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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].

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    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. PMID:2631593

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

    陈瑞海; 陈建望; 林日武

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    洪莲; 尧永华; 黎玉梅; 江涛; 唐春林; 沈翠玲; 符玲

    2015-01-01

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

  7. 右美托咪啶预防全麻心血管反应在妇科手术中的临床观察%The Effects of Dexmedetomidine Hydrochloride on Cardiovascular Responses in Anesthesia Recovery Period

    Institute of Scientific and Technical Information of China (English)

    程斌; 欧英余; 黄婧

    2012-01-01

    Objective To investigate the effects of dexmedetomidine hydrochloride on cardiovascular responses in anesthesia recovery period. Methods A total of 60 patients underwent selective abdominal operation under general anesthesia were enrolled in this study. All cases were divided into two groups: control group ( A, n = 30 ) and dexmedetomidine hydrochloride treatment group(B,n =30). Heart rate(HR). Mean arterial blood pressure (MAP) ,and the rate-pressure product (RPP) were detected at recovery of drowsiness and after-extubation treated 0, and 10 min, respectively. The recovery period with drowsiness, tracheal extu-bation,and respiratory depression were recorded. Results HR,MAP,and RPP were not significantly different between the two groups at pre- extubation(P >0. 05). However HR,MAP,and RPP were changed in A group in anesthesia recovery period( P 0. 05 ). There were no significant differences in the recovery time of drowsiness, extubation time and respiratory depression between the two groups (P>0.05). Conclusion Dexmedetomidine hydrochloride can effectively reduce cardiovascular responses in anesthesia recovery period,and while did not prolonging the recovery time from anesthesia.%目的 观察盐酸右美托咪啶对全麻患者苏醒期心血管反应的影响,借此探讨其相关的临床应用价值.方法 收集医院2012年5月-2012年7月需要全身麻醉下择期行腹部手术的女性患者60例,将患者随机分为对照组(A)和盐酸右美托咪啶治疗组(B),每组30例.检测患者麻醉自主呼吸恢复时、拔管时和拔管后10 min的心率(HR)、平均动脉压(MAP)、心率收缩压乘积(RPP),记录患者苏醒时间(呼之睁眼的时间)、拔管时间、呼吸恢复时间.结果 两组患者HR、MAP、RPP在麻醉前和拔管前差异都无统计学意义(P>0.05),但拔管后以及拔管10 min后上述指标A组较拔管前有显著的升高(P<0.05),而B组则无显著性变化(P>0.05).两组患者在麻醉后苏醒、拔管和

  8. Nursing of elderly patients with painless endoscopy in the recovery period of anesthesia%老年患者无痛内镜检查麻醉苏醒期的护理

    Institute of Scientific and Technical Information of China (English)

    杜玉梅; 郭培俊

    2015-01-01

    Objective To investigate the nursing care of patients with painless endoscopy in elderly patients during recovery period.Methods decimation in our hospital 2104 in May to 2015 may accept the 60 cases of elderly patients undergoing painless endoscopy in patients with research, the comprehensive implementation of patients with respiratory tract nursing, posture nursing, ECG monitoring nursing care, the investigation of patients with nursing effect.Results 60 cases of elderly patients with painless endoscopic examination to give timely and correct treatment and nursing, no accidents and other complications, safe return ward.Conclusion it is of significance to implement comprehensive nursing care for patients with anesthesia recovery period in order to prevent the occurrence of accidents and complications.%目的:探讨老年患者无痛内镜检查麻醉苏醒期的护理护理方法。方法抽选我院2104年5月至2015年5月间接受的60例老年无痛内镜检查患者进行研究,对患者综合实施呼吸道护理、体位护理、心电监测护理等护理,调查患者的护理效果。结果本组60例老年患者行无痛内镜检查后给予及时正确的治疗和护理,无意外及其他并发症发生,安返病房。结论为内镜检查麻醉苏醒期患者实施综合护理能有效防范意外及并发症发生,具有普及意义。

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

    Institute of Scientific and Technical Information of China (English)

    江烨岚; 梁敏; 郑文美; 周大春

    2014-01-01

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

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

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    Masood Entezariasl

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李廷坤; 卢锡华; 吕帅国; 章云飞; 王根生; 冯艳平

    2008-01-01

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

  12. 家长陪护对静脉麻醉复合骶麻小儿患者麻醉复苏期躁动的影响%The Impact of Parental Accompaniment in Children on Postoperative Recovery Period after Intravenous Anesthesia Combined with Caudal Block

    Institute of Scientific and Technical Information of China (English)

    王冉; 陈慧; 黄昆

    2015-01-01

    Objective To observe the impact of parental accompaniment in children on postoperative recovery period after intravenous anesthesia combined with caudal block. Methods The randomized controlled trial involved 60 children having operations under intravenous anesthesia combined with caudal block in our hospital. The children of observation group had parents accompanied during postoperative recovery period, while those of control group took conventional methods of anesthesia recovery. The wake-up time, the sedation scales and the incidence of restlessness and adverse reactions of both groups were recorded. Results The incidence of adverse reactions and the results of recovery indexes of observation group were significantly better than the results of control group. Conclusion Parental accompaniment improves the quality of the recovery and reduces the psychological trauma in children on postoperative period after intravenous anesthesia combined with caudal block.%目的::探讨家长陪护对静脉麻醉复合骶麻小儿患者麻醉复苏期躁动的影响。方法:采用随机对照法将某二甲医:2~6周岁静脉麻醉复合骶麻小儿患者60例作为研究对象,随机分为干预组和对照组。干预组采用在患儿麻醉复苏期安排家长陪护;对照组采取常规麻醉复苏方法。监测两组患儿术后睁眼时间、镇静评分、躁动评分和不良反应的发生率。结果:两组患儿睁眼时间和镇静评分无统计学差异,干预组患儿躁动评分、不良反应的发生率明显低于对照组。结论:家长陪护有利于减少静脉麻醉复合骶麻患儿复苏期躁动和不良反应发生率,减少患儿的心理创伤。

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

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    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. 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

  15. 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.

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

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    Mukesh Somvanshi

    2015-03-01

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

  17. Comparsion of the effect of different insulation measures on anesthesia recovery pe-riod in hypothermic elderly patients of urology surgery%泌尿外科低体温老年患者麻醉复苏期不同保温措施效果比较

    Institute of Scientific and Technical Information of China (English)

    邓燕; 赵庆兰

    2016-01-01

    目的:分析麻醉复苏期采用不同保温措施对泌尿外科低体温老年手术患者的影响情况。方法将120例泌尿外科低体温老年手术患者随机分为观察组和对照组进行研究。对照组采用常规调节室温加盖棉被的方法保温;观察组除以上护理措施外增加充气式保温毯包裹患者躯干部及双下肢进行保温。通过对低体温老年患者复苏期生命体征、复苏时间及并发症发生情况记录并进行分析。结果两组患者在氧饱和度、苏醒时间和寒战发生指标上有显著差异:观察组氧饱和度的变化值显著高于对照组(P<0.05);观察组苏醒时间显著低于对照组(P<0.01);在寒战发生情况上观察组患者的发生率显著低于对照组(P<0.01)。结论经过保温护理可以明显缩短泌尿外科全麻老年患者的苏醒时间,并能改善患者氧饱和度和寒战的发生。%Objective To analyze the effect of different insulation measures on anesthesia recovery period in hypothermic elderly patients in the department of urology. Methods A total of 120 cases of hypothermia elderly patients with surgery in the department of urology were randomly divided into observation group and control group. The patients in the control group adopted the conventional control method by adjusting the room temperature and being covered with the quilt to keep warm. The patients in the observation group, in addition to the above nursing measures, increased warming blanket insulation of the air insulation blanket wrapped with the trunk and lower limbs for thermal insulation. The vital signs of recovery, recovery time and complications of the hypothermia elderly patients were recorded and ana-lyzed. Results There were significant differences in oxygen saturation, recovery time and indicators of chill between control and observation groups. The change of the oxygen saturation of the observation group was significantly higher than that of the

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

    OpenAIRE

    Masood Entezariasl; Godrat Akhavanakbari; Khatereh Isazadehfar

    2012-01-01

    Background and Objective: With consideration the daily increased development of outpatient surgeries and high rate of these surgeries in elderly patients, rapid and safe recovery of patients is necessary. In this clinical trial study, recovery time and nausea and vomiting after the use of two rapid-onset narcotics, Alfentanil and Remifentanil, in elderly patients were evaluated. Methods: In this double-blind prospective clinical trial, 40 elderly patients (age above 65 years) candidate to cat...

  19. 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

  20. Effect of sufentanil or flurbiprofen axetil combined with tramadol hydrochloride on patients in recovery period after remifentanil-based general anesthesia%舒芬太尼与氟比洛芬酯复合曲马多对雷米芬太尼复合麻醉苏醒期的影响比较

    Institute of Scientific and Technical Information of China (English)

    李勇; 陆松虹; 程亮; 潘松

    2012-01-01

    Objective: To explore the effect of sufentail or flurbiprofen axetil combined with tramadol hydrochloride on patients in the recovery period after remifentanil-based general anesthesia. Methods: Forty patients undergoing laparoscopic cholecystectomy were evenly divided into two groups: sufentanil group ( group A ) and flurbiprofen axetil combined with tramadol hydrochloride group ( group B). Group A received intravenous injection of 0. 15 μg/kg sufentanil five minutes before the end of the operation, and group B received intravenous injection of 50 mg flurbiprofen axetil ten minutes before the operation and 50 mg flurbiprofen axetil with 2 mg/kg tramadol hydrochloride ten minutes before the end of the operation. The recovery time, verbal rating scale and incidence of side effects were evaluated. Results:The recovery time of group A was longer than that of group B(P <0. 01) . The VRS of group B at 10,20 and 30 min after extubation was significantly higher than that of group A( P < 0. 01) . The incidence of side effects was similar 2 h after extubation between the two groups ( P > 0. 05 ). Conclusions: Sufentanil provides more effective analgesia than flurbiprofen axetil combined with tramadol hydrochloride for patients in the early recovery period after remifentanil-based general anesthesia.%目的:比较超前使用舒芬太尼与氟比洛芬酯联合曲马多对雷米芬太尼复合全麻苏醒期的影响.方法:将40例择期腹腔镜胆囊切除术患者随机分为舒芬太尼组(A组)和氟比洛芬酯复合曲马多组(B组),每组20例.A组手术结束前5 min,静脉注射舒芬太尼0.15 μg/kg;B组手术开始前10 min,静脉注射氟比洛芬酯50 mg,手术结束前10 min,静脉注射氟比洛芬酯50 mg和曲马多2 mg/kg.记录并比较2组苏醒时间、苏醒后的镇痛评分(VRS)和不良事件发生例数.结果:A组苏醒时间长于B组(P<0.01);B组苏醒拔管后10、20、30 min的VRS均明显高于A组(P<0.01);2组拔管后2 h期

  1. 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

  2. [Anesthesia and recovery of infrarenal abdominal aortic aneurysm surgery].

    Science.gov (United States)

    Beye, S A; Kane, O; Tchikangoua, T N; Ndiaye, A; Dieng, P A; Ciss, G; Ba, P S; Ndiaye, M

    2009-01-01

    The aim of this study was to evaluate the anaesthetic assumption of responsibility of the surgery of the aneurism of under renal abdominal aorta. It was a retrospective study over two years (April 2005 - April 2007). Seven patients were operated, the mean age was 69,4 years. An operational pre evaluation was carried out among all patients including/understanding an interrogation, a clinical examination and a clinical assessment. All the patients profited from a general anaesthesia with controlled ventilation. Arterial hypertension (5 cases) was the independent factor of risk followed by the nicotinism (2 cases) with a patient at the stage of obstructive chronic broncho-pneumonopathy (BPCO). A patient was allowed in a table of rupture with acute abdominal pain and a cardiovascular collapse. Electrocardioscopic anomalies were noted among three patients with type of: HVD+ HBAG; HVG; HAG. A patient presented a hypertrophy cardiopathy with deterioration of the function of the VG and an important pulmonary arterial hypertension. A tensionnelle fall was found among three patients after induction with the midazolam. The aortic time of clampage varied between 20 and 120 mn with an average of 57, 6 mn. The incidents at the time of the clampage were: a bradycardia, a hypertensive push and a hypotension. No incident was observed at the time of the declampage. The blood losses per operational were estimated on average at 1000 ml and the numbers of transfusion by patient was on average of 4 pockets. The post operative issue was simple among 5 patients. A surgical recovery was necessary in front of a case of thrombosis of prosthesis. An oligoanurie, an acute respiratory insufficiency was found at the patient admitted in a table of rupture. The intermediate duration of stay threw 11 days. The maintenance of a homodynamic stability per and post operational remainder a good strategy to prevent the operational complications post. PMID:19666389

  3. Application of dexmedetomidine with total intravenous anesthesia on perioperative period of carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    Jun CHEN

    2014-02-01

    Full Text Available Objective To evaluate the safety and efficacy of dexmedetomidine in patients undergoing carotid endarterectomy (CEA, and to explore its mechanism in cerebral protection. Methods Forty patients undergoing CEA were divided into 2 groups: dexmedetomidine group (Group D, N = 20 and control group (Group S, N = 20, respectively receiving dexmedetomidine intravenous infusion (0.40 μg/kg and the same dose of normal saline. Total intravenous anesthesia (TIVA was applied in both 2 groups. Mean arterial pressure (MAP and heart rate (HR of each patient were recorded at T0 (before administration, T1 (before tracheal intubation, T2 (1 min after intubation, T3 (carotid explosing, T4 (before extubation and T5 (1 min after extubation respectively. Total amount of propofol and remifentanil, and patients' recovery conditions after anesthesia were also recorded. Tumor necrosis factor-α (TNF-α and interleukin-6 (IL-6 were measured and compared before and after operation between 2 groups. Results In Group D, MAP and HR decreased significantly at T1-5 compared with T0 (P < 0.05, for all; in group S, HR and MAP increased at the same condition (P < 0.05, for all. Total amount of propofol and remifentanil in Group D was lower than that in Group S (P < 0.05, for all. And the patients' recovery conditions in Group D after anesthesia was better than that in Group S (P < 0.05, for all. TNF-α and IL-6 increased after anesthesia compared with that before anesthesia in 2 groups, however, it was higher in Group S than in Group D (P < 0.05, for all. Conclusions Dexmedetomidine can provide stable hemodynamic condition during anesthesia in patients undergoing CEA, and improve both the outcome of operation and recovery. With good safety and efficacy, it can provide brain protection by reducing the level of TNF-α and IL-6.doi:10.3969/j.issn.1672-6731.2014.02.004

  4. 丁卡因胶浆对喉罩通气全麻苏醒期患者血流动力学的影响%Effect of tetracaine mucilage on hemodynamics of patients with laryngeal mask airway during recovery period of general anesthesia

    Institute of Scientific and Technical Information of China (English)

    慕玲霞; 孙玉川; 刘斐

    2014-01-01

    hoarseness in group A was low-er than that in group B(P﹤0. 05). Conclusions Application of tetracaine mucilage coated laryngeal mask can maintain the stable hemodynamics in patients during recovery period of general anesthesia,and relieve throat discomfort.

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    吴静; 杨帆

    2016-01-01

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

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

    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.

  8. 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.

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

    OpenAIRE

    GÜNAY, Hülya; Moğol, Elif Başağan; Kaya, Fatma Nur; Türker, Gürkan; Yavaşcaoğlu, Belgin; Ahun, Filiz; Bebek, Ayşe Neslihan; Yeniaydoğmuş, Tuba

    2012-01-01

    Objectives: Our aim was to compare effectiveness of esmolol and dexmedetomidine in the treatment of increased hemodynamic response during anesthesia recovery period. Materials and methods: 60 ASA I-II patients whom scheduled for elective surgery with endotracheal intubation were randomized before extubation according to their hemodynamic parameters that were increased 20% of their baseline values in order to receive 1mg/kg esmolol (Group Esmolol, n= 30) or 0.5 µg/kg dexmedetomid...

  10. 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。

  11. 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.

  12. Nitrous Oxide and Nitrous Oxide-Free Low-Flow Anesthesia Using Bispectral Index Monitoring: Effects on Hemodynamics, Recovery Times, Volatile Anesthetic Consumption and Costs

    Directory of Open Access Journals (Sweden)

    Bengü Gülhan Köksal

    2010-12-01

    Full Text Available Aim: In this study, we aimed to compare the effects of desfluraneN2O and desflurane-fentanyl combinations on hemodynamics, recovery times, volatile anesthetic consumption and costs in low-flow desflurane anesthesia by bispectral index (BIS monitoring of depth of anesthesia. Methods: After approval of ethics committee and obtaining patient consents, 60 patients were divided into two equal groups randomly. Non-invasive blood pressure measurement, ECG, SpO2 and BIS were monitored. All patients received 10 L .min-1 100% oxygen with mask for 5 minute before intubation. 2 mg.kg-1 propofol, 2 μg.kg-1 fentanyl and 0.6 mg.kg-1 rocuronium bromide were administered at induction in both groups. Desfluran 6% was chosen for anesthesia maintenance. Group 1 received 50% O2-N2O mixture in 6 L.min-1 and Group 2 received 50% O2-air mixture in 6 L.min-1 as carrier gas. Low-flow anesthesia (1 L.min-1 was started after a 10-min period of initial high flow (6 L.min-1. In Group 2, infusion of fentanyl was begun in 1 μg.kg.hour-1 rate. Desflurane level was adjusted at a main BIS value of 40-60. Blood pressure, heart rate, FiO2, etO2, FiN22, EtN2O, FiCO2, EtCO2, Fidesfluran and Etdesflurane were recorded. Results: There were no significant differences between the two groups in terms of heart rate, arterial blood pressure, settings of desfluran and recovery time. BIS values (p<0.001 and anesthetic agent costs (p<0.001 were higher in Group 2. Conclusion: Using fentanyl infusion instead of nitrous oxide in low flow-anesthesia with desflurane did not alter the hemodynamic parameters. Fentanyl infusion with medical air-oxygen as carrier gas is an alternative technique, but increases BIS values and anesthetic agent costs. (The Medical Bulletin of Haseki 2010; 48: 132-8

  13. 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).

  14. 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

  15. Recovery Following Desflurane Versus Sevoflurane Anesthesia for Outpatient Urologic Surgery in Elderly Females

    OpenAIRE

    Green, Michael S.; Green, Parmis; Neubert, Lee; Voralu, Kirtanaa; Saththasivam, Poovendran; Mychaskiw, George

    2015-01-01

    Background: An unresolved question is the time required for the ability to return to complex tasks following anesthesia. Objectives: This study aims to characterize the severity and duration of cognitive impairment following sevoflurane or desfluane anesthesia after brief surgery using tests of cognitive ability to objectively testing performance. Patients and Methods: This study is a double blinded randomized controlled trial. Patients were randomized to receive either a desflurane or sevofl...

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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

    Directory of Open Access Journals (Sweden)

    Dana Tahririan

    2016-01-01

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

  19. Anesthesia-related critical incidents in the perioperative period in children : A proposal for an anesthesia-related reporting system for critical incidents in children

    NARCIS (Netherlands)

    De Graaff, Jurgen C.; Sarfo, Marie Christine; Van Wolfswinkel, Leo; van der Werff, Desiree B. M.; Schouten, Antonius N J

    2015-01-01

    Background The incidence, type and severity of anesthesia-related critical incidents during the perioperative phase has been investigated less in children than in adults. Aim The aim of the study was to identify and analyze anesthesia-related critical incidents in children to identify areas to impro

  20. 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.

  1. Early postoperative cognitive recovery and gas exchange patterns after balanced anesthesia with sevoflurane or desflurane in overweight and obese patients undergoing craniotomy: a prospective randomized trial.

    Science.gov (United States)

    Bilotta, Federico; Doronzio, Andrea; Cuzzone, Vincenzo; Caramia, Remo; Rosa, Giovanni

    2009-07-01

    Overweight and obese patients are at especially high risk for delayed awakening after general surgery. Whether this risk also applies to cerebral neurosurgical procedures remains unclear. This study evaluated early postoperative cognitive recovery and gas exchange patterns, after balanced anesthesia with sevoflurane or desflurane, in overweight and obese patients undergoing craniotomy for supratentorial expanding lesions. Fifty-six patients were consecutively enrolled, and randomly assigned to 1 of 2 study groups to receive balanced anesthesia with sevoflurane or desflurane. Cognitive function was evaluated with the Short Orientation Memory Concentration Test and the Rancho Los Amigos Scale and gas exchange patterns (pH, PaO2, and PaCO2) were recorded in all patients at 5 time-points: preoperatively and postoperatively, after patients reached an Aldrete score >or=9, at 15, 30, 45, and 60 minutes. Preoperative cognitive status was similar in the 2 treatment groups. Early postoperative cognitive recovery was more delayed and Short Orientation Memory Concentration Test scores at 15 and 30 minutes postanesthesia were lower in patients receiving sevoflurane-based anesthesia than in those receiving desflurane-based anesthesia (21.5+/-3.5 vs. 14.9+/-3.5) (P<0.005) and (26.9+/-0.7 vs. 21.5+/-1.4) (P<0.005), and the postoperative Rancho Los Amigos Scalegrade 8 showed a similar trend (25/28 patients 89% vs. 8/28 patients 28% (P<0.005) and 28/28 patients (100% vs. 13/28 patients 46%) (P<0.005). Similarly, gas-exchange analysis showed higher PaCO2 at 15 and 30 minutes and lower pH up to 45 minutes postextubation in patients receiving sevoflurane-based anesthesia. In overweight and obese patients undergoing craniotomy desflurane-based anesthesia allows earlier postoperative cognitive recovery and reversal to normocapnia and normal pH. PMID:19542997

  2. Anesthesia Awareness

    Science.gov (United States)

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

  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. Seizure developed after palonosetron intravenous injection during recovery from general anesthesia -A case report-

    OpenAIRE

    Park, Pyung-Gul; Shin, Hwa-Yong; Kang, Hyun; Jung, Yong Hun; Woo, Young-Cheol; Kim, Jin-Yun; Koo, Gill Hoi; Park, Sun Gyoo; Baek, Chong Wha

    2012-01-01

    Seizure associated with antiemetics is rare. We report seizure associated with a 5-HT3 receptor antagonist in a 38 years old female. The patient underwent ureterorenoscopic lithotripsy due to left upper ureter stone. After operation, the patient complained of nausea in the postanesthetic recovery unit. In order to subside symptom, the patient was administrated 5-HT3 receptor antagonist, palonosetron, 0.075 mg intravenously. Shortly after administration of that, the patient developed generaliz...

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

    OpenAIRE

    Sherif A. ELokda; Elshamaa, Hossam A.

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  8. 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

  9. 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

  10. Analysis of the Complications of Anesthesia Analepsia Period of Children with Adenoid and Tonsil Operation in 56 cases%56例小儿扁桃体腺样体手术麻醉苏醒期并发症的分析

    Institute of Scientific and Technical Information of China (English)

    王洁

    2013-01-01

    目的对小儿扁桃体腺样体手术麻醉苏醒期的并发症的影响因素进行分析,并探讨预防和减少其发生的措施。方法选取扁桃体和腺样体切除手术的患儿56例,收集其手术和麻醉资料,观察患儿与麻醉、手术、治疗药物等因素有关的并发症发生的情况,分析和统计引起患儿手术麻醉苏醒期并发症的影响因素。结果术后麻醉苏醒的并发症的有17例;其中麻醉苏醒期的并发症与手术有直接关系的为4例;麻醉相关并发症11例;治疗药物相关并发症2例。结论麻醉方式、手术操作、治疗药物等因素均可以影响小儿扁桃体腺样体手术麻醉苏醒期并发症的发生。手术前的充分准备,手术和麻醉过程对咽峡部水肿的处理,术中认真操作、气管导管拔出时机的恰当选择对预防和减少小儿扁桃体腺样体手术麻醉苏醒期并发症的发生是比较有效的。%Objective To analyze the factors which inlfuence children with adenoid and tonsil operation anesthesia complications, and to discuss how to prevent and reduce the occurrence of measures. Methods Children with tonsil and adenoid resection operation in 56 cases, collecting the data operation and anesthesia, and anesthesia complications were observed, operation, treatment and other factors related to the case, analysis and statistics of the factors inlfuencing the recovery period of complications of anesthesia operation. Results There were 17 cases of recovery from anesthesia complications after operation;which is directly related to complications of operation and anesthesia recovery period in 4 cases;11 cases of complications of anesthesia;2 cases of drug treatment related complications. Conclusion Anesthesia, operation, treatment and other factors can inlfuence the occurrence of complications of anesthesia recovery period of children with adenoid and tonsil operation. Full preparation before operation, processing

  11. 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.

  12. Analysis of anesthesia-related medical disputes in the 2009-2014 period using the Korean Society of Anesthesiologists database.

    Science.gov (United States)

    Roh, Woon-Seok; Kim, Duk-Kyung; Jeon, Young-Hun; Kim, Seong-Hyop; Lee, Seung-Cheol; Ko, Young-Kwon; Lee, Yong-Cheol; Lee, Gyu-Hong

    2015-02-01

    Using the Korean Society of Anesthesiologists database of anesthesia-related medical disputes (July 2009-June 2014), causative mechanisms and injury patterns were analyzed. In total, 105 cases were analyzed. Most patients were aged sec most common type of anesthesia (37.1% of all cases), following by general anesthesia. Most sedation cases (27/39, 69.2%) showed a common lack of vigilance: no pre-procedural testing (82.1%), absence of anesthesia record (89.7%), and non-use of intra-procedural monitoring (15.4%). Most sedation (92.3%) was provided simultaneously by the non-anesthesiologists who performed the procedures. After the resulting injuries were grouped into four categories (temporary, permanent/minor, permanent/major, and death), their causative mechanisms were analyzed in cases with permanent injuries (n=20) and death (n=82). A 'respiratory events' was the leading causative mechanism (56/102, 54.9%). Of these, the most common specific mechanism was hypoxia secondary to airway obstruction or respiratory depression (n=31). The sec most common damaging event was a 'cardiovascular events' (26/102, 25.5%), in which myocardial infarction was the most common specific mechanism (n=12). Our database analysis demonstrated several typical injury profiles (a lack of vigilance in seemingly safe procedures or sedation, non-compliance with the airway management guidelines, and the prevalence of myocardial infarction) and can be helpful to improve patient safety. PMID:25653494

  13. Recovery of cortical binocularity and orientation selectivity after the critical period for ocular dominance plasticity.

    Science.gov (United States)

    Liao, David S; Krahe, Thomas E; Prusky, Glen T; Medina, Alexandre E; Ramoa, Ary S

    2004-10-01

    Cortical binocularity is abolished by monocular deprivation (MD) during a critical period of development lasting from approximately postnatal day (P) 35 to P70 in ferrets. Although this is one of the best-characterized models of neural plasticity and amblyopia, very few studies have examined the requirements for recovery of cortical binocularity and orientation selectivity of deprived eye responses. Recent studies indicating that different mechanisms regulate loss and recovery of binocularity raise the possibility that different sensitive periods characterize loss and recovery of deprived eye responses. In this report, we have examined whether the potential for recovery of binocularity and orientation selectivity is restricted to the critical period. Quantitative single unit recordings revealed recovery of cortical binocularity and full recovery of orientation selectivity of deprived eye responses following prolonged periods of MD (i.e., >3 wk) starting at P49, near the peak of plasticity. Surprisingly, recovery was present when binocular vision was restored after the end of the critical period for ocular dominance plasticity, as late as P83. In contrast, ferrets that had never received visual experience through the deprived eye failed to recover binocularity even though normal binocular vision was restored at P50, halfway through the critical period. Collectively, these results indicate that there is potential for recovery of cortical binocularity and deprived eye orientation selectivity after the end of the critical period for ocular dominance plasticity.

  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. Different fasting periods in tiletamine-zolezepam-anethetized cats: Glycemia, recovery, blood-gas and cardiorrespiratory parameters

    Directory of Open Access Journals (Sweden)

    A.P. Gering

    2013-12-01

    Full Text Available The effects of different fasting periods on glycemia levels and on cardiorrespiratory parameters in tiletamine-zolazepam-anesthetized cats were evaluated. Twenty one animals were randomly assigned to three groups: 8 hours (G8, 12 hours (G12 or 18 hours (G18 of the preoperative fasting. The tiletamine-zolazepam (2 mg/kg was administered intravenously. The heart rate (HR, respiratory rate (fR, rectal temperature (T R, glycemia (G, laboratorial glycemia (Glab, venous oxygen partial pressure (PvO2, venous carbon dioxide partial pressure (PvCO2, venous hemoglobin saturation (SvO2, pH, base deficit (BD, bicarbonate concentration (HCO3- and haematocrit were evaluated at 90 minutes after the last meal (T0, immediately before anesthesia (T1 and at ten (T2 and thirty (T3 minutes after tiletamine-zolezepam administration. The time between the administration of anesthetic and the cat's trial to elevate head (Th and the interval between drug administration and aniamal's quadrupedal position (Tqp were recorded. No differences among groups were recorded for glycemia, HR, PvO2, SvO2, pH, BD, HCO3-, Ht and Tqp. In G12 from T2, glycemia increased and from T1 PvCO2 decreased. At T1, PvO2 increased in all groups. In G8 and G12, from T1, DB and HCO3- decreased. In G12 and G18, from T2, Ht decreased. In G12, the Th mean was higher than G8. In conclusion, in tiletamine-zolazepam-anesthetized cats, the different preoperative fasting did not influence glycemia, blood-gas and cardiorrespiratory parameters. Additionally, there was no relationship between glycemia and anesthesia recovery.

  16. Repetitive Pediatric Anesthesia in a Non-Hospital Setting

    Energy Technology Data Exchange (ETDEWEB)

    Buchsbaum, Jeffrey C., E-mail: jbuchsba@iupui.edu [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); McMullen, Kevin P.; Douglas, James G. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Jackson, Jeffrey L.; Simoneaux, R. Victor; Hines, Matthew; Bratton, Jennifer; Kerstiens, John [Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Johnstone, Peter A.S. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States)

    2013-04-01

    Purpose: Repetitive sedation/anesthesia (S/A) for children receiving fractionated radiation therapy requires induction and recovery daily for several weeks. In the vast majority of cases, this is accomplished in an academic center with direct access to pediatric faculty and facilities in case of an emergency. Proton radiation therapy centers are more frequently free-standing facilities at some distance from specialized pediatric care. This poses a potential dilemma in the case of children requiring anesthesia. Methods and Materials: The records of the Indiana University Health Proton Therapy Center were reviewed for patients requiring anesthesia during proton beam therapy (PBT) between June 1, 2008, and April 12, 2012. Results: A total of 138 children received daily anesthesia during this period. A median of 30 fractions (range, 1-49) was delivered over a median of 43 days (range, 1-74) for a total of 4045 sedation/anesthesia procedures. Three events (0.0074%) occurred, 1 fall from a gurney during anesthesia recovery and 2 aspiration events requiring emergency department evaluation. All 3 children did well. One aspiration patient needed admission to the hospital and mechanical ventilation support. The other patient returned the next day for treatment without issue. The patient who fell was not injured. No patient required cessation of therapy. Conclusions: This is the largest reported series of repetitive pediatric anesthesia in radiation therapy, and the only available data from the proton environment. Strict adherence to rigorous protocols and a well-trained team can safely deliver daily sedation/anesthesia in free-standing proton centers.

  17. 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

  18. Combining isoflurane anesthesia with midazolam and butorphanol in rats.

    Science.gov (United States)

    Tsukamoto, Atsushi; Uchida, Kaho; Maesato, Shizuka; Sato, Reiichiro; Kanai, Eiichi; Inomata, Tomo

    2016-07-29

    Representative inhalant anesthetic agent, isoflurane is commonly used during surgery in rats. However, isoflurane mediates relatively strong respiratory depression. In human and veterinary medicine, sedatives and analgesics are co-administered to complement the anesthetic action of inhalant anesthesia. The present study aimed to establish the novel balanced anesthesia that combines midazolam and butorphanol with isoflurane (MBI) in rats. Male Sprague Dawley rats were divided into 2 groups, and administered either isoflurane monoanesthesia or isoflurane with midazolam (2.5 mg/kg, ip) and butorphanol (2.0 mg/kg, ip). The minimum alveolar concentration (MAC) in each group was evaluated. Induction and recovery times were measured in each group. Adverse reactions during induction were also recorded. In each group, vital signs were assessed for 1 h under 1.5×MAC of isoflurane. Instability of vital signs was assessed under each anesthesia by calculating coefficient of variance. Compared with isoflurane monoanesthesia, MBI anesthesia caused 32% MAC reduction (isoflurane monoanesthesia: 1.30 ± 0.09%, MBI 0.87 ± 0.08%, PMBI anesthesia resulted in a relatively stable respiratory rate without decreases in SPO2 during the anesthetic period. In summary, MB premedication is effective for attenuating respiratory depression induced by isoflurane, and achieving smooth induction. This anesthetic protocol serves as a novel option for appropriate anesthesia in rats. PMID:26876437

  19. 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.)

  20. Seniors and Anesthesia

    Science.gov (United States)

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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Jasminka Nancheva

    2016-07-01

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

  3. Effect of Different Anesthesia Downlink Abdominal Aortic Aneurysm Treatment of Perioperative Period%不同麻醉方式下行腹主动脉瘤腔内治疗的围手术期效果

    Institute of Scientific and Technical Information of China (English)

    仇大海; 张珂

    2015-01-01

    Objective To explore the different ways of anesthesia downward abdominal aortic aneurysm cavity effect of perioperative cure. Methods In our hospital 270 cases of patients with AAA as the research object, 103 cases of local anesthesia, using epidural anesthesia (EDA) of 54 patients, 113 patients were given general anesthesia, to observe the effect of three groups of patients. Results LA group, the EDA group postoperative mortality, there is no statistical significance (P>0.05). Postoperative complication rates were higher than in EDA group and GA group LA group and GA group of pulmonary complications is higher than LA group (P<0.05). Conclusion EVAR technique using local anesthesia for patients with fast recovery, become the local anesthetic EVAR best way of anesthesia.%目的:探究不同麻醉方式下行腹主动脉瘤腔内治的围手术期效果。方法以我院收治的270例 AAA 患者为研究对象,103例给予局部麻醉,采用硬膜外麻醉患者(EDA)54例,113例患者给予全身麻醉,观察三组患者治疗效果。结果 LA 组、EDA 组术后死亡率并无统计学意义(P >0.05)。GA 组术后并发症发生率均高于 EDA 组及 LA 组, GA 组肺部并发症比 LA 组高(P <0.05)。结论 EVAR 术采用局部麻醉有利于患者快速恢复,局部麻醉成为 EVAR 最佳的麻醉方式。

  4. Growth and physiological response of tomato plants to different periods of nitrogen starvation and recovery

    NARCIS (Netherlands)

    Martinez, V.; Amor, del F.M.; Marcelis, L.F.M.

    2005-01-01

    Young, vegetative-state tomato plants, starved of N for 1, 3 or 7 d, followed, in each case, by a 7-d recovery period with nutrient solution containing N, were examined. Relative growth rate (RGR), leaf photosynthesis and leaf expansion were reduced after only 1 d of N starvation.Tissue N concentrat

  5. METHODS FOR CAECECTOMY OF MUSCOVY DUCKS REGARDING BALANCE EXPERIMENTS OF DIGESTIBILIY ESTABLISHING II. RECOVERY PERIOD

    Directory of Open Access Journals (Sweden)

    Dimo PENKOV

    2007-07-01

    Full Text Available Some indexes of the recovery period of Muscovy ducklings after caecectomy have been studied. It’ established, that the birds recover the water intake 9 hours, the excreting- 12-15 hours after and the feed consumption (by food offering 24 hours after operation – 72-90 hours after the operation.

  6. Application of comfortable nursing of outpatient tumescent anesthesia liposuction in peri-operative period%舒适护理在门诊肿胀麻醉吸脂术围手术期的应用

    Institute of Scientific and Technical Information of China (English)

    刘丽黎; 李茂玉

    2012-01-01

    目的 总结门诊肿胀麻醉吸脂术围手术期舒适护理方法及其对术后满意度的影响.方法 对观察组341例实施环境舒适、接诊及手术过程舒适、恢复期居家及复诊换药舒适等舒适护理措施,并于受术者完全恢复后进行满意度调查,与对照组352例未给予舒适护理的吸脂减肥患者的术后满意度调查结果进行比较.结果 观察组与对照组满意率差异有统计学意义(P<0.05).结论 舒适护理是提高门诊吸脂减肥美容手术患者满意度的重要措施.%Objective This paper summarized the comfortable nursing method of outpatient tumescent anesthesia in peri-operative period and the impact of satisfaction rate. Methods 341 cases as experiment group are given comfortable condition, comfortable consultation and surgical process as well as used comfortable nursing method in recovery period at home and further consultation and dressing change ect. And then thus survey the satisfaction when surgical patients fully recovered. 352 liposuction patients as control group who aren't given normal comfortable nursing. At last, comparison with the satisfaction rat of two groups. Results There exists significant difference between the control and experimental group (P<0. 05). Conclusion The comfortable nursing is the important measure which increases the satisfaction rate of outpatient patients of liposuction cosmetic surgery.

  7. Effects of Isoflurane Anesthesia on Post-Anesthetic Sleep-Wake Architectures in Rats

    OpenAIRE

    Jang, Hwan-Soo; Jung, Ji-Young; Jang, Kwang-Ho; Lee, Maan-Gee

    2010-01-01

    The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were trea...

  8. The Measurement of the Sensory Recovery Period in Zygoma and Blow-Out Fractures with Neurometer Current Perception Threshold

    Science.gov (United States)

    Oh, Daemyung; Yun, Taebin; Choi, Jaehoon; Jeong, Woonhyeok; Chu, Hojun; Lee, Soyoung

    2016-01-01

    Background Facial hypoesthesia is one of the most troublesome complaints in the management of facial bone fractures. However, there is a lack of literature on facial sensory recovery after facial trauma. The purpose of this study was to evaluate the facial sensory recovery period for facial bone fractures using Neurometer. Methods Sixty-three patients who underwent open reduction of zygomatic and blowout fractures between December 2013 and July 2015 were included in the study. The facial sensory status of the patients was repeatedly examined preoperatively and postoperatively by Neurometer current perception threshold (CPT) until the results were normalized. Results Among the 63 subjects, 30 patients had normal Neurometer results preoperatively and postoperatively. According to fracture types, 17 patients with blowout fracture had a median recovery period of 0.25 months. Twelve patients with zygomatic fracture had a median recovery period of 1.00 month. Four patients with both fracture types had a median recovery period of 0.625 months. The median recovery period of all 33 patients was 0.25 months. There was no statistically significant difference in the sensory recovery period between types and subgroups of zygomatic and blowout fractures. In addition, there was no statistically significant difference in the sensory recovery period according to Neurometer results and the patients' own subjective reports. Conclusions Neurometer CPT is effective for evaluating and comparing preoperative and postoperative facial sensory status and evaluating the sensory recovery period in facial bone fracture patients.

  9. AAHA anesthesia guidelines for dogs and cats.

    Science.gov (United States)

    Bednarski, Richard; Grimm, Kurt; Harvey, Ralph; Lukasik, Victoria M; Penn, W Sean; Sargent, Brett; Spelts, Kim

    2011-01-01

    Safe and effective anesthesia of dogs and cats rely on preanesthetic patient assessment and preparation. Patients should be premedicated with drugs that provide sedation and analgesia prior to anesthetic induction with drugs that allow endotracheal intubation. Maintenance is typically with a volatile anesthetic such as isoflurane or sevoflurane delivered via an endotracheal tube. In addition, local anesthetic nerve blocks; epidural administration of opioids; and constant rate infusions of lidocaine, ketamine, and opioids are useful to enhance analgesia. Cardiovascular, respiratory, and central nervous system functions are continuously monitored so that anesthetic depth can be modified as needed. Emergency drugs and equipment, as well as an action plan for their use, should be available throughout the perianesthetic period. Additionally, intravenous access and crystalloid or colloids are administered to maintain circulating blood volume. Someone trained in the detection of recovery abnormalities should monitor patients throughout recovery. Postoperatively attention is given to body temperature, level of sedation, and appropriate analgesia. PMID:22058343

  10. 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, ...

  11. 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.

  12. 降低手术患者麻醉诱导期低体温发生率%Reduction of the Incidence of Low Body Temperature during Anesthesia Induction Period in Surgical Patients

    Institute of Scientific and Technical Information of China (English)

    魏凯静; 于恩杰

    2012-01-01

    目的 降低手术患者麻醉诱导期低体温发生率.方法 QC小组活动.结果 手术患者麻醉诱导期低体温发生率由活动前的43%下降到活动后的3.8%.结论 降低手术患者麻醉诱导期低体温发生率,可降低患者术后并发症发生率,确保患者安全.%Objective To reduce the incidence of low body temperature during anesthesia induction period in surgical patients. Method QC group activities. Result The incidence of low body temperature during anesthesia induction period in surgical patients was reduced from 43% to 3. 8% after the activities. Conclusion Reduction of the incidence of low body temperature during anesthesia induction period in surgical patients can reduce the incidence of postoperative complications to ensure patient safety.

  13. Society for Ambulatory Anesthesia

    Science.gov (United States)

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

  14. 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

  15. Investigating the recovery period of rat brain tissue after electrolytic and 980-nm laser induced lesions

    Science.gov (United States)

    Bozkulak, Ozguncem; Tabakoglu, H. Ozgur; Aksoy, Ayla; Canbeyli, Resit; Bilgin, Nes'e.; Kurtkaya, Ozlem; Sav, Aydin; Gulsoy, Murat

    2003-10-01

    The effects of 980-nm diode laser and electrolytic lesions in Wistar rat brain tissue were observed by immunohistochemical staining for CD68 marker and Hematoxylin-Eosin (H&E). Bilateral lesions; laser lesions (2W/2sec) in the right hemispheres, and electrolytic lesions (1.5mA/20sec) in the left hemispheres were done through in vivo stereotaxic neurosurgical procedure. Subjects were classified into three groups due to the recovery period. Subjects in Group I, II, and III were sacrificed after 0, 2 and 7 days of recovery period respectively. After saline perfusion their brains were dislocated, and paraffin embedded sections were taken. One section for H&E and one for CD68 were cut consecutively in 3μm thickness by examining the lesion in every 30-μm thickness. CD68 was found more efficient marker than H&E in observing the after-effects of both types of lesions. The total damage of laser was smaller than that of electrosurgical unit. The shape of the ablated area in laser induced lesions was more spherical than that of electrosurgical unit. The number of macrophages increased as the recovery period increased for all subjects. Group III showed the highest number of macrophages in three, and the number of macrophages around electrolytic lesion is nearly 1.5 times higher than that of laser lesion. The remarkable ablating ability, the damage zone created and the healing of nearby tissue clearly showed that the 980-nm diode laser is an effective and useful alternative to electrosurgical unit in neurosurgery.

  16. Potato uptake and recovery of nitrogen-15-enriched ammonium nitrate from periodic applications

    International Nuclear Information System (INIS)

    There is a trend in potato (Solanum tuberosum L.) production to make repeated additions of N fertilizer in sprinkler irrigation water for an extended part of the season. More information is needed on scheduling (rate and timing) these N supplements. A 3-year study on the use of frequent supplements of 15NH4-15NO3 by 'Russet Burbank' potato was conducted on Quincy loamy sand (mixed, mesic Xeric Torripsamment). The purpose of the experiment was to trace changes in the uptake and partitioning of 15N in vines and tubers from starter and periodic additions totaling 336 kg N ha-1. Labeled N fertilizer was sprayed on a different set of replicated potato plots according to the application schedule. Plant tissue samples were taken and analyzed regularly for labeled N uptake. Whole potato plants over the season recovered a maximum of 61 to 67% of the 15N-enriched increments of fertilizer applied, as compared to a maximum of 42 to 54% partitioning of the labeled N in tubers at final harvest. Recovery of 15NO3 was significantly higher on the average than recovery for 15NH4. Furthermore, in many cases the average recovery was highest from labeled N applied tuber bulking early in July, which suggests that this is a crucial time for maintaining adequate N fertility

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

    International Nuclear Information System (INIS)

    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

  18. 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.

  19. Mathematical modeling of the soaking period in a microbial enhanced oil recovery application

    Energy Technology Data Exchange (ETDEWEB)

    Behlulgil, K. [Middle East Technical University, Ankara (Turkey). Petroleum and Natural Gas Engineering Dept.; Durgut, I. [Norwegian University of Science and Technology, Trondheim (Norway). Petroleum Engineering and Applied Geophysics Dept.

    2003-09-01

    In this study, experimental conditions of the microbial enhanced oil recovery (MEOR) technique applied for Garzan oil (26{sup o} API; southeast Turkey) were utilized in a mathematical model that describes the transport of bacteria and its nutrients by convective and dispersive forces, including bacterial decay and growth. From the results of the variation of bacterial concentration with distance, it was observed that the bacterial concentration increased as the nutrients were consumed with time. Although some bacteria died during the experiments, this did not slow down the overall increase in bacterial population significantly at earlier times. However, in the later periods of the soaking process, severe bacterial decay occurred due to the lack of nutrients. The pressure behavior in the model during the shut-in period was also calculated and agreed well with the experimental results. (author)

  20. 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.

  1. 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

  2. Cardiac rehabilitation: impact of graded exercise in the recovery period following myocardial infarction

    Directory of Open Access Journals (Sweden)

    White S

    2013-07-01

    Full Text Available Simon WhiteSchool of Pharmacy, Keele University, Staffordshire, UKAbstract: This paper reviews the impact of graded exercise undertaken as part of a cardiac rehabilitation (CR program in the recovery period following a myocardial infarction, focusing on how CR may be best provided and the evidence-base relating to exercise-based CR. Essential components of CR are considered here to include education about healthy behavior, lifestyle modification where necessary (especially in relation to smoking, diet, and physical exercise, medical risk factor management, use of cardioprotective medicines and implantable devices, and psychosocial health management. It is argued that the totality of the evidence continues to demonstrate benefits of exercise-based CR in terms of mortality and morbidity, despite the debate about the magnitude of that benefit. However, given the wide variance in the quality and nature of CR service provision, there is no guarantee that patients eligible for CR will benefit fully. In line with national and international standards, CR should be tailored to the patient's individual needs, but structured exercise is recommended for most patients. Exercise sessions, whether based in hospital, in the community, or at home, should be designed to vary the frequency, intensity, duration, and type of exercise. They must include an initial warm-up period, before a conditioning period, and finish with a cool-down period. Patients should be taught to self-monitor so that they can exercise safely on their own. In designing interventions to support patients to change health behavior, health professionals should recognize that patients may only make lifestyle modifications to aspects of lifestyle perceived as causes of their cardiovascular disease and so, for example, may not do the recommended amount of exercise if they do not perceive lack of exercise to be a cause of their cardiovascular disease.Keywords: cardiovascular disease, public health

  3. Dopamine uptake dynamics are preserved under isoflurane anesthesia.

    Science.gov (United States)

    Brodnik, Zachary D; España, Rodrigo A

    2015-10-01

    Fast scan cyclic voltammetry is commonly used for measuring the kinetics of dopamine release and uptake. For experiments using an anesthetized preparation, urethane is preferentially used because it does not alter dopamine uptake kinetics compared to freely moving animals. Unfortunately, urethane is highly toxic, can induce premature death during experiments, and cannot be used for recovery surgeries. Isoflurane is an alternative anesthetic that is less toxic than urethane, produces a stable level of anesthesia over extended periods, and is often used for recovery surgeries. Despite these benefits, the effects of isoflurane on dopamine release and uptake have not been directly characterized. In the present studies, we assessed the utility of isoflurane for voltammetry experiments by testing dopamine signaling parameters under baseline conditions, after treatment with the dopamine uptake inhibitor cocaine, and after exposure to increasing concentrations of isoflurane. Our results indicate that surgical levels of isoflurane do not significantly alter terminal mechanisms of dopamine release and uptake over prolonged periods of time. Consequently, we propose that isoflurane is an acceptable anesthetic for voltammetry experiments, which in turn permits the design of studies in which dopamine signaling is examined under anesthesia prior to recovery and subsequent experimentation in the same animals. PMID:26321152

  4. 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.

  5. 保温护理对全身麻醉患者术中应激及术后复苏的影响%Efficacy of Insulation Nursing on Intraoperative Stress and Postoperative Recovery in Patients Anesthesia

    Institute of Scientific and Technical Information of China (English)

    薛晶

    2015-01-01

    Objective To study the thermal treatments applied to analyze the impact of general anesthesia in patients after their surgery stress and recovery. Methods From March 2013 to March 2015 in our hospital,86 patients under general anesthesia,were randomly divided into two groups,each of 43 cases. The control group using traditional care,observation group insulation care,clinical care contrast were compared. Results The postoperative epinephrine,norepinephrine,and C-reactive protein and other indicators were significantly lower than the control group,the difference was statistical y significant(P<0.05),observation group intubation time,ful y awake and PACU retention time was significantly shorter than the control group,the difference was statistical y significant(P<0.05). Conclusion The effect of heat treatment applied to general anesthesia significantly reduce patients' stress response can effectively shorten the postoperative recovery time.%目的:研究分析保温护理应用于全身麻醉患者对其术中应激和术后复苏的影响。方法选择2013年3月~2015年3月我院收治的全身麻醉患者86例,随机分为两组,各43例。对照组采用传统护理,观察组采用保温护理,对比临床护理效果。结果观察组术后肾上腺素、去甲肾上腺素和C反应蛋白等指标均低于对照组,差异有统计学意义(P<0.05);观察组气管插管时间、完全清醒时间和PACU滞留时间均短于对照组,差异有统计学意义(P<0.05)。结论保温护理应用于全身麻醉患者效果显著,能够有效降低患者应激反应,缩短患者术后复苏时间。

  6. 地佐辛预防瑞芬太尼复合七氟醚麻醉后恢复期躁动的临床效果观察%Clinical Effect of Prevention of Dezocine on Recovery Agitation after Rui Fentanyl Combined with Sevoflurane Anesthesia

    Institute of Scientific and Technical Information of China (English)

    何志恩; 张理宾; 郑映纯

    2015-01-01

    目的:探讨地佐辛对瑞芬太尼复合七氟醚麻术后躁动的效果。方法选择本院采用瑞芬太尼复合七氟醚麻醉术的患者124例,分为对照组(30例),地佐辛组(33例),芬太尼组(32例)和曲马多组(29例)。观察恢复期的躁动情况并进行量化评分;记录苏醒和拔管的时间;测量拔管即刻(T0),拔管后半 h(T1/2),1 h(T1)时的疼痛视觉模拟评分(VAS)和镇静评分(Ramsay)。结果4组患者苏醒时间和拔管时间无统计学意义。处理组躁动发生及评分均较低,持续的时间较短( P<0.05),地佐辛,芬太尼和曲马多组的疼痛评分和镇静评分与对照组相比均有统计学意义(P<0.05),而地高辛的疼痛改善作用较曲马多明显,镇静作用较芬太尼效果好(P<0.05)。结论地佐辛能够有效的预防瑞芬太尼复合七氟醚麻醉后恢复期躁动的发生。%Objective To study effect Dezocine on Recovery Agitation after rui fentanyl combined with sevoflurane anesthesia.Methods 126 cases were collected with rui fentanyl combined with sevoflurane anesthesia, who were divided into control group, dezocine,fentanyl group. Agitation during the recovery period were observe and a quantitative scores were performed; the items about recovery time and extubation time were noted, pain visual analogue scale (VAS) and sedation scores (Ramsay) were performed at half an hour after extubation (T1 / 2 ), 1 hour (T1 ) . Results Recovery time and extubation time were not significant difference statis-tically. Agitation and scores for treated groups are low, short duration (P<0. 05) compared to control group, the effect of dezocine was more obvious than rui fentanyland tramadol. Pain score and sedation scores of treated group showed significant statistical difference compared with control group (P<0. 05), effect of dezocine on pain was better than tramadol and calming effect was more excellent than fentanyl (P<0. 05). Conclusion Dezocine could improve recovery rgitation

  7. 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.

  8. 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.

  9. 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...

  10. 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.

  11. Influence of kinesitherapy on motor recovery and functional independence in patients with ischemic stroke in the chronic period

    OpenAIRE

    Vasileva, Dance; Lubenova, Daniela; Mihova, Marija; Grigorova-Petrova, Kristin; Dimitrova, Antoaneta

    2015-01-01

    The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on motor recovery and functional independence in patients with ischemic stroke in the chronic period (ISChP). Material and Methods The study was conducted with 56 patients with ISChP (32 men and 24 women, mean age 63.2 ± 8.8 years old, weight 77.9 ± 10.1 kg, height 169.2 ± 6.4 centimeters and duration of illness up to 1 year). Assessment of motor recovery and the level of functional independence...

  12. 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

  13. Unconventional gas recovery program. Semi-annual report for the period ending March 31, 1979

    Energy Technology Data Exchange (ETDEWEB)

    Wise, R.L. (ed.)

    1979-08-01

    This document is the second 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 Sand Project, and Geopressured Aquifers Project. This report is divided into five parts: a summary (Section 1), and a section devoted to each resource (Sections 2 through 5). Each resource section presents information which serves as an introduction to that project.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

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

  16. Spectroscopic characterization of bone tissue of experimental animals after glucocorticoid treatment and recovery period

    Science.gov (United States)

    Mitić, Žarko J.; Najman, Stevo J.; Cakić, Milorad D.; Ajduković, Zorica R.; Ignjatović, Nenad L.; Nikolić, Ružica S.; Nikolić, Goran M.; Stojanović, Sanja T.; Vukelić, Marija Đ.; Trajanović, Miroslav D.

    2014-09-01

    The influence of glucocorticoids on the composition and mineral/organic content of the mandible in tested animals after recovery and healing phase was investigated in this work. The results of FTIR analysis demonstrated that bone tissue composition was changed after glucocorticoid treatment. The increase of calcium, magnesium, phosphorus content and mineral part of bones was statistically significant in recovery phase and in treatment phase that included calcitonin and thymus extract. Some changes also happened in the organic part of the matrix, as indicated by intensity changes for already present IR bands and the appearance of new IR bands in the region 3500-1300 cm-1.

  17. 640-Gbit/s data transmission and clock recovery using an ultrafast periodically poled lithium niobate device

    DEFF Research Database (Denmark)

    Oxenløwe, Leif Katsuo; Gomez-Agis, F.; Ware, C.;

    2009-01-01

    This paper presents the first demonstration of the use of a periodically poled lithium niobate device for signal processing at 640 Gbit/s. Clock recovery is performed successfully using the lithium niobate device, and the clock signal is used to control fiber-based demultiplexer. The full 640-Gbi....../s system gives error-free performance with no pattern dependence and there is less than 1-dB power penalty after 50-km fiber transmission....

  18. 家长陪同在小儿麻醉诱导期中的应用%Application of parents' presence induction program in pediatric anesthesia induction period

    Institute of Scientific and Technical Information of China (English)

    赵晶; 刘敏敏

    2013-01-01

    Objective To study the effect of parents' presence induction program (PPIP) on the children' induction of anesthesia.Methods Retrospectively analyzed the clinical data of 178 patients who accepted the operation from 2011-2012 in Zaozhuang Mining Group Central Hospital.That 89 patients who were accompanied by their parents when they accepted the anesthesia induction under the instruction of the nurses as the experimental group,and 89 patients whose parents were not present,who were leaded into the operation room directly by the nurses as the control group.Blood pressure and pulse changes before and after the anesthesia induction of these children's patients were observed.The feeling of their heads of family before the operation and the satisfaction about PPIP were investigated.Results In experimental group,80.9% of the patients were quiet and cooperative,13.5% were disturbed,yet can cooperate,5.6% impatient and crying,while the distribution of the above indicators of the control group was 52.8%,36.1% and 18.1%.The difference of emotional condition of the two groups was statistically significant (x2 =16.010,P <0.05).Before the induction,34.8% of the patients of experimental group blood pressure increased more than 20% compared to baseline values and 43.8% of the patients' pulse increased more than 20% compared to baseline values,while the distribution of the above indicators of the control group was 58.4% and 68.5%.The difference of BP and pulse of the two groups was statistically significant (x2 =9.955,11.045,respectively; P < 0.05).Emotional responses and satisfaction of preoperative care of the parents of the experimental group was significantly better than that of the control group (P < 0.05).Conclusions PIPP can effectively alleviate the anxiety of in children and their families,which has a positive effect on the process of the operation.%目的 探讨小儿麻醉诱导期优质护理服务中增加家长陪同的效果.方法

  19. 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.

  20. 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....

  1. The effect of hypernatremic state on anesthesia: male Wistar rat

    Directory of Open Access Journals (Sweden)

    Heydarpour F, Rostami A, Alipour M, Amini B, Heydarpour P

    2008-07-01

    Full Text Available "nBackground: The function of internal systems can be influenced significantly by hypernatremia, even anesthesia may be affected by this electrolyte imbalance. The aim of this study was to determine the effects of a single anesthetic dose of ketamine in an experimental rat model of chronic hypernatremia. "n"nMethods: Sixty male Wistar rats, weighing 300(±20g, were allocated randomly to three groups: the control group received drinking water and test groups 1 and 2 received 1% and 2% NaCl, respectively, for 144 hours. We measured the parameters of sensitivity to the ketamine injection (125mg/kg including length of times to the inhibition of the righting reflex, inhibition of the response to painful stimulus and the times to the reappearance of the response to painful stimulus and recovery from anesthesia. We also determined the mortality rates during anesthesia. "n"nResults: The times for inhibition of the righting reflex and response to painful stimulus for group 2 were significantly shorter than those for group 1 and the control group. The times for the reappearance of response to painful stimulus and full recovery from anesthesia in group 2 were significantly longer than those of group 1 and the control group. "n"nConclusions: Hypernatremia affects ketamine anesthesia in the rat, increasing the speed of passing through the different steps of anesthesia. The duration of ketamine efficacy increases, while recovery from anesthesia is significantly delayed.

  2. 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

  3. Utilization of organic chromium from tannery waste on reducing transportation stress and shortening recovery period at beef cattle

    Directory of Open Access Journals (Sweden)

    U Santosa

    2012-06-01

    Full Text Available Transportation increases stress that subtantially decreases body weight and feed comsumption even weight gain loss after arriving at the location of fattening. A research has been conducted to study the effects of organic chromium from tannery wastes on the level of transportation stress and recovery period in beef cattle fattening. Twenty Ongole crossbreed cattles were transported from the Wirasaba Feedlot at Purbalingga in Central Java to the Agro Citra Buana Semesta Feedlot in Malangbong-Garut in West Java for about 18 hours. Completely Randomized Design (CRD was applied, wih four repetitions. The Cr-organic was given seven days before and after transportation. Dose of Cr-organic used was: R0 = control diet without Cr-organic, R1 = R0 + 1.5 ppm, R2 = R0 + 3.0 ppm, R3 = R0 + 4.5 ppm, R4 = R0 + 6.0 ppm. Results showed that 3.0 ppm organic chromium of the dry matter of ration tended to affect physiology and haematological conditions, as well as decreased weight loss, shortened recovery time, improved weight gain. It is concluded that organic chromium supplementation was able to lowered stress levels, shortened recovery time, and increased daily gain for one week recovery process, especially at dose of 3.0 ppm.

  4. [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.

  5. 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

  6. Semi-annual report for the unconventional gas recovery program, period ending September 30, 1980

    Energy Technology Data Exchange (ETDEWEB)

    Manilla, R.D. (ed.)

    1980-11-01

    Progress is reported in research on methane recovery from coalbeds, eastern gas shales, western gas sands, and geopressured aquifers. In the methane from coalbeds project, data on information evaluation and management, resource and site assessment and characterization, model development, instrumentation, basic research, and production technology development are reported. In the methane from eastern gas shales project, data on resource characterization and inventory, extraction technology, and technology testing and verification are presented. In the western gas sands project, data on resource assessments, field tests and demonstrations and project management are reported. In the methane from geopressured aquifers project, data on resource assessment, supporting research, field tests and demonstrations, and technology transfer are reported.

  7. [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.

  8. 组长轮转制在麻醉复苏区护士培养中的作用%Effects of alternated group leading on nurse training in an anesthesia recovery section

    Institute of Scientific and Technical Information of China (English)

    孙晓燕; 黄海霞; 朱四海

    2012-01-01

    Objective The aim of this study is to explore the effects of alternated group leading on nurse training in an anesthesia recovery section. Methods There were seven nurses joined the training program. For each month, two of them held the post of group leader as a pair in an alternating pattern. The group leader of morning-shift (A) was in charge of department environment and quality examination as well as other general affairs. The group leader of afternoon-shift (P) was in charge of the preparation and performance for all hospital and nursing department inspections, as well as the quality supervision of night-shift. Results During the 14-month post-rotation of group leader, seven nurses raised 16 pieces of advice, among which 15 were adopted. Department total ranking of all inspections raised from the 37th in 2009 to the 16th in 2010. The percentage of nurse talents increased from 40% to 100%. Conclusion The nurses' sense of administration, responsibility, competition and predictive thinking, as well as the nursing quality of anesthesia recovery section, can be increased by the application of post-alternating regimen.%目的 传统管理模式下护理组长长期固定,缺乏竞争.文中探讨护士轮流担任组长在麻醉监护护士培养中的作用. 方法 2人配对担任组长,每月轮换1次.A班组长负责科室环节质量检查及其他事务的沟通协调,P班组长负责全院、护理部各项检查的准备与落实及护士夜班工作质量的督查. 结果 7名护士在1年轮流担任组长中提出改进工作建议16条,被采纳15条;全院各项检查总排名从2009年的37名提升到2010年的16名;护士学组骨干所占比例从原来的40%提高到100%. 结论 护士轮流担任麻醉监护室组长制度培养了护士的管理意识、责任意识和竞争意识,提高了护士的预见性思维、语言表达和管理能力,大大提升了麻醉监护护理质量.

  9. 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......: The majority of the patients experienced leg oedema (90.7%). Secondary to this were pain (81.4%), sleeping disorders (47.7%) problems with appetite (38.4%) and bowel function (34.9%) were the most frequently identified physical health problems. In total, 69.8% of the patients indicated that they did...... not exercise or only partly exercise as recommended, but without associated experience of pain. CONCLUSION: Patients experienced a wide range of physical health problems following total knee replacement and deviation from recommended self-training was identified. These findings are valuable for health...

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

    Institute of Scientific and Technical Information of China (English)

    聂玲; 魏宏; 刘萍; 罗晓敏; 吕倩茹

    2014-01-01

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

  11. Periodization

    OpenAIRE

    Lorenz, Daniel S.; Reiman, Michael P.; Walker, John C.

    2010-01-01

    Background: Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progression—that is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation litera...

  12. 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.

  13. [Rocuronium anesthesia induced anaphylactic shock: a case report].

    Science.gov (United States)

    Qiu, Min; Zong, Ya-nan; Lu, Jian; Ma, Lu-lin; Zheng, Qing; Guo, Xiang-yang

    2015-10-18

    Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen, and it could be an unpredictable and life-threatening cause during anesthesia. The main purpose of this paper is to report a case of anaphylactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period. A 63-year-old man, with a mass on his adrenal, was scheduled to a laparoscopic adrenal tumor excision. During the anesthesia induction period, after administrated sulfentanil, propofol and rocuronium, the blood pressure was decreased and the heart rate was increased. Then, the patient had rash on his whole body and developed an anaphylactic shock. After being treated with the anti-allergic agents and norepinephrine, the rash disappeared and the vital sign become stable. The patient felt nothing uncomfortable during the two weeks'follow-up. Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period. The most common inducements are muscle relaxant, latex and antibiotics. Anaphylactic reactions in the perioperative period are often serious and potentially life-threatening conditions, involving multiple organ systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils. Before anesthesia, we should acquire the allergic history. During the anesthesia period, the vital sign and the skin should be observed carefully. PMID:26474637

  14. 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.

  15. 盐酸多沙普仑对右旋美托咪定全麻恢复期催醒效果临床观察%Clinical Observation of Wakening Effect of Doxapram in Recovery Stage under General Anesthesia with Dexmedetomidine

    Institute of Scientific and Technical Information of China (English)

    周爱国

    2011-01-01

    [Objective]To observe the wakening effect and adverse reaction of doxapram(DOX) in patients at peri anesthetic stage under general anesthesia with dexmedetomidine(DEX). [Methods] Forty adult patients undergoing bone surgery under general anesthesia were randomly divided into two groups with 20 cases in each. Group △ was given DEX and DOX. Group B was given DEX and normal saline. After 5min induction,both groups were given DOX lμg/kg with loading dose, and then were maintained by pump administration of 0.6~0. 8μg/(kg o min), and drugs were stopped at 10 min before surgery. At the moment of extubation,group A was given DOX lmng/kg, and group B was given isovolumic normal saline. Systolic blood pressure (SBP), diastolic blood pressure(DBP) and heart rate(HR) at 5min before induction(To), 5min after intuba tion(T1 ), drug withdrawal(T2), intubation(T3) and 5min after intubation(T4) were observed in two groups.Riker sedation agitation scale(SAS) and adverse reactions during peri anesthesia before operation(T0), intuba tion(T1) and 10min after intubation(T2) were also observed. [Results]The demography data in two groups had comparability( P >0.05). There was no significance in SBP, DBP and HR at every point between two groups( P >0.05). The SAS score at T2 in group A was higher than that in group B, and there was signifi cant difference between two groups( P <0.05). There was no significant difference in the incidence of extuba tion reaction score, nausea and vomiting, shivering and intraoperative awareness between two groups( P >0.05). [Conclusion] DEX used in the maintenance of anesthesia can provide stable hemodynamics, good sedation and more stable during recovering period of general anesthesia. DOX for the consciousness recovery after anes thesia with DEX is effective, and has little changes of hemodynamics and low incidence of adverse reactions.%[目的]观察盐酸多沙普仑用于右旋美托咪定全麻患者围麻醉期的催醒效果及不良

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

    Institute of Scientific and Technical Information of China (English)

    陈改平; 杨郁文; 汪永坚; 韩淼

    2014-01-01

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

  17. 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.

  18. PNEUMOTHORAX AFTER MODIFIED RADICAL MASTECTOMY UNDER GENERAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Amminikutty

    2014-11-01

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

  19. Effects of dexmedetomidine on patients with anesthesia hypertension about stress reaction between the extubation period%右美托咪定对高血压全麻患者围拔管期应激反应的影响

    Institute of Scientific and Technical Information of China (English)

    章玲宾; 樊理华; 卢向红; 楼天正; 何仁洪; 陈琴; 游敏吉; 丁友法

    2011-01-01

    目的:观察右美托咪定(dexmedetomidine,Dex)对高血压全麻患者围拔管期应激反应的影响.方法:选择既往有高血压病史,血压控制稳定,择期行胃癌根治手术的患者60例.随机分成右美托咪定0.5 μg/kg组(D1组)、右美托咪定1 μg/kg组(D2组)和生理盐水对照组(C组),每组20例.均采用静吸复合全麻,手术结束前60 min分别静脉微泵注射右美托咪定0.5 μg/kg、1μg/kg、生理盐水20 mL,输注时间30 min.于麻醉前、拔管前、拔管后1、3、5、10 min记录血流动力学参数,测定血浆肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(COR)、血糖(GLU)、血乳酸(LAC)浓度,并记录手术麻醉时间、唤醒时间、拔管时间.结果:三组患者围拔管期间平均动脉压(MAP)、心率(HR)数值和血浆E、NE、COR、GLU、LAC浓度均比麻醉前明显增高(P<0.01或P<0.05);与D1组、D2组比较,C组的MAP、HR、E、NE、COR、GLU、LAC明显增高(P<0.01或P<0.05);D2组的唤醒时间、拔管时间明显长于C组和D1组(P<0.05).结论:右美托咪定能明显抑制气管拔管期引起的应激反应,以0.5μtg/kg更为合适.%AIM: To observe the effect of dexmedetomidine on patients with anesthesia hypertension about stress reaction between the ex-tubation period. METHODS: 60 patients with previous history of hypertension, stable blood pressure control, gastric cancer surgery were enrolled in the research. The patients were randomly divided into dexmedetomidine 0. 5 fig/kg group (group D1 ), dexmedetomidine 1 μg/kg group (group D2 ) and saline control group (group C), n = 20. All the patients were used inhalation anesthesia. Dexmedetomidine 0.5 μg/kg,l μg/kg, and normal saline 20 mL were given with micro-pumps intravenous inject at 60 min before the end of surgery, the infusion time was 30 min. Before anesthesia, before extuba-tion, after extubation 1,3,5,10 min ,the hemo-dynamic parameters were recorded, the levels of plasma epinephrine (E

  20. [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.

  1. 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…

  2. 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.

  3. 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

  4. Subjective and objective observation of skin graft recovery on Indonesian local cat with different periods of transplantation time

    Directory of Open Access Journals (Sweden)

    Erwin

    2016-05-01

    Full Text Available Aim: The success of a skin graft in a cat is highly dependent on the granulation formed by the base of recipient bed. Granulation by the base of recipient bed will form after several days after injury. This research aimed to observe subjective and objective profile of skin graft recovery on forelimb of cats with different periods of donor skin placement. Materials and Methods: Nine male Indonesian local cats aged 1-2 years old, weighing 3-4 kg were divided into three groups. The first surgery for creating defect wound of 2 cm×2 cm in size was performed in the whole group. The wound was left for several days with the respective interval for each group, respectively: Group I (for 2 days, Group II (for 4 days, and Group III (for 6 days. In the whole group, the second surgery was done by the harvesting skin of thoracic area which then applied on recipient bed of respective groups. Result: The donor skin on Group II was accepted faster compared to Group I and Group III. The donor skin did not show color differences compared to surrounding skin, painless, bright red in bleeding test had faster both hair growth and drug absorption. Test toward the size of donor skin and the effect of drugs did not show a significant difference between each group. Conclusion: The observe subjective and objective profile of skin graft recovery on forelimb of cats on Group II were accepted faster compared to Group I and III.

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

    Institute of Scientific and Technical Information of China (English)

    许娜

    2011-01-01

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

  6. 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.

  7. Anesthesia and cor triatriatum

    OpenAIRE

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

    2014-01-01

    Aims and Objectives: Cor triatriatum sinistrum (CTS) and cor triatriatum dextrum (CTD) are rare congenital anomalies characterized by the presence of a perforated septum which divides the respective atrium into a proximal and distal chamber. This report reviews the perioperative course of patients with uncorrected cor triatriatum (CT) undergoing procedures requiring anesthesia. In addition, we performed a literature search that examines the experience of others regarding the peri-operative co...

  8. 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.

  9. 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...

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

    Institute of Scientific and Technical Information of China (English)

    慕玲霞; 刘斐; 孙鹏

    2014-01-01

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

  11. 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

  12. Administration of Anesthesia in a Patient with Allgrove Syndrome

    Directory of Open Access Journals (Sweden)

    Ayse B. Ozer

    2012-01-01

    Full Text Available The aim of the present paper is to report the anesthesia administration to a patient who was planned to undergo Heller myotomy for achalasia. There wasnot property in the patient whom allgrove syndrome was excepted any steroid treatment in preoperative period. The night before the operation 18 mg of prednisolone was administered intravenously. Induction of anesthesia was performed with thiopental sodium, vecuronium and fentanyl and the patient received endotracheal intubation. Eyes were taped closed and protected with ointment during surgery. Maintenance of anesthesia was achieved with 2% sevoflurane concentration in 50% O2-50% N2O. 25 mg of prednisolone was infused preoperatively, and intervention with insulin treatment was initiated when blood glucose level rose to 18 mmol/L at 2 hours. Safe anesthesia can be achieved by observing the preoperative development of tracheal aspiration, adrenal insufficiency and, autonomic dysfunction carefully and maintaining eye protection.

  13. [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.

  14. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I

    2007-01-01

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

  15. Anesthesia 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.

  16. 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.

  17. A comparison of different synchronization measures in electroencephalogram during propofol anesthesia.

    Science.gov (United States)

    Liang, Zhenhu; Ren, Ye; Yan, Jiaqing; Li, Duan; Voss, Logan J; Sleigh, Jamie W; Li, Xiaoli

    2016-08-01

    Electroencephalogram (EEG) synchronization is becoming an essential tool to describe neurophysiological mechanisms of communication between brain regions under general anesthesia. Different synchronization measures have their own properties to reflect the changes of EEG activities during different anesthetic states. However, the performance characteristics and the relations of different synchronization measures in evaluating synchronization changes during propofol-induced anesthesia are not fully elucidated. Two-channel EEG data from seven volunteers who had undergone a brief standardized propofol anesthesia were then adopted to calculate eight synchronization indexes. We computed the prediction probability (P K ) of synchronization indexes with Bispectral Index (BIS) and propofol effect-site concentration (C eff ) to quantify the ability of the indexes to predict BIS and C eff . Also, box plots and coefficient of variation were used to reflect the different synchronization changes and their robustness to noise in awake, unconscious and recovery states, and the Pearson correlation coefficient (R) was used for assessing the relationship among synchronization measures, BIS and C eff . Permutation cross mutual information (PCMI) and determinism (DET) could predict BIS and follow C eff better than nonlinear interdependence (NI), mutual information based on kernel estimation (KerMI) and cross correlation. Wavelet transform coherence (WTC) in α and β frequency bands followed BIS and C eff better than that in other frequency bands. There was a significant decrease in unconscious state and a significant increase in recovery state for PCMI and NI, while the trends were opposite for KerMI, DET and WTC. Phase synchronization based on phase locking value (PSPLV) in δ, θ, α and γ1 frequency bands dropped significantly in unconscious state, whereas it had no significant synchronization in recovery state. Moreover, PCMI, NI, DET correlated closely with each other and they

  18. Anesthesia and cor triatriatum

    Directory of Open Access Journals (Sweden)

    Federica Scavonetto

    2014-01-01

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

  19. Clinical strategies to accelerate recovery after surgery orthopedic femur in elderly patients

    OpenAIRE

    Imbelloni, Luiz Eduardo; Gomes, Danielly; Braga, Rafaela Lopes; de Morais Filho, Geraldo Borges; da Silva, Alberto

    2014-01-01

    Background: The prevalence of hip fracture is increasing with the continued aging of the population. The aim of this study was to compare the results after implementing the project accelerated post-operative recovery after surgery femur in patients aged over 60 years. Methods: Patients were observed during two distinct periods: Before implantation and after the implementation of the project Acerto. Patients underwent spinal anesthesia with post-operative analgesia by lumbar plexus block. Data...

  20. In elderly patients with hepatic resection after recovery from anesthesia-related factors affecting restlessness%中老年患者行肝叶切除后麻醉恢复期躁动的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    邹磊; 李晓理

    2014-01-01

    Objective:Analysis of elderly patients with hepatic resection after recovery from anesthesia-re-lated factors that influence restlessness .Methods :March 2010 to March 2011 186 patients undergoing elective surger-y performed hepatectomy patients were retrospectively analyzed clinical data ;according to Riker sedation-patients were divided into restless agitation level group of 40 patients and calm cooperation group of 146 cases were observed in patients with restless recovering from two factors .Results :The effects of middle-aged patients with hepatic resec-tion after recovery from anesthesia restlessness main factors have nine ;postoperative platelet not statistically signifi-cant (P>0 .05);Other factors were statistically significant (P<0 .05) .Conclusion:The cause elderly patients re-covering from anesthesia after hepatectomy include restlessness vein blood carbon dioxide partial pressure ,preopera-tive platelet preoperative aspartate aminotransferase ,total bilirubin preoperative and postoperative platelet ,aspartate aminotransferase surgery ,postoperative albumin ,postoperative pain ,postoperative alanine aminotransferase ,which is a protective factor for postoperative analgesia ,can prevent restlessness .%目的:探讨中老年患者行肝叶切除后麻醉恢复期躁动的影响因素。方法:回顾性分析186例择期肝叶切除术患者的临床资料,按照Riker镇静-躁动等级将患者分成躁动组40例和平静合作组146例,观察两组患者恢复期的躁动影响因素。结果:影响中老年患者行肝叶切除后麻醉恢复期躁动的主要因素有9个;术后血小板无统计学意义(P>0.05);其他影响因素均有统计学意义(P<0.05)。结论:引起中老年患者行肝叶切除后麻醉恢复期躁动包括动脉血二氧化碳分压、术前血小板、术前谷草转氨酶、术前总胆红素、术后血小板、术后谷草转氨酶、术后白蛋白、术后镇痛、术后谷丙转氨

  1. 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

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

    Science.gov (United States)

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

    2014-01-01

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

  3. 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

  4. 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

  5. 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...

  6. 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. PMID:26842666

  7. 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. PMID:27310976

  8. Optimal effect-site concentration of remifentanil for preventing cough during removal of the double-lumen endotracheal tube from sevoflurane-remifentanil anesthesia

    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

    2016-01-01

    Abstract 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. PMID:27310976

  9. 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

  10. The psychological support therapy for children with eye anesthesia awakening period of agitation effect observation%心理支持疗法用于眼科患儿全麻苏醒期躁动的效果观察

    Institute of Scientific and Technical Information of China (English)

    张杨; 任长和; 程燕; 梁静; 杨晓莹

    2014-01-01

    Objective:On the psychological support therapy in patients of Department of Ophthalmology anesthesia ef ect of nursing.Methods:Select the Department of Ophthalmology anesthesia in 130 patients as the research object,it wil be divided into intervention group and control group,routine nursing measures to patients,and on this basis,the observation group patients with psychological support therapy.Result:The control group was significantly less than that of nursing care of postoperative agitation in front,the intervention group were lower than those before agitation after nursing care,significant dif erence,there was statistical y significant (P<0.05);nursing intervention group after the agitation score lower than that of the control group after the treatment,significant dif erence,there was statisti-cal y significant (P<0.05).Conclusion:The Department of Ophthalmology anesthesia were treated by ef ective psychological support,can ef ectively al eviate the agitation,anxiety,improve the ef ects of treatment of the disease.%目的::对心理支持疗法在眼科患儿全麻苏醒期躁动护理中的效果进行探讨.方法:选取眼科全麻苏醒期躁动患者130例作为研究对象,将其分成干预组与对照组,对照组患者实行常规护理对策,而在此基础之上,对观察组患者采取心理支持疗法.结果:对照组护理后躁动评分明显低于护理前,干预组护理后躁动评分低于护理前,差异显著,有统计学意义(P<0.05);干预组护理后躁动评分低于对照组护理后,差异显著,有统计学意义(P<0.05).结论:对眼科全麻苏醒期躁动患儿予以有效的心理支持,能够有效缓解其躁动、焦虑等心理,提升疾病治疗的效果.

  11. 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.

  12. 右美托咪定对全麻腹腔镜手术术后CO2蓄积患者复苏阶段的影响%Effects of Dexmedetomidine to Anesthesia Laparoscopic Surgery on Postoperative Recovery Phase CO2 Accumulation Patients

    Institute of Scientific and Technical Information of China (English)

    邓方方; 吴昱

    2014-01-01

    观察右美托咪定对全麻腹腔镜手术术后CO2蓄积患者复苏阶段的影响。方法择期全麻行腹腔镜手术的患者,术毕前约40min测动脉血气,选取其中PaCO270~90mmHg ,pH0.05)。结论腹腔镜手术中,在CO2蓄积致高碳酸血症患者的麻醉复苏阶段,右美托咪定的作用是安全有效的。%Objective To observe the effects of dexmedetomidine to anesthesia laparoscopic sur⁃gery on postoperative recovery phase CO2 accumulation in patients. Methods Chose patients un⁃dergoing laparoscopic operation. Before the end of operation about 40 min measured arterial blood gas. Selecting 40 cases of patients with PaCO2 70-90mmHg and pH 0. 05). Conclu⁃sion Laparoscopic surgery,CO2 accumulation in patients with hypercapnia recovery phase of anes⁃thesia,given dexmedetomidine is safe and effective.

  13. 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.

  14. 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....

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

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

    邵兆军; 王迎虎; 何伟

    2011-01-01

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

  18. 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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    Divya Chander

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

  2. Using generalized linear models to estimate selectivity from short-term recoveries of tagged red drum Sciaenops ocellatus: Effects of gear, fate, and regulation period

    Science.gov (United States)

    Bacheler, N.M.; Hightower, J.E.; Burdick, S.M.; Paramore, L.M.; Buckel, J.A.; Pollock, K.H.

    2010-01-01

    Estimating the selectivity patterns of various fishing gears is a critical component of fisheries stock assessment due to the difficulty in obtaining representative samples from most gears. We used short-term recoveries (n = 3587) of tagged red drum Sciaenops ocellatus to directly estimate age- and length-based selectivity patterns using generalized linear models. The most parsimonious models were selected using AIC, and standard deviations were estimated using simulations. Selectivity of red drum was dependent upon the regulation period in which the fish was caught, the gear used to catch the fish (i.e., hook-and-line, gill nets, pound nets), and the fate of the fish upon recovery (i.e., harvested or released); models including all first-order interactions between main effects outperformed models without interactions. Selectivity of harvested fish was generally dome-shaped and shifted toward larger, older fish in response to regulation changes. Selectivity of caught-and-released red drum was highest on the youngest and smallest fish in the early and middle regulation periods, but increased on larger, legal-sized fish in the late regulation period. These results suggest that catch-and-release mortality has consistently been high for small, young red drum, but has recently become more common in larger, older fish. This method of estimating selectivity from short-term tag recoveries is valuable because it is simpler than full tag-return models, and may be more robust because yearly fishing and natural mortality rates do not need to be modeled and estimated. ?? 2009 Elsevier B.V.

  3. 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

  4. 妇科腔镜手术复苏期的护理%Nursing care in the recovery period after endoscopic operation in gynecology department

    Institute of Scientific and Technical Information of China (English)

    陈静

    2014-01-01

    Laparoscopic operation is a common mean of treatment of gynecological diseases,and postoperative nursing plays an important role in the rehabilitation of patients.In this paper,the author briefly introduces the nursing care in the recovery period after endoscopic operation in gynecology department.%腔镜手术是妇科常用的治疗手段,术后的护理对患者的康复起着重要的作用。本文简要介绍妇科腔镜手术复苏期的护理。

  5. High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty

    DEFF Research Database (Denmark)

    Calatayud, Joaquin; Casaña, Jose; Ezzatvar, Yasmin;

    2016-01-01

    the preoperative period reduces pain and improves lower limb muscle strength, ROM and functional task performance before surgery, resulting in a reduced length of stay at the hospital and a faster physical and functional recovery after TKA. The present training programme can be used by specialists to speed up......, T3 and T4, whereas isometric knee extension was greater for this group at T2 and T4 compared with control. CONCLUSION: The present study supports the use of preoperative training in end-stage OA patients to improve early postoperative outcomes. High-intensity strength training during...

  6. 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.

  7. Experimental test on the use of MS-222 for ostracod anaesthesia: concentration, immersion period and recovery time

    Directory of Open Access Journals (Sweden)

    Francesc MEZQUITA

    2010-08-01

    Full Text Available Anaesthesia of animals may be useful for different purposes, particularly for veterinary reasons or in experimental research, for manipulation or treatment of immobilized but alive animals. Its use in crustaceans is not uncommon, but it has never been described for Ostracoda. We provide brief and preliminary guidelines on the use of the tricaine mesylate (MS-222 on the widespread freshwater ostracod Eucypris virens and we show that this compound is an effective anaesthetic used as a bath treatment at minimum concentrations of 500 mg L-1. This value is considerably higher than that recommended for other aquatic animals like fish. Recovery time, ranging from 5 to 15 minutes, is mostly determined by anaesthetic bath concentration, while bath duration influenced to a lesser extent. Anaesthesia induced with MS-222 can prove useful for minute manipulation of living ostracods e.g. for identification, marking or image capture under the microscope.

  8. Experience with MR cholangiopancreatography with use of a fast inversion recovery sequence during a single breath-hold period

    Energy Technology Data Exchange (ETDEWEB)

    Shiono, Takahiro [Dokkyo Univ., Saitama (Japan). Koshigaya Hospital

    1997-11-01

    The purpose of this study was to evaluate the single breath-hold fast inversion recovery sequence (FIR) for depicting the biliary tract. A prospective study was performed in 40 patients with suspected diseases in the biliary tract. MRCP (magnetic resonance cholangiopancreatography) including cholecystograms of diagnostic quality was carried out in 35 patients. Impacted common duct stones were able to be distinguished from malignancies because of their characteristic shapes of obstruction in four of five cases. FIR with thick slices can provide a shorter acquisition time and fewer artifacts with better signal to noise ratio and contrast to noise ratio than MIP images obtained by means of gradient echo methods. MRCP with FIR was a useful adjunctive tool for non-invasive evaluation of patients with obstructive jaundice. (author)

  9. Limitation in monitoring depth of anesthesia: a case report.

    Science.gov (United States)

    Cascella, Marco; Bifulco, Francesca; Viscardi, Daniela; Tracey, Maura C; Carbone, Domenico; Cuomo, Arturo

    2016-04-01

    Although we describe a clinical situation that most likely occurs in hundreds of operatory rooms in the world, we report this case as provocation. It concerns an unexpected awakening from an appropriate depth of anesthesia, although the BIS monitor showed a BIS index of less than 50 for a prolonged period before and after the event. Approximately 30 min after induction of anesthesia, the patient had a hypothetic sudden arousal of consciousness, with spontaneous movements, facial muscle activation, intolerance to the tracheal tube, and tearing. After immediate intravenous administration of midazolam (4 mg), the patient returned to a depth of anesthesia status, and surgery was completed uneventfully. The patient had no recall of the event when questioned during the episode, at emergence, or at 24 h, 36 h, and 7 days after surgery. Were these events spinal reflexes to pain or stimulation although the cortex was still anesthetized? Maybe this is the more rational explanation. Was the patient awake but not aware? Is it possible that our patient experienced only a transient arousal from consciousness, and that he did not have recall because the arousal time was short and we blocked memory consolidation? The latter hypothesis provides an opportunity to discuss the evidence that at the moment there is no device to assess the depth of anesthesia. We also focus on the possibility of interfering with memory processing under anesthesia. PMID:26671259

  10. 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.

  11. 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...

  12. 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.

  13. 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

  14. 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...

  15. Anesthesia for adult rigid bronchoscopy.

    Science.gov (United States)

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

    2014-01-01

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

  16. Marsupial, insectivore, and chiropteran anesthesia.

    Science.gov (United States)

    Pye, G W

    2001-01-01

    This article covers the manual restraint and anesthesia of marsupials, insectivores, and chiroptera. Marsupials commonly kept as pets in the U.S. [e.g., eastern gray kangaroos (Macropus giganteus), Bennett's wallabies (Macropus rufogriseus), and sugar gliders (Petaurus breviceps)] are covered in detail. Marsupial species kept in zoological parks [e.g., Tasmanian devils, koalas (Phascolarctos cinereus), and common wombats (Vombatus ursinus)] are covered in less detail. Of the insectivores, only the African hedgehog (Atelerix albiventris) and the European hedgehog (Erinaceus europaeus) are commonly kept as pets and, consequently, the insectivore section concentrates on discussing these two species. The section on chiropteran anesthesia is divided into two broad categories: the megachiropterans (flying foxes and fruit bats) and the microchiropterans (insectivorous bats). Most of the information on the species covered in this article is anecdotal, and this should be kept in mind when using the anesthesia protocols described. PMID:11217462

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

    Directory of Open Access Journals (Sweden)

    LaQuia A. Vinson

    2016-08-01

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

  19. Back Pain and Neuraxial Anesthesia.

    Science.gov (United States)

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

    2016-06-01

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

  20. EEG entropy measures in anesthesia

    Directory of Open Access Journals (Sweden)

    Zhenhu eLiang

    2015-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    魏宇; 董有静

    2014-01-01

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

  2. 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...

  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. Use of Articaine in loco-regional anesthesia for day care surgical procedures

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available The popularity of day case surgical procedures has increased immensely over the last few years. Though various techniques are available for carrying out day-case anesthesia, preference for a technique depends upon the type of procedure, patient profile, associated co-morbidities, available infrastructure and back-up facilities, monitoring devices and comfort of the attending anesthesiologist with the technique. Day-case spinal anesthesia for ambulatory surgery has gained a wider acceptance and numerous drugs are available for use in loco-regional anesthesia. Articaine is one such amide local anesthetic drug which is increasingly being used in day care surgeries. Properties of articaine such as faster onset, shorter elimination time and rapid recovery from sensory and motor blockade make it a very useful agent in local and regional anesthesia for day care surgical procedures. This article aims to review these properties of articaine so as to evaluate how useful articaine can be for ambulatory surgical procedures.

  5. Dexmedetomidine for the prevention of shivering during spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Burhanettin Usta

    2011-01-01

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

  6. Periocular Anesthesia in Aesthetic Surgery

    OpenAIRE

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

    2007-01-01

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

  7. [Electronographic changes in general anesthesia].

    Science.gov (United States)

    Mircea, N; Jianu, E; Mănescu, M

    1982-01-01

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

  8. 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...

  9. History of anesthesia in Germany.

    Science.gov (United States)

    Wawersik, J

    1991-01-01

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

  10. 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.

  11. 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, ECmesophyll than Control leaves as a consequence of high EC. The area of palisade parenchyma (PP) increased while the area of spongy parenchyma (SP) decreased in RW leaves with respect to the C leaves. These structural changes could be considered as a strategy to maximize photosynthesis potential in saline conditions. Mycorrhizal inoculation improved the water status of both C and RW plants by increasing their Ψstem and gs values. As regards leaf structure, AMF showed an opposite effect to salinity for PP and SP. At the end of the recovery period, hardly any statistical differences of physiological parameters were found between treatments, although a tendency to improve them was observed in inoculated plants. In any case, the leaf structural changes and the great reduction in Kleaf observed at Ψleaf below -1.5 MPa would constitute an important mechanism for laurustinus plants to reduce the water loses produced by salinity.

  12. 心理干预联合氟比洛芬酯对七氟醚全麻腹腔镜手术苏醒期的影响%The Effect of Psychological Intervention Combined Flurbiprofen Axetil on Awake Period after Laparoscopic Surgery under Sevoflurane Anesthesia

    Institute of Scientific and Technical Information of China (English)

    俞正伟; 习建华

    2011-01-01

    目的 探讨心理干预联合氟比洛芬酯对七氟醚全麻下腹腔镜手术苏醒期的影响.方法 120例七氟醚全麻腹腔镜子宫切除术患者分为三组:对照组(Ⅰ组);氟比洛芬酯组(Ⅱ组);心理干预联合氟比洛芬酯组(Ⅲ组).三组患者诱导方法、术中维持相同,都采用七氟醚+异丙酚+瑞芬太尼维持麻醉.Ⅱ组术前10min静脉注射2mg/kg氟比洛芬酯,Ⅲ组术前心理干预联合手术开始前10min静脉注射2mg/kg氟比洛芬酯.对比观察三组患者拔管前、拔管后即刻和拔管后5min时躁动发生率及其强度、心率,平均动脉压、Ramsay镇静评分及不良反应.结果 Ⅲ组患者各时段的躁动发生率及其强度明显低于前两组,血流动力学更平稳,镇静评分更好,恶心呕吐等不良反应的发生率少.结论 心理干预联合氟比洛芬酯能很好维持苏醒期循环呼吸稳定,减轻疼痛,减少不良反应,是七氟醚全麻腹腔镜手术可靠易行的方法.%Objective To explore the effect of psychological intervention combined Flurbiprofen axetil on awake period after Laparoscopic surgery under sevoflurane anesthesia. Methods 120 patients undergoing hysterectomy under sevoflurane anesthesia were randomly divided into three groups(n =40 each) : control group(Ⅰ group) , flurbiprofen axetil group( Ⅱ group) and psychological intervention combined Flurbiprofen axetil group( Ⅲ group). Anesthesia was maintained with sevoflurane, propofol and remifentanil on all of patients in three groups. The patients in Ⅱ group were injected by flurbiprofen axetil(2mg/kg) 10 minutes before the operation. In Ⅲ group, flurbiprofen axetil(2mg/kg) was administrated 10 minutes before the operation and conbined psychological intervention. The incidence and intensity of restlessness, heart rate, mean arterial pressure, score of sedation ( Ramsay method) and adverse effects were monitored before extubation, 0 and 5 minutes after extubation in three groups

  13. Effect of rehabilitation treatment during different period on recovery of patients with spinal cord injury%脊髓损伤患者不同时期介入康复治疗的效果观察

    Institute of Scientific and Technical Information of China (English)

    马春山; 秦四遥

    2001-01-01

    Objective To investigate efficacy of rehabilitation treatment for patients with spinal cord injury(SCI) during different period.Methods 108 patients received rehabiltiation treatment during different period after SCI.Comparision study was performed retrospectively.Results ADL of patients recepting rehabilitation treatment 3 months after SCI was increased significantly.Conclusion Early rehabilitation interventions significantly accelerate functional recovery of patients with SCI.

  14. The review on activity of Leningrad local government for realization of social policy in years of the Great Patriotic War and during the post-war recovery period

    Directory of Open Access Journals (Sweden)

    Shcherbakov A. S.

    2015-01-01

    Full Text Available The review of activity of local governments of Leningrad on the solution of social problems is presented in article in the period of the Great Patriotic War and restoration of municipal economy during the post-war period. The considerable attention is paid to questions of ensuring activity of the population and the main directions of social policy. Consequences of the public regress caused by war, which detained for many decades development of the social sphere in the country, are not studied yet. In this regard, the judgment of process of overcoming of these consequences, research of the principles of work, methods and forms of administrative activities for the organization of full-fledged life of citizens during the recovery post-war period and in the next decades is of special interest. Completion of World War II entailed changes in a control system of the country - as it is known, extraordinary bodies of authority and management of a wartime in the capital and on places were abolished. Management of restoration and maintenance of full functioning life support system of the cities and areas transferred to local governments of the Soviet power - to city and regional councils of deputies and their constantly operating executive committees. The role of the social sphere in modern conditions more and more increases in improvement of economy, development of democratic processes. The scientific analysis of activity of the central and local authorities for protection and providing the population in years of war and the post-war period gives more deep understanding of role and importance of social questions in life of society. It reveals historical experience of creation, development and implementation of effective mechanism of such activity, that experience is useful for modern management practice of state and local authorities. The considerable case of sources, among which analytical and research works of applied and theoretical character is

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

    Institute of Scientific and Technical Information of China (English)

    刘焕仪; 张欢欢; 许学兵; 许立新

    2011-01-01

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

  16. 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.

  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. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

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

  19. 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....

  20. [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.

  1. Analysis of rehabilitation treatment and nursing of stroke recovery period%中风恢复期的康复治疗及护理分析

    Institute of Scientific and Technical Information of China (English)

    吴凤鸣

    2016-01-01

    目的:分析中风恢复期的康复治疗及护理方法。方法:选取我院在2012年3月~2014年3月收取的中风恢复期患者80例,并对其进行对应的康复治疗和护理。结果:康复治疗后,患者的生活自理能力明显提高,入院时患者生活自理能力评分是(1.3±1.1)分;入院后一个月,评分为(8.8±3.5)分;入院后半年,评分为(13.2±4.1)分。所以治疗的前后差异对比有统计学意义(P<0.05)。结论:对中风恢复期的患者实施对应的康复治疗和护理是必要的,可以加速提升患者的自理能力和生活质量。值得临床推广使用。%Objective To analyze the rehabilitation and nursing of stroke recovery. Methods Choose from March 2012 to March 2014 to collect 80 cases of patients with stroke recovery period, carry on the corresponding rehabilitation treatment and nursing.Results After rehabilitation, self-care ability of patients significantly improved patient admission daily living score was (1.3 ± 1.1) points; one month after admission, a score of (8.8 ± 3.5) points; six months after admission, scoring was (13.2 ± 4.1) points. So the difference before and after treatment was statistically significant comparison (P <0.05).Conclusion The implementation of recovery for stroke patients corresponding rehabilitation treatment and care is necessary, can be accelerated to enhance self-care ability and quality of life of patients. Worthy of clinical use.

  2. Anesthesia for opioid addict: Challenges for perioperative physician

    Directory of Open Access Journals (Sweden)

    Rohit Goyal

    2013-01-01

    Full Text Available Opioid addiction is on a rise globally. Such a patient presents to an anesthesiologist as well as to the surgeon with an array of challenges. We present the case of an opioid addict (pentazocine who presented for debridement and grafting of eschars and old healed scars. Initially he was medically managed for opioid addiction followed by a planned anesthesia. We hereby discuss the challenges faced during perioperative period.

  3. Smart marketing may improve public understanding of the anesthesia profession

    OpenAIRE

    Cohen, Barak; Ogorek, Daniel; Oifa, Stanislav; Cattan, Anat; Matot, Idit

    2015-01-01

    Background A 2005 survey led by the Israeli Society of Anesthesiologists (ISA) found that large parts of the Israeli public are not familiar with the profession of anesthesia. The ISA has subsequently been conducting a public campaign for several years with the aim to enhance community knowledge regarding the anesthesiologists’ training and their critical role in the perioperative period. Objective The present study sought to evaluate the value of a campaign aiming to enhance public understan...

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

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    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.

  5. 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...

  6. Survey of international regional anesthesia fellowship directors

    OpenAIRE

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

    2013-01-01

    Andrew K Lansdown,1,2 Paul G McHardy,1 Sanjiv C Patel,1,3 Catherine M Nix,1 Colin JL McCartney1 1Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; 2University of Sydney, Sydney, NSW, Australia; 3University College Hospital, London, UK Background: The scope of regional anesthesia fellowship programs has not been analyzed but may provide insights that could improve fellowship training and standards. Methods: Regional anesthesia fellowship ...

  7. 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

  8. 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

  9. 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

  10. Assessing pain responses during general anesthesia.

    Science.gov (United States)

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

    2001-06-01

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

  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. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Effect of Nursing Intervention on Elderly Intestinal Function Recovery after Intra-abdominal Non-gastrointestinal Surgery Under General Anesthesia%术前胃肠道护理干预对老年全麻腹腔非胃肠道手术后肠功能恢复的影响研究

    Institute of Scientific and Technical Information of China (English)

    刘菁; 张芹; 汤琼; 李欣

    2012-01-01

    Objective To investigate the influence of gastrointestinal preoperative nursing intervention to the elderly recovery of intestinal function after anesthesia intra -abdominal non - gastrointestinal surgery. Methods A total of 120 elderly patients hospitalized in general surgical department for anesthesia abdominal non - gastrointestinal surgery from April 2010 to December 2011 were divided randomly into groups Study and control. Control group conducted conventional preoperative fasting and forbidden to drink; Study group performed, based on conventional measures, preoperative gastrointestinal tract ( GIT ) nursing and at 18 : 00 of the day before operation given oral compound polyethylene glycol electrolyte powder. Adverse reactions were observed in study group before operation and abdominal distension, bowel tones ( BT ), time of first anal exhaust compared between 2 groups after operation. Results Mild adverse reactions occurred in group study after taking preoperative oral compound polyethylene glycol electrolyte powder, such as nausea ( 5 cases ), vomiting ( 1 case ), feeling of repletion ( 6 cases ), etc. without abdominal pains, allergies and other serious complications. After operation, abdominal distension scored ( 1.2 + 1.3), BT e-mergence time was ( 18. 2 ±6. 0 ) h, anal exhaust time ( 29. 3 ±6. 2 ) h in study group, while in control group ( 2. 7 ± 1. 8 ), ( 23. 7 ± 10. 0 ) h, ( 37. 4 ±6. 1 ) h, respectively. The postoperative bowel function indicators of study group were superior to those of control group, the difference was significant ( P <0. 01 ). Conclusion Preoperative GIT nursing is conductive to recovery of elderly intestinal function after anesthesia intra - abdominal non - gastrointestinal surgery.%目的 探讨术前胃肠道护理干预对老年全麻腹腔非胃肠道手术患者术后肠功能恢复的影响.方法 选择2010年4月-2011年12月在我院普外科住院的120例全麻腹腔非胃肠道手术老年患者为研究对象,

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

    Institute of Scientific and Technical Information of China (English)

    刘小玲

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. 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 (

  18. 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.

  19. 全麻诱导期药物应用对颅脑外伤所致脑损伤患者脑血流动力学的影响%Effects of cerebral hemodynamics for patients with craniocerebral trauma cured by different drugs in general anesthesia induction period

    Institute of Scientific and Technical Information of China (English)

    张生茂; 李娜; 韩亚升; 包娜日素

    2015-01-01

    Objective To investigate effects of cerebral hemodynamics for patients with craniocerebral trauma cured by dif‐ferent drugs in general anesthesia induction period.Methods 64 patients with craniocerebral trauma in recent 1 year in our hos‐pital were divided into two groups randomly ,the control group was given alfentanil in the period of general anesthesia induction , while the observation group was given remifentanil.We detected the relative parameters of cerebral hemodynamics in 5 different periods by TCD.Results After the application of the two drugs ,the cerebrovascular velocity ,mean arterial pressure and heart rate were significantly decreased than induction period(P0.05).Velocity ,pulsatility index and resistance index increased significantly(P0.05).Conclusion In the same drug concentration of alfentanil ,the effect of remifentanil on hemodynamics is more obvious.%目的:观察全麻诱导期药物应用对颅脑外伤所致脑损伤患者脑血流动力学的影响。方法入选近1a就诊于我院的颅脑外伤所致脑损伤患者64例,随机分为2组,对照组在全麻诱导期给予阿芬太尼,观察组给予瑞芬太尼,采用 T CD在不同时期分别检测患者脑血流动力学相关参数。结果2组输注药物后脑血管流速、平均动脉压和心率均较诱导期前明显降低,P<0.05;搏动指数和阻抗指数明显提高(P<0.05);气管插管前后平均动脉压和心率无明显变化(P>0.05);流速明显加快(P<0.05);搏动指数和阻抗指数明显升高(P<0.05)。应用瑞芬太尼较阿芬太尼血流速度在药物输注后和气管插管后下降更为显著(P<0.05);搏动指数和阻抗指数提高更为显著(P<0.05);但平均动脉压和心率组间差异无统计学意义(P>0.05)。结论在同等药物浓度情况下,瑞芬太尼对血流动力学的影响较为显著,阿芬太尼影响程度相对较小。

  20. The Effects of Epidural Top-Up Technique with Serum Physiological On Unilateral Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    İlkay Cömert

    2006-01-01

    Full Text Available This study was designed to investigate the influence of saline injections as epidural top-up on the sensory block duration, quality and hemodynamic effects of unilateral spinal anesthesia. The cases from ASA I-Il containing of 18-65 age group were randomly separated into three groups. For the purpose of unilateral spinal anesthesia, 6 mg 0.5% ‘heavy’ bupivacaine and for the purpose of epidural top-up, 10 mL saline were applied to the each patients of the groups. The study protocol was designed as:Ist group: Coming after the epidural catheter installation, unilateral spinal anesthesia was applied (n=20.IInd group: At first, unilateral spinal anesthesia was applied and after one minute, epidural top-up was done via the pre-installed epidural catheter (n=20.IIIrd group: At first the epidural catheter was installed and epidural top-up was applied. After one minute, unilateral spinal anesthesia was fulfilled (n=2O. Starting from the pre-anesthesic period, the hemodynamic data and following the anesthesia, the sensorial and motor block levels were recorded and evaluated.As the outcome of the inter-groups comparison of heart rate and mean arterial pressure, a statistically note-worthy differance was not determined; statistically significant but clinically acceptable hemodynamic changes were observed in intra-group evaluations, when the data was compared with control levels. The sensorial block levels were significantly higher in group II and significantly lower in group III.The application of 10 mL saline via epidural catheter 1 minute after the unilateral spinal anesthesia and remaining the patient leaning on the side of the extremity to be operated for 15 minutes improves the sensory block level of unilateral spinal anesthesia. It is determined that, for the lower extremity surgical operations with 1-1.5 hour estimated period, this method alone can be a worthwhile alternative.

  1. Partial intravenous anesthesia in cats and dogs.

    Science.gov (United States)

    Duke, Tanya

    2013-03-01

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

  2. 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.

  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. Regional block anesthesia in a patient with factor V Leiden mutation and axillary artery occlusion

    Science.gov (United States)

    Erkalp, Kerem; Comlekci, Mevlut; Inan, Bekir; Basaranoglu, Gokcen; Ozdemir, Haluk; Saidoglu, Leyla

    2011-01-01

    Anesthetic management of patients with coagulation disorders presents safety and technical challenges. This case describes a 58-year-old woman with factor V Leiden mutation who required distal saphenous vein harvest and axillo-brachial bypass to treat axillary artery occlusion. The patient underwent surgery with satisfactory anesthesia using infraclavicular brachial plexus block, thoracic paravertebral block, and unilateral subarachnoid block. These three regional anesthetic interventions were performed in lieu of general anesthesia to minimize risks of thrombotic events, pain, and to decrease recovery time. Despite higher failure rates of regional anesthesia, longer time required for procedures, and added discomforts during surgery, the benefits may outweigh risks for selected high-risk patients, including those with factor V Leiden mutations. PMID:22915885

  5. Anesthesia

    Science.gov (United States)

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

  6. 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

  7. 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.

  8. 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.

  9. Pain management and regional anesthesia for the dental patient.

    Science.gov (United States)

    Woodward, Tony M

    2008-05-01

    Current standards of care in veterinary medicine dictate an adequate level of pain control for our patients. Effective pain control uses a proactive, multimode approach that starts with preoperative medications, includes the anesthetic protocol selected, and continues into the postoperative period. A basic understanding of the physiology of pain assists in selecting those agents and modalities best suited for individual patients. Analgesic drug selection and local anesthesia are both integral parts of pain control when performing surgery in the oral cavity. Local (regional) anesthesia plays an important part in the pain control of oral surgical patients. Regional anesthetic techniques are used for many common oral procedures, including extractions, periodontal flap surgery, treatment of traumatic injuries of the oral cavity, tumor removal, palatal surgery, periodontal therapy, and root canal therapy. This presentation will cover strategies for analgesia and the techniques and materials used in local/regional anesthesia in the oral cavity. Anatomic landmarks and guidelines for effective regional blocks will be covered. PMID:18482711

  10. 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....

  11. Supplemental pulpal anesthesia for mandibular teeth

    Directory of Open Access Journals (Sweden)

    Thangavel Boopathi

    2013-01-01

    Full Text Available Clinical pulpal anesthesia is dependent on the interaction of three major factors. (1 the dentist (2 the patient and (3 local anesthesia. Many patients fear endodontic treatment due to a concern about pain. Although pain treatment is well managed in many endodontic patients, there exists a group of patients who do not receive adequate local anesthesia. The purpose of this review article is to discuss the possible reasons for pulpal anesthetic failures and also to focus on the measures for developing effective approaches for the same.

  12. 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....

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

    Science.gov (United States)

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

    2016-04-01

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

  14. Acupuncture assisted local anesthesia for penile surgeries

    OpenAIRE

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

    2013-01-01

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

  15. 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.

  16. Anaphylaxis due to thiopental sodium anesthesia.

    OpenAIRE

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

    1980-01-01

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

  17. 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. Varietal differences of wheat for 13C-discrimination and 15N-uptake as affected by drought and its recovery. Final report for the period 1 January 1993 - 31 December 1994

    International Nuclear Information System (INIS)

    A Pot experiment was conducted to investigate the varietal differences of wheat for shoot dry weight, 13C-discrimination, total N-yield and 15N-uptake as affected by drought and its recovery. Four wheat varieties were exposed to different watering regimes (i.e., W0 as normal irrigation of W1 as water stress) during the following growth periods: (i) from 3-leaf stage to third nod stage; (ii) from 3 nod stage to heading; and (iii) from heading to milk-dough stage. For drought recovery study, the experiment included another three water regime treatments induced by varying the irrigation of plants during the selected growth periods (i.e., W10, W100 and W010). The results indicated that water stress during the selected growth periods greatly decreased shoot dry weight, nabla value, total N-yield and amount of nitrogen derived from fertilizer. The (i) and (ii) are considered critical growth periods as far as the above-mentioned parameters are considered. Expression of any tested parameter under water stress as percentage of that of the corresponding control indicated that Dalcahue, Sakha-69 and Bonadur were less sensitive to water stress than the other varieties at (i), (ii) and (iii) growth periods, respectively. On the other hand, Bonadur at (i) and (ii) growth periods and Sakha-69 at (iii) growth period were more sensitive than the other varieties. Exposing of wheat varieties to water stress during (i) and (ii) growth periods resulted in severe injury with regard to shoot dry weight, total N-yield and amount of nitrogen derived from fertilizer. Re-irrigation of the stressed wheat varieties, resulted in drought recovery with different magnitude depending on the variety and the growth period in which the plants were exposed to water stress. Generally, the results demonstrated that Bonadur has better capacity to recover from drought than the other varieties. Therefore, Bonadur may be considered a possible candidate for programs aimed at breeding wheat for drought

  1. The use of alfaxalone and remifentanil total intravenous anesthesia in a dog undergoing a craniectomy for tumor resection.

    Science.gov (United States)

    Warne, Leon N; Beths, Thierry; Fogal, Sandra; Bauquier, Sébastien H

    2014-11-01

    A 7-year-old castrated border collie dog was anesthetised for surgical resection of a hippocampal mass. Anesthesia was maintained using a previously unreported TIVA protocol for craniectomy consisting of alfaxalone and remifentanil. Recovery was uneventful, and the patient was discharged from hospital. We describe the anesthetic management of this case. PMID:25392553

  2. 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.

  3. Postoperative effects of anesthesia and surgery on resting energy expenditure in horses as measured by indirect calorimetry

    OpenAIRE

    Cruz, Antonio M.; Coté, Nathalie; McDonell, Wayne N.; Geor, Raymond J.; Wilson, Brian A.; Monteith, Gabrielle; Li, Ronald

    2006-01-01

    In this study, we aimed to define the effects of anesthesia and surgery on the resting energy expenditure of horses in experimental conditions. Six horses were used in a longitudinal study with 2 study periods: before and after anesthesia and surgery. Every horse underwent a standard 90-min ventral midline exploratory laparotomy. Oxygen uptake ( ) and carbon dioxide output ( ) were measured, with the use of a closed-circuit spirometry system, on 5 consecutive days immediately before and...

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

    Directory of Open Access Journals (Sweden)

    Vlassakov KV

    2015-05-01

    Full Text Available Kamen V Vlassakov, Igor Kissin Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Abstract: The aim of this study was to assess progress in the field of anesthesia monitoring over the past 40 years using scientometric analysis. The following scientometric indexes were used: popularity indexes (general and specific, representing the proportion of articles on either a topic relative to all articles in the field of anesthetics (general popularity index, GPI or the subfield of anesthesia monitoring (specific popularity index, SPI; index of change (IC, representing the degree of growth in publications on a topic from one period to the next; and index of expectations (IE, representing the ratio of the number of articles on a topic in the top 20 journals relative to the number of articles in all (>5,000 biomedical journals covered by PubMed. Publications on 33 anesthesia-monitoring topics were assessed. Our analysis showed that over the past 40 years, the rate of rise in the number of articles on anesthesia monitoring was exponential, with an increase of more than eleven-fold, from 296 articles over the 5-year period 1974–1978 to 3,394 articles for 2009–2013. This rise profoundly exceeded the rate of rise of the number of articles on general anesthetics. The difference was especially evident with the comparison of the related GPIs: stable growth of the GPI for anesthesia monitoring vs constant decline in the GPI for general anesthetics. By the 2009–2013 period, among specific monitoring topics introduced after 1980, the SPI index had a meaningful magnitude (≥1.5 in 9 of 24 topics: Bispectral Index (7.8, Transesophageal Echocardiography (4.2, Electromyo­graphy (2.8, Pulse Oximetry (2.4, Entropy (2.3, Train-of-four (2.3, Capnography (1.9, Pulse Contour (1.9, and Electrical Nerve Stimulation for neuromuscular monitoring (1.6. Only one of these topics (Pulse

  5. Balanced anesthesia and constant-rate infusions in horses.

    Science.gov (United States)

    Valverde, Alexander

    2013-04-01

    Balanced anesthetic techniques are commonly used in equine patients, and include the combination of a volatile anesthetic with at least one injectable anesthetic throughout the maintenance period. Injectable anesthetics used in balanced anesthesia include the α2-agonists, lidocaine, ketamine, and opioids, and those with muscle-relaxant properties such as benzodiazepines and guaifenesin. Administration of these injectable anesthetics is best using constant-rate infusions based on the pharmacokinetics of the drug, which allows steady-state concentrations and predictable pharmacodynamic actions. This review summarizes the different drug combinations used in horses, and provides calculated recommended doses based on the pharmacokinetics of individual drugs. PMID:23498047

  6. 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

  7. 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

  8. 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.

  9. [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.

  10. Accepting Pain Over Comfort: Resistance to the Use of Anesthesia in the Mid-19th Century.

    Science.gov (United States)

    Meyer, Rachel; Desai, Sukumar P

    2015-10-01

    News of the successful use of ether anesthesia on October 16, 1846, spread rapidly through the world. Considered one of the greatest medical discoveries, this triumph over man's cardinal symptom, the symptom most likely to persuade patients to seek medical attention, was praised by physicians and patients alike. Incredibly, this option was not accepted by all, and opposition to the use of anesthesia persisted among some sections of society decades after its introduction. We examine the social and medical factors underlying this resistance. At least seven major objections to the newly introduced anesthetic agents were raised by physicians and patients. Complications of anesthesia, including death, were reported in the press, and many avoided anesthesia to minimize the considerable risk associated with surgery. Modesty prevented female patients from seeking unconsciousness during surgery, where many men would be present. Biblical passages stating that women would bear children in pain were used to discourage them from seeking analgesia during labor. Some medical practitioners believed that pain was beneficial to satisfactory progression of labor and recovery from surgery. Others felt that patient advocacy and participation in decision making during surgery would be lost under the influence of anesthesia. Early recreational use of nitrous oxide and ether, commercialization with patenting of Letheon, and the fighting for credit for the discovery of anesthesia suggested unprofessional behavior and smacked of quackery. Lastly, in certain geographical areas, notably Philadelphia, physicians resisted this Boston-based medical advance, citing unprofessional behavior and profit seeking. Although it appears inconceivable that such a major medical advance would face opposition, a historical examination reveals several logical grounds for the initial societal and medical skepticism. PMID:26828088

  11. Rocuronium anesthesia induced anaphylactic shock:a case report%罗库溴铵致过敏性休克1例

    Institute of Scientific and Technical Information of China (English)

    邱敏; 宗亚楠; 卢剑; 马潞林; 郑清; 郭向阳

    2015-01-01

    SUMMARY Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen , and it could be an unpre-dictable and life-threatening cause during anesthesia .The main purpose of this paper is to report a case of anaphy-lactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period .A 63-year-old man, with a mass on his adrenal , was scheduled to a laparoscopic adrenal tumor excision .During the anesthesia induction period , after administrated sul-fentanil, propofol and rocuronium , the blood pressure was decreased and the heart rate was increased .Then, the patient had rash on his whole body and developed an anaphylactic shock .After being treated with the anti-allergic agents and norepinephrine , the rash disappeared and the vital sign become stable .The patient felt nothing uncom-fortable during the two weeks ’ follow-up.Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period .The most common inducements are muscle relaxant , latex and antibiotics .Anaphylactic reac-tions in the perioperative period are often serious and potentially life-threatening conditions , involving multiple or-gan systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils .Before anesthesia , we should acquire the allergic history .During the anesthesia period , the vi-tal sign and the skin should be observed carefully .

  12. 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.

  13. 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

  14. WITHDRAWN The analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia.

    Science.gov (United States)

    Celik, M; Saricaoglu, F; Canbay, O; Dal, D; Uzumcigil, A; Leblebicioglu, G; Aypar, U

    2011-10-21

    Ahead of Print article withdrawn by publisher AIM: Intravenous regional anesthesia (IVRA) is frequently used in patients who will undergo upper extremity surgical operations for its ease of use, rapid effectiveness and short hospitalization period. Different drug combinations have been used to overcome some systemic adverse effects and to increase the postoperative analgesic effectiveness. In our study, we evaluated the effects of paracetamol (Perfalgan) when added to lidocaine for IVRA, looking specifically at tourniquet pain and postoperative pain. METHODS: Ninety patients undergoing elective hand surgery with IVRA were randomly assigned to three groups to receive either IV saline and C-IVRA with 0.5% lidocaine 3 mg/kg (control group, N=30), IV saline and IVRA with 0.5% lidocaine and 20 mL paracetamol (10 mg/cc) (P-IVRA group, N=30) or IV paracetamol and IVRA with 0.5% lidocaine (L-IV group, N=30). The following were measured: 1) sensory and motor block onset and recovery time, 2) tourniquet pain after tourniquet application and at 10, 20 and 30 min after tourniquet deflation, 3) the visual analog scale (VAS) scores of tourniquet pain at 30 min and 1, 2, 4, 6 and 24 h postoperatively, 4) the time to first analgesic requirement, 5) total analgesic consumption in 24 h and 6) side effects. RESULTS: Sensory and motor block onset and recovery times were similar in both groups. VAS scores of tourniquet pain were lower in group P-IRVA at 1, 2, 4, 6, and 24 h, postoperatively (PPerfalgan as an adjunct to lidocaine improves postoperative analgesia in IVRA without adverse effects. PMID:19935636

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. [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.

  20. Recovery self-efficacy and intention as predictors of running or jogging behavior: A cross-lagged panel analysis over a two-year period

    OpenAIRE

    Luszczynska, Aleksandra; Mazurkiewicz, Magda; Ziegelmann, Jochen P; Schwarzer, Ralf

    2007-01-01

    Objectives: The study investigates whether two kinds of self-efficacy and intention predict regular running or jogging behavior over 2 yr. Maintenance self-efficacy refers to beliefs about one's ability to maintain a behavior, whereas recovery self-efficacy pertains to beliefs about one's ability to resume a behavior after a setback. Design and methods: Longitudinal data from runners (N=139, 80% men) were collected twice with a time gap of 2 yr. Results: Cross-lagged panel analysis revealed t...

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

    Institute of Scientific and Technical Information of China (English)

    王浩杰; 郭创

    2012-01-01

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

  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. Survey of international regional anesthesia fellowship directors

    Directory of Open Access Journals (Sweden)

    Lansdown AK

    2013-07-01

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

  4. Minimally invasive parathyroidectomy under local anesthesia

    Directory of Open Access Journals (Sweden)

    Ö Karahan

    2013-01-01

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

  5. Anesthesia and thyroid surgery: The never ending challenges

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Sehgal, Vishal

    2013-01-01

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

  6. 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

  7. Regional block anesthesia in a patient with factor V Leiden mutation and axillary artery occlusion

    Directory of Open Access Journals (Sweden)

    Kerem Erkalp

    2011-02-01

    Full Text Available Kerem Erkalp1, Mevlut Comlekci1, Bekir Inan2, Gokcen Basaranoglu1, Haluk Ozdemir1, Leyla Saidoglu11Department of Anaesthesiology and Reanimation, Vakif Gureba Hospital, Istanbul, Turkey; 2Department of Vascular Surgery, Vakif Gureba Hospital, Istanbul, TurkeyAbstract: Anesthetic management of patients with coagulation disorders presents safety and technical challenges. This case describes a 58-year-old woman with factor V Leiden mutation who required distal saphenous vein harvest and axillo-brachial bypass to treat axillary artery occlusion. The patient underwent surgery with satisfactory anesthesia using infraclavicular brachial plexus block, thoracic paravertebral block, and unilateral subarachnoid block. These three regional anesthetic interventions were performed in lieu of general anesthesia to minimize risks of thrombotic events, pain, and to decrease recovery time. Despite higher failure rates of regional anesthesia, longer time required for procedures, and added discomforts during surgery, the benefits may outweigh risks for selected high-risk patients, including those with factor V Leiden mutations.Keywords: regional anesthesia, factor V Leiden, pain, vein harvest

  8. Application of reservoir characterization and advanced technology to improve recovery and economics in a lower quality shallow shelf San Andres Reservoir. Quarterly Report for the period: 1 April - 30 June 2001

    International Nuclear Information System (INIS)

    The Class 2 Project at West Welch was designed to demonstrate the use of advanced technologies to enhance the economics of improved oil recovery (IOR) projects in lower quality Shallow Shelf Carbonate (SSC) reservoirs, resulting in recovery of additional oil that would otherwise be left in the reservoir at project abandonment. Accurate reservoir description is critical to the effective evaluation and efficient design of IOR projects in the heterogeneous SSC reservoirs. Therefore, the majority of Budget Period 1 was devoted to reservoir characterization. Technologies being demonstrated include: (1) Advanced petrophysics; (2) Three-dimensional (3-D) seismic; (3) Crosswell bore tomography; (4) Advanced reservoir simulation; (5) Carbon dioxide (CO2) stimulation treatments; (6) Hydraulic fracturing design and monitoring; and (7) Mobility control agents

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

    Directory of Open Access Journals (Sweden)

    Charu Pandya

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

    This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use. PMID:27003489

  11. The review on activity of Leningrad local government for realization of social policy in years of the Great Patriotic War and during the post-war recovery period

    OpenAIRE

    Shcherbakov A. S.

    2015-01-01

    The review of activity of local governments of Leningrad on the solution of social problems is presented in article in the period of the Great Patriotic War and restoration of municipal economy during the post-war period. The considerable attention is paid to questions of ensuring activity of the population and the main directions of social policy. Consequences of the public regress caused by war, which detained for many decades development of the social sphere in the country, are not studied...

  12. 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...

  13. 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.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  15. 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…

  16. 21 CFR 884.5100 - Obstetric anesthesia set.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric anesthesia set. 884.5100 Section 884.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5100 Obstetric anesthesia set. (a) Identification. An obstetric anesthesia set is an assembly...

  17. 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...

  18. 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.

  19. 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

  20. 'Why are there so many drums playing until dawn?' Exploring the role of Gamba spirits and healers in the post-war recovery period in Gorongosa, Central Mozambique.

    Science.gov (United States)

    Igreja, Victor

    2003-12-01

    In the wake of a civil war, local resources can play a potential role in shaping the recovery process by providing both old and new exegeses for the disturbing effects of the past. Using the case of Gorongosa, this article aims to explore the ways in which the war has impacted upon traditional medicine by creating Gamba spirits that cause havoc but can also transform the psychosocial hurts of war survivors. Historically, traditional healing practice was under the sole responsibility of the Dzoca, an ancestral spirit that for generations was embodied in living people through lineage descent to exercise its healing powers. There is consensus among healers that the Gamba spirit and healers emerged after the war and are rapidly spreading throughout Gorongosa. I explore the emic theories to explain the Gamba's puzzling origins and the role they are currently playing in Gorongosa. PMID:14979463

  1. The effect of ketamine versus fentanyl on the incidence of emergence agitation after sevoflurane anesthesia in pediatric patients undergoing tonsillectomy with or without adenoidectomy

    Directory of Open Access Journals (Sweden)

    Ashraf Arafat Abdelhalim

    2013-01-01

    Full Text Available Background: Emergence agitation (EA has been documented as a common side-effect of sevoflurane anesthesia. This prospective, randomized, double-blind, placebo-controlled study was designed to compare the effects of ketamine versus fentanyl, administered 10 min before the end of surgery on the development of EA. Methods: A total of 120 children aged 3-7 years of American Society of Anesthesiologists I-II physical status were randomly assigned to one of three equal groups receiving either ketamine 0.5 mg/kg (Group K, fentanyl 1 μg/kg (Group F or saline (Group C at 10 min before the end of surgery. Post-operative EA was assessed with Aono′′s four point scale. Recovery times, the post-operative pain and adverse reactions were assessed. Results: There was no significant difference between the three groups regarding recovery and discharge times from post-anesthesia care unit. The incidence of EA was significantly low in Group K and Group F (15% and 17.5%, respectively compared to the control group (42.5%, with no significant difference between Group K and Group F. There were no significant differences in Children′s Hospital of Eastern Ontario Pain Scale between the three groups. The incidence of nausea or vomiting was significantly more in Group F compared to that in other two groups. However, no complications such as somnolence, oxygen desaturation or respiratory depression occurred during the study period and there were no episodes of hallucinations or bad dreams in the ketamine group. Conclusion: The intravenous administration of either ketamine 0.5 mg/kg or fentanyl 1 μg/kg before the end of surgery in sevoflurane-anesthetized children undergoing tonsillectomy with or without adenoidectomy reduces the incidence of post-operative agitation without delaying emergence.

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Cerebral state index during propofol anesthesia

    NARCIS (Netherlands)

    Jensen, EW; Litvan, H; Revuelta, M; Rodriguez, BE; Caminal, P; Martinez, P; Vereecke, H; Struys, MMRF

    2006-01-01

    Background: The objective of this study was to prospectively test the Cerebral State Index designed for measuring the depth of anesthesia. The Cerebral State Index is calculated using a fuzzy logic combination of four subparameters of the electroencephalographic signal. The performance of the Cerebr

  4. Update on complications in pediatric anesthesia

    Directory of Open Access Journals (Sweden)

    Giovanni de Francisci

    2013-02-01

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

  5. Respiratory Monitoring for Anesthesia and Sedation

    OpenAIRE

    Anderson, Jay A.

    1987-01-01

    This article reviews the theory and practice of routine respiratory monitoring during anesthesia and sedation. Oxygen monitoring and capnography methods are reviewed. The current ventilation monitoring system of choice is considered a combination of the pulse oximeter and capnography. Guidelines are provided for monitoring standards.

  6. [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.

  7. 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.

  8. 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

  9. Low dose spinal anesthesia for knee arthroscopy

    Directory of Open Access Journals (Sweden)

    Lakhin R.E.

    2015-06-01

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

  10. 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.

  11. 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...

  12. As intervenções do enfermeiro e as complicações em sala de recuperação pós-anestésica Las intervenciones del enfermero y las complicaciones en la sala de recuperación postanestésica Nurse interventions and the complications in the post-anesthesia recovery room

    Directory of Open Access Journals (Sweden)

    Débora Cristina Silva Popov

    2009-12-01

    oxigenoterapia; hipotensión: hidratación, exámenes complementares y observación; hipertensión: observación; tremor: manta térmica, transfusión sanguínea; náuseas/vómitos: rutina, medicación y sondaje vesical de alivio; hemorragia: rutina, medicación y curativos; hipoxemia: rutina y oxigenoterapia; hipotermia: rutina, manta térmica y medicación. El dolor, náuseas/vómitos, agitación y hemorragia obtuvieron relación estadísticamente significativa con el enfermero fijo en SRPA.The objective of this study was to identify the prevalent complications in the post-anesthesia recovery room (PARR, and correlate nurses' work hours with the complications. The sample consisted of 400 records of patients older than 18 years, who had major and medium surgical procedures, admitted at the PARR unit, with a stay of at least one hour. The prevalent complications were pain and hypothermia. The following complications showed a statistically significant relationship with the nursing intervention: pain: routine, oxygen therapy, medication and bandages; agitation/anxiety: routine and oxygen therapy; hypotension: hydration, complementary exams, and observation; hypertension: observation; tremor: mat heater, blood transfusion; nausea/vomiting: routine, medication and urinary catheterization; bleeding: routine, medication and bandages; hypoxemia: routine and oxygen therapy; hypothermia: routine, mat heater, and medication. Pain, nausea/vomiting, agitation and bleeding showed a statistically significant relationship with the PARR nurse.

  13. Joint Manipulation Under Anesthesia for Arthrofibrosis After Hallux Valgus Surgery.

    Science.gov (United States)

    Feuerstein, Catherine; Weil, Lowell; Weil, Lowell Scott; Klein, Erin E; Argerakis, Nicholas; Fleischer, Adam E

    2016-01-01

    Arthrofibrosis is a known complication of hallux valgus surgery. Joint manipulation under anesthesia has been studied for adhesive capsulitis of the shoulder; however, a paucity of published data exists on the use of this modality in the foot and ankle. The purpose of the present study was to investigate the outcomes of first metatarsophalangeal joint manipulation for arthrofibrosis that occurred as a complication of bunion surgery. The study population consisted of patients attending a single foot and ankle specialty clinic who were evaluated for arthrofibrosis after bunion surgery. Patients who underwent joint manipulation under anesthesia were asked to complete a research visit in which a clinical examination was performed and the presence and severity of joint pain were assessed. A total of 38 patients (34 females, 4 males, 53 feet), with a mean age of 55.7 ± 11.8 (range 30 to 83) years, agreed to participate. The mean follow-up period was 6.5 ± 3.4 (range 1 to 17) years. The visual analog scale scores improved significantly from baseline to the final follow-up visit (baseline 6.5 ± 1.5, range 2 to 10; final follow-up visit 2.3 ± 1.5, range 0 to 6; p mobility and alleviating pain in patients who experience arthrofibrosis after surgical correction of hallux valgus. PMID:26256296

  14. 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

  15. 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.

  16. 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.

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

    Science.gov (United States)

    Sehhati, G; Sarvestani, M

    1976-10-01

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

  18. 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.

  19. Use of preoperative hypnosis to reduce postoperative pain and anesthesia-related side effects.

    Science.gov (United States)

    Lew, Michael W; Kravits, Kathy; Garberoglio, Carlos; Williams, Anna Cathy

    2011-01-01

    The purpose of this pilot project was to test the feasibility of hypnosis as a preoperative intervention. The unique features of this study were: (a) use of a standardized nurse-delivered hypnosis protocol, (b) intervention administration immediately prior to surgery in the preoperative holding area, and (c) provision of hypnosis to breast cancer surgery patients receiving general anesthesia. A mixed-method design was used. Data collected from the intervention group and historical control group included demographics, symptom assessments, medication administration, and surgical, anesthesia, and recovery minutes. A semi-structured interview was conducted with the intervention group. A reduction in anxiety, worry, nervousness, sadness, irritability, and distress was found from baseline to postintervention while pain and nausea increased. The results support further exploration of the use of nurse-led preoperative hypnosis. PMID:21867377

  20. 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

  1. 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

  2. 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

  3. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

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

  4. Risk Management in the Application of Severe Stroke Recovery Period%风险管理在重症脑卒中恢复期中的应用探讨

    Institute of Scientific and Technical Information of China (English)

    郑瑞芳; 陈玉华; 王福华

    2015-01-01

    Objective To analysis the risk management in severe stroke recovery application effect.MethodsChose 80 patients with severe stroke recovery period,according to the method of random numbers were divided into control group(40)and the team(40),the control group took routine management,the team took the risk management,compared to two group management effect.Results The discharge when the team NHISS score lower than the control group(P<0.05). Team of lung infection,burn,the incidence of pressure ulcers,fal lower than the control group(P<0.05). Conclusion In patients with severe stroke recovery period to take risk management,can reduce the risk of nursing.%目的:分析风险管理在重症脑卒中恢复期应用效果。方法选取80例重症脑卒中恢复期患者,按照随机数字法分为对照组(40例)与研究组(40例),对照组采取常规管理,研究组采取风险管理,对比两组管理效果。结果出院时研究组NHISS评分低于对照组(P<0.05)。研究组肺部感染、烫伤、压疮、跌倒发生率低于对照组(P<0.05)。结论对重症脑卒中恢复期患者采取风险管理,可减少护理风险。

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

    Science.gov (United States)

    Gazal, G; Fareed, W M; Zafar, M S

    2016-01-01

    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. PMID:26955316

  6. 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.

  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. Theoretical understanding of the coping approaches and social support experiences of relatives of critically ill patients during the intensive care unit stay and the recovery period at home

    OpenAIRE

    Johansson, Ingrid

    2006-01-01

    Relatives may experience a difficult and demanding situation when the patient is critically ill. During the period in the intensive care unit (ICU), the relatives may be subject to strong emotions of an existential nature, and the situation may involve several stressors as a result of changed roles, responsibilities and routines. These emotional stress experiences may result in weakened mental and physical functioning on the part of the relatives. During the patient’s rehabilitation at home t...

  9. 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

  10. 椎管内麻醉并发寒战反应的相关因素分析%Analysis of the risk factors of shivering after intraspinal anesthesia

    Institute of Scientific and Technical Information of China (English)

    李燕萍

    2016-01-01

    目的:探讨椎管内麻醉后并发寒战反应相关影响因素。方法将2011年2月至2015年5月进行椎管内麻醉手术后进行麻醉恢复者640例作为研究对象,根据患者是否出现寒战反应将患者分为研究组和对照组,研究组包括出现寒战者,共328例,对照组包括未出现寒战者,共312例。对患者进行基本临床资料、手术时间和出血量、鼓膜温度、麻醉方式、麻醉阻滞平面等指标对比,探讨椎管内麻醉并发寒战反应的危险因素。结果640例患者中328例出现寒战反应,发生率为51.25%。单因素结果显示年龄较轻、男性、中心温度较低、手术时间持续较长、手术出血量较多、麻醉阻滞方式选择腰麻及麻醉阻滞平面在T8以上等指标与椎管内麻醉并发寒战反应存在密切关系,组间数据差异均有统计学意义(χ2=40.661、17.208、32.369、32.931、36.624、14.844、26.842,均P<0.05)。多因素logistic回归分析结果显示,年龄、性别、中心体温、手术时间、出血量、椎管内麻醉方式及麻醉阻滞平面等指标是椎管内麻醉患者麻醉后出现寒战反应的重要危险因素(OR=1.843、1.925、2.183、0.548、0.497、0.529、0.743,均P<0.05)。结论男性、年龄较轻、手术时间持续较长、术中出血量较大、鼓膜温度较低、麻醉方式选择蛛网膜下腔阻滞以及麻醉平面较高等因素是椎管内麻醉患者出现寒战反应的主要危险因素,在围手术期内需要对具有上述因素的患者进行密切监测。%Objective To explore the risk factors of shivering after intraspinal anesthesia.Methods 640 anesthesia recovery patients after intraspinal anesthesia from February 2011 to May 2015 were selected as the research subjects.According to whether patients appeared shivering,they were divided into research group and control group.The research group had 328 cases

  11. 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

  12. 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.

  13. 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.

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

    Science.gov (United States)

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

    2012-01-01

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

  15. 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. The ozone recovery in the NH extratropics: The trend analyses of the SBUV/SBUV-2 merged ozone data in the 1979-2012 period

    Science.gov (United States)

    Krzyścin, Janusz W.

    2014-12-01

    Regulations of the Montreal Protocol (MP) 1987 and its subsequent amendments resulted in a decreasing tendency of the ozone depleting substances (ODS) concentration in the stratosphere since the mid 1990s after few decades of the ODS increasing tendency. The long-term changes of the stratospheric ozone might be also effected by a number of factors (e.g., anthropogenic CH4 and N2O, the stratospheric cooling due to CO2), which are not controlled by MP. A statistical model is developed to evaluate the residual long-term variability of ozone in the period 1979-2012 due to combined effect of factors other than ODS. The SBUV/SBUV-2 merged ozone data ver.8.6 including the column ozone, the ozone content in the troposphere and lower stratosphere (1013-25.45 hPa), and in the upper stratosphere (4.034-1.013 hPa) are examined for the 5 degree wide zonal belts in the 30°-80°N region. The residual trend pattern is calculated for each zonal belt, i.e., the difference between the observed long-term ozone variability having dynamical effects removed and the trend curve due to ODS changes estimated from the standard multivariate trend model. The calculations are carried out separately for the four seasons of the year. The observed long-term change in the upper stratosphere O3 follows that due to ODS changes for all seasons of the year. The trend pattern of the ozone content in the troposphere and lower stratosphere starts to differ from that forced by the ODS changes since about 2005. At the end of considered time period (2012), the ozone content in this layer appears ˜2-3% below the reference level calculated from the ODS changes. It seems that this decline is somewhat related to short-term fluctuations in the atmosphere dynamics appearing in 2011-2012.

  17. [Perioperative risk management in anesthesia for thoracic surgery].

    Science.gov (United States)

    Goto, Keiji

    2008-06-01

    Thoracic surgery has become to be performed more safely by recent progress of operative method and anesthetic management. The surgery can be applicable for those patients who were formerly difficult for operation because of preoperative poor respiratory function, however, postoperative mortality and morbidity increase in such patients without appropriate perioperative management. Experienced anesthetic management can contribute to the risk reduction for these conditions. Since respiratory function which is injured by associated diseases is worsen by both thoracic surgery and general anesthesia, patients with coexisting respiratory diseases in particular need to be watched out intensively. Coherent risk management from preoperative to postoperative period becomes important. This is achieved by the comprehensive perioperative patient management which is consisted of the cooperation between the surgeon and the anesthetist, correct preoperartive evaluation, preoperative medical treatment with pulmonary rehabilitation, appropriate anesthetic management, and postoperative intensive care. PMID:18536299

  18. 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

  19. 腰麻与骶管麻醉应用于肛门手术74例%Spinal anesthesia or caudal anesthesia for anorectal surgery: An analysis of 74 cases

    Institute of Scientific and Technical Information of China (English)

    朱怀宇; 胡四育; 王增文

    2012-01-01

    AIM: To observe the clinical effect of spinal anesthesia and caudal anesthesia in anorectal surgery. METHODS: Seventy-four patients who underwent anorectal surgery between September 2009 and May 2012 were reviewed retrospectively. The patients were divided into spinal anesthesia group (n = 36) and caudal anesthesia group (n = 38). There were no significant differences in age, sex, illness, and operation time between the two groups. Anesthesia effect, onset time, cardiovascular complication, urinary retention, and time to sensory recovery were compared between the two groups. RESULTS: The rate of satisfaction with anesthesia effect was 95% in the spinal anesthesia group and 79% in the caudal anesthesia group (P 0.05). Mean time to sensory recovery was 324 min in the spinal anesthesia group and 288 min in the caudal anesthesia group (P > 0.05). CONCLUSION: Spinal anesthesia has better clinical effect than caudal anesthesia when used in anorectal surgery, but the blood pressure and heart rate must be closely monitored and cardiovascular changes must be handled on time.%目的:比较腰麻与骶管麻醉在肛门手术中的效果.方法:回顾性分析2008-09/2012-05应用腰麻及骶管麻醉行肛门手术病例共74例,36例采用腰麻(腰麻组),38例采用骶管麻醉(骶麻组).两组性别、年龄、病种分类及手术时间等资料相比,P>0.05.比较两组麻醉效果、起效时间、术中心血管系统不良反应情况、术后尿潴留的发生、术后感觉恢复时间.结果:腰麻组与骶麻组麻醉效果满意率分别为95%和79%(P<0.05),腰麻组与骶麻组术中心血管系统不良反应的发生率分别为30.6%和5.3%(P<0.01),腰麻组与骶麻组的平均麻醉起效时间分别为1.98 min和8.99 min(P<0.01),腰麻组与骶麻组分别发生尿潴留4例、3例(P>0.05),腰麻组与骶麻组术后平均感觉恢复时间分别为324 min和288 min(P>0.05).结论:肛门手术中应用腰麻效果优于骶管麻醉,

  20. 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

    2013-09-01

    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.

  1. 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.

  2. Acupuncture in ambulatory anesthesia: a review

    OpenAIRE

    Norheim AJ; Liodden I; Alræk T

    2015-01-01

    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-an...

  3. Human factors research in anesthesia patient safety.

    OpenAIRE

    Weinger, M.B.; Slagle, J.

    2001-01-01

    Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment. This paper describes data obtained recently using task analysis and workload assessment during actual patient care and the use of cognitive ...

  4. 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. PMID:26579661

  5. 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.

  6. Anesthesia of wild red howler monkeys (Alouatta seniculus) with medetomidine/ketamine and reversal by atipamezole.

    Science.gov (United States)

    Vié, J C; De Thoisy, B; Fournier, P; Fournier-Chambrillon, C; Genty, C; Kéravec, J

    1998-01-01

    Wild red howler monkeys (Alouatta seniculus) were translocated during the flooding of the forest at a hydroelectric dam site in French Guiana. For a variety of minor clinical procedures, 96 monkeys were anesthetized with various intramuscular injections of combinations of medetomidine and ketamine. The howler population was composed of healthy animals (42 males and 54 females) of various ages. Medetomidine (150 micrograms/kg) associated with ketamine (4 mg/kg) gave the best results and was used on 63 animals. The injection rapidly resulted in complete immobilization with good to excellent myorelaxation. The induction stage was quiet, with absence of both corneal and pedal withdrawal reflexes in 57 animals after 2.9 +/- 1.4 min. Six animals required an additional injection. Rectal temperature and respiratory and heart rates decreased during anesthesia, whereas relative oxyhemoglobin saturation increased. One death occurred during anesthesia. One abortion and one death also occurred the day following anesthesia but were more probably a result of capture stress. Atipamezole given i.m. at a dose of five times the medetomidine dose 38.4 +/- 8.0 min after the anesthetic injection led to standing recovery in 7.1 +/- 4.5 min. Spontaneous recovery occurred in 17 animals before the atipamezole injection after an average of 30.6 +/- 9.6 min. Total recovery time was shorter in young animals. Medetomidine/ketamine induced good myorelaxation and provided considerably shortened immobilization duration, which are two notable advantages for field studies. We recommend this association for short procedures including minor surgery in red howler monkeys. PMID:9702284

  7. 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

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

    OpenAIRE

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

    2005-01-01

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

  9. The heart rate variability when conducting anesthesia

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    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

  10. 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

  11. 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

  12. 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.

  13. Differential Postoperative Effects of Volatile Anesthesia and Intraoperative Remifentanil Infusion in 7511 Thyroidectomy Patients: A Propensity Score Matching Analysis.

    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

    2016-02-01

    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 surgeries

  14. 25 gauge vitrectomy under topical anesthesia: A pilot study

    OpenAIRE

    Raju Biju; Raju NSD; Raju Anju

    2006-01-01

    Aims: To evaluate the safety and efficacy of transconjunctival 25 gauge vitrectomy under topical anesthesia. Settings and Design: A pilot study of consecutive cases which underwent 25 gauge vitrectomy under topical anesthesia. Materials and Methods: Seven eyes of 7 patients underwent 25 gauge vitrectomy under topical anesthesia with a pledget soaked in anesthetic, for vitreous hemorrhage (2 eyes), retained cortex (1 eye) and postoperative endophthalmitis (4 eyes). Subjective pain and dis...

  15. 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.

  16. Dental treatment of handicapped patients using endotracheal anesthesia.

    OpenAIRE

    Pohl, Y.; A. Filippi; GEIGER, G.; Kirschner, H; Boll, M.

    1996-01-01

    Dental treatment using endotracheal anesthesia is indicated where acute odontogenic infections, accidental injuries, or multiple caries and periodontitis marginalis require surgical and/or restorative treatment. It is also indicated where it is not possible to use psychological support during local anesthesia or during premedication or analgosedation. Dental treatment of handicapped patients using endotracheal anesthesia is described, along with indication and frequency of such treatment. The...

  17. 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.

  18. 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.

  19. Application of Non-intubated Anesthesia in VATS

    Directory of Open Access Journals (Sweden)

    Xiaotan DAI

    2016-05-01

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

  20. 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.

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

    Science.gov (United States)

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

    2006-04-01

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

  2. 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.

  3. Updates of Topical and Local Anesthesia Agents.

    Science.gov (United States)

    Boyce, Ricardo A; Kirpalani, Tarun; Mohan, Naveen

    2016-04-01

    As described in this article, there are many advances in topical and local anesthesia. Topical and local anesthetics have played a great role in dentistry in alleviating the fears of patients, eliminating pain, and providing pain control. Many invasive procedures would not be performed without the use and advances of topical/local anesthetics. The modern-day dentist has the responsibility of knowing the variety of products on the market and should have at least references to access before, during, and after treatment. This practice ensures proper care with topical and local anesthetics for the masses of patients entering dental offices worldwide. PMID:27040295

  4. Anatomy of an anesthesia information management system.

    Science.gov (United States)

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

    2011-09-01

    Anesthesia information management systems (AIMS) have become more prevalent as more sophisticated hardware and software have increased usability and reliability. National mandates and incentives have driven adoption as well. AIMS can be developed in one of several software models (Web based, client/server, or incorporated into a medical device). Irrespective of the development model, the best AIMS have a feature set that allows for comprehensive management of workflow for an anesthesiologist. Key features include preoperative, intraoperative, and postoperative documentation; quality assurance; billing; compliance and operational reporting; patient and operating room tracking; and integration with hospital electronic medical records. PMID:21871398

  5. 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...

  6. 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.

  7. Blood transfusion in cardiac surgery: Does the choice of anesthesia or type of surgery matter?

    Directory of Open Access Journals (Sweden)

    Nešković Vojislava

    2013-01-01

    Full Text Available Background/Aim. In spite of the evidence suggesting a significant morbidity associated with blood transfusions, the use of blood and blood products remain high in cardiac surgery. To successfully minimize the need for blood transfusion, a systematic approach is needed. The aim of this study was to investigate the influence of different anesthetic techniques, general vs combine epidural and general anesthesia, as well as different surgery strategies, on-pump vs off-pump, on postoperative bleeding complications and the need for blood transfusions during perioperative period. Methods. Eighty-two consecutive patients scheduled for coronary artery bypass surgery were randomized according to surgical and anesthetic techniques into 4 different groups: group 1 (patients operated on off-pump, under general anesthesia; group 2 (patients operated on off-pump, with combined general and high thoracic epidural anesthesia; group 3 (patients operated on using standard revascularization technique, with the use of extracorporeal circulation, under general anesthesia, and group 4 (patients operated on using standard revascularization technique, with the use of extracorporeal circulation, with combined general and high thoracic epidural anesthesia. Indications for transfusion were based on clinical judgment, but a restrictive policy was encouraged. Bleeding was considered significant if it required transfusion of blood or blood products, or reopening of the chest. The quantity of transfused blood or blood products was specifically noted. Results. None of the patients was transfused blood or blood products during the surgery, and as many as 70/81 (86.4% patients were not transfused at all during hospital stay. No difference in postoperative bleeding or blood transfusion was noted in relation to the type of surgery and anesthetic technique applied. If red blood cells were transfused, postoperative bleeding was the most influential parameter for making clinical

  8. 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

  9. 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.

  10. [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.

  11. Complications after spinal anesthesia in adult tethered cord syndrome.

    Science.gov (United States)

    Liu, Jing-Jie; Guan, Zheng; Gao, Zhen; Xiang, Li; Zhao, Feng; Huang, Sheng-Li

    2016-07-01

    Since little has been reported about complications of spinal anesthesia in adult tethered cord syndrome (TCS), we sought to delineate the characteristics of the condition.A total of 4 cases of adult TCS after spinal anesthesia were reviewed. The medical charts of the patients were obtained. Anesthesia, which was combined spinal and epidural anesthesia or spinal anesthesia was performed, and follow-up were carried out in all patients.The most common neurological symptom of adult TCS before surgery was occasional severe pain in back, perineal region, or legs. Frequent micturition, diminished knee and ankle reflexes, and difficulty in bending were exhibited in partial patients. Paraesthesia of perineal region or/and lower extremities existed 2 to 3 days after spinal anesthesia in all the cases. Weakness of lower extremities existed in 1 case. Lumbar magnetic resonance imaging showed the low location of conus medullaris. At follow-up, 3 cases recovered completely within 3 weeks, and 1 case underwent permanent disability.These cases suggest anesthesiologists and surgeons alert to the association of adult TCS and spinal anesthesia. Spinal anesthesia should be prohibited in patients with adult TCS to prevent neurological damages. PMID:27442670

  12. The Effect of Neuraxial Anesthesia on Maternal Cerebral Hemodynamics

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Science.gov (United States)

    Halliburton, J R

    1998-05-01

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

  14. [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.

  15. 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.

  16. 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.

  17. 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.

  18. The history of the nurse anesthesia profession.

    Science.gov (United States)

    Ray, William T; Desai, Sukumar P

    2016-05-01

    Despite the fact that anesthesia was discovered in the United States, we believe that both physicians and nurses are largely unaware of many aspects of the development of the nurse anesthetist profession. A shortage of suitable anesthetists and the reluctance of physicians to provide anesthetics in the second half of the 19th century encouraged nurses to take on this role. We trace the origins of the nurse anesthetist profession and provide biographical information about its pioneers, including Catherine Lawrence, Sister Mary Bernard Sheridan, Alice Magaw, Agatha Cobourg Hodgins, and Helen Lamb. We comment on the role of the nuns and the effect of the support and encouragement of senior surgeons on the development of the specialty. We note the major effect of World Wars I and II on the training and recruitment of nurse anesthetists. We provide information on difficulties faced by nurse anesthetists and how these were overcome. Next, we examine how members of the profession organized, developed training programs, and formalized credentialing and licensing procedures. We conclude by examining the current state of nurse anesthesia practice in the United States. PMID:27041264

  19. Anesthesia considerations in the obese gravida.

    LENUS (Irish Health Repository)

    Tan, Terry

    2011-12-01

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

  20. Anesthesia for subglottic stenosis in pediatrics

    Directory of Open Access Journals (Sweden)

    Eid Essam

    2009-01-01

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

  1. Anesthesia for subglottic stenosis in pediatrics.

    Science.gov (United States)

    Eid, Essam A

    2009-07-01

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

  2. Simulation in teaching regional anesthesia: current perspectives

    Directory of Open Access Journals (Sweden)

    Udani AD

    2015-08-01

    Full Text Available Ankeet D Udani,1 T Edward Kim,2,3 Steven K Howard,2,3 Edward R Mariano2,3On behalf of the ADAPT (Anesthesiology-Directed Advanced Procedural Training Research Group1Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; 2Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; 3Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USAAbstract: The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Future research should be directed toward comparative-effectiveness of simulation versus other accepted teaching methods, exploring the combination of procedural training with realistic clinical scenarios, and the application of simulation-based teaching curricula to a wider range of learner, from the student to the practicing physician.Keywords: regional anesthesia, simulation, medical education, ultrasound, nerve block, simulator

  3. Isoflurane anesthesia is a valuable alternative for alpha-chloralose anesthesia in the forepaw stimulation model in rats.

    NARCIS (Netherlands)

    Sommers, M.G.J.; Egmond, J. van; Booij, L.H.D.J.; Heerschap, A.

    2009-01-01

    Isoflurane (ISO) can be a valuable alternative for alpha-chloralose (ACL) anesthesia in functional MRI (fMRI) studies. Therefore, we compared the efficacy of the blood oxygen level dependent (BOLD) effect in fMRI studies during ISO and ACL anesthesia sequentially in the same animals. After non-invas

  4. 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

  5. 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....

  6. Acupuncture in ambulatory anesthesia: a review

    Directory of Open Access Journals (Sweden)

    Norheim AJ

    2015-09-01

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

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

    Science.gov (United States)

    Vlassakov, Kamen V; Kissin, Igor

    2015-01-01

    The aim of this study was to assess progress in the field of anesthesia monitoring over the past 40 years using scientometric analysis. The following scientometric indexes were used: popularity indexes (general and specific), representing the proportion of articles on either a topic relative to all articles in the field of anesthetics (general popularity index, GPI) or the subfield of anesthesia monitoring (specific popularity index, SPI); index of change (IC), representing the degree of growth in publications on a topic from one period to the next; and index of expectations (IE), representing the ratio of the number of articles on a topic in the top 20 journals relative to the number of articles in all (>5,000) biomedical journals covered by PubMed. Publications on 33 anesthesia-monitoring topics were assessed. Our analysis showed that over the past 40 years, the rate of rise in the number of articles on anesthesia monitoring was exponential, with an increase of more than eleven-fold, from 296 articles over the 5-year period 1974-1978 to 3,394 articles for 2009-2013. This rise profoundly exceeded the rate of rise of the number of articles on general anesthetics. The difference was especially evident with the comparison of the related GPIs: stable growth of the GPI for anesthesia monitoring vs constant decline in the GPI for general anesthetics. By the 2009-2013 period, among specific monitoring topics introduced after 1980, the SPI index had a meaningful magnitude (≥1.5) in 9 of 24 topics: Bispectral Index (7.8), Transesophageal Echocardiography (4.2), Electromyography (2.8), Pulse Oximetry (2.4), Entropy (2.3), Train-of-four (2.3), Capnography (1.9), Pulse Contour (1.9), and Electrical Nerve Stimulation for neuromuscular monitoring (1.6). Only one of these topics (Pulse Contour) demonstrated (in 2009-2013) high values for both IC and IE indexes (76 and 16.9, respectively), indicating significant recent progress. We suggest that rapid growth in the field of

  8. 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

  9. 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.

  10. 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…

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

    Directory of Open Access Journals (Sweden)

    Umar Qadir

    2015-03-01

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

  12. Psychological Health Status and Psychological Intervention Demands of Cancer Patients In Recovery Period%康复期癌症患者心理健康及心理干预需求相关因素研究

    Institute of Scientific and Technical Information of China (English)

    王辉; 朱有才; 徐杰; 陈颖高; 王凤华

    2015-01-01

    Objective :To learn the psychological status and psychological intervention demands of cancer patients in re‐covery period ,then supply basis for psychological intervention of cancer patients .Methods :By face to face interview and questionnaire survey in outpatient department ,reexamined cancer patients in recovery period finished self‐compiled questionnaire ,Quality of Life Core Questionaire ,Distress Thermometer ,Hospital Anxiety and Depression Scale .Re‐sults :There are 102 cancer patients finished the study in total .Among them ,10 (9 .8% ) person got distress scores higher than threshold .5(4 .9% ) person got higher anxiety and depression scores .There are no difference between dif‐ferent gender and transfer status of life quality total score ,functional subscale and symptom subscale .The patients has cancer metastasis got higher HADS score than patients without cancer metastasis (t= 2 .144 ,P< 0 .05) .Advanced pa‐tients need psychological intervention urgently (χ2 = 6 .495 ,P< 0 .05) ,and tend to group psychological intervention (χ2= 13 .009 ,P < 0 .01) .Conclusion :Psychological knowledge education and expansion should be enhanced in cancer pa‐tients in recovery period .And many kinds of psychological interventions administrated together can improve cancer pa‐tients psychological level and life quality .%目的:了解康复期癌症患者的心理健康现状及对心理干预的需求,为癌症患者心理干预方案设计提供依据。方法:对门诊复查的102例康复期癌症患者,通过1对1访谈及问卷的方式进行调查。完成自编问卷、生活质量问卷、心理痛苦温度计、综合医院焦虑抑郁量表的测评工作。结果:共有102例癌症患者完成本研究,其中10例(9.8%)痛苦分数高于临界值,5例(占4.9%)焦虑抑郁分数高于临界值。不同性别、有无转移癌症患者生活质量评定,QLQ 总分、功能分量表、症状分量表均未见显著

  13. 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.

  14. 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 administration and to assess responses in other reptilian species. PMID:27468022

  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. 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

  17. 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

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

    Directory of Open Access Journals (Sweden)

    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

  19. Local Versus Global Effects of Isoflurane Anesthesia on Visual Processing in the Fly Brain.

    Science.gov (United States)

    Cohen, Dror; Zalucki, Oressia H; van Swinderen, Bruno; Tsuchiya, Naotsugu

    2016-01-01

    What characteristics of neural activity distinguish the awake and anesthetized brain? Drugs such as isoflurane abolish behavioral responsiveness in all animals, implying evolutionarily conserved mechanisms. However, it is unclear whether this conservation is reflected at the level of neural activity. Studies in humans have shown that anesthesia is characterized by spatially distinct spectral and coherence signatures that have also been implicated in the global impairment of cortical communication. We questioned whether anesthesia has similar effects on global and local neural processing in one of the smallest brains, that of the fruit fly (Drosophila melanogaster). Using a recently developed multielectrode technique, we recorded local field potentials from different areas of the fly brain simultaneously, while manipulating the concentration of isoflurane. Flickering visual stimuli ('frequency tags') allowed us to track evoked responses in the frequency domain and measure the effects of isoflurane throughout the brain. We found that isoflurane reduced power and coherence at the tagging frequency (13 or 17 Hz) in central brain regions. Unexpectedly, isoflurane increased power and coherence at twice the tag frequency (26 or 34 Hz) in the optic lobes of the fly, but only for specific stimulus configurations. By modeling the periodic responses, we show that the increase in power in peripheral areas can be attributed to local neuroanatomy. We further show that the effects on coherence can be explained by impacted signal-to-noise ratios. Together, our results show that general anesthesia has distinct local and global effects on neuronal processing in the fruit fly brain. PMID:27517084

  20. 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…

  1. Anesthesia and stimulation of pituitary beta-endorphin release in rats.

    Science.gov (United States)

    Maiewski, S; Muldoon, S; Mueller, G P

    1984-07-01

    The effects of several anesthetic drugs and artificial respiration on the release of pituitary beta-endorphin-like immunoreactivity (beta-END-LI) were examined in rats. Plasma beta-END-LI responses to halothane and pentobarbital were similar in magnitude and duration, being maximal (2- to 3-fold) by 10 min and returning to control values by 30 min after induction. Urethane anesthesia was associated with an 8-fold increase in plasma beta-END-LI throughout the 30-min treatment period. In comparison to anesthesia alone, anesthesia plus intubation with artificial respiration (standard parameters) was associated with considerably greater elevations in plasma beta-END-LI (up to 30-fold). Further, intubation and artificial respiration appear to have contributed separately, and in an additive fashion, to the overall beta-END-LI responses observed. As compared to halothane anesthesia alone, intubation evoked a 4-fold increase in circulating beta-END-LI, whereas intubation plus ventilation was associated with a 12-fold increase. Treatment with morphine (1 or 5 mg/kg), but not pancuronium (0.3 mg/kg), attenuated the plasma beta-END-LI response to mechanical ventilation, suggesting that a subconscious phenomenon, perhaps related to pain, was partially responsible for the profound release of pituitary beta-END-LI associated with artificial respiration. Chromatographic analysis of the molecular forms of beta-END-LI released into plasma revealed that both beta-END- and beta-lipotropin (beta-LPH)-sized peptides were secreted under the present experimental conditions. Since the analgesic form of beta-END (beta- END1 -31) is cosecreted with beta-LPH from the pars distalis, increases in the fraction of plasma beta-END-LI corresponding to beta-END in size were probably due to the release of opiate active beta- END1 -31. PMID:6328533

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

    Directory of Open Access Journals (Sweden)

    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. Total intravenous anesthesia using propofol and alfentanil for coronary artery bypass surgery.

    Science.gov (United States)

    Gordon, P C; Morrell, D F; Pamm, J D

    1994-06-01

    Total intravenous anesthesia (TIVA) using alfentanil and propofol was used in 10 patients undergoing coronary artery bypass grafting. In an attempt to diminish unwanted side effects, lower doses were chosen than if either drug had been used alone. Anesthesia was induced with alfentanil, 75 micrograms/kg, followed by a sleep dose of propofol (mean dose 0.5 mg/kg). Maintenance in the precardiopulmonary bypass (CPB) period was achieved by infusions of propofol (6 mg/kg/h) and alfentanil (100 micrograms/kg/h). These were decreased by two thirds on commencement of CPB, and increased to half the initial rate on rewarming to 32 degrees C. Additional boluses of alfentanil were used to control breakthrough hypertension. The mean arterial pressure (MAP) and left ventricular stroke work index (LVSWI) fell significantly on induction. MAP but not LVSWI returned to baseline levels at skin incision. The cardiac index (CI) was maintained. A degree of myocardial depression was suggested by a fall in LVSWI despite maintaining preload, and by the failure of CI to increase in the presence of a reduced SVR. Anesthesia was satisfactory in all but one patient who developed breakthrough hypertension on sternotomy with transient ST segment depression, and awareness after CPB despite a plasma alfentanil concentration of 450 ng/mL. Mean time to wakening was 55 minutes. The study indicated that TIVA using propofol and alfentanil in the dosages described provides satisfactory basal anesthesia for coronary artery bypass surgery in patients with good left ventricular function, but requires additional pharmacologic manipulation, particularly with boluses of alfentanil, to control breakthrough hypertension. PMID:8061261

  4. 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.

  5. 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

  6. 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

  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

    Directory of Open Access Journals (Sweden)

    M.ª Salete F. Martins

    2007-12-01

    Full Text Available 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: control (C continued to receive the control diet whereas the aproteic group (A received either a control diet (AC or a control diet supplementedwith 5% of rice bran (ARB. Results: The A group showed alterations in the colon and cecum, excreted dry feces mass and fecal nitrogen, compared with C rats. In the proximal colon of A rats, the external muscularis and the width of the colon wall were higher whereas in the distal colon they were lower than C. After the recovery period, the relative cecum mass, colon mass and colon length of the recovered groups (AC and ARB were higher than in the C group. Dry feces and fecal nitrogen excreted of the rats from recovered groups were lower than C group. Colon length of the AC group was lower than in the C group. Only the crypt's depthfrom ARB group was higher than in the C group. Conclusion: Control diet supplemented with 5% rice bran, reestablished the large intestine of aproteic rats. The recovery in the ARB group was even better than in the AC rats.Objetivo: investigar el desarrollo del colon en ratas sometidas a malnutrición proteico-calórica seguida de complementación con salvado de arroz. Material y métodos: se emplearon ratas Wistar macho destetadas (de 21 días de edad, peso (40-50 g que se dividieron en dos grupos: dieta con 17% de proteínas (C, grupo control y dieta aproteica (A, grupo aproteico, durante 12 días. Tras ello, se sacrificó al 50% de las ratas de cada grupo. A las ratas restantes se las dividi

  8. 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.

  9. 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.

  10. 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

  11. 运动洲练及呼吸肌锻炼对COPD患者稳定期的影响%Effects of Physical Training and Respiratary Muscle Training on the Patients With COPD in Recovery Period

    Institute of Scientific and Technical Information of China (English)

    黄友明

    2009-01-01

    Objiect ive To explore the effects of pulmonary rehabilitation in stable patients with chronic obstructive pulmonary diseases(COPD) ,after physical training and respiratary muscle training, Methods 73 COPD patients in recovery period were divided into the group of pulmonary rehaibilitation(n=35) and control group(n=38) in random, the former was given the treatment of exercise training and respiratary training, the other was given only medicament, the data of PaO2、 PaCO2、 FEV 1.0, FEV1.0 / FVC, 6MWD, SGRQ were evaluated before and 8 weeks after treatment. Resu Its the data of PaO2、 PaCO2、 FEV1.0, FEV1.0 / FVC were imoroved aider trained , the data of6MWD, SGRQ were significantly improved(P0.05). Conclusion The physical training and respiratary muscle traini ng can improve the endurance and the quality of life to the patients with chronic obstructive pulmonary diseases(COPD) in recovery period.%目的 评估运动训练及呼吸肌锻炼对稳定期慢性阻塞性肺疾病患者运动耐力和生活质量的影响,为患者的健康管理和生命质量的提高提供帮助.方法 73例COPD缓解期患者随机分为肺康复组(35例)与对照组(38例),肺康复组给予运动训练、呼吸肌锻炼及常规药物治疗措施,对照组仅在常规取药治疗,测定治疗前和治疗后8周PaO2、PaCO2、FEV10.0、FEV1.0/FVC、6分钟步行距离(6MWD)、SGRQ生活质量积分(QOL).评估两组患者运动耐力和生活质量.结果 肺康复组患者治疗后的PaO2、PaCO2、FEV1.0、FEV1.0/FVC有改善,SGRQ生活质量积分、6分钟步行距离较治疗前有明显改善(P0.05).结论 运动训练及呼吸肌锻炼对慢性阻塞性肺疾病稳定期患者运动耐力的提升和生活质量的提高有一定疗效.

  12. 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 when...... hypotension is present, which may have implications for the choice of treatment of hypotension. However, no long-term information or measurements of plasma volumes with or without hypotension after epidural anesthesia are available. METHODS: In 12 healthy volunteers, the authors assessed plasma (125I...... volunteers receiving hydroxyethyl starch. RESULTS: Plasma volume did not change per se after thoracic epidural anesthesia despite a decrease in blood pressure. Plasma volume increased with fluid administration but remained unchanged with vasopressors despite that both treatments had similar hemodynamic...

  13. Nursing intervention in gynecologic brachytherapy under general anesthesia

    International Nuclear Information System (INIS)

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

  14. 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...

  15. 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.

  16. A survey of user acceptance of electronic patient anesthesia records

    OpenAIRE

    Jin, Hyun Seung; Kim, Myung Hee; Lee, Suk Young; Jeong, Hui Yeon; Choi, Soo Joo; Lee, Hye Won

    2012-01-01

    Background An anesthesia information management system (AIMS), although not widely used in Korea, will eventually replace handwritten records. This hospital began using AIMS in April 2010. The purpose of this study was to evaluate users' attitudes concerning AIMS and to compare them with manual documentation in the operating room (OR). Methods A structured questionnaire focused on satisfaction with electronic anesthetic records and comparison with handwritten anesthesia records was administer...

  17. Issues of critical airway management (Which anesthesia; which surgical airway?)

    OpenAIRE

    Fabrizio Giuseppe Bonanno

    2012-01-01

    Which anesthesia for patients with critical airway? Safe and effective analgesia and anesthesia in critical airway is a skilled task especially after severe maxillofacial injury combined with head injury and hemorrhagic shock. If on one side sedation is wanted, on the other hand it may worsen the airway and hemodynamic situation to a point where hypoventilation and decrease of blood pressure, common side-effect of many opioids, may prejudice the patient′s level of consciousness and hemodynami...

  18. 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....

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  1. Oral transmucosal fentanyl pretreatment for outpatient general anesthesia.

    OpenAIRE

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

    2000-01-01

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

  2. 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.

  3. 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

  4. 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.

  5. 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. PMID:26072156

  6. 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.

  7. The state of UK pediatric anesthesia: a survey of National Health Service activity.

    Science.gov (United States)

    Sury, Michael R J; Arumainathan, Renuka; Belhaj, Alla M; MacG Palmer, James H; Cook, Tim M; Pandit, Jaideep J

    2015-11-01

    This secondary analysis of the 2013 United Kingdom National Health Service (NHS) Anaesthesia Activity Survey of the Fifth National Audit Project (of the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland) shows pediatric anesthesia activity in detail. A local coordinator (LC) in every NHS hospital collected data on patients undergoing any procedure managed by an anesthetist. Questionnaires had 30 question categories. Each LC was randomized to a 2-day period. The pediatric age groups were infants, (UK pediatric anesthetic practice and highlight differences between pediatric and adult services.

  8. Changes in intraocular pressures during laparoscopy: a comparison of propofol total intravenous anesthesia to desflurane-thiopental anesthesia.

    Science.gov (United States)

    Asuman, Arslan Onuk; Baris, Arslan; Bilge, Karsli; Bozkurt, Selen; Nurullah, Bülbüler; Meliha, Kahraman; Umit, Celik

    2013-02-01

    The aim of the study was to examine intraocular pressure (IOP) changes during laparoscopic cholecystectomy performed under either desflurane-thiopental anesthesia or propofol total intravenous anesthesia (TIVA). 36 patients who will undergo elective laparoscopic cholecystectomy were enrolled in the study. The patients were randomly divided into one of two groups: desflurane (Group D, n=18) or propofol (Group P, n=18). All patients received fentanyl 2 micro/kg IV, and then breathed 100% oxygen for 3 minutes prior to induction of anesthesia. Anesthesia was induced by using thiopental 5 mg/kg IV in Group D and 2 mg/kg IV propofol in group P. Neuromuscular block was achieved with rocuronium 0.6 mg/kg IV. Anesthesia was maintained with desflurane 3-6% in group D and propofol infusion 5-10 mg/kg/h in group P. Desflurane and propofol concentrations were adjusted to maintain mean arterial pressure witihin 20% of the preinduction value. During anaesthesia, fractionated doses of fentanyl 0.5-1 micro g /kg IV and maintenance doses of muscle relaxants were used. In both groups, the the mixture 60% nitrous oxide and 40% oxygen was administered used. Arterial pressure, heart rate, ETCO2, SpO2 and IOP were recorded at the predefined time points. Creation of pneumoperitoneum resulted in a significant increase in IOP which remained elevated throughout the operation in both groups. Also, we recorded a similar IOP changes with both techniques except at five minutes after pneumoperitoneum in 15 degrees reverse Trendelenburg position during desflurane-thiopental anesthesia. In c6nclusion, desflurane-thiopental anesthesia maintains the IOP at least at similar levels compared to propofol TIVA anesthesia.

  9. 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.

  10. 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

  11. [The history of anesthesia apparatus: basic principles].

    Science.gov (United States)

    Wawersik, J

    1982-10-01

    The beginnings of modern anesthetic equipment date back to Morton's inhalation flagon in 1846. The numerous devices developed and introduced subsequently can be divided into four groups: 1. Simple ether and chloroform masks for open inhalation anesthesia, from Simpson (1847) to Brown (1928). 2. Vapour inhalators according to the "draw over" principle of Snow (1847) up to the Oxford vaporizer (1941). 3. Closed or half-closed inhalation equipment for ether or chloroform with to and fro breathing, from Clover (1877) to Ombredanne (1908). 4. Equipment for anaesthesia with nitrous oxide. From 1868 onwards this led to the incorporation of gas bottles in anaesthetic equipment and between 1885 and 1890 to the construction of mixing-valves for nitrous oxide and oxygen. In addition, reducing valves, flow meters and vaporizers were developed. The first anaesthetic apparatus with circle system and CO2-absorber was constructed in 1925 by the Dräger factory in Lübeck. Sudeck and Schmidt introduced this technique of anaesthesia in the university hospital of Hamburg-Eppendorf between 1920 and 1925. PMID:6758628

  12. Reactive Software Agent Anesthesia Decision Support System

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    Grant H. Kruger

    2011-12-01

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

  13. 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

  14. DEXAMETHASON ADMINISTRATION IN INTRAVENOUS REGIONAL ANESTHESIA: ITS AFFECT ON POST OPERATIVE PAIN A RANDOMIZED DOUBLE BLINDED CLINICAL TRIAL

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    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.

  15. Recovery Spirituality

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    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. 不同剂量氟比洛芬酯对全麻腹腔镜单纯胆囊切除手术围拔管期中应激反应的影响%Effects of different doses of flurbiprofen on stress response during general anesthesia of laparoscopic cholecystectomy in tracheal extubation period

    Institute of Scientific and Technical Information of China (English)

    王凯; 谢翼; 刘兴敏

    2014-01-01

    Objective To observe the effects of different doses of flurbiprofen on inhibiting the stress response caused by tracheal extubation.Methods Fifty patients underwent laparoscopic cholecystectomy (LC) with tracheal intubation under general anesthesia were chose,and randomly divided into 5 groups (n =10):intralipid control group (group Ⅰ),flurbiprofen 0.75 mg/kg group (group Ⅱ),flurbiprofen 1 mg/kg group (group Ⅲ),flurbiprofen 1.25 mg/kg group (groupⅣ) and flurbiprofen 1.5 mg /kg group (group Ⅴ).The drugs in the above groups were diluted with saline to 12 ml.The first injection will be given 10 minutes after the gallbladder was cut and the second injection will be given 5 minutes after the first one.The two intravenous infusion will be half of the total dose respectively with each pumping more than 1 minute.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) was recorded at the end of the surgery (T1),the time of tracheal extubation (T2),2 minutes after extubation (T3),5 minutes after extubation (T4),10 minutes after extubation (T5),and 20 minutes after extubation (T6),and 3 ml venous blood was extracted at T1,T2 and T6 to measure the blood glucose,cortisol concentration.The time of patient' s consciousness and extubation was observed,and the sedation,pain and patient's satisfaction at 15 minutes,30 minutes and 45 minutes after extubation was evaluated.The adverse reactions such as cough,nausea were recorded.Results In regard to ease stress response to tracheal extubation,sedation,analgesia and raising patient's satisfaction,the effects in group Ⅳ and group Ⅴ were obviously better than those in other groups (P < 0.05).The effects in group Ⅳ and Ⅴ were close,there were no significant differences (P > 0.05).Conclusions 1.25 mg/kg dose of flurbiprofen has good sedation and analgesia effects,can reduce the occurence of adverse effect and raise patients' satisfaction degree.%目的 观察不同剂量的氟比洛芬酯抑制

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

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    Kumar Babu

    2014-11-01

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

  19. Dexmedetomidine versus propofol for sedation in patients undergoing vitreoretinal surgery under sub-Tenon′s anesthesia

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    Ashraf Ghali

    2011-01-01

    Full Text Available Purpose: The purpose of this study was to evaluate the hemodynamic, respiratory effects, the recovery profile, surgeons, and patients satisfaction with dexmedetomidine sedation compared with those of propofol sedation in patients undergoing vitreoretinal surgery under sub-Tenon′s anesthesia. Methods: Sixty patients were enrolled in this prospective, single-blind, randomized study. The patients were divided into two groups to receive either dexmedetomidine (group D or propofol (group P. Sedation level was titrated to a Ramsay sedation scale (RSS of 3. Hemodynamic and respiratory effects, postoperative recovery time, analgesic effects, surgeons and patients satisfaction were assessed. Results: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline values. The respiratory rate values of the dexmedetomidine group were significantly higher than those in the propofol group. The oxygen saturation values of the dexmedetomidine group were significantly higher than those of the propofol group. The expired CO 2 was similar in both groups. Postoperatively, the time to achieve an Aldrete score of 10 was similar in both groups. Dexmedetomidine patients have significantly lower visual analog scale for pain than propofol patients. The surgeon satisfaction with patients′ sedation was similar for both groups. The patients′ satisfaction was higher in the dexmedetomidine group. Conclusion: Dexmedetomidine at similar sedation levels with propofol was associated with equivalent hemodynamic effects, maintaining an adequate respiratory function, similar time of discharge from PACU, better analgesic properties, similar surgeon′s satisfaction, and higher patient′s satisfaction. Thus, dexmedetomidine may prove to be a valuable adjuvant for sedation in patients undergoing vitreoretinal surgery under sub-Tenon′s anesthesia.

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

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    Ramin Mazaheri-Khameneh

    2012-06-01

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

  1. 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…

  2. [Obstetric and gynecologic anesthesia reported in the "Revista Española de Obstetricia y Ginecología" (1916-1936)].

    Science.gov (United States)

    Llorente, A; Giménez, M C; Figueira, A; Montero, G

    1994-01-01

    This study follows the evolution of anesthesia in gynecology and obstetrics in Spain between 1916 and 1936. Research included revising all articles and references concerning anesthesiology appearing in the Revista Española de Obstetricia y Ginecologia over the 20 years during which that journal was published. Eighty-three articles were found: 18 (21.6%) original research reports, 37 (44.6%) reviews of the Spanish professional literature and 28 (33.7%) summaries and descriptions of meetings of scientific organizations. Spanish references constituted 39.8% with the remaining 60.2% coming from European and Hispano-American sources. Twenty-four (34.9%) were related to spinal anesthesia, 15 (18%) covered various methods for analgesia during childbirth and 14 (16.8%) were on barbiturates. The remaining articles referred to rectally administered anesthesia, local anesthesia, inhalatory anesthesia and pain in gynecology. In conclusion, our review reveals the strong international contacts in Spanish gynecology during this period, as well as the interest of gynecologists and obstetricians in various anesthetic techniques and the rapid incorporation of new methods into their therapeutic arsenal.

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

    Institute of Scientific and Technical Information of China (English)

    丁依红; 顾陈怿; 沈利荣; 吴凉森; 施征; 陈跃来

    2013-01-01

    ) were observed and recorded in the 3 groups at post-operative 4,6,8,24,and 44 h,respectively.Results (1) Compared with before anesthesia induction in the same group,the CI,CO,ACI of all patients decreased significantly at 5 min after pneumoperitoneum and at excision of gallbladder (P <0.01,P <0.05).The HR,MAP,SVRI obviously increased in Group B and Group C at each time point (P <0.05,P <0.01).Less change happened in Group A.Compared with Group C,the increment of MAP was less in Group A at 5 min after pneumoperitoneum,showing statistical difference (P <0.05).(2) The time consumption from discontinuation to analepsia and extubation was obviously shorter in Group A than in Group B and Group C (P <0.05,P <0.01).(3)The level of β-EP on the 1st day of operation was significantly lower in Group A than in Group B (P <0.05)and Group C (P <0.01).(4) The VAS score at post-operative 44 h was significantly lower in Group A than in Group B and Group C (P <0.05).Conclusions Electroacupuncture at acupoints combined general anesthesia could maintain the stabilization of haemodynamics,and relieve the stress reaction after pneumoperitoneum and operation,and prolong it to early post-operative period,and strengthen the effects of post-operative analgesia.The post-operative recovery was fast,safe,and reliable.%目的 观察不同麻醉方法对腹腔镜胆囊切除术围术期患者血流动力学及内啡肽的影响.方法 选择90例腹腔镜胆囊切除术患者,按美国麻醉医师协会(American Society of Anesthesiologists,ASA)病情分级Ⅰ~Ⅱ级,年龄29 ~ 80岁,随机分为3组:A组(电针经穴复合全麻组)、B组(电针非经非穴复合全麻组)、C组(全麻组),每组30例.3组患者均采用芬太尼3 μg/kg、异丙酚2 mg/kg、维库溴铵0.1 mg/kg进行全麻诱导,脑电双频指数(bispectral index,BIS)(40 ~65)处于全麻状态下,术中以静脉血浆靶控输注异丙酚,间断静脉注射芬太尼、维库溴铵维持麻醉.术后

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

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    Kyu-Jin Chung

    2012-09-01

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

  5. 25 gauge vitrectomy under topical anesthesia: A pilot study

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    Raju Biju

    2006-01-01

    Full Text Available Aims: To evaluate the safety and efficacy of transconjunctival 25 gauge vitrectomy under topical anesthesia. Settings and Design: A pilot study of consecutive cases which underwent 25 gauge vitrectomy under topical anesthesia. Materials and Methods: Seven eyes of 7 patients underwent 25 gauge vitrectomy under topical anesthesia with a pledget soaked in anesthetic, for vitreous hemorrhage (2 eyes, retained cortex (1 eye and postoperative endophthalmitis (4 eyes. Subjective pain and discomfort were graded from 0 (no pain or discomfort to 4 (severe pain and discomfort. Patients underwent an immediate postoperative assessment, followed by day one and one week postoperative evaluation. Results: All patients had grade 0 pain during the surgery. Five patients had grade 2 pain during the placement of the sclerotomies. None of the patients required any sedation during the procedure. No inadvertent eye movements were noted during surgery. Except one patient, none required postoperative analgesics. Five eyes had a favorable outcome. No eyes in this pilot study had any procedure-related complications. Conclusion: With appropriate case selection, topical anesthesia is a safe and effective alternative to infiltrative anesthesia for 25 gauge vitrectomy. A larger series of patients with a longer follow-up is required to validate the findings of this pilot study.

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

    Science.gov (United States)

    Douglas, James R; Ritter, Melody J

    2011-01-01

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

  7. Non-invasive anesthesia for children undergoing proton radiation therapy

    International Nuclear Information System (INIS)

    Background: Proton therapy is a newer modality of radiotherapy during which anesthesiologists face specific challenges related to the setup and duration of treatment sessions. Purpose: Describe our anesthesia practice for children treated in a standalone proton therapy center, and report on complications encountered during anesthesia. Materials and methods: A retrospective review of anesthetic records for patients ⩽18 years of age treated with proton therapy at our institution between January 2006 and April 2013 was performed. Results: A total of 9328 anesthetics were administered to 340 children with a median age of 3.6 years (range, 0.4–14.2). The median daily anesthesia time was 47 min (range, 15–79). The average time between start of anesthesia to the start of radiotherapy was 7.2 min (range, 1–83 min). All patients received Total Intravenous Anesthesia (TIVA) with spontaneous ventilation, with 96.7% receiving supplemental oxygen by non-invasive methods. None required daily endotracheal intubation. Two episodes of bradycardia, and one episode each of; seizure, laryngospasm and bronchospasm were identified for a cumulative incidence of 0.05%. Conclusions: In this large series of children undergoing proton therapy at a freestanding center, TIVA without daily endotracheal intubation provided a safe, efficient, and less invasive option of anesthetic care

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

    Science.gov (United States)

    Douglas, James R.; Ritter, Melody J.

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rochana Girish Bakhshi

    2011-11-01

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

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

    Science.gov (United States)

    Roberts, Matthew; Jagdish, S

    2016-01-01

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

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

    Science.gov (United States)

    Douglas, James R; Ritter, Melody J

    2011-01-01

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

  12. Possibilities of creating meaningful encounters in anesthesia nursing

    DEFF Research Database (Denmark)

    Aagaard, Karin

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

  13. Advances in Anesthesia Delivery in the Deployed Setting.

    Science.gov (United States)

    Wilson, John E; Barras, William P

    2016-01-01

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

  14. Pharmacodynamics and Pharmacokinetics of Levobupivacaine Used for Epidural Anesthesia in Patients with Liver Dysfunction.

    Science.gov (United States)

    Ran, Juhong; Wang, Yanping; Li, Fangkun; Zhang, Wei; Ma, Minyu

    2015-12-01

    The objective of this study was to study the pharmacodynamics and pharmacokinetics of levobupivacaine used for epidural anesthesia in patients with liver dysfunction. Twenty patients aged 20-60, American Society of Anesthesiologists (ASA) graded I-III according to the ASA guidelines, scheduled for elective upper abdominal surgery, were included in the study. They were divided into two groups of ten each. In group I, the patients with liver dysfunction were included, whereas group II was composed of those with normal liver function. In both groups, anesthesia was induced by general anesthesia combined with epidural block, given by T 8-9 interspace injection of 1.8 mg kg(-1) levobupivacaine (0.75 %) with 5 μg mL(-1) of adrenaline in 1.5 min. The sensory and motor blockade indices were recorded for 30 min after the injection. The plasma concentration of levobupivacaine was determined by high performance liquid chromatography from 0 to 1440 min after the injection and pharmacokinetics of the drug were calculated. The onset and recovery time from the sensory block in the two groups were similar with no significant difference (P > 0.05). The maximum spread of anesthetic effect, the number of spinal segments regressed, onset time, and degree of motor block after the injection were also insignificantly different in the two groups. The plasma levobupivacaine concentration/time curve of the liver dysfunction (group I) was significantly higher than that of the controls (group II). In the liver dysfunction patients, the volume of distribution (V/F) was significantly increased, the elimination rate, i.e., half-life (t 1/2β ), was prolonged, and the elimination rate constants (K 12 and K 10) were significantly decreased (P < 0.05 or P < 0.01). The patients with liver dysfunction injected with 0.75 % levobupivacaine exhibited normal onset and recovery time of the sensory and motor blocks within 30 min. However, in these patients, the metabolism of

  15. Managing anesthesia for cesarean section in obese patients: current perspectives.

    Science.gov (United States)

    Lamon, Agnes M; Habib, Ashraf S

    2016-01-01

    Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients. Neuraxial techniques are the preferred anesthetic techniques for cesarean delivery in obese parturients but can be technically challenging. An existing labor epidural catheter can be topped up for cesarean delivery. In patients who do not have a well-functioning labor epidural, a combined spinal epidural technique might be preferred over a single-shot spinal technique since it is technically easier in obese parturients and allows for extending the duration of the block as required. A continuous spinal technique can also be considered. Studies suggest that there is no need to reduce the dose of spinal bupivacaine in the obese parturient, but there is little data about spinal dosing in super obese parturients. Intraoperatively, patients should be placed in a ramped position, with close monitoring of ventilation and hemodynamic status. Adequate postoperative analgesia is crucial to allow for early mobilization. This can be achieved using a multimodal regimen incorporating neuraxial morphine (with appropriate observations) with scheduled nonsteroidal anti-inflammatory drugs and acetaminophen. Thromboprophylaxis is also important in this patient population due to the increased risk of thromboembolic complications. These patients should be monitored carefully in the postoperative period, since there is increased risk of postoperative complications in the morbidly obese parturients. PMID:27574464

  16. Periodic functions with variable period

    OpenAIRE

    Pryjmak, M. V

    2010-01-01

    The examples of rhythmical signals with variable period are considered. The definition of periodic function with the variable period is given as a model of such signals. The examples of such functions are given and their variable periods are written in the explicit form. The system of trigonometric functions with the variable period is considered and its orthogonality is proved. The generalized system of trigonometric functions with the variable period is also suggested; some conditions of it...

  17. 麻醉护理学专科建设实践与总结%Practice and summary in specialized subject construction of anesthesia nursing

    Institute of Scientific and Technical Information of China (English)

    侯晓旭; 张卫

    2015-01-01

    Objective To investigate the anesthesia nursing to fullfill the practice for anesthesia nursing in China,and construct the specialized subject system for anesthesia nursing.Methods The system of anesthesia nursing were established as eight subspeciahies,including clinical anesthesia care,post-anesthesia recovery care,pain care,post-anesthesia visiting,cell salvage,drug administration,infection management,equipment and information administration.All subspecialties have team leader and predefined echelon.The responsibility of anesthesia nurses was defined.Twenty eight working systems,thirty protocols,eighteen algorithms for special surgery,sixteen emergency plans and quality control system for anesthesia nursing were established,developed and improved during daily practice.Standardization protocol was established for training anesthetic nurses.Various forms of continuing post-graduation medical education were developed.Results Sixty seven anesthetic nurses completed the structured training and managed skill of anesthesia care.The responsibility of anesthesia nursing staff was clarified and the enthusiasm of staff was aroused.The value of anesthesia nursing was thoroughly realized in clinical anesthesia.The satisfaction of patients,doctors and nurses increased.We proposed the methods for constructing anesthesia nursing subspecialty system,also improved the anesthesia administration and anesthesia safety guarantee system,which will promote the development of both anesthesiology and anesthesia nursing and provide base for constructing anesthesia nursing subject.Conclusions It is demonstrated that the methods for constructing anesthesia nursing proposed in the present study is consistent with the requirement of nursing development in China.Furthermore,the development of anesthesia nursing is in its initial phase,and subject basement construction,specialized team,research platform and resources need further improvements.%目的 探索适合中国国情的麻醉护理单

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

    Science.gov (United States)

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Liehua Liu

    2016-01-01

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

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    João Frank Carvalho DANTAS

    2009-12-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

    Epley, J M

    1977-06-01

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

  4. Effect of yohimbine on xylazine-ketamine anesthesia in cats.

    Science.gov (United States)

    Hsu, W H; Lu, Z X

    1984-10-15

    Xylazine and ketamine are an anesthetic combination used in feline practice for routine surgical procedures. In a controlled study, we evaluated the effects of yohimbine, an antagonist of xylazine, on the anesthesia induced by this anesthetic combination in cats. Two intramuscular doses of xylazine and ketamine (2.2 mg of xylazine/kg plus 6.6 mg of ketamine/kg and 4.4 mg of xylazine/kg plus 6.6 mg of ketamine/kg) caused approximately 60 and 100 minutes of anesthesia, respectively, in control cats. When yohimbine (0.1 mg/kg) was given intravenously 45 minutes after ketamine administration, the cats regained consciousness within 3 minutes. They were ambulatory 1 to 2 minutes after regaining consciousness. Yohimbine also reversed the bradycardia and respiratory depression elicited by xylazine-ketamine. The results indicated that yohimbine may be useful for controlling the duration of xylazine-ketamine anesthesia in cats. PMID:6501048

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

    NARCIS (Netherlands)

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

    2001-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

    Bertelsen, Claus Anders

    2011-01-01

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

  8. 不同剂量艾司洛尔用于无痛胃肠镜镇静麻醉和麻醉复苏的临床研究%Different dosages of esmolol for sedation anesthesia and recovery of anaesthesia in painless gastrointestinal endoscopy

    Institute of Scientific and Technical Information of China (English)

    苗荷香

    2015-01-01

    目的 观察不同剂量的艾司洛尔用于无痛胃肠镜检查对镇静、麻醉复苏的影响.方法 选择100例行无痛胃肠镜检查的患者,随机分为A、B两组,各50例,均给予艾司洛尔,A组剂量为0.5 mg/kg,B组为1.0 mg/kg,对比两组患者的相关临床指标.结果 T0、T1、T2、T3四个时段,A组患者的MAP分别为(79.6±3.9) mmHg、(85.0±5.0)mmHg、(83.7±3.0) mmHg、(84.1±4.9)mmHg,HR分别为(79.6±3.9)次/min、(85.6±5.0)次/min、(83.4±3.0)次/min、(84.1±4.9)次/min;B组MAP分别为(79.4±4.0)mmHg、(80.2±4.4) mmHg、(80.2±4.0) mmHg、(80.5±4.6)mmHg,HR分别为(79.5±4.3)次/min、(80.4±4.6)次/min、(80.5±4.2)次/min、(80.7±4.8)次/min.A组在T0时段的MAP、HR与B组比较差异均无统计学意义,P>0.05;在T1、T2、T3时段均明显高于B组,P< 0.05.患者的麻醉苏醒时间、留院观察时间:A组分别为(2.7±0.1)min、(30.3±6.6) min,B组分别为(2.6±0.2) min、(30.5±6.0) min,两组比较差异无统计学意义,P> 0.05.结论 行无痛胃肠镜检查时,1.0 mg/kg为艾司洛尔的有效使用剂量,它可以有效维持平均动脉压及心率的稳定性,此剂量用药方案应当得到推广.%Objective To observe the effect of different dosages of esmolol on the sedation and the recovery of the anaesthesia in painless gastrointestinal endoscopy.Methods 100 patients undergoing painless gastrointestinal endoscopy were chosen and then were randomly divided into two groups,group A and group B.Group A took esmolol 0.5 mg/kg and group B 1.0 mg/kg.The clinical indicators were compared between the two groups.Results At T0,T1,T2,and T3,the MAP were(79.6±3.9)mmHg,(85.0±5.0)mmHg,(83.7±3.0)mmHg,and(84.1±4.9)mmHg in group A and were(79.4±4.0) mmHg,(80.2±4.4)mmHg,(80.2±4.0)mmHg,and(80.5±4.6)mmHg in group B and the HR were(79.6±3.9) times/min,(85.6±5.0)times/min,(83.4±3.0)times/min,and(84.1±4.9)times/min in group A and were (79.5±4.3)times/min,(80.4±4.6)times/min,(80.5±4.2)times

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

    Institute of Scientific and Technical Information of China (English)

    瞿兆奎; 祁薇; 杨岗林; 吉剑波; 吴大庆; 许少波

    2011-01-01

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

  10. Parental anxiety and stress before pediatric anesthesia: a pilot study on the effectiveness of preoperative clown intervention.

    Science.gov (United States)

    Agostini, Francesca; Monti, Fiorella; Neri, Erica; Dellabartola, Sara; de Pascalis, Leonardo; Bozicevic, Laura

    2014-05-01

    As induction of pediatric anesthesia can elicit anxiety in children and parents alike, this study was aimed at evaluating the effectiveness of clown intervention in decreasing maternal anxiety and stress in the preoperative phase. Before anesthesia induction, 25 children were randomly assigned to clown intervention and 25 to a control group with a routine procedure. In the waiting room and after separation from the child, maternal anxiety and stress were measured. The results showed that after separation, only in the clown group, maternal state anxiety significantly decreased and the tendency to somatization did not increase. Moreover, after clown intervention, older children's mothers significantly reduced the level of perceived stress. As clown intervention can positively influence maternal anxiety and stress in the preoperative period, its promotion in clinical-hospital environments is recommended. PMID:23456215

  11. Clonidine as an adjunct to intravenous regional anesthesia: A randomized, double-blind, placebo-controlled dose ranging study

    Directory of Open Access Journals (Sweden)

    Clarence S Ivie

    2011-01-01

    Full Text Available Background : The addition of clonidine to lidocaine intravenous regional anesthesia (IVRA has been previously reported to improve postoperative analgesia in patients undergoing upper extremity surgery. Our objective was to perform a dose ranging study in order to determine the optimal dose of clonidine used with lidocaine in IVRA. Design & Setting : We performed a double-blinded randomized placebo-controlled study with 60 patients scheduled for elective endoscopic carpal tunnel release under IVRA with 50 ml lidocaine 0.5%. University-affiliated outpatient surgery center. Data collected in operating rooms, recovery room, and by telephone after discharge from surgery center. Materials & Methods : Sixty adult ASA I or II patients undergoing outpatient endoscopic carpal tunnel release under intravenous regional anesthesia.Patients were randomized into five study groups receiving different doses of clonidine in addition to 50 ml 0.5% lidocaine in their IVRA. Group A received 0 mcg/kg, group B 0.25 mcg/kg, group C 0.5 mcg/kg, group D 1.0 mcg/kg and group E 1.5 mcg/kg of clonidine.Intraoperative fentanyl, recovery room pain scores, time to first postsurgical analgesic, total number of acetaminophen/codeine tablets consumed postsurgery, incidence of sedation, hypotension and bradycardia. Results & Conclusions : There was no benefit from any dose of clonidine compared to placebo. There were no clonidine-related side effects seen within the dose range studied. In short duration minor hand surgery, the addition of clonidine to lidocaine-based intravenous regional anesthesia provides no measurable benefit.

  12. O plantão noturno em anestesia reduz a latência ao sono El plantón nocturno en anestesia reduce la latencia al sueño Short sleep latency in residents after a period on duty in anesthesia

    Directory of Open Access Journals (Sweden)

    Lígia Andrade da Silva Telles Mathias

    2004-10-01

    ñana, después 24 horas de trabajo, sin dormir, sin plantón en los 3 días anteriores (M2; a las 13 horas de la tarde, después de 30 horas de trabajo, sin dormir, sin plantón en los 3 días anteriores (M3. En todas esas situaciones fue realizado electroencefalograma (EEG continuo, en sala apropiada para registro de los señales de sueño, evaluándose la latencia del sueño (LS. RESULTADOS: Se Verificó reducción significativa de la LS entre los residentes, después de 24 ó 30 horas de plantón sin dormir. Entre los praticantes que tuvieron noche de sueño normal en la víspera del examen, 36,4% presentaron LS en nivel considerado patológico. CONCLUSIONES: La jornada de plantón de 24 ó 30 horas lleva a valores de LS menores que 5 minutos, considerados patológicos, reflejando la fatiga extrema de residentes de Anestesiologia. Pode ser importante la reglamentación del número de horas de descanso pos-plantón.BACKGROUND AND OBJECTIVES: Physicians in general, and anesthesiologists in particular, have long working hours. Residents of Anesthesiology may present significant fatigue and stress. This study aimed at investigating first and second year residents’ sleep latency after a period on duty. METHODS: Participated in this study 11 residents in different situations: at 7:00 am, after a normal night sleep (> 7 h, without on duty period in the last 3 days (M1; at 7:00 am, after 24h of night work, without on duty period in the last 3 days (M2; and at 1:00 pm after 30h of work without on duty period in the last 3 days (M3. Continuous EEG was performed for all situations in adequate room to record sleep signals. Sleep latency (SL was evaluated. RESULTS: There has been significant shorter SL among residents after 24 or 30 hours without sleep. From residents after a normal night sleep the day before the evaluation, 36.4% presented pathological SL levels. CONCLUSIONS: Periods on duty for 24 or 30 hours lead to SL values below 5 minutes, which are considered pathologic and

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

    OpenAIRE

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

    2007-01-01

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

  14. Evaluation of patients' discomfort regarding regional anesthesia: 8AP6‐7

    OpenAIRE

    Gomes, B.; Sá Couto, P.; Amadeu, E.

    2013-01-01

    Background and Goal of Study: Regional anesthesia may cause physical and psychological discomfort. 50% of patients scheduled for urologic procedures undergo regional anesthesia, and their comfort represents a concern to the anesthesiologist. This study aims to: 1. identify factors related to patients’ discomfort regarding regional anesthesia(position for anesthesia and surgery procedures, puncture site pain, room temperature, audio-visual perception, sensitive/motor blockade...

  15. Quality and safety in anesthesia and perioperative care

    CERN Document Server

    Ruskin, Keith J; Rosenbaum, Stanley H

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

  17. [Analgesia and anesthesia in the prehospital stage of mechanical trauma].

    Science.gov (United States)

    Beliakov, V A; Sinitsyn, L N; Maksimov, G A; Akulov, M S; Kalachev, S A; Medvedskiĭ

    1993-01-01

    The work reviews the results of the use of various analgesics and anesthetics in 965 outpatients with mechanical traumas, including 340 ones with shock and blood loss. Central hemodynamics has been studied in 60 patients during anesthesia with lexir, ketamine, sodium hydroxybutyrate, respiratory function has been assessed in 20 patients. The results have been confirmed experimentally on 160 rats, 50 cats, and 40 dogs. It is recommended to apply narcotic and nonnarcotic analgesics, lexir, ketamine intramuscularly not only to patients with shock and pronounced blood loss in whom infusion therapy and intravenous anesthesia with sodium hydroxybutyrate are necessary but in all other cases as well. PMID:8116897

  18. Anesthesia information management system implementation: a practical guide.

    Science.gov (United States)

    Muravchick, Stanley; Caldwell, James E; Epstein, Richard H; Galati, Maria; Levy, Warren J; O'Reilly, Michael; Plagenhoef, Jeffrey S; Rehman, Mohamed; Reich, David L; Vigoda, Michael M

    2008-11-01

    Anesthesia Information Management Systems (AIMS) display and archive perioperative physiological data and patient information. Although currently in limited use, the potential benefits of an AIMS with regard to enhancement of patient safety, clinical effectiveness and quality improvement, charge capture and professional fee billing, regulatory compliance, and anesthesia outcomes research are great. The processes and precautions appropriate for AIMS selection, installation, and implementation are complex, however, and have been learned at each site by trial and error. This collaborative effort summarizes essential considerations for successful AIMS implementation, including product evaluation, assessment of information technology needs, resource availability, leadership roles, and training. PMID:18931218

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yuri Shiogai

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Application of high level of nursing service in the post-anesthesia care unit%优质护理服务在麻醉恢复室的应用

    Institute of Scientific and Technical Information of China (English)

    邓曼丽; 宿文清; 赵燕

    2013-01-01

    Objective To discuss the method and measures of high-quality nursing service in the postanesthesia care unit.Methods Many methods were adopted,that carried out the whole without aperture (holistic) nursing in the anesthesia recovery period,set up specialized nursing quality check list of PACU,strengthened the body and mind warm service,made nurse-patient communication card,paid attention to the five key links in the anesthesia recovery period,and used optimized of nursing documents writing and other new nursing measures.Results The degree of satisfaction among patients and anesthesiologists was significantly improved after the high-quality nursing service was implemented.And no nursing error,accident,and complaints occurred.Conclusions The implementation of high-quality nursing service will be beneficial to meeting the target:“ satisfy the patients,the society and the government”.%目的 探讨麻醉恢复室开展优质护理服务的方法和措施.方法 开展麻醉恢复期全程无缝隙护理,建立麻醉恢复室专科护理质量检查表,加强麻醉恢复室“身心温暖服务”,制作患者沟通卡片,把握好恢复期易出现危险的“五关”,简化护理文书书写等优质护理服务新措施.结果 麻醉恢复室实行优质护理服务后,患者和麻醉医生满意度得到明显提高.无护理差错、事故,无护理投诉.结论 开展麻醉恢复室优质护理服务,并持续工作改进,有利于实现“患者满意,社会满意,政府满意”的活动目标.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  4. The Anesthesia Effects of Clove Oil on Koi Carp (Cy prinus carpio)%丁香酚对锦鲤麻醉效果的研究

    Institute of Scientific and Technical Information of China (English)

    张志明; 胡盼; 姜志强; 刘东超; 丁慧萍

    2014-01-01

    水温18~20℃条件下,测定了丁香酚对锦鲤的麻醉效果。锦鲤体长12~15 cm ,质量30~40 g。通过预试验设计的丁香酚质量浓度梯度为10、30、60、100、200 m g/L。根据锦鲤的行为特征变化将麻醉及复苏过程各分成五个阶段。试验结果显示,随着丁香酚质量浓度30~200 mg/L的逐渐升高,锦鲤达到A4期麻醉状态的时间由32.27 min缩短至4.10 min ,复苏时间由8.26 min延长至13.38 min (P<0.01)。30 mg/L丁香酚液麻醉锦鲤60 min以及60 mg/L麻醉30 min ,锦鲤复苏率均为100%;100 mg/L麻醉20 min ,锦鲤复苏率为60%;200 mg/L麻醉10 min ,锦鲤复苏率为80%,麻醉15 min ,复苏率仅20%。经丁香酚液深麻的锦鲤置于空气中,随着丁香酚质量浓度30~200 m g/L的逐渐升高,锦鲤苏醒弹动时间由2.1 min延长至25.8 min(P<0.05)。不同质量浓度丁香酚麻醉锦鲤24 h ,丁香酚质量浓度大于35 mg/L时,锦鲤全部死亡,30 mg/L时,复苏率为60%,丁香酚质量浓度为10、15、20、25 mg/L时,复苏率均为100%。分别用5、10、15、20、25 mg/L丁香酚液麻醉锦鲤,耗氧率及排氨率均随质量浓度的升高而降低( P<0.05)。试验结果表明,锦鲤麻醉运输适宜质量浓度为15~20 m g/L ,锦鲤人工操作适宜质量浓度100 mg/L。%T he effects of clove oil (10 mg/L ,30 mg/L ,60 mg/L ,100 mg/L and 200 mg/L ) on anesthesia was investigated in koi carp (Cyprinus carpio) with body length of 12-15 cm and body weight of 30-40 g at water temperature of (18-20 ℃) .The anesthesia and recovery process were both divided into five stages according to the characteristics of the fish behavior .The anesthesia induction period was found to be shortened from 32 .27 min at 30 mg/L of clove oil to 4 .10 min at 200 mg/L of clove oil ,w hile the recovery time was found to be significantly prolonged from 8 .26min at 30 mg/L of clove oil to

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

    Science.gov (United States)

    Kuzin, A V

    2014-01-01

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

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

    Science.gov (United States)

    Rooke, G Alec

    2015-09-01

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

  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; E. F. G. C. Dores; J. E. de Aguilar-Nascimento; L. Missae Oyama; M.Q. Latorraca; 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. Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery

    Directory of Open Access Journals (Sweden)

    Siriphuwanun V

    2014-09-01

    Full Text Available Visith Siriphuwanun,1 Yodying Punjasawadwong,1 Worawut Lapisatepun,1 Somrat Charuluxananan,2 Ketchada Uerpairojkit2 1Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Mueang District, Chiang Mai, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Purpose: To determine the incidence of and factors associated with perioperative cardiac arrest within 24 hours of receiving anesthesia for emergency surgery. Patients and methods: This retrospective cohort study was approved by the ethical committee of Maharaj Nakorn Chiang Mai Hospital, Thailand. We reviewed the data of 44,339 patients receiving anesthesia for emergency surgery during the period from January 1, 2003 to March 31, 2011. The data included patient characteristics, surgical procedures, American Society of Anesthesiologists (ASA physical status classification, anesthesia information, location of anesthesia performed, and outcomes. Data of patients who had received topical anesthesia or monitoring anesthesia care were excluded. Factors associated with cardiac arrest were identified by univariate analyses. Multiple regressions for the risk ratio (RR and 95% confidence intervals (CI were used to determine the strength of factors associated with cardiac arrest. A forward stepwise algorithm was chosen at a P-value <0.05. Results: The incidence (within 24 hours of perioperative cardiac arrest in patients receiving anesthesia for emergency surgery was 163 per 10,000. Factors associated with 24-hour perioperative cardiac arrest in emergency surgery were age of 2 years or younger (RR =1.46, CI =1.03–2.08, P=0.036, ASA physical status classification of 3–4 (RR =5.84, CI =4.20–8.12, P<0.001 and 5–6 (RR =33.98, CI =23.09–49.98, P<0.001, the anatomic site of surgery (upper intra-abdominal, RR =2.67, CI =2.14–3.33, P<0.001; intracranial, RR =1.74, CI =1.35–2.25, P<0.001; intrathoracic, RR =2.35, CI =1.70–3

  9. Appropriate practice of anesthesia: A plea for better training

    Directory of Open Access Journals (Sweden)

    O P Adudu

    2011-01-01

    Full Text Available Background: The role of the anesthesiologist is often unknown among patients. But, the situation where the anesthesiologist is uncertain of his/her function gives more cause for concern. Methods: A questionnaire survey on the appraisal of anesthetic practices was carried out over 5 months using the style of clinical practice. Results: One-third of the anesthesiologists who responded to the survey attached little importance to the work they did by not communicating the same to their patients while 45.2% did not discuss the intraoperative findings with the surgeons. Although 57 (59.4% of the respondents usually visit their patients on the ward preoperatively, only 16 (21.6% discussed the proposed anesthetic procedure with the patients. Thirty-nine (40.2% respondents claimed that they do not wear ward coats to the ward at the preoperative visit. Less than 20% consistently conducted a postoperative visit. The majority of the respondents would treat all patients as important, irrespective of social status, while 74.5% of them considered obtaining informed consent for anesthesia from patients as significantly important. Conclusion: The current practice of anesthesia has been found wanting in several aspects. Knowledgeable discussion by anesthesiologists with surgeons as well as enlightenment of patients and their relatives about their work will improve the quality of anesthesia care remarkably. Changes in the anesthesia training curriculum to reflect these deficiencies would be helpful.

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

    Science.gov (United States)

    Mashour, George A; LaRock, Eric

    2008-12-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  12. 42 CFR 482.52 - Condition of participation: Anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... anesthesiologist; (2) A doctor of medicine or osteopathy (other than an anesthesiologist); (3) A dentist, oral... qualified doctor of medicine or osteopathy. The service is responsible for all anesthesia administered in..., following consultation with the State's Boards of Medicine and Nursing, requesting exemption from...

  13. Ambulatory anesthesia in plastic surgery: opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Facque AR

    2015-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  15. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Shah U

    2015-04-01

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

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

    OpenAIRE

    Webb, M. D.

    1990-01-01

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

  17. Fetal heart rate changes associated with general anesthesia.

    Science.gov (United States)

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

    1989-07-01

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

  18. Creation of an integrated outcome database for pediatric anesthesia.

    Science.gov (United States)

    Cravero, Joseph P; Sriswasdi, Patcharee; Lekowski, Rebecca; Carpino, Elizabeth; Blum, Richard; Askins, Nissa; Zurakowski, David; Sinnott, Sean

    2016-04-01

    Outcome analysis is essential to health care quality improvement efforts. Pediatric anesthesia faces unique challenges in analyzing outcomes. Anesthesia most often involves a one-time point of care interaction where work flow precludes detailed feedback to care givers. In addition, pediatric outcome evaluations must take into account patients' age, development, and underlying illnesses when attempting to establish benchmarks. The deployment of electronic medical records, including preoperative, operative, and postoperative data, offers an opportunity for creating datasets large and inclusive enough to overcome these potential confounders. At our institution, perioperative data exist in five distinct environments. In this study, we describe a method to integrate these datasets into a single web-based relational database that provides researchers and clinicians with regular anesthesia outcome data that can be reviewed on a daily, weekly, or monthly basis. Because of its complexity, the project also entailed the creation of a 'dashboard,' allowing tracking of data trends and rapid feedback of measured metrics to promote and sustain improvements. We present the first use of such a database and dashboard for pediatric anesthesia professionals as well as successfully demonstrating its capabilities to perform as described above. PMID:26956515

  19. Ingestion of a Fixed Partial Denture During General Anesthesia

    OpenAIRE

    Neustein, Steve; Beicke, Mark

    2007-01-01

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

  20. Fetal heart rate changes associated with general anesthesia.

    Science.gov (United States)

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

    1989-07-01

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

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

    Science.gov (United States)

    Su, H L; Chen, P S

    1992-12-01

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

  2. The prevalence and patterns of substance abuse among nurse anesthesia students.

    Science.gov (United States)

    Bozimowski, Gregory; Groh, Carla; Rouen, Patricia; Dosch, Michael

    2014-08-01

    The purpose of this study was to assess the prevalence, demographic factors, outcomes, and preventative measures for substance abuse among nurse anesthesia students over a 5-year period from 2008 to 2012. An electronic survey was sent to 111 program directors of accredited nurse anesthesia programs in the United States. Twenty-three programs (response rate = 21.7%) reported data related to 2,439 students. Sixteen incidents of substance abuse were reported for a 5-year prevalence of 0.65%. Opioids were the most frequent drug of choice (n = 9). The programs identified no predisposing risk factors in 50% of the incidents. For the students, reported outcomes included voluntary entry into treatment (n = 10), dismissal from the program (n = 7), loss of nursing license (n = 2), and 1 death. Pre-enrollment background checks and drug testing for cause were the most commonly reported screening practices. The most frequently reported prevention strategy was wellness promotion education. The prevalence was lower among student registered nurse anesthetists, as compared with certified registered nurse anesthetists. Although additional studies are necessary to verify this finding, an opportunity might exist for programs to be proactive in assessing risk postgraduation. Future studies evaluating the effectiveness of wellness promotion efforts might lead toward a standardized, best practice approach to risk reduction strategies. PMID:25167607

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

    Science.gov (United States)

    Su, H L; Chen, P S

    1992-12-01

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

  4. Effect of anesthesia, positioning, time, and feeding on the proventriculus: keel ratio of clinically healthy parrots.

    Science.gov (United States)

    Dennison, Sophie E; Paul-Murphy, Joanne R; Yandell, Brian S; Adams, William M

    2010-01-01

    Healthy, adult Hispaniolan Amazon parrots (Amazona ventralis) were imaged on three occasions to determine the effects of anesthesia, patient rotation, feeding, and short/long-term temporal factors on the proventriculus:keel ratio. Increasing rotation up to 15 degrees from right lateral resulted in increased inability to measure the proventriculus in up to 44% of birds, meaning that the proventriculus:keel ratio could not be calculated from those radiographs. There was a significant difference between the proventriculus:keel ratio for individual parrots when quantified 3 weeks apart. Despite this difference, all ratios remained within normal limits. No significant effect was identified due to anesthesia, feeding, fasting, or repeated imaging through an 8-h period. Interobserver agreement for measurability and correlation for the proventriculus:keel ratio values was high. It is recommended that the proventriculus:keel ratio be calculated from anesthetized parrots to attain images in true lateral recumbency. Ratio fluctuations within the normal range between radiographs obtained on different dates may be observed in normal parrots.

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

    Directory of Open Access Journals (Sweden)

    A. M. Ovezov

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-01-01

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

  7. Comparison of propofol/fentanyl and ketamine anesthesia in children during extracorporeal shockwave lithotripsy

    International Nuclear Information System (INIS)

    Extracorporeal Shockwave Lithotripsy (ESWL) is an effective and safe way for treatment of upper urinary system stones. For pediatric patients, throughout ESWL, sufficient sedation and analgesia is needed to cope with the procedural pain. In this study, our goal was to compare 2 methods of intravenous anesthesia, applied to pediatric patients during ESWL. Forty patients, between 3 months and 15 years of age who were admitted to the Faculty of Medicine, Hacettepe University, Turkey between September 2003 to September 2004 with upper urinary system calculi were randomized into 2 groups. All patients received intranasal midazolam 0.3 mg/kg premedication. Group K received intravenous (iv) ketamine 2 mg/kg; Group PF received a bolus of iv propofol 3 mg/kg and iv fentanyl 1 ug/kg along with a propofol infusion of 1 mg/kg/hr throughout the procedure. Procedural, recovery and discharge times, incidences of intra and post-procedural complications were compared. Demographics, procedural and discharge times were similar in 2 groups. While recovery times and post-procedural complication incidence was higher for the Group K, intra-procedural complication incidence was higher for the Group PF. Although both protocols do not differ much according to ease of application and efficacy in providing sufficient analgesia for ESWL, they have their corresponding side effects and they can only be practiced safely by experienced anesthesiologists in a monitorized and well equipped setting. (author)

  8. 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、、、、、、、、

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

    Science.gov (United States)

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

    2015-01-01

    kilogram body weight or total dose of lidocaine infiltrated and its peak levels or time existed. The extensive liposuction covering the 30% total body surface areas was well tolerated by the patients under tumescent anesthesia in combination with the supplemental IV sedation. Our previous study on the fluid management has demonstrated the risk of hypovolemia or fluid overload is very low with this technique, although the patients who received only maintenance fluid (500 mL) in the operating room and could discharge and resume oral intake after 6 hours of recovery room stay. The adequate anesthesia support is available in our office-based setting with adequate recovery facilities in place. It has a high margin of safety, without increasing of lidocaine toxicity or adverse cardiopulmonary sequelae while using a segmental tumescent infiltration with lower concentration of lidocaine.

  10. Costs of anesthetics and other drugs in anesthesia

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tarek Shams

    2013-01-01

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

  12. Ambulatory surgery with chloroprocaine spinal anesthesia: a review

    Directory of Open Access Journals (Sweden)

    Ghisi D

    2015-11-01

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

  13. An Investigation on the Current Status of the Operation Recovery Rooms in Yazd Hospitals in 2010-2011

    Directory of Open Access Journals (Sweden)

    MR Khajeh Aminian

    2012-08-01

    Full Text Available Introduction: The recovery ward is a vital unit to care patients awaking from anesthesia and is a standard requirement for the operating room. Recovery ward is located adjacent to the operation room and is easily accessible to trained and skilled individuals. The unit must have adequate equipment for surveillance and monitoring of patients and required medication should also be provided. Methods: This study is a cross-sectional conducted in one phase through referring to hospital facilities and equipment. Physical space, personnel and their skill levels and other factors that are involved in the care of patients in the recovery have been investigated. The instruments used in this study were a check list and observe sheet which were completed by the researchers. Data analysis was conducted by SPSS software. Results: The results showed that the standards of buildings and physical space in the researched areas were mostly nonstandard. Equipment standards were to some extent in line with the criteria set by American Association of Anesthesia. Besides, some equipment was blow standard levels. Personnel standards regarding the number of nurses toward the number of recovery beds did not meet the standard criteria in most of the cases. Conclusion: The research shows that building standards in most cases are not in line with mentioned references. Undertaking equipment standards in the hospital recovery wards needs reviewing and providing controlling equipment for preventing the complications of recovery phase of anesthesia in recovery wards.

  14. A Technical Evaluation of Wireless Connectivity from Patient Monitors to an Anesthesia Information Management System During Intensive Care Unit Surgery.

    Science.gov (United States)

    Simpao, Allan F; Galvez, Jorge A; England, W Randall; Wartman, Elicia C; Scott, James H; Hamid, Michael M; Rehman, Mohamed A; Epstein, Richard H

    2016-02-01

    Surgical procedures performed at the bedside in the neonatal intensive care unit (NICU) at The Children's Hospital of Philadelphia were documented using paper anesthesia records in contrast to the operating rooms, where an anesthesia information management system (AIMS) was used for all cases. This was largely because of logistical problems related to connecting cables between the bedside monitors and our portable AIMS workstations. We implemented an AIMS for documentation in the NICU using wireless adapters to transmit data from bedside monitoring equipment to a portable AIMS workstation. Testing of the wireless AIMS during simulation in the presence of an electrosurgical generator showed no evidence of interference with data transmission. Thirty NICU surgical procedures were documented via the wireless AIMS. Two wireless cases exhibited brief periods of data loss; one case had an extended data gap because of adapter power failure. In comparison, in a control group of 30 surgical cases in which wired connections were used, there were no data gaps. The wireless AIMS provided a simple, unobtrusive, portable alternative to paper records for documenting anesthesia records during NICU bedside procedures. PMID:26797553

  15. A Technical Evaluation of Wireless Connectivity from Patient Monitors to an Anesthesia Information Management System During Intensive Care Unit Surgery.

    Science.gov (United States)

    Simpao, Allan F; Galvez, Jorge A; England, W Randall; Wartman, Elicia C; Scott, James H; Hamid, Michael M; Rehman, Mohamed A; Epstein, Richard H

    2016-02-01

    Surgical procedures performed at the bedside in the neonatal intensive care unit (NICU) at The Children's Hospital of Philadelphia were documented using paper anesthesia records in contrast to the operating rooms, where an anesthesia information management system (AIMS) was used for all cases. This was largely because of logistical problems related to connecting cables between the bedside monitors and our portable AIMS workstations. We implemented an AIMS for documentation in the NICU using wireless adapters to transmit data from bedside monitoring equipment to a portable AIMS workstation. Testing of the wireless AIMS during simulation in the presence of an electrosurgical generator showed no evidence of interference with data transmission. Thirty NICU surgical procedures were documented via the wireless AIMS. Two wireless cases exhibited brief periods of data loss; one case had an extended data gap because of adapter power failure. In comparison, in a control group of 30 surgical cases in which wired connections were used, there were no data gaps. The wireless AIMS provided a simple, unobtrusive, portable alternative to paper records for documenting anesthesia records during NICU bedside procedures.

  16. PERI-ANESTHESIA ANAPHYLAXIS (PAA): WE STILL HAVE NOT STARTED POST-PAA TESTING FOR INCITING ANESTHESIA-RELATED ALLERGENS.

    Science.gov (United States)

    Alshaeri, Taghreed; Gupta, Deepak; Nagabhushana, Ananthamurthy

    2016-02-01

    Anaphylaxis during anesthesia is uncommon. Diagnosis of peri-anesthesia anaphylaxis (PAA) requires anesthesia providers' vigilance for prompt diagnosis and treatment. In this case report, we present a challenging case with suspected PAA including its perioperative management, intensive care unit (ICU) course, and post-discharge follow-up. A 44-year-old female (body mass index = 26) presented for elective abdominal panniculectomy. Post-intubation, severe bronchospasm occurred that was non-responsive to nebulized albuterol and intravenous epinephrine. Continuous infusion of epinephrine was initiated. After aborting surgical procedure, the patient was transferred to ICU on continuous intravenous infusion of epinephrine. Venous blood sampling showed elevated troponin level. Echocardiography revealed ejection fraction of 25% suspicious of Takotsubo cardiomyopathy (mid cavitary variant). Tracheal extubation was only possible after three days. Subsequently, patient was discharged home with a cardiology follow-up appointment and a referral to an allergy specialist. Unfortunately at our institution (an academic university hospital in United States) along with neighboring institutions in near-by areas, the only allergy skin tests available are for local anesthetics and antibiotics, while neuromuscular blocking agents (NMBAs) cannot be tested (the suspected anaphylactic agent in our case was presumably rocuronium). In summary, PAA requires and responds to emergent diagnosis and immediate treatment; however there is still a long way to go to ensure post-PAA testing for inciting anesthesia-related allergens. PMID:27382817

  17. Sympathoadrenal responses to cold and ketamine anesthesia in the rhesus monkey.

    Science.gov (United States)

    Kolka, M A; Elizondo, R S; Weinberg, R P

    1983-04-01

    The effect of cold exposure on the sympathoadrenal system in primates was studied with and without ketamine anesthesia in eight adult rhesus monkeys. Each monkey was placed in a primate chair at a thermoneutral temperature (25 degrees C) for 1 h (control) followed by cold exposure (12 degrees C) for 3 h or placed in a circulating water bath (28 degrees C) to induce a decrease in core temperature (Tre) to 35 and 33 degrees C. Plasma catecholamines were analyzed by high-pressure liquid chromatography with electrochemical detection (60-65% recovery, coefficient of variation = 15%). The 3-h cold exposure was associated with a 175% increase above control levels of norepinephrine (NE) and a 100% increase in epinephrine (E). Decreases were evident in Tre (0.5 degree C), mean skin temperature (Tsk, 5.5 degrees C), and mean body temperature (Tb, 2.0 degrees C). Continuous infusion of ketamine (0.65 mg . kg-1 . min-1) resulted in no change in the plasma levels of NE and E from the control levels. Tre, Tsk, and Tb all showed greater declines with the addition of ketamine infusion to the cold exposure. Water exposure (28 degrees C) under ketamine anesthesia resulted in a drop in Tre to 33 degrees C within 1 h. Plasma levels of NE and E were unchanged from control values at Tre of 35 and 33 degrees C. The data suggest that the administration of ketamine abolished both the thermoregulatory response and the catecholamine response to acute cold exposure. PMID:6853296

  18. 口腔颌面部外伤患者的麻醉研究%Study on Anesthesia Application in Patients With Oral and Maxillofacial Trauma

    Institute of Scientific and Technical Information of China (English)

    刘智勇

    2016-01-01

    Objective Anesthesia application effect in patients with oral and maxilofacial trauma is to be observed and studied.MethodsChose 41 patients with oral and maxilofacial trauma who were treated in hospital from January to September 2015 and separated them into study group(21 patients) and control group(20 patients) according to random digits. Patients in study group were given Sufentanil anesthesia application and patients in control group were given Fentanyl anesthesia application,and then compared patients’ anesthesia effects between two groups.Results Patients’ anesthesia effect in study group was much better than that in control group,besides,side-effect incidence was much lower in study group compared to that in control group,there was a differential between two groups and such a differential had statistic value(P<0.05).Conclusion Sufentanil anesthesia application is quite effective in treatment of patients with oral and maxilofacial trauma,such an anesthesia application is conducive to patients’ recovery.%目的:对空腔颌面部外伤患者进行舒芬太尼与芬太尼麻醉处理,观察并分析麻醉效果。方法按照随机数字的方式,将我院于2015年1~9月接受并治疗的41例口腔颌面部外伤患者分为两组,观察组(21例)和对照组(20例),给予观察组患者舒芬太尼麻醉治疗,给予对照组患者芬太尼麻醉治疗,对比分析两组患者治疗情况。结果观察组患者的麻醉效果优于对照组,且不良反应的发生率较低,两组数据差异具有统计学意义(P<0.05)。结论给予口腔颌面部外伤患者实施舒芬太尼麻醉治疗,效果较好,患者恢复速度快。

  19. Significant effects of sex, strain, and anesthesia in the intrahippocampal kainate mouse model of mesial temporal lobe epilepsy.

    Science.gov (United States)

    Twele, Friederike; Töllner, Kathrin; Brandt, Claudia; Löscher, Wolfgang

    2016-02-01

    The intrahippocampal kainate mouse model of mesial temporal lobe epilepsy is increasingly being used for studies on epileptogenesis and antiepileptogenesis. Almost all previous studies used male mice for this purpose, and no study is available in this or other models of acquired epilepsy that directly compared epileptogenesis in female and male rodents. Epidemiological studies suggest that gender may affect susceptibility to epilepsy and its prognosis; therefore, one goal of this study was to investigate whether sex has an influence on latent period and epileptogenesis in the intrahippocampal kainate model in mice. Another aspect that was examined in the present study was whether mouse strain differences in epileptogenesis exist. Finally, we examined the effects of different types of anesthesia (chloral hydrate, isoflurane) on kainate-induced status epilepticus (SE) and epileptogenesis. Continuous (24/7) video-EEG monitoring was used during SE and the 2 weeks following SE as well as 4-6 weeks after SE. In male NMRI mice with chloral hydrate anesthesia during kainate injection, SE was followed by a seizure-free latent period of 10-14 days if hippocampal paroxysmal discharges (HPDs) recorded from the kainate focus were considered the onset of epilepsy. Anesthesia with isoflurane led to a more rapid onset and higher severity of SE, and not all male NMRI mice exhibited a seizure-free latent period. Female NMRI mice differed from male animals in the lack of any clear latent period, independently of anesthesia type. Furthermore, HPDs were only rarely observed. These problems were not resolved by decreasing the dose of kainate or using other strains (C57BL/6, FVB/N) of female mice. The present data are the first to demonstrate marked sex-related differences in the latent period following brain injury in a rodent model of acquired epilepsy. Furthermore, our data demonstrate that the choice of anesthestic agent during kainate administration affects SE severity and as a

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

    Directory of Open Access Journals (Sweden)

    Barry D Kussman

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