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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. [Nursing care in the anesthesia recovery period: review of the literature].

    Science.gov (United States)

    de Moraes, Lygia Oliveira; Peniche, Aparecida de Cássia

    2003-12-01

    The present study was undertaken after it was observed that patients submitted to surgical procedures arrived in recovery room with incomplete records, thus complicating continuing nursing care. The goal of the present study is to analyze bibliographic data from 1990 to 2002 on recovery room nursing care. The data was obtained from LILACS (Latin America Literature about Health Science), PERIENF (Nursing School Library of the University of São Paulo) and BDENF (Library of Federal University of Minas Gerais). The key words were nursing care, recovery room and immediate post-operative period. Only 16 articles were found, indicating a shortage of literature on this topic. The recovery room period is an important period of hospitalization and the data are essential for continuous care. PMID:14727442

  3. 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.

  4. 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

  5. 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.

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

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    Munevera Hadžimešić

    2013-12-01

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

  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. Recovery profile-e comparison of isoflurane and propofol anesthesia for laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    To compare the recovery profile in terms of time of extubation, eye opening, orientation and mobility and frequency of Postoperative Nausea and Vomiting (PONV) between propofol and isoflurane based anesthesia in patients undergoing laparoscopic cholecystectomy with prophylactic antiemetic. After informed consent, a total of 60 ASA I-II patients scheduled for laparoscopic cholecystectomy were divided in two equal groups I and P. Anesthesia in all patients were induced by Nalbuphine 0.15 mg/kg, Midazolam 0.03 mg/kg, Propofol 1.5 mg/kg and Rocuronium 0.6 mg/kg. Anesthesia was maintained with Isoflurane in group I and propofol infusion in group P, while ventilation was maintained with 50% N/sub 2/O/sub 2/ mixture in both the groups. All patients were given antiemetic prophylaxis. Hemodynamics were recorded throughout anesthesia and recovery period. At the end of surgery, times of extubation, eye opening, orientation (by modified Aldrete score) and mobility (recovery profile) were assessed. PONV was observed and recorded immediately after extubation, during early postoperative period (0-4 hours) and late period (4-24 hours). Antiemetic requirements were also recorded for the same periods in both the groups. Propofol provided faster recovery (extubation and eye opening times) and orientation in immediate postoperative period with statistically significant differences between the groups (p<0.0001). Recovery characteristics were comparably lower in group I. More patients achieved full points (8) on modified Aldrete score at different time until 30 minutes in group P. Postoperative nausea and vomiting in early and late periods were significantly reduced in group P. Moreover, requirement of rescue antiemetic doses were significantly lower in group P in 24 hours (p<0.0001). In this series, recovery was much faster with earlier gain of orientation with propofol anesthesia compared to isoflurane in the early recovery periods. Propofol is likely to be a better choice of

  11. 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

  12. Anesthesia

    Science.gov (United States)

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

  13. 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。

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

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    ... after—an anesthetic is given. Before anesthesia, a preoperative interview with your anesthesia professional supplies valuable information ... to your mental state as well. Moreover, the anxiety that frequently accompanies important decisions is to be ...

  15. 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.

  16. Recovery from desflurane anesthesia in horses with and without post-anesthetic xylazine

    OpenAIRE

    Aarnes, Turi K.; Bednarski, Richard M.; Bertone, Alicia L.; Hubbell, John A.E.; Lerche, Phillip

    2014-01-01

    The objective of this study was to compare recovery from desflurane anesthesia in horses with or without post-anesthetic xylazine. Six adult horses were anesthetized on 2 occasions, 14 d apart using a prospective, randomized crossover design. Horses were sedated with xylazine, induced to lateral recumbency with ketamine and diazepam, and anesthesia was maintained with desflurane. One of 2 treatments was administered intravenously at the end of anesthesia: xylazine [0.2 mg/kg body weight (BW)]...

  17. 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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-06-01

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

  20. Recovery from desflurane anesthesia in horses with and without post-anesthetic xylazine.

    Science.gov (United States)

    Aarnes, Turi K; Bednarski, Richard M; Bertone, Alicia L; Hubbell, John A E; Lerche, Phillip

    2014-04-01

    The objective of this study was to compare recovery from desflurane anesthesia in horses with or without post-anesthetic xylazine. Six adult horses were anesthetized on 2 occasions, 14 d apart using a prospective, randomized crossover design. Horses were sedated with xylazine, induced to lateral recumbency with ketamine and diazepam, and anesthesia was maintained with desflurane. One of 2 treatments was administered intravenously at the end of anesthesia: xylazine [0.2 mg/kg body weight (BW)] or an equivalent volume of saline. Recovery parameters were recorded and assessed by 2 blinded observers. A Wilcoxon signed-rank test was used to analyze recovery data. Heart rate, arterial blood pressures, and arterial blood gas data were analyzed using 2-way analysis of variance (ANOVA) for repeated measures. Values of P stand, and standing. Number of attempts to stand and quality of recovery scores were not different between groups. Administering xylazine after desflurane anesthesia resulted in longer recovery times. Recovery scores were not significantly different between groups. PMID:24688171

  1. 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...

  2. 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

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

    International Nuclear Information System (INIS)

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

  4. The Effects of Changing from Isoflurane to Desflurane on the Recovery Profile during the Latter Part of Anesthesia

    OpenAIRE

    Kang, Hyun; Cha, Su-Man; Park,Sun-Gyoo; Jung, Yong-Hun; Woo, Young-Cheol; Kim,Jin-Yun; Koo, Gill-Hoi; Kim, Seong-Deok; Baek, Chong-Wha

    2010-01-01

    It is not known whether changing from isoflurane to desflurane during the latter part of anesthesia shows early emergence and recovery in long surgery. We therefore evaluated the effects of changing isoflurane to desflurane on emergence and recovery. Eighty-two patients were randomly assigned to receive isoflurane (Group I) or desflurane (Group D) or to change from isoflurane to desflurane anesthesia (Group X). At the point when there was an hour until the operation would end, isoflurane was ...

  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. 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.

  7. Postexercise recovery period: carbohydrate and protein metabolism.

    Science.gov (United States)

    Viru, A

    1996-02-01

    The essence of the postexercise recovery period is normalization of function and homeostatic equilibrium, and replenishment of energy resources and accomplishment of the reconstructive function. The repletion of energy stores is actualized in a certain sequence and followed by a transitory supercompensation. The main substrate for repletion of the muscle glycogen store is blood glucose derived from hepatic glucose output as well as from consumption of carbohydrates during the postexercise period. The repletion of liver glycogen is realized less rapidly. It depends to a certain extent on hepatic gluconeogenesis but mainly on supply with exogenous carbohydrates. The constructive function is founded on elevated protein turnover and adaptive protein synthesis. Whereas during and shortly after endurance exercise intensive protein breakdown was found in less active fast-twitch glycolytic fibers, during the later course of the recovery period the protein degradation rate increased together with intensification of protein synthesis rate in more active fast-twitch glycolytic oxidative and slow-twitch oxidative fibers. PMID:8680938

  8. 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%)

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

    Directory of Open Access Journals (Sweden)

    Liu JL

    2014-02-01

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

  10. 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.

  11. 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.

  12. 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...

  13. 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。

  14. 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

  15. 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).

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

    Directory of Open Access Journals (Sweden)

    Dipalisingh

    2014-06-01

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

  17. 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...

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    Lakhin R.E.

    2015-09-01

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

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

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    Dana Tahririan

    2016-01-01

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

  1. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  3. Anesthesia Awareness

    Science.gov (United States)

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

  4. Patient management in the recovery period of stroke

    Directory of Open Access Journals (Sweden)

    O. V. Kosivtsova

    2014-12-01

    Full Text Available Stroke heads the list of all causes of disability in middle-aged and elderly people. In recent years, there have been about 30% of morbid events among able-bodied persons (less than 65 years of age. The major post-stroke incapacitating disorders are motor and speech defects, cognitive and psychoemotional disorders, and pelvic organ dysfunctions. The patients’ quality of life largely depends on the degree of recovery of lost functions. In turn, the degree of their recovery depends on the start, proportioning, and continuity of initiated rehabilitation measures and on whether the patient has cognitive, speech, and psychoemotional problems and pelvic organ dysfunctions. Unfortunately, after discharge from a specialized unit, only a small number of post-stroke patients are admitted to specialized rehabilitation centers. The responsibility of caring forthese patients rests with their relatives and outpatient physicians.The main tasks in the early and late recovery periods following stroke are, in addition to the prevention of recurrent stroke, the implementation of rehabilitation programs to correct motor and speech disorders and cognitive impairments, the stabilization of emotions, and the provision of proper and qualitative general care for patients with severe motor defects and pelvic organ dysfunctions. The paper considers the main principles of patient management in the early and late post-stroke recovery periods. The authors give rehabilitation recommendations and main errors in routine practice (their relatives and junior medical staff have no speech contact with patients having speech disorders; psychoemotional disorders are underestimated and uncorrected; proper general care for patients with pelvic organ dysfunctions is absent.

  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. Hypokalemic periodic paralysis

    OpenAIRE

    Abbas, Haider; Kothari, Nikhil; Bogra, Jaishri

    2012-01-01

    Hypokalemic periodic paralysis is a rare genetic disorder characterized by recurrent attacks of skeletal muscle weakness with associated hypokalemia which is precipitated by stress, cold, carbohydrate load, infection, glucose infusion, hypothermia, metabolic alkalosis, anesthesia, and steroids. We encountered one such incidence of prolonged recovery after general anesthesia, which on further evaluation revealed a case of hypokalemic paralysis. The key to successful management of such a patien...

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

    Directory of Open Access Journals (Sweden)

    Ayşe Neslihan Bebek

    2012-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Adriano Fernandes

    2014-12-01

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

  11. Transient Neurological Symptoms after Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Zehra Hatipoglu

    2013-02-01

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

  12. Regional anesthesia techniques for ambulatory orthopedic surgery.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2012-02-03

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

  13. General anesthesia

    Science.gov (United States)

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

  14. 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

  15. Efficiency of drug therapy in complex rehabilitation of patients in late recovery period of stroke

    OpenAIRE

    Dilshod Sagatov

    2011-01-01

    Clinical and neurological studies in 73 patients (44 men and 29 women) with the consequences of ischemic stroke in late recovery period were performed. Dopplerographic and electroencephalographic parameters before and after the rehabilitation measures were examined. In this study, we assessed the therapeutic effect of nootropics in drug rehabilitation with the inclusion of Nootropil and Cavinton Forte in late stroke recovery period.

  16. The effect of short recovery period investment on least-cost generation system expansion

    International Nuclear Information System (INIS)

    The effect of the short recovery period of private investment on least-cost generation system expansion is analysed, and a trade-off method for generation system expansion, which gives consideration to both the least-cost strategy and the short recovery period of private investment, is presented. First, the optimal mix of generation units under a standard recovery period for all units is established, and then the surcharge, due to the difference between the short recovery period and the standard recovery period, is calculated and shared between all units. The former is an optimization to make best use of natural resources, and the latter is a trade-off method to spread the surcharge throughout the system. (Author)

  17. 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.

  18. Repetitive Pediatric Anesthesia in a Non-Hospital Setting

    International Nuclear Information System (INIS)

    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

  19. Spinal and epidural anesthesia

    Science.gov (United States)

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

  20. Efficiency of drug therapy in complex rehabilitation of patients in late recovery period of stroke

    Directory of Open Access Journals (Sweden)

    Dilshod Sagatov

    2011-03-01

    Full Text Available Clinical and neurological studies in 73 patients (44 men and 29 women with the consequences of ischemic stroke in late recovery period were performed. Dopplerographic and electroencephalographic parameters before and after the rehabilitation measures were examined. In this study, we assessed the therapeutic effect of nootropics in drug rehabilitation with the inclusion of Nootropil and Cavinton Forte in late stroke recovery period.

  1. 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

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

    OpenAIRE

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

    2014-01-01

    Objective: The aim was to evaluate general anesthesia (GA) plus ilioinguinal nerve block (IIB) versus spinal anesthesia (SA) in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. Materials and Methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, main...

  3. 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 ...

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

    International Nuclear Information System (INIS)

    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.)

  5. 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.)

  6. Anesthesia Basics

    Science.gov (United States)

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

  7. 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.

  8. 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.

  9. 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...

  10. 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.

  11. 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

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

    OpenAIRE

    Yousef, Gamal T.; Lasheen, Ahmed E.

    2012-01-01

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

  13. Society for Ambulatory Anesthesia

    Science.gov (United States)

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

  14. 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, ...

  15. 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...... of exercising in the early recovery period after discharge from hospital following total knee replacement. METHOD: A cross-sectional survey was conducted using a questionnaire. A total of 86 patients were included following first-time elective total knee replacement. Descriptive statistics were used....... RESULTS: 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...

  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

    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.

  18. 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

  19. 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.

  20. 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)

  1. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2009-01-01

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

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Sultan

    2016-04-01

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

  4. 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

  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. Hand Surgery: Anesthesia

    Science.gov (United States)

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

  7. Topical anesthesia in phacoemulsification

    Directory of Open Access Journals (Sweden)

    Saad Waheeb

    2010-01-01

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

  8. 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.

  9. 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

  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. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

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

  13. 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. 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.

  15. 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.

  16. Fast track anesthesia for liver transplantation: Review of the current practice.

    Science.gov (United States)

    Aniskevich, Stephen; Pai, Sher-Lu

    2015-09-18

    Historically, patients undergoing liver transplantation were left intubated and extubated in the intensive care unit (ICU) after a period of recovery. Proponents of this practice argued that these patients were critically ill and need time to be properly optimized from a physiological and pain standpoint prior to extubation. Recently, there has been a growing movement toward early extubation in transplant centers worldwide. Initially fueled by research into early extubation following cardiac surgery, extubation in the operating room or soon after arrival to the ICU, has been shown to be safe with proper patient selection. Additionally, as experience at determining appropriate candidates has improved, some institutions have developed systems to allow select patients to bypass the ICU entirely and be admitted to the surgical ward after transplant. We discuss the history of early extubation and the arguments in favor and against fast track anesthesia. We also described our practice of fast track anesthesia at Mayo Clinic Florida, in which, we extubate approximately 60% of our patients in the operating room and send them to the surgical ward after a period of time in the post anesthesia recovery unit. PMID:26380654

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

    DEFF Research Database (Denmark)

    Bertelsen, Mads Frost; Mosley, Craig; Crawshaw, Graham J.; Dyson, Doris; Smith, Dale A.

    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....

  18. 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.

  19. Effects of Anesthesia

    Science.gov (United States)

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

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

    OpenAIRE

    Akamatsu Akinori; Lee Cheolsung; Morino Hirofumi; Miura Takanori; Ogata Norio; Shibata Takashi

    2012-01-01

    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...

  1. 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....

  2. 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.

  3. 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

  4. 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.

  5. Cardiovascular adjustments induced by training evaluated during semisupine isotonic exercise and recovery period: an echocardiographic study.

    Science.gov (United States)

    Di Bello, V; Santoro, G; Cini, G; Pentimone, F; Ginanni, A; Romano, M F; Giusti, C

    1987-12-01

    Two groups of subjects were examined: trained athletes (group A) and a sedentary control group (group B). The subjects performed submaximal bicycle exercise in the semisupine position to evaluate the differences between the two groups with regard to cardiovascular response during exercise and recovery and to point out all the changes due to training. During the first part of exercise, cardiac output increased contemporary with heart rate and myocardial contractility as shown by the trend of the ejection fraction, higher in group A, under the same level of total vascular peripheral resistances. Later there was an increase of cardiac output for a further increase of heart rate and cardiac inotropism due to the homeometric mechanism. During recovery the heart rate and peripheral vascular resistance reduction led to an increase of venous return which set up the Frank-Starling mechanism via an increase of left ventricular dimensions. These adjustments were more efficient in group A. During exercise and recovery the heart rate-pressure product was constantly lower in group A with a significant difference to group B. Therefore, trained athletes' myocardium is more efficient than that of the sedentary group because it performs an external work load with a lower oxygen consumption. PMID:3429087

  6. 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

  7. 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.

  8. Tissue microcirculation measured by vascular occlusion test during anesthesia induction.

    Science.gov (United States)

    Kim, Tae Kyong; Cho, Youn Joung; Min, Jeong Jin; Murkin, John M; Bahk, Jae-Hyon; Hong, Deok Man; Jeon, Yunseok

    2016-02-01

    Tissue microcirculation measured by vascular occlusion test is impaired during septic shock. However, it has not been investigated extensively during anesthesia induction. The aim of the study is to evaluate tissue microcirculation during anesthesia induction. We hypothesized that during anesthesia induction, tissue microcirculation measured by vascular occlusion test might be enhanced with peripheral vasodilation during anesthesia induction. We conducted a prospective observational study of 50 adult patients undergoing cardiac surgery. During anesthesia induction, we measured and analyzed tissue oxygen saturation, vascular occlusion test, cerebral oximetry, forearm-minus-fingertip skin temperature gradients and hemodynamic data in order to evaluate microcirculation as related to alterations in peripheral vasodilation as reflected by increased Tforearm-finger thermal gradients. During anesthesia induction, recovery slope during vascular occlusion test and cerebral oxygen saturation increased from 4.0 (1.5) to 4.7 (1.3) % s(-1) (p = 0.02) and 64.0 (10.2) to 74.2 (9.2) % (p Forearm-minus-fingertip skin temperature gradients decreased from 1.9 (2.9) to -1.4 (2.2) °C (p blood pressure and forearm-minus-fingertip skin temperature gradients decrease while cerebral oximetry and vascular occlusion test recovery slope increase. These findings suggest that anesthesia induction increases tissue microcirculation with peripheral vasodilation. PMID:25750016

  9. Orthopedic Anesthesia in Haiti

    OpenAIRE

    Osteen, Kristie D.

    2011-01-01

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

  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. NEURAXIAL ANESTHESIA and OBESITY

    OpenAIRE

    Şahin, Aynur; Doğru, Hatice Yılmaz

    2013-01-01

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

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

    OpenAIRE

    Erwin; Gunanti; Ekowati Handharyani; Deni Noviana

    2016-01-01

    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 surg...

  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. Tramadol as an adjuvant to intravenous regional anesthesia with lignocaine

    International Nuclear Information System (INIS)

    Objective was to assess the effect of different doses of tramadol when added to lignocaine during intravenous regional anesthesia (IVRA). Sixty patients, scheduled for hand surgery under IVRA in King Fahd University Hospital, Al-Khobar, Saudi Arabia from January 2006 to January 2007 were randomly allocated into 3 groups (20 patients each) in a double blind controlled study. All patients received 0.5% lignocaine, 40ml plus 2ml of a study solution containing either isotonic saline (control group), or tramadol 50mg (group T50) or tramadol100mg (group T100). Hemodynamic changes, sensory and motor block onset and recovery time, tourniquet tolerance time, the quality of intraoperative anesthesia and the duration of postoperative analgesia were assessed. All patients 20 in each group completed the study period. Patients who received tramadol had earlier onset of sensory block (5.2+-1.2; 4.9+-1.2 min in the T50; and T100 groups) compared with the control group (7.6+-1.4 min). Patients who received 100mg of tramadol had better tolerance of tourniquet (p=0.011), and less intraoperative fentanyl supplementation (p=0.042). They had also a longer time to the first postoperative analgesic request (p=0.001) compared with the control group. Tramadol 100 mg is a beneficial additive to lignocaine for IVRA since it shortened the onset of sensory block, enhanced the tourniquet tolerance and improved the perioperative analgesia. (author)

  15. 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...

  16. [Morphological changes in the adenohypophysis during the recovery period after single individually graded physical exercise].

    Science.gov (United States)

    Samarin, M Iu

    1983-02-01

    Morpho-functional changes occurring in the anterior principle part of the adenohypophysis have been studied light optically in dogs during the restorative period 1 day after the effect of single individually-dosed loadings of a moderate and great intensity. During one day the restoration of the gland is not completed. Certain structural signs that characterize the main regularities in the course of the restorative process have been revealed. Thus, an additional activation of the adenohypophysis during the restorative period makes it possible to suppose an oscillatory character of the restorative process, in particular--the supercompensation phase. Heterochronicity in restoration of some morpho-functional parameters of the gland has been also determined. It has been stated that manifestation of restoration in the anterior principle part of the adenohypophysis depends on the dose of the physical loading: the greater the loading, the more active, economic and effective is the restoration. PMID:6687799

  17. [Rapid opiate detoxification under anesthesia (RODA)].

    Science.gov (United States)

    Dubols, N; Hallet, C; Luppens, D; Ansseau, M; Charlier, C

    2013-01-01

    Rapid Opiate Detoxification under Anesthesia (RODA) involves the use of opiate antagonists combined with anesthesia and pharmacotherapy to reduce withdrawal symptoms. The aim of our study was to measure the plasma concentrations of heroin metabolites and methadone during anesthesia and patient stay at the hospital in order to assess the amount of active substances at each protocol step. Plasma concentrations of antagonists were also quantified and compared to the recommended target values. Blood samples were drawn in 10 patients undergoing RODA at different times of the procedure (during anesthesia, in post-anesthesia care unit and in psychiatry unit). The plasma concentrations of heroin metabolites, methadone and antagonists were measured using a previously described method. Heroin active metabolites were no longer detected in the patient blood when helshe left the hospital; by contrast, methadone was still present at significant concentrations 3 days after the beginning of the detoxification procedure. Naltrexone analysis allowed us to adjust doses to insure opiate receptor blockade during acute withdrawal, which is a critical period. PMID:23888580

  18. Comparison of 3 different anesthetic techniques on 24-hour recovery after otologic surgical procedures.

    Science.gov (United States)

    Jellish, W S; Leonetti, J P; Fahey, K; Fury, P

    1999-03-01

    Intravenous propofol anesthesia is better than inhalational anesthesia for otologic surgery, but cost and intraoperative movement make this technique prohibitive. This study compares a propofol sandwich anesthetic with a total propofol or inhalational anesthetic for otologic surgery to determine which produces the best perioperative conditions and least expense. One hundred twenty patients undergoing ear surgery were randomly chosen to receive an anesthetic with either isoflurane (INHAL), total propofol (TPROP), or propofol used in conjunction with isoflurane (PSAND). Postoperative wakeup and the incidence and severity of nausea, vomiting, and pain were compared among groups. Antiemetic administration and discharge times from recovery and the hospital were also compared. The groups were similar, but anesthesia times were longer in the INHAL group. Emergence from anesthesia after PSAND or TPROP was more rapid than after INHAL. Recovery during the next 24 hours was associated with less nausea and vomiting with PSAND than with INHAL. The cost of the PSAND anesthetic was similar to that of INHAL, and both were less than TPROP. PSAND anesthesia may be similar to TPROP and better than INHAL for otologic procedures. PSAND was less expensive than TPROP and produced a similar recovery profile and antiemetic effect in the 24-hour period after surgery. PMID:10064647

  19. 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.

  20. 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

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Lucía Vizcaíno-Martínez

    2014-01-01

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

  3. Anesthesia for radiologic procedures

    International Nuclear Information System (INIS)

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

  4. 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.

  5. Regional Anesthesia in Trauma Medicine

    OpenAIRE

    Loreto Lollo; Wu, Janice J.; Andreas Grabinsky

    2011-01-01

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

  6. Anesthesia for interventional radiology

    International Nuclear Information System (INIS)

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

  7. 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.

  8. Anesthesia for pediatric external beam radiation therapy

    International Nuclear Information System (INIS)

    Background: For very young patients, anesthesia is often required for radiotherapy. This results in multiple exposures to anesthetic agents over a short period of time. We report a consecutive series of children anesthetized for external beam radiation therapy (EBRT). Methods: Five hundred twelve children ≤ 16 years old received EBRT from January 1983 to February 1996. Patient demographics, diagnosis, anesthesia techniques, monitoring, airway management, complications, and outcome were recorded for the patients requiring anesthesia. Results: One hundred twenty-three of the 512 children (24%) required 141 courses of EBRT with anesthesia. Anesthetized patients ranged in age from 20 days to 11 years (mean 2.6 ± 1.8 ). The frequency of a child receiving EBRT and requiring anesthesia by age cohort was: ≤ 1 year (96%), 1-2 years (93%), 2-3 years (80%), 3-4 years (51%), 4-5 years (36%), 5-6 years (13%), 6-7 years (11%), and 7-16 years (0.7%). Diagnoses included: primary CNS tumor (28%), retinoblastoma (27%), neuroblastoma (20%), acute leukemia (9%), rhabdomyosarcoma (6%), and Wilms' tumor (4%). Sixty-three percent of the patients had been exposed to chemotherapy prior to EBRT. The mean number of anesthesia sessions per patient was 22 ± 16. Seventy-eight percent of the treatment courses were once daily and 22% were twice daily. Anesthesia techniques included: short-acting barbiturate induction + inhalation maintenance (21%), inhalation only (20%), ketamine (19%), propofol only (12%), propofol induction + inhalation maintenance (7%), ketamine induction + inhalation maintenance (6%), ketamine or short-acting barbiturate induction + inhalation maintenance (6%). Monitoring techniques included: EKG (95%), O2 saturation (93%), fraction of inspired O2 (57%), and end-tidal CO2 (55%). Sixty-four percent of patients had central venous access. Eleven of the 74 children with a central line developed sepsis (15%): 6 of the 11 were anesthetized with propofol (55%), 4 with a short

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Jang Tsong-Rong

    2011-11-01

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

  11. Control of period-one oscillation for all-optical clock division and clock recovery by optical pulse injection driven semiconductor laser

    International Nuclear Information System (INIS)

    The period-one oscillation produced by an external optical pulse injection driven semiconductor laser is applied to clock recovery and frequency division. By adjusting the repetition rate or injection power of the external injection optical pulses to lock the different harmonic frequencies of the period-one state, the clock recovery and the frequency division (the second and third frequency divisions) are achieved experimentally. In addition, in frequency locking ranges of 2 GHz and 1.9 GHz, the second and third frequency divisions are obtained with the phase noise lower than -100 dBc/Hz, respectively. Our experimental results are consistent well with the numerical simulations. (classical areas of phenomenology)

  12. Mass spectrometer for real-time metabolism monitoring during anesthesia

    Science.gov (United States)

    Elizarov, A. Yu.; Levshankov, A. I.

    2012-06-01

    Mass-spectrometric monitoring of metabolism (CO2/O2) in the inspiration-expiration regime is used to estimate the anesthetic protection of the patient against surgical stimulation during combined anesthesia. A correlation between the anesthetic protection of the patient and the metabolic rate is demonstrated, and the periodic variation of the metabolic rate with time is found. The sevoflurane metabolism products and intravenous analgesic fentanyl are found in the blowing air of the patient during anesthesia.

  13. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    OpenAIRE

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

    2007-01-01

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

  14. 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...

  15. 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.

  16. Numerical Simulation of Exhaust Gas Cooling in Channels with Periodic Elbows for Application in Compact Heat Recovery Systems

    International Nuclear Information System (INIS)

    Miniature and Micro devices represent the new frontier for advanced heat and mass transfer technology. Due to the small length scales, the use of CFD is very useful for designing and optimizing microfluidic devices since experimentation and visualization at these scales can be difficult. In this work a high temperature air microfluidic cooling strategy for applications such as compact waste heat recovery, exhaust gas recirculation and fuel cell thermal management is proposed. Initially, the application of a simple straight microchannel is considered. In an effort to partially compensate for the poor thermal properties of air, right-angle bends are introduced in order to induce Dean vortices which periodically restart the thermal boundary layer development, thus improving the heat transfer and fluid mixing. Numerical simulations in the range of 100 ≤ ReDh ≤ 1000 have been carried out for channels of square cross-section. Channel wall lengths of 1.0 mm are investigated for elbow spacings of 5 mm, 10 mm and 15 mm. High temperature air (300°C) at atmospheric inlet pressure is the working fluid. The results indicate that the elbows substantially improve the local and average heat transfer in the channels while increasing the pressure drop. Design considerations are discussed which take into account the heat transfer and pressure drop characteristics of the channels.

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

    Directory of Open Access Journals (Sweden)

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

    2011-04-01

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

  18. Plasma catecholamine concentrations in rainbow trout (Salmo gairdneri) at rest and after anesthesia and surgery

    Science.gov (United States)

    Gingerich, W.H.; Drottar, K.R.

    1989-01-01

    The effects of surgery and anesthesia on concentrations of plasma epinephrine (E), norepinephrine (NE), and dopamine (DA) were investigated in rainbow trout fitted with dorsal aorta cannulae. Baseline catecholamines (CA) concentrations, established in resting rainbow trout, were 1.55 ± 0.90 ϱmol/ml (X ± SD) for E, 2.07 ± 1.26 for NE, and 1.33 ± 0.87 for DA. These values were based on the pooled analyses of five individual fish taken over seven different sampling periods. The E:NE ratio in resting fish was always less than 1.0. In a second experiment, fish were subjected to dorsal aorta cannulation and sequential blood samples were taken immediately after surgery, and 6, 24, and 48 hr later. Plasma E concentrations were 36 times greater than baseline values in the first sample; NE was 15 times greater and DA was 41 times greater. After surgery, plasma concentrations of all CAs fell rapidly but values were still higher than baseline 6 hr after surgery, then were near baseline at 24 and 48 hr after surgery. The E:NE ratio was about 3.0 immediately after surgery, dropped to 1.8 at 6 hr, and was about 1.0 at 24 and 48 hr. In a third experiment, plasma CAs were determined in a group of five animals anesthetized with tricaine methanesulfonate (100 mg/ml) to advanced anesthesia, and then allowed to recover in flowing well water over a 12-hr observation period. Plasma E and NE concentrations in the fish during early anes-thesia (1.14 ± 0.14 min) were not significantly different from preanesthesia values. During advanced anesthesia (2.31 ± 0.21 min), values for E and NE were significantly greater and continued to be elevated during the 12-hr recovery period. The E:NE ratio exceeded 1.0 during advanced anesthesia and for the rest of the experiment.

  19. The comparative effects of sevoflurane versus propofol in the induction and maintenance of anesthesia in adult patients.

    Science.gov (United States)

    Jellish, W S; Lien, C A; Fontenot, H J; Hall, R

    1996-03-01

    A randomized, prospective study was performed at four institutions to compare anesthetic induction, maintenance, and recovery characteristics between sevoflurane- and propofol-based anesthesia in 186 ASA physical status I and 11 patients undergoing elective surgical procedures of 1-3 h. Group 1 (n = 93) patients received sevoflurane-nitrous oxide for both induction and maintenance of anesthesia while Group 2 (n = 93) received propofol-nitrous oxide anesthesia. Induction of anesthesia and tracheal intubation times were significantly shorter with propofol (2.21 +/- 0.2 min, 5.11 +/- 0.3 min, respectively) than with sevoflurane (3.11 +/- 0.2 min, 7.21 +/- 0.3 min, respectively). Emergence times after sevoflurane (8.81 +/- 1.2 min) were significantly shorter than with propofol (13.21 +/- 1.2 min). Overall frequency of complication-free induction, maintenance, and emergence did not differ between the two anesthetic groups. However, side effects involving airway excitement were more prevalent during mask induction with sevoflurane as compared to propofol. Patients in the sevoflurane group were oriented and required postoperative analgesia much earlier than those who received propofol. Both groups were hemodynamically stable throughout the study period. The incidence of postoperative nausea, vomiting, and pain-discomfort scores were similar between the two groups. Urinary specific gravity decreased in the sevoflurane-treated group while serum creatinine and urinary pH were unchanged from preoperative values in both groups. Sevoflurane compared favorably with propofol when used for anesthesia for elective procedures of 1-3 h duration. PMID:8623947

  20. Safe Anesthesia For Every Tot

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus on the...... improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps in...

  1. Anesthesia - what to ask your doctor - adult

    Science.gov (United States)

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

  2. Anesthesia - what to ask your doctor - child

    Science.gov (United States)

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

  3. 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

  4. [Demand for cleanliness of anesthesia machines and apparatus].

    Science.gov (United States)

    Kasuda, Haruyuki; Ozawa, Yoshiko; Miyake, Satoshi; Ohkubo, Takashi

    2010-05-01

    (1) Outer surface of anesthesia machines and patient monitors, and breathing bags are exposed to the contaminated anesthetists' hands and fingers. Disinfection by wiping surface of anesthesia machines with alcohol, and disinfecting hands and fingers with rubbing-type, alcohol-based antiseptics are encouraged. (2) Anesthesia equipments' breathing circuit part is contaminated by patients' breath and respiratory secretions. It is necessary to set rules for exchange of breathing circuit tubes and breathing bags, periodical cleansing and disinfection of canisters as well as inhalation and exhalation valves, and usage of bacteria filters. (3) Anesthesia apparatus (laryngoscope, tracheal tube and suction tube) contact with patients' oral cavity and airway, and thus they are categorized as semi-critical items that require high-level disinfection. PMID:20486566

  5. 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.

  6. 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

    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...... vasoconstrictor mechanism of the vascular smooth muscle cells or both. It is suggested that fentanyl/N2O anesthesia is better suited for this kind of studies....

  7. Anesthesia for bronchoscopy.

    Science.gov (United States)

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

    2012-01-01

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

  8. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I

    2007-01-01

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

  9. Paediatric Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Rakhee Goyal

    2008-01-01

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

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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

  15. Accidently Discovered Postpartum Pituitary Apoplexy after Epidural Anesthesia

    Directory of Open Access Journals (Sweden)

    Rafik Sedra

    2014-11-01

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

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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....

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. Mesotubular-Structured Hybrid Membrane Nanocontainer for Periodical Monitoring, Separation, and Recovery of Cobalt Ions from Water.

    Science.gov (United States)

    El-Safty, Sherif A; Sakai, Masaru; Selim, Mahmoud M; Alhamid, Abdulaziz A

    2015-09-01

    Exposure to toxins can cause deleterious effects even at very low concentrations. We have developed an optical sensor, filter, and extractor (i.e., containerlike) in a nanoscale membrane (NSM) for the ultratrace sensing, separation, and recovery of Co(2+) ions from water. The design of the NSM is successfully controlled by dense decoration of a hydrophobic oil-hydrophilic receptor onto mesoscale tubular-structured silica nanochannels made of a hybrid anodic alumina membrane. The particular structure of the nanocontainer is ideal to control the multiple functions of the membrane, such as the optical detection/recognition, rejection/permeation, and recovery of Co(2+) species in a single step. A typical sensor, filter, and extractor assessment experiment was performed by using a benchtop contact time technique and a flow-through cell detector to allow for precise control of the optical detection and exclusive rejection of target ions and the permeation of nontarget metal ions in water. This nanocontainer membrane has great potential to meet the increasing needs of purification and separation of Co(2+) ions. PMID:26033713

  6. 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

  7. Bispectral index monitoring in isoflurane anesthesia in laparoscopic cholecystectomy of morbid obese patients

    OpenAIRE

    Mitra Golmohammadi; Mehdi Abasgholizadeh

    2014-01-01

    Background: Morbid obesity is associated with a some of significant comorbidities. Early and uneventful postoperative recovery of obese patients remains a challenge for anesthesiologists. It seems Bispecteral Index (BIS) monitoring may reduce drug usage and hasten recovery time in inhalation anesthesia. The aim of this study was to investigate the effect of BIS monitoring on intraoperative isoflurane utilization and the early recovery profile. Methods: Fifty morbidly obese adult patients (...

  8. 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.

  9. 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。

  10. Cardiorespiratory effects of isoflurane anesthesia in crested caracaras (Caracara plancus).

    Science.gov (United States)

    Escobar, André; Thiesen, Roberto; Vitaliano, Sérgio N; Belmonte, Emílio A; Werther, Karin; Valadão, Carlos A A

    2011-03-01

    To evaluate the cardiorespiratory changes induced by isoflurane (ISO) anesthesia in the crested caracara (Caracara plancus), eight crested caracaras that weighed 1.0 kg (range 0.9-1.1 kg) were the subjects for the study. The birds were anesthetized by face mask with ISO for brachial artery catheterization. After recovery, anesthesia was re-induced and maintained with ISO with spontaneous ventilation. Electrocardiography, direct systolic arterial blood pressure (SAP), diastolic arterial blood pressure (DAP), mean arterial blood pressure (MAP), respiratory rate (RR), end-tidal carbon dioxide (P(ET)CO2), and cloacal temperature (T degrees C) were measured before induction (baseline, under physical restraint) and after 5, 10, 15, 20, 25, 30, 35, and 40 min of ISO anesthesia. Arterial blood samples were collected for blood gas analysis at baseline, 10, 25, and 40 min. No cardiac arrhythmias were observed in the present study. RR, SAP, DAP, MAP, T degrees C and pH decreased from baseline values, whereas arterial partial pressures of oxygen and carbon dioxide, bicarbonate concentration, and P(ET)CO2 were significantly higher than baseline. Apnea was not observed in any bird. ISO anesthesia is suitable for use in healthy members of this species despite the moderate cardiovascular and respiratory depression produced. PMID:22946364

  11. 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.

  12. 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)

  13. 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.

  14. Marsupial, insectivore, and chiropteran anesthesia.

    Science.gov (United States)

    Pye, G W

    2001-01-01

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

  15. 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...

  16. Anesthesia for Children Having Eye Surgery

    Science.gov (United States)

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

  17. Anesthesia for Adults Having Eye Surgery

    Science.gov (United States)

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

  18. Anesthesia Safe for Infants, Toddlers, Study Says

    Science.gov (United States)

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

  19. 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.

  20. 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

  1. 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.

  2. 21 CFR 868.6700 - Anesthesia stool.

    Science.gov (United States)

    2010-04-01

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

  3. 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

  4. Accidently Discovered Postpartum Pituitary Apoplexy after Epidural Anesthesia

    OpenAIRE

    Rafik Sedra

    2014-01-01

    Anesthetic consideration of obstetric patients with pituitary disorders is an important topic to deal with. Few cases were reported with accidently discovered pituitary tumor complications especially in the postpartum period. A 26 years old primigravida lady with 39 weeks gestational period was reported to have severe headache and sudden loss of conscious after normal vaginal delivery with lumbar epidural anesthesia. Accidently discovered pituitary adenoma was proved after neurology, endocrin...

  5. 39-week toxicity and toxicokinetic study of ponezumab (PF-04360365) in cynomolgus monkeys with 12-week recovery period.

    Science.gov (United States)

    Freeman, Gary B; Lin, John C; Pons, Jaume; Raha, Nancy M

    2012-01-01

    Ponezumab (PF-04360365) is a novel humanized IgG2Δa monoclonal antibody that binds to amyloid-β (Aβ). It is designed to have reduced immune effector function compared to other passive immunotherapies for Alzheimer's disease (AD). Toxicity was evaluated in cynomolgus monkeys treated intravenously with vehicle or 10, 30, or 100 mg/kg of ponezumab every 10th day for up to 39 weeks, and after a 12-week recovery phase. The Aβ peptide sequence of monkeys is identical to that of humans. No substantial difference in test article exposure between sexes was observed, and mean plasma Cmax and AUC0-n were approximately dose-proportional. Ponezumab was detectable approximately 9 weeks after cessation of dosing. All animals, except two males given 10 mg/kg, maintained exposure to test article. One of these males tested positive for anti-ponezumab antibodies. Ponezumab was detected in the cerebrospinal fluid (CSF) of animals given active treatment. The estimated CSF/plasma ponezumab concentration ratio was AUC basis, respectively, than human exposures at the highest dose (10 mg/kg) in a single-dose Phase I trial. These data suggest an acceptable safety profile for ponezumab as an immunotherapy for AD. PMID:22045481

  6. 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.

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

    DEFF Research Database (Denmark)

    Carli, Francesco; Kehlet, Henrik; Baldini, Gabriele; Steel, Andrew; McRae, Karen; Slinger, Peter; Hemmerling, Thomas; Salinas, Francis; Neal, Joseph M.

    2011-01-01

    fast-track methodologies, were identified. The impact of epidural and paravertebral blockade, spinal analgesia, peripheral nerve blocks, and new regional anesthesia techniques on main procedure-specific postoperative outcomes is discussed. Finally, in the last section, implementations required to......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...

  8. 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.

  9. Intestinal circulation during inhalation anesthesia

    International Nuclear Information System (INIS)

    This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of 86Rb and 9-microns spheres labeled with 141Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001). Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO2) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines

  10. 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...

  11. 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.

  12. 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

  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. TONSILLECTOMY UNDER LOCAL ANESTHESIA IN MALI

    Directory of Open Access Journals (Sweden)

    SACKO HB

    2015-04-01

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

  15. 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...

  16. Psychological aspects of pediatric anesthesia

    Directory of Open Access Journals (Sweden)

    Drašković Biljana

    2015-01-01

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

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

    Science.gov (United States)

    Wedemeyer, Gary

    1970-01-01

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

  18. 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

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

    Directory of Open Access Journals (Sweden)

    Shahi

    2014-04-01

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

  1. The Mesoscopic Modeling of Burst Suppression during Anesthesia

    OpenAIRE

    Liley, David T. J.; Walsh, Matthew

    2013-01-01

    The burst-suppression pattern is well recognized as a distinct feature of the mammalian electroencephalogram (EEG) waveform. Consisting of alternating periods of high amplitude oscillatory and isoelectric activity, it can be induced in health by deep anesthesia as well as being evoked by a range of pathophysiological processes that include coma and anoxia. While the electroencephalographic phenomenon and clinical implications of burst suppression have been studied extensively, the physiologic...

  2. 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...

  3. 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 ...

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

    OpenAIRE

    2015-01-01

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

  5. 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.

  6. Assessing pain responses during general anesthesia.

    Science.gov (United States)

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

    2001-06-01

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

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Campbell JP

    2013-08-01

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

  9. 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

  10. 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,

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

    Directory of Open Access Journals (Sweden)

    Poonam S Ghodki

    2014-01-01

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

  12. Neonatal anesthesia with limited resources.

    Science.gov (United States)

    Bösenberg, Adrian T

    2014-01-01

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

  13. Local anesthesia for prostate brachytherapy

    International Nuclear Information System (INIS)

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

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

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    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.

  15. 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.

  16. 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。

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

    Science.gov (United States)

    Ferragut, E

    1979-10-01

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

  18. Inhalational anesthesia for organ procurement: potential indications for administering inhalational anesthesia in the brain-dead organ donor.

    Science.gov (United States)

    Elkins, Laurie J

    2010-08-01

    Organs needed for transplantation far outweigh their availability. There is minimal research regarding perioperative care of the brain-dead organ donor during the procurement procedure. Current research attributes a great deal of organ damage to autonomic or sympathetic storm that occurs during brain death. Literature searches were performed with the terms brain death, organ donor, organ procurement, anesthesia and organ donor, anesthesia and brain death, anesthesia and organ procurement, inhalational anesthetics and organ procurement, and inhalational anesthetics and brain dead. Additional resources were obtained from reference lists of published articles. The literature review showed there is a lack of published studies researching the use of inhalational anesthetics in organ procurement. No studies have been published evaluating the effect of preconditioning with inhalational agents (administering 1.3 minimal alveolar concentration of an inhalational agent for the 20 minutes before periods of ischemia) in the brain-dead organ donor population. Further studies are required to determine if administration of inhalational anesthetics reduces catecholamine release occurring with surgical stimulation during the organ procurement procedure and whether this technique increases viability of transplanted organs. Anesthetic preconditioning before the ischemic period may reduce ischemia-reperfusion injury in transplanted organs, further increasing viability of transplanted organs. PMID:20879630

  19. 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 ...

  20. 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

  1. THORACIC EPIDURAL ANESTHESIA FOR MODIFIED RADICAL MASTECTOMY-IN TYPE2 DIABETES MELLITUS PATIENT

    Directory of Open Access Journals (Sweden)

    Vishwanath R

    2014-12-01

    Full Text Available Modified radical mastectomy (MRM, the standard oncologic surgical procedure of the carcinoma of breast is routinely performed under general anesthesia. Carcinoma breast patients are considered to be at high risk for anesthesia due to high possibility of perioperative complications and mortality when associated with long standing type 2 Diabetes Mellitus (DM with other co morbidities. Cardiac complications due to macro vascular and micro vascular involvement can pose a real threat. Here we present a case report of successful perioperative management of modified radical mastectomy only with thoracic epidural anesthesia (TEA in a case of carcinoma breast with long standing type 2 DM and hypertension. A 71year old female, a known case of DM since 7years with co morbidity; hypertension having a carcinoma breast was scheduled for modified radical mastectomy. Continuous epidural anesthesia was administered at T4-5 level. Local anesthetic supplementation titrated as per the demands of surgery and good postoperative analgesia maintained for 48 hours. Long standing DM with hypertension can lead to perioperative morbidity and mortality due to cardiac complications. However, Thoracic epidural anesthesia (TEA reduces cardiac and sympathetic activity and thereby improves perioperative function of vital organs and reduces postoperative morbidity and mortality. The procedure can lead to prompt recovery with additional benefit of prolonged post-operative analgesia. TEA proved to be an excellent anesthetic technique for MRM in patient with long standing DM.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Science.gov (United States)

    Anderson, Brian J; Merry, Alan F

    2015-12-01

    Demonstrably accurate records facilitate clinical decision making, improve patient safety, provide better defense against frivolous lawsuits, and enable better medical policy decisions. Anesthesia Information Management Systems (AIMS) have the potential to improve on the accuracy and reliability of handwritten records. Interfaces with electronic recording systems within the hospital or wider community allow correlation of anesthesia relevant data with biochemistry laboratory results, billing sections, radiological units, pharmacy, earlier patient records, and other systems. Electronic storage of large and accurate datasets has lent itself to quality assurance, enhancement of patient safety, research, cost containment, scheduling, anesthesia training initiatives, and has even stimulated organizational change. The time for record making may be increased by AIMS, but in some cases has been reduced. The question of impact on vigilance is not entirely settled, but substantial negative effects seem to be unlikely. The usefulness of these large databases depends on the accuracy of data and they may be incorrect or incomplete. Consequent biases are threats to the validity of research results. Data mining of biomedical databases makes it easier for individuals with political, social, or economic agendas to generate misleading research findings for the purpose of manipulating public opinion and swaying policymakers. There remains a fear that accessibility of data may have undesirable regulatory or legal consequences. Increasing regulation of treatment options during the perioperative period through regulated policies could reduce autonomy for clinicians. These fears are as yet unsubstantiated. PMID:26432199

  4. 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

  5. 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.

  6. 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.

  7. 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...

  8. 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.

  9. 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...

  10. Methylphenidate Actively Induces Emergence from General Anesthesia

    OpenAIRE

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

    2011-01-01

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

  11. 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

  12. 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...

  13. Epidural anesthesia in repeated cesarean section.

    Directory of Open Access Journals (Sweden)

    Rolando T. Espín González

    2003-04-01

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

  14. 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

  15. 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

  16. The effects of two dosages of midazolam on short-duration anesthesia in the harp seal (Phoca groenlandica).

    Science.gov (United States)

    Pang, Daniel S J; Rondenay, Yves; Measures, Lena; Lair, Stéphane

    2006-03-01

    The purpose of this study was to provide safe anesthesia for bronchoalveolar lavage and assess the utility of premedication with i.m. midazolam for short-duration anesthesia with isoflurane in harp seals (Phoca groenlandica). Fourteen yearling harp seal pups were anesthetized three times each as part of a prospective, cross-over, blinded study. Each animal received i.m. premedication with saline, low-dose, or high-dose midazolam (respectively 0.1 and 0.2 mg/ kg). Following premedication, anesthesia was induced with 4% isoflurane in oxygen delivered through a mask and connected to a Bain non-rebreathing system. A significantly longer time was taken from the end of general anesthesia to head movement in the high-dose group compared with the saline group (P = 0.002). A significantly longer time was taken from the end of general anesthesia to ambulation in the high-dose group compared with the saline group (P = 0.006). There were no significant differences between groups in the subjective assessment of anesthetic quality or ease of intubation. Premedication with i.m. midazolam at the dosages used did prolong recovery from anesthesia, although to a degree unlikely to be significant clinically. PMID:17312808

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

    OpenAIRE

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

    2005-01-01

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

  18. 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

  19. 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

  20. 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 .

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

    Directory of Open Access Journals (Sweden)

    Stošić Mila

    2006-01-01

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

  2. Peri-infarct depolarizations during focal ischemia in the awake Spontaneously Hypertensive Rat. Minimizing anesthesia confounds in experimental stroke.

    Science.gov (United States)

    Kudo, K; Zhao, L; Nowak, T S

    2016-06-14

    Anesthesia profoundly impacts peri-infarct depolarizations (PIDs), but only one prior report has described their monitoring during experimental stroke in awake animals. Since temporal patterns of PID occurrence are model specific, the current study examined PID incidence during focal ischemia in the awake Spontaneously Hypertensive Rat (SHR), and documented the impact of both prior and concurrent isoflurane anesthesia. For awake recordings, electrodes were implanted under isoflurane anesthesia 1day to 5weeks prior to occlusion surgery. Rats were then subjected to permanent or transient (2h) tandem occlusion of the middle cerebral and ipsilateral common carotid arteries, followed by PID monitoring for up to 3days. Comparison perfusion imaging studies evaluated PID-associated hyperemic transients during permanent ischemia under anesthesia at varied intervals following prior isoflurane exposure. Prior anesthesia attenuated PID number at intervals up to 1week, establishing 2weeks as a practical recovery duration following surgical preparation to avoid isoflurane preconditioning effects. PIDs in awake SHR were limited to the first 4h after permanent occlusions. Maintaining anesthesia during this interval reduced PID number, and prolonged their occurrence through several hours following anesthesia termination. Although PID number otherwise correlated with infarct size, PID suppression by anesthesia was not protective in the absence of reperfusion. PIDs persisted up to 36h after transient occlusions. These results differ markedly from the one previous report of such monitoring in awake Sprague-Dawley rats, which found an extended biphasic PID time course during 24h after both permanent and transient filament occlusions. PID occurrence closely reflects the time course of infarct progression in the respective models, and may be more useful than absolute PID number as an index of ongoing pathology. PMID:27026594

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

    DEFF Research Database (Denmark)

    Nielsen, Joachim; Krustrup, Peter; Nybo, Lars; Gunnarsson, Thomas P; Madsen, Klavs; Schrøder, Henrik Daa; Bangsbo, Jens; Ortenblad, Niels

    2012-01-01

    biopsy collected immediately after and 24, 48, 72 and 120 h after a competitive soccer match. Transmission electron microscopy was used to estimate the subcellular distribution of glycogen and individual particle size. During the first day of recovery, glycogen content increased by ~60% in all...

  4. Effects of unilateral spinal anesthesia with low dose bupivacaine and

    Directory of Open Access Journals (Sweden)

    Nermin Göğüş

    2011-03-01

    Full Text Available Our aim was to compare unilateral spinal anesthesiaproduced by 6 mg hyperbaric bupivacaine or 4mg hyperbaric bupivacaine plus 10 0.05. Although level ofsensory block, and time to reach T12 dermatome werenot different (p>0.05, level of motor block, ambulationtime and time to discharge were significantly longer inGroup I than Group II (p<0.05. Side effects were not differentbetween groups, except more itching in Group II.Conclusion: Spinal anesthesia with using 4 mg hyperbaricbupivacaine+10recovery characteristics.J Clin Exp Invest 2011; 2(1: 22- 29

  5. Hemodynamic stability, myocardial ischemia, and perioperative outcome after carotid surgery with remifentanil/propofol or isoflurane/fentanyl anesthesia.

    Science.gov (United States)

    Jellish, W Scott; Sheikh, Taqdees; Baker, William H; Louie, Eric K; Slogoff, Stephen

    2003-07-01

    This study compares remifentanil/propofol (remi/prop) with isoflurane/fentanyl (iso/fen) anesthesia to determine which provides the greater hemodynamic stability, lesser myocardial ischemia, and morbidity with better postoperative outcomes after carotid endarterectomy. Sixty patients undergoing unilateral carotid endarterectomy were randomized to receive either a remi/prop or iso/fen anesthetic. Hemodynamic variables were recorded during the surgical procedure. In addition, transesophageal echocardiography was used to assess evidence of intraoperative regional wall motion abnormalities suggestive of cardiac ischemia. Emergence and extubation times, recovery from anesthesia, hemodynamic instability, nausea, vomiting, and pain in post anesthesia recovery, discharge delays, ICU admittance, hospital discharge, and preoperative and postoperative troponin levels were compared using appropriate statistical methods with P < 0.05 considered significant. The groups were demographically alike. Hemodynamic variables were similar during intubation and throughout surgery. Twenty-two percent of patients receiving iso/fen developed intraoperative regional wall motion abnormalities suggestive of ischemia, whereas no remi/prop patients had changes (P < 0.05). There was no difference in ST-T wave changes after surgery, and no patient had an elevation in troponin I levels. Postoperative variables were similar except that patients who received iso/fen had lower Stewart recovery scores during the first 15 minutes after post anesthesia care unit admission and a higher incidence of nausea and vomiting the day after surgery, whereas patients receiving remi/prop had discharge delays secondary to hypertension. ICU admittance, time to first void, oral intake, and time to hospital discharge were similar between the groups. At 9 times the cost of an iso/fen anesthesia technique, remi/prop offers little advantage over inhalational anesthesia for carotid endarterectomy. PMID:12826964

  6. Organ Protective Effect of Isoflurane Anesthesia in Cardiac Surgeries with Artificial Circulation

    Directory of Open Access Journals (Sweden)

    Eldyrev А.Y.

    2012-12-01

    Full Text Available The aim of the investigation is to give full estimation of organ protective effect of isoflurane anesthesia in cardiac surgeries with artificial circulation. Materials and Methods. There were analyzed the results of clinical, functional, biochemical and morphological examinations of 424 patients operated under the conditions of artificial circulation using two variants of anesthesia: 203 patients were given isoflurane (experimental group; 221 patients — propofol (control group. There were studied clinical progression of rehabilitation period, the change of myocardial contractile function indices, myocardial ultrastructure, and biochemical blood values after the operation. Conclusion. Isoflurane anesthesia provides an additional protective effect in cardiac surgeries with artificial circulation. This effect is proved by complex clinical studies regarding the heart, liver, and kidneys. Myocardial effect of additional protection is supported by clinical, functional, morphological, and biochemical criteria.

  7. 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.

  8. 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.

  9. 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

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

    Science.gov (United States)

    Muhly, Wallis T; Gurnaney, Harshad G; Ganesh, Arjunan

    2015-01-01

    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. PMID:26609245

  11. 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

  12. 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...

  13. 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.

  14. 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

  15. Convulsions during cataract surgery under peribulbar anesthesia: a case report

    OpenAIRE

    Bensghir, Mustapha; Badou, Najlae; Houba, Abdelhafid; Balkhi, Hicham; Haimeur, Charki; Azendour, Hicham

    2014-01-01

    Introduction Locoregional anesthesia techniques are increasingly used for cataract surgery. From these techniques, peribulbar anesthesia has been very successful over the retrobulbar anesthesia seen its effectiveness and safety. However, peribulbar anesthesia is not without risk. Case presentation A 70-year-old African man was scheduled for cataract surgery and lens implant for his right eye. His medical history included hypertension, diabetes mellitus and gall bladder surgery. There were no ...

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

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2015-06-01

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

  17. Simultaneous Bilateral Cataract Surgery in General Anesthesia Patients

    Directory of Open Access Journals (Sweden)

    Tien-En Huang

    2007-04-01

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

  18. 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

  19. 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...

  20. 21 CFR 868.5170 - Laryngotracheal topical anesthesia applicator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laryngotracheal topical anesthesia applicator. 868... topical anesthesia applicator. (a) Identification. A laryngotracheal topical anesthesia applicator is a device used to apply topical anesthetics to a patient's laryngotracheal area. (b) Classification....

  1. 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…

  2. 21 CFR 868.5140 - Anesthesia conduction kit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction kit. 868.5140 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a) Identification. An anesthesia conduction kit is a device used to administer to a patient conduction, regional,...

  3. 21 CFR 868.5130 - Anesthesia conduction filter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction filter. 868.5130 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5130 Anesthesia conduction filter. (a) Identification. An anesthesia conduction filter is a microporous filter used while administering to a...

  4. 21 CFR 868.5150 - Anesthesia conduction needle.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction needle. 868.5150 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5150 Anesthesia conduction needle. (a) Identification. An anesthesia conduction needle is a device used to inject local anesthetics into a patient...

  5. 21 CFR 868.5120 - Anesthesia conduction catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction catheter. 868.5120 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5120 Anesthesia conduction catheter. (a) Identification. An anesthesia conduction catheter is a flexible tubular device used to...

  6. 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...

  7. 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...

  8. Acute life-threatening arrhythmias caused by severe hyperkalemia after induction of anesthesia in an infant with methylmalonic acidemia.

    Science.gov (United States)

    Chao, Pei-Wen; Chang, Wen-Kuei; Lai, I-Wen; Liu, Chinsu; Chan, Kwok-Hon; Tsao, Cheng-Ming

    2012-05-01

    Methylmalonic acidemia (MMA) is a very rare genetic disease of metabolism that progressively leads to neurological and renal sequelae. This report describes an unusual case of a patient with MMA who developed severe hyperkalemia and severe dysrhythmia during anesthesia. A 13-month-old male infant with MMA underwent urgent insertion of a port-a-cath under general anesthesia. A life-threatening arrhythmia suddenly occurred, with severe hyperkalemia (up to 7.4 mmol/L), immediately following induction of anesthesia. Emergent resuscitation was successfully carried out, with a complete neurological recovery after 7 days after surgery. Although MMA is a rare complication, the possibility of severe hyperkalemia should be considered in the differential diagnosis of patients with MMA presenting with wide QRS complex tachycardia. The management and intraoperative complications of this disorder are reported here, and the available literature is reviewed. PMID:22632992

  9. 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.

  10. Management of coal waste by energy recovery: Mild gasification/flash pyrolysis of coal preparation waste: Quarterly report (draft) for the period July-September 1986

    Energy Technology Data Exchange (ETDEWEB)

    Chu, C.I.C.; Gillespie, B.L.

    1986-11-01

    One of the most perplexing problems facing the coal industry is how to properly dispose of the waste and/or even recovery a small fraction of the Btu value of the waste, while minimizing the environmental concerns. UCC Research considers this monumental environmental problems as an opportunity to recovery useable organic materials and reduce the environmental problems created by coal waste. Mild gasification is the method used by UCC Research to realize these objectives. Coal feedstocks are fed into the mild gasification system yielding liquids, char, and gases for commercial application. The program consists of seven tasks: Task 1, Characterize Management of Coal Preparation Wastes; Task 2, Review Design Specifications and Prepare Preliminary Test Plan; Task 3, Select and Characterize Test Feedstocks; Task 4, Acquire/Construct Process Elements; Task 5, Prepare Final Test Plan; Task 6, Implement Final Test Plan; Task 7, Analyze Test Results and Assess System Economics. A schedule of the program is given. The program was initiated on September 30, 1984. Tasks 1, 2, 3, 4, 5, and 6 have been completed. Work is continuing on Task 7.

  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. [Comparative assessment of inhalation anesthesia with sevofluran and intravenous anesthesia with propofol for carotid endarterectomy].

    Science.gov (United States)

    Neĭmark, M I; Shmelev, V V; Simagin, V Iu

    2009-01-01

    Total intravenous anesthesia with propofol and inhalation sevofluran was assessed in 130 patients with carotid endarterectomy. The parameters of brain blood circulation, brain damage markers were studied. It was shown that sevofluran anesthesia caused less depression of the hemodynamic parameters, supported more optimum level of brain blood flow that limited ischemic and reperfusion damage of the brain and was accompanied by a fewer number of postoperative complications. PMID:20209996

  13. General anesthesia for horses with specific problems

    International Nuclear Information System (INIS)

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

  14. 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

  15. 42 CFR 415.178 - Anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Anesthesia services. 415.178 Section 415.178 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING...

  16. Testing haptic sensations for spinal anesthesia.

    LENUS (Irish Health Repository)

    2011-01-01

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

  17. 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...

  18. Update on complications in pediatric anesthesia

    Directory of Open Access Journals (Sweden)

    Giovanni de Francisci

    2013-02-01

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

  19. [Anesthesia in the Signal Processing Methods].

    Science.gov (United States)

    Gu, Jiajun; Huang, Yan; Ye, Jilun; Wang, Kaijun; Zhang, Meimei

    2015-09-01

    Anesthesia plays an essential role in clinical operations. Guiding anesthesia by EEG signals is one of the most promising methods at present and it has obtained good results. The analysis and process of the EEG signals in anesthesia can provide clean signal for further research. This paper used variance threshold method to remove the mutation fast and large interfering signals; and used notch filter to remove frequency interference, smoothing filter to remove baseline drift and Butterworth low-pass filter to remove high frequency noise at the same time. In addition to this, the translation invariant wavelet method to remove interference noise on the signals which was after the classical filter and retained non-stationary characteristics was used to evaluate parameter calculation. By comparing the calculated parameters from treated signal using this paper's methods and untreated signal and standard signal, the standard deviation and correlation has been improved, particularly the major parameters BetaR, which provides better signal for integration of multi-parameter to evaluate depth of anesthesia index for the latter. PMID:26904870

  20. 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.

  1. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

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

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

  2. 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

  3. 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.

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

    Institute of Scientific and Technical Information of China (English)

    韩跃刚; 田军; 刘万秀; 卢珊

    2002-01-01

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

  5. 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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Sinem Sarı

    2015-08-01

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

  8. 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

  9. 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.

  10. '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

  11. 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

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Jelenković Ankica V.

    2005-01-01

    Full Text Available It is expected that clinical recovery after surgically induced brain trauma is followed by molecular and biochemical restitution. Seven days after surgery, we investigated whether the plastic cannula implanted in the left brain ventricle of adult Wistar rats (n = 6-7, performed in pentobarbital anesthesia, could influence oxidative stress elements (superoxide anion and lipid peroxidation, as well as the antioxidative system (superoxide dismuthase-SOD. Also, we investigated whether nitric oxide (NO is involved in these processes. Biochemical analyses was performed in the forebrain cortex, striatum and hippocampus. Clinical recovery was complete seven days after surgery. Thereafter, thirty minutes before decapitation, through the cannula, one group of rats received saline intracerebroventricularly (control group, and the treated group received Nω-nitro-L-arginine methyl ester (L-NAME. The third group was left unoperated and untreated. Before and after the treatments, rectal body temperature was measured. Compared to the untreated group the index of lipid peroxidation was increased in all three brain structures in the group that received saline (p<0.05 to 0.01. Application of L-NAME deteriorated it in the striatum and hippocampus (p<0.01 compared to the both other groups, but the value in the forebrain cortex was similar to the untreated group. Supeoxide anion level was decreased in the L-NAME treated group only in the striatum (p<0.01 compared to control and untreated groups, but SOD was increased in the hippocampus compared to the saline treated group (p<0.05. Seven days after brain surgery in pentobarbital anesthesia, recovery of biochemical disturbances was not parallel to clinical recovery. Long lasting biochemical changes are rather the consequence of brain injury than to pentobarbital anesthesia. In this experimental model, NO had protective effects, acting against lipid per oxidation in the striatum and hippocampus, but not in the

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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。

  20. 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.

  1. 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...

  2. The comparison between lateral spinal anesthesia and sitting positions in lower limb vascular surgery

    Directory of Open Access Journals (Sweden)

    Mohajer MR

    2011-10-01

    Full Text Available "nBackground: Patients who require surgery on the lower extremities are considered to be a high risk group from the point of anesthesia. This study was performed to compare sitting and lateral positions in spinal anesthesia method with hyperbaric bupivacaine 0.5% for hemodynamic status and analgesic period in patients under vascular surgery of the lower limbs in Imam-Khomeini Hospital Complex affiliated to Tehran University of Medical Sciences in 2009."n "nMethods: In this study 40 patients were divided into two groups of 20 to undergo spinal anesthesia with 3 ml of hyperbaric bupivacaine 0.5% injected into the subarachnoid space in sitting or lateral positions. The anesthesia was performed at T10 level and the hemodynamic status and analgesic periods were compared in the two groups."n "nResults: The changes in mean arterial blood pressure and systolic and diastolic blood pressures were different between the two groups (P<0.05. Except in the first and thirtieth minutes, the changes in heart rate (HR were significantly different throughout the study between the two groups (P<0.04 and they were higher in sitting position. The duration of analgesia was significantly longer in lateral position (P<0.04 and the use of fluid was significantly larger in the sitting group (P<0.05."n "nConclusion: According to the obtained results, the changes in hemodynamic variables were significantly lower in the group in lateral versus sitting position in patients undergoing spinal anesthesia with bupivacaine for vascular surgery of the lower limb.

  3. Emergence from anesthesia in children undergoing ambulatory surgery- a comparison between propofol and sevoflurane using single anesthetic technique

    International Nuclear Information System (INIS)

    Objective: To compare emergence from anesthesia using total intravenous anesthesia (TIVA) with propofol and volatile induction maintenance anesthesia (VIMA) with sevoflurane, in children undergoing ambulatory inguinal herniorrhaphy. Study Design: Randomized, controlled trials. Place and Duration of Study: Shifa Hospital of Pakistan Navy, from 1st Mar 2005 to 28th Feb 2006. Patients and Methods: Eighty children, aged 5-10 years of ASA physical status I or II were divided into two groups of 40 each using random numbers table. Group P received propofol 3mg/kg for induction and 100-400 micro g/kg/min infusion for maintenance of anesthesia, while group S received sevoflurane 8% (inspired concentration) in 100% oxygen for induction and 2-3% in oxygen for maintenance of anesthesia. No sedative premedication was given. Analgesia was provided with caudal block using 0.25% bupivacaine. Speed of emergence from anesthesia was assessed by time to extubation, time to eye opening, and time to crying / stating name. A modified aldrete score system was used to evaluate recovery while Pain/Discomfort scale to assess the quality of emergence from anesthesia. These were recorded by a separate consultant anesthetist blind to the anesthetic technique. Results: Emergence from anesthesia occurred significantly quicker in the S group as compared to P group, as evident by times in minutes (mean +- SD) to extubation: 8.3+-6.9 versus 4.7+-2.6(p=0.017), eye opening: 9.1 +- 5.3 vs. 5.6 +- 2.6 (p=0.043) and crying / state name: 14.7 +-7.2 vs.11.3 +- 4.6(p=0.039). Similarly, more patients in the S group scored maximum points in the modified aldrete score at 10 min: 17 (42.5%) vs.7 (17.5%) (p=0.015), 20 min: 32 (80%) vs.23 (57.5%) (p=0.030). Although, number of patients in the S group compared to P group scoring max points in Pain-discomfort scale at 10 min: 8 (20%) vs4 (10%), p=0.210; 20 min: 6 (15%) vs.2 (5%), p=0.136 and 30 min: 4 (10%) vs. 0, p=0.130 were more, these results were not

  4. 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.

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

    International Nuclear Information System (INIS)

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

  6. 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,

  7. 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.

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

    OpenAIRE

    Dipyaman Sengupta; Pramod R. Nandi

    2013-01-01

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

  9. 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.

  10. 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.

  11. 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...

  12. A Computerized Record System for Anesthesia Services

    OpenAIRE

    Chase, Christopher R.; Merz, Barbara A.

    1982-01-01

    We have developed a computerized record system, the CAPE system, which supports patient management, administrative and research applications for anesthesia services in our hospital, the Medical Center Hospital of Vermont. In this paper we briefly describe the CAPE system and, as an example of its use in our hospital, we describe the development and implementation of a preoperative screening program used to identify patients at high risk to postoperative respiratory complications.

  13. Assessment of propofol anesthesia in the rabbit

    OpenAIRE

    Campos, Sónia Patrícia Seabra

    2010-01-01

    The growing interests in propofol as an intravenous anesthetic agent and in particular to its use in rabbits were the motivation for this work. The rabbit is the third most common pet, and is also used as a biomedical research model in a wide range of science branches such as pharmacology, toxicology, anesthesiology and surgery. The main goal of this study was to explore the effects of Total Intravenous Anesthesia (TIVA) with propofol in rabbits. Different infusion rates were administrated...

  14. 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 ...

  15. [Chronic pain and regional anesthesia in children].

    Science.gov (United States)

    Dadure, C; Marec, P; Veyckemans, F; Beloeil, H

    2013-10-01

    Chronic pain is usually underestimated in children, due to lack of knowledge and its specific signs. In addition to suffering, chronic pain causes a physical, psychological, emotional, social, and financial burden for the child and his family. Practitioners may find themselves in a situation of failure with depletion of medical resources. Some types of chronic pain are refractory to conventional systemic treatment and may require the use of regional anesthesia. Cancer pain is common in children and its medical management is sometimes insufficient. It is accessible to neuroaxial or peripheral techniques of regional anesthesia if it is limited to an area accessible to one of these techniques and no contraindications (e.g., thrombopenia) are present. Complex regional pain syndrome 1 is not rare in children and adolescents, but it often goes undiagnosed. Regional anesthesia may contribute to the treatment of complex regional pain syndrome 1, mainly in case of recurrence, because it provides rapid effective analgesia and allows rapid implementation of intensive physiotherapy. These techniques have also shown interest in phantom limb pain after limb amputation, but they remain controversial for erythromelalgia pain or chronic abdominopelvic pain. Finally, the treatment of postdural puncture headache due to cerebrospinal fluid leak can be treated by performing an epidural injection of the patient's blood, called a blood-patch. Finally, the management of children with chronic pain should be multidisciplinary (pediatrician, physiotherapist, psychologist, surgeon, anesthesiologist) to support the child and her problem in its entirety. PMID:23953871

  16. 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

  17. General versus epidural anesthesia for lumbar microdiscectomy.

    Science.gov (United States)

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

    2015-08-01

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

  18. 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

  19. 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.

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

    OpenAIRE

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

    2005-01-01

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

  1. 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

  2. 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.

  3. A comparison of the immunological effects of propofol and isoflurane for maintenance of anesthesia in healthy dogs.

    Science.gov (United States)

    Tomihari, Mizuki; Nishihara, Akira; Shimada, Terumasa; Yanagawa, Masashi; Miyoshi, Masafumi; Miyahara, Kazurou; Oishi, Akihiro

    2015-10-01

    Most anesthetics have an immuno-suppressive effect on cellular and neurohumoral immunity, and research shows that total intravenous anesthesia (TIVA) with propofol has a greater immuno-protective effect than inhalational anesthesia in human medicine. However, in veterinary clinics, these effects remain ambiguous. To clarify the details, we focused on propofol and isoflurane, investigating clinical blood hematology and immunological profiles drawn from healthy dogs under and after two anesthesia techniques. Twelve healthy adult beagles were included in this study, randomly assigned to the propofol anesthesia group (group P: n=6) or the isoflurane anesthesia group (group I: n=6). In both groups, the number of lymphocytes in peripheral blood decreased after 2 hr of anesthesia (2 hr), but group P showed significantly less decrease than group I. For T-lymphocyte subsets examined by flowcytometry, the ratio of CD3+, CD4+ and CD8+ lymphocytes in the peripheral blood mononuclear cell (PBMC) of group P at 2 hr also exhibited a high level compared to group I. Moreover, for mRNA expression of cytokines measured by real-time PCR, the IL2 (pro-inflammatory cytokine) of group P showed no decrease like group I. The IL10 (anti-inflammatory cytokine) of group P also showed no increase like group I, while both cytokines maintained nearly the same level until 2 hr. These results suggest that, compared to propofol, isoflurane had more strongly immuno-suppression caused by anesthesia, and propofol itself might have some immuno-protective effects. Thus, TIVA with propofol might benefit immunological support in the perioperative period of dogs. PMID:25960120

  4. 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

  5. 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...

  6. 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...

  7. Modeling the dynamical effects of anesthesia on brain circuits

    OpenAIRE

    Ching, ShiNung; Brown, Emery N

    2014-01-01

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

  8. 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.

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

    International Nuclear Information System (INIS)

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

  10. The application of sacral block anesthesia in pediatric interventional therapy

    International Nuclear Information System (INIS)

    Objective: To discuss the management and feasibility of sacral block anesthesia in pediatric interventional therapy. Methods: A total of 80 pediatric patients were randomly and equally divided into two groups. Patients in group A received sacral block anesthesia together with basic anesthesia with propofol, while patients in group B received intravenous anesthesia with propofol. Small amount of ketamine as maintaining dose was used in both groups when needed. Results: The interventional management was successfully completed in all patients. A marked decrease in blood pressure occurred in three patients of group A receiving sacral block anesthesia. In group B receiving intravenous anesthesia, a decrease of SpO2 to below 90 percent was seen in 8 cases, and obvious bradycardia developed in 12 cases. All these patients were treated with intravenous medication or by reducing the dose of propofol. Additional small dose of ketamine was needed in 4 patients during the procedure. Conclusion: Sacral block anesthesia combined with intravenous anesthesia is one of the effective anesthesia management schemes for pediatric interventional therapy. (authors)

  11. Caudal epidural anesthesia during intracavitary brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    It has been suggested that pain control during intracavitary brachytherapy for cervical cancer is insufficient in most hospitals in Japan. Our hospital began using caudal epidural anesthesia during high-dose-rate (HDR) intracavitary brachytherapy in 2011. The purpose of the present study was to retrospectively investigate the effects of caudal epidural anesthesia during HDR intracavitary brachytherapy for cervical cancer patients. Caudal epidural anesthesia for 34 cervical cancer patients was performed during HDR intracavitary brachytherapy between October 2011 and August 2013. We used the patients' self-reported Numeric Rating Scale (NRS) score at the first session of HDR intracavitary brachytherapy as a subjective evaluation of pain. We compared NRS scores of the patients with anesthesia with those of 30 patients who underwent HDR intracavitary brachytherapy without sacral epidural anesthesia at our hospital between May 2010 and August 2011. Caudal epidural anesthesia succeeded in 33 patients (97%), and the NRS score was recorded in 30 patients. The mean NRS score of the anesthesia group was 5.17 ± 2.97, significantly lower than that of the control group's 6.80 ± 2.59 (P = 0.035). The caudal epidural block resulted in no side-effects. Caudal epidural anesthesia is an effective and safe anesthesia option during HDR intracavitary brachytherapy for cervical cancer. (author)

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Gaszynski T

    2014-07-01

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

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

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    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.

  15. Anesthesia for tracheostomy for huge maxillofacial tumor

    Directory of Open Access Journals (Sweden)

    Abeer A Arab

    2014-01-01

    Full Text Available Providing sedation for patients with compromised upper airway is challenging. A 19-year-old female patient with huge maxillofacial tumor invading the whole pharynx scheduled for elective tracheostomy under local anesthesia due to compromised airway. The patient had gastrostomy tube for feeding. Venous cannulation was totally refused by the patient after repeated trials for exhausted sclerosed veins. Pre-operative mixture of dexmedetomidine with ketamine was administered through the gastrostomy tube with eutectic mixture of local anesthetics cream application over the planned tracheostomy site. The patient was sedated with eye opening to command. Local infiltration followed by tracheostomy was performed without patient complaints or recall of operative events.

  16. 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

  17. 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

  18. 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

  19. Simulation of electroencephalographic signals for depth of anesthesia assessment

    Science.gov (United States)

    Panichev, Oleg; Popov, Anton; Bodilovskyi, Oleg; Tkachenko, Valerii

    2011-10-01

    The problem of simulating electroencephalographic (EEG) signals for different stages of anesthesia is considered. Review of existing techniques for EEG simulation is made and the new technique for simulating the EEG using only preliminary definition of magnitudes of harmonic components for every frequency ranges is presented. During experimental part EEG signals for four stages of ether anesthesia were simulated.

  20. 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

  1. 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

  2. Laparoscopic cholecystectomy under epidural anesthesia: A feasibility study

    Directory of Open Access Journals (Sweden)

    Ranendra Hajong

    2014-01-01

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

  3. Improving Patient Safety in Anesthesia: A Success Story?

    International Nuclear Information System (INIS)

    Anesthesia is necessary for surgery; however, it does not deliver any direct therapeutic benefit. The risks of anesthesia must therefore be as low as possible. Anesthesiology has been identified as a leader in improving patient safety. Anesthetic mortality has decreased, and in healthy patients can be as low as 1:250,000. Trends in anesthetic morbidity have not been as well defined, but it appears that the risk of injury is decreasing. Studies of error during anesthesia and Closed Claims studies have identified sources of risk and methods to reduce the risks associated with anesthesia. These include changes in technology, such as anesthetic delivery systems and monitors, the application of human factors, the use of simulation, and the establishment of reporting systems. A review of the important events in the past 50 years illustrates the many steps that have contributed to the improvements in anesthesia safety

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

    Directory of Open Access Journals (Sweden)

    Cengiz Kaplan

    2015-02-01

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

  5. Emergence from general anesthesia and the sleep-manifold

    Directory of Open Access Journals (Sweden)

    Darren Fletcher Hight

    2014-08-01

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

  6. General anesthesia for nuclear magnetic resonance imaging

    International Nuclear Information System (INIS)

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

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. Anesthesia during and Immediately after Spaceflight

    Science.gov (United States)

    Seubert, Christoph N.; Price, Catherine; Janelle, Gregory M.

    2006-01-01

    The increasing presence of humans in space and long-duration manned missions to the Moon or Mars pose novel challenges to the delivery of medical care. Even now, cumulative person-days in space exceed 80 years and preparations for a return to the Moon are actively underway. Medical care after an emergent de-orbit or an accident during a non-nominal landing must not only address the specific disease or injuries but also the challenges posed by physiologic adaptations to microgravity. In the highly autonomous situation of a long-term space mission the situation is even more complex, because personnel, equipment, specific training, and clinical experience are by definition limited. To summarize our current knowledge specifically for anesthetic care during and immediately after spaceflight, we will review physiologic adaptations to microgravity with particular emphasis on the resulting anesthetic risks, discuss veterinary experiences with anesthesia in weightlessness or in animals adapted to microgravity, describe current research that pertains to anesthesia and spaceflight and point out unresolved questions for future investigation.

  12. Respiratory diagnostic possibilities during closed circuit anesthesia.

    Science.gov (United States)

    Verkaaik, A P; Erdmann, W

    1990-01-01

    An automatic feed back controlled totally closed circuit system (Physioflex) has been developed for quantitative practice of inhalation anesthesia and ventilation. In the circuit system the gas is moved unidirectionally around by a blower at 70 l/min. In the system four membrane chambers are integrated for ventilation. Besides end-expiratory feed back control of inhalation anesthetics, and inspiratory closed loop control of oxygen, the system offers on-line registration of flow, volume and respiratory pressures as well as a capnogram and oxygen consumption. Alveolar ventilation and static compliance can easily be derived. On-line registration of oxygen consumption has proven to be of value for determination of any impairment of tissue oxygen supply when the oxygen delivery has dropped to critical values. Obstruction of the upper or lower airways are immediately detected and differentiated. Disregulations of metabolism, e.g. in malignant hyperthermia, are seen in a pre-crisis phase (increase of oxygen consumption and of CO2 production), and therapy can be started extremely early and before a disastrous condition has developed. Registration of compliance is only one of the continuously available parameters that guarantee a better and adequate control of lung function (e.g. atalectasis is early detected). The newly developed sophisticated anesthesia device enlarges tremendously the monitoring and respiratory diagnostic possibilities of artificial ventilation, gives new insights in the (patho)physiology and detects disturbances of respiratory parameters and metabolism in an early stage. PMID:2260424

  13. 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

  14. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Science.gov (United States)

    Auler, José Otavio C.; Torres, Marcelo L. A.; Cardoso, Mônica M.; Tebaldi, Thais C.; Schmidt, André P.; Kondo, Mario M.; Zugaib, Marcelo

    2010-01-01

    BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia. PMID:20835557

  15. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Directory of Open Access Journals (Sweden)

    José Otavio Costa Auler Junior

    2010-06-01

    Full Text Available BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements, after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia, at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01. Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001 and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.

  16. Intracameral anesthesia for cataract surgery: a population-based study on patient satisfaction and outcome

    Directory of Open Access Journals (Sweden)

    Westborg I

    2013-10-01

    Full Text Available Inger Westborg,1,2 Eva Mönestam1 1Department of Clinical Sciences/Ophthalmology, Umeå University, Umeå, Sweden; 2Eye Clinic, Sunderby Hospital, Luleå, Sweden Purpose: To evaluate if the standard anesthetic regimen – topical combined with intracameral anesthesia without sedation – in a population-based cohort of unselected cataract surgery cases is adequate, optimal, and good practice, or if improvements are necessary. Methods: We conducted a prospective, observational study on all cases of cataract surgery during a 1-year period at one institution (n=1249. Data were collected from the patients’ records. Outcome measures were use of preoperative sedation, type of anesthesia, complications, and adverse events. In a subgroup of patients (n=124 satisfaction with the anesthetic regimen was evaluated using a short questionnaire. Results: Most cases (90%, 1125/1249 had combined topical and intracameral anesthesia without sedation. Patients who chose preoperative sedation (midazolam hydrochloride sublingually were significantly younger and more often female (P=0.0001 and P=0.011, respectively. In the questionnaire subgroup, the median pain score after surgery was 0.7 (visual analog scale, 0–10. A pain score of 1.9 or less was reported by 76% of the patients. Patients reporting a pain score of 2 or more had sedation and additional anesthetics more often. No significant difference was found regarding age, sex, pulse rate, oxygen saturation, first or second eye surgery, or adverse intraoperative events for patients with pain scores of 1.9 or less and 2 or more. Conclusion: This large population-based series of small-incision phacoemulsification surgery shows that combined topical and intracameral anesthesia without sedatives is well tolerated for most phacoemulsification patients. It is also effective in cases when complications or adverse events occur. It is important to be responsive to the individual patient’s needs and adjust operating

  17. 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

  18. 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

  19. 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

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

    Science.gov (United States)

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

    2016-01-01

    We report the successful management of general anesthesia for a patient with Pelizaeus-Merzbacher disease (PMD). PMD is one of a group of progressive, degenerative disorders of the cerebral white matter. The typical clinical manifestations of PMD include psychomotor retardation, nystagmus, abnormal muscle tone, seizures, and cognitive impairment. General anesthesia for a patient with PMD may be difficult mainly because of seizures and airway complications related to poor pharyngeal muscle control. In addition, the possibility of exacerbation of spasticity should be considered. A 20-year-old man with PMD required removal of impacted wisdom teeth under general anesthesia. General anesthesia was induced with thiamylal, fentanyl, and desflurane. Anesthesia was maintained with desflurane and continuous intravenous remifentanil under bispectral index and train-of-4 monitoring. Anesthesia lasted 1 hour 20 minutes and was completed uneventfully. Airway complications, seizures, and exacerbation of spasticity did not occur postoperatively. Preoperatively, our patient had no history of epilepsy attacks or aspiration pneumonia, and no clinical symptoms of gastroesophageal reflux disease. Therefore, exacerbation of spasticity was one of the most likely potential complications. Identification of these associated conditions and evaluation of risk factors during preoperative examination is important for performing safe anesthesia in these patients. PMID:27269667

  1. Total spinal anesthesia in an achondroplasic patient: case report

    Directory of Open Access Journals (Sweden)

    Amiri H R

    2008-06-01

    Full Text Available Background: Total spinal anesthesia is a complication of lumbar epidural anesthesia following undiagnosed subarachnoid or subdural injection of local anesthetic. Although many achondroplastic dwarfs have a normal spine, catheter insertion may be more problematic with a narrow epidural space making a subarachnoid tap more probable.  Other malformations associated with achondroplasia, such as prolapsed intervertebral discs, reduced interpedicular distance, shortened pedicles, and osteophyte formation, combined with a narrow epidural space may make identification of the space difficult and increases the risk of dural puncture. Furthermore, subarachnoid tap or dural puncture may be hard to recognize if a free flow of CSF is difficult to achieve due spinal stenosis. Yet, for those who meet the criteria, epidural regional anesthesia is frequently preferred over other forms, which often have more or more dangerous side effects in this type of patient.Case report: A 22-year-old achondroplastic male dwarf patient was scheduled for pelvic mass resection and was considered a candidate for continuous epidural anesthesia. The anesthesia became complicated by total spinal anesthesia, which was reversed following supportive management for about two hours.Conclusion: There is significant debate over the composition and volume of the test dose, especially for patients with achondroplasia. We nevertheless recommend repeated test-doses during the accomplishment of epidural anesthesia to exclude unintended intravascular, intrathecal or subdural injection, keeping in mind that a test dose of local anesthetic does not completely prevent complications.

  2. Predictors of recovery in first episode psychosis

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  3. 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 < 0.001). The times to movement and to complete recovery were also significantly faster for both treatments than for saline (P < 0.02). Treated turtles displayed increases in temperature not documented in the control (P < 0.001). Turtles administered epinephrine showed significantly increased heart rates and end-tidal CO2 (P < 0.001). No adverse effects were noted in the study animals. The mechanisms of action were not elucidated in the present investigation. Nevertheless, the use of parenteral epinephrine or GV-26 stimulation in the immediate postanesthetic period produces clinically relevant reductions in anesthetic recovery time in common snapping turtle. Further research is necessary to evaluate the effects of concurrent GV-26 and epinephrine administration

  4. 42 CFR 415.110 - Conditions for payment: Medically directed anesthesia services.

    Science.gov (United States)

    2010-10-01

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

  5. 42 CFR 414.46 - Additional rules for payment of anesthesia services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Additional rules for payment of anesthesia services... Physicians and Other Practitioners § 414.46 Additional rules for payment of anesthesia services. (a... each anesthesia code that reflects all activities other than anesthesia time. These activities...

  6. Inguinal hernia repair with tension-free hernioplasty under local anesthesia

    International Nuclear Information System (INIS)

    To evaluate the use of local anesthesia in tension-free hernioplasty in a local hospital. The study took place at Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China during the period from January 2007 to May 2008. All 110 patients who had undergone inguinal hernia repair with mesh under local anesthesia were included in the study. To increase the homogeneity of the sample, we excluded umbilical hernia repairs, parastomal hernia repairs, non-elective procedures, procedures not involving mesh, and repairs performed concurrently with another surgical procedure. We performed a retrospective review of all 110 patients' data. The average operating time was 45 minutes (30-70 minutes), and the average hospital stay was 3-4 days. There was no postoperative mortality in this study. No surgical site infection occurred. Two patients (18%) that suffered from a moderate scrotal hematoma had recovered after extract injection therapy was applied. The duration of incisional pain was 2-3 days, and no patient required post-operative analgesia. During the follow-up, no recurrence occurred. The use of local anesthesia in inguinal hernia repair with tension-free hernioplasty is a safe and effective alternative for inpatient treatment. (aothor)

  7. 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

  8. 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

  9. Lack of effect of spinal anesthesia on drug metabolism

    International Nuclear Information System (INIS)

    The effect of spinal anesthesia on drug disposition was determined in six dogs with chronically implanted vascular catheters using propranolol as a model compound. On the first study day, 40 mg of unlabeled propranolol and 200 microCi of [3H]propranolol were injected into the portal and femoral veins respectively. Arterial blood samples were taken for 4 hr for measurement of plasma concentrations of labeled and unlabeled propranolol by high-pressure liquid chromatography (HPLC) and of [3H]propranolol by liquid scintillation counting of the HPLC eluant corresponding to each propranolol peak. Twenty-four hr later, spinal anesthesia was induced with tetracaine (mean dose 20.7 +/- 0.6 mg) with low sacral to midthoracic levels and the propranolol infusions and sampling were then repeated. Spinal anesthesia had no significant effect on either the intrinsic clearance of propranolol (2.01 +/- 0.75 L/min before and 1.9 +/- 0.7 L/min during spinal anesthesia), or on mean hepatic plasma flow (2.01 +/- 0.5 L/min before and 1.93 +/- 0.5 L/min during spinal anesthesia). The systemic clearance and elimination half-life of propranolol were also unchanged by spinal anesthesia (0.9 +/- 0.23 L/min on the first day, 0.7 +/- 0.1 L/min during spinal anesthesia; and 101 +/- 21 min on the first day, 115 +/- 16 min during spinal anesthesia, respectively). The volume of distribution (Vd) of propranolol was similarly unaffected by spinal anesthesia

  10. Propofol alternatives in gastrointestinal endoscopy anesthesia

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

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

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

    OpenAIRE

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

    2011-01-01

    The analgesic effects of three different doses of tramadol as a preanesthetic in medetomidine-ketamine anesthesia in dogs were compared. Twenty-eight healthy adult mongrel dogs were used. The dogs were divided into four groups at random; 1 ml kg-1 of normal saline, 1, 2 or 4mg kg-1 of tramadol premedication (group Control, TRA1, TRA2 and TRA4) was then administered intravenously followed by medetomidine and ketamine anesthesia. The behavioral changes, the duration of surgical anesthesia, bloo...

  12. Effects of leucovorin and methylcobalamin with N2O anesthesia

    International Nuclear Information System (INIS)

    Results of the deoxyuridine suppression test, a good marker for defining biochemical megaloblastosis caused by deficiency of folate and vitamin B12, became abnormal (> 10%) after 6 hours of administration of nitrous oxide anesthesia. 5-Formyltetrahydrofolate and methylcobalamin administration during nitrous oxide anesthesia have no remarkable effect on the correction of deoxyuridine suppression test values. On the other hand, 5-formyltetrahydrofolate and methylcobalamin administrated at the end of nitrous oxide anesthesia corrected the abnormal deoxyuridine suppression test values nearly to normal range within 1 hour. 19 references, 4 figures, 3 tables

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-08-15

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

  15. 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.

  16. 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

  17. 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

  18. Risk of Chronic Low Back Pain Among Parturients Who Undergo Cesarean Delivery With Neuraxial Anesthesia

    Science.gov (United States)

    Chia, Yuan-Yi; Lo, Yuan; Chen, Yan-Bo; Liu, Chun-Peng; Huang, Wei-Chun; Wen, Chun-Hsien

    2016-01-01

    Abstract To investigate the risk of chronic low back pain (LBP) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia (NA). LBP is common during pregnancy and also after delivery, but its etiology is poorly understood. Previous studies that investigated the correlation between epidural labor analgesia and chronic low back pain were inconclusive. These studies lacked objective diagnostic criteria for LBP and did not exclude possible confounders. We performed this nationwide population-based retrospective cohort study to explore the relationship between CD with NA and subsequent LBP. From the Taiwan National Health Insurance Research Database (NHIRD), we identified all primiparas who had given birth between January 1, 2000 and December 31, 2013. Using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes, we identified the women who had vaginal delivery (VD) and those who had CD. The mode of anesthesia was ascertained by the NHI codes. Multivariable logistic regression was used to estimate the odds of postpartum LBP in women undergoing CD with NA compared with those having VD. The outcome was a diagnosis of LBP according to the first ICD-9-CM diagnosis code. The patients were observed for 3 years after delivery or until diagnosis of postpartum LBP, withdrawal from the NHI system, death, or December 31, 2013. Of the 61,027 primiparas who underwent delivery during the observation period, 40,057 were eligible for inclusion in the study. Of these women, 27,097 (67.6%) received VD, 8662 (21.6%) received CD with spinal anesthesia, and 4298 (10.7%) received CD with epidural anesthesia (EA). Women who received CD with EA were found to have higher risk of LBP than did women who received VD, with the adjusted OR being 1.26 (95% CI: 1.17–1.34). CD with EA might increase the risk of subsequent chronic LBP. PMID:27100449

  19. 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.

  20. Recovery Online

    Science.gov (United States)

    Clark, John R.

    2007-01-01

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

  1. 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…

  2. 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

  3. Obesity Is Independently Associated with Spinal Anesthesia Outcomes: A Prospective Observational Study

    OpenAIRE

    Kim, Hyo-Jin; Kim, Won Ho; Lim, Hyung Woo; Kim, Jie Ae; Kim, Duk-Kyung; Shin, Byung Seop; Sim, Woo Seog; Hahm, Tae Soo; Kim, Chung Su; Lee, Sangmin M.

    2015-01-01

    The influence of body-mass index (BMI) on spinal anesthesia is still controversial, with discrepant results reported in previous studies. To compare spinal anesthesia in obese and non-obese subjects, the anesthesia profiles in patients who underwent spinal anesthesia using intrathecal hyperbaric bupivacaine were compared. A total of 209 patients undergoing elective total knee replacement arthroplasty (TKRA) surgery under spinal anesthesia were divided into an NO (non-obese) group (BMI < 30 kg...

  4. 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.

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

    International Nuclear Information System (INIS)

    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.

  6. Endarterectomia carotídea sob bloqueio loco-regional Carotid endarterectomy under locoregional anesthesia

    Directory of Open Access Journals (Sweden)

    Ana Terezinha Guillaumon

    2005-09-01

    trazem um diferencial no tratamento da doença carotídea.OBJECTIVE: The purpose of this study is to evaluate the results of carotid endarterectomy performed under locoregional anesthesia with invraoperative cerebral protection and selective shunting. METHOD: We reviewed 107 patients who underwent carotid endarterectomy under locoregional anesthesia, at Hospital das Clínicas da Universidade Estadual de Campinas (UNICAMP, between March 1996 and May 2004. This study is composed of 119 endarterectomies (108 patients, being 69 male (63.8% and 39 female (36.2%. Mean age was 63 years, ranging from 43 to 83 years. Surgery was performed to treat symptomatic stenosis in 60 patients (55.5% and asymptomatic stenosis in 48 patients (44.5%. All patients were assessed by color-flow duplex scanning and arteriography. RESULTS: Five patients were excluded from the study, since they required conversion to general anesthesia due to intolerance to carotid clamping. Of the 103 patients submitted to 114 endarterectomies, a shunt was inserted in four patients (3.5%, due to the patient's intolerance to carotid clamping during the surgery. A patch was applied in 19 patients (16.6%. Mortality rate in the immediate postoperative period was 2.6% (three patients, all due to vascular cerebral accident. One patient (0.87% presented a lower ischemic cerebral vascular accident, and one patient (0.87% presented hyperfusion syndrome, which progressed to a hemorrhagic cerebral vascular accident. This patient was submitted to aspiration of the cerebral hematoma, with full recovery of the neurological deficit. In the late postoperative period, there was restenosis or occlusion in four patients (5.3%. CONCLUSION: Carotid endarterectomy can be safely performed in the awake patient, by selective shunting and cerebral protection. Good outcome and low morbidity and mortality rate bring a differential in the treatment of the carotid disease.

  7. 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

  8. Mass-spectrometric monitoring of the stress reaction during anesthesia

    Science.gov (United States)

    Elizarov, A. Yu.; Levshankov, A. I.; Faizov, I. I.; Shchegolev, A. V.

    2013-10-01

    Clinical testing data for a mass-spectrometric method of estimating the patient's stress reaction to an injury done during anesthesia are presented. The essence of the method is monitoring the respiratory coefficient, which is defined as ratio N of the expiratory mass concentration of CO2 to the inspiratory mass concentration of O2 at each breathing cycle. For on-line monitoring of N, an electron ionization mass spectrometer connected to the breathing circuit of an inhalational anesthesia machine is used. Estimates of the anesthesia adequacy obtained with this method are compared with those obtained with the method that analyzes induced acoustic encephalographic potentials. It is shown that the method suggested is more sensitive to the level of the patient's stress reaction during anesthesia than the induced potential method.

  9. 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)

  10. 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...

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

    OpenAIRE

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  13. [Development of an anesthesia ledger using relational database].

    Science.gov (United States)

    Hayashi, I; Mizoguchi, H; Fujiwara, M; Kato, H; Kawamura, J; Odashiro, M

    1993-08-01

    An anesthesia ledger was developed using relational database KIRI Ver3. This anesthesia database includes 33 items for input, for example patient's name, patient's I.D. number, data of operation, diagnosis, operative procedure, name of surgeon, name of anesthesiologists and so on. One can select data from displayed menu cards only by rolling down or rolling up the cursor at 19 items and can input numbers by keyboard at twelve items. Even a computer beginner can easily operate it after a minimal training. Only patient's name must be input by text style. We can construct this anesthesia database only by use of functions of KIRI Ver3 without programming. One can use this anesthesia ledger at any operative facilities by changing a part of database and a file of doctor's name. PMID:8366569

  14. 42 CFR 482.52 - Condition of participation: Anesthesia services.

    Science.gov (United States)

    2010-10-01

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

  15. STUDY OF INJECTION TRAMADOL AS ADDITIVE IN INTRAVENOUS REGIONAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Rajesh

    2015-10-01

    is no effect of Tramadol on onset of motor blocked in both the group. In post - operative period the need of analgesic is delayed in group 2 which is statistically significant.( p value is 0.00001 We observe post - oper ative nausea and vomiting events more in group - 1(24% and in group - 2 (16 % but there isno statistical difference. Pain is the significant factor for post - operative nausea and vomiting. Group 2 patients (Tramadol group are more comfortable with tourniquet intra - operatively but statistically it is not significant. Intraoperative discomfort may attribute to anxiety and fear along with possibility of dilution of drugs because of inadequate exsanguination . CONCLUSION : We conclude that addition of injection Tra madol 50mg in intravenous regional anesthesia will improve the onset of sensory blockade and improves the post - operative analgesia without any increase of postoperative nausea and vomiting. Also it is concluded that injection Tramadol has no effect on moto r blocked.

  16. 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.

  17. Monitoring of propofol and its metabolite during total intravenous anesthesia

    Science.gov (United States)

    Elizarov, A. Yu.; Ershov, T. D.; Levshankov, A. I.

    2011-12-01

    Intravenous hypnotic propofol and its metabolite are detected in real time during total intravenous anesthesia by an electron ionization mass spectrometer. The mass spectrometer is connected directly to the breathing circuit of an apparatus for inhalational anesthesia. Ratios between the propofol concentrations in expired air and blood serum are measured. It is concluded that real-time noninvasive monitoring of the propofol concentration in blood using electron ionization mass spectrometry is feasible.

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ezhevskaya А.А.

    2014-09-01

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

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

    OpenAIRE

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

    2008-01-01

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

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

    OpenAIRE

    Alaattin Ozturk

    2014-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

  4. 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...

  5. 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...

  6. 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...

  7. Succinylcholine Use in Adult Anesthesia – A Multinational Questionnaire Survey

    OpenAIRE

    Karanović, Nenad; CAREV, MLADEN; Kardum, Goran; Tomanović, Nikac; Stuth, Eckehard; Gal, Janos; Tonković-Capin, Mislav; Đogaš, Varja; Račić, Goran; Đogaš, Zoran

    2011-01-01

    There are no definitive evidence based standards regarding use of succinylcholine (SCh) for anesthesia induction. However, there is a global trend toward eliminating SCh not only in elective, but also in emergency surgery in adults. The aim of the study was to survey the use of SCh in adult elective and emergency anesthesia practice in several European countries and the United States by questionnaire. One hundred and seventy anesthesiologists out of 201 possible, from six institutions in five...

  8. 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...

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

    OpenAIRE

    Chia-Hung Chang; Ching-Yue Yang; Lai-Chu See; Ping-Wing Lui

    2004-01-01

    Background: The aim of this study was to compare students' satisfaction between problem-based learning (PBL) and lecture-based traditional teaching of anesthesia.Methods: One hundred and thirty-seven fifth-year medical students were enrolled in acourse which used a hybrid curriculum for teaching about anesthesia. Thehybrid curriculum included 9 essential lectures and 3 related PBL case discussions.A Linkert 5-point scale was used for to assess students' satisfactionlevels between PBL and lect...

  10. 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...

  11. Safety of warfarin therapy during cataract surgery under topical anesthesia

    OpenAIRE

    2015-01-01

    ABSTRACT Purpose: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. Methods: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30) and a control (n=30) group. Results: There were no records of intraoperative or postoperative intracameral bleeding complications ...

  12. 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.

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

    International Nuclear Information System (INIS)

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

  14. 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.

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Chetana Sachin Makade

    2014-01-01

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

  17. 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.

  18. 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. PMID:23833850

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

    Tetanus is an acute often fatal disease produced by gram positive obligate anaerobic bacterium Clostridium tetani. Tetanolysin damages local tissue and provides optimal conditions for bacterial multiplication. It is therefore important to perform a wide debridement of any wound suspected of being a portal of entry for the bacteria. Little evidence exists to recommend specific anesthetic protocols. We encountered a child scheduled for fracture both bone forearm with developing tetanus. Initial management done with intravenous (i.v) diazepam, phenobarbitone, and metronidazole. After premedication with midazolam and fentanyl, induction was done by propofol 60 mg, vecuronium 2.5 mg, ventilated with O2+ N2O 50:50 with sevoflurane 2% and tracheal intubation was done with 5.5 ID cuffed PVC endotracheal tube. Anesthesia was maintained with sevoflurane 2% and vecuronium intermittently when required. Intraop vitals were stable. On completion of surgery, reversal given and patient was extubated uneventfully and shifted to recovery room. Little evidence exists to recommend specific anesthetic technique for tetanus patient posted for surgery. When present, obvious wounds should be surgically debrided. Ideally patients considered for surgery should undergo anesthesia and surgery before severe autonomic dysfunction develops. Most anesthetic managements are based on limited evidence. However, we used sevoflurane and vecuronium successfully, further study is needed to establish their efficacy and safety. Major challenges lie in the control of muscle rigidity and spasm, autonomic disturbances and prevention of complications. PMID:25886114

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

    Directory of Open Access Journals (Sweden)

    Sussan Soltani Mohammadi

    2007-01-01

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

  2. Remifentanil-based anesthesia versus a propofol technique for otologic surgical procedures.

    Science.gov (United States)

    Jellish, W S; Leonetti, J P; Avramov, A; Fluder, E; Murdoch, J

    2000-02-01

    Otologic procedures require a still surgical field and are associated with a 50% incidence of emetic symptoms. Propofol reduces nausea and vomiting but not intraoperative movement. This study compares a remifentanil/propofol anesthetic to a propofol/fentanyl combination to determine which provides the best perioperative conditions for otologic microsurgery. Eighty healthy patients were randomly assigned to receive one of the anesthetic combinations. Demographic data, hemodynamic variables, movement, and bispectral index monitoring values in addition to anesthetic emergence, nausea, vomiting, pain, and other recovery variables were compared between groups with appropriate statistical methods. Both groups were similar. Times to eye opening (7.7 +/- 0.7 vs 12.4 +/- 1.2 minutes) and extubation (9.8 +/- 0.9 vs 12.4 +/- 1.0 minutes) were shorter with remifentanil. This group also had lower hemodynamic variables and movement (23% vs 65%) under anesthesia. Postoperative pain was mild in both groups, but remifentanil patients had more than the propofol group. All other postoperative parameters were similar. Remifentanil-based anesthesia produces better hemodynamic stability, less movement, and faster emergence after otologic surgery, with propofol's antiemetic effect, for the same cost. PMID:10652394

  3. Refractory cardiac arrest due to inadvertent intravenous injection of 0.25% bupivacaine used for local infiltration anesthesia

    OpenAIRE

    Vijay, Bhavani S; Mitra, Subhro; Shahin N Jamil

    2013-01-01

    The cardiotoxic effect of bupivacaine is a well-known fact that can lead to asystole, and most of the time it is refractory to resuscitative measures. We describe the case of a three-year-old child operated for anorectal malformation (ARM) by abdominal approach. Apart from congenital anomalies, preoperative evaluation was unremarkable. General anesthesia and controlled ventilation were instituted through endotracheal tube (ET). She had an uneventful intraoperative period. Immediately after su...

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

    OpenAIRE

    Gaszynski T; Gaszynska E; Szewczyk T

    2014-01-01

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

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

    OpenAIRE

    Gaszynski, Tomasz

    2014-01-01

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

  6. Anesthesia cutoff phenomenon: Interfacial hydrogen bonding

    International Nuclear Information System (INIS)

    Anesthesia cutoff refers to the phenomenon of loss of anesthetic potency in a homologous series of alkanes and their derivatives when their sizes become too large. In this study, hydrogen bonding of 1-alkanol series (ethanol to eicosanol) to dipalmitoyl-L-alpha-phosphatidylcholine (DPPC) was studied by Fourier transform infrared spectroscopy (FTIR) in DPPC-D2O-in-CCl4 reversed micelles. The alkanols formed hydrogen bonds with the phosphate moiety of DPPC and released the DPPC-bound deuterated water, evidenced by increases in the bound O-H stretching signal of the alkanol-DPPC complex and also in the free O-D stretching band of unbound D2O. These effects increased according to the elongation of the carbon chain of 1-alkanols from ethanol (C2) to 1-decanol (C10), but suddenly almost disappeared at 1-tetradecanol (C14). Anesthetic potencies of these alkanols, estimated by the activity of brine shrimps, were linearly related to hydrogen bond-breaking activities below C10 and agreed with the FTIR data in the cutoff at C10

  7. [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

  8. 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.

  9. Comparison of the effects of dexmedetomidine-ketamine and sevoflurane-sufentanil anesthesia in children with obstructive sleep apnea after uvulopalatopharyngoplasty: An observational study

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    Xinqi Cheng

    2014-01-01

    Full Text Available Background: Children with obstructive sleep apnea (OSA are particularly at risk under anesthesia after uvulopalatopharyngoplasty (UPPP. This prospective randomized double-blind study focused on the comparison of dexmedetomidine-ketamine and sevoflurane-sufentanil anesthesia on children with respect to safety, feasibility, and clinical effects. Materials and Methods: A total of 60 children, aged 2-10 years, classified as American Society of Anesthesiologists (ASA status I and II scheduled for UPPP were prospectively studied. Patients were randomly allocated to receive either dexmedetomidine-ketamine-based anesthesia (group DK, n = 30 or sevoflurane-sufentanil-based anesthesia (group SS, n = 3 0. Heart rate (HR and systolic blood pressure during the first 60 min of the procedure, Ramsay sedation score, the Pediatric Anesthesia Emergence Delirium (PAED scale and a 5-point scale used to evaluate emergence agitation (EA in postanesthesia care unit (PACU and postoperative outcomes data were recorded. Results: During the first 60 min of anesthesia, mean HR, and mean diastolic noninvasive arterial blood pressure (NIBP were not statistically different in the two groups (P > 0.05 Compared with group SS, the patients in group DK had lower rescue tramadol requirement and lower pain score, PAED score, and EA score at 5, 10, 15, and 30 min in PACU; but had a higher Ramsay scale at 10, 15, 30, 45, and 60 min in PACU and the incidence of SpO 2 below 95%, also the time of first bowel movement and ambulation in group DK was shorter. Conclusions: The dexmedetomidine-ketamine combination was not superior to a sevoflurane-sufentanil combination because of late awake time and a high potential for adverse respiratory events in PACU, the benefit of dexmedetomidine administration being a decreased incidence of EA and a lower recovery time of bowel movement and ambulation.

  10. Acute Paraplegia as a Result of Hemorrhagic Spinal Ependymoma Masked by Spinal Anesthesia: Case Report and Review of Literature

    Science.gov (United States)

    Lee, Sang-Hyo; Jeun, Sin-Soo

    2016-01-01

    Ependymomas are the most common intramedullary spinal cord tumors in adults. Although a hemorrhage within spinal ependymoma on imaging studies is not uncommon, it has rarely been reported to bea cause of acute neurological deficit. In the present report, we describe a case of a 24-year-old female patient who developed acute paraplegia as a result of hemorrhagic spinal ependymoma immediately after a cesarean delivery under spinal regional anesthesia. We review the literature of hemorrhagic spinal ependymomas presenting with acute neurological deficit and discuss the most appropriate treatment for a good neurological recovery. PMID:27195260

  11. Anestesia para ressecção transuretral de próstata: comparação entre dois períodos em hospital universitário Anestesia para resección transuretral de próstata: comparación entre dos períodos en un hospital universitario Anesthesia for transurethral resection of the prostate: comparison between two periods in a university hospital

    Directory of Open Access Journals (Sweden)

    Liana Maria Torres de Araújo

    2005-04-01

    exámenes complementarios y de evaluación cardiológica previa en los pacientes sometidos a la cirugía en aquel período. El tiempo de permanencia de los pacientes en la sala de recuperación pos-anestésica fue semejante en los dos grupos, pero la incidencia de complicaciones fue mayor en el grupo I. El número de transfusiones sanguíneas y la mortalidad peri-operatoria no difirieron en los dos grupos. CONCLUSIONES: Aunque, después de este intervalo de 10 años, haya habido mejora con relación al instrumental quirúrgico, a la monitorización anestésica y a la técnica anestésica (nuevas drogas y equipos, no se pudo observar reducción en el número de complicaciones (intra o postoperatorias, transfusiones sanguíneas o mortalidad en las primeras 24 horas después de la cirugía.BACKGROUND AND OBJECTIVES: Anesthesia for transurethral resection of the prostate (TURP has been studied for years due to the uniqueness of the surgical procedure. This study aimed at comparing TURP anesthetic techniques and possible surgical complications in two different time periods with a ten-year interval, to detect evolution of those techniques and decrease in morbidity-mortality rates. METHODS: Medical records of all patients submitted to TURP in HC-FMRP-USP in two different 4-year periods were retrospectively evaluated: GI - surgical procedures (TURP performed between 1989 and 1992; GII - surgical procedures (TURP performed between 1999 and 2002. Malignant prostate and bladder neoplasias were excluded. A total of 300 medical records were included: 120 in GI and 180 in GII. RESULTS: Regional anesthesia was predominant in both groups and spinal anesthesia was more frequently used. Mean procedure length was higher in GII and the incidence of intraoperative adverse events such as hypotension, arrhythmias and hypothermia was not statistically different between groups. In the first 24 postoperative hours however, more GI patients had acute myocardial infarction, probably due to lack

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kumar Babu

    2014-11-01

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

  14. Application effects of dexmedetomidine combined with sevoflurane for anesthesia in short operations in children with burn injury

    Directory of Open Access Journals (Sweden)

    Jin-xin WANG

    2016-04-01

    Full Text Available Objective  To evaluate the effectiveness and safety of dexmedetomidine combined with sevoflurane for anesthesia in short operations in pediatric burn patients. Methods  Forty hospitalized children undergoing short operation for burn injury were allocated to sevoflurane group (S group or sevoflurane combined dexmedetomidine group (group D(20 patients each. Children in group D inhaled 8% sevoflurane in the beginning until loss of eyelash reflex, and then the density of sevoflurane was reduced to 3% for maintenance, 5μg/(kg.h of dexmedetomidine was pumped for 10 mins, then the density was reduced to 0.5μg/(kg.h. Then operation was started herewith till to the end. Children in group S received sevoflurane anethesia alone, and dexmedetomidine was replaced by the same volume of physiological saline. Additional 3mg/kg propofol was injected when anesthesia was inadequate. During the procedure, HR, MAP, SpO2 and Ramsay scale were recorded at baseline (T1, loss of eyelash reflex (T2, 5min after the start of operation (T4, 10min (T5 and the end of operation (T6. The operation time, anethesia time, propofol consumption, case of respiratory depression and pediatric anesthesia emergence delirium scale (PAED in pediatric anesthesia care unit (PACU were recorded. Results  There was no significant difference in operation time between the two groups. Intraoperative SpO2 was higher in group D than in group S (P<0.05, respiratory inhibition occurred in 4 cases of group D and 10 cases of group S (P<0.05. Propofol consumption was less and the operation time was longer in group D than in group S (P<0.05. At T3-T6, the MAP and HR were lower, but the Ramsay scale was higher in group D than in group S (P<0.05. In PACU, PAED scale was lower in group D than in group S (P<0.05. Conclusions  Dexmedetomidine combined with sevoflurane for anesthesia for short burn surgery in children not only stabilize hemodynamic parameters but also reduce the impact to respiration

  15. 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.

  16. Recovery Spirituality

    Directory of Open Access Journals (Sweden)

    Ernest Kurtz

    2015-01-01

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

  17. 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.

  18. Drug recovery following buccal absorption of propranolol.

    OpenAIRE

    Henry, J A; Ohashi, K.; Wadsworth, J.; Turner, P.,

    1980-01-01

    1 Buccal absorption of propranolol in two volunteers was followed by repeated rinsing of the mouth with buffer solutions for twelve 2 min periods. Values for absorption, recovery and asymptotic recovery were calculated. 2 Large amounts of propranolol were recoverable from the buccal mucosa; recovery was biexponential and the amount recovered depended on the time allowed for absorption and on the pH of buffers used for recovery. 3 In the case of the drug studied, the buccal absorption test was...

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

    Directory of Open Access Journals (Sweden)

    Kyu-Jin Chung

    2012-09-01

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

  20. Permutation auto-mutual information of electroencephalogram in anesthesia

    Science.gov (United States)

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

    2013-04-01

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

  1. 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.

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

    Science.gov (United States)

    Ching, Shinung; Brown, Emery N

    2014-04-01

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

  3. 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

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

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    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.

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

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    Chia-Hung Chang

    2004-09-01

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

  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. 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

  8. Intraoperative haloperidol does not improve quality of recovery and postoperative analgesia

    OpenAIRE

    Amin Ebneshahidi; Mojtaba Akbari; Masood Mohseni

    2013-01-01

    Introduction: Haloperidol has an established role in nausea and vomiting prophylaxis and possible effects on multiple aspects of postoperative recovery including pain and sedation. The purpose of this study was to evaluate the effects of low-dose intraoperative intravenous haloperidol on quality of recovery (QoR) and pain control after general anesthesia and surgery. Methods: Ninety eight American Society of Anesthesiologists (ASA) physical status I-II patients undergoing elective general...

  9. 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

  10. A clinical pathway to accelerate recovery after colonic resection

    DEFF Research Database (Denmark)

    Basse, L; Hjort Jakobsen, D; Billesbølle, P; Werner, M; Kehlet, H

    2000-01-01

    -induced organ dysfunction, paralytic ileus, pain, and fatigue. It has been hypothesized that an accelerated multimodal rehabilitation program with optimal pain relief, stress reduction with regional anesthesia, early enteral nutrition, and early mobilization may enhance recovery and reduce the complication rate......OBJECTIVE: To investigate the feasibility of a 48-hour postoperative stay program after colonic resection. SUMMARY BACKGROUND DATA: Postoperative hospital stay after colonic resection is usually 6 to 12 days, with a complication rate of 10% to 20%. Limiting factors for early recovery include stress...

  11. Safety of warfarin therapy during cataract surgery under topical anesthesia

    Directory of Open Access Journals (Sweden)

    Newton Kara-Junior

    2015-06-01

    Full Text Available ABSTRACT Purpose: To analyze the safety of warfarin therapy during cataract surgery under topical anesthesia. Methods: This was a prospective nonrandomized comparative study of 60 eyes of 60 patients treated with or without concurrent oral warfarin anticoagulant therapy, referred for cataract surgery under topical anesthesia. The sample included a treatment (n=30 and a control (n=30 group. Results: There were no records of intraoperative or postoperative intracameral bleeding complications in both the groups. At 1-month postoperative follow-up, 90.0% of patients presented spectacle-corrected visual acuity of at least 20/40. Conclusion: Cataract surgery by phacoemulsification with topical anesthesia can be successfully conducted without discontinuing warfarin.

  12. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  14. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  16. 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....

  17. 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...

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

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Aasvang, Eske Kvanner

    2015-01-01

    Regional anesthesia for knee and hip arthroplasty may have favorable outcome effects compared with general anesthesia by effectively blocking afferent input, providing initial postoperative analgesia, reducing endocrine metabolic responses, and providing sympathetic blockade with reduced bleeding...... randomized controlled trials comparing modern general anesthesia and spinal anesthesia for knee and hip arthroplasty prevents final recommendations and calls for prospective detailed studies in this clinically important field....

  19. The Relationship Between Creatine and Whey Protein Supplements Consumption and Anesthesia in Rats

    Science.gov (United States)

    Saberi, Kianoush; Gorji Mahlabani, Mohammad Amin; Tashayoie, Mohammad; Nasiri Nejad, Farinaz

    2016-01-01

    Background: Because the trend of pharmacotherapy is toward controlling diet rather than administration of drugs, in our study we examined the probable relationship between Creatine (Cr) or Whey (Wh) consumption and anesthesia (analgesia effect of ketamine). Creatine and Wh are among the most favorable supplements in the market. Whey is a protein, which is extracted from milk and is a rich source of amino acids. Creatine is an amino acid derivative that can change to ATP in the body. Both of these supplements result in Nitric Oxide (NO) retention, which is believed to be effective in N-Methyl-D-aspartate (NMDA) receptor analgesia. Objectives: The main question of this study was whether Wh and Cr are effective on analgesic and anesthetic characteristics of ketamine and whether this is related to NO retention or amino acids’ features Materials and Methods: We divided 30 male Wistar rats to three (n = 10) groups; including Cr, Wh and sham (water only) groups. Each group was administered (by gavage) the supplements for an intermediate dosage during 25 days. After this period, they became anesthetized using a Ketamine-Xylazine (KX) and their time to anesthesia and analgesia, and total sleep time were recorded. Results: Data were analyzed twice using the SPSS 18 software with Analysis of Variance (ANOVA) and post hoc test; first time we expunged the rats that didn’t become anesthetized and the second time we included all of the samples. There was a significant P-value (P < 0.05) for total anesthesia time in the second analysis. Bonferroni multiple comparison indicated that the difference was between Cr and Sham groups (P < 0.021). Conclusions: The data only indicated that there might be a significant relationship between Cr consumption and total sleep time. Further studies, with rats of different gender and different dosage of supplement and anesthetics are suggested.

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

    Science.gov (United States)

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

    2016-06-01

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

  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. Cortico-cardio-respiratory network interactions during anesthesia.

    Directory of Open Access Journals (Sweden)

    Yuri Shiogai

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

  3. 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

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

    Science.gov (United States)

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

    2014-02-01

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

  5. [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

  6. 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

  7. 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.

  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. 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...

  10. 21 CFR 868.5160 - Gas machine for anesthesia or analgesia.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gas machine for anesthesia or analgesia. 868.5160... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5160 Gas machine for anesthesia or analgesia. (a) Gas machine for anesthesia—(1) Identification. A gas machine for anesthesia is...

  11. Satisfaction level with topical versus peribulbar anesthesia experienced by same patient for phacoemulsification

    Directory of Open Access Journals (Sweden)

    Nauman Ahmad

    2012-01-01

    Full Text Available Background: Various studies have assessed patient satisfaction with topical versus peribulbar anesthesia with conflicting results. Aim of study was to determine satisfaction level in same patient who gets topical anesthesia in one eye and peribulbar block in another eye. We propose that evaluation of various indicators of patient satisfaction will enable better selection of cases for topical anesthesia in the future. Methods: Eighty patients scheduled for phacoemulsification were enrolled in prospective, randomized, double-blind study. Each patient scheduled twice for one eye under topical anesthesia and other in peribulbar block. Pain, discomfort and pressure during application of local anesthetic, during phacoemulsification and at 2 hours after procedure were assessed on standard scales. Before discharge patient satisfaction level was checked with Iowa satisfaction with anesthesia scale (ISAS. The Student′s t-test was used to determine the significance of IOWA score in both groups. P<0.05 was considered significant. Results: Feeling of pain, pressure and discomfort scores during administration of topical anesthesia were all significantly lower compared to peribulbar anesthesia (P=0.004, 0.000, 0.002, respectively. In contrast, intraoperative scores were significantly higher in the topical anesthesia group compared to peribulbar anesthesia (P=0.022, 0.000, 0.000, respectively. Patient satisfaction measured with ISAS shows that peribulbar anesthesia with P=0.000 is strongly significant. Conclusion: Peribulbar anesthesia provided significantly better patient satisfaction in comparison with topical anesthesia when used for cataract surgery.

  12. Cardiac arrest during spinal anesthesia for cervical conization: a case report.

    Science.gov (United States)

    Shinohara, Satoshi; Sakamoto, Ikuko; Numata, Masahiro; Ikegami, Atsushi; Teramoto, Katsuhiro; Hirata, Shuji

    2016-05-01

    Spinal anesthesia is regularly performed worldwide and is an integral part of the modern day anesthesia practice. Although unexpected cardiac arrests during this procedure are very rare, medical professionals should be aware of the potential for this complication. In making the decision to use spinal anesthesia, judicious patient selection, adequate preventive measures, and strict monitoring are important. PMID:27190608

  13. 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.

  14. 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

  15. 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

  16. Assessment of Intraoperative Intra-articular Morphine and Clonidine Injection in the Acute Postoperative Period After Hip Arthroscopy

    Science.gov (United States)

    Cogan, Charles J.; Knesek, Michael; Tjong, Vehniah K.; Nair, Rueben; Kahlenberg, Cynthia; Dunne, Kevin F.; Kendall, Mark C.; Terry, Michael A.

    2016-01-01

    Background: Previous authors have suggested that intra-articular morphine and clonidine injections after knee arthroscopy have demonstrated equivocal analgesic effect in comparison with bupivacaine while circumventing the issue of chondrotoxicity. There have been no studies evaluating the effect of intra-articular morphine after hip arthroscopy. Purpose: To evaluate the efficacy of intra-articular morphine in combination with clonidine on postoperative pain and narcotic consumption after hip arthroscopy surgery for femoroacetabular impingement. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was performed on 43 patients that underwent hip arthroscopy for femoroacetabular impingement at a single institution between September 2014 and May 2015. All patients received preoperative celecoxib and acetaminophen, and 22 patients received an additional intra-articular injection of 10 mg morphine and 100 μg of clonidine at the conclusion of the procedure. Narcotic consumption, duration of anesthesia recovery, and perioperative pain scores were compared between the 2 groups. Results: Patients who received intra-articular morphine and clonidine used significantly less opioid analgesic (mEq) in the postanesthesia recovery (median difference, 17 mEq [95% CI, –32 to –2 mEq]; P = .02) compared with the control group. There were no differences in time spent in recovery before hospital discharge or in visual analog pain scores recorded immediately postoperatively and at 1 hour after surgery. Conclusion: Intraoperative intra-articular injection of morphine and clonidine significantly reduced the narcotic requirement during the postsurgical recovery period after hip arthroscopy. The reduction in postsurgical opioids may decrease adverse effects, improve overall pain management, and lead to better quality of recovery and improved patient satisfaction. PMID:26977421

  17. Effect of anesthesia on glucose production and utilization in rats

    International Nuclear Information System (INIS)

    This study was undertaken to determine the effects of pentobarbital anesthesia (50 mg/kg ip) on glucose kinetics and individual tissue glucose utilization in vivo, in chronically catheterized rats. Glucose turnover studies were carried out using [3-3H] glucose as tracer. A transient hyperglycemia and an increased glucose production were observed 3 min after induction of anesthesia. However, 40 min after induction of anesthesia, glycemia returned to the level observed in awake animals, whereas glucose turnover was decreased by 30% as compared with unanesthetized rats. These results are discussed with regard to the variations observed in plasma insulin, glucagon, and catecholamine levels. Glucose utilization by individual tissues was studied by the 2-[1-3H] deoxyglucose technique. A four- to fivefold decrease in glucose utilization was observed in postural muscles (soleus and adductor longus), while in other nonpostural muscles (epitrochlearis, tibialis anterior, extensor digitorum longus, and diaphragm) and other tissues (white and brown adipose tissues) anesthesia did not modify the rate of glucose utilization. A decrease in glucose utilization was also observed in the brain

  18. 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

  19. 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

  20. Effect of anesthesia on glucose production and utilization in rats

    Energy Technology Data Exchange (ETDEWEB)

    Penicaud, L.; Ferre, P.; Kande, J.; Leturque, A.; Issad, T.; Girard, J.

    1987-03-01

    This study was undertaken to determine the effects of pentobarbital anesthesia (50 mg/kg ip) on glucose kinetics and individual tissue glucose utilization in vivo, in chronically catheterized rats. Glucose turnover studies were carried out using (3-/sup 3/H) glucose as tracer. A transient hyperglycemia and an increased glucose production were observed 3 min after induction of anesthesia. However, 40 min after induction of anesthesia, glycemia returned to the level observed in awake animals, whereas glucose turnover was decreased by 30% as compared with unanesthetized rats. These results are discussed with regard to the variations observed in plasma insulin, glucagon, and catecholamine levels. Glucose utilization by individual tissues was studied by the 2-(1-/sup 3/H) deoxyglucose technique. A four- to fivefold decrease in glucose utilization was observed in postural muscles (soleus and adductor longus), while in other nonpostural muscles (epitrochlearis, tibialis anterior, extensor digitorum longus, and diaphragm) and other tissues (white and brown adipose tissues) anesthesia did not modify the rate of glucose utilization. A decrease in glucose utilization was also observed in the brain.

  1. Review of knee arthroscopy performed under local anesthesia

    Directory of Open Access Journals (Sweden)

    Law Billy

    2009-01-01

    Full Text Available Abstract Local anesthesia for knee arthroscopy is a well documented procedure with diagnostic and therapeutic role. Numerous therapeutic procedures including partial menisectomy, meniscus repair, abrasion chondroplasy, synovectomy, loose body removal can be performed safely and comfortably. Appropriate case selection, anesthetic strategy and technical expertise are the key to smooth and successful surgery.

  2. 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

  3. 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.

  4. 76 FR 16796 - Pediatric Anesthesia Safety Initiative (PASI)

    Science.gov (United States)

    2011-03-25

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

  5. 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

  6. 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.

  7. 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...

  8. The Ryder Cognitive Aid Checklist for Trauma Anesthesia.

    Science.gov (United States)

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

    2016-05-01

    Despite mixed results regarding the clinical utility of checklists, the anesthesia community is increasingly interested in advancing research around this important topic. Although several checklists have been developed to address routine perioperative care, few checklists in the anesthesia literature specifically target the management of trauma patients. We adapted a recently published "trauma and emergency checklist" for the initial phase of resuscitation and anesthesia of critically ill trauma patients into an applicable perioperative cognitive aid in the form of a pictogram that can be downloaded by the medical community. The Ryder Cognitive Aid Checklist for Trauma Anesthesia is a letter-sized, full-color document consisting of 2 pages and 5 sections. This cognitive aid describes the essential steps to be performed: before patient arrival to the hospital, on patient arrival to the hospital, during the initial assessment and management, during the resuscitation phase, and for postoperative care. A brief online survey is also presented to obtain feedback for improvement of this tool. The variability in utility of cognitive aids may be because of the specific clinical task being performed, the skill level of the individuals using the cognitive aid, overall quality of the cognitive aid, or organizational challenges. Once optimized, future research should be focused at ensuring successful implementation and customization of this tool. PMID:27101496

  9. 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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...

  11. Pupil Size in Relation to Cortical States during Isoflurane Anesthesia

    Science.gov (United States)

    Kum, Jeung Eun; Han, Hio-Been

    2016-01-01

    In neuronal recording studies on anesthetized animals, reliable measures for the transitional moment of consciousness are frequently required. Previous findings suggest that pupil fluctuations reflect the neuronal states during quiet wakefulness, whose correlation was unknown for the anesthetized condition. Here, we investigated the pupillary changes under isoflurane anesthesia simultaneously with the electroencephalogram (EEG) and electromyogram (EMG). The pupil was tracked by using a region-based active contour model. The dose was given to the animal in a stepwise increasing mode (simulating induction of anesthesia) or in a stepwise decreasing mode (simulating emergence of anesthesia). We found that the quickly widening pupil action (mydriasis) characterizes the transitional state in anesthesia. Mydriasis occurred only in the light dose in the emergence phase, and the events were accompanied by an increase of burst activity in the EEG followed by EMG activity in 47% of the mydriasis events. Our findings suggest that recording such pupil changes may offer a noncontact monitoring tool for indexing the transitional state of the brain, particularly when a lower threshold dose is applied. PMID:27122995

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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): ...

  17. 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)

  18. 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

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

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    Tarek Shams

    2013-01-01

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

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

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    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.