active and passive

  6. Assessing the length of the post-disturbance recovery period for woodland caribou habitat after fire and logging in west-central Manitoba

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    Juha M. Metsaranta

    2007-04-01

    Full Text Available This study examined the habitat characteristics of areas used by woodland caribou and areas disturbed by fire or logging in the Naosap caribou range in west-central Manitoba. The population inhabiting this area is currently considered to be of high conservation concern. The purpose was to determine how long after disturbance forests again resembled caribou habitat and whether there were differences in the recovery period between fire disturbed and logged areas. Sample transects were located in areas used by caribou and areas disturbed by fire or logging. Previously, it was shown that variables positively associated with habitat suitability in this region were species composition (presence of black spruce, an index of arboreal lichen abundance and tree size, while variables negatively associated with habitat suitability were deadfall abundance and species composition (presence of trembling aspen. It was hypothesized that if disturbed sites had become suitable caribou habitat, then they should be statistically indistinguishable from sites used by caribou based on these variables. Using cluster analysis, it was found that 2 statistical clusters showed the highest level of agreement with sampling clusters, with 88% of plots used by caribou classified into one cluster, and 74% of disturbed plots classified into the other. Although a small proportion (12% of disturbed plots resembled used plots, 30 years (the age of the oldest disturbed plot was not enough time, in general, for forest to return to conditions resembling caribou habitat in this region.

  7. Anesthesia Fact Sheet

    Science.gov (United States)

    ... of tools to study them at the molecular level contributed to this period of slow scientific progress. Today, advances in cell biology, genetics and molecular biology have transformed anesthesiology into ...

  8. Dexmedetomidine for the prevention of shivering during spinal anesthesia

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    Burhanettin Usta

    2011-01-01

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

  9. Sufentanil reduces emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl

    Institute of Scientific and Technical Information of China (English)

    LI Jun; HUANG Zhi-lian; ZHANG Xu-tong; LUO Ke; ZHANG Zhan-qin; MAO Yi; ZHUANG Xiao-biao; LIAN Qing-quan; CAO Hong

    2011-01-01

    Background Emergence agitation is a common problem in pediatric anesthesia,especially after sevoflurane induction and maintenance anesthesia.The purpose of this study was to investigate the effect of sufentanil to reduce emergence agitation after sevoflurane anesthesia in children undergoing adenotonsillectomy compared with fentanyl.Methods One hundred and five children,aged 3-11 years,were randomly allocated to receive normal saline (control group),sufentanil 0.2 μg/kg (S2) or fentanyl 2 μg/kg (F2) 1 minute after loss of the eyelash reflex.Anesthesia was induced and maintained with sevoflurane.Time to tracheal extubation,recovery time,Paediatric Anesthesia Emergence Delirium (PAED) scale,and emergence behavior were assessed.Results The incidence of severe agitation was significantly lower in S2 and F2 groups vs.the control group,4/32 and 15/34 vs.24/34 respectively,(P=0.002,0.009,respectively).PAED scales were significantly different among three groups (P=0.007),and lower in the S2 and F2 groups than in the control group (P=0.007 and P=0.025,respectively).And the incidence of severe agitation and the PAED scale score was significantly different between the S2 and F2 groups (P=0.007,P=0.019,respectively).Time to tracheal extubation and recovery time were similar in all three groups.Conclusions Administration of sufentanil at 0.2 μg/kg after induction of anesthesia reduced emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl.This was without delaying the recovery time or causing significant hypotension.

  10. Observe the curative effect of Seven sevofl urane inhalation anesthesia for elderly patients in general anesthesia surgery%七氟烷吸入麻醉用于老年患者全身麻醉手术中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张会娟

    2015-01-01

    目的:探讨七氟烷吸入麻醉用于老年患者全身麻醉手术中的疗效。方法将我院收治手术治疗老年患者116例随机平均分为观察组与对照组,各58例。对照组给予异氟烷吸入麻醉,观察组给予七氟烷吸入麻醉。对两组麻醉前后的心率、血压及认知功能进行测定。结果两组行插管与手术后血压对比,差异有统计学意义(P<0.05),观察组患者拔管后认知恢复时间显著短于对照组,差异有统计学意义(P<0.05)。结论对老年手术治疗患者采用七氟烷吸入麻醉能够取得显著的疗效,并且患者认知功能恢复时间短、安全性高,值得临床推广。%ObjectiveTo explore the sevoflurane inhalation anesthesia used in elderly patients with the clinical effect of general anesthesia.MethodsWill be our hospital surgical treatment of elderly patients with 116 cases randomly divided into observation group and control group,58 cases were treated isoflurane inhalation anesthesia,bservation group of 58 cases give sevoflurane inhalation anesthesia.The two groups before and after anesthesia heart rate,blood pressure and cognitive function were measured.ResultsThe two groups in signifi cant difference compared with that of blood pressure after surgery(P<0.05),intubation observation groups during after pull out urinous catheter cognitive recovery time was significantly shorter than the control group(P<0.05). Conclusions Surgical treatment for the elderly patients with sevofl urane inhalation anesthesia can obtain signifi cant clinical effect,and cognitive function in patients with recovery period,high safety,worth clinical promotion.

  11. Intestinal circulation during inhalation anesthesia

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

    1985-04-01

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

  12. 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...

  13. Study on preoperative gradual muscles relaxation training to reduce restlessness of patients in analepsia period of general anesthesia%术前渐进性肌肉放松训练减轻全身麻醉病人苏醒期躁动程度的研究

    Institute of Scientific and Technical Information of China (English)

    谢珍; 李瑞英; 向承红

    2011-01-01

    Objective: To investigate the effect of gradual muscles relaxation training to reduce restlessness of patients in analepsia period of general Anesthesia.Methods: A total of 60 patients selected from general surgery, five sense organs, gynecology , liver and gall department who were scheduled for accepting tracheal intubation and combined intravenous and inhalation anesthesia were randomly divided into test group and control group.Patients of control group wcre just received routine visiting.Patients of test group were received preoperative visiting on the day before operation and were carried out gradual muscles relaxation training.Then heart rate, blood pressure.blood oxygen saturation (SpO2 ) , scoring of restless - sedation in analepsia period,and incidence of restless of the two group patients had recorded before the induction, right after operation, on the time of extubation,5 minutes and 10 minutes after the extubation respectively.Results : In terms of heart rate and blood pressure, there were statistical significant differences between the two group patients (P<0.05).The score of restless - sedation in test group patients was 0.65±0.34 and was 1.98 ± 0.38 in control group cases.There was statistical significant difference between the two groups (P<0.05).The incidence of restless in test group patients was 13.3% and was 46.7% in control group.There was statistical significant difference between the two groups (P<0.05).Conclusion: The gradual muscles relaxation training was helpful to decrease the incidence and the degree of restlessess of patients in analepsia period of general anesthesia.%[目的]探讨渐进性肌肉放松训练对减轻全身麻醉病人苏醒期躁动程度的影响.[方法]选择普外科、五官科、妇科、肝胆科拟行气管插管静脉吸入复合麻醉的手术病人60例,随机分为实验组和对照组.实验组术前1d访视并进行渐进性肌肉放松训练,对照组常规术前访视.记录两组病人诱

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

    Science.gov (United States)

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

    2016-04-01

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

  15. Influence of low doses of dexmedetomidine on quality of cognitive recovery and cardiovascular response in hypertensive patients during extubation after general anesthesia%小剂量右美托咪定对高血压全麻患者苏醒质量和心血管反应的影响

    Institute of Scientific and Technical Information of China (English)

    刘彬; 姚爱军; 冯祝余

    2014-01-01

    目的 探讨小剂量右美托咪定(Dex)对高血压全麻患者苏醒质量和心血管反应的影响.方法 80例ASA Ⅰ或Ⅱ级拟行腹腔镜胆囊切除术高血压患者,随机分为Dex组(D组)和对照组(C组),每组40例.D组于麻醉诱导前15 min给予Dex负荷剂量0.6μg/kg,术中以小剂量0.3μg/(kg·h)维持静脉泵注至手术结束前30 min,C组则静脉泵注相同剂量的生理盐水.记录两组患者呼吸恢复时间、拔管时间、定向力恢复时间、Ramsay镇静评分、VAS镇痛评分和不良反应发生率及拔管前(T0)、拔管时(T1)、拔管后5min(T2)、15 min(T3)、30 min(T4)BP、HR和SpO2的变化.结果 两组患者的呼吸恢复时间、拔管时间、定向力恢复时间比较差异无统计学意义(P>0.05),D组拔管后各时点Ramsay镇静评分高于C组、VAS镇痛评分低于C组,比较差异有统计学意义(P<0.05),与C组比较,D组拔管期不良反应明显减少(P<0.05),心血管反应明显减轻(P<0.05);与拔管前比较,C组拔管时、拔管后血压明显升高(P<0.05).结论 小剂量右美托咪定可有效地改善高血压患者全麻拔管期苏醒质量,并明显减轻心血管反应.%Objectives To investigate the influence of low doses dexmedetomidine on the quality of cognitive recovery and cardiovascular response in hypertensive patients during extubation after general anesthesia.Methods 80 hypertensive patients (ASA Ⅰ-Ⅱ) scheduled for laparoscopic cholecystectomy were randomly divided into a Dex group (group D) and a control group(group C),40 for each group.Group D were given dexmedetomidine with a loading dose of 0.6 μ g/kg 15 min before the induction intravenously and maintained the operation with a low dose of 0.3 μ g/(kg · h) until 30 min before the end of the operation.Group C were given saline of the same dose intravenously.The breathing recovery time,the extubation time,the cognitive recovery time,the Ramsay sedation score,the Visual Analogue Scale,and the

  16. Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature.

    Science.gov (United States)

    Kumari, Anita; Gupta, Ruchi; Bajwa, Sukhminder Jit Singh; Singh, Amrinder

    2014-01-01

    Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs timely reporting and exploring all the possible causes of these unusual and possibly avoidable events. The present case reports are an important addition to a series of recently published mishaps that occurred during spinal anesthesia in young and healthy patients.

  17. A COMPARISON OF THE EFFECTS OF THE PROPOFOL VERSUS MIDAZOLAM DURING TOTAL INTRAVENOUS ANESTHESIA FOR GYNECOLOGICAL SURGERY PROCEDURES

    Institute of Scientific and Technical Information of China (English)

    叶铁虎; 龚志毅; 金永芳; 王玲; 任洪智; 罗爱伦

    1995-01-01

    The effects of propofol and midazolam as an intravenous anesthetic were compared in 40 ASA Ⅰ - Ⅱ patlents undergoing gynecological surgery during total intravenous anesthesia (TIVA). They were divided into propofol group (P n=20) and rnidazolam group (M n=20) randomly. The anesthesia was designed for each group respectively. Here, we discuss the experimental method and the results, which indicate that propofol is not only an effective anesthetic but also has more rapid and head-cleat recovery properties than midazolam.

  18. Effect of sevoflurane titration anesthesia on recovery time in bispectral index monitoring laparoscopic cholecystectomy%七氟烷减量法对行腹腔镜下胆囊切除术患者苏醒时间的影响

    Institute of Scientific and Technical Information of China (English)

    李华; 孙波; 佘高明; 谢红; 王琛

    2012-01-01

    Objective To study the effect of sevoflurane titration anesthesia on recovery time in bispectral index (BIS) monitoring laparoscopic cholecystectomy. Methods Forty-five patients (American Society of Anesthesiologists [ASA] Ⅰ - Ⅱ level) underwent laparoscopic cholecystectomy and were randomly divided into 3 groups (n = 15). The patients in group I stopped inhaling sevoflurane after skin closure and oxygen flow increased to 10 L/min. The patients in group Ⅱ stop inhaling sevoflurane after peritoneal suture, oxygen flow increased to 10 L/min, and propofol (0.5 mg/kg) was intravenously injected. For group 1, sevoflurane decreased to 0.5 minimum alveolar concentration (MAC) at the end of peritoneal closure and was stopped after skin closure, and oxygen flow increased to 10 L/min. The recovery time (from finishing skin closure to opening eyes under orders), the time of BIS being 90, and vital signs (mean arterial pressure [MAP], heart rate [HR], pulse, saturation of blood oxygen [SpO2], and carbon dioxide of end expiration [pstCO2]) were recorded. Results The recovery time and the time of BIS being 90 in groups Ⅱ and Ⅲ were significantly shorter than those in group Ⅰ (all P0. 05). Conclusion Sevoflurane titration anesthesia can reduce the impact of combined drug use, shorten the recovery time after surgery and keep the recovery quality in laparoscopic cholecystectomy.%目的 观察七氟烷减量法对行腹腔镜下胆囊切除术患者苏醒时间的影响.方法 45例美国麻醉医师学会(ASA)分级Ⅰ~Ⅱ级、行择期腹腔镜胆囊切除术患者,随机分为3组,每组15例:Ⅰ组,皮肤缝合结束时停止吸入七氟烷,增加氧流量至10 L/min;Ⅱ组,腹膜缝合结束时停止吸入七氟烷,增加氧流量至10 L/min,静脉注射丙泊酚0.5 mg/kg;Ⅲ组,关闭腹膜即刻,降低七氟烷浓度至0.5最低肺泡有效浓度(MAC),缝合皮肤结束时停止吸人七氟烷,增加氧流量至10 L/min.观察苏醒时间(自皮肤缝合结束

  19. Stress of anesthesia with M.S. 222 and Benzocaine in Rainbow Trout (Salmo gairdneri)

    Science.gov (United States)

    Wedemeyer, Gary

    1970-01-01

    Rainbow trout (Salmo gairdneri) anesthetized with M.S. 222 for periods up to 12 min experience interrenal ascorbate depletion, uremia, and moderate hypercholesterolemia. Anesthesia with neutralized M.S. 222 (pH 7) or benzocaine prevented these changes and significantly reduced the variability in plasma glucose, cholesterol, and cortisol, indicating that the stress of anesthesia with M.S. 222 is due to the low pK of the sulfonic acid moiety.

  20. TONSILLECTOMY UNDER LOCAL ANESTHESIA IN MALI

    Directory of Open Access Journals (Sweden)

    SACKO HB

    2015-04-01

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

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

    Science.gov (United States)

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

    2008-09-01

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

  2. Evidence Basis for Regional Anesthesia in Multidisciplinary Fast-Track Surgical Care Pathways

    DEFF Research Database (Denmark)

    Carli, Francesco; Kehlet, Henrik; Baldini, Gabriele

    2011-01-01

    Fast-track programs have been developed with the aim to reduce perioperative surgical stress and facilitate patient's recovery after surgery. Potentially, regional anesthesia and analgesia techniques may offer physiological advantages to support fast-track methodologies in different type of surge......Fast-track programs have been developed with the aim to reduce perioperative surgical stress and facilitate patient's recovery after surgery. Potentially, regional anesthesia and analgesia techniques may offer physiological advantages to support fast-track methodologies in different type...... of surgeries. The aim of this article was to identify and discuss potential advantages offerred by regional anesthesia and analgesia techniques to fast-track programs. In the first section, the impact of regional anesthesia on the main elements of fast-track surgery is addressed. In the second section......, procedure-specific fast-track programs for colorectal, hernia, esophageal, cardiac, vascular, and orthopedic surgeries are presented. For each, regional anesthesia and analgesia techniques more frequently used are discussed. Furthermore, clinical studies, which included regional techniques as elements...

  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, 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....

  4. [Emergencies evolving from local anesthesia].

    Science.gov (United States)

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

    2002-01-01

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

  5. [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.

  6. Comparison of Propofol and Isoflurane Effects on Cognitive Function and Postoperative Elderly Patients Recovery Time after Anesthesia Operation%丙泊酚与异氟烷对老年患者麻醉恢复及术后认知功能的影响比较

    Institute of Scientific and Technical Information of China (English)

    谢明祥

    2015-01-01

    目的:观察并比较丙泊酚与异氟烷全身麻醉对老年患者术后认知功能的影响。方法选择2013年1月至2014年12月医院收治的择期行腹部胃肠手术的老年患者68例,随机均分为丙泊酚组和异氟烷组。由同一医护人员采用简易精神状态量表(MMSE)于术前及术后1,6,12,24,48 h的分别检查评价认知功能。结果两组患者手术时间、麻醉时间差异无统计学意义( P﹥0.05);丙泊酚组患者术后自主呼吸恢复、睁眼、拔管和应答时间均比异氟烷组少( P﹤0.05);丙泊酚组12 h MMSE评分恢复至术前水平,异氟烷组于术后24 h恢复至术前水平( P﹥0.05);两组患者术后均有不良反应如恶心、呕吐和眩晕等不适症状出现,但丙泊酚组的发生率明显偏低( P﹤0.05)。丙泊酚组患者用药后可有效平稳维持心率和血压。结论丙泊酚和异氟烷均能影响老年手术患者的术后认知功能,但丙泊酚影响较小。%Objective To observe the influence of propofol and isoflurane anesthesia on cognitive function in elderly patients after. Methods select January 2013 to December 2014 in our hospital undergoing gastrointestinal operation in elderly patients in 68 cases, were randomly divided into propofol group and isoflurane group. By the same medical workers using mini mental state examination ( MMSE ) incidence in the preoperative and postoperative 1, 6, 12, 24, 48 h respectively for patients with inspection and evaluation of cognitive function and POCD. Results the two groups of patients with operation, anesthesia with when the difference was not statistically significant ( P ﹥ 0. 05 );however, patients in the propofol group after spontaneous breathing recovery, eye opening, extubation and response time are compared with isoflurane group, the difference was statistically significant ( P ﹤ 0. 05 );Propofol group 12 h MMSE score level before restoration to the operation

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

    Science.gov (United States)

    Mortenson, Jack A; Moriarty, Katie M

    2015-01-01

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

  8. Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-Criteria in multiple sclerosis patients within a 16-months period

    Science.gov (United States)

    Thaler, Christian; Ceyrowski, Tim; Broocks, Gabriel; Treffler, Natascha; Sedlacik, Jan; Stürner, Klarissa; Stellmann, Jan-Patrick; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

    2017-01-01

    Purpose In patients with multiple sclerosis (MS), Double Inversion Recovery (DIR) magnetic resonance imaging (MRI) can be used to identify cortical lesions (CL). We sought to evaluate the reliability of CL detection on DIR longitudinally at multiple subsequent time-points applying the MAGNIMs scoring criteria for CLs. Methods 26 MS patients received a 3T-MRI (Siemens, Skyra) with DIR at 12 time-points (TP) within a 16 months period. Scans were assessed in random order by two different raters. Both raters separately marked all CLs on each scan and total lesion numbers were obtained for each scan-TP and patient. After a retrospective re-evaluation, the number of consensus CLs (conL) was defined as the total number of CLs, which both raters finally agreed on. CLs volumes, relative signal intensities and CLs localizations were determined. Both ratings (conL vs. non-consensus scoring) were compared for further analysis. Results A total number of n = 334 CLs were identified by both raters in 26 MS patients with a first agreement of both raters on 160 out of 334 of the CLs found (κ = 0.48). After the retrospective re-evaluation, consensus agreement increased to 233 out of 334 CL (κ = 0.69). 93.8% of conL were visible in at least 2 consecutive TP. 74.7% of the conL were visible in all 12 consecutive TP. ConL had greater mean lesion volumes and higher mean signal intensities compared to lesions that were only detected by one of the raters (p<0.05). A higher number of CLs in the frontal, parietal, temporal and occipital lobe were identified by both raters than the number of those only identified by one of the raters (p<0.05). Conclusions After a first assessment, slightly less than a half of the CL were considered as reliably detectable on longitudinal DIR images. A retrospective re-evaluation notably increased the consensus agreement. However, this finding is narrowed, considering the fact that retrospective evaluation steps might not be practicable in clinical routine

  9. 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.

  10. Use of local or epidural anesthesia in inguinal hernia repair: a randomized trial%局部麻醉和硬膜外麻醉在腹股沟疝无张力修补术中的对照研究

    Institute of Scientific and Technical Information of China (English)

    杨斌; 梁明娟; 张育超; 陈双

    2008-01-01

    目的 探讨局部麻醉和硬膜外麻醉下行腹股沟疝修补术的疗效与安全性. 方法 2004年1月至2006年12月我院收治的269例腹股沟疝患者,按数字表法随机分为两组,143例采用局部浸润麻醉,126例采用硬膜外麻醉,比较分析两组临床资料. 结果 局部麻醉组在手术(加麻醉)时间、下床时间、住院天数及费用方面均明显少于硬膜外麻醉组(P0.05).两组患者的伤口及阴囊并发症发生率差异无统计学意义(P>0.05).硬膜外麻醉组术中平均动脉压下降,术后恶心、呕吐、尿潴留发生率显著高于局部麻醉组(P0.05). 结论 局部麻醉下行腹股沟疝修补手术简单、安全、经济、可靠,是更为理想的麻醉方式.%Objective To investigate the efficacy and safety of local anesthesia and epidural anesthesia in tension-free repair of inguinal hernia. Methods Between January 2004 and December 2006, 269 patients underwent inguinal hernia repair were randomly divided into two groups, receiving local anesthesia (143 cases) and epidural anesthesia (126 cases). The clinical data from the two groups were analyzed retrospectively. Results The operation time, ambulation time, length of hospital stay and cost of hospitalization in local anesthesia group were significantly less than those in epidural anesthesia group( P < 0. 05 ). No significant differences were found in intra-operative use of ancillary sedation drugs, postoperative recovery situation, pain scores and operation-correlated complications between the two groups. The occurrence of postoperative anaesthetic complication rate was also significantly lower in local anesthesia group (P < 0. 05 ). One case of recurrence occurred in each group during postoperative follow-up period. Conclusion Tension-free inguinal hernia repair under local anesthesia is a simple, safe, economical, effective procedure and superior to epidural anesthesia.

  11. Influence of anesthesia techniques of caesarean section on memory, perception and speech

    Directory of Open Access Journals (Sweden)

    Volkov O.O.

    2014-06-01

    Full Text Available In obstetrics postoperative cognitive dysfunctions may take place after caesarean section and vaginal delivery with poor results both for mother and child. The goal was to study influence of anesthesia techniques following caesarian section on memory, perception and speech. Having agreed with local ethics committee and obtained informed consent depending on anesthesia method, pregnant women were divided into 2 groups: 1st group (n=31 had spinal anesthesia, 2nd group (n=34 – total intravenous anesthesia. Spinal anesthesia: 1.8-2.2 mLs of hyperbaric 0.5% bupivacaine. ТIVА: Thiopental sodium (4 mgs kg-1, succinylcholine (1-1.5 mgs kg-1. Phentanyl (10-5-3 µgs kg-1 hour and Diazepam (10 mgs were used after newborn extraction. We used Luria’s test for memory assessment, perception was studied by test “recognition of time”. Speech was studied by test "name of fingers". Control points: 1 - before the surgery, 2 - in 24h after the caesarian section, 3 - on day 3 after surgery, 4 - at discharge from hospital (5-7th day. The study showed that initially decreased memory level in expectant mothers regressed along with the time after caesarean section. Memory is restored in 3 days after surgery regardless of anesthesia techniques. In spinal anesthesia on 5-7th postoperative day memory level exceeds that of used in total intravenous anesthesia. The perception and speech do not depend on the term of postoperative period. Anesthesia technique does not influence perception and speech restoration after caesarean sections.

  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. 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

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

    Directory of Open Access Journals (Sweden)

    Campbell JP

    2013-08-01

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

  15. Skeletal muscle glycogen content and particle size of distinct subcellular localizations in the recovery period after a high-level soccer match

    DEFF Research Database (Denmark)

    Nielsen, Joachim; Krustrup, Peter; Nybo, Lars;

    2012-01-01

    biopsy collected immediately after and 24, 48, 72 and 120 h after a competitive soccer match. Transmission electron microscopy was used to estimate the subcellular distribution of glycogen and individual particle size. During the first day of recovery, glycogen content increased by ~60% in all...... subcellular localizations, but during the subsequent second day of recovery glycogen content located within the myofibrils (Intramyofibrillar glycogen, a minor deposition constituting 10-15% of total glycogen) did not increase further compared with an increase in subsarcolemmal glycogen (-7 vs. +25......%, respectively, P = 0.047). Conversely, from the second to the fifth day of recovery, glycogen content increased (53%) within the myofibrils compared to no change in subsarcolemmal or intermyofibrillar glycogen (P ...

  16. Anesthesia mumps resulting in temporary facial nerve paralysis after the auditory brainstem implantation in a 3-year-old child.

    Science.gov (United States)

    Özdek, Ali; Bayır, Ömer; Işık, Murat Eray; Tatar, Emel Çadallı; Saylam, Güleser; Korkmaz, Hakan

    2014-01-01

    An acute transient sialadenitis of the major salivary glands in the early postoperative period is called 'anesthesia mumps'. It has been reported in different surgical procedures especially in neurosurgical procedures. Anesthesia mumps develops very fast after the extubation period but it usually regresses with no sequelae within a few hours. However, sometimes serious complication can occur such as respiratory distress. In this report, we present a 3-year-old girl with an anesthesia mumps and facial palsy occurring after successful auditory brainstem implantation and we discuss the cause and the management of this rare complication in this report.

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

    Directory of Open Access Journals (Sweden)

    Poonam S Ghodki

    2014-01-01

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

  18. 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 (

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  20. Dexmedetomidine: Expanding role in anesthesia

    Directory of Open Access Journals (Sweden)

    Jyotsna S Paranjpe

    2013-01-01

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

  1. Anesthesia in a patient with Stiff Person Syndrome.

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    1997-06-01

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

  3. 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

  4. Preinduction incentive spirometry versus deep breathing to improve apnea tolerance during induction of anesthesia in patients of abdominal sepsis: A randomized trial

    Directory of Open Access Journals (Sweden)

    M Tripathi

    2013-01-01

    Full Text Available Background: Abdominal sepsis is associated with varied degree of hypoxemia and atelactasis in the lung and can enhance the onset of desaturation of arterial blood during apnea. Aims : This study looked at methods to improve safety margin of apnea during induction of anesthesia in these high-risk patients. Settings and Design: It was a randomized, single blind study on adult patients presenting for emergency laparotomy due to peritonitis in a university teaching hospital setting. Materials and Methods: In group 1 (IS (n = 32, three sessions of incentive spirometry (IS were performed within one hour before induction of anesthesia. In group 2 (DB (n = 34, patients were subjected to deep breathing sessions in a similar manner. All patients received preoxygenation (100% by mask for 3 min, followed by rapid-sequence induction of anesthesia using fentanyl, thiopental, and suxamethonium and endotracheal intubation. Patients were subjected to a period of apnea by keeping the end of the endotracheal tube open to air till they developed 95% hemoglobin saturation (SpO 2 by pulse oxymetry. Positive pressure ventilation was resumed at the end. We observed for hemodynamic changes, apnea time, and SpO 2 (100% recovery time on resuming ventilation. Arterial blood gas samples were taken before intervention, after IS or DB, after preoxygenation, and at the end of apnea. Statistical analysis used: One-way analysis of variance (ANOVA, X 2 test, Kaplan-Meier graph, and log-rank tests were applied to compare the two study groups. Results: Oxygenation level in group 1 (265 ± 76.7 mmHg patients was significantly (P < 0.001 higher than in group 2 (221 ± 61.8 mmHgat the end of preoxygenation. The apnea time (median: lower bound - upper bound Confidence Interval apnea time (272:240-279 s in group 1 (IS patients was significantly higher P < 0.05 than in group 2 (180:163-209 s patients. Saturation recovery time (35:34-46 s in group 1 (IS patients was also quicker than in

  5. Recovery Swaps

    OpenAIRE

    Berd, Arthur M.

    2010-01-01

    We derive an arbitrage free relationship between recovery swap rates, digital default swap spreads and conventional CDS spreads, and argue that the fair forward recovery rate used in recovery swaps must contain a convexity premium over the expected recovery value.

  6. 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.

  7. Exposure to ketamine anesthesia affects rat impulsive behavior

    Directory of Open Access Journals (Sweden)

    António Melo

    2016-11-01

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

  8. Spinal morphine anesthesia and urinary retention.

    Science.gov (United States)

    Mahan, K T; Wang, J

    1993-11-01

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

  9. A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

    Directory of Open Access Journals (Sweden)

    Hande Celiker

    2014-01-01

    Full Text Available Background. To compare the efficacy and safety of topical anesthesia versus retrobulbar anesthesia in 23-gauge vitreoretinal surgery. Materials and Methods. A total of 63 patients scheduled for 23 G posterior vitrectomy without scleral buckling procedures were included in the study. The patients were randomly assigned to receive either topical (Group 1, n=31 or retrobulbar anesthesia (Group 2, n=32. Postoperatively, patients were shown a visual analogue pain scale (VAPS from 1 (no pain or discomfort to 4 (severe pain or discomfort to rate the levels of pain. Results. There was more discomfort in patients in Group 2 while anesthetic was administered (Group 1:  1.0±0, Group 2: 2.3±0.7, P=0.0001. Between the two groups the level of pain during surgery (Group 1: 1.4±0.5, Group 2: 1.5±0.5; P=0.85 was noted. There was also no significant difference between two groups postoperatively (Group 1: 1.2±0.4, Group 2: 1.3±0.4; P=0.28. There were no complications in either group related to the anesthetic technique. No patient needed sedation or anesthesia supplement during the surgery or postoperative period. Conclusion. Topical anesthesia in posterior vitrectomy procedures is an effective and safe method that is alternative to retrobulbar anesthesia.

  10. Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series

    Directory of Open Access Journals (Sweden)

    Joe Iwanaga

    2016-01-01

    Full Text Available Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the TMJ. The age of patients ranged from 18 to 93 years. Bilateral eminectomy of the TMJ was performed for two patients, and unilateral eminectomy was performed for three patients. Two were examined under intravenous propofol sedation and local anesthesia, while three patients were examined under general anesthesia. One patient died from ileus one month after surgery. The follow-up period except for the case that died from ileus ranged from 12 to 33 months. No recurrent dislocation of the TMJ has been identified. Based on our experience and two other series in the literature, eminectomy with sedation and local anesthesia can be considered and might be a good option in elderly patients.

  11. Clinical application of local anesthesia for tension-free hernia repair operation%局麻下无张力疝修补术的临床应用

    Institute of Scientific and Technical Information of China (English)

    邓海

    2014-01-01

    目的:总结应用局麻方式进行无张力疝修补术的方法和特点。方法应用1%利多卡因进行腹股沟区浸润及阻滞麻醉,对2011年1月~2013年12月410例腹股沟疝患者应用补片进行无张力疝修补术,回顾分析患者的临床资料。结果本组患者均治愈,麻醉效果满意,手术时间25~90min,平均38min,5例阴囊肿胀,对症保守治疗后痊愈。切口疼痛轻微,无明显异物感,无切口感染等并发症,术后2~3天出院。随访12~38个月,无复发。结论在腹股沟疝手术治疗中,局部麻醉的方法是安全可行的,镇痛效果良好,易于掌握,对患者干扰小,并发症少,恢复快。%Objective To explore the surgical technique and characteristics of tension-free hernia repair operation with local anesthesia. Methods A retrospective analysis was made on the clinical data of 410 inguinal hernia patients who under-went tension-free hernia repair operation with local anesthesia by 1% lidocaine from Jan 2011 to Dec 2013. Results All the 410 patients were successfully treated with good anesthesia effect. The operation time was 25~90 minutes,average 38 minutes. 5 patients had suffered hydrocele who treated by conservative treatment. Some patients had minor postoperative pain. No obvious foreign body sensation and incision infection was found. The hospitalization time after operation was 2~3 days. No recurrence was observed during the follow-up period of 12~38 months. Conclusion Tension-free hernia repair operation with local anesthe-sia is a safe method with lower anesthesia risk, less complications and less postoperative recovery time.

  12. STUDY ON THE ANTAGONISTIC EFFECT OF ACUPUNCTURE OF SHUIGOU (GV 26) UPON VENOUS ANESTHESIA

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To observe the antagonistic effect of acupuncture of Shuigou (水沟 GV 26) on intravenous anesthesia for surgical operation. Methods: Forty patients received intravenous anesthesia were randomly and evenly divided into treatment group and control group. At the termination of anesthesia, Shuigou (GV 26) was needled for patients in treatment group, in control group patients aroused spontaneously. Recovery degrees of every patient were assessed by using modified Robertzon Scoring Scale. Results: Results showed that from the 6th min on, the scores of treatment group were significantly bigger than those of control group (6 min: 5.3±0.42 vs 3.2±0.33, P<0.05; 15 min: 13.7±0.32 vs 8.23±0.77, P<0.01), suggesting that the recovery of the patient's consciousness of treatment group was markedly quicker than that of control group. Conclusion: Puncturing Shuigou (GV 26) can hasten the patient's arousal from postoperative anesthesia and thus may be used as an effective remedy for resisting the aftereffects of intravenous anesthetics.

  13. 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.

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

    Science.gov (United States)

    Anderson, Brian J; Merry, Alan F

    2015-12-01

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

  15. Evaluation of Bacterial Contamination in Anesthesia Breathing Circuits

    Directory of Open Access Journals (Sweden)

    F Farnia

    2007-07-01

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

  16. 泵注瑞芬太尼及异丙酚维持麻醉对甲状腺切除患者麻醉的临床效果%Clinical Research of the Anesthesia Effect of Remifentanil Combine Propofol for Resection of Thyroid Gland Opera-tion Anesthesia

    Institute of Scientific and Technical Information of China (English)

    杜秋

    2014-01-01

    目的:观察瑞芬太尼及异丙酚联合麻醉对甲状腺切除患者的临床麻醉效果。方法本试验自制定方案日起,严格选择受试者,选择2010年3月至2011年3月在我院接受甲状腺手术患者100例,纳入研究的受试人群,将患者以完全等量随机的科学研究方法分为观察组( n=50例)及对照组( n=50例)。对照组采用静脉泵注异丙酚及芬太尼间断推注麻醉。观察组予异丙酚、瑞芬太尼持续静脉泵注维持麻醉。监测患者术前及术后的心率及平均动脉压等血流动力学的变化,记录患者手术后拔除插管以及开始自主呼吸的时间以及术后患者steward的得分情况,并详细记录刺激性咳嗽及躁动不安等不良反应发生的程度及人次。结果插管、拔管及拔管10min时2组患者的自主呼吸恢复时间、拔管时间、steward评分比较具有统计学意义(P<0.05);对照组患者出现刺激性咳嗽以及躁动不安等不良反应的人数要明显多于观察组患者发生率要明显多于对照组患者(P<0.05)。结论泵注瑞芬太尼及异丙酚维持麻醉用于甲状腺手术患者具有稳定患者血流动力学,缩短苏醒时间,减少不良反应的发生等效果。%Objective To analyze the anesthesia effect of remifentanil combine propofol for resection of thyroid gland op-eration anesthesia. Methods 100 cases were randomly divided into two groups,50 cases in each group,two gorups of patients were given tracheal intubation general anesthesia. The observation group was treated with continuous intravenous infusino of remifentanil and propofol. The control group using continuous intravenous infusion of propofol and fentanyl anesthesia maintained by intermittent bolus injiction. Hemodynamic changes in patients after operation for spontanesous breathing, recovery time, waking time, calling the goggle time, extubation time,steward score of recovery and the recovery period the incidence of

  17. 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....

  18. Desflurane Allows for a Faster Emergence when Compared to Sevoflurane Without Affecting the Baseline Cognitive Recovery Time.

    Directory of Open Access Journals (Sweden)

    Joseph G. Werner

    2015-10-01

    Full Text Available Aims, We compared the effect of desflurane and sevoflurane on anesthesia recovery time in patients undergoing urological cystoscopic surgery. The Short Orientation Memory Concentration Test (SOMCT measured and compared cognitive impairment between groups and coughing was assessed throughout the anesthetic.Methods and Materials, This investigation included 75 ambulatory patients. Patients were randomized to receive either desflurane or sevoflurane. Inhalational anesthetics were discontinued after removal of the cystoscope and once repositioning of the patient was final. Coughing assessment and awakening time from anesthesia were assessed by a blinded observer.Statistical analysis used: Statistical analysis was performed by using t-test for parametric variables and Mann-Whitney U test for nonparametric variables. Results, The primary endpoint, mean time to eye-opening, was 5.0±2.5 minutes for desflurane, and 7.9±4.1 minutes for sevoflurane (p <0.001. There were no significant differences in time to SOMCT recovery (p=0.109, overall time spent in the post anesthesia care unit (p=0.924 or time to discharge (p=0.363. Median time until readiness for discharge was nine minutes in the desflurane group, while the sevoflurane group had a median time of 20 minutes (p=0.020. The overall incidence of coughing during the perioperative period was significantly higher in the desflurane (p=0.030. Conclusions, We re-confirmed that patients receiving desflurane had a faster emergence and met the criteria to be discharged from the post anesthesia care unit earlier. No difference was found in time to return to baseline cognition between desflurane and sevoflurane.

  19. Alzheimer’s disease and anesthesia

    Directory of Open Access Journals (Sweden)

    Marie-Amélie ePapon

    2011-01-01

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

  20. Discussion on Recovery Protection for HVDC Thyristor Valve in the Non-periodic Firing Tests%HVDC晶闸管换流阀非周期触发试验中恢复期保护的探讨

    Institute of Scientific and Technical Information of China (English)

    陆建挺; 杨涛; 申萌; 钟磊; 周敏刚

    2011-01-01

    The non-periodic firing test is an important test of valve type tests for HVDC thyristor valve. For a complete valve, parallel capacitor method is normally adopted for testing. Some issues about recovery protection in the non-periodic firing tests have been discussed in this paper. Tests show that after the thyristor triggered, in recovery period, over high Aid At or re-triggered the thyristor, this may cause damage to thyristor. Base on this, the appropriate recommendations are proposed.%高压直流输电HVDC晶闸管换流阀的非周期触发试验是换流阀型式试验中的一项重要试验.对于完整的阀,通常采用并联电容器法进行试验.笔者比较了几个不同工程晶闸管换流阀的试验数据,探讨了晶闸管非周期触发试验中恢复期保护的几个问题.实验证明,晶闸管触发后恢复期内过高的du/dt或再次触发将可能导致晶闸管的损害,并提出了相应的建议.

  1. 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....

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

    Science.gov (United States)

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

    1993-03-01

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

  3. [Anesthesia for the surgery of delayed postoperative stenosis in the pulmonary suture in children with corrected transposition of the great vessels with Jatene's technique].

    Science.gov (United States)

    Suán, C; Cerro, J; Ojeda, R; García-Perla, J L

    1996-11-01

    Any patient with congenital heart disease is at high risk for anesthesia no matter what surgical procedure is performed. Children undergoing D-transposition of the great arteries using Jatene's technique present stenosis of the pulmonary artery in 10-20% of cases and may require surgery to correct that or some other surgically caused anomally. In either case the children must be managed as patients with heart disease, with special attention to cardiovascular depression and rhythm abnormalities. We report the cases of two children who underwent D-transposition of the great arteries in the neonatal period using Jatene's anatomical technique. They were later anesthetized at ages 5 and 6 years to correct pulmonary suture stenosis. Recovery was good.

  4. Effect of trimetazidine on exercise capacity of the patients with old myocardial infarction during recovery period%曲美他嗪对陈旧性心肌梗死康复期运动耐量的影响

    Institute of Scientific and Technical Information of China (English)

    韩跃刚; 田军; 刘万秀; 卢珊

    2002-01-01

    Objective To investigate the effect of trimetazidine(TMZ) on exercise capacity of the patients with old myocardial infarction during recovery period. Method 28 patients were administered hitrales, blockers and antipemic agents. 30 patients were administered TMZ 20 mg tid. After 12 weeks ,we compared nitrite expenditures, time to onset of angina after exercise, the time to 1 mm ST segment depression after exercise and rate pressure product. Result Nitrite expenditures per week were significantly reduced than before treatment and comprehensive group(P0.05). Conclusion TMZ may increase exercise capacity of patients with old myocardial infarction.

  5. Regional anesthetic activity of new decahydroquinolinyl derivative by the experimental model of terminal anesthesia

    Directory of Open Access Journals (Sweden)

    Goncharuk V.V.

    2014-09-01

    Full Text Available anesthesia. Material and Methods. Decahydroquinolinyl derivative under laboratory code PAS-68 synthesized in the A. B. Bekturov Institute of Chemical Sciences under the guidance of K. D. Praliev has been studied. Benzocaine, lido-caine and tetracaine were used as the comparison drugs. Male rabbits of 2,0-3,5 kg weight were used as experimental animals. A threshold of corneal sensitivity to tactile effects (Rainier index was determined by the standard method. Computer prognosis of PAS-68 acute toxicity also was made. Results. The local anesthetic activity of 1 %, 0,5% and 0,25% solutions of PAS-68 were identified as higher than that for lidocaine and benzocaine in similar concentrations (p <0,05 but lower than that for tetracaine (p<0,05. PAS-68 has no local irritating action. The duration of anesthesia, 0,5% and 1 % PAS 68 exceeds that for benzocaine and lidocaine at equivalent concentrations (p<0,05. By this kind of activity PAS-68 is a second to the duration of anesthesia by tetracaine (p<0,05. The latent period of anesthesia induced by PAS-68 is shorter than the latent periods induced by benzocaine, lidocaine and tetracaine. On the base of predictive analysis it was concluded that PAS-68 is of low toxicity. Conclusion. PAS-68 exceeds benzocaine and lidocaine by the local anesthetic activity and duration of anesthesia and is second only to tetracaine. The latent period of anesthesia PAC-68 is shorter than the latent period of benzocaine, lidocaine and tetracaine respectively.

  6. 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.

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

    Science.gov (United States)

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

    2013-12-01

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

  8. Anesthesia: What to Expect (For Parents)

    Science.gov (United States)

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

  9. Pharmacokinetics of Lidocaine With Epinephrine Following Local Anesthesia Reversal With Phentolamine Mesylate

    OpenAIRE

    Moore, Paul A.; Hersh, Elliot V.; Papas, Athena S; Goodson, J. Max; Yagiela, John A; Rutherford, Bruce; Rogy, Seigried; Navalta, Laura

    2008-01-01

    Phentolamine mesylate accelerates recovery from oral soft tissue anesthesia in patients who have received local anesthetic injections containing a vasoconstrictor. The proposed mechanism is that phentolamine, an alpha-adrenergic antagonist, blocks the vasoconstriction associated with the epinephrine used in dental anesthetic formulations, thus enhancing the systemic absorption of the local anesthetic from the injection site. Assessments of the pharmacokinetics of lidocaine and phentolamine, a...

  10. Total anesthesia, rats brain surgery, nitric oxide (NO) and free radicals

    OpenAIRE

    Jelenković Ankica V.; Jovanović Marina; Ninković Milica; Maksimović M.; Bošković Bogdan

    2005-01-01

    It is expected that clinical recovery after surgically induced brain trauma is followed by molecular and biochemical restitution. Seven days after surgery, we investigated whether the plastic cannula implanted in the left brain ventricle of adult Wistar rats (n = 6-7), performed in pentobarbital anesthesia, could influence oxidative stress elements (superoxide anion and lipid peroxidation), as well as the antioxidative system (superoxide dismuthase-SOD). Also, we investigated whether nitric o...

  11. Emergency anesthesia for evacuating a traumatic acute subdural hemorrhage in a child overdosed with hypertonic saline

    Directory of Open Access Journals (Sweden)

    Chulananda Goonasekera

    2016-01-01

    Full Text Available A previously healthy 1-year-old child with a traumatic acute subdural hemorrhage received 10 times higher dose of hypertonic saline inadvertently immediately before surgery. This case report describes deviations in fluid management needed to alleviate salt toxicity and its adverse effects during surgery under anesthesia perioperatively. The child made an uneventful recovery with no evident residual damage at follow-up.

  12. Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital

    OpenAIRE

    2016-01-01

    Background Local anesthesia (LA) has been reported to be the best choice for elective open inguinal hernia repair because it is cost efficient, with less post-operative pain and enables more rapid recovery. However, the role of LA in emergency inguinal hernia repair is still controversial. The aim of this study is to investigate the safety and effectiveness of LA in emergency inguinal hernia repair. Methods All patients underwent emergency inguinal hernia repair in our hospital between Januar...

  13. Investigations Regarding Anesthesia during Hypovolemic Conditions.

    Science.gov (United States)

    1983-09-25

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

  14. Single-lung ventilation in pediatric anesthesia.

    Science.gov (United States)

    Choudhry, Dinesh K

    2005-12-01

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

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

    OpenAIRE

    Khayata, Issam; Bourque, Jesse

    2012-01-01

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

  16. Advances in local anesthesia in dentistry.

    Science.gov (United States)

    Ogle, Orrett E; Mahjoubi, Ghazal

    2011-07-01

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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Firstborn offspring sex ratio is skewed towards female offspring in anesthesia care providers: A questionnaire-based nationwide study from United States

    Directory of Open Access Journals (Sweden)

    Deepak Gupta

    2013-01-01

    Objectives: The objective was to conduct a nation-wide survey to observe (a whether firstborn offspring sex ratio (OSR in anesthesia providers is skewed towards increased female offspring, and (b to identify potential factors influencing firstborn OSR, particularly those relating to the peri-conceptional practice of inhalational anesthesia induction among anesthesia providers. Materials and Methods: After institutional review board approval, a questionnaire was uploaded on SurveyMonkey and sent to anesthesia providers through their program coordinators in United States (US to complete the survey. Results: The current US national total-population sex ratio is 0.97 male (s/female with an at-birth sex ratio of 1.05 male (s/female; comparatively, the results from anesthesia providers′ survey respondents (n = 314 were a total OSR of 0.93 male (s/female ( P = 0.61 with firstborn OSR 0.82 male (s/female (a 6% increase in female offspring; P = 0.03, respectively. The only significant peri-conceptional factor related to anesthesia providers′ firstborn OSR′s skew was inhalational induction practice by anesthesia care provider favoring female offspring ( P < 0.01. Conclusion: Based on the results of this limited survey, it can be concluded that anesthesia care providers who practice inhalation induction of anesthesia during the peri-conceptional period are significantly more likely to have firstborn female offspring.

  2. Potential anesthesia protocols for space exploration missions.

    Science.gov (United States)

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

    2013-03-01

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

  3. 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.

  4. 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

  5. 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

  6. Perspectives on ambulatory anesthesia: the patient’s point of view

    Directory of Open Access Journals (Sweden)

    Sehmbi H

    2014-12-01

    Full Text Available Herman Sehmbi, Jean Wong, David T WongDepartment of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, CanadaAbstract: Recent advances in anesthetic and surgical techniques have led to tremendous growth of ambulatory surgery. With patients with many co-morbid conditions undergoing complex procedures in an ambulatory setting, the challenges in providing ambulatory surgery and anesthesia are immense. In recent years, the paradigm has shifted from a health-care provider focus involving process compliance and clinical outcomes, to a patient-centered strategy that includes patients’ perspectives of desired outcomes. Improving preoperative patient education while reducing unnecessary testing, improving postoperative pain management, and reducing postoperative nausea and vomiting may help enhance patient satisfaction. The functional status of most patients is reduced postoperatively, and thus the pattern of recovery is an area of ongoing research. Standardized and validated psychometric questionnaires such as Quality of Recovery-40 and Postoperative Quality of Recovery Scale are potential tools to assess this. Patient satisfaction has been identified as an important outcome measure and dedicated tools to assess this in various clinical settings are needed. Identification of key aspects of ambulatory surgery deemed important from patients’ perspectives, and implementation of validated outcome questionnaires, are important in improving patient centered care and patient satisfaction.Keywords: ambulatory, patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives

  7. Resource Conservation and Recovery Act ground-water monitoring projects for Hanford Facilities: Progress report for the period July 1 to September 30, 1989 - Volume 1 - Text

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.M.; Bates, D.J.; Lundgren, R.E.

    1989-12-01

    This is Volume 1 of a two-volume document that describes the progress of 14 Hanford Site ground-water monitoring projects for the period July 1 to September 30, 1989. This volume discusses the projects; Volume 2 provides as-built diagrams, completion/inspection reports, drilling logs, and geophysical logs for wells drilled, completed, or logged during this period. Volume 2 can be found on microfiche in the back pocket of Volume 1. The work described in this document is conducted by the Pacific Northwest Laboratory under the management of Westinghouse Hanford Company for the US Department of Energy. Concentrations of ground-water constituents are compared to federal drinking water standards throughout this document for reference purposes. All drinking water supplied from the sampled aquifer meets regulatory standards for drinking water quality.

  8. Intravenous dexmedetomidine versus propofol for intraoperative moderate sedation during spinal anesthesia: A comparative study

    Directory of Open Access Journals (Sweden)

    Pratibha Jain Shah

    2016-01-01

    Full Text Available Background and Aims: There has been a paradigm shift of focus toward quality of spinal anesthesia with sedation being an integral aspect of this regional anesthesia technique. Thus, this study was designed to compare efficacy of intravenous dexmedetomidine and propofol for moderate sedation during spinal anesthesia. Material and Methods: A total of 120 patients of age group 18-60 years of American Society of Anesthesiologists grade I & II, posted for surgeries under spinal anesthesia were randomly divided in to three groups (n = 40 each; Group D received infusion of dexmedetomidine 1 μg/kg over 10 min followed by maintenance infusion of 0.5 μg/kg/h. Group P received infusion of propofol 6 mg/kg/h for 10 min followed by the infusion maintenance of 2.5 mg/kg/h. Group C (control group received normal saline. Level of sedation (using observer′s assessment of alertness/sedation score, pain intensity (by visual analogue scale, onset and recovery from sedation, hemodynamic changes, and overall patient′s satisfaction were assessed. Results: The onset and recovery from sedation were significantly earlier with propofol (15.57 ± 1.89 min vs. 27.06 ± 2.26 min; P < 0.001 however intraoperative sedation (level 4, and overall patient′s satisfaction was significantly better with dexmedetomidine group (p < 0.05. Duration of postoperative analgesia was significantly prolonged with dexmedetomidine (225.53 ± 5.61 min vs. 139.60 ± 3.03 min; P = 0.0013. Mean heart rate and blood pressure were significantly lower in the propofol group (P < 0.05. Conclusion: Dexmedetomidine with its stable cardio-respiratory profile, better sedation, overall patient′s satisfaction, and analgesia could be a valuable adjunct for intraoperative sedation during spinal anesthesia.

  9. Significant treatment effect of add-on ketamine anesthesia in electroconvulsive therapy in depressive patients: A meta-analysis.

    Science.gov (United States)

    Li, Dian-Jeng; Wang, Fu-Chiang; Chu, Che-Sheng; Chen, Tien-Yu; Tang, Chia-Hung; Yang, Wei-Cheng; Chow, Philip Chik-Keung; Wu, Ching-Kuan; Tseng, Ping-Tao; Lin, Pao-Yen

    2017-01-01

    Add-on ketamine anesthesia in electroconvulsive therapy (ECT) has been studied in depressive patients in several clinical trials with inconclusive findings. Two most recent meta-analyses reported insignificant findings with regards to the treatment effect of add-on ketamine anesthesia in ECT in depressive patients. The aim of this study is to update the current evidence and investigate the role of add-on ketamine anesthesia in ECT in depressive patients via a systematic review and meta-analysis. We performed a thorough literature search of the PubMed and ScienceDirect databases, and extracted all relevant clinical variables to compare the antidepressive outcomes between add-on ketamine anesthesia and other anesthetics in ECT. Total 16 articles with 346 patients receiving add-on ketamine anesthesia in ECT and 329 controls were recruited. We found that the antidepressive treatment effect of add-on ketamine anesthesia in ECT in depressive patients was significantly higher than that of other anesthetics (p<0.001). This significance persisted in both short-term (1-2 weeks) and moderate-term (3-4 weeks) treatment courses (all p<0.05). However, the side effect profiles and recovery time profiles were significantly worse in add-on ketamine anesthesia group than in control group. Our meta-analysis highlights the significantly higher antidepressive treatment effect of add-on ketamine in depressive patients receiving ECT compared to other anesthetics. However, clinicians need to take undesirable side effects into consideration when using add-on ketamine anesthesia in ECT in depressive patients.

  10. 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

  11. [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.

  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. 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.

  14. Radiotherapy in pediatric patients without anesthesia or sedation: Feasibility and challenges

    Directory of Open Access Journals (Sweden)

    Ayan Basu

    2014-01-01

    Full Text Available Conventionally fractionated radiotherapy treatment involves strict immobilization for accurate delivery and typically is delivered in five daily fractions every week for several weeks. To ensure rigid immobility during treatment planning and delivery in children, anesthesia or sedation has been used but valid concerns have been raised about the safety and long-term consequences of such practice on daily basis for prolonged periods. We tested the feasibility of avoiding daily anesthesia or sedation in our pediatric radiotherapy patients by extensive pretreatment counseling and demonstration of the treatment procedure ensuring their comfort and compliance.

  15. [Effects of repeated sevoflurane anesthesia on hepatic and renal function in a pediatric patient].

    Science.gov (United States)

    Tanikawa, M; Mitsuhata, H; Shimizu, R; Akazawa, S; Fukuda, H; Saitoh, K; Hirabayashi, Y; Togashi, H

    1994-10-01

    A 10-yr-old boy with an injured lower extremity received sevoflurane anesthesia 5 times within 40 days. Laboratory tests for hepatic and renal function i.e., serum transaminase (glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, gamma-glutamyl transpeptidase), serum cholinesterase, plasma protein, serum cholinesterase, serum bilirubine, serum lactic dehydrogenase, serum prothrombin time, blood urea nitrogen, serum creatinine, beta 2-microglobulin, N-acetyl-D-glucosamidase and 24 hr-creatinine clearance remained within normal ranges throughout his perioperative period. Repeated sevoflurane anesthesia did not exert any adverse effect on hepatic and renal function in this patient.

  16. Intracranial subdural hematoma after spinal anesthesia for cesarean section: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Uma Srivastava

    2014-01-01

    Full Text Available Subdural hematoma (SDH is a rare but serious complication of spinal anesthesia. We report a case of intracranial SDH in a patient developing 11 days after spinal anesthesia for cesarean section. The patient complained of headache on the 2nd post-operative day that was relieved by analgesics, bed rest and hydration. Later she presented with severe headache, vomiting, dizziness, dysarthria, irritability and somnolence. Diagnosis of the left sided SDH was confirmed radiologically and treated surgically. The patient recovered completely. The report highlights the need of considering the possibility of SDH in patients when postdural puncture headache is prolonged or recurs after a headache free period with neurological symptoms.

  17. Enhanced oil recovery by surfactant-enhanced volumetric sweep efficiency: First annual report for the period September 30, 1985-September 30, 1986. [Sandpacks

    Energy Technology Data Exchange (ETDEWEB)

    Harwell, J H; Scamehorn, J F

    1987-05-01

    Surfactant-enhanced volumetric sweep efficiency is a novel EOR method which utilizes precipitation/coacervation of surfactants to plug the most permeable regions of the reservoir, improving the efficiency of a waterflooding operation. This technique does not rely on reduction of interfacial tension between aqueous and oleic phases to enhance oil recovery. Therefore, even though surfactants are involved, this new technique is not a substitute or improvement on classical surfactant flooding; however, it has the potantial to compete with polymer flooding as an alternative sweep efficiency improvement method. In surfactant-enhanced volumetric sweep efficiency, a slug containing one kind of surfactant is injected into the reservoir, followed by a brine spacer. This is followed by injection of a second kind of surfactant which has lower adsorption than the first surfactant used. Anionic and cationic surfactants are one possible combination for this application. These may form either a precipitate or a coacervate upon mixing. Phase boundaries for some specific systems of this type have been determined over a wide range of conditions and a model developed to describe this behavior. Another possibility is the use of nonionic surfactants, which may form coacervate under proper conditions. The adsorption behavior of mixtures of anionic and nonionic surfactants was measured to aid in modeling the chromatographic effects with these surfactants in the reservoir. Studies with sandpacks of different permeabilities in parallel configuration using mixtures of anionic and cationic surfactants have demonstrated the capability of this method to reduce flow rates through a more permeable sandpack more than that through a less permeable sandpack. 4 refs., 23 figs., 8 tabs.

  18. Effects of physical and mental task demands on cervical and upper limb muscle activity and physiological responses during computer tasks and recovery periods.

    Science.gov (United States)

    Wang, Yuling; Szeto, Grace P Y; Chan, Chetwyn C H

    2011-11-01

    The present study examined the effects of physical and mental workload during computer tasks on muscle activity and physiological measures. Activity in cervical postural muscles and distal forearm muscles, heart rate and blood pressure were compared among three tasks and rest periods of 15 min each in an experimental study design. Fourteen healthy pain-free adults participated (7 males, mean age = 23.2 ± 3.0 years) and the tasks were: (1) copy-typing ("typing"), (2) typing at progressively faster speed ("pacing"), (3) mental arithmetic plus fast typing ("subtraction"). Typing task was performed first, followed by the other two tasks in a random order. Median muscle activity (50th percentile) was examined in 5-min intervals during each task and each rest period, and statistically significant differences in the "time" factor (within task) and time × task factors was found in bilateral cervical erector spinae and upper trapezius muscles. In contrast, distal forearm muscle activity did not show any significant differences among three tasks. All muscles showed reduced activity to about the baseline level within first 5 min of the rest periods. Heart rate and blood pressure showed significant differences during tasks compared to baseline, and diastolic pressure was significantly higher in the subtraction than pacing task. The results suggest that cervical postural muscles had higher reactivity than forearm muscles to high mental workload tasks, and cervical muscles were also more reactive to tasks with high physical demand compared to high mental workload. Heart rate and blood pressure seemed to respond similarly to high physical and mental workloads.

  19. Effect of estradiol, vitamin A, E and selenium treatment with varying sexual rest period on recovery rate in cross-bred cows with chronic endometritis

    OpenAIRE

    Dipyaman Sengupta; Pramod R. Nandi

    2013-01-01

    Aim:This work was done to study the effect of vitamin A, E and Se with varying sexual rest period in cross-bred cows with chronic endometritis. Materials and Methods: Cross-bred cows (n=396) from different villages of West Bengal with purulent or muco-purulent discharge with a history of infertility and repeat breeding for 3 to 6 months were chosen for the present study. These cows received uterine wash with lugol's iodine, intra-uterine and parenteral antibiotics and de-worming as general tr...

  20. Resource Conservation and Recovery Act ground-water monitoring projects for Hanford facilities: Progress report for the period October 1 to December 31, 1989

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.M.; Bates, D.J.; Lundgren, R.E. (eds.)

    1990-03-01

    This is Volume 1 of a two-volume document that describes the progress of 15 Hanford Site ground-water monitoring projects for the period October 1 to December 31, 1989. This volume discusses the projects. The work described in this document is conducted by the Pacific Northwest Laboratory under the management of Westinghouse Hanford Company for the US Department of Energy. Concentrations of ground-water constituents are compared to federal drinking water standards throughout this document for reference purposes. All drinking water supplied from the samples aquifer meets regulatory standards for drinking water quality. 51 refs., 35 figs., 86 tabs.

  1. Acoustic method respiratory rate monitoring is useful in patients under intravenous anesthesia.

    Science.gov (United States)

    Ouchi, Kentaro; Fujiwara, Shigeki; Sugiyama, Kazuna

    2017-02-01

    Respiratory depression can occur during intravenous general anesthesia without tracheal intubation. A new acoustic method for respiratory rate monitoring, RRa(®) (Masimo Corp., Tokyo, Japan), has been reported to show good reliability in post-anesthesia care and emergency units. The purpose of this study was to investigate the reliability of the acoustic method for measurement of respiratory rate during intravenous general anesthesia, as compared with capnography. Patients with dental anxiety undergoing dental treatment under intravenous anesthesia without tracheal intubation were enrolled in this study. Respiratory rate was recorded every 30 s using the acoustic method and capnography, and detectability of respiratory rate was investigated for both methods. This study used a cohort study design. In 1953 recorded respiratory rate data points, the number of detected points by the acoustic method (1884, 96.5 %) was significantly higher than that by capnography (1682, 86.1 %) (P < 0.0001). In the intraoperative period, there was a significant difference in the LOA (95 % limits of agreement of correlation between difference and average of the two methods)/ULLOA (under the lower limit of agreement) in terms of use or non-use of a dental air turbine (P < 0.0001). In comparison between capnography, the acoustic method is useful for continuous monitoring of respiratory rate in spontaneously breathing subjects undergoing dental procedures under intravenous general anesthesia. However, the acoustic method might not accurately detect in cases in with dental air turbine.

  2. Attention-Deficit/Hyperactivity Disorder and Successful Completion of Anesthesia Residency: A Case Report.

    Science.gov (United States)

    Fitzsimons, Michael G; Brookman, Jason C; Arnholz, Sarah H; Baker, Keith

    2016-02-01

    Cognitive and physical disabilities among anesthesia residents are not well studied. Cognitive disabilities may often go undiagnosed among trainees, and these trainees may struggle during their graduate medical education. Attention-deficit/hyperactivity disorder (ADHD) is an executive function disorder that may manifest as lack of vigilance, an inability to adapt to the rapid changes associated with anesthesia cases, distractibility, an inability to prioritize activities, and even periods of hyperfocusing, among other signs. Programs are encouraged to work closely with residents with such disabilities to develop an educational plan that includes accommodations for their unique learning practices while maintaining the critical aspects of the program. The authors present the management of a case of an anesthesia resident with a diagnosis of ADHD, the perspectives of the trainee, program director, clinical competency director, and the office of general counsel. This article also provides follow-up in the five years since completion of residency.

  3. Resource Conservation and Recovery Act ground-water monitoring projects for Hanford facilities: Progress Report for the Period April 1 to June 30, 1989

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.M.; Bates, D.J.; Lundgren, R.E.

    1989-09-01

    This report describes the progress of 13 Hanford ground-water monitoring projects for the period April 1 to June 30, 1989. These projects are for the 300 area process trenches (300 area), 183-H solar evaporation basins (100-H area), 200 areas low-level burial grounds, nonradioactive dangerous waste landfill (southeast of the 200 areas), 1301-N liquid waste disposal facility (100-N area), 1324-N surface impoundment and 1324-NA percolation pond (100-N area), 1325-N liquid waste disposal facility (100-N area), 216-A-10 crib (200-east area), 216-A-29 ditch (200-east area), 216-A-36B crib (200-east area), 216-B-36B crib (200-east area), 216-B-3 pond (east of the 200-east area), 2101-M pond (200-east area), grout treatment facility (200-east area).

  4. Anesthesia and thyroid surgery: The never ending challenges

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Sehgal, Vishal

    2013-01-01

    Thyroidectomy is the most common endocrine surgical procedure being carried out throughout the world. Besides, many patients who have deranged thyroid physiology, namely hyperthyroidism and hypothyroidism, have to undergo various elective and emergency surgical procedures at some stage of their life. The attending anesthesiologist has to face numerous daunting tasks while administering anesthesia to such patients. The challenging scenarios can be encountered at any stage, be it preoperative, intra-op or postoperative period. Preoperatively, deranged thyroid physiology warrants optimal preparation, while anticipated difficult airway due to enlarged thyroid gland further adds to the anesthetic challenges. Cardiac complications are equally challenging as also the presence of various co-morbidities which make the task of anesthesiologist extremely difficult. Thyroid storm can occur during intra-op and post-op period in inadequately prepared surgical patients. Postoperatively, numerous complications can develop that include hemorrhage, laryngeal edema, nerve palsies, tracheomalacia, hypocalcemic tetany, pneumothorax, etc., The present review aims at an in-depth analysis of potential risk factors and challenges during administration of anesthesia and possible complications in patients with thyroid disease. PMID:23776893

  5. Assessing patient satisfaction with cataract surgery under topical anesthesia supplemented by intracameral lidocaine combined with sedation

    Directory of Open Access Journals (Sweden)

    Manuela Bezerril Cipião Fernandes

    2013-12-01

    Full Text Available PURPOSE: Ocular akinesia, the use of anticoagulants, and patient collaboration are some of the factors that must be taken into consideration when choosing the appropriate anesthesia for phacoemulsification cataract surgery. The satisfaction of patients with the use of topical anesthesia and conscious sedation for this procedure has not been enough described in Brazil. Conscious sedation allows patient walk and answer a voice command. To assess the satisfaction, pain, and perioperative hemodynamic alterations of patients subjected to phacoemulsification under conscious sedation and topical anesthesia supplemented with intracameral lidocaine. METHODS: Prospective cohort non-controlled study that included patients treated by the same surgical team over a 70-day period. Sedation was performed with midazolam at a total dose of 3 mg and topical anesthesia with 0.5% proxymetacaine chlorhydrate and 2% lidocaine gel combined with 2% lidocaine by intracameral route. The intraoperative vital parameters, scores based on the Iowa Satisfaction with Anesthesia Scale (ISAS, and the pain visual analog scale (VAS were recorded at several time points after surgery. RESULTS: A total of 106 patients were enroled in study (73.6% female, the mean age was 65.9 years. The surgical procedures lasted 11.2 minutes on average. The hemodynamic parameters did not exhibit significant changes at any of the investigated time points. The average ISAS score was 2.67 immediately after surgery and 2.99 eight hours after the surgery; this increase was statistically significant (p<0.0001. More than two-thirds (68.9% of the participants (73 patients did not report any pain in the transoperative period, and 98.1% of patients denied the occurrence of pain after surgery. CONCLUSIONS: Patients that received topical anesthesia supplemented by intracameral lidocaine combined with sedation for phacoemulsification cataract surgery reported adequate level of satisfaction with the anesthetic

  6. Survey of international regional anesthesia fellowship directors

    Directory of Open Access Journals (Sweden)

    Lansdown AK

    2013-07-01

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

  7. 腰丛-坐骨神经阻滞与腰麻在老年患者膝关节置换围术期的对比分析%Comparison of lumbar plexus-sciatic nerve block and spinal anesthesia on elderly patients with knee joint sur-gery during the perioperative period

    Institute of Scientific and Technical Information of China (English)

    黄文锋; 陈杰; 包晓航; 杜智勇; 黄河; 李洪; 杨天德

    2016-01-01

    Objective To compare and analyze the clinical application of lumbar plexus combined with sciatic nerve block and spinal anesthesia for elderly patients with knee joint surgery.Methods A total of 77 elderly patients with ASAⅠ ~Ⅲ undergoing single knee re-placement surgery were randomly divided into combined group which recieved lumbar plexus combined with sciatic nerve block and spinal an-esthesia group.The baseline values,blood pressure and heart rate at multiple time points,the block area and duration,the volume of intraoper-ative fluid,and other indexes of adverse reaction were observed.Results The MAP,SBP and DBP in the spinal anesthesia group after the op-eration have changed significantly at the time of T1,T2 and T3.The operating of anesthesia in the combined group was shorter than that of spi-nal anesthesia group.The rate of adverse reactions in combined group was significantly lower than that inspinal anesthesia group.Conclusion The spinal anesthesia can be satisfied for operation requirements,but it will cause the unstable circulation and varied adverse reactions.Lum-bar plexus combined with sciatic nerve block is safe and effective with less adverse reactions,less disturbance of hemodynamics,which is much better for the old or the patients with coagulation abnormalities combined heart and lung disease.%目的:对比分析腰丛联合坐骨神经阻滞与腰麻在老年患者膝关节手术中的应用,探讨两者在老年患者膝关节置换术围手术期的优缺点。方法77例老年单膝关节置换术患者,ASA Ⅰ~Ⅲ级,按麻醉方式不同分为腰丛神经阻滞联合坐骨神经阻滞组(联合组)和腰麻组,观察并纪录麻醉前基础值,以及麻醉后、切皮时、术中放置骨水泥后、手术结束时的血压、心率、阻滞区域及维持时间、术中输液量、围术期不良反应等指标。结果腰麻组患者在麻醉后 MAP、SBP、DBP 在 T1、T2、T3时间点波动明显,联合组麻醉

  8. 七氟烷在小儿全身麻醉中的应用%Application of Sevoflurane in pediatric anesthesia

    Institute of Scientific and Technical Information of China (English)

    安波

    2015-01-01

    目的:探讨七氟烷用于小儿手术中的麻醉效果。方法选取2011-05—2013-02接受腹股沟斜疝疝囊高位结扎术患儿50例,随机分为F组和L组2组,F组(25例)采用七氟烷吸入麻醉,L组(25例)采用氯胺酮静脉麻醉,比较2组麻醉效果。结果 F组患儿诱导时间显著慢于L组。苏醒时间、意识恢复时间F组显著快于L组。 F组患儿诱导期心动过速、苏醒期躁动发生率显著低于L组。 L组诱导期短、血压显著高于F组,2组比较,差异均有统计学意义( P<0.05)。结论七氟烷具有血气分配系数低、麻醉诱导快,循环干扰小、苏醒迅速、可控性强、心脏保护作用好等特点,可在小儿短小手术的麻醉中应用。%Objective To investigate the sevoflurane anesthesia for pediatric surgery results.Methods From May 2011 to February 2013 in our hospital 50 patients children inguinal hernia surgery with high ligation of were randomly divided into two groups of Group F and L group, F group(25 cases) were using sevoflurane inhalation anesthesia, L group(25 cases) using intravenous ketamine anesthesia, the anes-thetic effect of two groups were compared.Results The two groups of children induction and recovery time comparison:F induction time of pa-tients was significantly slower than that of the L group; recovery time, consciousness recovery time was significantly faster than that of the L group.Two groups of patients and the induction of adverse reactions: F group induction tachycardia, restlessness incidence was significantly lower than that of group L;L group short induction period, blood pressure was significantly higher than that of the F group, the difference was statistically significant(P<0.05).Conclusion Sevoflurane has a low blood-gas partition coefficient, fast induction of anesthesia, a small circulation interference, waking quickly, controllability and strong features, and a certain degree of cardioprotective

  9. Validação de um instrumento de registro para sala de recuperação pós-anestésica Validación de un instrumento de registro para la sala de recuperación pos anestésica Content validity of an instrument to document recovery of patients in post anesthesia care unit

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Silva Mirancos da Cunha

    2007-06-01

    reenviado a los jueces, quienes nuevamente analizaron el instrumento sugiriendo nuevos cambios. CONCLUSIÓN: consideramos que después de estas dos fases la herramienta fue validada en cuanto a su contenido y forma de presentación, pudiendo haber adecuaciones de acuerdo con el tipo de institución y de pacientes atendidos en la sala de recuperación pos anestésica.OBJECTIVE: To determine the content validity of an instrument to document the assessment and recovery of surgical patients in post anesthesia care unit (PACU. METHODS: Delphi technique was used to conduct this two-phase study. RESULTS: Items on admission and vital signs, Audrete and Kroulik index, pediatric index, nursing orders, and progress notes reached 100% consensus among expert judges. Items regarded as being repetitive by 79% of experts were revised or excluded from the instrument. Following this procedure, items of the instruments were again evaluated by the experts and new revisions were made as appropriate to achieve minimum agreeement among experts as recommended by Delphi technique. CONCLUSION: The instrument was validated regarding its content and format. Further analysis might be necessary according to hospital and type of patient admitted to the PACU.

  10. Resource Conservation and Recovery Act ground-water monitoring projects for Hanford facilities: Progress report for the period July 1 to September 30, 1988: Volume 1, Text

    Energy Technology Data Exchange (ETDEWEB)

    Fruland, R.M.; Bates, D.J.; Lundgren, R.E.

    1989-02-01

    This report describes the progress of 12 Hanford ground-water monitoring projects for the period July 1 to September 30, 1988. During this quarter, field activities at the 300 Area process trenches, the Nonradioactive Dangerous Waste Landfill, the 183-H Solar Evaporation Basins, the 1324-N/NA Surface Impoundment and Percolation Ponds, the 1301-N and 1325-N Liquid Waste Disposal Facilities, and the 216-A-36B Crib consisted of ground-water sampling and analyses, and water-level monitoring. The 200 Area Low-Level Burial Grounds section includes well development data, sediment analysis, and water-level measurements. Ground-water sampling was begun at this site, and results will be included in next quarter's report. Twelve new wells were installed during the quarter, two at the 216-A-29 Ditch, size at the 216-A-10 Crib, and four at the 216-B-3 Pond. Preliminary characterization data for these new wells are included in this report. Driller's logs and other drilling and site characterization data will be provided in the next quarterly report. At the 2101-M Pond, construction was completed on four wells, and initial ground-water samples were taken. The drilling logs, geophysical logging data, and as-built diagrams are included in this report in Volume 2. 19 refs., 24 figs., 39 tabs.

  11. 双管喉罩在临床麻醉中的应用%Application of ProSeal laryngeal mask in clinical anesthesia

    Institute of Scientific and Technical Information of China (English)

    袁纳; 牛涛

    2016-01-01

    目的:探讨在临床麻醉中应用双管喉罩(LMA-Supreme)的适应症、可行性及安全性。方法选择MalapetI-Ⅲ级的患者60例,按照Malapet分级随机分为2组,双管喉罩组(LMA,n:30)与气管插管组(ET,n:30),对麻醉诱导前、置管(喉罩)即刻、拔管(喉罩)即刻SBP、DBP、MBP、HR和SpO2进行记录,术中丙泊酚、瑞芬太尼、维库溴胺的用量,比较术毕苏醒时间、复苏期躁动、咽部不适发生率。结果两组首次置管成功率分别为97%和94%(P>0.05),丙泊酚、瑞芬太尼及维库溴胺用量,ET组明显多于LMA组(P 0.05), propofol, fentanyl and vecuronium dosage, et group significantly more than the LMA group (P < 0.05); recovery time of ET group was significantly longer than that of the LMA group (P< 0.05); catheter (LMA) immediately and pull tube (LMA) immediately DBP, MBP and HR differences were statistically significant (P < 0.05); postoperative recovery period et group have occurred in 5 cases and restlessness, after extubation has 3 patients complained of sore throat discomfort.Conclusion This study results show that the ProSeal laryngeal mask airway anesthesia and the stability of circulation, securing the airway, the dosage is obviously reduced, better solution for clinical anesthesia.

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

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    1991-05-01

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

  14. Application of club day rehabilitation model in patients with episode schizophrenia during recovery period%会所模式日间康复在首发恢复期精神分裂症病人中的应用

    Institute of Scientific and Technical Information of China (English)

    沈玉蓉; 熊燕; 李广珍; 陈远华; 张元东

    2016-01-01

    [目的]探讨会所模式日间康复在首发恢复期精神分裂症病人中的应用效果。[方法]将111例首发恢复期精神分裂症病人随机分为会所组和常规组,常规组进行常规社区干预,会所组在常规社区干预的基础上进行会所模式日间康复干预,比较两组干预前和干预1个月、3个月、6个月和12个月的简明精神评定量表(BPRS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)和社会功能缺陷筛选表(SDSS)得分。[结果]会所组干预6个月和12个月的 BPRS 得分、SDS 得分、SAS 得分和 SDSS 得分低于常规组,差异有统计学意义(P <0.05)。[结论]会所模式日间康复有助于改善首发恢复期精神分裂症病人的病情、心理状态和社会功能,是首发恢复期精神分裂症病人的有效康复模式。%Objective:To probe into the application effect of club day rehabilitation model for patients with epi-sode schizophrenia during recovery period.Methods:A total of 1 1 1 patients with episode schizophrenia during recovery period were randomly divided into club group and conventional group.The patients in conventional group received the routine community intervention,and the patients in intervention group were conducted in routine community intervention and club day rehabilitation model.Then the scores of the Brief Psychiatric Rat-ing Scale(BPRS),depression self rating scale(SDS),Zung self rating scale(SAS)and social disability screening scale(SDSS)were compared between both groups before the intervention and intervention for 1 month,3 months,6 months and 12 months.Results:BPRS score,SDS score,SAS score and SDSS score of 6 months and 12 months in club group were lower than those in conventional group,the difference was statistically significant (P <0.05).Conclusion:Club day rehabilitation model was helpful to improve the condition,mental state and so-cial function of patients with episode schizophrenia during recovery periods.It was an

  15. Effects of lidocaine and esmolol infusions on hemodynamic changes, analgesic requirement, and recovery in laparoscopic cholecystectomy operations

    Directory of Open Access Journals (Sweden)

    Serpil Dagdelen Dogan

    2016-04-01

    Full Text Available ABSTRACT OBJECTIVE: We compared the effects of lidocaine and esmolol infusions on intraoperative hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery in laparoscopic cholecystectomy surgery. METHODS: The first group (n = 30 received IV lidocaine infusions at a rate of 1.5 mg/kg/min and the second group (n = 30 received IV esmolol infusions at a rate of 1 mg/kg/min. Hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery characteristics were evaluated. RESULTS: In the lidocaine group, systolic arterial blood pressures values were lower after the induction of anesthesia and at 20 min following surgical incision (p < 0.05. Awakening time was shorter in the esmolol group (p < 0.001; Ramsay Sedation Scale scores at 10 min after extubation were lower in the esmolol group (p < 0.05. The modified Aldrete scores at all measurement time points during the recovery period were relatively lower in the lidocaine group (p < 0.05. The time to attain a modified Aldrete score of ≥9 points was prolonged in the lidocaine group (p < 0.01. Postoperative resting and dynamic VAS scores were higher in the lidocaine group at 10 and 20 min after extubation (p < 0.05, p < 0.01, respectively. Analgesic supplements were less frequently required in the lidocaine group (p < 0.01. CONCLUSION: In laparoscopic cholecystectomies, lidocaine infusion had superiorities over esmolol infusions regarding the suppression of responses to tracheal extubation and postoperative need for additional analgesic agents in the long run, while esmolol was more advantageous with respect to rapid recovery from anesthesia, attenuation of early postoperative pain, and modified Aldrete recovery (MAR scores and time to reach MAR score of 9 points.

  16. Percutaneous Nephrolithotomy under Spinal Anesthesia with Marcaine

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    S.M.R. Rabani

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2015-06-01

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

  18. 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...

  19. Inguinal hernioraphy under local anesthesia in the elderly patients

    OpenAIRE

    2012-01-01

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

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

    OpenAIRE

    Douglas, James R.; Ritter, Melody J.

    2011-01-01

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

  1. Effects of Moderate Hyperventilation on Jugular Bulb Gases under Propofol or Isoflurane Anesthesia during Supratentorial Craniotomy

    Institute of Scientific and Technical Information of China (English)

    Lan Meng; Shu-Qin Li; Nan Ji; Fang Luo

    2015-01-01

    Background:The optimal ventilated status under total intravenous or inhalation anesthesia in neurosurgical patients with a supratentorial tumor has not been ascertained.The purpose of this study was to intraoperatively compare the effects of moderate hyperventilation on the jugular bulb oxygen saturation (SjO2),cerebral oxygen extraction ratio (O2ER),mean arterial blood pressure (MAP),and heart rate (HR) in patients with a supratentorial tumor under different anesthetic regimens.Methods:Twenty adult patients suffered from supratentorial tumors were randomly assigned to receive a propofol infusion followed by isoflurane anesthesia after a 30-min stabilization period or isoflurane followed by propofol.The patients were randomized to one of the following two treatment sequences:hyperventilation followed by normoventilation or normoventilation followed by hyperventilation during isoflurane or propofol anesthesia,respectively.The ventilation and end-tidal CO2 tension were maintained at a constant level for 20 min.Radial arterial and jugular bulb catheters were inserted for the blood gas sampling.At the end of each study period,we measured the change in the arterial and jugular bulb blood gases.Results:The mean value of the jugular bulb oxygen saturation (SjO2) significantly decreased,and the oxygen extraction ratio (O2ER) significantly increased under isoflurane or propofol anesthesia during hyperventilation compared with those during normoventilation (SjO2:t =-2.728,P =0.011 or t =-3.504,P =0.001;O2ER:t =2.484,P =0.020 or t =2.892,P =0.009).The SjO2 significantly decreased,and the O2ER significantly increased under propofol anesthesia compared with those values under isoflurane anesthesia during moderate hyperventilation (SjO2:t =-2.769,P =0.012;O2ER:t =2.719,P =0.013).In the study,no significant changes in the SjO2 and the O2ER were observed under propofol compared with those values under isoflurane during normoventilation.Conclusions:Our results suggest that the

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

    Science.gov (United States)

    Ford, Mary Bryant

    2010-01-01

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

  3. 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...

  4. Inguinal hernioraphy under local anesthesia in the elderly patients

    Directory of Open Access Journals (Sweden)

    Nurettin Kahramansoy

    2012-12-01

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

  5. 21 CFR 868.5240 - Anesthesia breathing circuit.

    Science.gov (United States)

    2010-04-01

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

  6. Lumbar spinal anesthesia with cervical nociceptive blockade. Critical review of a series of 1,330 procedures

    Directory of Open Access Journals (Sweden)

    Percio Ramón Becker Benitez

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: The manufacture of minimally traumatic needles and synthesis of pharmacological adjuncts with safe and effective action on inhibitory and neuromodulatory synapses distributed along the nociceptive pathways were crucial for a new expansion phase of spinal anesthesia. The objectives of this paper are present our clinical experience with 1330 lumbar spinal anesthesia performed with purposeful nociceptive blockade of the thoracic and cervical spinal nerves corresponding to dermatomes C4 or C3; warn about the method pathophysiological risks, and emphasize preventive standards for the safe application of the technique. CONTENT: Review of the historical background and anatomical spinal anesthesia with cervical levels of analgesia. Description of the technique used in our institution; population anesthetized; and surgery performed with the described method. Critical exposition of the physiological, pathophysiological, and clinical effects occurred and registered during anesthesia-surgery and postoperative period. CONCLUSION: Spinal anesthesia with nociceptive blockade to dermatome C4, or C3, is an effective option for surgery on somatic structures distal to the metamer of the third cervical spinal nerve, lasting no more than four or five hours. The method safety depends on the unrestricted respect for the essential rules of proper anesthesia.

  7. Effect of dexmedetomidine on cognitive function and related cytokine contents after sevoflurane anesthesia

    Institute of Scientific and Technical Information of China (English)

    Qing-Bo Han

    2016-01-01

    Objective:To analyze the effect of dexmedetomidine on cognitive function and related cytokine contents after sevoflurane anesthesia.Methods:A total of 118 who received surgical treatment in our hospital all received sevoflurane intravenous-inhalation combined anesthesia, and according to the intraoperative application of dexmedetomidine or not, all included patients were divided into observation group and control group by half. Control group received sevoflurane intravenous-inhalation combined anesthesia alone, observation group received dexmedetomidine on the basis of intravenous-inhalation combined anesthesia, and then differences in the values of hemodynamic parameters, immune function indicators, cognition-related indicators, illness-related indicators and so son were compared between two groups. Results:CVP values of observation group at T2 and T3 were higher than those of control group, and Rv, CO and CI values were lower than those of control group (P<0.05); CD3+, CD4+, CD8+ and CD16+/CD56+ values of observation group at T2 and T3 were higher than those of control group, and TNF-α and IL-1β values were lower than those of control group (P<0.05); serum BDNF, S100β andβ-EP values of observation group immediately after operation were lower than those of control group, and ChAT and NGF values were higher than those of control group (P<0.05); serum HIF-1α value of observation group immediately after operation was higher than that of control group, and ALD, NF-κB and sICAM-1 values were lower than those of control group (P<0.05).Conclusions:Application of dexmedetomidine in sevoflurane anesthesia can protect patients’ cognitive function and stabilize circulation, and contributes to postoperative body function recovery.

  8. Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges

    Directory of Open Access Journals (Sweden)

    Muhly WT

    2015-11-01

    Full Text Available Wallis T Muhly, Harshad G Gurnaney, Arjunan GaneshDepartment of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, PA, USAAbstract: The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs for postoperative analgesia following orthopedic surgery has been well established in adults. Recent studies have also demonstrated earlier functional recovery after surgery in patients who received PNBs. In children, PNB is gaining popularity, and increasing data are emerging to demonstrate the feasibility, efficacy, and safety in this population. In this paper, we will review some of the most common indications for surgery involving the knee in children and the anatomy of knee, associated dermatomal and osteotomal innervation, and the PNBs most commonly used to produce analgesia at the level of the knee. We will review the evidence in support of regional anesthesia in children in terms of both the quality conferred to the immediate postoperative care and the role of continuous PNBs in maintaining effective analgesia following discharge. Also we will discuss some of the subtle challenges in utilizing regional anesthesia in the pediatric patient including the use of general anesthesia when performing regional anesthesia and the issue of monitoring for compartment syndrome. Finally, we will offer some thoughts about areas of practice that are in need of further investigation.Keywords: pediatric surgery, regional anesthesia, analgesia, knee surgery

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

    Science.gov (United States)

    Mehta, Nandita; Gupta, Sunana; Sharma, Atul; Dar, Mohd Reidwan

    2015-01-01

    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.

  10. Comparison of propofol infusion and isoflurane for maintenance of anesthesia for dentistry in mentally retarded patients.

    Science.gov (United States)

    Antila, H.; Valli, J.; Valtonen, M.; Kanto, J.

    1992-01-01

    A continuous infusion of propofol following an induction dose of 2 mg/kg was compared with thiopental/isoflurane for the induction and maintenance of anesthesia in 20 mentally retarded outpatients undergoing routine dental procedures. The infusion rate of propofol and the concentration of isoflurane were adjusted to maintain the heart rate and blood pressure within +/- 25% of the baseline values. Postoperative wakefulness was assessed using a 100-mm visual analogue scale at the time of extubation and at 5, 10, 15, 30, 60, 90, and 120 min after extubation. Both agents provided adequate anesthesia for the treatment, and no major adverse reactions occurred. Recovery was more complete during the first hour after extubation in the propofol group, and these patients were discharged earlier. PMID:1308378

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  12. A Case Report of Radial Artery Spasm during Anesthesia

    Directory of Open Access Journals (Sweden)

    M Masoudifar

    2010-01-01

    Full Text Available Introduction & objective: One of the most important drawbacks of radial artery is its tendency toward spasm and one of the rare etiologies of that is recurrent blood sampling of the artery. Other causes are injection of drugs in artery in spite of vein, or using radial artery in cardiopulmonary bypass. Papaverine is a useful drug in vasospasm, but it must be used with special caution to avoid it's complications such as arrhythmia. Case: The patient was a 72 year old man with intestinal gangrene and peritonitis whom was operated in Al-Zahra hospital in 2008. During Laparatomy surgery, because of severe acidosis, blood sampling was done 3 times for blood gas analysis. After being taken to the recovery ward, no radial pulse was detectable in the patient's right hand and severe cyanosis in the same hand was seen. After inserting the arterial catheter in brachial artery, treatment with Papaverine, indications of recovery were seen. Conclusion: Despite the rarity of radial artery spasm during anesthesia, it is very dangerous situation, and anesthesiologist must try to prohibit and be able to manage this problem and have suitable drugs in the operation room.

  13. Anesthesia in pregnant women with HELLP syndrome: case report

    Directory of Open Access Journals (Sweden)

    Eduardo Barbin Zuccolotto

    Full Text Available Abstract Background and objectives: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24% and perinatal (up 40% mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. Case report: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100 mmHg and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome. Indicated for general anesthesia, we opted for total intravenous with intubation after rapid sequence induction with propofol and remifentanil in continuous target-controlled infusion, and rocuronium at a dose of 1.2 mg/kg. Maintenance was achieved with propofol and remifentanil. The surgical procedure was uneventful, the child was born with APGAR 1/5 and transferred to the NICU. At the end of surgery, the patient was extubated in the operating room and taken to the ICU. The postoperative period was uneventful with no changes worthy of note and the patient was discharged on the sixth postoperative day. Conclusion: When general anesthesia is the choice in parturient with HELLP syndrome, tracheal intubation with rapid sequence induction due to possible difficult airway, as well as the use of drugs to control the hemodynamic response can minimize the complications associated with the procedure, as occurred in this case.

  14. Subarachnoid versus General Anesthesia in Penile Prosthetic Implantation: Outcomes Analyses

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    Gerard D. Henry

    2012-01-01

    Full Text Available The leading patient complaint during the perioperative period for penile prosthesis implantation is postoperative pain, while emesis and urticaria also affect the procedure’s perceived success. In analyzing surgical outcomes, assessment of the anesthetic for postoperative pain and side effects should be included. This paper retrospectively reviews 90 consecutive, primary inflatable penile prosthetic operations performed by a single surgeon at one private medical center. Fifty-seven patients were included in final analysis. Patients who had more than one procedure that day or who used chronic pain medication were excluded. The type and amount of each drug used for each respective side effect (within the first 24 hours after procedure were compared to determine relative benefit. Twenty patients received general anesthesia (denoted herein as “GA” and 37 received spinal (or also known as subarachnoid anesthesia (denoted herein as “SA”. Patients receiving GA had significantly greater (P<0.0001 occurrence and amount of intravenous pain treatment than those receiving SA. Patients with SA required less intravenous pain medication and less treatment for nausea/emesis.

  15. Awareness during general anesthesia: An Indian viewpoint

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    Reshma P Ambulkar

    2016-01-01

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

  16. Testing haptic sensations for spinal anesthesia.

    LENUS (Irish Health Repository)

    2011-01-01

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

  17. [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.

  18. 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...

  19. 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

  20. Low dose spinal anesthesia for knee arthroscopy

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    Lakhin R.E.

    2015-06-01

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

  1. 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.

  2. 七氟醚与丙泊酚用于小儿烧伤手术麻醉维持临床效果分析%Clinical effect analysis of Anesthesia maintenance sevoflurane and propofol in pediatric burn operation

    Institute of Scientific and Technical Information of China (English)

    周彦昆

    2013-01-01

    目的 比较分析七氟醚与丙泊酚在临床中治疗小儿烧伤手术中麻醉效果,以便进一步了解对于小儿烧伤手术时麻醉用药的选择以及用药剂量等,使患者能够更快的恢复正常.方法 选取我院自2008年1月至2011年12月内收治的小儿烧伤患者46例,利用随机数字表法,对所有患者进行随机分组,一组为七氟醚组,另一组为丙泊酚组,对在患儿进行手术前进行不同的麻醉方法,并及时检测手术各时段患儿的血压变化、麻醉时间、药物用量、苏醒时间等,术后统计所得数据进行相关分析.结果 与丙泊酚组相比七氟醚组的患者,能够在术后较早的苏醒,并且七氟醚组患者在手术期间血流动力学指标要明显优于丙泊酚组,同时患儿手术的自主呼吸恢复时间以及苏醒时间均明显小于丙泊酚组,即两组间存在显著差异P<0.05,具有统计学意义.结论 七氟醚在小儿烧伤手术的临床治疗中具有麻醉循环稳定,术后患者恢复快,明显减少术后并发症的发生等优点,因此七氟醚在小儿烧伤手术治疗中具有较好的临床疗效,可广泛的用于临床使用,值得推广.%Objective To compare the anesthesia effect of sevoflurane and propofol in the clinical treatment of pediatric burn operation,in order to further understand for pediatric burn operation anesthesia drug selection and dosage,to enable patients to a faster return to normal.Methods In our hospital from 20081January to2011December were treated46 cases of pediatric burn patients,using a random number table,all the patients underwent randomization,a group of sevoflurane group,another group of propofol group,in children with different anesthesia methods before operation,and timely detection operation in each period of children blood pressure changes,duration of anesthesia,drug dosage,recovery time,postoperative statistical data by correlation analysis.Results Compared with propofol and sevoflurane in

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Sinem Sarı

    2015-08-01

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

  5. 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.

  6. Clinical Experience of Total Intravenous Anesthesia in 77 Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Pinar Ergenoglu

    2013-08-01

    .5% had response to commands at postoperative 5th minutes and 85.7% of patients were completely cooperative-oriented after 30 minutes. None of patients had deep sedation or respiratory depression. Conclusion:Total intravenous anesthesia can be considered as a safe method in patients with renal transplantation, may contribute to early postoperative recovery and transfer to the transplantation unit. [Cukurova Med J 2013; 38(4.000: 617-625

  7. Olfactory bulb encoding during learning under anesthesia

    Science.gov (United States)

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

    2014-01-01

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

  8. 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

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

    Directory of Open Access Journals (Sweden)

    G Gazal

    2016-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  11. Effect of Cytoflavin on Early Postanesthetic Recovery of Cancer Patients

    Directory of Open Access Journals (Sweden)

    K. F. Fatullayeva

    2008-01-01

    Full Text Available Objective: to evaluate the effect of the metabolic antihypoxant cytoflavin on the course of early postanesthetic recovery in patients operated on for various cancers. Subjects and methods: Fifty-seven patients aged 30 to 65 years, operated on for gynecological cancer, were examined. The patients were divided into 2 groups: 1 28 patients who took cytoflavin and 2 29 who did not. At the end of an operation, the agent was intravenously injected in a dose of 10 ml in a mixture with an equal volume of 0.9% sodium chloride solution. Thiopental sodium was used for initial anesthesia; arduan was employed to maintain muscle relaxation. Neuroleptic analgesia with fentanyl and droperidol or ataralgesia (fentanyl + relanium was applied in both groups. The levels of hemoglobin, glucose, sodium, potassium, calcium, malonic dialdehyde (MDA (Andreyev’s test, antioxidative activity (AOA (Semenov’s test were measured to evaluate the functional state of patients. The rating system for determining the recovery of consciousness, respiration, and motor activity, proposed by Aldret and Kroulik [8], and Bidway’s psychological testing, blood oxygen saturation and cardiac performance monitoring (TRITON, Russia and some others were used to evaluate the efficacy of the drug in the early postanesthetic period. The results were statistically processed using Microsoft Excel and a package of Biostatistics 6.0. Results. The use of cytoflavin at the end of surgery has been established to have a beneficial effect on the early recovery period. This is manifested as shorter recovery of consciousness and respiration mainly in the ataralgesia group; fair oxygen saturation, lower MDA concentrations and higher AOA are revealed. Conclusion. Cytoflavin significantly reduces the recovery of consciousness and adequate respiration and the incidence of the fever, muscle tremor syndrome and fails to favor the occurrence of hypoglycemia. Inclusion of cytoflavin into a complex of

  12. Can children undergoing ophthalmologic examinations under anesthesia be safely anesthetized without using an IV line?

    Directory of Open Access Journals (Sweden)

    Vigoda M

    2011-04-01

    Full Text Available Michael M Vigoda, Azeema Latiff, Timothy G Murray, Jacqueline L Tutiven, Audina M Berrocal, Steven GayerBascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To document that with proper patient and procedure selection, children undergoing general inhalational anesthesia for ophthalmologic exams (with or without photos, ultrasound, laser treatment, peri-ocular injection of chemotherapy, suture removal, and/or replacement of ocular prosthesis can be safely anesthetized without the use of an intravenous (IV line. Children are rarely anesthetized without IV access placement. We performed a retrospective study to determine our incidence of IV access placement during examinations under anesthesia (EUA and the incidence of adverse events that required intraoperative IV access placement.Methods: Data collected from our operating room (OR information system includes but is not limited to diagnosis, anesthesiologist, surgeon, and location of IV catheter (if applicable, patient’s date of birth, actual procedure, and anesthesia/procedure times. We reviewed the OR and anesthetic records of children (>1 month and <10 years who underwent EUAs between January 1, 2003 and May 31, 2009. We determined the percentage of children who were anesthetized without IV access placement, as well as the incidence of any adverse events that required IV access placement, intraoperatively.Results: We analyzed data from 3196 procedures performed during a 77-month period. Patients’ ages ranged from 1 month to 9 years. Overall, 92% of procedures were performed without IV access placement. Procedure duration ranged from 1–39 minutes. Reasons for IV access placement included parental preference for antinausea medication and/or attending preference for IV access placement. No child who underwent anesthesia without an IV line had an intraoperative adverse event requiring insertion of an IV line.Conclusion: Our data suggest that for

  13. Comparative study between sugammadex and neostigmine in neurosurgical anesthesia in pediatric patients

    Directory of Open Access Journals (Sweden)

    Ayman A Ghoneim

    2015-01-01

    Full Text Available Background: Postoperative recurarization remains a risk following the use of the conventional neuromuscular blocking agents. In addition, none of the commonly used reversal agents, such as neostigmine or edrophonium are capable of reliably reversing profound blockade. The present comparative and randomized study investigated the use of sugammadex for reversing profound neuromuscular blockade (NMB in pediatric neurosurgical patients undergone posterior fossa tumor excision. Patients and Methods: Forty pediatric patients undergoing elective craniotomy for posterior fossa tumor excision were randomly divided into either of neostigmine or sugammadex group in which muscle relaxant was reversed at the end of anesthesia either with neostigmine 0.04 mg/kg added to atropine 0.02 mg/kg or sugammadex 4 mg/kg alone, respectively. The primary endpoint was the time from the administration of sugammadex or neostigmine to recovery of the train of four (TOF ratio to 90% after rocuronium-induced neuromuscular block. Unpaired t-test was used to compare continuous variables between groups. Meanwhile, repeated ANOVA was used to detect intragroup differences. Results: Patients in sugammadex group attained a TOF ratio 90% in statistically shorter time (1.4 ± 1.2 min than those in neostigmine group (25.16 ± 6.49 min for reversal of the rocuronium. Mean arterial pressure and heart rate were significantly higher in neostigmine group at 2, 5 and 10 min after administration of the reversal agents and returned nonsignificantly different after that. With no recurarization in any patient throughout the study period. Conclusion: Sugammadex rapidly and effectively reverses rocuronium-induced NMB in pediatric patients undergoing neurosurgery when administered at reappearance of T2 of TOF at dose 4 mg/kg.

  14. 电力系统恢复初期考虑动态特性的负荷恢复优化%Load Restoration Optimization Considering Dynamic Constraints During Initial Period of Power System Recovery

    Institute of Scientific and Technical Information of China (English)

    龚薇; 刘俊勇; 贺星棋; 胥威汀

    2014-01-01

    During the initial period of power system recovery, how to maximally restore the power supply in a weak power system was researched. Considering great changes of voltage and frequency during power system transient process after the service restoration, the physical nature during the initial period of power system recovery can be revealed better by using transient energy function of non-autonomous system to analyze the dynamic frequency and to calculate the ultimate capacity in each load that can be restored. The load impact energy and the dynamic frequency constraint are led in to guide the drafting of maximal load restoration programs, therefrom a method to draw up the load restoration scheme, in which the dynamic characteristics is taken into account, is put forward. Using this method a maximal load restoration scheme, which can meet the requirement on power system dynamic characteristics, could be drawn up, meanwhile it can be found that using load impact energy the impact of putting load into operation on power system can be reflected more accurately, thus it can offer helpful guidance to the drafting and evaluation of load restoration strategy.%电力系统恢复初期,对如何在薄弱小电网下最大限度地恢复负荷进行了研究。考虑到投入负荷后的系统过渡过程中各种状态量的巨大变化,从非自治系统暂态能量函数的角度分析其动态变化过程,能更好地揭示系统恢复初期的物理本质。引入负荷冲击能量和动态频率来指导制定最大限度的负荷恢复方案,由此提出考虑动态特性的负荷恢复方案制定方法。通过该方法能够制定出满足系统动态特性要求的最大限度负荷恢复方案,同时可以发现用负荷冲击能量能更准确地反映负荷投入对系统的影响,为负荷恢复策略制定及评估提供有益的指导。

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

    Science.gov (United States)

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

    2012-01-01

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

  16. Anesthesia and transport of fat snook Centropomus parallelus with the essential oil of Nectandra megapotamica(Spreng. Mez

    Directory of Open Access Journals (Sweden)

    Juliana Simoni Moraes Tondolo

    Full Text Available This study analyzed the chemical composition and anesthetic potential of essential oil (EO of Nectandra megapotamica in fat snook (Centropomus parallelus. For the extraction of EO by hydrodistillation, leaves were separated in young (EO-Y or old (EO-O, and the chemical composition of the EOs was determined by CG-MS. The anesthetic potential was assessed by the evaluation of induction and recovery time of anesthesia and stress response from anesthesia and transport. Three experiments were carried out: i four different concentrations of each EO were tested to evaluate anesthesia induction and recovery time; ii two concentrations of EO-O were tested for the evaluation of its effects on stress parameters (glucose, lactate, and Na+ and K+ plasma levels caused by anesthesia; and iii fish were transported in plastic bags, supplied with two concentrations of EO-O for the evaluation of water quality and mortality. All experiments were performed on fish acclimated to 0 and 33 ppt salinity. The main constituents of the Y and O-EOs were bicyclogermacrene (46.5/34.6%, α-pinene (26.8/26.2%, β-pinene (7.9/12.3%, and germacrene D (9.6/9.1%. Mild sedation was achieved at 30 °L L-1(1.3-3.2 min and deep anesthesia at 150 °L L-1(5.6-8.0 min with both EOs. The recovery time ranged from 1-10 min. The EO-O was not able to avoid the stress of anesthesia evidenced by elevated glucose and lactate plasma levels observed in all groups. Plasma levels of Na+ and K+ were not significantly affected by treatments. During transport, the use of EO-O did not prevent deterioration in water quality and the post-transport mortality. In conclusion, the EO of N. megapotamica has anesthetic activity in fat snook, but it was not able to prevent the stress of anesthesia and transport.

  17. Dextromethorphan Reduces Postoperative Pain of Post Partum Tubal Ligation under General Anesthesia

    Directory of Open Access Journals (Sweden)

    N. Manochehrian

    2009-04-01

    Full Text Available Introduction & Objective: Postoperative pain has harmful effects in many systems. Dextromethorphan reduces postoperative pain in post partum tubal ligation under general anesthesia. Materials & Methods: In this research 40 patients with ASA class I and II in double blind randomized clinical trial were studied in two groups. 90 minutes before surgery the patients received 90 mg dextromethorphan or placebo (oral. The patients induced general anesthesia with thiopental (5mg/kg, fentanyl 1.5 g/kg and succinylcholin(1-1.5 mg/kg and maintenance with halothane and N2O 50%. Patients were observed studied for analgesic requirement, nausea, vomiting, urinary retention and respiratory depression in recovery and 2,4,8 and 24 hours after surgery. Results: There was no significant difference in age, education, . . . Pain in recovery, 2 and 4 hours after surgery in dextromethorphan was less than placebo group. The analgesic requirement (pethidine in dextromethophan was less than placebo group.Conclusion: Administration of 90 mg dextromethorphan 90 minutes before the surgery under GA reduces pain in recovery time , 2 and 4 hours after the surgery.

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

    Directory of Open Access Journals (Sweden)

    Jing-Dong Ke

    2015-01-01

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

  19. Cerebral oximetry in cardiac anesthesia

    Science.gov (United States)

    Vretzakis, George; Georgopoulou, Stauroula; Stamoulis, Konstantinos; Stamatiou, Georgia; Tsakiridis, Kosmas; Katsikogianis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Mpakas, Andreas; Beleveslis, Thomas; Koletas, Alexander; Siminelakis, Stavros N.; Zarogoulidis, Konstantinos

    2014-01-01

    Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively according their risk. Intraoperatively, it provides continuous information about brain oxygenation and allows the use of brain as sentinel organ indexing overall organ perfusion and injury. This review focuses on the clinical validity and applicability of this monitor for cardiac surgical patients. PMID:24672700

  20. Recovery Online

    Science.gov (United States)

    Clark, John R.

    2007-01-01

    Since the founding of Alcoholics Anonymous (AA) in 1935, programs offering opportunity for recovery from alcoholism and other addictions have undergone vast changes. The Internet has created nearly limitless opportunities for recovering people and those seeking recovery to find both meetings and places where they can gather virtually and discuss…

  1. Backup & Recovery

    CERN Document Server

    Preston, W

    2009-01-01

    Packed with practical, freely available backup and recovery solutions for Unix, Linux, Windows, and Mac OS X systems -- as well as various databases -- this new guide is a complete overhaul of Unix Backup & Recovery by the same author, now revised and expanded with over 75% new material.

  2. Predictors of recovery in first episode psychosis

    DEFF Research Database (Denmark)

    Austin, Stephen F; Mors, Ole; Secher, Rikke Gry

    2013-01-01

    Recovery, the optimal goal in treatment, is the attainment of both symptomatic and functional remission over a sustained period of time. Identification of factors that promote recovery can help develop interventions that facilitate good outcomes for people with first episode psychosis.......Recovery, the optimal goal in treatment, is the attainment of both symptomatic and functional remission over a sustained period of time. Identification of factors that promote recovery can help develop interventions that facilitate good outcomes for people with first episode psychosis....

  3. Magnesium in obstetric anesthesia and intensive care.

    Science.gov (United States)

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

    2017-02-01

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

  4. Robust Adaptive Control of Hypnosis During Anesthesia

    Science.gov (United States)

    2007-11-02

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

  5. Anesthesia for Patients with Traumatic Brain Injuries.

    Science.gov (United States)

    Bhattacharya, Bishwajit; Maung, Adrian A

    2016-12-01

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

  6. The effects of cigarette smoking on anesthesia.

    OpenAIRE

    Rodrigo, C.

    2000-01-01

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

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

    OpenAIRE

    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...

  8. Effects of anesthesia type on short-term postoperative cognitive function in obstetric patients following cesarean section

    Science.gov (United States)

    Altun, Celalettin; Borazan, Hale; Şahin, Osman; Gezginç, Kazım

    2015-01-01

    Objective We aimed to compare the effects of general and spinal anesthesia on cognitive functions in pregnant patients undergoing elective cesarean section. Material and Methods Seventy-five American Society of Anesthesiology (ASA) I pregnant patients aged 18–40 years who were scheduled to undergo elective cesarean section were divided into three groups. Group sevoflurane (Group S) and Group desflurane (Group D) were administered general anesthesia, whereas Group regional (Group R) was administered spinal anesthesia. Hemodynamic variables, bispectral index, oxygen saturation were measured at baseline, after induction, spinal injection, and during the surgery. Extubation and eye opening time and Aldrete scores were recorded. Mini-mental state examination, Trieger dot test, and clock drawing test were performed one day before the surgery and repeated at the 1st, 3rd and 24th h postoperatively. Results There was no statistically significant difference among the groups in terms of demographic data and duration of surgery (p>0.05). Durations of anesthesia for Group S, Group R, and Group D were significantly different (pAldrete recovery scores and total remifentanil consumption were significantly higher in Group D than in Group S (p<0.05). Extubation and eye opening times were significantly shorter in Group D than in Group S (p<0.01). According to TDT, statistical significance was found among Group S, Group R, and Group D at the 3rd and 24th h postoperatively (p<0.05), and there was a statistically high significant difference in Groups S and R (p<0.0001). Conclusion We concluded that general anesthesia with sevoflurane or desflurane and spinal anesthesia had no effects on cognitive functions in patients undergoing cesarean operation. PMID:26692772

  9. Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia

    Science.gov (United States)

    Won, Young Ju; Lim, Byung Gun; Lee, So Hyun; Park, Sangwoo; Kim, Heezoo; Lee, Il Ok; Kong, Myoung Hoon

    2016-01-01

    Abstract Background: The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy. Methods: Forty-five patients undergoing elective thyroidectomy were randomly assigned to an SPI group (SPI-guided analgesia group, n = 23) or a control group (conventional analgesia group, n = 22). Anesthesia was maintained with sevoflurane to achieve bispectral index values between 40 and 60. In the SPI group, oxycodone 1 mg was administered intravenously at SPI values over 50; in the control group, oxycodone 1 mg was administered intravenously at the occurrence of tachycardia or hypertension event. Intraoperative oxycodone consumption and extubation time were recorded. The number of hemodynamic and somatic movement events was recorded, as were postoperative pain and recovery scores. Results: Patients’ characteristics were comparable between the groups. Intraoperative oxycodone consumption in the SPI group was significantly lower than the control group (3.5 ± 2.4 vs 5.1 ± 2.4 mg; P = 0.012). Extubation time was significantly shorter in the SPI group (10.6 ± 3.5 vs 13.4 ± 4.6 min; P = 0.026). Hemodynamic and somatic movement events during anesthesia were comparable between the groups, as were numeric rating scales for pain and modified Aldrete scores at postanesthesia care unit. Conclusions: SPI-guided analgesia reduces intravenous oxycodone consumption and extubation time compared with conventional analgesia based on clinical parameters during sevoflurane anesthesia in patients undergoing thyroidectomy. PMID:27583920

  10. The National Anesthesia Clinical Outcomes Registry.

    Science.gov (United States)

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

    2015-12-01

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

  11. Effects of hand massage on anxiety in patients undergoing ophthalmology surgery using local anesthesia

    Directory of Open Access Journals (Sweden)

    Jafar Rafiei Kiasari

    2012-08-01

    Full Text Available Introduction: Anxiety is a common disorder in patients before surgery. Inappropriately managed anxiety can cause psychological and physiological reactions and will affect the process of surgery and recovery. Therefore, this study examined the effects of hand mas-sage on anxiety in patients undergoing ophthalmology surgery using local anesthesia. Methods: In this interventional study, 52 patients who were supposed to undergo oph-thalmology surgery using local anesthesia were studied. Patients were randomly as-signed to two groups of intervention, who received hand massage before surgery (n = 27 and control (n = 25. Massaging lasted for 5 minutes (2.5 minutes on each hand before surgery. Stroking and scrubbing methods were performed by 2 trained research-ers. Anxiety level, blood pressure, heart rate, and respiratory rate were measured before and after the intervention in both groups. Anxiety was evaluated using Spielberger State-Trait Anxiety Inventory. Data was analyzed by chi-square, independent samples t-test, and paired t-test. Results: There were no significant differences in mean anxiety, systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate between the two groups before the intervention (p > 0.05. However, there was a significant differenc in the mean stress level between the two groups after the intervention (p 0.05. Conclusion: Our findings suggested that 5 minutes of hand massage before ophthalmology surgery (under local anesthesia could reduce anxiety. Therefore, this method can be used to increase patient comfort and reduce anxiety before surgical interventions.

  12. The Effect of Acupressure on Nausea and Vomiting after Cesarean Section Under Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Heydar Noroozinia

    2013-03-01

    Full Text Available Postoperative nausea and vomiting (PONV is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S under spinal anesthesia. In a prospective randomized clinical trial, 152 patients who were candidate for elective C/S under spinal anesthesia were evaluated in two groups (acupressure vs control groups. Subjects in the acupressure group received constant pressure by a specific wrist elastic band (without puncture of the skin on the Nei-Guan acupuncture point, 30 min prior to spinal anesthesia. The incidence of PONV was assessed during the surgery, at recovery room and at 1st, 2nd and 3rd two hours after the surgery. Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure and control groups, with a reduction in the incidence rate of nausea from 35.5% to 13.2%. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the study group. In view of the total absence of side-effects in acupressure, its application is worthy. Our study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting, when applied 30 minutes prior to surgery

  13. The effect of acupressure on nausea and vomiting after cesarean section under spinal anesthesia.

    Science.gov (United States)

    Noroozinia, Heydar; Mahoori, Alireza; Hasani, Ebrahim; Gerami-Fahim, Mohsen; Sepehrvand, Nariman

    2013-04-06

    Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S) under spinal anesthesia. In a prospective randomized clinical trial, 152 patients who were candidate for elective C/S under spinal anesthesia were evaluated in two groups (acupressure vs control groups). Subjects in the acupressure group received constant pressure by a specific wrist elastic band (without puncture of the skin) on the Nei-Guan acupuncture point, 30 min prior to spinal anesthesia. The incidence of PONV was assessed during the surgery, at recovery room and at 1st, 2nd and 3rd two hours after the surgery. Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure and control groups, with a reduction in the incidence rate of nausea from 35.5% to 13.2%. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the study group. In view of the total absence of side-effects in acupressure, its application is worthy. Our study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting, when applied 30 minutes prior to surgery.

  14. The use of ketamine, xylazine and midazolam combination for total intravenous anesthesia (TIVA in surgical removal of abdominal testis at stallion

    Directory of Open Access Journals (Sweden)

    Bojan D. Toholj

    2014-10-01

    Full Text Available Equine veterinarians frequently anesthetize horses. In majority of cases performing short-term anesthesia (duration, 20 minutes. But there is substantial need for long term anesthesia. The aim of this work is to present our experience with a long term and short term total intravenous anesthesia in horses. In this paper we are presenting results of anesthesia monitoring of a horse undergoing surgical remove of an abdominal testis (complete abdominal cryptorchid. Sedation of the horse was conducted with xylazine, 1.0 mg/kg, iv, and midazolam 0.06 mg/kg, iv. The total anesthesia was induced using a combination of ketamine 2.2mg/kg/iv, and midazolam 0.1 mg/kg/iv. After induction the horse was restrained and anesthesia was maintained with continuous intravenous drip of a combination of drugs mixed in infusion bottle with midazolam (0.002 mg/kg/min, ketamine (0.03 mg/kg/min, and xylazine (0.016 mg/kg/min. Additional ketamine (0.03 mg/kg and midazolam 0.03 mg/kg/iv was administered if the horse moved its head or limbs during the procedure. The duration of anesthesia was 90 minutes. During this time cardiopulmonary parameters and reflexes were monitored continuously.The recovery of anesthesia was 30 minutes and horse stood on the first attempt 40 minutes. Midazolam, ketamine, and xylazine in combination produced TIVA in this horse and can be used for short term, middle term, and longer lasting surgical procedures in the field.

  15. Untreated Recovery from Eating Disorders

    Science.gov (United States)

    Woods, Susan

    2004-01-01

    This retrospective study explored the experience of recovery from anorexia nervosa and bulimia nervosa without professional treatment. A nine-question open-ended electronic survey was posted for a period of four months at a mid-western university. Sixteen female and two male respondents reported recovery from adolescent-onset full syndrome…

  16. Clinical research of enteral nutrition therapy in stroke patients with dysphagia during recovery period%重度脑卒中恢复期病人肠内营养支持的临床研究

    Institute of Scientific and Technical Information of China (English)

    张丽; 王小姗; 张晓雷

    2011-01-01

    Objective: To evaluate the comparison of nutrition index, tolerance and infectious complications in stroke patients with dysphagia during recovery period before and after enteral nutrition (EN) therapy. Methods: The index of total protein, albumin, prealbumin, hemoglobin, transferin, HbAlc, IgA and IgG were examined in 45 stroke patients before and after 1,3 and 6 months during the EN treatment. The infection rate and antibiotic treatment time were analysed before and after 6 months treatment. The tolerance was observed in the period of EN treatment. Results: The levels of albumin and transferin increased after one month EN treatment(P <0. 05). The levels of albumin, hemoglobin and IgG increased after 3 months treatment(P <0.05). The higher levels of total protein, albumin, pre albumin, hemoglobin and transferin were seen after 6 months EN treatment. IgA and HbAlc were not statistically significant. The infection complications and antibiotic use time were obviously reduced. Conclusion: EN treatment can significantly improve nutritional status, strengthen immunity, reduce the incidence of infectious complications in recovery period of stroke patients.%目的:探讨重度脑卒中恢复期伴进食障碍病人进行肠内营养(EN)支持前后,营养状况指标、耐受性和感染并发症的对比研究. 方法:检测45例脑卒中恢复期病人治疗前、治疗后1、3和6个月血清总蛋白(TP)、清蛋白( ALB)、前清蛋白(PA)、血红蛋白(Hb)、转铁蛋白(TF)、糖化血红蛋白(HbA1c)、IgA和IgG等指标,并进行对比,比较治疗前后感染发生率和抗生素使用时间,并观察EN半年内的依从性和耐受性. 结果:治疗后1个月,PA和TF优于治疗前(P<0.05);治疗后3个月,ALB、Hb和IgG优于治疗前(P<0.05),PA和TF改善更加明显;治疗后6个月,TP、ALB、PA、Hb和TF较治疗前有增高(P<0.05),其中TF和IgG较治疗后3个月增高更明显(P<0.05).IgA和HbAlc治疗前后无显著性差异.感染并发

  17. Analysis of anesthesia practice and needs in Louisiana.

    Science.gov (United States)

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

    2001-07-01

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

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

    Science.gov (United States)

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

    2008-07-01

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

  19. 脑梗死恢复期患者康复科住院期间死因分析%Death Cause Analysis of Patients with Cerebral Infarction during the Recovery Period in Rehabilitation Department

    Institute of Scientific and Technical Information of China (English)

    黄旭明; 石艺华; 张明兴; 张滨

    2015-01-01

    目的:探讨脑梗死恢复期患者在康复科住院过程中死亡的相关影响因素。方法:回顾性分析2013年1月~2014年12月在本院康复医学科住院期间死亡的23例脑梗死恢复期患者的临床资料,对其一般资料、基础病变及入院时NIHSS、ADL评定等进行统计分析,并与对照组进行比较。结果:脑梗死恢复期住院期间死亡率为1.04%,其中肺部感染并呼吸衰竭12例(52.17%)、急性心肌梗塞3例(13.04%)、卒死2例(8.70%)、急性心衰2例(8.70%)、再发大面积梗塞2例(8.7%)、上消化道出血1例(4.35%)、肾功能衰竭1例(4.35%);与对照组比较,两组在高龄(>70岁)、房颤史、大面积梗塞、合并肺部感染、血浆白蛋白水平及入院时NIHSS量表、ADL量表评分等方面差异均有统计学意义(P0.05)。结论:脑梗死恢复期患者康复治疗期间的病死率与患者的高龄、梗塞面积、房颤,血浆白蛋白水平及神经功能缺损程度、日常生活能力水平、合并肺部感染等均有密切关系,尤其肺部感染是导致直接死亡的最主要原因。%Objetive:To investigate the death-related factors and causes of death in patients with cerebral infarction during the recovery period in reha-bilitation department. Methods:Clinical data of 23 cases of patients with cerebral infarction who were dead during the recovery period in rehabilita-tion medical department of our hospital were retrospective analyzed, and statistical analyzed their general information, basic pathological changes and NIHSS, ADL on admission, and compared with control group. Results:The hospital mortality in patients with cerebral infarction during the re-covery period was 1.04%, the leading direct cause of death were 12 cases of pneumonia and respiratory failure (52.17%), 3 cases of acute myocardial infarction (13.04%), 2 cases of sudden death (8.70%), 2 cases of acute heart failure (8.70%), 2 cases

  20. Study of factors related to cognitive function in patients withcerebral hemorrhage in recovery period%康复期脑出血患者认知功能的相关因素研究

    Institute of Scientific and Technical Information of China (English)

    戢运建; 况娥

    2016-01-01

    Objective To investigate the factors related to cognitive dysfunction in patients withhypertensive cerebral hemorrhage in recovery period.Methods 128 hypertensive cerebral hemorrhage, from June 2012 to December 2014 in our hospital, were selected for this study.Clinical data such as age, sex, educational level, history of diabetes, smoking and drink-ing history, CT results, blood lipids and high-sensitivity C-reactive protein levels were collected. Neurological recovery of pa-tients was evaluated by the US National Institutes of Health Stroke Scale (NIHSS) at 4 weeks after onset. Cognitive impairment was evaluated byMontreal Cognitive Scale (MoCA). The risk factors of cognitive dysfunction analysised by multiple Logistic regression.Results There were 57 cases with vascular cognitive impairment in 128 hypertensive cerebral hemorrhage, ac-counting for 44.53%. Scores of executive function, memory, language, and disorientation in patients with cognitive impairment were (4.4±0.7), (2.6±1.6), (2.4±0.4), (5.9±0.4), and were significantly higher than those without cognitive impairment pa-tients[(2.9±0.8), (2.0±1.5), (1.9±0.8) , (5.6±0.8)]. Univariate analysis showed that age, education level, regular exercise, dia-betes, lesion side, lesion range, high sensitivity C-reactive protein, homocysteine disease and the scores of NIHSS reduced were related to cognitive impairment in patients withcerebral hemorrhage in recovery period. Logistic regression analysis showed that age, regular physical exercise, high sensitivity C-reactive protein disease and lower NIHSS score were the main factors affect-ing the cognitive dysfunction. Conclusion Aged> 60 years, no regular physical exercise, with high sensitivity C-reactive protein disease and the scores of NIHSS reduced were the main factors related to cognitive dysfunction in patients with hypertensive cerebral hemorrhage in recovery period.%目的:探讨影响康复期高血压脑出血患者发生认知功能障碍的

  1. Anestesia para colonoscopia: anestesia inhalatoria con sevoflurano frente a anestesia intravenosa con propofol Colonoscopic anesthesia: Inhalatory anesthesia with sevoflurane versus intravenous anesthesia with propofol

    Directory of Open Access Journals (Sweden)

    S. De la Torre Carazo

    2012-03-01

    studied the characteristics of both techniques in two groups of 150 patients each, valuing the benefits of each, complications, tolerance, recovery time, acceptation by the endoscopist and the patient for both techniques. Results: In both techniques few complications, the degree of tolerance is good / very good in 99% of the group (A, compared to 97% of the group (B. Discussion: Although we found no publications comparing both techniques in anesthesia for colonoscopy, the use of sevoflurane has been shown similarly favorable characteristics in patients contraindicated for use of propofol, whenever we change the pattern of intravenous anesthesia by inhalation. Conclusion: Both techniques are equally useful and reliable and can be used with sevoflurane inhalation technique in patients if the propofol is inappropriate, with equal performance and versatility.

  2. 压力支持通气模式联合右美托咪定用于气管内插管患者苏醒期的效果%Effect of Pressure Support Ventilation combined with Dexmedetomidine on Recovery Period in Endotracheally Intubated Patients

    Institute of Scientific and Technical Information of China (English)

    周良军; 王寿平; 陈晓彤

    2015-01-01

    目的:探讨压力支持通气( PSV )呼吸模式联合右美托咪定对气管内插管患者苏醒期的影响。方法:选择因乳腺癌改良根治手术而行气管内插管全麻的患者40例,ASA Ⅰ-Ⅱ级,随机分成C、D两组各20例,两组在整个麻醉及手术过程中机械通气的模式均持续采用容量控制通气(VCV),持续至气管导管拔出,C组在手术结束前约30 min静脉注射0.9%生理盐水;D组术毕患者有自主呼吸时采用PSV呼吸模式持续至气管导管拔出,D组在手术结束前约30 min静脉注射右美托咪啶0.5μg/kg。记录手术结束后呼之睁眼时间及拔管时间,记录气管导管拔管时Riker镇静、躁动评分及Ramsay镇静评分,记录入室基础值(T0)、拔管即刻(T1)、拔管后2 min (T2)、5 min (T3)、10 min(T4)各时点患者的平均动脉压、心率。结果:与C组比较,D组呼之睁眼时间及拔管时间差异均无统计学意义(P>0.05);D组的躁动发生率明显降低(P<0.01),D组患者Ramsay镇静评分2-4分;D组内T0至T4各时间点心率、血压无明显变化。结论:联合使用PSV呼吸模式与右美托咪定既可防治气管内插管患者苏醒期躁动及心血管不良反应,又不延迟苏醒。%Objective:To evaluate the efficacy of pressure support ventilation(PSV) combined with dexmedetomidine on recovery period in endotracheally intubated patients. Methods:40 ASA physical status I orⅡ patients undergoing modified radical mastectomy under endotracheal general anesthesia were randomly assigned into group C (n=20) and group D(n=20). In group C, volume control ventilation(VCV) was used during operation until extubation and 0.9%normal saline was injected intravenously 30min before the end of operation. In group D, VCV was used during operation then transferred to PSV when spontaneous breath appeared and dexmedetomidine was injected intravenously 30 min

  3. The heart rate variability when conducting anesthesia

    Directory of Open Access Journals (Sweden)

    Khmel'nitskiy I.V.

    2016-03-01

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

  4. Clinical Analysis of Pediatric Anesthesia%小儿麻醉临床分析研究

    Institute of Scientific and Technical Information of China (English)

    曾强

    2010-01-01

    目的 探讨氯胺酮复合丙泊酚用于小儿手术麻醉的临床效果.方法 将2009年1月到2010年2月于我院进行手术的80例患儿随机分为两组,氯胺酮组37例使用氯胺酮单独麻醉,联合组43例采用氯胺酮联合丙泊酚的麻醉方法,观察两组术后的不良反应发生率和术后苏醒时间,进行统计分析.结果 联合组术前和术后HR和RR变化优于氯胺酮组,两组比较差异有统计学意义,P<0.05;联合组的不良反应发生率为9.3%低于氯胺酮组的24.3%,两组比较差异有统计学意义,P<0.05;联合组的患儿苏醒时间短于氯胺酮组,两组比较差异也具有统计学意义,P<0.05.结论 氯胺酮复合丙泊酚用于小儿手术麻醉的效果优于单一的氯胺酮麻醉,值得推广应用.%Objective To investigate the ketamine and propofol anesthesia for pediatric clinical effect.Methods From january 2009 to February 2010 in our hospital 80 cases surgery children were randomly divided into two groups of 37 cases of ketamine anesthesia using ketamine alone, 43 cases combined with propofol ketamine anesthesia to observe the postoperative incidence of adverse reactions, and postoperative recovery time,for statistical analysis. Results The preoperative and postoperative changes in HR and RR were better than the ketamine group, the difference was statistically significant, P< 0. 05; 9.3% adverse reaction rate in combined group was 24. 3% lower than the ketamine group,There were significant differences between groups, P <0. 05;recovery time in children of combimed group were less than ketamine group, the difference was also statistically significant, P< 0.05. Conclusion Ketamine and propofol anesthesia for children is better than a single ketamine anesthesia, should be widely applied.

  5. Nonoperating room anesthesia for the gastrointestinal endoscopy suite.

    Science.gov (United States)

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

    2014-06-01

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

  6. Total Extraperitoneal Preperitoneal Laparoscopic Hernia Repair Using Spinal Anesthesia

    OpenAIRE

    2006-01-01

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

  7. Effects of anesthesia and surgery on serial blood gas values and lactate concentrations in yellow perch (Perca flavescens), walleye pike (Sander vitreus), and koi (Cyprinus carpio).

    Science.gov (United States)

    Hanley, Christopher S; Clyde, Victoria L; Wallace, Roberta S; Paul-Murphy, Joanne; Patterson, Tamatha A; Keuler, Nicholas S; Sladky, Kurt K

    2010-05-15

    OBJECTIVE-To evaluate serial blood gas values and lactate concentrations in 3 fish species undergoing surgery and to compare blood lactate concentrations between fish that survived and those that died during the short-term postoperative period. DESIGN-Prospective cohort study. Animals-10 yellow perch, 5 walleye pike, and 8 koi. PROCEDURES-Blood samples were collected from each fish at 3 time points: before anesthesia, during anesthesia, and immediately after surgery. Blood gas values and blood lactate concentrations were measured. Fish were monitored for 2 weeks postoperatively. RESULTS-All walleye and koi survived, but 2 perch died. Blood pH significantly decreased in perch from before to during anesthesia, but increased back to preanesthesia baseline values after surgery. Blood Pco(2) decreased significantly in perch from before anesthesia to immediately after surgery, and also from during anesthesia to immediately after surgery, whereas blood Pco(2) decreased significantly in koi from before to during anesthesia. Blood Po(2) increased significantly in both perch and koi from before to during anesthesia, and also in koi from before anesthesia to immediately after surgery. For all 3 species, blood lactate concentrations increased significantly from before anesthesia to immediately after surgery. Blood lactate concentration (mean +/- SD) immediately after surgery for the 8 surviving perch was 6.06 +/- 1.47 mmol/L, which was significantly lower than blood lactate concentrations in the 2 nonsurviving perch (10.58 and 10.72 mmol/L). CONCLUSIONS AND CLINICAL RELEVANCE-High blood lactate concentrations following surgery in fish may be predictive of a poor short-term postoperative survival rate.

  8. Risk factors associated with insomnia in recovery period of ischemic stroke%缺血性卒中恢复期伴失眠的危险因素研究

    Institute of Scientific and Technical Information of China (English)

    李婉仪; 陈仰昆; 李伟; 袁伟杰; 翁汉育; 刘勇林; 屈剑锋; 林显仙; 肖卫民

    2015-01-01

    Objective To investigate the clinical and psychological risk factors of insomnia during recovery period of ische‐mic stroke .Methods A total of 225 patients with acute ischemic stroke participated in this study .All participants received in‐somnia and neuropsychological assessments at 3 months after stroke .Insomnia symptoms were evaluated using a standard in‐somnia questionnaire .Depressive and anxious symptoms were measured by the Hamilton Depression Scales(HDS)and Hamil‐ton Anxiety Scales(HAS) .Clinical and neuropsychological variables were compared between the insomnia and non‐insomnia group .Logistic regression was performed to find the related factors of insomnia .Results Sixty‐seven (29 .8% )patients had in‐somnia .Compared with non‐insomnia cases ,patients with insomnia had significantly higher NIHSS scores and HDS scores on admission (P<0 .05) .Insomnia was more common in insomnia subjects before stroke(52 .2% vs .12 .7% ,P<0 .001) .Logis‐tic regression analysis showed that insomnia before stroke (OR=2 .729 ,95% CI=1 .550‐4 .804 , P= 0 .001) and the HDS score (OR=1 .240 ,95% CI=1 .158‐1 .327 , P<0 .001) were significantly related to insomnia at recovery stage of ischemic stroke .Conclusion Insomnia is common at recovery stage of ischemic stroke .Pre‐stroke insomnia and severity of post‐stroke depressive symptoms are the major determinants of insomnia .%目的:探讨缺血性脑卒中患者恢复期伴失眠的临床及神经心理学危险因素。方法纳入225例急性缺血性脑卒中患者,在卒中后3个月进行失眠及神经心理学评估。失眠的评估采用标准的失眠问卷,抑郁症状评估采用汉密尔顿抑郁量表(HDS),焦虑症状评估采用汉密尔顿焦虑量表(HAS)。比较失眠及非失眠2组间的临床及神经心理学指标,应用Logis‐tic回归分析失眠的影响因素。结果67例(29.8%)存在失眠。失眠患者入院NIHSS评分及 HDS评

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

    Science.gov (United States)

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

    2017-02-15

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

  10. 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.

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

    Science.gov (United States)

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

    2008-06-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gaszynski T

    2014-07-01

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

  14. Tricaine (MS-222) is a safe anesthetic compound compared to benzocaine and pentobarbital to induce anesthesia in leopard frogs (Rana pipiens).

    Science.gov (United States)

    Cakir, Yavuz; Strauch, Stephen M

    2005-01-01

    Tricaine (MS-222) is used commonly for sedation, immobilization, and anesthesia of poikilothermic animals. The anesthetic efficacy of different concentrations of MS-222 was compared to benzocaine and pentobarbital on the physiological changes, heart rate and ECG (electrocardiogram) parameters in the leopard frog, Rana pipiens. Loss of righting reflex (RR), loss of pain response (NR = nociceptor response) and recovery time were measured. Heart rate and ECG parameters were also tested before and during anesthesia. The time to loss of RR and NR decreased while recovery time markedly increased with the increasing concentration of MS-222. Benzocaine at 200 mg/l induced a rapid anesthesia, but all frogs needed resuscitation. Pentobarbital at 300 mg/l induced a slow anesthesia, however, all of the frogs also needed resuscitation. All anesthetics at the mentioned concentrations decreased heart rate significantly as well as altered the ECG parameters. All anesthetics prolonged the Q-T interval, and MS-222 at 800 mg/l and benzocaine at 200 mg/l were the most effective anesthetic concentrations in increasing the Q-T interval. Frogs anesthetized by benzocaine and pentobarbital and high concentrations of MS-222 required resuscitation due to hypoxia. Pentobarbital and benzocaine seem to be very effective compounds, but their safety margins are narrow because of ventilatory failure. Therefore, MS-222 at a concentration of 200 mg/l or less is highly recommended for leopard frogs because prolonged recovery, high mortality rate and significant ECG changes are observed with higher concentrations of MS-222.

  15. EPINEPHRINE OR GV-26 ELECTRICAL STIMULATION REDUCES INHALANT ANESTHESTIC RECOVERY TIME IN COMMON SNAPPING TURTLES (CHELYDRA SERPENTINA).

    Science.gov (United States)

    Goe, Alexandra; Shmalberg, Justin; Gatson, Bonnie; Bartolini, Pia; Curtiss, Jeff; Wellehan, James F X

    2016-06-01

    Prolonged anesthetic recovery times are a common clinical problem in reptiles following inhalant anesthesia. Diving reptiles have numerous adaptations that allow them to submerge and remain apneic for extended periods. An ability to shunt blood away from pulmonary circulation, possibly due to changes in adrenergic tone, may contribute to their unpredictable inhalant anesthetic recovery times. Therefore, the use of epinephrine could antagonize this response and reduce recovery time. GV-26, an acupuncture point with reported β-adrenergic and respiratory effects, has reduced anesthetic recovery times in other species. In this prospective randomized crossover study, six common snapping turtles (Chelydra serpentina) were anesthetized with inhalant isoflurane for 90 min. Turtles were assigned one of three treatments, given immediately following discontinuation of isoflurane: a control treatment (0.9% saline, at 0.1 ml/kg i.m.), epinephrine (0.1 mg/kg i.m.), or acupuncture with electrical stimulation at GV-26. Each turtle received all treatments, and treatments were separated by 48 hr. Return of spontaneous ventilation was 55% faster in turtles given epinephrine and 58% faster in the GV-26 group versus saline (P turtles displayed increases in temperature not documented in the control (P Turtles administered epinephrine showed significantly increased heart rates and end-tidal CO(2) (P turtle. Further research is necessary to evaluate the effects of concurrent GV-26 and epinephrine administration and to assess responses in other reptilian species.

  16. RECOVERY FOLLOWING SUBARACHNOID BLOCK : EVALUATION USING 128 HZ TUNING FORK

    Directory of Open Access Journals (Sweden)

    Goyal

    2014-07-01

    Full Text Available BACKGROUND: Following spinal anesthesia it is very important to see complete recovery before ambulation and discharge of the patient. Conventional methods to see recovery from spinal block use different types of motor power tests like Bromage score or the Formal motor power test system. MATERIAL AND METHODS: A total of one hundred and fifty patients of ASA grade I and II, presenting for lower segment caesarean section under spinal anesthesia were taken up for the study. We compared the use of a 128-Hz tuning fork with the results of conventional evaluation of block recovery. Conventional block recovery testing included Bromage score, Formal muscle power testing according to the British Medical Research Council, pinprick testing, and warm/cold testing. After obtaining base line values, a subarachnoid block was performed and patients were tested every 15 minutes after surgery, till the vibration score of one less than the baseline was achieved. Statistical analysis was performed to compare the results of the different methods to the time at which baseline values of vibration sense were reached. RESULTS: At the time vibration sense testing returned to baseline, 100% of the patients had attained Bromage score of 0 with no residual motor block. 98% of the patients regained foot extension and foot flexion strength completely while 92% of the patients showed complete recovery of the quadriceps strength. CONCLUSION: Recovery of vibration sense corresponds with recovery of motor block after spinal anesthesia and may serve as an easy means of documenting recovery with a single test before discharge.

  17. Disaster Debris Recovery Database - Recovery

    Data.gov (United States)

    U.S. Environmental Protection Agency — The US EPA Region 5 Disaster Debris Recovery Database includes public datasets of over 6,000 composting facilities, demolition contractors, transfer stations,...

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

    Directory of Open Access Journals (Sweden)

    Majid Razavi

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Delin Zhang

    2016-01-01

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

  20. Anesthesia for major general surgery in neonates with complex cardiac defects.

    Science.gov (United States)

    Walker, Amy; Stokes, Monica; Moriarty, Anthony

    2009-02-01

    Centers with large cardiac workloads may be presented with neonates who need major general surgery before correction or palliation of a serious cardiac defect. This is still a rare situation with only three short case reports available in the medical literature (1-3). We have reviewed the anesthetic and analgesic regimens of 18 such neonates who presented to the Birmingham Children's Hospital in the 4-year period 2004-2007. These children require meticulous preoperative evaluation and although it might be anticipated that they would pose a serious challenge to anesthetists, in reality with thorough investigation, preparation, and careful management, they tolerate general anesthesia well. These children may be transferred to centers of specialist pediatric cardiac anesthesia to be benefited from experience obtained there.

  1. [Iontophoresis - local anesthesia at the ear canal and tympanic membrane (author's transl)].

    Science.gov (United States)

    Tolsdorff, P

    1980-02-01

    Operations to the external ear canal and tympanic membrane necessitate sufficient local anesthesia. General sedation followed by infiltration anestesia, is rather time-consumming, can be painful due to the injection, and is not particularly satisfactory for the treatment of outpatients. The iontophorese-technique, however, of local anesthesia, is applicable particularly for the treatment of outpatients. Principally, the local anesthetic is transported in ionisised form to the nerve membrane, by means of calvanic currents through the healthy surface epithelial tissue of the external ear canal or the eardrum. The technique described for the first time in 1911 no longer shows toxic sides-effects since the introduction of improved electrodes and more modern local anesthetic. The anatomic, pharmacological, chemical and physical basics of the technique will be described. The lecture will be based on personal experience of the method, taken from large groups of patients over a period of more than two years, using equipment specially designed for this purpose.

  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. Anesthesia for the child with cancer.

    Science.gov (United States)

    Latham, Gregory J

    2014-03-01

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

  4. Oxidative Stress and Anesthesia in Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Peivandi Yazdi A

    2014-04-01

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

  5. Anatomy of an anesthesia information management system.

    Science.gov (United States)

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

    2011-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Ch. Srinivas

    2015-01-01

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

  7. Alcohol exposure after mild focal traumatic brain injury impairs neurological recovery and exacerbates localized neuroinflammation.

    Science.gov (United States)

    Teng, Sophie X; Katz, Paige S; Maxi, John K; Mayeux, Jacques P; Gilpin, Nicholas W; Molina, Patricia E

    2015-03-01

    Traumatic brain injury (TBI) represents a leading cause of morbidity and mortality among young individuals. Alcohol abuse is a risk factor associated with increased TBI incidence. In addition, up to 26% of TBI patients engage in alcohol consumption after TBI. Limited preclinical studies have examined the impact of post-injury alcohol exposure on TBI recovery. The aim of this study was to determine the isolated and combined effects of TBI and alcohol on cognitive, behavioral, and physical recovery, as well as on associated neuroinflammatory changes. Male Sprague-Dawley rats (∼300g) were subjected to a mild focal TBI by lateral fluid percussion (∼30PSI, ∼25ms) under isoflurane anesthesia. On day 4 after TBI, animals were exposed to either sub-chronic intermittent alcohol vapor (95% ethanol 14h on/10h off; BAL∼200mg/dL) or room air for 10days. TBI induced neurological dysfunction reflected by an increased neurological severity score (NSS) showed progressive improvement in injured animals exposed to room air (TBI/air). In contrast, TBI animals exposed to alcohol vapor (TBI/alcohol) showed impaired NSS recovery throughout the 10-day period of alcohol exposure. Open-field exploration test revealed an increased anxiety-like behavior in TBI/alcohol group compared to TBI/air group. Additionally, alcohol-exposed animals showed decreased locomotion and impaired novel object recognition. Immunofluorescence showed enhanced reactive astrocytes, microglial activation, and HMGB1 expression localized to the injured cortex of TBI/alcohol as compared to TBI/air animals. The expression of neuroinflammatory markers showed significant positive correlation with NSS. These findings indicated a close relationship between accentuated neuroinflammation and impaired neurological recovery from post-TBI alcohol exposure. The clinical implications of long-term consequences in TBI patients exposed to alcohol during recovery warrant further investigation.

  8. 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.

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

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  10. Local anesthesia for endovascular abdominal aortic aneurysm repair

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    1987-03-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  13. The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

    NARCIS (Netherlands)

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

    2014-01-01

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

  14. Anesthesia methods used by anesthetic specialists for circumcision cases

    Science.gov (United States)

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

    2017-01-01

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

  15. Recovery Spirituality

    Directory of Open Access Journals (Sweden)

    Ernest Kurtz

    2015-01-01

    Full Text Available There is growing interest in Alcoholics Anonymous (A.A. and other secular, spiritual, and religious frameworks of long-term addiction recovery. The present paper explores the varieties of spiritual experience within A.A., with particular reference to the growth of a wing of recovery spirituality promoted within A.A. It is suggested that the essence of secular spirituality is reflected in the experience of beyond (horizontal and vertical transcendence and between (connection and mutuality and in six facets of spirituality (Release, Gratitude, Humility, Tolerance, Forgiveness, and a Sense of Being-at-home shared across religious, spiritual, and secular pathways of addiction recovery. The growing varieties of A.A. spirituality (spanning the “Christianizers” and “Seculizers” reflect A.A.’s adaptation to the larger diversification of religious experience and the growing secularization of spirituality across the cultural contexts within which A.A. is nested.

  16. Anesthesia Maintenance During Mini-Invasive Cardiac Valve Surgery

    Directory of Open Access Journals (Sweden)

    L. A. Krichevsky

    2013-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    1992-07-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  20. 27-Gauge Vitrectomy for Symptomatic Vitreous Floaters with Topical Anesthesia

    Science.gov (United States)

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

    2017-01-01

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

  1. 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.

  2. Anesthesia for subglottic stenosis in pediatrics

    Directory of Open Access Journals (Sweden)

    Eid Essam

    2009-01-01

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

  3. Anesthesia for subglottic stenosis in pediatrics.

    Science.gov (United States)

    Eid, Essam A

    2009-07-01

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

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

    Science.gov (United States)

    Ortega, Rafael A

    2005-08-01

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

  5. Comparison of the clinical effect of combined spinal epidural anesthesia and epidural anesthesia for labor analgesia%腰麻联合硬膜外麻醉与硬膜外麻醉用于分娩镇痛的临床效果比较

    Institute of Scientific and Technical Information of China (English)

    陈日亮

    2015-01-01

    目的:比较腰麻联合硬膜外麻醉(CSEA)与硬膜外麻醉(CEA)在分娩镇痛中的临床效果。方法选择2013年12月-2015年1月医院接受分娩镇痛的足月、单胎、头位初产妇60例,根据麻醉方式不同分为腰麻联合硬膜外麻醉(CSEA 组)和单纯硬膜外麻醉(CEA 组)各30例。观察2组孕妇麻醉起效时间、麻醉至手术开始时间、痛觉恢复时间、运动恢复时间、术中孕妇视觉模拟疼痛评分(VAS)、不良反应发生率、新生儿1min Apgar 评分。结果与CEA 组比较,CSEA 组麻醉起效时间、麻醉至手术开始时间较短,而痛觉恢复时间、运动恢复时间及术中孕妇视觉模拟疼痛评分(VAS)长于或优于 CEA 组,比较差异均有统计学意义(P ﹤0.05);2组不良反应发生率以及新生儿1min Ap-gar 评分比较差异无统计学意义(P ﹥0.05)。结论腰麻联合硬膜外麻醉时间短于单纯应用硬膜外麻醉,但恢复时间较长,临床可视患者情况而应用。%Objective To compare the clinical effect of lumbar anesthesia combined with epidural anesthesia (CSEA)and epidural anesthesia(CEA)for labor analgesia. Methods Select 60 cases of pregnant women in labor analgesia. According to different anesthesia,60 cases of pregnant women were divided into CSEA group and CEA group,30 cases in each group. The onset time of anesthesia,the onset time of anesthesia,the recovery time of pain,recovery time of pain,the visual an-alog pain score(VAS),the incidence of adverse reactions,and the Apgar 1min score of neonates were observed in the 2 groups. Results Compared with group CSEA,the onset time of anesthesia,the onset time of anesthesia,the recovery time of pain,recovery time of exercise,and the visual analog pain score(VAS)of pregnant women were significantly higher than those in CEA group,The difference was statistically significant(P ﹤ 0. 05);There was no significant difference in the incidence of

  6. Spontaneous Recovery

    Science.gov (United States)

    Rescorla, Robert A.

    2004-01-01

    Spontaneous recovery from extinction is one of the most basic phenomena of Pavlovian conditioning. Although it can be studied by using a variety of designs, some procedures are better than others for identifying the involvement of underlying learning processes. A wide range of different learning mechanisms has been suggested as being engaged by…

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

    Directory of Open Access Journals (Sweden)

    H Aghamohammadi

    2008-12-01

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

  8. Impact of obesity on recovery and pulmonary functions of obese women undergoing major abdominal gynecological surgeries.

    Science.gov (United States)

    Moustafa, Ahmed A M; Abdelazim, Ibrahim A

    2016-06-01

    To determine impact of obesity on recovery parameters and pulmonary functions of women undergoing major abdominal gynecological surgeries. Eighty women undergoing major gynecological surgeries were included in this study. Anesthesia was induced by remifentanil bolus, followed by propofol and cisatracurium to facilitate oro-tracheal intubation and was maintained by balanced anesthesia of remifentanil intravenous infusion and sevoflurane in oxygen and air. Time from discontinuation of maintenance anesthesia to fully awake were recorded at 1-min intervals and time from discontinuation of anesthesia until patient was transferred to post-anesthesia care unit (PACU) and discharged from PACU was also recorded. Pulmonary function tests were performed before surgery and repeated 4 h, days 1, 2 and 3 post-operative for evaluation of forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow rate. Occurrence of post-operative complications, re-admission to ICU, hospital stay and morbidities were also recorded. Induction of anesthesia using remifentanil bolus injection resulted in significant decrease of heart rate and arterial pressures compared to pre-operative and pre-induction values. Recovery times were significantly shorter in obese compared to morbidly obese women. Post-operative pulmonary function tests showed significant deterioration compared to pre-operative measures but showed progressive improvement through first 3 post-operative days. Hospital stay was significantly shorter for obese compared to morbid obese women. Obesity delays recovery from general anesthesia, adversely affects pulmonary functions and increases post-operative complications. Remifentanil infusion and sevoflurane could be appropriate combination for obese and morbidly obese women undergoing major surgeries.

  9. A Comparison of Multiscale Permutation Entropy Measures in On-Line Depth of Anesthesia Monitoring

    Science.gov (United States)

    Li, Xiaoli; Li, Duan; Li, Yongwang; Ursino, Mauro

    2016-01-01

    Objective Multiscale permutation entropy (MSPE) is becoming an interesting tool to explore neurophysiological mechanisms in recent years. In this study, six MSPE measures were proposed for on-line depth of anesthesia (DoA) monitoring to quantify the anesthetic effect on the real-time EEG recordings. The performance of these measures in describing the transient characters of simulated neural populations and clinical anesthesia EEG were evaluated and compared. Methods Six MSPE algorithms—derived from Shannon permutation entropy (SPE), Renyi permutation entropy (RPE) and Tsallis permutation entropy (TPE) combined with the decomposition procedures of coarse-graining (CG) method and moving average (MA) analysis—were studied. A thalamo-cortical neural mass model (TCNMM) was used to generate noise-free EEG under anesthesia to quantitatively assess the robustness of each MSPE measure against noise. Then, the clinical anesthesia EEG recordings from 20 patients were analyzed with these measures. To validate their effectiveness, the ability of six measures were compared in terms of tracking the dynamical changes in EEG data and the performance in state discrimination. The Pearson correlation coefficient (R) was used to assess the relationship among MSPE measures. Results CG-based MSPEs failed in on-line DoA monitoring at multiscale analysis. In on-line EEG analysis, the MA-based MSPE measures at 5 decomposed scales could track the transient changes of EEG recordings and statistically distinguish the awake state, unconsciousness and recovery of consciousness (RoC) state significantly. Compared to single-scale SPE and RPE, MSPEs had better anti-noise ability and MA-RPE at scale 5 performed best in this aspect. MA-TPE outperformed other measures with faster tracking speed of the loss of unconsciousness. Conclusions MA-based multiscale permutation entropies have the potential for on-line anesthesia EEG analysis with its simple computation and sensitivity to drug effect

  10. 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

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

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    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

  12. Re-discussion about the effects of aspirin on surgery and spinal epidural anesthesia during the perioperative period%再谈围术期服用阿司匹林对手术和椎管内麻醉的影响

    Institute of Scientific and Technical Information of China (English)

    汪涛; 王茹; 严志勇; 钱燕宁

    2016-01-01

    Background There are no specific,widely accepted recommendations for the perioperative management of patients with cardiovascular disease (CVD) receiving antiplatelet therapy,and performing neuraxial anesthesia in patients receiving antiplatelet therapy is controversial due to the increased risk of spinal epidural hematoma.Objective To review the mechanism of action of aspirin and the clinical literature for relationships among aspirin dosage,efficacy,and safety.Content With a high prevalence of CVD,the appropriate perioperative management of high-risk patients treated with aspirin is a common clinical problem for surgeons and anesthetists.For this reason,many treatment decisions have to be made for patients with CVD who need cardiac and non-cardiac surgery.Trend Perioperative antithrombotic management is based on risk assessment for thromboembolism and bleeding,and recommended approaches aim to simplify patient management and minimize negative clinical outcomes by multidisciplinary teams.%背景 对患有心血管疾病(cardiovascular disease,CVD)正在进行抗血小板治疗的患者,目前不仅无具体的、可被接受的围术期管理建议,而且对该类患者行椎管内麻醉存在争议,因接受抗血小板治疗可增加硬膜外血肿的风险. 目的 对阿司匹林的作用机制及其剂量、临床疗效与安全性关系进行综述. 内容 随着CVD患病率的不断增加,对接受阿司匹林治疗的高风险患者给予恰当的围手术期管理,是外科医师和麻醉医师共同面对的一个临床问题.为此,对需要行心血管或非心血管手术的CVD患者,必须在临床作出诸多治疗决策. 趋向 围术期抗凝治疗是以对血栓和出血事件的风险评估为依据的,应通过多学科协作来实现简化患者管理和最小化临床不良结局的治疗目标.

  13. Effects of diary therapy on psychiatric symptoms of schizophrenia patients in recovery period%日记疗法对恢复期精神分裂症患者精神症状的影响

    Institute of Scientific and Technical Information of China (English)

    陈慧月; 林敏; 黄惠君; 黄清如

    2016-01-01

    Objective To explore the effects of diary therapy on psychiatric symptoms of schizophrenia patients in recovery period.Methods A total of 100 patients with schizophrenia were randomly divided into two groups:control group and training group,50 cases in each group.The patients of control group received the psychiatric routine nursing which meant to carry out daily life guidance,to carry out recreational activities,had regular health education by charging nurses,and so on.The patients of training group were under the basis of conventional treatment and care,and implemented diary therapy.The brief psychiatric rating scale (BPRS) was used to assess the prognosis of the patients before and after the intervention.Results In the training group after the intervention,the total scores of BPRS and anxiety depression,lack of energy,thought disorder,activation and hostile suspiciousness factor scores were (24.340 ± 1.891),(5.540 ±0.734),(5.980 ± 1.152),(5.680 ±0.935),(3.720 ± 0.757),(3.420 ± 0.499),which were better than those of the control group (31.740 ± 2.354),(7.140 ± 1.069),(7.500 ± 0.995),(7.320 ± 0.891),(4.940 ± 0.843),(4.840 ± 0.842) (F =70.969,13.383,29.353,35.284,9.297,17.614;P <0.05).Conclusions In the recovery period of schizophrenia patients,the implementation of diary therapy can reduce the patient's mental symptoms,improve the patient's thinking,emotion and behavior,and promote the rehabilitation of patients.%目的 探讨日记疗法对恢复期精神分裂症患者的精神症状的影响.方法 将100例恢复期精神分裂症住院患者随机分为对照组和训练组各50例,对照组按精神科护理常规手段进行护理,即每天进行日常生活指导、开展娱乐活动、责任护士定期健康教育等.训练组在常规治疗与护理的基础上,实施日记疗法.采用简明精神病量表(BPRS)分别于干预前及干预后进行评定.结果 干预后训练组患者的BPRS总分及焦虑/抑郁、缺乏活力、思维

  14. Acupuncture in ambulatory anesthesia: a review

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    Norheim AJ

    2015-09-01

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

  15. Impact comparison of ketamine and sodium thiopental on anesthesia during electroconvulsive therapy in major depression patients with drug-resistant; a double-blind randomized clinical trial

    Science.gov (United States)

    Salehi, B.; Mohammadbeigi, A.; Kamali, A. R.; Taheri-Nejad, M. R.; Moshiri, I.

    2015-01-01

    Background: Electroconvulsive therapy (ECT) is one of the available and the most effective therapies for the treatment of resistant depression. Considering the crucial role of seizure duration on therapeutic response in patients treated with ECT, this study aimed to compare the effect of ketamine and sodium thiopental anesthesia during ECT for treatment of patients with drug-resistant major depression (DRMD). Materials and Methods: In a double-blind randomized clinical trial, 160 patients with DRMD were selected consequently and were assigned randomly into two groups including ketamine 0.8 mg/kg and sodium thiopental 1.5 mg/kg. The seizure duration, recovery time, and the side effects of anesthesia were evaluated after 1-h after anesthesia. Data of recovery time and complication collected in 2nd, 4th, 6th, and 8th ECT. Depression was assessed by Hamilton depression scale. Results: The results indicated that ketamine and sodium thiopental had a significant effect on the reduction of depression scores in patients with DRMD (P ketamine group (P > 0.05). But ketamine was more effective in improvement of depression score and increasing systolic and diastolic blood pressure (P ketamine during ECT therapy increased blood pressure and seizure duration. Therefore, due to lower medical complication and attack rate of seizure, ketamine is an appropriate option for anesthesia with ECT in patients with DRMD. PMID:26440233

  16. Effects of endotoxemia on the pharmacodynamics and pharmacokinetics of ketamine and xylazine anesthesia in Sprague–Dawley rats

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    Vachon P

    2012-10-01

    area under the plasma concentration–time curve increased and the clearance decreased in the moderate (10 µg/kg and high (100 µg/kg lipopolysaccharide groups.Conclusion: During ketamine–xylazine anesthesia, endotoxemia may alter xylazine pharmacokinetics and selected biochemical and physiological parameters, suggesting that anesthetic drug dosages could be modified for a more rapid recovery.Keywords: lipopolysaccharide, ketamine, xylazine, pharmacokinetics, rats

  17. A report of the anesthesia in posterior fossa operations in the sitting position in 55 patients

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    Jahanguiri B

    1994-04-01

    Full Text Available In this survey, 55 patients were studied in a period of six years for having the anesthesia in the sitting position. In this position, the surgeon will had a better access to the location, whose damages have been sustained, so less damages would be given to the healthy tissues. For the patients, due to their critical general conditions, one week prior to giving anesthesia to the posterior fossa, operation in the sitting position the right ventriculoatiral shunt was placed. For preventing the fall of blood pressure, a bandage was placed in the lower limbs after inducing anesthesia and changing supine position to sitting position. Before the induction, central venous pressure was measured for treating the air embolism. The head of catheter was placed inside the right atrial. Premedications such as atropine, pethidine, and inductive agents like thiopenton, and muscle relaxants, maintained with halothane and nitrous oxide. All of the patients endured this condition without the fall of blood pressure and air embolism

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

    OpenAIRE

    2016-01-01

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

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

    Science.gov (United States)

    Kulacoglu, Hakan; Alptekin, Alp

    2011-01-01

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

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

    Science.gov (United States)

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

    1986-10-01

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

  1. 舒芬太尼与瑞芬太尼在急诊脑外伤手术麻醉中应用研究%Sufentanil in Emergency Brain Injury With Fentanyl Anesthesia in Applied Research

    Institute of Scientific and Technical Information of China (English)

    李征

    2016-01-01

    目的:在急诊脑外伤手术中分别对患者行舒芬太尼、瑞芬太尼麻醉,对比治疗效果。方法选取广州市番禺区钟村医院于2014年8月—2016年4月期间收治的脑外伤患者82例,按照患者入院时间,划分为治疗组与参照组,每组各41例。对参照组患者行瑞芬太尼麻醉,对治疗组患者行舒芬太尼麻醉,对比两组患者的临床治疗效果。结果治疗组患者的麻醉持续时间、苏醒时间、气管插管拔管时间、术后视觉模拟评分法( VAS)评分均明显优于参照组患者,组间差异P0.05);此外,治疗组患者的不良反应发生率为9.76%,与参照组患者的17.07%对比,组间优势不具有明显性,即P>0.05,不存在统计学意义。结论在急诊脑外伤手术过程中,对患者行舒芬太尼麻醉,不仅可以改善临床麻醉效果,提高临床疗效,保证临床治疗安全,还能促进患者术后恢复,临床应用与推广价值较为显著。%Objective Respectively in emergency brain trauma surgery for patients with sufentanil and fentanyl anesthesia, compare the treatment effect. Methods Will pick in our hospital in August 2014— April 2016 admitted during the period of 82 patients with traumatic brain injuries, according to the patients in hospital time, divided into treatment group and control group, each group of 41 cases. Line, fentanyl anesthesia in patients with control group, the treatment group patients ShuFen too, anesthesia, compared two groups of patients with the clinical therapeutic effect. Results The treatment group patients duration of anesthesia, wake up of time, trachea cannula extubation time, postoperative visual analogue scale ( VAS) score were significantly better than the control group patients, differences between groups (P0. 05 ); In addition, the incidence of adverse reactions in patients with treatment group for 9. 76 %, compared with control group patients 17. 07 %, advantages between groups have no obvious sex, namely

  2. Effect of magnesium sulfate with propofol induction of anesthesia on succinylcholine-induced fasciculations and myalgia

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    Mahendra Kumar

    2012-01-01

    Full Text Available Background: Magnesium sulfate and propofol have been found to be effective against succinylcholine-induced fasciculations and myalgia, respectively, in separate studies. A prospective randomized double blind controlled study was designed to assess the effect of a combination of magnesium sulfate with propofol for induction of anesthesia on succinylcholine-induced fasciculations and myalgia. Materials and Methods: Randomly selected 60 adult patients scheduled for elective surgery under general anesthesia were allocated to one of the two equal groups by draw of lots. The patients of MG Group were pretreated with magnesium sulfate 40 mg/kg body weight in 10 ml volume, while patients of NS group were given isotonic saline 0.9% in the same volume (10 ml intravenously slowly over a period of 10 min. Anesthesia was induced with fentanyl 1.5 mcg/kg and propofol 2 mg/kg, followed by administration of succinylcholine 2 mg/kg intravenously. Muscle fasciculations were observed and graded as nil, mild, moderate, or severe. Postoperative myalgia was assessed after 24 h of surgery and graded as nil, mild, moderate, or severe. Observations were made in double blind manner. Results: Demographic data of both groups were comparable (P> 0.05. Muscle fasciculations occurred in 50% patients of MG group versus in 100% patients of NS group with a significant difference (P< 0.001. After 24 h of surgery, no patient of MG group and 30% patients of NS group had myalgia with a significant difference (P< 0.002. Conclusion: Magnesium sulfate 40 mg/kg intravenously may be used with propofol for induction of anesthesia to control succinylcholine-induced fasciculations and myalgia.

  3. Propofol alternatives in gastrointestinal endoscopy anesthesia

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    Basavana Gouda Goudra

    2014-01-01

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

  4. Neurologic deficits and arachnoiditis following neuroaxial anesthesia.

    Science.gov (United States)

    Aldrete, J A

    2003-01-01

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

  5. Sedation in hypoalbuminemic geriatric patients under spinal anesthesia in hip surgery

    Science.gov (United States)

    Ersoy, Ayşın; Kara, Deniz; Ervatan, Zekeriya; Çakırgöz, Mensure; Kıran, Özlem

    2015-01-01

    Objectives: To compare midazolam and propofol sedation in hypoalbuminemic geriatric patients under spinal anesthesia in hip surgery with bispectral index monitoring. Methods: This prospective and randomized study was completed in the Department of Anesthesiology, Okmeydani Training and Research Hospital, Istanbul, Turkey between February 2013 and December 2014. Sixty patients undergoing elective hip surgery under spinal anesthesia in the geriatric age group with albumin levels below 3 g/dl were randomly divided into Group I and Group II. After administration of spinal block, Group I were given 0.05 mg/kg bolus midazolam, and then 0.02-0.1 mg/kg/hr dose infusion was begun. In Group II, 1 mg/kg bolus propofol was given within 10 minutes, and then 1-3 mg/kg/hr infusion was begun. The systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, peripheral oxygen saturation values, respiratory rate, and Wilson’s 5-stage sedation score were recorded at 15-minute intervals. At the end of the operation, the recovery time and surgeon satisfaction were recorded. Results: The recovery times for patients in Group I were found to be longer than in Group II (p<0.05). The respiration rate in patients in Group I at the start of surgery, 15th minute of surgery, and after surgery were lower than in Group II (p<0.05). Conclusion: We conclude that propofol is more reliable in terms of hemodynamic stability than midazolam, as it causes less respiratory depression and faster recovery in the propofol group. PMID:26446330

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

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2010-01-01

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

  7. Advanced techniques and armamentarium for dental local anesthesia.

    Science.gov (United States)

    Clark, Taylor M; Yagiela, John A

    2010-10-01

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

  8. 康复护理在股骨骨折患者功能恢复过程中的作用%The effect of rehabilitation nursing on patients with fracture of femur in the period of function recovery

    Institute of Scientific and Technical Information of China (English)

    杨绍霞; 曹乃美; 蔡跃花

    2003-01-01

    @@ BACKGROUND:Dysfunction of knee joint is a common sequela after fracture of femur.The key of avoiding or decreasing dysfunction lies in early prevention,muscular practices of isometric contraction and functional exercises of knee joint as soon as possible.It is an essential component part of rehabilitation care for functional recovery of patients with fracture of femur.

  9. Anestesia geral versus raquianestesia para colecistectomia videolaparoscópica Anestesia general versus raquianestesia para colecistectomía videolaparoscópica General anesthesia versus spinal anesthesia for laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2010-06-01

    general anesthesia. METHODS: Between July 2007 and September 2008, 68 patients with symptoms of cholelithiasis were included in this study. Patients with physical status ASA I and II were randomly divided to undergo laparoscopic cholecystectomy with low-tension pneumoperitoneum with CO2 under general anesthesia (n = 33 or spinal anesthesia (n = 35. Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for general anesthesia. Hyperbaric bupivacaine 15 mg, and fentanyl 20 µg to achieve a sensorial level of T3· were used for the spinal anesthesia. Intraoperative parameters, postoperative pain, complications, recovery, patient satisfaction, and cost were compared between both groups. RESULTS: All surgical procedures were completed with the chosen method and spinal anesthesia was converted to general anesthesia only in one patient. Pain was significantly lower at 2, 4, and 6 hours after the procedure under spinal anesthesia. The cost of the spinal anesthesia was significantly lower than that of the general anesthesia. All patients were discharged after 24 hours. In the postoperative evaluation, all patients were satisfied with the spinal anesthesia and would recommend this procedure. CONCLUSIONS: Laparoscopic cholecystectomy with low-pressure pneumoperitoneum with CO2 can be safely performed under spinal anesthesia. Spinal anesthesia was associated with an extremely low level of postoperative pain, better recovery, and lower cost than general anesthesia.

  10. 急性心肌梗死患者恢复期体力活动状况的调查分析%Investigation analysis of physical activity status in patients with acute myocardial infarction during recovery period

    Institute of Scientific and Technical Information of China (English)

    于涛; 李明子; 赵立新; 张晶晶; 武燕燕

    2016-01-01

    目的:探讨急性心肌梗死恢复期患者的体力活动现状及其影响因素,为个性化护理干预提供科学的理论依据。方法采用方便取样法,选取急性心肌梗死后3~6个月的患者,应用国际体力活动问卷(IPAQ)、患者健康问卷抑郁量表(PHQ-9)及自行编制的性生活调查表进行问卷调查。结果体力活动方式分布集中表现为步行和中等强度的活动,其1周体力活动总MET中位数分别为1386.00和410.40,而高强度体力活动的参与者较少,其1周体力活动总MET中位数仅为0.00,而且体力活动主要集中于闲暇时、交通行程和家务。患者中等强度以上的体力活动缺乏,未发现体力活动与体质量指数(BMI)、出院时心功能(Killip分级)、射血分数(EF)间的相关性(P>0.05);虽然根据患者目前心功能( NYHA分级)在步行总能量消耗、1周活动总能量消耗、中等强度活动总能量、家务活动总能量消耗之间存在差别(P0. 05). There were significant differences in patients′ total energy consumption of walking, physical activity for 1 week, moderate intensity activities and housework according to cardiac functional grading at present (P<0. 05). However, there were still some patients who exercised little with good cardiac functions and normal EF values. Physical activities in patients with depression were less than that in patients with non depression (P<0. 05). Lastly, sexual life of most patients had not restored. Conclusions There were not enough physical activities in patients with acute myocardial infarction during recovery period. Lack of knowledge, low self confidence and excessive caution may be the main influencing factors. Individualized health-education and nursing intervention are needed to promote the healthy behaviors.

  11. Radiologically-placed venous ports in children under venous anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak [Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2015-02-15

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Reda S. Abdelrahman

    2012-10-01

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

  14. Effects of combined ketamine/xylazine anesthesia on light induced retinal degeneration in rats.

    Directory of Open Access Journals (Sweden)

    Blanca Arango-Gonzalez

    Full Text Available OBJECTIVES: To explore the effect of ketamine-xylazine anesthesia on light-induced retinal degeneration in rats. METHODS: Rats were anesthetized with ketamine and xylazine (100 and 5 mg, respectively for 1 h, followed by a recovery phase of 2 h before exposure to 16,000 lux of environmental illumination for 2 h. Functional assessment by electroretinography (ERG and morphological assessment by in vivo imaging (optical coherence tomography, histology (hematoxylin/eosin staining, TUNEL assay and immunohistochemistry (GFAP and rhodopsin staining were performed at baseline (ERG, 36 h, 7 d and 14 d post-treatment. Non-anesthetized animals treated with light damage served as controls. RESULTS: Ketamine-xylazine pre-treatment preserved retinal function and protected against light-induced retinal degeneration. In vivo retinal imaging demonstrated a significant increase of outer nuclear layer (ONL thickness in the non-anesthetized group at 36 h (p0.05, indicating a stabilizing and/or protective effect with regard to phototoxicity. Histology confirmed light-induced photoreceptor cell death and Müller cells gliosis in non-anesthetized rats, especially in the superior hemiretina, while ketamine-xylazine treated rats showed reduced photoreceptor cell death (TUNEL staining: p<0.001 after 7 d, thicker ONL and longer IS/OS. Fourteen days after light damage, a reduction of standard flash induced a-wave amplitudes and a-wave slopes (p = 0.01 and significant alterations in parameters of the scotopic sensitivity function (e.g. Vmax of the Naka Rushton fit p = 0.03 were observed in non-treated vs. ketamine-xylazine treated animals. CONCLUSIONS: Our results suggest that pre-treatment with ketamine-xylazine anesthesia protects retinas against light damage, reducing photoreceptor cell death. These data support the notion that anesthesia with ketamine-xylazine provides neuroprotective effects in light-induced cell damage.

  15. Effects of Combined Ketamine/Xylazine Anesthesia on Light Induced Retinal Degeneration in Rats

    Science.gov (United States)

    Bolz, Sylvia; Eslava-Schmalbach, Javier; Willmann, Gabriel; Zhour, Ahmad; Zrenner, Eberhart; Fischer, M. Dominik; Gekeler, Florian

    2012-01-01

    Objectives To explore the effect of ketamine-xylazine anesthesia on light-induced retinal degeneration in rats. Methods Rats were anesthetized with ketamine and xylazine (100 and 5 mg, respectively) for 1 h, followed by a recovery phase of 2 h before exposure to 16,000 lux of environmental illumination for 2 h. Functional assessment by electroretinography (ERG) and morphological assessment by in vivo imaging (optical coherence tomography), histology (hematoxylin/eosin staining, TUNEL assay) and immunohistochemistry (GFAP and rhodopsin staining) were performed at baseline (ERG), 36 h, 7 d and 14 d post-treatment. Non-anesthetized animals treated with light damage served as controls. Results Ketamine-xylazine pre-treatment preserved retinal function and protected against light-induced retinal degeneration. In vivo retinal imaging demonstrated a significant increase of outer nuclear layer (ONL) thickness in the non-anesthetized group at 36 h (p0.05), indicating a stabilizing and/or protective effect with regard to phototoxicity. Histology confirmed light-induced photoreceptor cell death and Müller cells gliosis in non-anesthetized rats, especially in the superior hemiretina, while ketamine-xylazine treated rats showed reduced photoreceptor cell death (TUNEL staining: p<0.001 after 7 d), thicker ONL and longer IS/OS. Fourteen days after light damage, a reduction of standard flash induced a-wave amplitudes and a-wave slopes (p = 0.01) and significant alterations in parameters of the scotopic sensitivity function (e.g. Vmax of the Naka Rushton fit p = 0.03) were observed in non-treated vs. ketamine-xylazine treated animals. Conclusions Our results suggest that pre-treatment with ketamine-xylazine anesthesia protects retinas against light damage, reducing photoreceptor cell death. These data support the notion that anesthesia with ketamine-xylazine provides neuroprotective effects in light-induced cell damage. PMID:22558200

  16. STUDY OF INJECTION TRAMADOL AS ADDITIVE IN INTRAVENOUS REGIONAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Rajesh

    2015-10-01

    is no effect of Tramadol on onset of motor blocked in both the group. In post - operative period the need of analgesic is delayed in group 2 which is statistically significant.( p value is 0.00001 We observe post - oper ative nausea and vomiting events more in group - 1(24% and in group - 2 (16 % but there isno statistical difference. Pain is the significant factor for post - operative nausea and vomiting. Group 2 patients (Tramadol group are more comfortable with tourniquet intra - operatively but statistically it is not significant. Intraoperative discomfort may attribute to anxiety and fear along with possibility of dilution of drugs because of inadequate exsanguination . CONCLUSION : We conclude that addition of injection Tra madol 50mg in intravenous regional anesthesia will improve the onset of sensory blockade and improves the post - operative analgesia without any increase of postoperative nausea and vomiting. Also it is concluded that injection Tramadol has no effect on moto r blocked.

  17. Thoracic Paravertebral Block, Multimodal Analgesia, and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Anis Dizdarevic

    2016-01-01

    Full Text Available Objective. Primary lateral sclerosis (PLS is a rare idiopathic neurodegenerative disorder affecting upper motor neurons and characterized by spasticity, muscle weakness, and bulbar involvement. It can sometimes mimic early stage of more common and fatal amyotrophic lateral sclerosis (ALS. Surgical patients with a history of neurodegenerative disorders, including PLS, may be at increased risk for general anesthesia related ventilatory depression and postoperative respiratory complications, abnormal response to muscle relaxants, and sensitivity to opioids, sedatives, and local anesthetics. We present a case of a patient with PLS and recent diagnosis of breast cancer who underwent a simple mastectomy surgery uneventfully under an ultrasound guided thoracic paravertebral block, multimodal analgesia, and monitored anesthesia care. Patient reported minimal to no pain or discomfort in the postoperative period and received no opioids for pain management before being discharged home. In patients with PLS, thoracic paravertebral block and multimodal analgesia can provide reliable anesthesia and effective analgesia for breast surgery with avoidance of potential risks associated with general anesthesia, muscle paralysis, and opioid use.

  18. Thoracic Paravertebral Block, Multimodal Analgesia, and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis

    Science.gov (United States)

    Fernandes, Anthony

    2016-01-01

    Objective. Primary lateral sclerosis (PLS) is a rare idiopathic neurodegenerative disorder affecting upper motor neurons and characterized by spasticity, muscle weakness, and bulbar involvement. It can sometimes mimic early stage of more common and fatal amyotrophic lateral sclerosis (ALS). Surgical patients with a history of neurodegenerative disorders, including PLS, may be at increased risk for general anesthesia related ventilatory depression and postoperative respiratory complications, abnormal response to muscle relaxants, and sensitivity to opioids, sedatives, and local anesthetics. We present a case of a patient with PLS and recent diagnosis of breast cancer who underwent a simple mastectomy surgery uneventfully under an ultrasound guided thoracic paravertebral block, multimodal analgesia, and monitored anesthesia care. Patient reported minimal to no pain or discomfort in the postoperative period and received no opioids for pain management before being discharged home. In patients with PLS, thoracic paravertebral block and multimodal analgesia can provide reliable anesthesia and effective analgesia for breast surgery with avoidance of potential risks associated with general anesthesia, muscle paralysis, and opioid use. PMID:27200193

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  20. 42 CFR 482.52 - Condition of participation: Anesthesia services.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  3. Cardiac Dysrhythmias with General Anesthesia during Dental Surgery

    OpenAIRE

    Rodrigo, Chandra R.

    1988-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

  5. Rational use of oxygen in medical disease and anesthesia

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  6. Application of Ketamine and Propofol Effect Observed in Pediatric Anesthesia%氯胺酮联合丙泊酚在小儿麻醉中的应用效果观察

    Institute of Scientific and Technical Information of China (English)

    梁海玉

    2015-01-01

    目的:探讨氯氨酮联合丙泊酚在小儿麻醉中的应用效果。方法将120例患儿分为两组,观察组采用氯氨酮联合丙泊酚麻醉,对照组单用氯氨酮麻醉。结果观察组麻醉后的MAP、SPO2、HR以及RR值与对照组比较,有显著差异;观察组患儿的苏醒时间明显短于对照组。结论小儿麻醉中应用氯氨酮联合丙泊酚麻醉,具有苏醒快以及生命体征稳定等优点。%Objective To investigate ketamine and propofol application results in pediatric anesthesia.Methods 120 patients were divided into two groups, the observation group ketamine combined with propofol anesthesia group Ketamine anesthesia alone.Results MAP observation group after anesthesia, SPO2, HR and RR with the control group, a significant difference; children awake observation group was signiifcantly shorter than the control group.Conclusion Pediatric Anesthesia ketamine combined with propofol anesthesia with rapid recovery and stable vital signs, etc.

  7. Rice bran supplementation during nutritional recovery period of malnourished rats improves colon development El suplemento con salvado de arroz durante el periodo de recuperación nutricional de ratas malnutridas mejora con el desarrollo del colon

    OpenAIRE

    M.ª Salete F. Martins; DORES, E. F. G. C.; J. E. Aguilar-Nascimento; L. Missae Oyama; Latorraca, M. Q.; M.ª H. G. Gomes-da-Silva; C. M.ª Oller do Nascimento

    2007-01-01

    Objective: To investigate the colon's development in rats subjected to protein energy malnutrition followed bysupplementation with rice bran. Materials and methods: Weaned Wistar male rats (21 days old), weight (40-50 g) were divided into two groups: diet with 17% protein (C; control group) or an aproteic diet (A; aproteic group), for 12 days. After this, 50% of the rats from each group were sacrificed. The remaining rats were further distributed in the three groups for a recovery (21 days): ...

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

    Science.gov (United States)

    Van de Velde, Marc; De Buck, Frederik

    2012-01-01

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

  9. 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.

  10. A novel anesthesia regime enables neurofunctional studies and imaging genetics across mouse strains.

    Science.gov (United States)

    Petrinovic, Marija M; Hankov, Georges; Schroeter, Aileen; Bruns, Andreas; Rudin, Markus; von Kienlin, Markus; Künnecke, Basil; Mueggler, Thomas

    2016-04-15

    Functional magnetic resonance imaging (fMRI) has revolutionized neuroscience by opening a unique window that allows neurocircuitry function and pathological alterations to be probed non-invasively across brain disorders. Here we report a novel sustainable anesthesia procedure for small animal neuroimaging that overcomes shortcomings of anesthetics commonly used in rodent fMRI. The significantly improved preservation of cerebrovascular dynamics enhances sensitivity to neural activity changes for which it serves as a proxy in fMRI readouts. Excellent cross-species/strain applicability provides coherence among preclinical findings and is expected to improve translation to clinical fMRI investigations. The novel anesthesia procedure based on the GABAergic anesthetic etomidate was extensively validated in fMRI studies conducted in a range of genetically engineered rodent models of autism and strains commonly used for transgenic manipulations. Etomidate proved effective, yielded long-term stable physiology with basal cerebral blood flow of ~0.5 ml/g/min and full recovery. Cerebrovascular responsiveness of up to 180% was maintained as demonstrated with perfusion- and BOLD-based fMRI upon hypercapnic, pharmacological and sensory stimulation. Hence, etomidate lends itself as an anesthetic-of-choice for translational neuroimaging studies across rodent models of brain disorders.

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

    Science.gov (United States)

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

    2014-01-01

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

  12. A comparison of sevoflurane and isoflurane for short-term anesthesia in polecats (Mustela eversmanni)

    Science.gov (United States)

    Gaynor, J. S.; Wimsatt, J.; Mallinckrodt, C.; Biggins, D. E.

    1997-01-01

    Twenty-four Siberian polecats (Mustela eversmanni) from 12 litters were anesthetized with either inhaled sevoflurane or isoflurane. With 7% delivered sevoflurane and 5% delivered isoflurane, time to loss of righting reflex (mean +/- SE) with sevoflurane (1.9 +/- 0.1 min) was significantly shorter compared with isoflurane (2.6 +/- 0.1 min). During maintenance at a light plane of anesthesia, systolic arterial pressure was significantly higher with sevoflurane (83 +/- 2 mm Hg) compared with isoflurane (66 +/- 2 mm Hg), and heart rate was significantly lower with sevoflurane (191 +/- 3 beats/min) compared with isoflurane (204 +/- 3 beats/min). There was no difference in respiratory rate jugular venous pH, pCO3, HCO3-, base excess, or recovery of righting reflex. Induction of anesthesia is more rapid and blood pressure is better maintained with sevoflurane compared with isoflurane; therefore, sevoflurane may be less stressful and safer. Inhaled sevoflurane should be an appropriate anesthetic for black-footed ferrets (Mustela nigripes) in laboratory and field conditions.

  13. Influence of Volatile Anesthesia on the Release of Glutamate and other Amino Acids in the Nucleus Accumbens in a Rat Model of Alcohol Withdrawal: A Pilot Study

    Science.gov (United States)

    Seidemann, Thomas; Spies, Claudia; Morgenstern, Rudolf; Wernecke, Klaus-Dieter; Netzhammer, Nicolai

    2017-01-01

    Background Alcohol withdrawal syndrome is a potentially life-threatening condition, which can occur when patients with alcohol use disorders undergo general anesthesia. Excitatory amino acids, such as glutamate, act as neurotransmitters and are known to play a key role in alcohol withdrawal syndrome. To understand this process better, we investigated the influence of isoflurane, sevoflurane, and desflurane anesthesia on the profile of excitatory and inhibitory amino acids in the nucleus accumbens (NAcc) of alcohol-withdrawn rats (AWR). Methods Eighty Wistar rats were randomized into two groups of 40, pair-fed with alcoholic or non-alcoholic nutrition. Nutrition was withdrawn and microdialysis was performed to measure the activity of amino acids in the NAcc. The onset time of the withdrawal syndrome was first determined in an experiment with 20 rats. Sixty rats then received isoflurane, sevoflurane, or desflurane anesthesia for three hours during the withdrawal period, followed by one hour of elimination. Amino acid concentrations were measured using chromatography and results were compared to baseline levels measured prior to induction of anesthesia. Results Glutamate release increased in the alcohol group at five hours after the last alcohol intake (p = 0.002). After 140 min, desflurane anesthesia led to a lower release of glutamate (p < 0.001) and aspartate (p = 0.0007) in AWR compared to controls. GABA release under and after desflurane anesthesia was also significantly lower in AWR than controls (p = 0.023). Over the course of isoflurane anesthesia, arginine release decreased in AWR compared to controls (p < 0.001), and aspartate release increased after induction relative to controls (p20min = 0.015 and p40min = 0.006). However, amino acid levels did not differ between the groups as a result of sevoflurane anesthesia. Conclusions Each of three volatile anesthetics we studied showed different effects on excitatory and inhibitory amino acid concentrations. Under

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

    Directory of Open Access Journals (Sweden)

    Chetana Sachin Makade

    2014-01-01

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

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

    OpenAIRE

    Gaszynski T; Gaszynska E; Szewczyk T

    2014-01-01

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

  16. Comparison of the effects of dexmedetomidine-ketamine and sevoflurane-sufentanil anesthesia in children with obstructive sleep apnea after uvulopalatopharyngoplasty: An observational study

    Directory of Open Access Journals (Sweden)

    Xinqi Cheng

    2014-01-01

    Full Text Available Background: Children with obstructive sleep apnea (OSA are particularly at risk under anesthesia after uvulopalatopharyngoplasty (UPPP. This prospective randomized double-blind study focused on the comparison of dexmedetomidine-ketamine and sevoflurane-sufentanil anesthesia on children with respect to safety, feasibility, and clinical effects. Materials and Methods: A total of 60 children, aged 2-10 years, classified as American Society of Anesthesiologists (ASA status I and II scheduled for UPPP were prospectively studied. Patients were randomly allocated to receive either dexmedetomidine-ketamine-based anesthesia (group DK, n = 30 or sevoflurane-sufentanil-based anesthesia (group SS, n = 3 0. Heart rate (HR and systolic blood pressure during the first 60 min of the procedure, Ramsay sedation score, the Pediatric Anesthesia Emergence Delirium (PAED scale and a 5-point scale used to evaluate emergence agitation (EA in postanesthesia care unit (PACU and postoperative outcomes data were recorded. Results: During the first 60 min of anesthesia, mean HR, and mean diastolic noninvasive arterial blood pressure (NIBP were not statistically different in the two groups (P > 0.05 Compared with group SS, the patients in group DK had lower rescue tramadol requirement and lower pain score, PAED score, and EA score at 5, 10, 15, and 30 min in PACU; but had a higher Ramsay scale at 10, 15, 30, 45, and 60 min in PACU and the incidence of SpO 2 below 95%, also the time of first bowel movement and ambulation in group DK was shorter. Conclusions: The dexmedetomidine-ketamine combination was not superior to a sevoflurane-sufentanil combination because of late awake time and a high potential for adverse respiratory events in PACU, the benefit of dexmedetomidine administration being a decreased incidence of EA and a lower recovery time of bowel movement and ambulation.

  17. THE EFFECT OF ANESTHESIA AND OF SEDATIVES ON THE SERUM THERAPY OF EXPERIMENTAL BOTULISM.

    Science.gov (United States)

    Bronfenbrenner, J J; Weiss, H

    1924-03-31

    When guinea pigs are fed large amounts of botulinus toxin, they develop symptoms of intoxication within 6 hours and die usually within 12 hours after the feeding of toxin. If very large amounts of toxin are introduced intraperitoneally, the animals may show symptoms of intoxication at the end of the 1st hour and die usually within 2 hours following the administration of toxin. If these animals are placed under anesthesia following the administration of toxin, the intoxication proceeds much more slowly. Anesthesia, by ether, is effective in this manner whether the toxin is given per os or intraperitoneally. The life of guinea pigs kept under ether after the administration of lethal amounts of toxin is prolonged by a period approximately equal to that during which the administration of the anesthetic is continued. When anesthesia is discontinued, the intoxication proceeds at its usual rate. It appears, therefore, that administration of ether delays the rate of intoxication but does not alter the toxin or the nature of the mechanism of intoxication. Anesthesia thus delays the progress of intoxication not only when administered immediately after the intake of toxin, but when administered much later after the intoxication has already progressed far enough to cause definite objective symptoms of poisoning. At this late stage of intoxication, the unsupported serum therapy of botulism in guinea pigs usually remains without effect. If, however, the animals are anesthetized at this time and kept under the influence of ether for some time, antitoxin therapy becomes effective. Indeed the antitoxin treatment can be delayed further for several hours, provided the animal is kept under anesthesia during the interval. Results of a similar nature were obtained with luminal sodium, nitrous oxide-oxygen mixture, and morphine used in place of ether. In view of the fact that the published data indicate that botulinus antitoxin has thus far failed to give beneficial results in the

  18. EPIDURAL COMBINED INTRAVENOUS ANESTHESIA AND TOTAL INTRAVENOUS ANESTHESIA IN UPPER ABDOMINAL SURGERY%硬膜外复合静脉全麻与全凭静脉麻醉在上腹部手术中的比较

    Institute of Scientific and Technical Information of China (English)

    朱洪远; 刘充卫; 姜华华

    2011-01-01

    [目的]比较硬膜外复合静脉全麻与全凭静脉麻醉对上腹部手术患者血流动力学、静脉麻醉药用量、术后苏醒、躁动及术后疼痛的影响.[方法]80例择期行上腹部手术患者完全随机分为硬膜外复合全麻组(A组)与全凭静脉麻醉组(B组).观察记录不同时间点两组患者血流动力学、静脉麻醉药用量、术后苏醒时间、躁动例数及术后疼痛VAS评分.[结果]两组患者术前术中血流动力学变化比较,差异无统计学意义.拔管后B组患者MAP和HR明显比A组增加,差异有统计学意义(P<0.05).A组患者丙泊酚、芬太尼、顺苯阿曲库铵用量明显比B组少,差异有统计学意义(P<0.01),术后清醒早,拔管时间明显缩短、躁动例数明显减少、术后镇痛良好.[结论]胸段硬膜外复合静脉全麻用于上腹部手术是一种安全、经济、有效并利于患者术后恢复快通道麻醉的首选麻醉方法.%[Objective] To compare the epidural combined intravenous anesthesia and total intravenous anesthesia on hemodynamics, drug dosage, intravenous anesthesia postoperative effects of waking up, restlessness and postoperative pain of patients with upper abdominal surgery. [Methods] 80 patients with elective abdominal operation on a row totally were randomly divided into epidural combined with General anesthesia Croup (group A) and total intravenous anaesthesia group (Group B). We recorded the blood flow dynamics in patients with two groups at various points the dosage, intravenous anesthesia, postoperative recovery time, number of restlessness and postoperative VAS pain score. [ Results] We compared the hemodynamic changes in patients of the two groups before surgery, and there was significant difference between the two groups. MAP and HR in Group B after extubation significantly increased than the group A (P < 0.05). The propofol, fentanyl and CIS-Atracurium dosage of benzene in Group A were significantly lower than in the B group

  19. DEXAMETHASON ADMINISTRATION IN INTRAVENOUS REGIONAL ANESTHESIA: ITS AFFECT ON POST OPERATIVE PAIN A RANDOMIZED DOUBLE BLINDED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    H SARYAZDI

    2002-03-01

    Full Text Available Introduction. Intravenous regional anesthesia (IVRA is one of the successful method of anesthesia in relief of pain of surgery. It has a multiple advantages including feasibility, rapidity of recovery, rapid onest, muscular relaxation and controllable onset of anesthesia. But this technique dose not relief postoperative pain. In the previous studies it had been tried to add some drugs to local anesthetic in IVRA for relief postoperative pain. Methods. One hundred and ten adult patients in class I and II ASA scheduled for elective operation of unilatral upper extrimeties under IVRA, randomly allocated into interventional and control groups. NRA was done with Lidocaine 0.5 percent with or without dexamethason. Postoperative pain was assessed by visual analogue scale. Results. Addition of dexamethason to local anesthetic in IVRA resulted in better tolleration of turniquate pain and reduced VAS score. Frequency of severe postoperative pain was reduced in case group. Discussion. It seems that dexamethason usage in local anesthetic in IVRA prevents sever postoperative pain in patients. The results of this study is simillar to the study wich added ketorolac to IVRA solution.

  20. The Impact of HiLo Training on the Rats' Blood Rheolgy During the Recovery Period After Exercise%高住低练对运动后恢复期大鼠血液流变学的影响

    Institute of Scientific and Technical Information of China (English)

    阮凌; 郝选明; 肖国强

    2012-01-01

    Objective: To observe the blood rheolgy change during recovery period after exercise by Hilo training;Method: We divide 32 rats into 4 groups.After 4 weeks incremental training,we measure blood rheolgy and changes of related indexes.Results:(1) From low shear to high shear training group,the viscosity of the blood is lower than that of the control group and the middle shear and high shear have a significant difference(P0.05).Hilo group is lower than the control group and training group.Compared with the training group,the low-shear and middle-shear group have a significant difference(P 0.05).(2) The rigidity index in training group and control group has a significant difference(P 0.05).Hilo group is lower than the control group and training group.Compared with the high living group,the deformation index of Hilo group has significant difference(P0.05).(3) The fibrinogen of the training group is lower than the control group and has significant difference(P0.05).The Hilo group is lower than the other group and compared with the training group its fibrinogen has a significant difference(P 0.05).Compared with high living group,the Hilo group's deformation index has a significant difference(P 0.05).Conclusion: In this test for blood rheolgy and related indexes,the Hilo training group is the most ideal training model.%目的:通过高住低练这种低氧训练模式观察大鼠运动后恢复期血液流变学的变化。方法:将32只大鼠分为4组,经过4周递增负荷跑台训练后,测得血液流变学及相关指标的变化。结果:①从低切到高切运动组的血液粘度均低于安静组,其中中切和高切具有显著性差异(P〈0.05);高住组低于安静组和运动组,和运动组相比,低切和中切值具有显著性差异(P〈0.05)。②运动组低于安静组且刚性指数具有显著性差异(P〈0.05);高住组低于安静组和运动组,高住低练组变形性指数

  1. 行为治疗对住院精神病患者恢复期服药依从性的影响%Effect of behavioral therapy on medication compliance in recovery period for hospitalized psychopathic patients

    Institute of Scientific and Technical Information of China (English)

    朱明荣; 高洁

    2014-01-01

    、Objective To investigate effect of behavioral therapy on medication compliance in recovery period for hospitalized psychopathic patients.Methods 312 psychopaths were random-ly divided into the control group 、147 cases、and the observation group 、154 cases、.The control group was given routine nursing intervention、and the observation group was treated with behav-ioral therapy based on routine nursing.ITAQ、PANSS、SDSS and medication compliance in the two groups were observed and compared.Results After the treatment for half a year、the medica-tion compliance rate in the observation group was 88.31% and 70.75% in the control group、the difference was significant、P 0.05、.The difference in adverse events in both groups was not statistically significant、P >0.05、.Conclusion Behavior therapy can effectively improve the medication compliance and self-management、effectively control disease recurrence、and fundamentally improve the quality of life of psychopaths.Compliance for the doctors is to prevent and cure diseases and accord to the doctors′orders、so it is worthy of promotion in clinical applications.%目的:、、、、、、、、、、、、、、、、、、、、、、、、、、方法、、、、、、、、、、、312、、、、、、、、、、、、、、、、、、、、、、、、、、、147、、、、、154、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、、2、、、、 ITAQ、PANSS、SDSS 、、、、、、、、、、、、结果、、、、、、、、、、、、、、、、、88.31%、、、、、、、、、、70.75%、、、、、、、、、、、、、P <0.05、、2、 ITAQ 、、、、、、、、、、P <0.05、、2、 PANSS 、、、、SDSS 、、、、、、、、、、、、、、P >0.05、、2、、、、、、、、、、、、、、、、、、、、、、、、、、P >0.05、、结论、、、、、、、、

  2. Reactive Software Agent Anesthesia Decision Support System

    Directory of Open Access Journals (Sweden)

    Grant H. Kruger

    2011-12-01

    Full Text Available Information overload of the anesthesiologist through technological advances have threatened the safety of patients under anesthesia in the operating room (OR. Tradi