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Sample records for surgery traditional anesthesia

  1. 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.

  2. Anesthesia for thoracoscopic surgery

    OpenAIRE

    Conacher I

    2007-01-01

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

  3. Anesthesia for Adults Having Eye Surgery

    Science.gov (United States)

    ... 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 “general”, “local”, or “topical” ...

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  6. The Biochemical Impact of Surgery and Anesthesia

    NARCIS (Netherlands)

    J.W. Hol (Jaap Willem)

    2014-01-01

    markdownabstract__Abstract__ General anesthesia has been considered by some medical historians as one of the most important contributions to modern medicine second to perhaps the concept of antiseptic medicine and hygiene. The first historical mention of a deep unnatural sleep so that surgery can t

  7. 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.

  8. [Modern inhalational anesthesia in pediatric maxillofacial surgery].

    Science.gov (United States)

    Afonin, D V; Afonina, N V; Marusev, D L; Petrova, L L

    2007-01-01

    The paper deals with the use of sevoflurane and isoflurane in elective pediatric maxillofacial surgery. Having outlined the major features of anesthesia in this category of patients, the authors emphasize the application of the conception of the minimum alveolar concentration (MAC) and its derivatives (MAC bar and MAC awake) reflecting the analgesic and hypnotic power of an inhalational anesthetic, respectively, and theoretically substantiate the use of certain anesthetic concentrations at particular stages of surgery. The technique described in the paper was used in 82 patients aged 1.5 months to 18 years, undergoing cleft lip and cleft palate repair, residual lip and nose deformation repair, and other elective maxillofacial procedures. The interventions lasted 40 minutes to 8 hours. Sevoflurane was commonly used as an induction agent while isoflurane was applied to maintain anesthesia. The anesthetics were administered at 1 to 1.3 and 0.8 MAC at traumatic and low traumatic stages of surgery, respectively. During the first traumatic period, the dose of fentanyl was not greater than 1.5 and 2.5 microg/kg in old and young children, respectively. Hemodynamics was characterized by moderate controlled hypotension with an average decrease in mean blood pressure by 30% of the age-related value. Emergence occurred 5-15 min after an anesthetic was discontinued. By and large, the technique demonstrated its efficiency and safety in this group of patients.

  9. 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...

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

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

  11. Anesthesia Maintenance During Mini-Invasive Cardiac Valve Surgery

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    L. A. Krichevsky

    2013-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  13. Evaluation of closed-loop anesthesia delivery for propofol anesthesia in pediatric cardiac surgery.

    Science.gov (United States)

    Biswas, Indranil; Mathew, Preethy J; Singh, Rana S; Puri, Goverdhan D

    2013-12-01

    The objective of this study was to compare the feasibility of closed-loop anesthesia delivery with manual control of propofol in pediatric patients during cardiac surgery. Forty ASA II-III children, undergoing elective cardiac surgery under cardiopulmonary bypass (CPB) in a tertiary care hospital, were randomized to receive propofol either through a closed-loop anesthesia delivery system (CL group) or through traditional manual control (manual group) to achieve a target BIS of 50. Patients were induced and subsequently maintained with a propofol infusion. The propofol usage and the efficacy of closed-loop system in controlling BIS within ±10 of the target were compared with that of manual control. The maintenance of BIS within ±10 of target and intraoperative hemodynamic stability were similar between the two groups. However, induction dose of propofol was less in the CL group (2.06 ± 0.79 mg·kg(-1) ) than the manual group (2.95 ± 1.03 mg·kg(-1) ) (P = 0.006) with less overshoot of BIS during induction in the closed-loop group (P = 0.007). Total propofol used in the off-CPB period was less in the CL group (6.29 ± 2.48 mg·kg(-1) h(-1) vs 7.82 ± 2.1 mg·kg(-1) h(-1) ) (P = 0.037). Phenylephrine use in the pre-CPB period was more in the manual group (16.92 ± 10.92 μg·kg(-1) vs 5.79 ± 5.98 μg·kg(-1) ) (P = 0.014). Manual group required a median of 18 (range 8-29) dose adjustments per hour, while the CL group required none. This study demonstrated the feasibility of closed-loop controlled propofol anesthesia in children, even in challenging procedures such as cardiac surgery. Closed-loop system needs further and larger evaluation to establish its safety and efficacy. © 2013 John Wiley & Sons Ltd.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  16. Cardiac Dysrhythmias with General Anesthesia during Dental Surgery

    OpenAIRE

    Rodrigo, Chandra R.

    1988-01-01

    Dysrhythmias with general anesthesia during dental surgery have been frequently reported. The incidence appears higher in spontaneously breathing patients lightly anesthetized with halothane. Anxiety, sitting posture, hypoxia, Chinese race, and heart disease appear to aggravate the condition. Use of beta blockers or lidocaine prior to anesthesia, intravenous induction, controlled ventilation with muscle relaxants, and use of isoflurane or enflurane in spontaneously breathing patients appear t...

  17. Regional anesthesia in faciomaxillary and oral surgery

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    Manimaran Kanakaraj

    2012-01-01

    Full Text Available Faciomaxillary and oral surgical procedures are frequently done under local anesthesia. Only few techniques are used widely in these areas in spite of the numerous blocks available. Knowledge about these techniques could encourage use of these techniques for the benefit of patients and operators′ comfort. Leaving aside the commonly used intraoral anesthetic technique by faciomaxillary and dental surgeons, focus is given on regional blocks of extraoral route, like maxillary block, mandibular block, superficial cervical plexus block, forehead and scalp block, trigeminal nerve block, sphenopalatine nerve block, and they are discussed with their indications and technical details involved in administering them. Advantages of using the regional blocks over general anesthesia and multiple pricks include reduced dosage and number of needle pricks. Pediatric considerations like prolonged duration of anesthesia and wider area of action for regional blocks warrant that they should be used with caution.

  18. Anesthesia for off-pump coronary artery bypass surgery

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    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.

  19. Ambulatory anesthesia in plastic surgery: opportunities and challenges

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    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

  20. Contact topical anesthesia for strabismus surgery in adult patients.

    Science.gov (United States)

    Vallés-Torres, J; García-Martín, E; Peña-Calvo, P; Sanjuan-Villarreal, A; Gil-Arribas, L M; Fernández-Tirado, F J

    2015-05-01

    To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Non-intubated anesthesia in thoracic surgery-technical issues.

    Science.gov (United States)

    Kiss, Gabor; Castillo, Maria

    2015-05-01

    Performing awake thoracic surgery (ATS) is technically more challenging than thoracic surgery under general anesthesia (GA), but it can result in a greater benefit for the patient. Local wound infiltration and lidocaine administration in the pleural space can be considered for ATS. More invasive techniques are local wound infiltration with wound catheter insertion, thoracic wall blocks, selective intercostal nerve blockade, thoracic paravertebral blockade and thoracic epidural analgesia, offering the advantage of a catheter placement which can also be continued for postoperative analgesia.

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

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    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

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

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    Ashish

    2014-09-01

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

  4. Remifentanil consumption in septoplasty surgery under general anesthesia

    Science.gov (United States)

    Al-Mustafa, Mahmoud M.; Al Oweidi, Abdelkarim S.; Al-Zaben, Khaled R.; Qudaisat, Ibraheem Y.; Abu-Halaweh, Sami A.; Al-Ghanem, Subhi M.; Massad, Islam M.; Samarah, Walid K.; Al-Shaer, Reem A.; Ismail, Said I.

    2017-01-01

    Objectives: To evaluate the influence of the ORM1 variants in codon 118 on the intra-operative remifentanil consumption under general anesthesia. Methods: A prospective gene association study, performed at the Jordan University Jordan, Amman, Jordan from September 2013 to August 2014. It includes patients who underwent septoplasty surgery under general anesthesia. All patients received standard intravenous anesthesia. Anesthesia maintained with fixed dose of Sevoflurane and variable dose of Remifentanil to keep the systolic blood pressure between 90-100 mm Hg. The Remifentanil dose was calculated and correlated with ORM1 genotype variance. Results: Genotype and clinical data were available for 123 cases. The A118A genotype was seen in 96 patients (78%), the A118G genotype was seen in 25 patients (20.3%), and only 2 patients had genotype G118G (1.6%). The G118G variant was removed from the statistical analysis due to small sample size. There was a significant effect of ORM1 genotype variant and the amount of remifentanil consumed. The A118A genotype received 0.173 ± 0.063 µg kg-1 min-1 and the A118G genotype received 0.316 ± 0.100 µg kg-1 min-1 (p<0.0001). Conclusion: The ORM1 gene has a role in intra-operative remifentanil consumption in patients who underwent septoplasty surgery under general anesthesia. The A118G gene required higher dose of remifentanil compared with the A118A genotype. PMID:28133690

  5. 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

  6. Seniors and Anesthesia

    Science.gov (United States)

    ... Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia Awareness Obesity and Anesthesia Sleep Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery Seniors and Anesthesia The older you are, the more ...

  7. Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients.

    Science.gov (United States)

    Mittal, M; Kumar, A; Srivastava, D; Sharma, P; Sharma, S

    2015-01-01

    Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups.

  8. Cognitive outcome after spinal anesthesia and surgery during infancy.

    Science.gov (United States)

    Williams, Robert K; Black, Ian H; Howard, Diantha B; Adams, David C; Mathews, Donald M; Friend, Alexander F; Meyers, H W Bud

    2014-09-01

    Observational studies on pediatric anesthesia neurotoxicity have been unable to distinguish long-term effects of general anesthesia (GA) from factors associated with the need for surgery. A recent study on elementary school children who had received a single GA during the first year of life demonstrated an association in otherwise healthy children between the duration of anesthesia and diminished test scores and also revealed a subgroup of children with "very poor academic achievement" (VPAA), scoring below the fifth percentile on standardized testing. Analysis of postoperative cognitive function in a similar cohort of children anesthetized with an alternative to GA may help to begin to separate the effects of anesthesia from other confounders. We used a novel methodology to construct a combined medical and educational database to search for these effects in a similar cohort of children receiving spinal anesthesia (SA) for the same procedures. We compared former patients with a control population of students matched by grade, gender, year of testing, and socioeconomic status. Vermont Department of Education records were analyzed for 265 students who had a single exposure to SA during infancy for circumcision, pyloromyotomy, or inguinal hernia repair. Exposure to SA and surgery had no significant effect on the odds of children having VPAA. (mathematics: P = 0.18; odds ratio 1.50, confidence interval (CI), 0.83-2.68; reading: P = 0.55; odds ratio = 1.19, CI, 0.67-2.1). There was no relationship between duration of exposure to SA and surgery and performance on mathematics (P = 0.73) or reading (P = 0.57) standardized testing. There was a small but statistically significant decrease in reading and math scores in the exposed group (mathematics: P = 0.03; reading: P = 0.02). We found no link between duration of surgery with infant SA and scores on academic achievement testing in elementary school. We also found no relationship between infant SA and surgery with VPAA on

  9. 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 arthrofibrosis after surgical correction of hallux valgus. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. [Progress in ambulatory anesthesia applied to gynecological surgery].

    Science.gov (United States)

    Rascol, N; Schneider, E; Gindre, G; Schoeffler, P

    2006-05-01

    Ambulatory gynecological surgery enables fast recovery of vital functions, ambulation and a relational life of quality. Patients whose disease is well-controlled at the anesthesia consultation can benefit from ambulatory procedures. Improved material and surgical practices broaden potential indications, limiting the risk of postoperative pain which can be controlled with simple analgesic protocols. The choice of the anesthesic techniques or the agents used during the intervention ensures fast recovery of higher functions. Nausea and vomiting, which may develop after returning home and compromise oral drug intake, must be prevented. More ambulatory gynecological procedures can be expected in the near future, pointing out the importance of developing more adapted medical structures.

  11. Contact topical anesthesia versus general anaesthesia in strabismus surgery.

    Science.gov (United States)

    Vallés-Torres, J; Garcia-Martin, E; Fernández-Tirado, F J; Gil-Arribas, L M; Pablo, L E; Peña-Calvo, P

    2016-03-01

    To evaluate the anesthetic block provided by contact topical anesthesia (CTA) in strabismus surgery in adult patients. To analyze postoperative pain and surgical outcome obtained by CTA compared with general anesthesia (GA). Prospective longitudinal cohort study of adult patients undergoing strabismus surgery by CTA or GA. The intensity of pain perceived by patients during the course of surgery and in the postoperative period was measured using Numerical Pain Scale. The success of the surgical outcome, considered as a residual ocular deviation<10 prism diopters, was evaluated. Twenty-three patients were operated using CTA and 26 using AG. During the course of surgery, pain intensity experienced by patients in ATC group was 3.17±2.44. There were no differences between CTA group and AG group in the intensity of pain in the immediate postoperative period (2.13±2.39 vs. 2.77±2.18, respectively; P=.510) and during the first postoperative day (3.22±2.84 vs. 3.17±2.73; P=.923). Surgical success was significantly higher in the CTA group than in the GA group (78.3 vs. 73.1%; P=.019). CTA provides adequate sensory block to perform strabismus surgery. The control of postoperative pain is similar to that obtained with AG. Conservation of ocular motility providing CTA enables better surgical outcome. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Does obesity prolong anesthesia in children undergoing common ENT surgery?

    Science.gov (United States)

    Lee, Jennifer J; Sun, Lena S; Gu, Brian; Kim, Minjae; Wang, Shuang; Han, Sena

    2014-10-01

    To report the epidemiology of obesity in a pediatric surgical population and determine whether obesity is a risk factor for longer anesthesia duration. Childhood obesity is a significant public health problem in the United States. Epidemiologic studies on pediatric surgical populations have been limited to states with very high prevalence of adult obesity (Michigan, Texas). Data from other states and more recent data since 2006 are unavailable. We examined anesthesia records for surgical patients age 2-18 years at Columbia University Medical Center from January 2009 to December 2010. Patients undergoing bariatric surgery or those with records missing preoperative height or weight data were excluded. Body mass index (BMI) was calculated as weight (kg)/height (m(2) ). BMI ≥95th percentile according to national growth charts were considered obese. We reviewed 9522 patients of which 1639 were obese (17.2%). The sex-age category interaction on obesity was not significant using logistic regression (P = 0.11). Among surgical groups, the otolaryngology (ENT) cohort had the highest obesity rate (21.7%, 360/1656). Obese children who had tonsillectomy, adenoidectomy, or both did not have a prolonged anesthetic (P = 0.33) or surgical duration (P = 0.61) compared with nonobese children, adjusting for surgeon, season, surgical procedure code, and ASA status. Children presenting for surgery, particularly the ENT cohort, have a high prevalence of obesity. Obese and nonobese children who had tonsillectomy, adenoidectomy, or both had comparable durations of anesthesia. Therefore, obesity did not lead to longer anesthetic duration. © 2014 John Wiley & Sons Ltd.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  14. Outcome of Anesthesia and Open Heart Surgery in Pregnant Patients

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    Golamali Mollasadeghi

    2007-06-01

    Full Text Available Background: Cardiovascular disease is an important non-obstetric cause of maternal and fetal /neonatal morbidity and mortality during pregnancy. For a pregnant woman with cardiac disease, the potential inability of the maternal cardiovascular system to contend with normal pregnancy-induced physiologic changes may produce deleterious effects on both mother and fetus. To determine the most frequent surgical indications of maternal and fetal mortality, we studied 15 cases of severe cardiac disease in pregnant women who required cardiac surgical procedures. Methods: In this descriptive study, fifteen pregnant women who underwent cardiac surgery were studied. Maternal age ranged from 27 to 36 years, and gestational age varied from 4 to 22 weeks. Most of the patients were in New York Heart Association Classes II and III. Opioid- based anesthesia with fentanyl citrate (50µ/kg or sufentanil (5µ/kg plus low dose of thiopental were used for the induction of anesthesia. During non-pulsatile cardio-pulmonary bypass, core temperature was between 28-36 °C, average CBP time was 61.2±22 min, average aortic cross-clamp time was 34.13±14 min, and mean pump pressure was maintained between 65-80 mmHg. Results: Ten patients had severe mitral valve disease (66.6%, three had aortic valve disease (20%, one had subvalvular aortic stenosis (6.7%, and the remaining one had left atrial myxoma (6.7%. There were five fetal deaths (33.3% and one maternal death (6.7%. Conclusion: It seems that open heart surgery in the first trimester is very hazardous for the fetus and may lead to fetal death. If possible, surgery should be carried out in the second trimester of pregnancy. The recommendations are simply guidelines because research data and clinical experience in this area are limited.

  15. Comparative study of general, local and topical anesthesia for cataract surgery

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    Tarighat Monfared MH

    2001-07-01

    Full Text Available Recently, small incision cataract extraction by phaco and implantation of a foldable intraocular lense with topical anesthesia has used in an attempt to decrease the complication of general anesthesia and peribulbar injection. To compare effects and complications of topical, local and general anesthesia, 92 patients admitted to Imam Hosein hospital for cataract surgery, were randomly assigned to three groups and surgery was done under different methods of anesthesia. During routine ECCE, lid and globe movements, miosis and viterous bulg were observed more in topical anesthesia than the other techniques, but serious complications such as posterior capsular rupture and viterous loss were not seen. Because of less systemic and local complications and rapid return of vision and possibility of outpatient surgery, topical anesthesia should be considered as an alternative to local and general methods.

  16. [Comparison between Greenbaum's parabulbar anesthesia and Ripart's subtenon anesthesia in the anterior segment surgery].

    Science.gov (United States)

    de la Marnierre, E; Mage, F; Alberti, M; Batisse, J L; Baltenneck, A

    2002-02-01

    To compare two methods of sub-tenon anesthesia in 80 surgical procedures (phakoemulsification, glaucoma and combined surgery) in a prospective, single-surgeon study. Forty patients requiring anterior segment surgery in each eye were randomised to receive subtenon anaesthesia by either Greenbaum's method (using a flexible plastic cannula) or Ripart's method (using a 23G hypodermic needle). Randomization dictated the mode of anaesthesia for the first eye, the other technique being used for the second eye. Anaesthesia consisted of 1.5ml lidocaïne 2% and 1.5ml bupivacaïne 0.5% in all cases, and was performed by the same surgeon (EDLM) immediately before surgery. Type of surgical procedure, duration, complications, presence of sub-conjunctival haemorrhage, were assessed by the surgeon, who also graded chemosis (0-3), nuclear hardness (1-4), and ocular akinesia (0-2) for each patient. Pain was scored subjectively by each patient (0-10) during the injection, peroperatively and postoperatively. Chemosis was significatively higher with Greenbaum's method than Ripart's method (panesthesic techniques characterized by an immediate, intense and prolonged analgesia (sometimes 60mn). Complete akinesia is rare and this is sometimes limiting. Chemosis was more often associated with Greenbaum's method, but Ripart's method carries the potential for needle-related complications.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  18. Effect of general anesthesia and major versus minor surgery on late postoperative episodic and constant hypoxemia

    DEFF Research Database (Denmark)

    Rosenberg, J; Oturai, P; Erichsen, C J

    1994-01-01

    STUDY OBJECTIVE: To evaluate the relative contribution of general anesthesia alone and in combination with the surgical procedure to the pathogenesis of late postoperative hypoxemia. DESIGN: Open, controlled study. SETTING: University hospital. PATIENTS: 60 patients undergoing major abdominal...... surgery and 16 patients undergoing middle ear surgery, both with comparable general anesthesia. MEASUREMENTS AND MAIN RESULTS: Patients were monitored with continuous pulse oximetry on one preoperative night and the second postoperative night. Significant episodic or constant hypoxemia did not occur...... on the second postoperative night following middle ear surgery and general anesthesia, but severe episodic and constant hypoxemia did occur on the second postoperative after major abdominal surgery and general anesthesia. CONCLUSIONS: General anesthesia in itself is not an important factor in the development...

  19. Anesthesia and Surgery Impair Blood–Brain Barrier and Cognitive Function in Mice

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    Siming Yang

    2017-08-01

    Full Text Available Blood–brain barrier (BBB dysfunction, e.g., increase in BBB permeability, has been reported to contribute to cognitive impairment. However, the effects of anesthesia and surgery on BBB permeability, the underlying mechanisms, and associated cognitive function remain largely to be determined. Here, we assessed the effects of surgery (laparotomy under 1.4% isoflurane anesthesia (anesthesia/surgery for 2 h on BBB permeability, levels of junction proteins and cognitive function in both 9- and 18-month-old wild-type mice and 9-month-old interleukin (IL-6 knockout mice. BBB permeability was determined by dextran tracer (immunohistochemistry imaging and spectrophotometric quantification, and protein levels were measured by Western blot and cognitive function was assessed by using both Morris water maze and Barnes maze. We found that the anesthesia/surgery increased mouse BBB permeability to 10-kDa dextran, but not to 70-kDa dextran, in an IL-6-dependent and age-associated manner. In addition, the anesthesia/surgery induced an age-associated increase in blood IL-6 level. Cognitive impairment was detected in 18-month-old, but not 9-month-old, mice after the anesthesia/surgery. Finally, the anesthesia/surgery decreased the levels of β-catenin and tight junction protein claudin, occludin and ZO-1, but not adherent junction protein VE-cadherin, E-cadherin, and p120-catenin. These data demonstrate that we have established a system to study the effects of perioperative factors, including anesthesia and surgery, on BBB and cognitive function. The results suggest that the anesthesia/surgery might induce an age-associated BBB dysfunction and cognitive impairment in mice. These findings would promote mechanistic studies of postoperative cognitive impairment, including postoperative delirium.

  20. Severe Anisocoria after Oral Surgery under General Anesthesia

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    Francesco Inchingolo, Marco Tatullo, Fabio M. Abenavoli, Massimo Marrelli, Alessio D. Inchingolo, Bruno Villabruna, Angelo M. Inchingolo, Gianna Dipalma

    2010-01-01

    Full Text Available Introduction. Anisocoria indicates a difference in pupil diameter. Etiologies of this clinical manifestation usually include systemic causes as neurological or vascular disorders, and local causes as congenital iris disorders and pharmacological effects.Case Report. We present a case of a 47-year-old man, suffering from spastic tetraparesis. After the oral surgery under general anesthesia, the patient developed severe anisocoria: in particular, a ~4mm diameter increase of the left pupil compared to the right pupil.We performed Computed Tomography (CT in the emergency setting, Nuclear magnetic resonance (NMR of the brain and Magnetic Resonance Angiography of intracranial vessels. These instrumental examinations did not show vascular or neurological diseases. The pupils returned to their physiological condition (isocoria after about 180 minutes.Discussion and Conclusions. Literature shows that the cases of anisocoria reported during or after oral surgery are rare occurrences, especially in cases of simple tooth extraction. Anisocoria can manifest in more or less evident forms: therefore, it is clear that knowing this clinical condition is of crucial importance for a correct and timely resolution.

  1. General Anesthesia in Cardiac Surgery: A Review of Drugs and Practices

    OpenAIRE

    Alwardt, Cory M.; Redford, Daniel; Larson, Douglas F.

    2005-01-01

    General anesthesia is defined as complete anesthesia affecting the entire body with loss of consciousness, analgesia, amnesia, and muscle relaxation. There is a wide spectrum of agents able to partially or completely induce general anesthesia. Presently, there is not a single universally accepted technique for anesthetic management during cardiac surgery. Instead, the drugs and combinations of drugs used are derived from the pathophysiologic state of the patient and individual preference and ...

  2. Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery

    Science.gov (United States)

    Ellakany, Mohamed Hamdy

    2014-01-01

    Aim: A double-blinded randomized controlled study to compare discharge time and patient satisfaction between two groups of patients submitted to open surgeries for abdominal malignancies using segmental thoracic spinal or general anesthesia. Background: Open surgeries for abdominal malignancy are usually done under general anesthesia, but many patients with major medical problems sometimes can’t tolerate such anesthesia. Regional anesthesia namely segmental thoracic spinal anesthesia may be beneficial in such patients. Materials and Methods: A total of 60 patients classified according to American Society of Anesthesiology (ASA) as class II or III undergoing surgeries for abdominal malignancy, like colonic or gastric carcinoma, divided into two groups, 30 patients each. Group G, received general anesthesia, Group S received a segmental (T9-T10 injection) thoracic spinal anesthesia with intrathecal injection of 2 ml of hyperbaric bupivacaine 0.5% (10 mg) and 20 ug fentanyl citrate. Intraoperative monitoring, postoperative pain, complications, recovery time, and patient satisfaction at follow-up were compared between the two groups. Results: Spinal anesthesia was performed easily in all 30 patients, although two patients complained of paraesthesiae, which responded to slight needle withdrawal. No patient required conversion to general anesthesia, six patients required midazolam for anxiety and six patients required phenylephrine and atropine for hypotension and bradycardia, recovery was uneventful and without sequelae. The two groups were comparable with respect to gender, age, weight, height, body mass index, ASA classification, preoperative oxygen saturation and preoperative respiratory rate and operative time. Conclusion: This preliminary study has shown that segmental thoracic spinal anesthesia can be used successfully and effectively for open surgeries for abdominal malignancies by experienced anesthetists. It showed shorter postanesthesia care unit stay

  3. Comparing prophylactic effect of phenylephrine and ephedrine on hypotension during spinal anesthesia for hip fracture surgery

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    Rahman Abbasivash

    2016-01-01

    Conclusion: At the doses of ephedrine and phenylephrine administered in this trial, phenylephrine was better to prevent hypotension during hip fracture surgery with spinal anesthesia. Higher frequency of hypotension was observed in the ephedrine group.

  4. Anesthesia and pain management in traditional Iranian medicine.

    Science.gov (United States)

    Salehi, Alireza; Alembizar, Faranak; Hosseinkhani, Ayda

    2016-12-01

    Studying the history of science could help develop an understanding of the contributions made by ancient nations towards scientific advances. Although Iranians had an important impact on the improvement of science, the history of Iranian medicine seems not to have been given enough attention by historians. The present study focused on the history of anesthesia and pain management in Iranian medical history. In this regard, related books such as Avesta and Shahnameh were studied in order to obtain the history of anesthesiology in Iranian pre Islamic era. This subject was also studied in the famous books of Rhazes, Haly Abbas, Avicenna, Jorjani, MomenTunekaboni and Aghili from different times of the Islamic era. Scientific data bases such as PubMed, Scopus and Google Scholar were searched using key words "Iranian", "Persian", "pain management" and "anesthesia". It was discovered that pain management and anesthesiology were well known to the Iranians. Rhazes and Avicenna had innovations in this regard. Fourteen Mokhader (anesthetic) herbs, which were included in the collection of the previous knowledge of the 18th century entitled Makhzan al-Advieyh and used as the Persian Materia Medica, were identified and listed. This study introduces the history of anesthesiology and pain management at different periods in the history of Iran.

  5. Is there any benefit in associating neuraxial anesthesia to general anesthesia for coronary artery bypass graft surgery?

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    Fabiano Timbó Barbosa

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: The use of neuraxial anesthesia in cardiac surgery is recent, but the hemodynamic effects of local anesthetics and anticoagulation can result in risk to patients. OBJECTIVE: To review the benefits of neuraxial anesthesia in cardiac surgery for CABG through a systematic review of systematic reviews. CONTENT: The search was performed in Pubmed (January 1966 to December 2012, Embase (1974 to December 2012, The Cochrane Library (volume 10, 2012 and Lilacs (1982 to December 2012 databases, in search of articles of systematic reviews. The following variables: mortality, myocardial infarction, stroke, in-hospital length of stay, arrhythmias and epidural hematoma were analyzed. CONCLUSIONS: The use of neuraxial anesthesia in cardiac surgery remains controversial. The greatest benefit found by this review was the possibility of reducing postoperative arrhythmias, but this result was contradictory among the identified findings. The results of findings regarding mortality, myocardial infarction, stroke and in-hospital length of stay did not show greater efficacy of neuraxial anesthesia.

  6. Is there any benefit in associating neuraxial anesthesia to general anesthesia for coronary artery bypass graft surgery?

    Science.gov (United States)

    Barbosa, Fabiano Timbó; de Sousa Rodrigues, Célio Fernando; Castro, Aldemar Araújo; da Cunha, Rafael Martins; Barbosa, Tatiana Roa Bezerra Wanderley

    2016-01-01

    The use of neuraxial anesthesia in cardiac surgery is recent, but the hemodynamic effects of local anesthetics and anticoagulation can result in risk to patients. To review the benefits of neuraxial anesthesia in cardiac surgery for CABG through a systematic review of systematic reviews. The search was performed in Pubmed (January 1966 to December 2012), Embase (1974 to December 2012), The Cochrane Library (volume 10, 2012) and Lilacs (1982 to December 2012) databases, in search of articles of systematic reviews. The following variables: mortality, myocardial infarction, stroke, in-hospital length of stay, arrhythmias and epidural hematoma were analyzed. The use of neuraxial anesthesia in cardiac surgery remains controversial. The greatest benefit found by this review was the possibility of reducing postoperative arrhythmias, but this result was contradictory among the identified findings. The results of findings regarding mortality, myocardial infarction, stroke and in-hospital length of stay did not show greater efficacy of neuraxial anesthesia. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  7. Sudden Sensorineural Hearing Loss after Orthopedic Surgery under Combined Spinal and Epidural Anesthesia

    OpenAIRE

    Ditza de Vilhena; Luís Pereira; Delfim Duarte; Nuno Oliveira

    2016-01-01

    Postoperative hearing loss following nonotologic surgery is rare. For patients undergoing subarachnoid anesthesia, the loss of cerebral spinal fluid and hence the drop in intracranial pressure can result in hearing loss and cranial nerve palsy. We report a case in which a patient sustained orthopedic surgery under combined spinal and epidural anesthesia complicated by severe and persistent sensorineural hearing loss. This report is a reminder that postoperative sudden sensorineural hearing lo...

  8. Differences between Total Intravenous Anesthesia and Inhalation Anesthesia in Free Flap Surgery of Head and Neck Cancer.

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    Yi-Ting Chang

    Full Text Available Many studies have evaluated risk factors associated with complications after free flap surgery, but these studies did not evaluate the impact of anesthesia management. The goal of the current study was to evaluate the differences between patients who received inhalation and total intravenous anesthesia (TIVA in free flap surgery.One hundred and fifty-six patients who underwent free flap surgery for head and neck cancer were retrospectively divided into the TIVA (96 patients and the inhalation group (87 patients. Perioperative hemodynamic data and postoperative medical complications were determined by documented medical records.Ninety-six patients in the TIVA group were compared with 87 patients who received inhalation anesthesia. There were no differences in gender, age, classification of physical status based on American Society for Anesthesiologists (ASA score, and cormobidities between the two groups. Patients in the TIVA group required less perioperative crystalloid (4172.46 ± 1534.95 vs. 5183.91 ± 1416.40 ml, p < 0.0001 and colloid (572.46 ± 335.14 vs. 994.25 ± 434.65 ml, p < 0.0001 to maintain hemodynamic stability. Although the mean anesthesia duration was shorter in the TIVA group (11.02 ± 2.84 vs. 11.70± 1.96 hours, p = 0.017, the blood loss was similar between groups (p = 0.71. There was no difference in surgical complication rate, but patients in the TIVA group developed fewer pulmonary complications (18 vs. 47, p = 0.0008. After multivariate regression, patients in the TIVA group had a significantly reduced risk of pulmonary complication compared with the inhalation group (Odds ratio 0.41, 95% CI 0.18-0.92.Total intravenous anesthesia was associated with significantly fewer pulmonary complications in patients who received free flap reconstruction.

  9. Choice of the method of anesthesia management of traumatological surgeries in young patients

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    Наталія Миколаївна Богуславська

    2015-07-01

    Full Text Available Aim of research. Study of the hemodynamic state, evaluation of the pain level, stress markers and its correlations in traumatologic patients of the young age in conditions of the different kinds of anesthesia.Materials and methods. The research includes 102 patients: 72 men (70,6 %, 30 women (29,4 % 18 – 45years old (33,5±0,7 years, who underwent osteosynthesis because of traumatic injure of limbs. Patients were separated into 3 groups depending on the kind of anesthesia: I group (n=32 – underwent surgery in conditions of conduction anesthesia without sedation (average age 31,9±1,3 years, II group (n=44 – underwent surgery in conditions of conduction anesthesia with sedation (35,0±1,0 years, III group (n=26 – underwent surgery in conditions of intravenous anesthesia (32,7±1,4years.Results of research. MAPB level at the surgery stages didn’t exceed the output values in patients of all groups. As for HR it must be noticed its increase in patients of the 1 and II groups at the traumatic stage and at the end of surgery that can be explained by an effect of adrenaline added to the local anesthetic. The pain level was the lowest in the group of patients who underwent an anesthesia with sedation in first postsurgical day. Hyperglycemia was noticed in patients of the 1 group in first postsurgical day, and in patients of the III group – the tendency to hypercortisolemia. The cortisone-insulin ratio at the surgery stages was maximal in patients of the 1 group and in postsurgical day – in the III group. НОМА index at the surgery stages was within norm in patients of all groups and only in postsurgical day it had a tendency to increase in patients of the I group.Conclusions. Conduction anesthesia without sedation, conduction anesthesia with sedation (propofol and intravenous anesthesia (propofol, fentanyl demonstrate hemodynamic stability at osteosynthesis in young patients. The conduction anesthesia with sedation (propofol and

  10. Comparison of the effects and complications of unilateral spinal anesthesia versus standard spinal anesthesia in lower-limb orthopedic surgery

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    Seyyed Mostafa Moosavi Tekye

    2014-06-01

    Full Text Available Introduction: A restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes. This prospective randomized study compared unilateral and bilateral spinal anesthesia with respect to the intra- and postoperative advantages and complications of each technique. Material and methods: Spinal anesthesia was induced with 0.5% hyperbaric bupivacaine and a 25-G Quincke needle (Dr. J in two groups of patients with physical status ASA I-II who had been admitted for orthopedic surgeries. In group A, dural puncture was performed with the patient in a seated position using 2.5 cm3 of hyperbaric bupivacaine. Each patient was then placed in the supine position. In group B, dural puncture was performed with the patient in the lateral decubitus position with 1.5 cm3 of hyperbaric bupivacaine. The lower limb was the target limb. The speed of injection was 1 mL/30 s, and the duration of time spent in the lateral decubitus position was 20 min. Results: The demographic data were similar in both groups. The time to the onset of the sensory and motor block was significantly shorter in group A (p = 0.00. The duration of motor and sensory block was shorter in group B (p < 0.05. The success rate for unilateral spinal anesthesia in group B was 94.45%. In two patients, the spinal block spread to the non-dependent side. The incidence of complications (nausea, headache, and hypotension was lower in group B (p = 0.02. Conclusion: When unilateral spinal anesthesia was performed using a low-dose, low-volume and low-flow injection technique, it provides adequate sensory-motor block and helps to achieve stable hemodynamic parameters during orthopedic surgery on a lower limb. Patients were more satisfied with this technique as opposed to the conventional approach. Furthermore, this technique avoids unnecessary paralysis on the non-operated side.

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

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    Ashraf Abd Elmawgood

    2015-01-01

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

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

    DEFF Research Database (Denmark)

    Kehlet, H

    1988-01-01

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

  13. A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery

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    Hosoda Y

    2016-06-01

    Full Text Available Yoshikatsu Hosoda, Shoji Kuriyama, Yoko Jingami, Hidetsugu Hattori, Hisako Hayashi, Miho Matsumoto Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan Purpose: The purpose of this study was to compare the level of patient pain during the phacoemulsification and implantation of foldable intraocular lenses while under topical, intracameral, or sub-Tenon lidocaine.Patients and methods: This was a retrospective study. Three hundred and one eyes subjected to cataract surgery were included in this study. All eyes underwent phacoemulsification surgery and intraocular lens implantation using topical, sub-Tenon, or intracameral anesthesia. The topical group received 4% lidocaine drops, and the intracameral group received a 0.1–0.2 cc infusion of 1% preservative-free lidocaine into the anterior chamber through the side port combined with topical drops of lidocaine. The sub-Tenon group received 2% lidocaine. Best-corrected visual acuity, corneal endothelial cell loss, and intraoperative pain level were evaluated. Pain level was assessed on a visual analog scale (range 0–2.Results: There were no significant differences in visual outcome and corneal endothelial cell loss between the three groups. The mean pain score in the sub-Tenon group was significantly lower than that in the topical and intracameral groups (P=0.0009 and P=0.0055, respectively. In 250 eyes without high myopia (<-6D, there were no significant differences in mean pain score between the sub-Tenon and intracameral groups (P=0.1417. No additional anesthesia was required in all groups.Conclusion: Intracameral lidocaine provides sufficient pain suppressive effects in eyes without high myopia, while sub-Tenon anesthesia is better for cataract surgery in eyes with high myopia. Keywords: cataract, anesthesia, topical, intracameral, sub-Tenon

  14. [Anesthesia management of geriatric patients with arterial pressure-based cardiac output monitoring FloTrac sensor for emergency surgery].

    Science.gov (United States)

    Yamamoto, Shunsuke; Goto, Koji; Yasuda, Norihisa; Kusaka, Junya; Hidaka, Seigo; Miyakawa, Hiroshi; Noguchi, Takayuki

    2009-06-01

    In cases of emergency surgery for geriatric patients, immediate anesthesia induction and careful intraoperative management is necessary without sufficient preoperative information. We report anesthesia management of a 96-year and a 90-year old patients with FloTrac sensor which is an arterial pressure-based cardiac output monitoring device and is able to manage critical patients effectively and safely during anesthesia.

  15. Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine

    OpenAIRE

    Elif Basagan-Mogo; Suna Goren; Gulsen Korfali; Gurkan Turker; Fatma Nur Kaya

    2010-01-01

    OBJECTIVE: The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. INTRODUCTION: Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting ...

  16. Anesthesia Dolorosa of Trigeminal Nerve, a Rare Complication of Acoustic Neuroma Surgery

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    Foad Elahi

    2014-01-01

    Full Text Available Anesthesia dolorosa is an uncommon deafferentation pain that can occur after traumatic or surgical injury to the trigeminal nerve. This creates spontaneous pain signals without nociceptive stimuli. Compression of the trigeminal nerve due to acoustic neuromas or other structures near the cerebellopontine angle (CPA can cause trigeminal neuralgia, but the occurrence of anesthesia dolorosa subsequent to acoustic tumor removal has not been described in the medical literature. We report two cases of acoustic neuroma surgery presented with anesthesia dolorosa along the trigeminal nerve distribution. The patients’ pain was managed with multidisciplinary approaches with moderate success.

  17. Ocular risk management in patients undergoing general anesthesia: an analysis of 39,431 surgeries

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    Newton Kara-Junior

    2015-08-01

    Full Text Available OBJECTIVE:This study sought to describe and analyze ocular findings associated with nonocular surgery in patients who underwent general anesthesia.METHODS:The authors retrospectively collected a series of 39,431 surgeries using standardized data forms.RESULTS:Ocular findings were reported in 9 cases (2.3:10,000, which involved patients with a mean age of 58.9±19.5 years. These cases involved patients classified as ASA I (33%, ASA II (55% or ASA III (11%. General anesthesia with propofol and remifentanil was used in 4 cases, balanced general anesthesia was used in 4 cases, and regional block was used in combination with balanced general anesthesia in one case. Five patients (55% underwent surgery in the supine position, one patient (11% underwent surgery in the lithotomy position, two patients (22% underwent surgery in the prone position, and one patient (11% underwent surgery in the lateral position. Ocular hyperemia was detected in most (77% of the 9 cases with ocular findings; pain/burning of the eyes, visual impairment, eye discharge and photophobia were observed in 55%, 11%, 11% and 11%, respectively, of these 9 cases. No cases involved permanent ocular injury or vision loss.CONCLUSION:Ophthalmological findings after surgeries were uncommon, and most of the included patients were relatively healthy. Minor complications, such as dehydration or superficial ocular trauma, should be prevented by following systematic protocols that provide appropriate ocular occlusion with a lubricating ointment and protect the eye with an acrylic occluder. These procedures will refine the quality of anesthesia services and avoid discomfort among patients, surgeons and anesthesia staff.

  18. Anesthesia for off-floor dental and oral surgery.

    Science.gov (United States)

    Giovannitti, Joseph A

    2016-08-01

    Anesthesia for dentistry is commonly performed outside the operating room. The combination of a shared airway between surgeon and anesthetist, the variety of open airway techniques, and the out-of-operating room setting often results in anxiety and avoidance of dental cases among anesthesia personnel. This review attempts to demystify dental treatment and facilitate the anesthesia provider in providing effective sedation of dental procedures performed in the nonoperating room setting. Specific indications for dental anesthesia improve the patient selection process. Airway assessment and strategies to secure the difficult airway are paramount because of the nature of the procedures and the patients on whom they are performed. Pediatric patients and those with special needs present specific preanesthetic assessment, induction, and management challenges. Emergence delirium is disruptive, possibly dangerous, prolongs recovery time, and may necessitate hospitalization. Simplified techniques and objective recovery criteria are necessary to ensure a safe and smooth discharge to home. Airway fire precautions should not be overlooked given the rare but potential risk of airway fire during dental treatment. This article reviews the indications, facility and equipment needs, monitoring requirements, treatment methods, and recovery protocols necessary for the safe administration of off-floor anesthesia for dentistry.

  19. 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

  20. Segmental thoracic spinal has advantages over general anesthesia for breast cancer surgery

    Science.gov (United States)

    Elakany, Mohamed Hamdy; Abdelhamid, Sherif Ahmed

    2013-01-01

    Background: Thoracic spinal anesthesia has been used for laparoscopic cholecystectomy and abdominal surgeries, but not in breast surgery. The present study compared this technique with general anesthesia in breast cancer surgeries. Materials and Methods: Forty patients were enrolled in this comparative study with inclusion criteria of ASA physical status I-III, primary breast cancer without known extension beyond the breast and axillary nodes, scheduled for unilateral mastectomy with axillary dissection. They were randomly divided into two groups. The thoracic spinal group (S) (n = 20) underwent segmental thoracic spinal anesthesia with bupivacaine and fentanyl at T5-T6 interspace, while the other group (n = 20) underwent general anesthesia (G). Intraoperative hemodynamic parameters, intraoperative complications, postoperative discharge time from post-anesthesia care unit (PACU), postoperative pain and analgesic consumption, postoperative adverse effects, and patient satisfaction with the anesthetic techniques were recorded. Results: Intraoperative hypertension (20%) was more frequent in group (G), while hypotension and bradycardia (15%) were more frequent in the segmental thoracic spinal (S) group. Postoperative nausea (30%) and vomiting (40%) during PACU stay were more frequent in the (G) group. Postoperative discharge time from PACU was shorter in the (S) group (124 ± 38 min) than in the (G) group (212 ± 46 min). The quality of postoperative analgesia and analgesic consumption was better in the (S) group. Patient satisfaction was similar in both groups. Conclusions: Segmental thoracic spinal anesthesia has some advantages when compared with general anesthesia and can be considered as a sole anesthetic in breast cancer surgery with axillary lymph node clearance. PMID:25885990

  1. Optimization of Spinal Anesthesia in Surgery of Intervertebral Disks

    Directory of Open Access Journals (Sweden)

    V. I. Gorbachev

    2006-01-01

    Full Text Available The paper gives the data of preoperative evaluation of autonomous nervous system tone and its correction, pharmacokinetics of local anesthetics in the subarachnoidal space, as well as the optimization of a procedure for spinal anesthesia in patients operated on for lumbosacral radiculitis. 

  2. Current techniques and strategies for anesthesia in patients undergoing peripheral bypass surgery.

    Science.gov (United States)

    Bouman, E; Dortangs, E; Buhre, W; Gramke, H F

    2014-04-01

    Peripheral arterial disease is an illness with a high prevalence in Europe and North America. The disease is associated with a significant impact on quality of life. Despite advanced medical and endovascular treatments, surgery is often indicated to prevent the consequences of ischemic injury. Usually, these patients do have significant comorbidities resulting in an increased risk for anesthesia-related complications. While general anesthesia is commonly used for the majority of the patients, local and regional anesthesia (RA) offer several possible advantages such as stable cardiovascular hemodynamic perioperative course, improved postoperative pain relief and prevention of chronic postsurgical pain syndromes. This review will discuss perioperative management, available evidence regarding general anesthesia and various regional anesthetic techniques for peripheral vascular surgery, and the current advises regarding anticoagulants and RA. No definitive conclusions can be drawn from the existing literature with respect to superiority of general or neuraxial anesthesia or even RA. Maybe the profits lie in the combination of techniques, a strategy, to overcome the risks of one and use the benefits of the other technique. From circumstantial evidence, it is most likely that the experience of the anesthetic and surgical team is one of the major determinants of perioperative complications independent from the individual anesthesia technique.

  3. The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery.

    Science.gov (United States)

    Lu, I-Cheng; Chang, Pi-Ying; Su, Miao-Pei; Chen, Po-Nien; Chen, Hsiu-Ya; Chiang, Feng-Yu; Wu, Che-Wei

    2017-08-01

    The use of neuromuscular blocking agent (NMBA) during anesthesia may interfere with facial nerve monitoring (FNM) during parotid surgery. Sugammadex has been reported to be an effective and safe reversal of rocuronium-induced neuromuscular block (NMB) during surgery. This study investigated the feasibility and clinical effectiveness of sugammadex for NMB reversal during FNM in Parotid surgery. Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25) and sugammadex group (Group S, n = 25). Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%). In group S, rapid reverse of NMB was found and the twitch (%) recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery. Copyright © 2017. Published by Elsevier Taiwan.

  4. Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery.

    Science.gov (United States)

    Doger, Cihan; Kahveci, Kadriye; Ornek, Dilsen; But, Abdulkadir; Aksoy, Mustafa; Gokcinar, Derya; Katar, Didem

    2016-01-01

    Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n = 30) and low-flow sevoflurane anesthesia group (Group L, n = 30). The fresh gas flow rate was of 4 L/min in high-flow sevoflurane anesthesia group and 1 L/min in low-flow sevoflurane anesthesia group. Heart rate (HR), mean arterial blood pressure (MABP), peripheral oxygen saturation (SpO2), and end-tidal carbon dioxide concentration (ETCO2) were recorded. Pulmonary function tests were performed before and 2, 8, and 24 hours after surgery. Results. There was no significant difference between the two groups in terms of HR, MABP, SpO2, and ETCO2. Pulmonary function test results were similar in both groups at all measurement times. Conclusions. The effects of low-flow sevoflurane anesthesia on pulmonary functions are comparable to high-flow sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy.

  5. Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Cihan Doger

    2016-01-01

    Full Text Available Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n=30 and low-flow sevoflurane anesthesia group (Group L, n=30. The fresh gas flow rate was of 4 L/min in high-flow sevoflurane anesthesia group and 1 L/min in low-flow sevoflurane anesthesia group. Heart rate (HR, mean arterial blood pressure (MABP, peripheral oxygen saturation (SpO2, and end-tidal carbon dioxide concentration (ETCO2 were recorded. Pulmonary function tests were performed before and 2, 8, and 24 hours after surgery. Results. There was no significant difference between the two groups in terms of HR, MABP, SpO2, and ETCO2. Pulmonary function test results were similar in both groups at all measurement times. Conclusions. The effects of low-flow sevoflurane anesthesia on pulmonary functions are comparable to high-flow sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy.

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

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    Zeynab Maghsood-Taleghani

    2007-01-01

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

  7. Superior subconjunctival anesthesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kongsap P

    2012-11-01

    Full Text Available Pipat KongsapDepartment of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandPurpose: To evaluate the effectiveness of subconjunctival anesthesia as compared to retrobulbar anesthesia for pain control during manual small-incision cataract surgery (MSICS performed by third-year residents.Design: A randomized, controlled trial.Patients and methods: A total of 150 patients undergoing routine cataract surgery were randomly assigned to receive either subconjunctival anesthesia (group 1, n = 75 or retrobulbar anesthesia (group 2, n = 75. Third-year residents performed MSICS using the modified Blumenthal technique. Subconjunctival anesthesia was administered by injecting 2% xylocaine with adrenalin into the superior conjunctiva, and retrobulbar anesthesia by injecting 2 mL of 2% xylocaine with adrenalin into the retrobulbar space. We studied the following variables: intraoperative pain score rated on a 100-point visual analog scale (VAS, operative time, and injection and operative complications.Results: A mean age of 69 vs 70 years, an operative time of 47.1 (SD, 9.9 min vs 47.7 (10.9 min, and a median (interquartile range pain score of 40 (range, 20–70 vs 40 (range, 20–50 were observed in the subconjunctival and the retrobulbar groups, respectively. The injection complication of subconjunctival hemorrhage was significantly higher in the subconjunctival group (25.3% compared to the retrobulbar group (1.3%. The operative complication rate between groups was not different (P > 0.05.Conclusion: Both, superior subconjunctival anesthesia and retrobulbar anesthesia were effective during MSICS when used in a residency training program.Keywords: subconjunctival anesthesia, retrobulbar anesthesia, cataract surgery, small-incision cataract surgery, visual analog scale, pain score

  8. 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.

  9. Anesthesia for thoracic surgery: A survey of middle eastern practice

    Directory of Open Access Journals (Sweden)

    Abdelazeem Eldawlatly

    2012-01-01

    Full Text Available Purpose: The main objective of this survey is to describe the current practice of thoracic anesthesia in the Middle Eastern (ME region. Methods: A prospective online survey. An invitation to participate was e-mailed to all members of the ME thoracic-anaesthesia group. A total of 58 members participated in the survey from 19 institutions in the Middle East. Questions concerned ventilation strategies during one-lung ventilation (OLV, anesthesia regimen, mode of postoperative analgesia, use of lung isolation techniques, and use of i.v. fluids. Results: Volume-controlled ventilation was favored over pressure-controlled ventilation (62% vs 38% of respondents, P<0.05; 43% report the routine use of positive end-expiratory pressure. One hundred percent of respondents report using double-lumen tube (DLT as a first choice airway to establish OLV. Nearly a third of respondents, 31.1%, report never using bronchial blocker (BB in their thoracic anesthesia practice. Failure to pass a DLT and difficult airway are the most commonly cited indications for BB use. Regarding postoperative analgesia, the majority 61.8% favor thoracic epidural analgesia over other techniques (P<0.05. Conclusions: Our survey provides a contemporary snapshot of the ME thoracic anesthetic practice.

  10. 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

  11. Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine

    Directory of Open Access Journals (Sweden)

    Elif Basagan-Mogo

    2010-01-01

    Full Text Available OBJECTIVE: The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. INTRODUCTION: Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting surgery is both the attenuation of sympathetic responses to noxious stimuli and the prevention of hypotension. METHODS: Thirty patients undergoing coronary artery bypass grafting surgery were randomized to receive either ketamine 2 mg.kg-1 (Group K or propofol 0.5 mg.kg-1 (Group P during induction of anesthesia. Patients also received standardized doses of midazolam, fentanyl, and rocuronium in the induction sequence. The duration of anesthesia from induction to skin incision and sternotomy, as well as the supplemental doses of fentanyl and sevoflurane, were recorded. Heart rate, mean arterial pressure, central venous pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index, systemic and pulmonary vascular resistance indices, stroke work index, and left and right ventricular stroke work indices were obtained before induction of anesthesia; one minute after induction; one, three, five, and ten minutes after intubation; one minute after skin incision; and at one minute after sternotomy. RESULTS: There were significant changes in the measured and calculated hemodynamic variables when compared to their values before induction. One minute after induction, mean arterial pressure and the systemic vascular resistance index decreased significantly in group P (p<0.01. CONCLUSION: There were no differences between groups in the consumption of sevoflurane or in the use of additional fentanyl. The combination of ketamine, midazolam, and

  12. Force-length recording of eye muscles during local-anesthesia surgery in 32 strabismus patients

    NARCIS (Netherlands)

    H.J. Simonsz (Huib)

    1994-01-01

    textabstractAbstract. Force-length recordings were made from isolated human eye muscles during strabismus surgery in local, eye-drop anesthesia in 32 adult patients. From each muscle three recordings were made: (1) while the patient looked with the other eye into the field of action of the recorded

  13. Local anesthesia for cochlear implant surgery: low risks for the patient and few costs for the hospital, a rational alternative.

    Science.gov (United States)

    Hamerschmidt, R; Mocellin, M; Gasperin, A; Faria, J L G; Wiemes, G; Kutianski, V; Pasinato, L; Soares, W

    2011-01-01

    The aim of this article is to illustrate the possibility of performing a cochlear implant with local anesthesia and sedation, the anesthesic technique and the advantages of that in comparison to a general anesthesia. We describe two successful surgeries done with local anesthesia, including the neural telemetry and the conditions the patient presented after the surgery, with a very good recovery and no complications during and after the procedure. The results of these two surgeries are described regarding the fast recovery, no symptoms of dizziness and vomiting after the surgeries, discharging from the hospital on the same day, and the immediate post operative period by meaning of complaints from the patient. Local anesthesia with sedation for cochlear implant surgery in adults is a very good alternative for lowering the morbidity of the patient, fewer risks, lower costs for the hospital, with a very good control of the surgery.

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

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    Meziyet Sarac Ahrazoglu

    2012-08-01

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

  15. Intraoperative eye position after sub-Tenon's anesthesia for cataract surgery.

    Science.gov (United States)

    Kumar, Nishant; Jivan, Sharmila; Pulpa, Vidya; Butler, John; Khan, Mohammed Younis

    2006-08-01

    To evaluate the incidence and extent of ocular deviation associated with sub-Tenon's anesthesia. Seventy-five consecutive patients undergoing routine phacoemulsification with sub-Tenon's anesthesia at the Eye Unit, Royal Gwent Hospital, were prospectively enrolled in this observational case series. The exclusion criteria were patients taking warfarin, or patients with preexisting ocular motility disorders, allergy to local anesthetics, or previous surgery for squint or retinal detachment. Eleven patients were subsequently excluded from the study group as they required additional anesthesia blocks before measurements were taken for ocular deviation. We injected 5 mL of a local anesthetic mixture of 2% lignocaine and 7.5 mg/mL levobupivacaine in the sub-Tenon's space in the inferonasal quadrant. Ocular deviation was assessed objectively by means of the Krimsky test. Forced duction tests were performed before and after anesthesia. Hyperdeviation was documented in 49 (77%) eyes, exodeviation in 62 (97%), and hypodeviation in 6 (9.4%). No esodeviations were documented. Only 2 patients were orthophoric after anesthesia. Mean vertical deviation was 4.4 prism dioptres (PD) (SD 4.7 PD, 95% CI 3.2-5.5 PD, range 0-14 PD). Mean horizontal deviation was 19.5 (SD 9.6, 95% CI 17-22, range 0-50) PD. Forced duction test revealed no mechanical restriction before or after anesthesia. This study suggests that there is an appreciable ocular deviation with sub-Tenon's anesthesia. Intraoperative ocular deviation may make certain procedures more difficult; therefore, we recommend a low threshold for an additional corrective block administered before surgery to rectify the deviation.

  16. Anesthesia and thyroid surgery: The never ending challenges

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    Sukhminder Jit Singh Bajwa

    2013-01-01

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

  17. Anesthesia and thyroid surgery: The never ending challenges

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Sehgal, Vishal

    2013-01-01

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

  18. The Feasibility of a Completely Automated Total IV Anesthesia Drug Delivery System for Cardiac Surgery.

    Science.gov (United States)

    Zaouter, Cedrick; Hemmerling, Thomas M; Lanchon, Romain; Valoti, Emanuela; Remy, Alain; Leuillet, Sébastien; Ouattara, Alexandre

    2016-10-01

    In this pilot study, we tested a novel automatic anesthesia system for closed-loop administration of IV anesthesia drugs for cardiac surgical procedures with cardiopulmonary bypass. This anesthesia drug delivery robot integrates all 3 components of general anesthesia: hypnosis, analgesia, and muscle relaxation. Twenty patients scheduled for elective cardiac surgery with cardiopulmonary bypass were enrolled. Propofol, remifentanil, and rocuronium were administered using closed-loop feedback control. The main objective was the feasibility of closed-loop anesthesia defined as successful automated cardiac anesthesia without manual override by the attending anesthesiologist. Secondary qualitative observations were clinical and controller performances. The clinical performance of hypnosis control was the efficacy to maintain a bispectral index (BIS) of 45. To evaluate the hypnosis performance, BIS values were stratified into 4 categories: "excellent," "good," "poor," and "inadequate" hypnosis control defined as BIS values within 10%, ranging from 11% to 20%, ranging from 21% to 30%, or >30% of the target value, respectively. The clinical performance of analgesia was the efficacy to maintain NociMap values close to 0. The analgesia performance was assessed classifying the NociMap values in 3 pain control groups: -33 to +33 representing excellent pain control, -34 to -66 and +34 to +66 representing good pain control, and -67 to -100 and +67 to +100 representing insufficient pain control. The controller performance was calculated using the Varvel parameters. Robotic anesthesia was successful in 16 patients, which is equivalent to 80% (97.5% confidence interval [CI], 53%-95%) of the patients undergoing cardiac surgery. Four patients were excluded from the final analysis because of technical problems with the automated anesthesia delivery system. The secondary qualitative observations revealed that the clinical performance of hypnosis allowed an excellent and good control

  19. [Awareness during general anesthesia for head and neck surgery--a case report].

    Science.gov (United States)

    Kino, Atsunari; Nakamura, Kumi

    2011-02-01

    We report a second case of awareness during general anesthesia with sevoflurane supplemented with fentanyl. A 58-year-old man, weighing 61 kg, underwent an 8.8-hour operation for a malignant tumor of the right mandible. His right eye was guarded with ointment but kept open for observation of facial movement following muscle stimulation by the surgeon. The intraoperative course and emergence from anesthesia were otherwise uneventful. The patient became agitated in the recovery room and could recall his visual memory during the operation. We speculated contribution of visual input through the open eye and/or the effects of cranial bone oscillation during the surgery to his intraoperative awareness.

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

    DEFF Research Database (Denmark)

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

    Introduction: There is a pronounced variation in level of cognitive function and rate of cognitive decline in late life. Results from smaller human and animal studies suggest that exposure to anesthesia may be a risk factor for cognitive impairment. Using a twin design, the objective of the present...... study was to examine whether exposure to anesthesia and surgery is associated with level of cognitive function in middle and old age. Materials and Methods: The study is based on two population-based surveys comprising 8,503 Danish twins aged 45–102 years at study intake during 1995–2001. Through...... linkage to the Danish National Patient Register, we obtained information on surgeries performed in hospitals in Denmark from 1977 and until study intake. Four exposure groups were defined based on type of surgery (major, minor, knee and hip replacement, other). A cognitive test battery consisting of five...

  1. Tumescent Local Anesthesia for Hand Surgery: Improved Results, Cost Effectiveness, and Wide-Awake Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Donald Lalonde

    2014-07-01

    Full Text Available This is a review article of the wide-awake approach to hand surgery. More than 95% of all hand surgery can now be performed without a tourniquet. Epinephrine is injected with lidocaine for hemostasis and anesthesia instead of a tourniquet and sedation. This is sedation-free surgery, much like a visit to a dental office. The myth of danger of using epinephrine in the finger is reviewed. The wide awake technique is greatly improving results in tendon repair, tenolysis, and tendon transfer. Here, we will explain its advantages.

  2. A Study to Compare the Quality of Surgical Field Using Total Intravenous Anesthesia (with Propofol) versus Inhalational Anesthesia (with Isoflurane) for Functional Endoscopic Sinus Surgeries

    Science.gov (United States)

    Aujla, K. S.; Kaur, Manbir; Gupta, Ruchi; Singh, Sukhjinder; Bhanupreet; Tavleen

    2017-01-01

    Background and Objectives: Functional endoscopic sinus surgery (FESS) being a delicate technique, intraoperative bleeding is one of the major challenges. Even a little bleeding can adversely affect the surgeon's ability to visualize the region to be operated. General anesthesia is preferred over topical anesthesia in FESS. This study was conducted to compare the surgical field using total intravenous anesthesia (TIVA) with propofol and inhalational anesthesia with isoflurane for FESS. Secondary outcomes such as intraoperative blood loss and the incidence of perioperative complications were also recorded. Subjects and Methods: A total of sixty patients in the age group of 16–60 years with physical status American Society of Anesthesiologists Classes I and II, undergoing FESS were randomly divided into two groups of thirty each after taking informed consent and approval from the Hospital Ethics Committee. Thirty patients in Group I: received isoflurane-based inhalational anesthesia and other Thirty patients in Group II: were administered TIVA with propofol. Various parameters were recorded and statistically analyzed. Results: There was improved quality of surgical field at the end of surgery in the Group II as compared to Group I. Total blood loss during surgery and incidence of intraoperative complications were less in Group II as compared to Group I. Conclusion: This study concludes that in FESS, using TIVA with propofol decreases blood loss and the incidence of complications during surgery in addition to providing good quality of surgical field.

  3. Anesthesia for Ambulatory Pediatric Surgery in Sub-Saharan Africa: A Pilot Study in Burkina Faso.

    Science.gov (United States)

    Kabré, Yvette B; Traoré, Idriss S S; Kaboré, Flavien A R; Ki, Bertille; Traoré, Alain I; Ouédraogo, Isso; Bandré, Emile; Wandaogo, Albert; Ouédraogo, Nazinigouba

    2017-02-01

    Long surgical wait times and limited hospital capacity are common obstacles to surgical care in many countries in Sub-Saharan Africa (SSA). Introducing ambulatory surgery might contribute to a solution to these problems. The purpose of this study was to evaluate the safety and feasibility of introducing ambulatory surgery into a pediatric hospital in SSA. This is a cross-sectional descriptive study that took place over 6 months. It includes all patients assigned to undergo ambulatory surgery in the Pediatric University Hospital in Ouagadougou, Burkina Faso. Eligibility criteria for the ambulatory surgery program included >1 year of age, American Society of Anesthesiologists (ASA) 1 status, surgery with a low risk of bleeding, lasting surgery, of whom 515 were elective cases; 115 of these met the criteria for ambulatory surgery; 103 patients, with an average age of 59.74 ± 41.57 months, actually underwent surgery. The principal indications for surgery were inguinal (62) and umbilical (47) hernias. All patients had general anesthesia with halothane. Sixty-five percent also received regional or local anesthesia consisting of caudal block in 79.23% or nerve block in 20.77%. The average duration of surgery was 33 ± 17.47 minutes. No intraoperative complications were noted. All the patients received acetaminophen and a nonsteroidal anti-inflammatory drug in the recovery room. Twelve (11.7%) patients had complications in recovery, principally nausea and vomiting. Eight (7.8%) patients were admitted to the hospital. No serious complications were associated with ambulatory surgery. Its introduction could possibly be a solution to improving pediatric surgical access in low-income countries.

  4. Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    Full Text Available CONTEXT AND OBJECTIVE: Taking the outcome of mortality into consideration, there is controversy about the beneficial effects of neuraxial anesthesia for orthopedic surgery. The aim of this study was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for orthopedic surgery. DESIGN AND SETTING: Systematic review at Universidade Federal de Alagoas. METHODS: We searched the Cochrane Central Register of Controlled Trials (Issue 10, 2012, PubMed (1966 to November 2012, Lilacs (1982 to November 2012, SciELO, EMBASE (1974 to November 2012 and reference lists of the studies included. Only randomized controlled trials were included. RESULTS: Out of 5,032 titles and abstracts, 17 studies were included. There were no statistically significant differences in mortality (risk difference, RD: -0.01; 95% confidence interval, CI: -0.04 to 0.01; n = 1903, stroke (RD: 0.02; 95% CI: -0.04 to 0.08; n = 259, myocardial infarction (RD: -0.01; 95% CI: -0.04 to 0.02; n = 291, length of hospitalization (mean difference, -0.05; 95% CI: -0.69 to 0.58; n = 870, postoperative cognitive dysfunction (RD: 0.00; 95% CI: -0.04 to 0.05; n = 479 or pneumonia (odds ratio, 0.61; 95% CI: 0.25 to 1.49; n = 167. CONCLUSION: So far, the evidence available from the studies included is insufficient to prove that neuraxial anesthesia is more effective and safer than general anesthesia for orthopedic surgery. However, this systematic review does not rule out clinically important differences with regard to mortality, stroke, myocardial infarction, length of hospitalization, postoperative cognitive dysfunction or pneumonia.

  5. Oxidative stress markers in Thoroughbred horses after castration surgery under inhalation anesthesia.

    Science.gov (United States)

    Tsuzuki, Nao; Sasaki, Naoki; Kusano, Kanichi; Endo, Yoshiro; Torisu, Shidow

    2016-01-01

    Oxidative stress has been reported to occur during surgery. It is important to reduce intraoperative oxidative stress to improve the postoperative prognosis. However, there are no reports regarding oxidative stress related to surgery in horses. In the present study, we measured pre and postsurgical diacron-reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP); the oxidative stress index (OSI) was then calculated (OSI=d-ROMs/BAP × 100). d-ROMs were not significantly different between the pre and postsurgical periods. However, BAP significantly decreased after surgery (P=0.02), and OSI significantly increased after surgery (P=0.02). Based on these results, it suggested that castration surgery under inhalation anesthesia decreases the antioxidant potential and causes oxidative stress in horses.

  6. 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.

  7. To ventilate or not after minimally invasive direct coronary artery bypass surgery : The role of epidural anesthesia

    NARCIS (Netherlands)

    de Vries, AJ; Mariani, MA; van der Maaten, JMAA; Loef, BG; Lip, H

    2002-01-01

    Objective: To evaluate the effect of immediate postoperative extubation and postoperative ventilation after minimally invasive direct coronary artery bypass (MIDCAB) surgery and to assess the role of epidural anesthesia. Design: Randomized prospective study. Setting: University hospital, single inst

  8. Use of a Combination of Regional and General Anesthesia during Emergency Thoracic Surgery

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    V. Kh. Sharipova

    2015-01-01

    Full Text Available Objective: to elaborate multimodal anesthetic regimens and to evaluate their efficiency during emergency thoracic surgeries for varying injuries. Subjects and methods. A total of 116 patients emergently admitted to the Republican Research Center for Emergency Medical Care for chest traumatic injuries were examined and divided into 3 groups according to the mode of anesthesia. Results. Perioperative multimodal anesthetic regimens for emergency thoracic surgery, which involved all components of the pathogenesis of pain, were elaborated. Conclusion. The combination of regional and general anesthesia contributes to the smooth course of an intra operative period with minimal hemodynamic stress and it is cost effective in decreasing the use of narcotic anal gesics in the intraoperative period. 

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

    Science.gov (United States)

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

    2017-12-01

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

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

    OpenAIRE

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

    2005-01-01

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

  11. The effects of sevoflurane and propofol anesthesia on cerebral oxygenation in gynecological laparoscopic surgery

    OpenAIRE

    Kim, Sung-Jin; Kwon, Jae Young; Cho, Ah-Reum; Kim, Hae Kyu; Kim, Tae Kyun

    2011-01-01

    Background Both the Trendelenburg position and pneumoperitoneum with carbon dioxide have been reported to increase intracranial pressure (ICP) and to alter cerebral blood flow or cerebral blood volume. Also anesthetic agents have variable effects on cerebral hemodynamics and ICP. The present study was conducted to determine whether regional cerebral oxygen saturation (rSO2) values differ between propofol and sevoflurane anesthesia during laparoscopic surgery in the Trendelenburg position. Met...

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

    Science.gov (United States)

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

    2017-01-01

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

  13. Parotitis after epidural anesthesia in plastic surgery: report of three cases.

    Science.gov (United States)

    Rosique, Marina Junqueira Ferreira; Rosique, Rodrigo Gouvea; Costa, Ilson Rosique; Lara, Brunno Rosique; Figueiredo, Jozé Luiz Ferrari; Ribeiro, Davidson Gomes Barbosa

    2013-08-01

    Acute swelling of the parotid glands after general anesthesia has become known as anesthesia mumps. Its cause is unknown. Only one case of postsurgical parotitis without general anesthesia is reported. This report describes three cases in this setting after plastic surgery. A 37-year-old women underwent breast surgery and abdominoplasty with a dual thoracic/lumbar epidural block (bupivacaine 0.5 %). The operative time totaled almost 6 h. Subsequently, 4 h after surgery, the patient experienced painless bilateral parotid swelling without palpable crepitus. The edema resolved completely within 12 h under clinical observation and parenteral hydration. A 45-year-old patient received subglandular breast implants and body contouring with liposuction, all with the patient under a dual thoracic/lumbar epidural block with 0.5 % marcaine. The total surgical time was 5 h. Subsequently, 3 h after surgery, the patient experienced a similar clinical presentation. The problem resolved completely in 36 h with clinical observation and parenteral hydration. CASE 3: A 30-year-old patient received a subglandular breast implant and underwent liposuction of the outer thighs using a dual thoracic/lumbar epidural block with lidocaine 1 %. The duration of surgery was 1 h. Subsequently, 5 h postoperatively, the patient experienced a similar clinical presentation. Dexamethasone and parenteral hydration were administered. The problem resolved completely in 48 h without sequelae. The occurrence of parotitis in patients undergoing surgery under epidural anesthesia is a novel situation, which increases the range of possible etiologies for this little known condition. Dehydration leading to transient parotid secretion obstruction may play a significant role. Further reports of parotitis occurring in the regional anesthesia setting are expected to help elucidate its pathophysiology. This journal requires that authors assign a level of evidence to each article. For a full description of

  14. Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery

    Directory of Open Access Journals (Sweden)

    Hiroaki Kawano

    2016-02-01

    Full Text Available BACKGROUND: We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. METHODS: Patients were randomly divided into three groups: those maintained with sevoflurane (Group S, n = 42, propofol (Group P, n = 42, or combined propofol and sevoflurane (Group PS, n = 42. We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use, incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24 h after surgery. RESULTS: The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2 h (74%, 76% and 43%, respectively, p = 0.001 and 0-24 h (71%, 76% and 38%, respectively, p < 0.0005. The incidence of nausea at 0-2 h (Group S = 57%, Group P = 26% and Group PS = 21%, p = 0.001 and 0-24 h (Group S = 62%, Group P = 29% and Group PS = 21%, p < 0.0005 was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24 h. CONCLUSION: Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. We term this novel method of anesthesia "combined intravenous-volatile anesthesia (CIVA".

  15. [Simplified topical anesthesia protocol for ambulatory cataract surgery: safety and patient and surgeon satisfaction].

    Science.gov (United States)

    Batta, B; Fuchs-Buder, T; Tréchot, F; Angioi, K

    2014-09-01

    The purpose of our study was to assess safety and efficacy of cataract surgery (CS) under topical anesthesia alone, i.e. without pre-anesthetic evaluation and without direct presence of an anesthesiologist. To this end we assessed the incidence of patients' preoperative anxiety, perioperative adverse events and patients' and surgeons' satisfaction. Patients undergoing CS under topical anesthesia over a one-month period were included. An anesthesiologist and nurse anesthetist were present in the area and could intervene in case of an adverse event. Patients' anxiety was scored using the Amsterdam Preoperative Anxiety & Information Scale (APAIS), and their satisfaction with the Iowa Satisfaction with Anesthesia Scale (ISAS). Surgeons' satisfaction was scored with a VAS from 0 to 10 (0: surgery not possible & 10: excellent surgical conditions). One hundred and twenty-four consecutive patients were included; mean age was 71 (±9.4) years. Mean APAIS I was 6.4/20 (±3.7). Mean APAIS II was 3.1 (±1.8). Mean ISAS score was 5.5/6 (±0.6), indicating high patient satisfaction. Surgeon satisfaction score was 8.9/10 (±1.7). Twenty-three adverse events occurred of which 16 required interventions by the anaesthesiologist or surgeon: 5 supplemental local or regional anaesthesia, 6 iv-analgesia, 5 management of hypertension. These preliminary data suggest that a simplified topical anesthesia protocol for ambulatory CS appears to be feasible and safe, as long as an anesthesia team is present in the area to intervene if needed. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  16. Efficacy of sevoflurane as an adjuvant to propofol-based total intravenous anesthesia for attenuating secretions in ocular surgery.

    Science.gov (United States)

    Lai, Hou-Chuan; Chang, Yun-Hsiang; Huang, Ren-Chih; Hung, Nan-Kai; Lu, Chueng-He; Chen, Jou-Hsiu; Wu, Zhi-Fu

    2017-04-01

    The incidence of nasal secretions into the operative field is as high as 5% in ophthalmic surgery under general anesthesia. It may induce postoperative endophthalmitis. Secretions under propofol-based total intravanous anesthesia (TIVA) are greater than sevoflurane anesthesia during surgery. Postoperative nausea and vomiting (PONV) after inhalational anesthesia is higher than TIVA and may increase intraocluar pressure. We investigated the effect of sevoflurane combination with propofol-based TIVA on nasopharyngeal secretions and PONV in ocular surgery. Fifty patients undergoing ocular operations were randomly assigned for propofol-based TIVA or propofol/sevoflurane anesthesia. In the TIVA group (n = 25), anesthesia was induced and maintained with propofol and fentanyl; in the propofol/sevoflurane group (n = 25), 1% sevoflurane anesthesia was added. Nasopharyngeal excretion volume was significantly higher in the propofol-based TIVA group than in the propofol/sevoflurane group (31.0 ± 18.1 vs 13.7 ± 12.6 ml; P propofol-based TIVA: 6.4 ± 3.6 vs propofol/sevoflurane: 7.4 ± 3.0 minutes; P = .34). No postoperative endophthalmitis or PONV in both groups was observed. Sevoflurane attenuated secretions under propofol-based TIVA and did not increase the incidence of PONV or prolonged extubation in ocular surgery.

  17. Audiovisual distraction as a useful adjunct to epidural anesthesia and sedation for prolonged lower limb microvascular orthoplastic surgery.

    Science.gov (United States)

    Athanassoglou, Vassilis; Wallis, Anna; Galitzine, Svetlana

    2015-11-01

    Lower limb orthopedic operations are frequently performed under regional anesthesia, which allows avoidance of potential side effects and complications of general anesthesia and sedation. Often though, patients feel anxious about being awake during operations. To decrease intraoperative anxiety, we use multimedia equipment consisting of a tablet device, noise-canceling headphones, and a makeshift frame, where patients can listen to music, watch movies, or occupy themselves in numerous ways. These techniques have been extensively studies in minimally invasive, short, or minor procedures but not in prolonged orthoplastic operations. We report 2 cases where audiovisual distraction was successfully applied to 9.5-hour procedures, proved to be a very useful adjunct to epidural anesthesia + sedation, and made an important contribution to positive patients' outcomes and overall patients' experience with regional anesthesia for complex limb reconstructive surgery. In the era when not only patients' safety and clinical outcomes but also patients' positive experiences are of paramount importance, audiovisual distraction may provide a simple tool to help improve experience of appropriately informed patients undergoing suitable procedures under regional anesthesia. The anesthetic technique received a very positive appraisal by both patients and encouraged us to study further the impact of modern audiovisual technology on anxiolysis for major surgery under regional anesthesia. The duration of surgery per se is not a contraindication to the use of audiovisual distraction. The absolute proviso of successful application of this technique to major surgery is effective regional anesthesia and good teamwork between the clinicians and the patients.

  18. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System

    Science.gov (United States)

    D'Antò, Vincenzo; Fauxpoint, Gabriel; De Rosa, Sara; Vallogini, Giulia

    2017-01-01

    Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years), requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system) and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal–Wallis) for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe. PMID:28293129

  19. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System

    Directory of Open Access Journals (Sweden)

    Annelyse Garret-Bernardin

    2017-01-01

    Full Text Available Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years, requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal–Wallis for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe.

  20. Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System.

    Science.gov (United States)

    Garret-Bernardin, Annelyse; Cantile, Tiziana; D'Antò, Vincenzo; Galanakis, Alexandros; Fauxpoint, Gabriel; Ferrazzano, Gianmaria Fabrizio; De Rosa, Sara; Vallogini, Giulia; Romeo, Umberto; Galeotti, Angela

    2017-01-01

    Aim. To evaluate the pain experience and behavior during dental injection, using the Wand computerized delivery system versus conventional local anesthesia in children and adolescents. Methods. An observational crossover split mouth study was performed on 67 patients (aged 7 to 15 years), requiring local anesthesia for dental treatments in both sides of the dental arch. Patients received both types of injections in two separate appointments, one with the use of a Computer Delivery System (the Wand STA system) and one with the traditional syringe. The following data were recorded: pain rating; changes in heart rate; level of collaboration; patient satisfaction. The data were analyzed using ANOVA for quantitative outcomes and nonparametric analysis (Kruskal-Wallis) for qualitative parameters. Results. The use of the Wand system determined significantly lower pain ratings and lower increase of heart rate than the traditional syringe. During injection, the number of patients showing a relaxed behavior was higher with the Wand than with the traditional local anesthesia. The patient level of satisfaction was higher with the Wand compared to the conventional local anesthesia. Conclusions. The Wand system may provide a less painful injection when compared to the conventional local anesthesia and it seemed to be better tolerated with respect to a traditional syringe.

  1. Continuous spinal anesthesia versus combined spinal epidural block for major orthopedic surgery: prospective randomized study

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    Full Text Available CONTEXT AND OBJECTIVES: In major orthopedic surgery of the lower limbs, continuous spinal anesthesia (CSA and combined spinal epidural anesthesia (CSE are safe and reliable anesthesia methods. In this prospective randomized clinical study, the blockading properties and side effects of CSA were compared with single interspace CSE, among patients scheduled for major hip or knee surgery. DESIGN AND SETTING: Prospective clinical study conducted at the Institute for Regional Anesthesia, Hospital de Base, São José do Rio Preto. METHODS: 240 patients scheduled for hip arthroplasty, knee arthroplasty or femoral fracture treatment were randomly assigned to receive either CSA or CSE. Blockades were performed in the lateral position at the L3-L4 interspace. Puncture success, technical difficulties, paresthesia, highest level of sensory and motor blockade, need for complementary doses of local anesthetic, degree of technical difficulties, cardiocirculatory changes and postdural puncture headache (PDPH were recorded. At the end of the surgery, the catheter was removed and cerebrospinal fluid leakage was evaluated. RESULTS: Seven patients were excluded (three CSA and four CSE. There was significantly lower incidence of paresthesia in the CSE group. The resultant sensory blockade level was significantly higher with CSE. Complete motor blockade occurred in 110 CSA patients and in 109 CSE patients. Arterial hypotension was observed significantly more often in the CSE group. PDPH was observed in two patients of each group. CONCLUSION: Our results suggest that both CSA and CSE provided good surgical conditions with low incidence of complications. The sensory blockade level and hemodynamic changes were lower with CSA.

  2. Quality of recovery from anesthesia in patients undergoing orthopedic surgery of the lower limbs.

    Science.gov (United States)

    Moro, Eduardo Toshiyuki; Silva, Manoel Arthur Nóbrega da; Couri, Marcelo Gouvêa; Issa, Danielle da Silva; Barbieri, Julia Morais

    For patients undergoing regional anesthesia for orthopedic surgery, a common situation in our work environment, the quality of recovery may be influenced in different ways, which justifies studies to identify possible predictive factors of dissatisfaction. The aim of this study was to assess the opinion of patients on recovery from anesthesia for lower limb orthopedic surgeries. We also identified potential predictive factors for poor quality of recovery. We evaluated patients undergoing lower limb orthopedic surgeries and able to participate in the study. Data related to surgery, anesthesia, possible complications in the post-anesthetic care unit (PACU) and in the ward were recorded. In the morning after surgery, patients were evaluated by a medical student who applied the QoR-40 questionnaire. The resulted score-between 40 and 200-was used to determine the quality of recovery and identify the potential predictors. We evaluated 172 patients. The questionnaire average score was 192 points. The chance to have lower scores in the QoR-40 was two times higher among males. Patients who remained under sedation, classified as greater than or equal to 4 on the scale proposed by Ramsay, had a 3.5 times higher risk of having lower scores in the QoR-40 compared to those who remained with level 1 or 2 of sedation. Regarding pain, at every increase of one unit in the numerical scale (0-10), there was a 19% increase in risk for QoR-40≤195. Similarly, the risk for a score below the median was 2.3 times higher among those presenting with nausea and/or vomiting in the ward. Male, nausea, vomiting, pain while in the ward, and deeper levels of sedation are possible predictive factors for lower scores according to the adopted instrument. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  3. [Quality of recovery from anesthesia in patients undergoing orthopedic surgery of the lower limbs].

    Science.gov (United States)

    Moro, Eduardo Toshiyuki; Silva, Manoel Arthur Nóbrega da; Couri, Marcelo Gouvêa; Issa, Danielle da Silva; Barbieri, Julia Morais

    For patients undergoing regional anesthesia for orthopedic surgery, a common situation in our work environment, the quality of recovery may be influenced in different ways, which justifies studies to identify possible predictive factors of dissatisfaction. The aim of this study was to assess the opinion of patients on recovery from anesthesia for lower limb orthopedic surgeries. We also identified potential predictive factors for poor quality of recovery. We evaluated patients undergoing lower limb orthopedic surgeries and able to participate in the study. Data related to surgery, anesthesia, possible complications in the post-anesthetic care unit (PACU) and in the ward were recorded. In the morning after surgery, patients were evaluated by a medical student who applied the QoR-40 questionnaire. The resulted score-between 40 and 200-was used to determine the quality of recovery and identify the potential predictors. We evaluated 172 patients. The questionnaire average score was 192 points. The chance to have lower scores in the QoR-40 was two times higher among males. Patients who remained under sedation, classified as greater than or equal to 4 on the scale proposed by Ramsay, had a 3.5 times higher risk of having lower scores in the QoR-40 compared to those who remained with level 1 or 2 of sedation. Regarding pain, at every increase of one unit in the numerical scale (0-10), there was a 19% increase in risk for QoR-40 ≤ 195. Similarly, the risk for a score below the median was 2.3 times higher among those presenting with nausea and/or vomiting in the ward. Male, nausea, vomiting, pain while in the ward, and deeper levels of sedation are possible predictive factors for lower scores according to the adopted instrument. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. [Effect of dexmedetomidine infusion on postoperative recovery for patients undergoing major spinal surgery during propofol anesthesia].

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    Li, B Y; Geng, Z Y; Wang, D X

    2016-06-18

    To evaluate the effect of intraoperative dexmedetomidine (DEX) infusion during propofol intravenous anesthesia on postoperative recovery after major spinal surgery. Sixty patients aged 18 to 65 (American Society of Anesthesiologists, ASA I-II), scheduled for spinal surgery from January 2014 to May 2014 were randomized into two groups. The DEX group (n=30) received 0.5 μg/kg of DEX ten minutes before anesthesic induction, followed by an infusion of DEX at 0.2 μg/(kg×h) intraoperatively and the control group (n=30) was given identical amounts of normal saline. At the end of surgery, the patients of both groups received patient-controlled intravenous analgesia (PCIA) with morphine 0.5 mg/h (1 mg demand dose and 8 min lockout). Heart rate and mean arterial pressure (MAP) were continually monitored during operation and in the post-anesthesia care unit (PACU). The propofol and sufentanil consumptions during operation and the morphine consumption 48 h after surgery were recorded. The time for recovery and extubation were recorded. The followed-up evaluations were performed to assess Ramsay scores, visual analogue scale (VAS) pain scores as well as side effects in PACU and 48 h after surgery. Heart rate of DEX group was lower than that of control group after intubation and extubation and in PACU 10 min (Panesthesic induction, the sufentanil consumption during operation and the cumulative consumption of morphine 2 h and 6 h after surgery were decreased (P<0.05). There were no differences between the two groups as to the time for recovery or extubation. Compared with control group, the VAS pain scores were significantly decreased (P<0.01), the incidence of postoperative nausea and vomiting in DEX group were significantly decreased (P<0.05) 48 h after surgery. Intraoperative infusion of DEX improved quality of recovery, provided good analgesia, and decreased morphine use and the incidence of postoperative nausea and vomiting after major spinal surgery.

  5. [Percutaneous Endovascular Aortic Repair with Local Anesthesia - One Day Surgery].

    Science.gov (United States)

    Sousa, Joel; Brandão, Daniel; Barreto, Paulo; Ferreira, Joana; Almeida Lopes, José; Mansilha, Armando

    2016-06-01

    Introdução: Avaliar os resultados do tratamento endovascular do aneurisma da aorta abdominal (EVAR) por via percutânea e anestesia local, segundo o conceito de one day surgery.Material e Métodos: Análise retrospetiva, unicêntrica dos doentes com doença aneurismática aorto-ilíaca, consecutivamente submetidos a tratamento endovascular do aneurisma da aorta abdominal por via percutânea (pEVAR) pela técnica de Preclose, seguindo critérios de ambulatorização com pernoita após o procedimento. O sucesso técnico, exclusão do saco aneurismático, endoleak, reintervenção e tempo de internamento foram avaliados.Resultados: Vinte doentes consecutivos (todos homens, idade média 74,65 anos) foram tratados por pEVAR e anestesia local, dos quais 95% (19) apresentavam aneurisma da aorta abdominal e 5% (1) aneurisma da artéria ilíaca comum. Todos os implantes foram realizados com sucesso, com uma taxa de endoleak inicial de 10% (2), à custa de um endoleak 1a corrigido intraoperatoriamente com sucesso, e um endoleak 2a diagnosticado na primeira angio-tomografia computorizada pós-operatória, que selou espontaneamente no controlo aos 6 meses. O sucesso técnico inicial do encerramento percutâneo foi de 97,5%, com um caso reportado de pseudo-aneurisma femoral, corrigido posteriormente por injeção percutânea de trombina. A mediana de internamento foi de 1 dia [1-10], com follow-up médio de 11,4 meses [1-36]. A reintervenção e mortalidade são de 0% no período descrito. Conclusão: O tratamento ambulatório do aneurisma da aorta abdominal por via endovascular com acesso percutâneo segundo o nosso modelo de one day surgery é inovador, seguro e eficaz, respeitando os critérios de seleção.

  6. Thoracic and lumbar spinal surgery under local anesthesia for patients with multiple comorbidities: A consecutive case series

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    Muhammad Babar Khan

    2014-01-01

    Full Text Available Background: Although some patients with symptomatic spinal disease may benefit greatly from surgery, their multiple attendant comorbidities may make general anesthesia risky or contraindicated. However, there is scarce literature describing the efficacy and safety of local anesthesia to perform these operations. Here we report seven patients who successfully underwent spinal surgery utilizing local anesthesia to limit the risks and complications of general anesthesia. Methods: Seven patients for whom general anesthesia was contraindicated were prospectively followed for a minimum of 3 months following spinal surgery performed under local anesthesia. Pain and functional improvement were assessed utilizing the Visual Analog Scores (VAS and Oswestry Disability Index (ODI scores. Results: Five patients had interlaminar decompressions for stenosis alone, while two patients had laminectomies for debulking of tumors. The mean duration of surgery was 79.8 ± 16.6 min, the mean estimated blood loss was 157.1 ± 53.4 ml, the mean dose of local anesthetic was 1.9 ± 0.7 mg/kg, and the mean length of hospital stay after surgery was 3.2 ± 1.2 days. There were no intraoperative complications. The surgery resulted in improved VAS and ODI scores consistent with significant improvement in pain (P = 0.017 and functionality (P = 0.011. Conclusions: Performing spinal surgery under local anesthesia is a safe and effective alternative when patient′s major comorbidities preclude a general anesthetic. For all the seven patients studied, spinal surgery, performed under a local anesthetic, resulted in a statistically significant reduction in pain and improvement in function.

  7. Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery.

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    Siriphuwanun, Visith; Punjasawadwong, Yodying; Lapisatepun, Worawut; Charuluxananan, Somrat; Uerpairojkit, Ketchada

    2014-01-01

    To determine the incidence of and factors associated with perioperative cardiac arrest within 24 hours of receiving anesthesia for emergency surgery. 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 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, Psurgery (upper intra-abdominal, RR =2.67, CI =2.14-3.33, Pcardiac, RR =3.61, CI =2.60-4.99, Pcardiac arrest within 24 hours of anesthesia for emergency surgery was high and associated with multiple factors such as young age (≤2 years old), cardiovascular and respiratory comorbidities, increasing ASA physical status classification, preoperative shock, and surgery site. Perioperative care providers, including surgeons, anesthesiologists, and nurses, should be prepared to manage promptly this high risk group of surgical patients.

  8. Visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery

    Institute of Scientific and Technical Information of China (English)

    Wei-Qi; Chen; Vishal; Jhanji; Hao-Yu; Chen; Gui-Hua; Zhang; Ping; Hou

    2014-01-01

    AIM:To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery.METHODS:In this prospective case series, consecutive patients who underwent combined phacoemulsification and pars plana vitrectomy(PPV) under sub-Tenon anesthesia between October 2008 and September 2009 were enrolled. The patients were asked whether they could see the light of the operating microscope or not between various surgical steps with their contralateral eye being covered.RESULTS:A total of 163 eyes of 163 patients were enrolled in this study. After their contralateral eyes were covered, 152(93.3%) patients said that they could not see any light at least during one of the surgical steps. All eyes recovered to at least light perception on the first postoperative day. The incidence of no light perception during the surgery was not related to demographic factors, including age, gender, or type of ocular diseases.CONCLUSION:The incidence of no light perception during combined phacoemulsification and vitrectomy under sub-Tenon anesthesia was high in our study.Patients should be duly informed about this temporary but potential intraoperative event.

  9. The feasibility of sugammadex for general anesthesia and facial nerve monitoring in patients undergoing parotid surgery

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    I-Cheng Lu

    2017-08-01

    Fifty patients undergoing parotid surgery were randomized allocated into conventional anesthesia group (Group C, n = 25 and sugammadex group (Group S, n = 25. Group C did not receive any NMBA. Group S received rocuronium 0.6 mg/kg at anesthesia induction and sugammadex 2 mg/kg at skin incision. The intubating condition and influence on FNM evoked EMG results were compared between groups. The intubation condition showed significantly better in group S patients than C group patients (excellent in 96% v.s. 24%. In group S, rapid reverse of NMB was found and the twitch (% recovered from 0 to >90% within 10 min. Positive and high EMG signals were obtained in all patients at the time point of initial facial nerve stimulation in both groups. There was no significant difference as comparing the EMG amplitudes detected at the time point of initial and final facial nerve stimulation in both groups. Implementation of sugammadex in anesthesia protocol is feasible and reliable for successful FNM during parotid surgery.

  10. 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.

  11. The comparison of combined femoral-sciatic nerve block with spinal anesthesia at lower extremity surgery

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    Selim Almaz

    2014-06-01

    Full Text Available Introduction: In this study, we aimed to compare the spinal anesthesia technique with combined femoral-sciatic block technique in patients undergoing lower limb surgery. Methods: In this study, after obtaining the approval of the Dicle University Faculty of Medicine Ethics Committee, scheduled for elective lower extremity surgery, the ASA 1-2 groups, between the ages of 18-65, 60 patients were enrolled. Study was planned as a prospective, randomized and controlled. Patients were randomly divided into 2 groups as the spinal anesthesia (Group S and combined sciatic-femoral nerve block (Group CSF to be. Results: Demographic data similar between the groups (p> 0.05. The implementation period of the technique was long in the Group CSF compared with in the Group S (p <0.001. Surgery delivery time was shorter in the Group S compared with in the Group CSF (p <0.001. The time of motor block occurrence was longer in the Group CSF compared with in the Group S (p <0.001. The duration of motor block was long in the Group CSF compared with in the Group S (p <0.001. Conclusion: The each of two methods is safe and effective in lower extremity orthopedic surgery, but the application of peripheral nerve block to provide the long-term advantages such as postoperative analgesia and reducing postoperative analgesic consumption. J Clin Exp Invest 2014; 5 (2: 443-446

  12. Antidepressant treatment with MAO-inhibitors during general and regional anesthesia: a review and case report of spinal anesthesia for lower extremity surgery without discontinuation of tranylcypromine.

    Science.gov (United States)

    Krings-Ernst, Ilana; Ulrich, Sven; Adli, Mazda

    2013-10-01

    Monoamine oxidase-(MAO)-inhibitors are a treatment of last resort in treatment resistant depression, which is regarded as a condition of increased psychiatric risk. General and regional anesthesia for elective surgery during use of long-term MAO-inhibitors remains a matter of debate because of an increased risk of drug interactions and decreased sympathetic stability. A series of case reports and new comparative studies reveal the safety of anesthesia/analgesia in non-cardiac surgery without discontinuation of the MAO-inhibitor if best effort is made for maintenance of sympathetic homeostasis and if known drug interactions are avoided. Very few reports with severe adverse incidents have been noted. Severe cardiovascular morbidity, a contraindication of MAO-inhibitors, probably contributed to peri- and postoperative complications. According to new studies, the risk of pharmacokinetic drug interactions is lower for tranylcypromine than for phenelzine. In the present case, a 66-year-old psychiatric patient on permanent treatment with 20 mg/day tranylcypromine was admitted for forefoot surgery. Anesthetic premedication consisted of 7.5 mg oral midazolam. Intravenous midazolam (0.5 mg) was dispensed for intraoperative sedation. After local anesthesia of the puncture site with 30 mg isobar prilocaine, spinal anesthesia was achieved by a single shot of 13.5 mg hyperbar bupivacaine (0.5%) intrathecally. Postoperative regional and general analgesia were accomplished by a peripheral nerve block with 50 mg isobar bupivacaine as well as oral etoricoxib and oxycodone. No peri- or postoperative complications were encountered. It is concluded that general or regional anesthesia for noncardiac surgery without discontinuation of MAO-inhibitor treatment may be a safe intervention after careful evaluation of an individual's perioperative and psychiatric risk. The increased psychiatric risk in patients treated with MAO-inhibitors outweighs the increased, however manageable

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

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    Ertan Piri

    2014-03-01

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

  14. Technical aspects of anesthesia and cardiopulmonary bypass in patients undergoing totally thoracoscopic cardiac surgery.

    Science.gov (United States)

    Zhang, Zong-Wang; Zhang, Xue-Jun; Li, Chang-Ying; Ma, Long-Le; Wang, Le-Xin

    2012-04-01

    The use of fast-track general anesthesia in patients undergoing nonrobotically assisted and totally thoracoscopic cardiac surgeries has not been previously reported previously. A prospective clinical study. A university hospital. Ninety-six patients (41 males; mean age, 13.2 ± 6.2 years; range, 5-47 years). Nonrobotically assisted totally thoracoscopic surgeries were performed for atrial (n = 58) or ventricular septal defect (n = 32), tetralogy of Fallot (n = 2), left atrial myxoma (n = 3), and pulmonary valve stenosis (n = 1). Fast-track general anesthesia was induced with midazolam, propofol, fentanyl, and vecuronium and was maintained with remifentanil and sevoflurane. Cardiopulmonary bypass was established peripherally through the femoral vein and artery. All surgeries were successful. There were no perioperative mortality or major complications. The mean cardiopulmonary bypass and aortic cross-clamp times were 42 ± 21 minutes and 33 ± 8 minutes, respectively. In 82 cases, the heart regained beats automatically after the release of the aortic cross-clamp, whereas in 14 patients external defibrillation was required. Extubation was conducted in 32 patients (33.3%) in the operating room 15 minutes after the operation. The mean times of mechanical ventilation and stay in the intensive care unit were 1.5 ± 0.2 hours and 20.1 ±1.2 hours, respectively. Cardiopulmonary bypass for totally thoracoscopic cardiac surgery can be established through the femoral artery and femoral vein. With fast-track anesthesia, early extubation in the operating room can be achieved in more than one third of patients. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  15. The effect of neuraxial anesthesia on cancer recurrence and survival after cancer surgery: an updated meta-analysis

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    Weng, Meilin; Chen, Wankun; Hou, Wenting; Li, Lihong; Ding, Ming; Miao, Changhong

    2016-01-01

    Several animal and observational studies have evaluated the effects of neuraxial anesthesia on the recurrence and survival of cancer surgery; studies reported benefit, whereas others did not. To provide further evidence that neuraxial anesthesia(combined with or without general anesthesia (GA))may be associated with reduced cancer recurrence and long-term survival after cancer surgery, we conducted this meta-analysis. A total of 21 studies were identified and analyzed, based on searches conducted using PubMed, Web of Science, EMBASE database and the Cochrane Database of Systematic Reviews. After data abstraction, adjusted hazard ratios (HR) with 95% confidence intervals (CIs) were used to assess the impact of neuraxial anesthesia (combined with or without GA) and GA on oncological outcomes after cancer surgery. For overall survival (OS), a potential association between neuraxial anesthesia and improved OS (HR 0.853, CI 0.741-0.981, P = 0.026, the random-effects model) was observed compared with GA. Specifically, we found a positive association between neuraxial anesthesia and improved OS in colorectal cancer (HR 0.653, CI 0.430-0.991, P = 0.045, the random-effects model). For recurrence-free survival (RFS), a significant association between neuraxial anesthesia and improved RFS (HR 0.846, CI 0.718-0.998, P = 0.047, the random-effects model) was detected compared with GA. Our meta-analysis suggests that neuraxial anesthesia may be associated with improved OS in patients with cancer surgery, especially for those patients with colorectal cancer. It also supports a potential association between neuraxial anesthesia and a reduced risk of cancer recurrence. More prospective studies are needed to elucidate whether the association between neuraxial use and survival is causative. PMID:26918830

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

    Science.gov (United States)

    Walker, Amy; Stokes, Monica; Moriarty, Anthony

    2009-02-01

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

  17. Exposure to Surgery and Anesthesia After Concussion Due to Mild Traumatic Brain Injury.

    Science.gov (United States)

    Abcejo, Arnoley S; Savica, Rodolfo; Lanier, William L; Pasternak, Jeffrey J

    2017-07-01

    To describe the epidemiology of surgical and anesthetic procedures in patients recently diagnosed as having a concussion due to mild traumatic brain injury. Study patients presented to a tertiary care center after a concussion due to mild traumatic brain injury from July 1, 2005, through June 30, 2015, and underwent a surgical procedure and anesthesia support under the direct or indirect care of a physician anesthesiologist. During the study period, 1038 patients met all the study inclusion criteria and subsequently received 1820 anesthetics. In this population of anesthetized patients, rates of diagnosed concussions due to sports injuries, falls, and assaults, but not motor vehicle accidents, increased during 2010-2011. Concussions were diagnosed in 965 patients (93%) within 1 week after injury. In the 552 patients who had surgery within 1 week after concussive injury, 29 (5%) had anesthesia and surgical procedures unrelated to their concussion-producing traumatic injury. The highest use of surgery occurred early after injury and most frequently required general anesthesia. Orthopedic and general surgical procedures accounted for 57% of procedures. Nine patients received 29 anesthetics before a concussion diagnosis, and all of these patients had been involved in motor vehicle accidents and received at least 1 anesthetic within 1 week of injury. Surgical and anesthesia use are common in patients after concussion. Clinicians should have increased awareness for concussion in patients who sustain a trauma and may need to take measures to avoid potentially injury-augmenting cerebral physiology in these patients. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  18. Awakening from anesthesia using propofol or sevoflurane with epidural block in radical surgery for senile gastric cancer.

    Science.gov (United States)

    Zhang, Ling; Chen, Chen; Wang, Lin; Cheng, Gao; Wu, Wei-Wei; Li, Yuan-Hai

    2015-01-01

    To study the awakening of the elderly patients from propofol intravenous general anesthesia or sevoflurane inhalation general anesthesia combined with epidural block after radical gastric cancer surgery. Eighty cases receiving selective radical surgery for gastric cancer were included. They were aged 65-78 years and classified as ASA grade I-II. Using a random number table, the cases were divided into 4 groups (n = 20): propofol intravenous general anesthesia (P group), sevoflurane inhalation general anesthesia (S group), propofol intravenous general anesthesia combined with epidural block (PE group), and sevoflurane inhalation general anesthesia combined with epidural block (SE group). For P and PE group, target controlled infusion of propofol was performed; for S and SE group, sevoflurane was inhaled to induce and maintain general anesthesia; for PE and SE group, before general anesthesia induction, epidural puncture and catheterization at T7-8 was performed. After surgery, perform patient controlled intravenous analgesia (PCIA) or patient controlled epidural analgesia (PCEA), and maintain VAS ≤ 3. The recorded indicators were as follows: time to recovery of spontaneous respiration, time to awakening, time of endotracheal tube removal, time to orientation, time to achieve modified Aldrete scores ≥ 9, modified OAA/S and Aldrete scores upon endotracheal tube removal (T1), 5 min after removal (T2), 15 min after removal (T3) and 30 min after removal (T4), dose of intraoperative remifentanil, intraoperative hypotension, and emergence agitation. Time to awakening, time of endotracheal tube removal, time to orientation, and time to achieve modified Aldrete scores ≥ 9 in PE and SE group were obviously shortened compared with P and S group (P Aldrete scores at T1 and T2 in PE and SE group were significantly higher than those in P and S group (P < 0.05), and the scores of SE group at T1 were much higher compared to PE group (P < 0.05). Dose of intraoperative

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

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    Hagino Tetsuo

    2012-03-01

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

  20. Propofol anesthesia.

    Science.gov (United States)

    Short, C E; Bufalari, A

    1999-05-01

    Although questions may still remain regarding the use of this unique sedative-hypnotic drug with anesthetic properties in high-risk patients, our studies have provided cardiopulmonary and neurological evidence of the efficacy and safety of propofol when used as an anesthetic under normal and selected impaired conditions in the dog. 1. Propofol can be safely and effectively used for the induction and maintenance of anesthesia in normal healthy dogs. Propofol is also a reliable and safe anesthetic agent when used during induced cardiovascular and pulmonary-impaired conditions without surgery. The propofol requirements to induce the safe and prompt induction of anesthesia prior to inhalant anesthesia with and without surgery have been determined. 2. The favorable recovery profile associated with propofol offers advantages over traditional anesthetics in clinical situations in which rapid recovery is important. Also, propofol compatibility with a large variety of preanesthetics may increase its use as a safe and reliable i.v. anesthetic for the induction and maintenance of general anesthesia and sedation in small animal veterinary practice. Although propofol has proven to be a valuable adjuvant during short ambulatory procedures, its use for the maintenance of general anesthesia has been questioned for surgery lasting more than 1 hour because of increased cost and marginal differences in recovery times compared with those of standard inhalant or balanced anesthetic techniques. When propofol is used for the maintenance of anesthesia in combination with a sedative/analgesic, the quality of anesthesia is improved as well as the ease with which the practitioner can titrate propofol; therefore, practitioners are able to use i.v. anesthetic techniques more effectively in their clinical practices. 3. Propofol can induce significant depression of respiratory function, characterized by a reduction in the rate of respiration. Potent alpha 2 sedative/analgesics (e.g., xylazine

  1. Ambulatory hernia surgery under local anesthesia is feasible and safe in obese patients.

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    Acevedo, A; León, J

    2010-02-01

    Ambulatory hernia surgery under local anesthesia is becoming more widely used worldwide. Although many reports include obese patients, there are no studies that report specifically on the feasibility and safety of ambulatory hernia surgery in this category of patients. This paper documents our experience in this respect. The present investigation is an observational study performed at the CRS Hernia Center, Santiago, Chile, on 510 obese and 1,521 non-obese patients with all kinds of hernias susceptible to ambulatory hernia repair under local anesthesia. Both tissue and mesh repairs were performed. Obesity was defined as a body mass index (BMI) greater than 30. Patients with a BMI greater than 45 were excluded from this study. Operative time and pain experienced during the intervention were recorded. During the controls performed by a staff member at the 7th postoperative day, a questionnaire was answered by each patient regarding satisfaction, complaints, and postoperative pain. A second questionnaire was completed on the 30th postoperative day. Satisfaction and pain were both measured by means of a 10-point visual analog scale (VAS). The mean age was similar in both groups (51 years for non-obese and 52 years for obese patients). Obesity was present in 38.3% of women and in 17.5% of men (P ambulatory abdominal wall hernia repair under local anesthesia is feasible in obese patients. Because of the increased length of surgery in these patients, monitored sedation and prophylactic antibiotic cover should be used. The slight decrease in patient satisfaction is balanced by the lower risks and higher costs associated with full general anesthetic.

  2. Pain after major elective orthopedic surgery of the lower limb and type of anesthesia: does it matter?

    Science.gov (United States)

    Pereira, Diogo Luís; Meleiro, Hugo Lourenço; Correia, Inês Araújo; Fonseca, Sara

    Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis. Data collection and pain evaluation questionnaires were performed in three different moments: preoperatively, 24 hours postoperatively and at 6 months after surgery. To characterize pain, Brief Pain Inventory (BPI) was used and SF-12v2 Health survey was used to further evaluate the sample's health status. Forty and three patients were enrolled: 25.6% men and 74.4% women, 51,2% for total knee arthroplasty and48.8% for total hip arthroplasty, with a mean age of 68 years. Surgeries were performed in 25.6% of patients under general anesthesia, 55.8% under neuraxial anesthesia and 18.6% under combined anesthesia. Postoperatively, neuraxial anesthesia had a better pain control. Comparing pain evolution between anesthesia groups, neuraxial anesthesia was associated with a decrease in "worst", "medium" and "now" pain at six months. Combined anesthesia was associated with a decrease of "medium" pain scores at six months. Of the three groups, only those in neuraxial group showed a decrease in level of pain interference in "walking ability". TKA, "worst" pain preoperatively and general were predictors of pain development at six months. Patients with gonarthrosis and severe pain preoperatively may benefit from individualized pre- and intraoperative care, particularly preoperative analgesia and neuraxial anesthesia. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  3. [Pain after major elective orthopedic surgery of the lower limb and type of anesthesia: does it matter?

    Science.gov (United States)

    Pereira, Diogo Luís; Meleiro, Hugo Lourenço; Correia, Inês Araújo; Fonseca, Sara

    Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis. Data collection and pain evaluation questionnaires were performed in three different moments: preoperatively, 24hours postoperatively and at 6 months after surgery. To characterize pain, Brief Pain Inventory (BPI) was used and SF-12v2 Health survey was used to further evaluate the sample's health status. Forty and three patients were enrolled: 25.6% men and 74.4% women, 51,2% for total knee arthroplasty and48.8% for total hip arthroplasty, with a mean age of 68 years. Surgeries were performed in 25.6% of patients under general anesthesia, 55.8% under neuraxial anesthesia and 18.6% under combined anesthesia. Postoperatively, neuraxial anesthesia had a better pain control. Comparing pain evolution between anesthesia groups, neuraxial anesthesia was associated with a decrease in "worst", "medium" and "now" pain at six months. Combined anesthesia was associated with a decrease of "medium" pain scores at six months. Of the three groups, only those in neuraxial group showed a decrease in level of pain interference in "walking ability". TKA, "worst" pain preoperatively and general were predictors of pain development at six months. Patients with gonarthrosis and severe pain preoperatively may benefit from individualized pre- and intraoperative care, particularly preoperative analgesia and neuraxial anesthesia. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Pain after major elective orthopedic surgery of the lower limb and type of anesthesia: does it matter?

    Directory of Open Access Journals (Sweden)

    Diogo Luís Pereira

    Full Text Available Abstract Background and objectives: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. Methods: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA or total hip arthroplasty (THA for osteoarthritis. Data collection and pain evaluation questionnaires were performed in three different moments: preoperatively, 24 hours postoperatively and at 6 months after surgery. To characterize pain, Brief Pain Inventory (BPI was used and SF-12v2 Health survey was used to further evaluate the sample's health status. Results: Forty and three patients were enrolled: 25.6% men and 74.4% women, 51,2% for total knee arthroplasty and48.8% for total hip arthroplasty, with a mean age of 68 years. Surgeries were performed in 25.6% of patients under general anesthesia, 55.8% under neuraxial anesthesia and 18.6% under combined anesthesia. Postoperatively, neuraxial anesthesia had a better pain control. Comparing pain evolution between anesthesia groups, neuraxial anesthesia was associated with a decrease in “worst”, “medium” and “now” pain at six months. Combined anesthesia was associated with a decrease of “medium” pain scores at six months. Of the three groups, only those in neuraxial group showed a decrease in level of pain interference in “walking ability”. TKA, “worst” pain preoperatively and general were predictors of pain development at six months. Conclusions: Patients with gonarthrosis and severe pain preoperatively may benefit from individualized pre- and intraoperative care, particularly preoperative analgesia and neuraxial anesthesia.

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

    Institute of Scientific and Technical Information of China (English)

    叶铁虎; 龚志毅; 金永芳; 王玲; 任洪智; 罗爱伦

    1995-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  7. Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia.

    Science.gov (United States)

    Yamada, Makiko Hardy; Takazawa, Tomonori; Iriuchijima, Nobuhisa; Horiuchi, Tatsuo; Saito, Shigeru

    2016-12-01

    Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. This study investigated the effect of sevoflurane and propofol anesthesia on IOP in the LDP. A total of 28 patients undergoing surgery in the LDP were included. Patients were randomly allocated to sevoflurane or propofol groups. IOP in both eyes was recorded and compared between groups at five time points: after anesthesia induction, after endotracheal intubation, at 5 min and 1 h after a positional change to the LDP, and 5 min after returning to the supine position. In the sevoflurane group, IOP was significantly increased in both dependent and non-dependent eyes 1 h after changing to the LDP. In the propofol group, IOP decreased in both dependent and non-dependent eyes after tracheal intubation, but did not increase after changing to the LDP. The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.

  8. A Theoretical Model of Flow Disruptions for the Anesthesia Team During Cardiovascular Surgery.

    Science.gov (United States)

    Boquet, Albert; Cohen, Tara; Diljohn, Fawaaz; Cabrera, Jennifer; Reeves, Scott; Shappell, Scott

    2017-07-03

    This investigation explores flow disruptions observed during cardiothoracic surgery and how they serve to disconnect anesthesia providers from their primary task. We can improve our understanding of this disengagement by exploring what we call the error space or the accumulated time required to resolve disruptions. Trained human factors students observed 10 cardiac procedures for disruptions impacting the anesthesia team and recorded the time required to resolve these events. Observations were classified using a human factors taxonomy. Of 301 disruptions observed, interruptions (e.g., those events related to alerts, distractions, searching activity, spilling/dropping, teaching moment, and task deviations) accounted for the greatest frequency of events (39.20%). The average amount of time needed for each disruption to be resolved was 48 seconds. Across 49.87 hours of observation, more than 4 hours were spent resolving disruptions to the anesthesia team's work flow. By defining a calculable error space associated with these disruptions, this research provides a conceptual metric that can serve in the identification and design of targeted interventions. This method serves as a proactive approach for recognizing systemic threats, affording healthcare workers the opportunity to mitigate the development and incidence of preventable errors precedently.

  9. Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery.

    Science.gov (United States)

    Kawano, Hiroaki; Ohshita, Naohiro; Katome, Kimiko; Kadota, Takako; Kinoshita, Michiko; Matsuoka, Yayoi; Tsutsumi, Yasuo M; Kawahito, Shinji; Tanaka, Katsuya; Oshita, Shuzo

    2016-01-01

    We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. Patients were randomly divided into three groups: those maintained with sevoflurane (Group S, n=42), propofol (Group P, n=42), or combined propofol and sevoflurane (Group PS, n=42). We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use), incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24h after surgery. The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2h (74%, 76% and 43%, respectively, p=0.001) and 0-24h (71%, 76% and 38%, respectively, p<0.0005). The incidence of nausea at 0-2h (Group S=57%, Group P=26% and Group PS=21%, p=0.001) and 0-24h (Group S=62%, Group P=29% and Group PS=21%, p<0.0005) was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24h. Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. We term this novel method of anesthesia "combined intravenous-volatile anesthesia (CIVA)". Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  10. Anesthesia & Down Syndrome

    Science.gov (United States)

    ... Health Care » Associated Conditions » Anesthesia & Down Syndrome Anesthesia & Down Syndrome Complications of anesthesia (sedation during surgery) occur in ... histories are complicated. Why Would an Individual With Down Syndrome Need A nesthesia? 40-60% of infants born ...

  11. 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, ...

  12. Addition of intrathecal Dexamethasone to Bupivacaine for spinal anesthesia in orthopedic surgery

    Directory of Open Access Journals (Sweden)

    Nadia Bani-hashem

    2011-01-01

    Full Text Available Objectives: Spinal anesthesia has the advantage that profound nerve block can be produced in a large part of the body by the relatively simple injection of a small amount of local anesthetic. Intrathecal local anesthetics have limited duration. Different additives have been used to prolong spinal anesthesia. The effect of corticosteroids in prolonging the analgesic effects of local anesthetics in peripheral nerves is well documented. The purpose of this investigation was to determine whether the addition of dexamethasone to intrathecal bupivacaine would prolong the duration of sensory analgesia or not. Methods: We conducted a randomized, prospective, double-blind, case-control, clinical trial. A total of 50 patients were scheduled for orthopedic surgery under spinal anesthesia. The patients were randomly allocated to receive 15 mg hyperbaric bupivacaine 0.5% with 2 cc normal saline (control group or 15 mg hyperbaric bupivacaine 0.5% plus 8 mg dexamethasone (case group intrathecally. The patients were evaluated for quality, quantity, and duration of block; blood pressure, heart rate, nausea, and vomiting or other complications. Results: There were no signification differences in demographic data, sensory level, and onset time of the sensory block between two groups. Sensory block duration in the case group was 119±10.69 minutes and in the control group was 89.44±8.37 minutes which was significantly higher in the case group (P<0.001. The duration of analgesia was 401.92±72.44 minutes in the case group; whereas it was 202±43.67 minutes in the control group (P<0.001. The frequency of complications was not different between two groups. Conclusion: This study has shown that the addition of intrathecal dexamethasone to bupivacaine significantly improved the duration of sensory block in spinal anesthesia without any changes in onset time and complications.

  13. Subjective pain response to two anesthetic systems in dental surgery: traditional syringe vs. a computer controlled delivery system.

    Science.gov (United States)

    Patini, R; Coviello, V; Raffaelli, L; Manicone, P F; Dehkhargani, S Z; Verdugo, F; Perfetti, G; D'Addona, A

    2012-01-01

    The present study was conducted to evaluate human pain perception at different phases of dental surgery using a computer controlled device, the Single Tooth Anesthesia System (STA System), versus the traditional syringe technique. One hundred healthy patients participated in this single-blind split-mouth design study. Individuals provided pain ratings at needle insertion, delivery of anesthetic solution and tooth extraction via a numeric visual rating scale or NVRS. The anterior middle superior alveolar, or AMSA, injection was compared with traditional syringe injections in maxillary quadrants. NVRS scores for AMSA were significantly lower for the STA System when compared to traditional syringe technique at needle insertion, delivery of anesthetic solution (p less than 0.0001) and also during tooth extractions (p=0.0002). A higher percentage of patients (23 percent) required a second injection after the traditional syringe technique. Subjects reported having less clinical pain with AMSA injection at every step of the dental surgery. The STA System combines an anesthetic pathway and controlled flow rate resulting in virtually imperceptible needle insertion and injection, and a rapid onset of profound anesthesia. NVRS scoring system facilitated patient comprehension in assessing pain value and intensity experienced. The two anesthetic delivery techniques were therapeutically equivalent for maxillary injections but AMSA/computer controlled protocol significantly minimizes subjective pain perception at needle insertion, anesthetic delivery and during tooth extraction.

  14. Anesthesia management in laparoscopic bariatric surgery: Perioperative complications and outcomes in the third year of practice

    Directory of Open Access Journals (Sweden)

    Serkan Karaman

    2014-06-01

    Full Text Available Objective: In this study, we aimed to assess the perioperative and postoperative results of the patients who underwent bariatric surgery. Methods: After obtaining approval, a retrospectively designed observational study was conducted. All adult patients who underwent laparoscopic gastric plication, sleeve gastrectomy, or roux-en-Y anastomosis between January 2011 and May 2013 were included. Results: A total of 104 patients were included in the study period: 49 (47.1% underwent laparoscopic roux-en-Y anastomosis, 44 (42.3% underwent laparoscopic sleeve gastrectomy, and 11 (10.6% underwent laparoscopic gastric plication. The present study showed a mortality rate of 1.9% (n = 2, one after Roux-en-Y anastomosis operation, and the other one after gastric plication. Conclusion: The anesthesia methods and approaches have no association with morbidity and mortality in such procedures of bariatric surgery indicated in the present study. J Clin Exp Invest 2014; 5 (2: 200-205

  15. Anesthesia for robotic cardiac surgery: An amalgam of technology and skill

    Directory of Open Access Journals (Sweden)

    Chauhan Sandeep

    2010-01-01

    Full Text Available The surgical procedures performed with robtic assitance and the scope for its future assistance is endless. To keep pace with the developing technologies in this field it is imperative for the cardiac anesthesiologists to have aworking knowledge of these systems, recognize potential complications and formulate an anesthetic plan to provide safe patient care. Challenges posed by the use of robotic systems include, long surgical times, problems with one lung anesthesia in presence of coronary artery disease, minimally invasive percutaneous cardiopulmonary bypass management and expertise in Trans-Esophageal Echocardiography. A long list of cardiac surgeries are performed with the use of robotic assistance, and the list is continuously growing as surgical innovation crosses new boundaries. Current research in robotic cardiac surgery like beating heart off pump intracardic repair, prototype epicardial crawling device, robotic fetal techniques etc. are in the stage of animal experimentation, but holds a lot of promise in future

  16. [Non-verbal communication of patients submitted to heart surgery: from awaking after anesthesia to extubation].

    Science.gov (United States)

    Werlang, Sueli da Cruz; Azzolin, Karina; Moraes, Maria Antonieta; de Souza, Emiliane Nogueira

    2008-12-01

    Preoperative orientation is an essential tool for patient's communication after surgery. This study had the objective of evaluating non-verbal communication of patients submitted to cardiac surgery from the time of awaking from anesthesia until extubation, after having received preoperative orientation by nurses. A quantitative cross-sectional study was developed in a reference hospital of the state of Rio Grande do Sul, Brazil, from March to July 2006. Data were collected in the pre and post operative periods. A questionnaire to evaluate non-verbal communication on awaking from sedation was applied to a sample of 100 patients. Statistical analysis included Student, Wilcoxon, and Mann Whittney tests. Most of the patients responded satisfactorily to non-verbal communication strategies as instructed on the preoperative orientation. Thus, non-verbal communication based on preoperative orientation was helpful during the awaking period.

  17. Myocardial protection during off pump coronary artery bypass surgery: A comparison of inhalational anesthesia with sevoflurane or desflurane and total intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    Sharadaprasad Suryaprakash

    2013-01-01

    Full Text Available Aims and Objectives: The objective of the study was to evaluate the myocardial protective effect of volatile agents-sevoflurane and desflurane versus total intravenous anesthesia (TIVA with propofol in offpump coronary artery bypass surgery (OPCAB by measuring cardiac troponin-T (cTnT as a marker of myocardial cell death. Materials and Methods: The study was conducted on 139 patients scheduled to undergo elective OPCAB surgery. The patients were randomly allocated to receive anesthesia with sevoflurane, desflurane or TIVA with propofol. The cTnT levels were measured preoperatively, at arrival in postoperative intensive care unit, at 8, 24, 48 and 96 hours thereafter. Results: The changes in cTnT levels at all time intervals were comparable in the three groups. Conclusion: The study did not reveal any difference in myocardial protection after OPCAB with either sevoflurane or desflurane or TIVA using propofol as assessed by measuring serial cTnT values.

  18. Short term general anesthesia for retro-bulbar block in ophthalmic surgery generates no significant hypercapnia.

    Science.gov (United States)

    Baulig, Werner; Weber, Monica; Beck-Schimmer, Beatrice; Theusinger, Oliver M; Biro, Peter

    2017-03-11

    To assess the impact of short time hypnosis for retro-bulbar anesthesia on ventilation in patients undergoing ophthalmic surgery of the anterior eye chamber. In all patients, a combined continuous transcutaneous carbon dioxide tension (PtcCO2) and partial oxygen saturation (SpO2) measurement was applied in addition to routine monitoring. To enable unconscious application of retro-bulbar anesthesia, intravenous thiopental was given in one to multiple bolus doses. Transient breathing support included chin lift, Esmarch maneuver and manual hand-bag ventilation via face mask. Main endpoints were apnea time, recovery time according to the Richmond Agitation Sedation Scale, as well as SpO2 and PtcCO2 readings at predefined time points. Fifty-two patients with a mean age of 68 ± 13 years were included. Average thiopental dose was 2.7 ± 0.6 mg/kg. In seven (13.5%) patients repeated doses of thiopental were necessary to a total of 3.3 ± 1.1 mg/kg. Except one patient, no severe, significant or clinical relevant hypercapnia or desaturation periods were observed, and the occurring elevation of PtcCO2 values did not correlate with the application of repeated doses of thiopental or the need for the Esmarch maneuver. Higher PtcCO2 values were associated with the presence of hypertension and smoking. Apnea (p < 0.001) and recovery (p = 0.003) time were significantly prolonged in the patients needing the Esmarch maneuver. Short term anesthesia with thiopental in ophthalmic surgery is associated with a mild but not clinically relevant hypercapnia.

  19. [Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery].

    Science.gov (United States)

    Kawano, Hiroaki; Ohshita, Naohiro; Katome, Kimiko; Kadota, Takako; Kinoshita, Michiko; Matsuoka, Yayoi; Tsutsumi, Yasuo M; Kawahito, Shinji; Tanaka, Katsuya; Oshita, Shuzo

    2016-01-01

    We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. Patients were randomly divided into three groups: those maintained with sevoflurane (Group S; n = 42), propofol (Group P; n = 42), or combined propofol and sevoflurane (Group PS; n = 42). We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use), incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24h after surgery. The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2h (74%; 76% and 43%; respectively, p = 0.001) and 0-24h (71%; 76%, and 38%; respectively, p < 0.0005). The incidence of nausea at 0-2h (Group S = 57%; Group P = 26% and Group PS = 21%; p = 0.001) and 0-24h (Group S = 62%; Group P = 29% and Group PS = 21%; p < 0.0005) was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24h. Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. Use of the virtual instrumentation laboratory for the assessment of human factors in surgery and anesthesia.

    Science.gov (United States)

    Berguer, R; Loeb, R G; Smith, W D

    1997-01-01

    There is a growing consensus that human factors issues for anesthesiologists, surgeons, and other operating room personnel require serious attention. We have established a program of collaboration between the University of California Davis Medical Center Departments of Anesthesiology and Surgery and the California State University Sacramento Biomedical Engineering Program to address ergonomic problems in anesthesiology and surgery using a Virtual Instrumentation Laboratory. A 17-workstation Virtual Instrument Laboratory using LabVIEW software on Power Macintosh platforms permits rapid prototyping of medical monitor displays as well as rapid development of data acquisition and processing circuits for physiologic data collection. The Virtual Instrument Lab has been used for three Master's thesis projects and a BME course titled Human Factors in the Design of Medical and Assistive Technology. Course projects have included: 1) The design of novel physiologic data displays for potential use in anesthesia workstations, and 2) The measurement of surface electromyographic signals and heart rate variability to investigate the physical and mental workload of performing laparoscopic surgery. The Virtual Instrument Lab allows BME students to investigate relatively complex human factors issues in anesthesiology and surgery in a short time span.

  1. Surgeon-administered conscious sedation and local anesthesia for ambulatory anorectal surgery.

    Science.gov (United States)

    Hina, Miss; Hourigan, Jon S; Moore, Richard A; Stanley, J Daniel

    2014-01-01

    Anorectal procedures are often performed in an outpatient setting using a variety of anesthetic techniques. One technique that has not been well studied is surgeon-administered conscious sedation along with local anesthetic. The purpose of this study was to evaluate the use of this technique with emphasis on safety, efficacy, and patient satisfaction. Chart review was performed on 133 consecutive patients who had anorectal procedures at an outpatient surgery center. Additionally, 65 patients were enrolled prospectively and completed a satisfaction survey. Inclusively, charts of 198 patients who underwent outpatient anorectal surgery under conscious sedation and local anesthesia under the direction of a colorectal surgeon from 2004 through 2008 were reviewed. Parameters related to patient and procedural characteristics, safety, efficacy, and satisfaction were evaluated. Surgeon-administered sedation consisted of combined fentanyl and midazolam in 90 per cent. Eighty per cent of procedures were performed in the prone position and 23 per cent were in combination with an endoscopic procedure. Eighty-two per cent were classified as American Society of Anesthesiologists Grade 1 or 2. Transient mild hypoxemia or hypotension occurred in 4 and 3 per cent of the patients, respectively. Mean operative time was 29 minutes with a mean stay in the postanesthesia care unit of 37 minutes. There were no early major cardiac or respiratory complications. Ninety-seven per cent of the patients surveyed reported a high degree of satisfaction. Surgeon-administered conscious sedation with local anesthesia was well tolerated for outpatient anorectal surgeries. Additional studies are needed to confirm the safety and efficacy of this technique.

  2. Efficacy of topical plus intracameral anesthesia for cataract surgery in high myopia: randomized controlled trial.

    Science.gov (United States)

    Lofoco, Giorgio; Ciucci, Francesco; Bardocci, Antonio; Quercioli, Pierpaolo; De Gaetano, Cristiano; Ghirelli, Giorgio; Perdicaro, Serenella; Schiano Lomoriello, Domenico; Cacciamani, Andrea

    2008-10-01

    To assess the efficacy of intracameral lidocaine supplementation of topical anesthesia during cataract surgery in eyes with high myopia. Department of Ophthalmology, Ospedale San Pietro-Fatebenefratelli, Rome, Italy. This prospective double-blind study comprised 120 highly myopic eyes with an axial length (AL) greater than 26.0 mm scheduled for routine cataract surgery. Cases were divided into 2 groups of 60 eyes each. One group received a placebo of balanced salt solution (BSS) (control group) and the other group, a supplement of 0.1 mL preservative-free lidocaine hydrochloride 1% injected in the capsular bag during hydrodissection (lidocaine group). Intraoperative pain was assessed by recording spontaneous patient reports of sensation of pain or ocular discomfort during 3 surgical stages: phaco tip insertion, irrigation/aspiration (I/A) system insertion for cortical aspiration, I/A system insertion for ophthalmic viscosurgical device removal after intraocular lens implantation. Postoperative pain was assessed on a visual analog scale (range 0 to 10). Data were compared by chi-square and Mann-Whitney U tests. The overall mean AL was 28.58 mm (28.57 mm control group; 28.50 mm lidocaine group). Fewer patients in the lidocaine group reported intraoperative pain, ocular discomfort, or tissue manipulation (odds ratio=0.36; 95% confidence interval, 0.16-0.80; P= .019). The mean postoperative pain score was 1.88+/-2.17 (SD) in the control group and 1.36+/-2.02 in the lidocaine group; the difference was not statistically significant (P= .21). Intracameral lidocaine supplementation for cataract surgery may improve intraoperative comfort under topical anesthesia in highly myopic eyes.

  3. Efficacy and safety of hyaluronidase 75 IU as an adjuvant to mepivacaine for retrobulbar anesthesia in cataract surgery.

    Science.gov (United States)

    Remy, Matthias; Pinter, Florian; Nentwich, Martin M; Kampik, Anselm; Schönfeld, Carl-Ludwig

    2008-11-01

    To evaluate the efficacy and safety of hyaluronidase as an adjuvant to mepivacaine for retrobulbar anesthesia in cataract surgery. Department of Ophthalmology, Ludwig-Maximilians-University, Munich, and Eye Center Munich East, Munich-Haar, Germany. Eyes having cataract surgery at 1 of the 2 centers were included in this prospective randomized double-blind placebo-controlled clinical trial. Retrobulbar anesthesia was administered by the surgeon using a solution of 5 mL mepivacaine 1% with additional hyaluronidase (Hylase Dessau) 75 IU (40 eyes) or additional placebo (40 eyes). The main target parameter was akinesia 5 minutes after administration of the study medication. Secondary parameters were akinesia at later times, additional injections, ptosis of the upper eyelid, time to reach complete anesthesia, assessment of pain using a visual analog scale, assessment of efficacy and tolerability by the patient and the surgeon, and adverse events. Complete akinesia 5 minutes after retrobulbar injection was reached in significantly more cases in the hyaluronidase group (29) than in the placebo group (13) (P mepivacaine for retrobulbar anesthesia in cataract surgery enhanced the safety of the surgical procedure due to more complete akinesia and quicker onset of complete anesthesia.

  4. Tracheotomy improves experiment success rate in mice during urethane anesthesia and stereotaxic surgery.

    Science.gov (United States)

    Moldestad, Olve; Karlsen, Pernille; Molden, Sturla; Storm, Johan F

    2009-01-30

    Urethane anesthesia is frequently used for acute experiments on small rodents in physiology and neuroscience. Severe respiratory distress is a common side-effect of urethane anesthesia in many strains of mice. Associated complications interfere with completion of experiments, and as a consequence more animals must be sacrificed. During experiments with stereotaxic brain surgery, we found that intubation by means of tracheotomy is an efficient way to maintain patent airways in these animals. Artificial ventilation of the animals is not required. In this paper we describe a simple, fast and reliable method for intubation of mice in experiments that involve a stereotaxic instrument. The method proved considerably easier to learn and apply than conventional intubation through the oral route. The incidence of breathing problems decreased from 77% in untreated mice to 9% in those that underwent tracheotomy. In addition, the success rate for our acute electrophysiological experiments increased from 24 to 77%. We conclude that tracheotomy reduces the number of sacrificed animals, and saves time and labor.

  5. Pleth variability index-directed fluid management in abdominal surgery under combined general and epidural anesthesia.

    Science.gov (United States)

    Yu, Yinan; Dong, Jing; Xu, Zifeng; Shen, Hao; Zheng, Jijian

    2015-02-01

    Pleth variability index (PVI), a noninvasive dynamic indicator of fluid responsiveness has been demonstrated to be useful in the management of the patients with goal directed fluid therapy under general anesthesia, but whether PVI can be used to optimize fluid management under combined general and epidural anesthesia (GEN-EPI) remains to be elucidated. The aim of our study was to explore the impact of PVI as a goal-directed fluid therapy parameter on the tissue perfusion for patients with GEN-EPI. Thirty ASA I-II patients scheduled for major abdominal surgeries under GEN-EPI were randomized into PVI-directed fluid management group (PVI group) and non PVI-directed fluid management group (control group). 2 mL/kg/h crystalloid fluid infusion was maintained in PVI group, once PVI>13%, a 250 mL colloid or crystalloid was rapidly infused. 4-8 mL/kg/h crystalloid fluid infusion was maintained in control group, and quick fluid infusion was initiated if mean arterial blood pressure (BP)PVI than control group, PPVI-based goal-directed fluid management can reduce the intraoperative fluid amount and blood lactate levels in patients under GEN-EPI, especially the crystalloid. Furthermore, the first hour following GEN-EPI might be the critical period for anesthesiologist to optimize the fluid management.

  6. 27-Gauge Vitrectomy for Symptomatic Vitreous Floaters with Topical Anesthesia

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

    2017-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Jin-E Du

    2016-01-01

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

  8. [Cervical epidural anesthesia for upper extremity surgery using three different formulations of local anesthetics].

    Science.gov (United States)

    Guevara-López, Uriah; Bárcenas-Olivares, Juan; Gutiérrez-Sougarret, Bernardo; Aldrete, J Antonio; Olascoaga-Ortega, Gabriela

    2005-01-01

    To evaluate the efficiency and safety of the cervical epidural blockade (CEB) in upper extremity surgery, using lidocaine 2%, bupivacaine 5% and a mixture of both local analgesics. Eighty five patients were submitted to upper limb surgery under CEB. They were assigned into one of three groups: group I received 100 mg of 2% lidocaine; group II received 30 mg of 0.5% bupivacaine, and group III received a mixture of 60 mg of 2% lidocaine and 15 mg of 0.5% bupivacaine. We evaluated their effects on vital signs, blockade quality, adverse effects, and patient comfort. Anesthesiologist and surgeon evaluated the technique as "good" in 80% of the patients. Significant differences were found for motor blockade. Group II developed complete motor block (100%). Observed adverse effects were vomiting in groups II and III and dural puncture was present in 6.7% of the cases in group II. This study confirms the safety of cervical epidural anesthesia for upper limb surgery using three different formulations of local anesthetics.

  9. A review of repeat general anesthesia for pediatric dental surgery in Alberta, Canada.

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    Schroth, Robert J; Smith, W F

    2007-01-01

    The purpose of this study was to review data from the province of Alberta, Canada for First Nations children who required more than 1 general anesthesia (GA) procedure for dental surgery from 1996 to 2005. This study was limited to First Nations and Inuit children younger than 18 years old in Alberta who received 2 or more GA procedures to facilitate dental treatment Data spanning 1996 to 2005 were provided from the Alberta Regional Office of First Nations & Inuit Health Branch, Health Canada. The entire database contained claims for 339 children who received repeat GA procedures for rehabilitative dental core. Seventy-six percent received 2 procedures, while the remainder underwent 3 or more surgeries. Twenty-four percent of First Nations children in this cohort were subjected to >2 GA procedures. Retreatment of previously restored teeth was a common observation. The majority of children were treated by general practitioners instead of pediatric dentists. Seventy-four percent who had 2 or more surgeries were treated by general dentists at the time of the first GA procedure. The mean age of children at the time of the first GA procedure was not associated with whether children received 2 or more GA procedures for dental care (P=.07). These data suggest that there may be on over-reliance on GA to treat dental caries for First Notions children in Alberta.

  10. Willingness to pay for one-stop anesthesia in pediatric day surgery

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    Di Caro Elisabetta

    2011-05-01

    Full Text Available Abstract Background This study assesses the parents' Willingness To Pay (WTP for One Stop Anesthesia (OSA. OSA is part of a free screening procedure that determines the timing of the anesthesiological assessment. In OSA-positive patients, the preoperative assessment is carried out on the same day as the surgery. The OSA allows patients who have to undergo surgery in a pediatric day surgery to avoid accessing the pre-admission clinic. Method This is a descriptive cohort study. A sample of 106 parents were interviewed directly by means of a questionnaire. The questionnaire builds a hypothetical scenario where the interviewee has a chance to buy the OSA health service with the WTP. The WTP values are distributed in classes and are contingent to the market built in the questionnaire. The Chi Square and Cramer's V tests evaluate the WTP dependence on the parents' place of origin and occupation. Results The approximate average of the WTP classes is €87.21 per family. The Chi Square test relative to the WTP classes and the places of origin is statistically significant (p Conclusion Nearly 90% of pediatric patients who were screened for timing the preoperative assessment are true positives to OSA. This allows doing away with the pre-hospitalization, with definite advantages for the families. This screening is a health service that families would be hypothetically willing to pay.

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

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

    2006-01-01

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

  12. Cardiac anesthesia and surgery in geriatric patients: epidemiology, current surgical outcomes, and future directions.

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    Castillo, J G; Silvay, G; Chikwe, J

    2009-01-01

    The mean life expectancy of the population of the United States is projected to increase from 78.3 years at present to over 81 years in 2025, with a concomitant increase in the percentage of the population over the age of 75 years. Elderly patients are more likely to present with valvular and coronary artery disease than younger patients, and as better perioperative management contributes to improving post-operative outcomes and lower referral thresholds, very elderly patients form an increasingly large proportion of the cardiac surgical population. This article summarizes the impact of age-related pathophysiologic changes on patients' response to cardiac surgery and anesthesia, outlines useful perioperative strategies in this age group, and reviews the literature on outcomes after valvular and coronary in elderly patients.

  13. 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.

  14. [A Case of General Anesthesia for a Cardiac Transplanted Patient Undergoing Inguinal Hernia Repair under Laparoscopic Surgery].

    Science.gov (United States)

    Inoue, Mitsuko; Hayashi, Yasue; Fujita, Yuki; Shimizu, Motoko; Hotta, Arisa; Nakamoto, Ai; Yoshikawa, Noriko; Ohira, Naoko; Tatekawa, Shigeki

    2016-04-01

    A 52-year-old man was scheduled for the repair of inguinal hernia recurrence. When he was 48 years of age, he received a heart transplantation due to severe heart failure resulting from ischemic heart disease. When he was 50 years old, he suffered from inguinal hernia, and it was repaired under spinal anesthesia. During this surgery, he experienced pain because of the inadequate effect of anesthesia, but his blood pressure and heart rate were stable. We suspected that this was because of denervation of the heart. On hernia repair for inguinal hernia recurrence, general anesthesia was chosen, induced with midazolam, rocuronium, and fentanyl and maintained with sevoflurane, rocuronium, fentanyl, and remifentanil. The blood pressure was mostly stable during anesthesia, but we noted an increase in the heart rate when the trachea was intubated and extubated and when surgical incision started. This phenomenon may indicate reinnervation of the transplanted heart. We could safely manage anesthesia without invasive monitoring because the transplanted heart functioned favorably and surgery was minimally invasive.

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

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    Lakhin R.E.

    2015-09-01

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

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

    Science.gov (United States)

    Beloeil, H; Nouette-Gaulain, K

    2012-06-01

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

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

    Science.gov (United States)

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

    2010-05-15

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

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

    Science.gov (United States)

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

    2016-04-01

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

  19. Simultaneous occlusion of three cilioretinal arteries following scleral buckling surgery under local anesthesia

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    Napoli PE

    2016-09-01

    Full Text Available Pietro Emanuele Napoli,* Alberto Cuccu,* Roberta Farci, Maurizio Fossarello Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy *These authors contributed equally to this work Background: Cilioretinal artery (CRA occlusions are rare in young patients. In these cases, the most commonly associated causes are considered to be the same as those implicated in central retina artery occlusions, such as vasculitic processes, migraine, cardiac disorder, and coagulation abnormality. The aim of this article was to report for the first time the medical records and investigational results of an unusual case of simultaneous occlusion of three CRAs after scleral buckling surgery under local anesthesia.Methods: A complete ophthalmic examination, including color fundus image, fundus fluorescein angiography, optical coherence tomography, visual field, as well as systemic and laboratory assessments, was performed.Results: A case of contemporaneous blockage of three CRAs after ab externo surgery for retinal detachment in a 29-year-old Caucasian woman was reported. The interdisciplinary approach and the imaging results have allowed us the clinical definition of such a very rare case.Conclusion: Here, we reported that optical coherence tomography is an indispensable tool to better delineate the pathological process and follow atrophic changes in the macula, especially in cases in which fundus fluorescein angiography and systemic tests may be poorly informative. Keywords: cilioretinal artery occlusion, optical coherence tomography, retinal detachment

  20. A clinical study of aprotinin blood anesthesia used in the surgery of liver cancer

    Institute of Scientific and Technical Information of China (English)

    易斌; 陶国才; 毕敏; 刘怀琼

    2004-01-01

    Objective: To investigate the role of aprotinin blood anesthesia used in hepatotomy. Methods: Patients with liver cancer undergoing hepatotomy were divided into two groups. In experimental group (40 patients) a loading dose with 1112 EPU aprotinin and maintained by 278 EPU/h was used until 2 h after operation. The control group (42 patients)was treated with 0.9% normal saline. The venous blood was withdrew for blood routine, thrombelastography and coagulable test at the time of preinduced, 1 h, 2 h and 4 h following the operation beginning, 6 h and 12 h after operation. The change of TEG and coagulable profile were monitored during the whole surgery. The volume of blood transfusion and hemorrhage between two groups were compared. Results: After the usage of aprotinin, the preoperative hypercoagulability of the experimental group was remitted and the coagulative state was kept relatively stable during the operation. However, hypercoagulability of the control group aggravated following the operation beginning and some of them switched to hypocoagulability. The volumes and rates of hemorrhage and transfusion were smaller in the experimental group than in the control group. Conclusion: Aprotinin can stabilize the coagulable state, reduce the volumes and rates of hemorrhage and transfusion, and is worth using in the surgery of operations of liver cancer.

  1. The effects of different oxygen concentrations on recruitment maneuver during general anesthesia for laparoscopic surgery.

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    Topuz, Ufuk; Salihoglu, Ziya; Gokay, Banu V; Umutoglu, Tarik; Bakan, Mefkur; Idin, Kadir

    2014-10-01

    Recruitment maneuvers (RMs), which aim to ventilate the collaborated alveolus by temporarily increasing the transpulmonary pressure, have positive effects in relation to respiration, mainly oxygenation. Although many studies have defined the pressure values used during RM and the application period, our knowledge of the effects of different oxygen concentrations is limited. In this study, we aimed to determine the effects of different oxygen concentrations during RM on the arterial oxygenation and respiration mechanics in laparoscopic cases. Thirty-two patients undergoing laparoscopic cholecystectomy were recruited into the study. The patients were randomly divided into 2 groups. RM with a 30% oxygen concentration was performed in patients within the first group (group I, n=16), whereas patients in the second group (group II, n=16) received RM with 100% oxygen. To study respiratory mechanics, dynamic compliance (Cdyn), airway resistance (Raw), and peak inspiratory pressure were measured at 3 different times: 5 minutes after anesthesia induction, 5 minutes after the abdomen was insufflated, and 5 minutes after the abdomen was desufflated. Arterial blood gases were measured during surgery and 30 minutes after surgery (postoperative). The average postoperative partial arterial oxygen pressure values of the patients in groups I and II were 121 and 98 mm Hg, respectively. The difference between the groups was statistically significant. In addition, the decrease in compliance from induction values after desufflation in group II was statistically significant. On the basis of our results, maintaining oxygen concentrations below 100% during RM may be more beneficial in terms of respiratory mechanics and gas exchange.

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

    Science.gov (United States)

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

    2013-01-01

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

  3. Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery

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    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

  4. Anesthesia for pediatric day-case dental surgery: a study comparing the classic laryngeal mask airway with nasal trachea intubation.

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    Zhao, Nan; Deng, Feng; Yu, Cong

    2014-05-01

    To study sevoflurane inhalation general anesthesia using the laryngeal mask airway (LMA) and nasal endotracheal (ET) intubation to maintain the airway in pediatric day-case dental surgery. A total of 171 children aged 2 to 7 years received elective day-case dental surgical procedure under general anesthesia. Children were randomly grouped into LMA groups (L) and nasal ET intubation group (N). In L groups, LMA was inserted after induction of anesthesia using 8% sevoflurane and were allowed to breathe spontaneously. Rocuronium and remifentanil were given intravenously during 8% sevoflurane induction by nasal ET intubation in the N group . The time of anesthetic induction, maintenance, recovery, surgical access, and bispectral index score were recorded. Postoperative nausea and vomiting and the incidence of adverse events during induction and recovery period were also recorded. The insertion time of LMA was significantly shorter than nasal ET (P index were not different between the 2 groups. However, recovery time was significantly shorter in group L (P < 0.05). The incidence of sore throat and postoperative nausea and vomiting (P < 0.01) were much less in group L as well. Sevoflurane inhalation anesthesia through LMA is a safe and reliable method for pediatric day-case dental surgery.

  5. Thoracic Paravertebral Block, Multimodal Analgesia, and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis

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    Anis Dizdarevic

    2016-01-01

    Full Text Available Objective. Primary lateral sclerosis (PLS is a rare idiopathic neurodegenerative disorder affecting upper motor neurons and characterized by spasticity, muscle weakness, and bulbar involvement. It can sometimes mimic early stage of more common and fatal amyotrophic lateral sclerosis (ALS. Surgical patients with a history of neurodegenerative disorders, including PLS, may be at increased risk for general anesthesia related ventilatory depression and postoperative respiratory complications, abnormal response to muscle relaxants, and sensitivity to opioids, sedatives, and local anesthetics. We present a case of a patient with PLS and recent diagnosis of breast cancer who underwent a simple mastectomy surgery uneventfully under an ultrasound guided thoracic paravertebral block, multimodal analgesia, and monitored anesthesia care. Patient reported minimal to no pain or discomfort in the postoperative period and received no opioids for pain management before being discharged home. In patients with PLS, thoracic paravertebral block and multimodal analgesia can provide reliable anesthesia and effective analgesia for breast surgery with avoidance of potential risks associated with general anesthesia, muscle paralysis, and opioid use.

  6. Thoracic Paravertebral Block, Multimodal Analgesia, and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis

    Science.gov (United States)

    Fernandes, Anthony

    2016-01-01

    Objective. Primary lateral sclerosis (PLS) is a rare idiopathic neurodegenerative disorder affecting upper motor neurons and characterized by spasticity, muscle weakness, and bulbar involvement. It can sometimes mimic early stage of more common and fatal amyotrophic lateral sclerosis (ALS). Surgical patients with a history of neurodegenerative disorders, including PLS, may be at increased risk for general anesthesia related ventilatory depression and postoperative respiratory complications, abnormal response to muscle relaxants, and sensitivity to opioids, sedatives, and local anesthetics. We present a case of a patient with PLS and recent diagnosis of breast cancer who underwent a simple mastectomy surgery uneventfully under an ultrasound guided thoracic paravertebral block, multimodal analgesia, and monitored anesthesia care. Patient reported minimal to no pain or discomfort in the postoperative period and received no opioids for pain management before being discharged home. In patients with PLS, thoracic paravertebral block and multimodal analgesia can provide reliable anesthesia and effective analgesia for breast surgery with avoidance of potential risks associated with general anesthesia, muscle paralysis, and opioid use. PMID:27200193

  7. Ultrasound guided single injection caudal epidural anesthesia of isobaric bupivacaine with/without dexamethasone for geriatric patients undergoing total hip replacement surgery

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    H.A. El Gendy

    2014-07-01

    Conclusion: Adding dexamethasone with isobaric bupivacaine caudal anesthesia prolongs the duration of postoperative analgesia and decreased postoperative analgesic requirement in geriatric patients undergoing total hip replacement surgery in comparison isobaric bupivacaine alone.

  8. Anesthesia and critical-care delivery in weightlessness: A challenge for research in parabolic flight analogue space surgery studies

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    Ball, Chad G.; Keaney, Marilyn A.; Chun, Rosaleen; Groleau, Michelle; Tyssen, Michelle; Keyte, Jennifer; Broderick, Timothy J.; Kirkpatrick, Andrew W.

    2010-03-01

    BackgroundMultiple nations are actively pursuing manned exploration of space beyond low-earth orbit. The responsibility to improve surgical care for spaceflight is substantial. Although the use of parabolic flight as a terrestrial analogue to study surgery in weightlessness (0 g) is well described, minimal data is available to guide the appropriate delivery of anesthesia. After studying anesthetized pigs in a 0 g parabolic flight environment, our group developed a comprehensive protocol describing prolonged anesthesia in a parabolic flight analogue space surgery study (PFASSS). Novel challenges included a physically remote vivarium, prolonged (>10 h) anesthetic requirements, and the provision of veterinary operating room/intensive care unit (ICU) equivalency on-board an aircraft with physical dimensions of ethical approval, multiple ground laboratory sessions were conducted with combinations of anesthetic, pre-medication, and induction protocols on Yorkshire-cross specific pathogen-free (SPF) pigs. Several constant rate infusion (CRI) intravenous anesthetic combinations were tested. In each regimen, opioids were administered to ensure analgesia. Ventilation was supported mechanically with blended gradients of oxygen. The best performing terrestrial 1 g regime was flight tested in parabolic flight for its effectiveness in sustaining optimal and prolonged anesthesia, analgesia, and maintaining hemodynamic stability. Each flight day, a fully anesthetized, ventilated, and surgically instrumented pig was transported to the Flight Research Laboratory (FRL) in a temperature-controlled animal ambulance. A modular on-board surgical/ICU suite with appropriate anesthesia/ICU and surgical support capabilities was employed. ResultsThe mean duration of anesthesia (per flight day) was 10.28 h over four consecutive days. A barbiturate and ketamine-based CRI anesthetic regimen supplemented with narcotic analgesia by bolus administration offered the greatest prolonged hemodynamic

  9. [State of the sympathoadrenal system and hemodynamics in children during congenital heart defect surgery with high thoracic epidural anesthesia using lidocaine-clofelin].

    Science.gov (United States)

    Slin'ko, S K

    2000-01-01

    Effects of high thoracic epidural anesthesia (HTEA) on the hemodynamics and sympathoadrenal system were studied in patients during cardiopulmonary bypass surgery. In 55 patients aged 1-14 years, HTEA was used in combination with oxygen-air-halothane anesthesia. In one group lidocaine and fentanyl were used for HTEA and in another clonidine and lidocaine. In the control, standard intravenous fentanyl-diazepam anesthesia was combined with oxygen-air-halothane anesthesia. In the clonidine-lidocaine group the endocrine stress response was decreased in comparison with other groups even without narcotics; hemodynamics was stable even in patients with NYHA class III-IV.

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

    DEFF Research Database (Denmark)

    Stenger, Michael; Fabrin, Anja; Schmidt, Henrik

    2013-01-01

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

  11. Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center.

    Science.gov (United States)

    Mudumbai, Seshadri C

    2016-01-01

    Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

  12. Surgery under extreme conditions in the aftermath of the 2010 Haiti earthquake: the importance of regional anesthesia.

    Science.gov (United States)

    Missair, Andres; Gebhard, Ralf; Pierre, Edgar; Cooper, Lebron; Lubarsky, David; Frohock, Jeffery; Pretto, Ernesto A

    2010-01-01

    The 12 January 2010 earthquake that struck Port-au-Prince, Haiti caused >200,000 deaths, thousands of injuries requiring immediate surgical interventions, and 1.5 million internally displaced survivors. The earthquake destroyed or disabled most medical facilities in the city, seriously hampering the ability to deliver immediate life- and limb-saving surgical care. A Project Medishare/University of Miami Miller School of Medicine trauma team deployed to Haiti from Miami within 24 hours of the earthquake. The team began work at a pre-existing tent facility in the United Nations (UN) compound based at the airport, where they encountered 225 critically injured patients. However, non-sterile conditions, no means to administer oxygen, the lack of surgical equipment and supplies, and no anesthetics precluded the immediate delivery of general anesthesia. Despite these limitations, resuscitative care was administered, and during the first 72 hours following the event, some amputations were performed with local anesthesia. Because of these austere conditions, an anesthesiologist, experienced and equipped to administer regional block anesthesia, was dispatched three days later to perform anesthesia for limb amputations, debridements, and wound care using single shot block anesthesia until a better equipped tent facility was established. After four weeks, the relief effort evolved into a 250-bed, multi-specialty trauma/intensive care center staffed with >200 medical, nursing, and administrative staff. Within that timeframe, the facility and its staff completed 1,000 surgeries, including spine and pediatric neurological procedures, without major complications. This experience suggests that when local emergency medical resources are completely destroyed or seriously disabled, a surgical team staffed and equipped to provide regional nerve block anesthesia and acute pain management can be dispatched rapidly to serve as a bridge to more advanced field surgical and intensive care

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

    Directory of Open Access Journals (Sweden)

    Mandal Sripurna

    2011-01-01

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

  14. Positional change of hyoid bone after anesthesia in anterior surgery of upper cervical spine.

    Science.gov (United States)

    Lim, Jong-Han; Wang, Seong-Il; Kim, Do-Yeon; Song, Kyung-Jin; Kim, Tae Gyun; Lee, Kwang-Bok

    2014-09-01

    The hyoid bone is used as a landmark in anterior upper cervical spine operations and is supposed to represent the level of C3 body. However, this correspondence between hyoid bone position and cervical level is not static and changes during surgery (extension after anesthesia). To find the cervical level corresponding to the position of hyoid bone before and after anesthesia and to evaluate the adequacy of its usage as a surgical landmark. A retrospective study. One hundred twenty-eight patients with degenerative cervical diseases who had undergone anterior cervical discectomy and fusion. Radiologic measure. For each patient, preanesthesia neutral, preanesthesia extension, and postanesthesia induction extension C-spine lateral image were obtained. The level of cervical vertebra that midline of hyoid bone indicated was measured by radiological method. A cervical vertebra was divided into three segments, consisting of upper half, lower half, and disc space, and each of these segments was considered as one level. The differences between pre- and postanesthesia induction hyoid positions were classified as minimal change (one level or less) and significant change (two levels or greater). Relationship between positional change of hyoid bone to gender, obesity, and age were respectively investigated. There were 20 cases of one-level distal displacement of the hyoid bone, 40 cases of two-level distal displacement, 34 cases of three-level distal displacement, 16 cases of 4-level distal displacement, and two cases of five-level distal displacement. In eight cases, there was no level change, and in the remaining 8 cases, the hyoid bone had been displaced proximally. There were 34 cases of minimal change. The remaining 94 cases (73.4%) had significant changes. No respective relationship was found between sex, obesity, age and pre-and postanesthesia induction positional change of hyoid bone. Among the 128 cases studied, 73.4% hyoid bone positions had changed by more than one

  15. Prolonged analgesia following preoperative bupivacaine neural blockade for oral surgery performed under general anesthesia.

    Science.gov (United States)

    Chapman, P J; Ganendran, A

    1987-03-01

    The effectiveness of prolonged neural blockade following removal of impacted third molars under general anesthesia was evaluated in a controlled clinical study. There was a significant reduction in the amount of postoperative pain experienced, and no complications, either local or systemic, occurred. The technique has advantages, especially when general anesthesia is administered to outpatients.

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

    DEFF Research Database (Denmark)

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

    1989-01-01

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

  17. Surgery increases cell death and induces changes in gene expression compared with anesthesia alone in the developing piglet brain

    Science.gov (United States)

    Fierens, Igor; Rocha-Ferreira, Eridan; Hristova, Mariya; Ezzati, Mojgan; Rostami, Jamshid; Alonso-Alconada, Daniel; Chaban, Badr; Hassell, Jane; Fleiss, Bobbi; Gressens, Pierre; Sanders, Robert D.; Robertson, Nicola J.

    2017-01-01

    In a range of animal species, exposure of the brain to general anaesthesia without surgery during early infancy may adversely affect its neural and cognitive development. The mechanisms mediating this are complex but include an increase in brain cell death. In humans, attempts to link adverse cognitive development to infantile anaesthesia exposure have yielded ambiguous results. One caveat that may influence the interpretation of human studies is that infants are not exposed to general anaesthesia without surgery, raising the possibility that surgery itself, may contribute to adverse cognitive development. Using piglets, we investigated whether a minor surgical procedure increases cell death and disrupts neuro-developmental and cognitively salient gene transcription in the neonatal brain. We randomly assigned neonatal male piglets to a group who received 6h of 2% isoflurane anaesthesia or a group who received an identical anaesthesia plus 15 mins of surgery designed to replicate an inguinal hernia repair. Compared to anesthesia alone, surgery-induced significant increases in cell death in eight areas of the brain. Using RNAseq data derived from all 12 piglets per group we also identified significant changes in the expression of 181 gene transcripts induced by surgery in the cingulate cortex, pathway analysis of these changes suggests that surgery influences the thrombin, aldosterone, axonal guidance, B cell, ERK-5, eNOS and GABAA signalling pathways. This suggests a number of novel mechanisms by which surgery may influence neural and cognitive development independently or synergistically with the effects of anaesthesia. PMID:28355229

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

    Directory of Open Access Journals (Sweden)

    Baratollah Shaban

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Baratollah Shaban

    2013-12-01

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

  20. 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

  1. Local Anesthesia in Cataract Surgery-A Comparison of Different Methods

    Institute of Scientific and Technical Information of China (English)

    Nolan; J; Aziz; M; Ahmad; M; Shehata; M; Iqbal; F

    1993-01-01

    Seven groups of thirty patients undergoing cataract extraction under local anesthesia were each given different combinations of local anesthesia. These varied from a maximum approach using supra-orbital, infra-orbital and facial blocks with Hyalase, orbital compression and pre-operative Acetazolamide down to a minimum group receiving purely an infra- orbital and supra-orbital block with a Ugnocaine/Bupivacaine mixture. There was no significant difference in local analgesia or in the complication rates b...

  2. Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery

    OpenAIRE

    Cihan Doger; Kadriye Kahveci; Dilsen Ornek; Abdulkadir But; Mustafa Aksoy; Derya Gokcinar; Didem Katar

    2016-01-01

    Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n = 30) an...

  3. Amino acid infusion during anesthesia attenuates the surgery induced decline in IGF-1 and diminishes the "diabetes of injury"

    Directory of Open Access Journals (Sweden)

    Eksborg Staffan

    2007-01-01

    Full Text Available Abstract Background Surgery, commonly performed after an overnight fast, causes a postoperative decline in the anabolic and glucose lowering insulin-like growth factor-1 (IGF-1. Clinical fasting studies have exhibited a positive correlation between IGF-1 and nitrogen balance during different conditions. A perioperative amino acid infusion changes nitrogen balance and might thereby influence serum IGF-1. We hypothesized that amino acid infusion would enhance IGF-1 and thereby might influence glucose homeostasis after surgery. In this study we examined two different regimes of perioperative amino acids infusion. Methods 24 females scheduled for abdominal hysterectomy were randomized into three groups; Ringer's solution infusion throughout anesthesia (Group B, amino acid infusion throughout anesthesia (Group C and amino acid infusion 1 hour before anesthesia and during 1.5 hrs of surgery (Group D. Six female volunteers, who were not operated, but received the same amino acids infusion after fasting, served as controls (Group A. Fasting levels of IGF-1, Insulin-like growth factor binding protein-1 (IGFBP-1, insulin and P-glucose were studied prior to, and four days following, operation. Homeostasis model assessment (HOMA was used as an index of insulin resistance. Non-parametric statistical methods were used. Results During the study the Ringer-group exhibited a decrease in IGF-1 and an increase in insulin and plasma glucose after surgery. Within the other groups there were no significant alterations over time after surgery, with the exception of a postoperative decrease in IGF-1 in group D. Group C had higher IGF-1 levels compared to group B on all days. Also, group D had higher IGF-1 levels than group B on day 2 – 4. From baseline to the first postoperative day there was a significant increase in HOMA and IGFBP-1 in groups B and C. These changes were not found in group D, in which insulin, glucose, HOMA and IGFBP-1 did not change. Amino acid

  4. Effects of Addition of Systemic Tramadol or Adjunct Tramadol to Lidocaine Used for Intravenous Regional Anesthesia in Patients Undergoing Hand Surgery

    OpenAIRE

    Abdulkadir Yektaş; Funda Gümüş; Abdulhalim Karayel; Ayşin Alagöl

    2016-01-01

    Intravenous regional anesthesia (IVRA) is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages. The present study aimed to investigate the effects of addition of systemic tramadol or adjunct tramadol to lidocaine for IVRA in patients undergoing hand surgery. American Society of Anesthesiologists (ASA) I-II patients (n = 60) who underwent hand surgery were included. For this purpose, only lidocaine (LDC), lidocaine+adjunct tramadol (LDC+...

  5. BEST-PRACTICE GUIDELINES FOR FIELD-BASED SURGERY AND ANESTHESIA ON FREE-RANGING WILDLIFE. II. SURGERY.

    Science.gov (United States)

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

    2016-04-01

    The principles of surgical asepsis apply to field surgeries with few exceptions. The minimum level for performance of surgeries in the field on free-ranging animals should be the same as for domestic animals undergoing surgery in animal hospitals. Surgeries in the field are typically done as part of research and management projects and usually involve a combination of biologists and veterinarians with the possibility of conflicts in scientific cultures. This article outlines a minimum standard of care for field surgeries and will serve as a resource for Institutional Animal Care and Use Committees and biologists and veterinarians planning projects that involve surgeries on free-ranging wildlife in field conditions.

  6. Combined use of remifentanil and propofol to limit patient movement during retinal detachment surgery under local anesthesia

    Directory of Open Access Journals (Sweden)

    Mahfouz Abdul Kader

    2010-01-01

    Full Text Available Background: One of the drawbacks of performing ophthalmic surgery under local anesthesia is patient movement, which might affect optimal surgical outcome. Purpose: The study aims to evaluate the efficacy of the combined use of propofol and remifentanil as a sedative technique in comparison with the use of propofol alone to limit patient discomfort and movement during local anesthesia for vitreo-retinal surgery lasting for more than two hours. Materials and Methods: A total of 140 patients scheduled for vitreo-retinal surgery under local anesthesia, with an expected surgical time of more than two hours, were included in the study. Patients were divided randomly into two equal groups: group I where patients were given propofol and remifentanil by continuous infusion and group II where patients were given propofol alone by continuous infusion. Results: The two groups were comparable with regard to age, weight, gender, ASA physical status and duration of surgery. There was a significant decrease in heart rate and mean arterial blood pressure (MABP in each group 10 minutes after the start of sedation compared with pre-sedation data and continued all through the procedure. There was an insignificant difference between the two groups with regard to changes in heart rate and MABP all through surgical procedure. There was no significant difference between the two groups with regard to the incidence of complications except for an increased incidence of breakthrough pain and discomfort which necessitated the use of fentanyl as a rescue treatment in the propofol group P<0.001. There were no instances of movements with a major effect on the surgical field, which could have affected surgical outcome, in the two groups. The number of patients who did not move was significantly higher, 56 (80%, in group I compared with 38 (54.29% in group II with P<0.001. The ophthalmologist satisfaction scale was significantly higher in group I (4.5±0.63 compared with group

  7. [Effect of pediatric TCI system for propofol plus remifentanil in pediatric short-duration surgery with laryngeal mask airway anesthesia].

    Science.gov (United States)

    Liu, Hua-cheng; Li, Jun; Yang, Bo; Shangguan, Wang-ning; Cai, Ming-yang; Lian, Qing-quan

    2011-03-08

    To study the effect of a pediatric TCI patent system for propofol plus remifentanil in pediatric short-duration surgery with laryngeal mask airway (LMA) anesthesia. A total of 120 pediatric patients underwent short-duration elective surgery, aged 3 - 9 years old, weighted 13 - 26 kg, ASAI grade, were randomly divided into 3 groups (n = 40 each). The propofol concentrations of effect compartment were set at 2 µg/ml in Group A, 3 µg/ml in Group B and 4 µg/ml in Group C. The remifentanil initial concentration of plasma compartment was 2 ng/ml and increased stepwise by 0.5 ng/ml until a successful insertion of LMA. The remifentanil concentration was recorded when LMA was successfully inserted and the cases were numerated at the each remifentanil concentration. Heart rate (HR), mean arterial pressure (MAP), BIS (bispectral index) values and postoperative adverse events were also recorded at the time points of pre-induction (T0), 2 min post-remifentanil TCI (T1), LMA insertion (T2), skin incision (T3), 5 min post-skin incision (T4), 10 min post-skin incision, (T5) and beginning surgery (T6). The satisfactory ratios of a successful insertion of LMA were highest in remifentanil 3.0 ng/ml (AR subgroup), 2.5 ng/ml (BR subgroup) and 2.0 ng/ml (CR subgroup) respectively. The laryngeal mask satisfactory ratio was high in BR subgroup (P propofol 3 µg/ml effect compartment concentration plus remifentanil 2.5 ng/ml plasma concentration TCI displays stable hemodynamics, less stress, fewer complications and better clinical outcomes in pediatric short-duration surgery with LMA anesthesia.

  8. Evaluation of the influence of pulmonary hypertension in ultra-fast-track anesthesia technique in adult patients undergoing cardiac surgery

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    Paulo Sérgio da Silva

    2015-08-01

    Full Text Available Abstract Objective: To evaluate the influence of pulmonary hypertension in the ultra-fast-track anesthesia technique in adult cardiac surgery. Methods: A retrospective study. They were included 40 patients divided into two groups: GI (without pulmonary hypertension and GII (with pulmonary hypertension. Based on data obtained by transthoracic echocardiography. We considered as the absence of pulmonary hypertension: a pulmonary artery systolic pressure (sPAP 40 mmHg associated with additional echocardiographic signs of PH. It was established as influence of pulmonary hypertension: the impossibility of extubation in the operating room, the increase in the time interval for extubation and reintubation the first 24 hours postoperatively. Univariate and multivariate analyzes were performed when necessary. Considered significant a P value <0.05. Results: The GI was composed of 21 patients and GII for 19. All patients (100% were extubated in the operating room in a medium time interval of 17.58±8.06 min with a median of 18 min in GII and 17 min in GI. PH did not increase the time interval for extubation (P=0.397. It required reintubation of 2 patients in GII (5% of the total, without statistically significant as compared to GI (P=0.488. Conclusion: In this study, pulmonary hypertension did not influence on ultra-fast-track anesthesia in adult cardiac surgery.

  9. Cerebral oxygenation in patients undergoing shoulder surgery in beach chair position: comparing general to regional anesthesia and the impact on neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, J; Borgeat, A; Trachsel, T; Cobo Del Prado, I; De Andrés, J; Bühler, P

    2014-02-01

    Ischemic brain damage has been reported in healthy patients after beach chair position for surgery due to cerebral hypoperfusion. Near-infrared spectroscopy has been described as a non-invasive, continuous method to monitor cerebral oxygen saturation. However, its impact on neurobehavioral outcome comparing different anesthesia regimens has been poorly described. In this prospective, assessor-blinded study, 90 patients undergoing shoulder surgery in beach chair position following general (G-group, n=45) or regional anesthesia (R-group; n=45) were enrolled to assess the prevalence of cerebral desaturation events comparing anesthesia regimens and their impact on neurobehavioral and neurological outcome. Anesthesiologists were blinded to regional cerebral oxygen saturation values. Baseline data assessed the day before surgery included neurological and neurobehavioral tests, which were repeated the day after surgery. The baseline data for regional cerebral oxygen saturation/bispectral index and invasive blood pressure both at heart and auditory meatus levels were taken prior to anesthesia, 5 min after induction of anesthesia, 5 min after beach chair positioning, after skin incision and thereafter all 20 min until discharge. Patients in the R-group showed significantly less cerebral desaturation events (p<0.001), drops in regional cerebral oxygen saturation values (p<0.001), significantly better neurobehavioral test results the day after surgery (p<0.001) and showed a greater hemodynamic stability in the beach chair position compared to patients in the G-group. The incidence of regional cerebral oxygen desaturations seems to influence the neurobehavioral outcome. Regional anesthesia offers more stable cardiovascular conditions for shoulder surgery in beach chair position influencing neurobehavioral test results at 24h. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  10. The Influence of Oral Ginger before Operation on Nausea and Vomiting after Cataract Surgery under General Anesthesia: A double-blind placebo-controlled randomized clinical trial

    Science.gov (United States)

    Seidi, Jamal; Ebnerasooli, Shahrokh; Shahsawari, Sirous; Nzarian, Simin

    2017-01-01

    Background According to Iranian traditional medicine, using safe ginger may contribute to taking less chemical medicines and result in fewer side effects. Objective To determine the influence of using ginger before operation on nausea and vomiting, after cataract surgery under general anesthesia. Methods This study was a double-blind placebo-controlled randomized clinical trial conducted at Kurdistan University of Medical Sciences in 2015. 122 candidates of cataract surgery were randomly allocated in three groups. The first group received a ginger capsule in a single 1 g dose, the second received two separate doses of ginger capsule each containing 500 mg and the third group received placebo capsule before operation. The patients were examined and studied for the level of nausea and occurrence of vomiting for 6 hours after the operation. The intensity of nausea was scored from zero to ten, based upon Visual Analog Scale. SPSS version 20 was used to analyze the data. We used Chi square and Kruskal-Wallis test for the analyses of outcomes. Results The frequency and intensity of nausea and the frequency of vomiting after operation among those who had taken the ginger capsule in 2 separate 500 mg doses was less than the other 2 groups. This difference was significant (pKurdistan University of Medical Sciences, Sanandaj, Iran. PMID:28243400

  11. Anesthesia-related morbidity and mortality after surgery for muscle biopsy in children with mitochondrial defects.

    NARCIS (Netherlands)

    Driessen, J.J.; Willems, S.; Dercksen, S.J.; Giele, J.L.P.; Staak, F.H.J.M. van der; Smeitink, J.A.M.

    2007-01-01

    BACKGROUND: Children with mitochondrial defects (MD) may have an increased risk for cardiorespiratory and neurological complications from anesthesia. The aim of this study was to determine the incidence of perioperative complications and adverse events in children with MD. METHODS: We performed a re

  12. Pharmacoeconomics of desflurane based minimal flow anesthesia for different durations of surgery

    Directory of Open Access Journals (Sweden)

    Habib M. R. Karim

    2016-12-01

    Conclusions: Desflurane consumption and cost do not depend on sex but on age, flow and time. It becomes more cost-effective for relatively longer duration of minimal flow anesthesia. [Int J Basic Clin Pharmacol 2016; 5(6.000: 2528-2533

  13. Comparison of surgical conditions in 2 different anesthesia techniques of esmolol-induced controlled hypotension in breast reduction surgery

    Science.gov (United States)

    Besir, Ahmet; Cekic, Bahanur; Kutanis, Dilek; Akdogan, Ali; Livaoglu, Murat

    2017-01-01

    Abstract Background: Breast reduction surgery is a common cosmetic surgery with a high incidence of blood loss and transfusion. In this surgery, the reduction of blood loss related to surgical manipulation and the volume of resected tissue is a target. In the present study, we compared the effects of esmolol-induced controlled hypotension on surgical visibility, surgical bleeding, and the duration of surgery in patients anesthetized with propofol/remifentanil (PR) or sevoflurane/remifentanil (SR). Methods: Patients in the American Society of Anesthesiologists I/II risk group undergoing breast reduction surgery were prospectively randomized into PR (n = 25) and SR (n = 25) groups. Controlled hypotension was induced with esmolol in both groups. During the intraoperative period, the heart rate (HR), mean arterial pressure (MAP), operation duration, volume of intraoperative blood loss, volume of blood received through postoperative drains, volume of resected tissues, and surgical area bleeding score were recorded. Results: The duration of operation in the incisional period was shorter in group PR compared to group SR (P = 0.04). The change in HR was lower in incision and hemostasis periods in the group PR compared to the group SR (P blood received through drains on postoperative postoperative day 1, day 2, and in total were found to be significantly lower in group PR compared to group SR. Surgical visibility scoring was more effective in group PR compared to SR. Conclusion: In the breast reduction surgery performed under esmolol-induced controlled hypotension, the effect of propofol + remifentanil anesthesia on the duration of incisional surgery, surgical visibility, and volume of surgical blood loss was more reliable and effective compared to that of sevoflurane + remifentanil, which seems to be an advantage. PMID:28272228

  14. Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Hammoudeh, MD, DDS

    2015-02-01

    Conclusions: It is our opinion that virtual model surgery will displace and replace traditional model surgery as it will become cost and time effective in both the private and academic setting for practitioners providing orthognathic surgical care in cleft and noncleft patients.

  15. Anesthesia management for robotic thoracic surgery%机器人辅助普胸手术的麻醉管理

    Institute of Scientific and Technical Information of China (English)

    沈耀峰; 徐美英; 吴镜湘

    2010-01-01

    Objective To explore the method of anesthesia and intra-operative management for robotic thoracic surgery. Methods Twelve patients who underwent robotic thoracic surgery using the Da Vinci surgical system were anesthetized with general anesthesia combined with T4-8 paravertebral block. After induction of anesthesia, a double-lumen endotracheal tube was positioned by bronchofibroscope to allow onelung ventilation during intra-operative procedure. Hemodynamics and respiratory function were routinely monitored and arterial blood gas (ABG) were tested during operation. Results All patients could tolerate the anesthesia for robotic thoracic surgery and there was no hospital mortality. The arterial carbon dioxide tension (PaCO2) and arterial oxygen tension (PaO2) after induction were (35.2 ± 3.6) mm Hg( 1 mm Hg =0.133 kPa) and (213.3 ± 57.5) mm Hg respectively; PaCO2 and PaO2 30 min after one -lung ventilation were (37.9 ± 4.8) mm Hg and ( 125.3 ± 36.5) mm Hg respectively. When the one-lung ventilation started about 58% (7/12) of the patient developed temporarily low SpO2 (over 0.90) and recovered to 0.95 soon when using 3 - 5 cm H2O( 1 cm H2O = 0.098 kPa) positive end expiratory pressure (PEEP). The anesthesia time was ( 291.5 ± 99.4) min, the time for one-lung ventilation was (206.3 ± 93.4) min, the volume of blood loses in operation was ( 171.7 ± 110.3 ) ml and the tracheal catheter extration time was ( 16.3 ± 4.5 ) min, all the patients left ICU on the second day after surgery. Conclusions The anesthesia for robotic thoracic surgery with Da Vinci surgical system is multiplicity, the hemodynamics and respiratory function can be instable, it is a new challenge for the technology and management of anesthesia. Good one-lung ventilation is important for this surgery, ventilation parameter need to be adjusted when hypoxia occurred and PEEP could be used to the ventilated lung. General anesthesia combined with paravertebral block will be a good option for

  16. The effect of sevoflurane versus propofol anesthesia on troponin I after congenital heart surgery, a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Leila Mahdavi

    2015-01-01

    Full Text Available Background : The ischemic preconditioning phenomenon can save myocardium against move severe ischemic damages and reduce infarction size and furthermore a heart rhythm disturbance. In this study we examine relationship between troponin I (as a structural myocardial protein level and anesthetic agents in the children. Materials and Methods: In this study 84 children under 12 years age before cardiac surgery were divided randomly into two groups of 42 each. For anesthetic maintenance sevoflurane with dose of 0.5-1 MAC was used in Group 1 and 100-150 mg/kg/min of intravenous propofol in Group 2 for maintenance of anesthesia. Troponin I level was assessed 2 before and 1 hour after anesthetic induction. Outcome measures included the serum cardiac troponin I level in children before and after surgery in two study groups. Results: There was no significant difference between two groups in indices and both groups were homogenous in this point of view. The troponin I level after surgery was significantly increased in two groups. In the sevoflurane group it was 0.04 ± 0.12 to 0.05 ± 0.09 ng/ml (P value = 0.003 and the propofol group was 0.12 ± 0.26 to 0.19 ± 0.38 ng/ml (P value = 0.001. Conclusions: In this study two Anesthetic regimens were compared to assess the mean troponin I level before and after pediatric closed heart surgery, and it was shown that mean troponin level before and after surgery in the sevoflurane group was less than the propofol group. But this result was not statistically significant. These results indicate that although more protective effects of sevoflurane on myocardial injuries during pediatric cardiac surgery is predominant but this effect has no significant difference in the propofol group.

  17. Inhaled nitric oxide in cardiac surgery: Evidence or tradition?

    Science.gov (United States)

    Benedetto, Maria; Romano, Rosalba; Baca, Georgiana; Sarridou, Despoina; Fischer, Andreas; Simon, Andre; Marczin, Nandor

    2015-09-15

    Inhaled nitric oxide (iNO) therapy as a selective pulmonary vasodilator in cardiac surgery has been one of the most significant pharmacological advances in managing pulmonary hemodynamics and life threatening right ventricular dysfunction and failure. However, this remarkable story has experienced a roller-coaster ride with high hopes and nearly universal demonstration of physiological benefits but disappointing translation of these benefits to harder clinical outcomes. Most of our understanding on the iNO field in cardiac surgery stems from small observational or single centre randomised trials and even the very few multicentre trials fail to ascertain strong evidence base. As a consequence, there are only weak clinical practice guidelines on the field and only European expert opinion for the use of iNO in routine and more specialised cardiac surgery such as heart and lung transplantation and left ventricular assist device (LVAD) insertion. In this review the authors from a specialised cardiac centre in the UK with a very high volume of iNO usage provide detailed information on the early observations leading to the European expert recommendations and reflect on the nature and background of these recommendations. We also provide a summary of the progress in each of the cardiac subspecialties for the last decade and initial survey data on the views of senior anaesthetic and intensive care colleagues on these recommendations. We conclude that the combination of high price tag associated with iNO therapy and lack of substantial clinical evidence is not sustainable on the current field and we are risking loosing this promising therapy from our daily practice. Overcoming the status quo will not be easy as there is not much room for controlled trials in heart transplantation or in the current atmosphere of LVAD implantation. However, we call for international cooperation to conduct definite studies to determine the place of iNO therapy in lung transplantation and high

  18. Total intravenous anesthesia for aortic aneurysm replacement surgery in a patient with limb-girdle dystrophy.

    Science.gov (United States)

    López Álvarez, A; Román Fernández, A; Vilanova Vázquez, V; Corujeira Rivera, M C; Areán González, I; Valiño Hortas, C

    2014-01-01

    We report the anesthetic management with total intravenous anesthesia of a 61-year-old male diagnosed with limb-girdle muscular dystrophy admitted for replacement of ascending aorta due to an aortic aneurysm. Limb-girdle muscular dystrophy belongs to a genetically heterogeneous group of muscular dystrophies involving shoulder and hip girdles. Although the risk of malignant hyperthermia does not seem to be increased in these patients compared with the general population, the exposure to inhaled anesthetics and succinylcholine should probably be avoided because these patients have a predisposition to hyperkalemia and rhabdomyolysis. We chose to use total intravenous anesthesia with propofol, remifentanil and muscle relaxants to reduce oxygen consumption, and later to reduce the doses of propofol and remifentanil. The combination of a carefully planned anesthetic strategy, anesthetic depth, and neuromuscular blockade monitoring is explained.

  19. Anesthesia and the Developing Brain: Relevance to the Pediatric Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Lisa Wise-Faberowski

    2014-04-01

    Full Text Available Anesthetic neurotoxicity has been a hot topic in anesthesia for the past decade. It is of special interest to pediatric anesthesiologists. A subgroup of children potentially at greater risk for anesthetic neurotoxicity, based on a prolonged anesthetic exposure early in development, are those children receiving anesthesia for surgical repair of congenital heart disease. These children have a known risk of neurologic deficit after cardiopulmonary bypass for surgical repair of congenital heart disease. Yet, the type of anesthesia used has not been considered as a potential etiology for their neurologic deficits. These children not only receive prolonged anesthetic exposure during surgical repair, but also receive repeated anesthetic exposures during a critical period of brain development. Their propensity to abnormal brain development, as a result of congenital heart disease, may modify their risk of anesthetic neurotoxicity. This review article provides an overview of anesthetic neurotoxicity from the perspective of a pediatric cardiac anesthesiologist and provides insight into basic science and clinical investigations as it relates to this unique group of children who have been studied over several decades for their risk of neurologic injury.

  20. 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.

  1. Effect of desflurane-remifentanil vs. Propofol-remifentanil anesthesia on arterial oxygenation during one-lung ventilation for thoracoscopic surgery: a prospective randomized trial

    OpenAIRE

    Cho, Youn Joung; Kim, Tae Kyong; Hong, Deok Man; Seo, Jeong-Hwa; Bahk, Jae-Hyon; Jeon, Yunseok

    2017-01-01

    Background One-lung ventilation during thoracic surgery frequently disturbs normal systemic oxygenation. However, the effect of anesthetics on arterial oxygenation during one-lung ventilation has not been well established in human study. In this clinical trial, we investigated whether a difference between desflurane-remifentanil and propofol-remifentanil anesthesia can be observed with regard to oxygenation during one-lung ventilation for thoracoscopic surgery. Methods Adult patients with lun...

  2. Low-Volume Brachial Plexus Block Providing Surgical Anesthesia for Distal Arm Surgery Comparing Supraclavicular, Infraclavicular, and Axillary Approach. A Randomized Observer Blind Trial

    DEFF Research Database (Denmark)

    Vazin, Mojgan; Jensen, Kenneth; Hjort, Mathias

    2016-01-01

    Background. Distal arm surgery is widely performed under regional anesthesia with brachial plexus block. The preponderance of evidence for the efficacy relies upon injection of local anesthetic in excess of 30 mL. We aimed to compare three different ultrasound-guided brachial plexus block techniq...

  3. A Survey on Awareness about the Role of Anesthesia and Anesthesiologists among the Patients Undergoing Surgeries in a Tertiary Care Teaching Women and Children Hospital

    Science.gov (United States)

    Marulasiddappa, Vinay; Nethra, H. N.

    2017-01-01

    Background: Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital. Designs: A prospective cross-sectional survey with a sample size of 100 patients. Materials and Methods: Patients scheduled to undergo elective surgery in the age group of 18–65 years with the American Society of Anesthesiologists (ASA) Grades 1 and 2, who are willing to participate and given written informed consent. Patients whose age 0.05) between those with previous surgery and those without previous surgery regarding their knowledge of anesthesiology and anesthesiologist. Ninety percent did not know the complications, types of anesthesia and 44% did not know that anesthesiologist is a doctor. Conclusion: Most of the participants were not aware of the role of anesthesia and anesthesiologists inside and outside OT. Although this could be attributed to their lower level of education, the fraternity of anesthesiologists has to educate patients and surgeons about the role of anesthesia. PMID:28298774

  4. A Triple-Masked, Randomized Controlled Trial Comparing Ultrasound-Guided Brachial Plexus and Distal Peripheral Nerve Block Anesthesia for Outpatient Hand Surgery

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    Nicholas C. K. Lam

    2014-01-01

    Full Text Available Background. For hand surgery, brachial plexus blocks provide effective anesthesia but produce undesirable numbness. We hypothesized that distal peripheral nerve blocks will better preserve motor function while providing effective anesthesia. Methods. Adult subjects who were scheduled for elective ambulatory hand surgery under regional anesthesia and sedation were recruited and randomly assigned to receive ultrasound-guided supraclavicular brachial plexus block or distal block of the ulnar and median nerves. Each subject received 15 mL of 1.5% mepivacaine at the assigned location with 15 mL of normal saline injected in the alternate block location. The primary outcome (change in baseline grip strength measured by a hydraulic dynamometer was tested before the block and prior to discharge. Subject satisfaction data were collected the day after surgery. Results. Fourteen subjects were enrolled. Median (interquartile range [IQR] strength loss in the distal group was 21.4% (14.3, 47.8%, while all subjects in the supraclavicular group lost 100% of their preoperative strength, P = 0.001. Subjects in the distal group reported greater satisfaction with their block procedures on the day after surgery, P = 0.012. Conclusion. Distal nerve blocks better preserve motor function without negatively affecting quality of anesthesia, leading to increased patient satisfaction, when compared to brachial plexus block.

  5. Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification

    Institute of Scientific and Technical Information of China (English)

    Ming; Chen; Christian; Swinney; Mindy; Chen

    2015-01-01

    AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery(FLACS) and traditional phacoemulsification for the first 18 mo of FLACS use at a private surgical center in Hawaii.METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined.All surgeries were performed at a single surgical center in Hawaii. The presence of intraoperative complications was used as the main outcome measure. Approval was obtained from the institutional review board of the University of Hawaii.RESULTS: The overall complication rate for FLACS was 1.8%, while that of the traditional procedure was5.8%(P <0.05). A majority of the surgeons(80%) had a lower complication rate while using FLACS.CONCLUSION: FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients.

  6. Comparing the intraoperative complication rate of femtosecond laser-assisted cataract surgery to traditional phacoemulsification

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2015-02-01

    Full Text Available AIM: To compare the complication rate of femtosecond laser-assisted cataract surgery (FLACS and traditional phacoemulsification for the first 18mo of FLACS use at a private surgical center in Hawaii. METHODS: A retrospective chart review was conducted from January 2012 to June 2013. The first 273 consecutive eyes receiving FLACS and 553 eyes receiving traditional phacoemulsification were examined. All surgeries were performed at a single surgical center in Hawaii. The presence of intraoperative complications was used as the main outcome measure. Approval was obtained from the institutional review board of the University of Hawaii. RESULTS: The overall complication rate for FLACS was 1.8%, while that of the traditional procedure was 5.8% (PCONCLUSION: FLACS is comparable in safety, if not safer, than traditional cataract surgery when performed by qualified cataract surgeons on carefully selected patients.

  7. Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries.

    Science.gov (United States)

    Lee, Gyusung I; Lee, Mija R; Clanton, Tameka; Clanton, Tamera; Sutton, Erica; Park, Adrian E; Marohn, Michael R

    2014-02-01

    We conducted this study to investigate how physical and cognitive ergonomic workloads would differ between robotic and laparoscopic surgeries and whether any ergonomic differences would be related to surgeons' robotic surgery skill level. Our hypothesis is that the unique features in robotic surgery will demonstrate skill-related results both in substantially less physical and cognitive workload and uncompromised task performance. Thirteen MIS surgeons were recruited for this institutional review board-approved study and divided into three groups based on their robotic surgery experiences: laparoscopy experts with no robotic experience, novices with no or little robotic experience, and robotic experts. Each participant performed six surgical training tasks using traditional laparoscopy and robotic surgery. Physical workload was assessed by using surface electromyography from eight muscles (biceps, triceps, deltoid, trapezius, flexor carpi ulnaris, extensor digitorum, thenar compartment, and erector spinae). Mental workload assessment was conducted using the NASA-TLX. The cumulative muscular workload (CMW) from the biceps and the flexor carpi ulnaris with robotic surgery was significantly lower than with laparoscopy (p  0.05). Robotic surgery experts and novices had significantly higher performance scores with robotic surgery than with laparoscopy (p cognitive ergonomics with robotic surgery were significantly less challenging. Additionally, several ergonomic components were skill-related. Robotic experts could benefit the most from the ergonomic advantages in robotic surgery. These results emphasize the need for well-structured training and well-defined ergonomics guidelines to maximize the benefits utilizing the robotic surgery.

  8. Body temperature increases during pediatric full mouth rehabilitation surgery under general anesthesia

    Directory of Open Access Journals (Sweden)

    Yi-Shan Chuang

    2015-12-01

    Conclusion: Body temperature transiently increased during pediatric full mouth rehabilitation surgery. The increase in body temperature was associated with operation duration. The etiology is uncertain. Continuous body temperature monitoring and the application of both heating and cooling devices during pediatric full mouth rehabilitation surgery should be mandatory.

  9. [Cardiac arrest after epidural anesthesia for a esthetic plastic surgery: a case report].

    Science.gov (United States)

    Pinheiro, Larissa Cardoso; Carmona, Bruno Mendes; de Nazareth Chaves Fascio, Mário; de Souza, Iris Santos; de Azevedo, Rui Antonio Aquino; Barbosa, Fabiano Timbó

    Cardiac arrest during neuraxial anesthesia is a serious adverse event, which may lead to significant neurological damage and death if not treated promptly. The associated mechanisms are neglected respiratory failure, extensive sympathetic block, local anaesthetic toxicity, total spinal block, in addition to the growing awareness of the vagal predominance as a predisposing factor. In the case reported, the patient was 25 years old, ASA I, scheduled for aesthetic lipoplasty. After sedation with midazolam and fentany, epidural anesthesia in interspaces T12-L1 and T2-T3 and catheter insertion into inferior puncture were performed. The patient remained in the supine position for 10minutes. Then, she was placed in the prone position, developing asystolic cardiac arrest 20minutes after the completion of neuraxial blockade. The medical team immediately placed the patient in the supine position and began cardiopulmonary resuscitation. Spontaneous circulation was achieved after twenty minutes of resuscitation. We discuss in this report the exacerbated vagal response as the main event mechanism. The patient's successful outcome emphasizes the importance of anaesthetic monitoring by anesthesiologists, prompt recognition and treatment of rhythm changes on the electrocardiogram. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  10. A comparison of thoracic spinal anesthesia with low-dose isobaric and low-dose hyperbaric bupivacaine for orthopedic surgery: A randomized controlled trial

    Science.gov (United States)

    Imbelloni, Luiz Eduardo; Gouveia, Marildo A.

    2014-01-01

    Background: The thoracic spinal anesthesia was first described in 1909 and recently revised for various surgical procedures. This is a prospective study aims to evaluate the parameters of the thoracic spinal anesthesia (latency, motor block and paresthesia), the incidence of cardiovascular changes and complications comparing low doses of isobaric and hyperbaric bupivacaine. Materials and Methods: A total of 200 orthopedic patients operated under spinal anesthesia were included in this study. Spinal anesthesia was between T9-T10, with a 27G cutting point or pencil tip in lateral or sitting. Spinal anesthesia was performed with 0.5% bupivacaine isobaric or hyperbaric. Patients remained in cephalad or head down position 10-20° for 10 minutes. We evaluated the demographics, analgesia, and degree of motor block, incidence of paresthesia, bradycardia, hypotension, anesthesia success and neurological complications. Results: All patients developed spinal and there was no failure. The solution did not affect the onset of the blockade. The duration of motor block was greater than the sensitive with isobaric. The duration of sensory block was greater than the motor block with hyperbaric solution. The incidence of paresthesia was 4%, with no difference between the needles. The incidence of hypotension was 12.5% with no difference between the solutions. There was no neurological damage in all patients. Conclusion: The beginning of the block is fast regardless of the solution used. By providing a sensory block of longer duration than the motor block hyperbaric bupivacaine is reflected in a better indication. Thoracic spinal anesthesia provides excellent anesthesia for lower limb orthopedic surgery PMID:25886099

  11. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis - hip ... You may receive general anesthesia for this surgery. This means you ... spinal anesthesia . With this kind of anesthesia, medicine is ...

  12. DEXAMETHASONE PROPHYLAXIS ON INCIDENCES OF POST-OPERATIVE NAUSEA AND VOMITING (PONV IN PATIENTS UNDERGOING GYNECOLOGICAL SURGERIES UNDER SPINAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Chandrashekharappa

    2014-05-01

    Full Text Available BACK GROUND: Nausea and vomiting are the most common distressing symptom in the post-operative period. It can result in delayed hospital discharge and increased hospital cost. The present study was done to assess the effect of dexamethasone prophylaxis on the incidences of nausea and vomiting in post-operative period in patients undergoing gynecological surgeries. MATERIAL AND METHODS: A total number of 66 patients, aged between 20 to 65 years, posted for elective gynecological surgeries under spinal anesthesia were included in the study. Patients were randomized into two groups of 33 patients each, and the study group (group-D received Inj. Dexamethasone 8 mg intravenously as prophylactic antiemetic 1 hour before surgery whereas control group (group-N received normal saline. Post-operatively, the frequency of nausea and vomiting were observed and its influences on postoperative analgesia were also noted. RESULTS: In our study, 4(12.1% patients in group-D and 8(24.2% patients in group-N had nausea and vomiting in the intraoperative period (p value=0.202. 24.2% patients in group-D had vomiting in the postoperative period as compared to 72.7% in group-N and group D patients had significant reduction in incidences of nausea and vomiting in immediate post-operative period compared to group N (p-value 0.016. Accordingly, the mean requirement of rescue antiemetic was less in group- D compared to Group-N. Further, patients in group-D had better VAS scores compared to patients in group-N in post-operative period. CONCLUSION: Use of Dexamethasone prior to subarachnoid block in patients undergoing gynecological surgeries reduces the incidence of nausea and vomiting and the requirement of antiemetic in the postoperative period, and better post-operative analgesia.

  13. Is I-gel airway a better option to endotracheal tube airway for sevoflurane-fentanyl anesthesia during cardiac surgery?

    Science.gov (United States)

    Elgebaly, Ahmed Said; Eldabaa, Ahmed Ali

    2014-01-01

    Background: Anesthetists used lower doses of fentanyl, successfully with hemodynamic control by titrating volatile anesthetic agents or vasodilators for fast-tracking in cardiac surgery. Hypothesis: Lower total doses of anesthetics and fentanyl could be required with hemodynamic control by use of supraglottic devices than endotracheal tube (ETT) and helps in fast-tracking. Design: A prospective randomized observational clinical trial study. Aims: The authors compared the utility of I-gel airway with a conventional ETT during the induction and maintenance of anesthesia with sevoflurane and fentanyl in adults undergoing cardiac surgery. Patients and Methods: A total of 49 adult patients underwent cardiac surgery were randomized into two groups according to the airway management: I-gel group (n = 23) and ETT group (n = 26). Doses of fentanyl and hemodynamic parameters (heart rate [HR], mean arterial pressure [MAP] central venous pressure [CVP], pulmonary artery pressure [PAP], and pulmonary capillary wedge pressure [PCWP]) were recorded preoperative, 5 min following tracheal intubation or I-gel airway insertion, after skin incision, after stenotomy, and after weaning off bypass. Results: None of the patients in the I-gel group required additional doses of fentanyl during the I-gel insertion, compared with 74% of the patients during laryngoscopy and endotracheal insertion in the ETT group, for an average total dose of 22.6 ± 0.6 μg/kg. The MAP and HR did not significantly differ from the baseline values at any point of measurement in either group. Furthermore, CVP, PAP, and PCWP measured during the procedure were significantly lower in I-gel group than ETT group. Extubation required more amount of time in ETT than I- gel group. Conclusion: The I-gel airway is well-tolerated by adult patients undergoing cardiac surgery, and requires lower total doses of anesthetics than endotracheal intubation with hemodynamic control and helps in fast-tracking. PMID:25886229

  14. 急腹症手术30例的麻醉处理%The Anesthesia Treatment of 30 Cases of Acute Abdomen Surgeries

    Institute of Scientific and Technical Information of China (English)

    于晓玲

    2014-01-01

    目的:探讨急腹症手术的麻醉处理。方法对2013年1月~2014年6月收治的急腹症手术患者30例,麻醉前准备,麻醉实施方法资料进行分析。结果所有急腹症患者经手术治疗均恢复良好,无麻醉并发症。结论根据急腹患者的具体情况,选择适合的麻醉方式进行操作,有效降低和避免手术中不良反应的发生,提高手术效果。%Objective The anesthesia treatment of abdomen surgeries to be investigated. Methods Analyzing the pre-anesthesia prepare work and anesthesia treatment data selected from 30 cases of patients with acute abdomen who are treated in hospital from January 2013 to June 2014.Results All of patients with acute abdomen have improved health state after surgery and no complications relapsed. Conclusion Choosing proper anesthesia way to cure patients based on their personal condition in order to reduce the side-effects of surgery and improve the surgical efficacy.

  15. Comparison of Hemodynamic Changes during General Anesthesia with Low-dose Isoflurane or Propofol in Elderly Patients Undergoing Upper Femoral Surgery

    Directory of Open Access Journals (Sweden)

    Mir Mohammad Taghi Mortazavi

    2016-01-01

    Full Text Available Background & objectives: Surgery of upper part of femor in elderly patients can be due to the fracture of femoral neck, shaft and arthroplasty. Hemodynamic changes and complications of the anesthesia are among the major concerns. The aim of this study was to compare the hemodynamic changes in low dose isoflurane with propofol in upper femoral surgeries in elderly patients. Methods: This prospective clinical trial study was done on 60 patients over 65 year-old elderly patients with ASA physical status of I and II that were candidate for upper femoral surgery in two groups (inhalational: isoflurane 0.5-0.6 MAC and (total intravenous anesthesia with propofol 50-100 mic/kg/min. Hemodynamic changes were compared in these groups with the same anesthetic depth (HR-SBP-DBP-MBP-SaO₂. Results: There was no significant difference in heart rate, age or sex between two groups. In isoflurane group SBP on 20 and 25th minutes and DBP and MBP on 20, 25 and 35th minutes were significantly higher than propofol group. In propofol group SaO₂ was significantly more than isoflurane group on induction, start of surgery and on 5, 25, 35 and 45th minutes of surgery. Conclusion: In anesthesia with the same Bi-Spectral Index, isoflurane provides more stable hemodynamic parameters than propofol.

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

    Directory of Open Access Journals (Sweden)

    Luciana Moraes dos Santos

    2009-04-01

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

  17. Is it safe to use local anesthesia with adrenaline in hand surgery? WALANT technique.

    Science.gov (United States)

    Pires Neto, Pedro José; Moreira, Leonardo de Andrade; Las Casas, Priscilla Pires de

    2017-01-01

    In the past it was taught that local anesthetic should not be used with adrenaline for procedures in the extremities. This dogma is transmitted from generation to generation. Its truth has not been questioned, nor the source of the doubt. In many situations the benefit of use was not understood, because it was often thought that it was not necessary to prolong the anesthetic effect, since the procedures were mostly of short duration. After the disclosure of studies of Canadian surgeons, came to understand that the benefits went beyond the time of anesthesia. The WALANT technique allows a surgical field without bleeding, possibility of information exchange with the patient during the procedure, reduction of waste material, reduction of costs, and improvement of safety. Thus, after passing through the initial phase of the doubts in the use of this technique, the authors verified its benefits and the patients' satisfaction in being able to immediately return home after the procedures.

  18. [Post-operative management for 86 cases of heart valve replacement surgery patients undergoing transcutaneous electrical acupoint stimulation combined with general anesthesia].

    Science.gov (United States)

    Zhou, Wen-Xiong; Xu, Jian-Jun; Wu, Yao-Yao; Chi, Hao; Chen, Tong-Yu; Ge, Wen; Zhou, Jia

    2014-02-01

    To summarize post-operative management strategy for heart valve replacement surgery under transcutaneous electrical acupoint stimulation (TEAS) combined with general anesthesia. From July 2006 to June 2012, a total of 86 cases of open-heart surgery patients experiencing TEAS plus general anesthesia with cardiopulmonary bypass (heart valve replacement surgery without intubation) were recruited in the present summary. Post-operative managements in the Intensive Care Unit (ICU) were administrated with strict hemodynamic monitoring for volume infusion, routine administration of vasoactive drugs (including dopamine and nitroglycerin), oxygen inhalation, and analgesics and monitoring of central nervous system and renal function. All the 86 patients under TEAS + general anesthesia and cardiopulmonary bypass and without intubation experienced successful heart valve replacement surgery. The post-operative pulmonary infection was found in 8 cases (9.30%), the average stay duration in ICU was (28.6 +/- 6.2) hours, and the average draining volume of the interpleural space was (291 +/- 73)mL. The cardia insufficiency was found in 5 cases (5.81%), hypoxia occurred in 8 cases (9.30%), nausea in 8 cases (9.30%), vomiting 5 cases (5.81%) and post-operative gastrointestinal distension 13 cases (15.12%), mild renal insufficiency 3 cases (3.49%), fever (> 38.5 degrees C) 1 case(1. 16%) and severe post-operative pain 7 cases (8.14%). TEAS combined with general anesthesia is safe for patients undergoing heart valve replacement surgery under cardiopulmonary bypass. The key points of treatment in ICU are volume infusion, body temperature maintenance, and pain control.

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

    Science.gov (United States)

    Fernandes, Adriano; Ettinger, João; Amaral, Fabiano; Ramalho, Maria José; Alves, Rodrigo; Módolo, Norma Sueli Pinheiro

    2014-12-01

    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. 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 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. 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 laparoscopic bariatric surgery.

  20. Effect of different anesthesia and analgesia methods on theT lymphocyte subsets, cytokines and stress hormone level in patients with breast cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Yan Ma; Xi-Qiang He; Geng Wang

    2015-01-01

    Objective: To explore the effect of different anesthesia and analgesia methods on the T lymphocyte subsets, cytokines and the levels of the stress hormone in patients with breast cancer surgery.Methods: 86 cases of breast cancer were divided into two groups by random digits table, control group of 43 cases with total intravenous anesthesia, and the observation group of 43 cases with total intravenous anesthesia combined with epidural anesthesia and postoperative underwent analgesia. The T lymphocyte subsets, cytokines and the levels of the stress hormone were detected before and after operation and compared. Results:CD3+, CD4+ and CD4+/CD8+ of the two groups at T1 or T2 were significantly lower than those at T0, and those in the observation group were significantly lower than the control group, and the difference between the two groups has statistical significance. IL-6, CRP and TNF-α levels of the two groups at T1, T2 or T3 were significantly higher than those at T0, and those in the observation group were significantly lower than the control group, and the difference between the two groups has statistical significance. Each index of two groups at T4 were restored to T0, and the differences were no statistically significant. The cortisol levels of two groups at T1 or T2 were significantly increased compared with T0, and the increase in the observation group was less than that of the control group, the difference between the two groups has statistical significance. The cortisol levels of two groups at T4 were restored to T0, and the differences were no statistically significant.Conclusion:Epidural analgesia after the intravenous anesthesia combined with epidural anesthesia for breast cancer cure patients has lighter immunosuppression and stress reaction, has less influence on inflammatory factors, is an ideal anesthesia and analgesia.

  1. Regional anesthesia for pediatrics

    OpenAIRE

    Türk, Hacer Şebnem; Işıl, Canan Tülay; Açık, Mehmet Eren; Ediz, Naim; Sayın, Pınar; Tombul, Merih; Oba, Sibel

    2015-01-01

    Objectives: Relevancy to regional anesthesia in pediatrics has increased, because it is complementary to general anesthesia, allows conscious postoperative analgesia without respiratory depression, technical difficulties have been defeated and new local anesthetics have been improved. Therefore we reported data of patients who underwent pediatric surgery and received regional anesthesia.Patients and methods: We retrospectively analyzed data of all patients, who were operated in the pediatric ...

  2. Risk factors of bradycardia in 50 cases of gastric surgery under general anesthesia

    Directory of Open Access Journals (Sweden)

    Reza Shariat Moharari

    2014-10-01

    Conclusion: The history of gastric cancer and previous chemotherapy might be the only common factors that cause to bradycardia and irresponsible asystole during gastric surgery in these patients. It seems that only close monitoring and vigilant anesthesiologist require for treatment and prevention from adverse effect of such a sever bradycardia event.

  3. High Spinal Anesthesia Enhances Anti-Inflammatory Responses in Patients Undergoing Coronary Artery Bypass Graft Surgery and Aortic Valve Replacement: Randomized Pilot Study.

    Science.gov (United States)

    Lee, Trevor W R; Kowalski, Stephen; Falk, Kelsey; Maguire, Doug; Freed, Darren H; HayGlass, Kent T

    2016-01-01

    Cardiac surgery induces many physiologic changes including major inflammatory and sympathetic nervous system responses. Here, we conducted a single-centre pilot study to generate hypotheses on the potential immune impact of adding high spinal anaesthesia to general anaesthesia during cardiac surgery in adults. We hypothesized that this strategy, previously shown to blunt the sympathetic response and improve pain management, could reduce the undesirable systemic inflammatory responses caused by cardiac surgery. This prospective randomized unblinded pilot study was conducted on 14 patients undergoing cardiac surgery for coronary artery bypass grafting and/or aortic valve replacement secondary to severe aortic stenosis. The primary outcome measures examined longitudinally were serum pro-inflammatory (IL-6, IL-1b, CCL2), anti-inflammatory (IL-10, TNF-RII, IL-1Ra), acute phase protein (CRP, PTX3) and cardiovascular risk (sST2) biomarkers. The kinetics of pro- and anti-inflammatory biomarker was determined following surgery. All pro-inflammatory and acute phase reactant biomarker responses induced by surgical stress were indistinguishable in intensity and duration between control groups and those who also received high spinal anaesthesia. Conversely, IL-10 levels were markedly elevated in both intensity and duration in the group receiving high spinal anesthesia (p = 0.005). This hypothesis generating pilot study suggests that high spinal anesthesia can alter the net inflammatory response that results from cardiac surgery. In appropriately selected populations, this may add incremental benefit by dampening the net systemic inflammatory response during the week following surgery. Larger population studies, powered to assess immune, physiologic and clinical outcomes in both acute and longer term settings, will be required to better assess potential benefits of incorporating high spinal anesthesia. ClinicalTrials.gov NCT00348920.

  4. [Caudal and spinal anesthesia in sub-umbilical surgery in children. Apropos of 1875 cases].

    Science.gov (United States)

    Aguemon, A R; Terrier, G; Lansade, A; Favereau, J P; Nathan, N; Feiss, P

    1996-01-01

    Caudal and spinal anaesthesia are two techniques widely used in European children. The aim of this retrospective study was to evaluate the applicability of this practice in developing countries. The study concerned 1875 children, 1 day to 17 years old. isobaric 0.5% bupivacaine was used for spinal anaesthesia (n = 730) and mixture a of 1% lidocaine-0.25% bupivacaine with epinephrine 1/200,000 for caudal anaesthesia (n = 1,145). Spinal anaesthesia was performed in neonates and infants (< 3 years) and caudal anaesthesia in children (aged 14 days to 17 years) undergoing urological and lower extremity surgery. No variation of heart rate, blood pressure or blood oxygen saturation (SpO2) were observed during surgery. Failure of the technique was less than 1%. These two regional anaesthesia techniques are easy to perform and are inexpensive. This is advantageous for developing countries.

  5. ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo

    Directory of Open Access Journals (Sweden)

    Leticia Bôa-Hora Rodrigues

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVES: Takotsubo cardiomyopathy, also known as broken heart syndrome is a stress-induced cardiomyopathy, which can be interpreted as an acute coronary syndrome as it progresses with suggestive electrocardiographic changes. The purpose of this article is to show the importance of proper monitoring during surgery, as well as the presence of an interdisciplinary team to diagnose the syndrome.CASE REPORT: Male patient, 66 years old, with diagnosis of gastric carcinoma, scheduled for diagnostic laparoscopy and possible gastrectomy. In the intraoperative period during laparoscopy, the patient always remained hemodynamically stable, but after conversion to open surgery he presented with ST segment elevation in DII. ECG during surgery was performed and confirmed ST-segment elevation in the inferior wall. The cardiology team was contacted and indicated the emergency catheterization. As the surgery had not yet begun irreversible steps, we opted for the laparotomy closure, and the patient was immediately taken to the hemodynamic room where catheterization was performed showing no coronary injury. The patient was taken to the hospital room where an echocardiogram was performed and showed slight to moderate systolic dysfunction, with akinesia of the mid-apical segments, suggestive of apical ballooning of the left ventricle. Faced with such echocardiographic finding and in the absence of coronary injury, the patient was diagnosed with intraoperative Takotsubo syndrome.CONCLUSION: Because the patient was properly monitored, the early detection of ST-segment elevation was possible. The presence of an interdisciplinary team favored the syndrome early diagnosis, so the patient was again submitted to safely intervention, with the necessary security measures taken for an uneventful new surgical intervention.

  6. ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo

    OpenAIRE

    Leticia Bôa-Hora Rodrigues; Ana Batista; Fátima Monteiro; João Silva Duarte

    2015-01-01

    ABSTRACTBACKGROUND AND OBJECTIVES: Takotsubo cardiomyopathy, also known as broken heart syndrome is a stress-induced cardiomyopathy, which can be interpreted as an acute coronary syndrome as it progresses with suggestive electrocardiographic changes. The purpose of this article is to show the importance of proper monitoring during surgery, as well as the presence of an interdisciplinary team to diagnose the syndrome.CASE REPORT: Male patient, 66 years old, with diagnosis of gastric carcinoma,...

  7. Music Reduces Postoperative Pain Perception in Male Patients after Abdominal Surgery under General Anesthesia

    OpenAIRE

    Varbanova MR; Neamtu A; Gaar E; Grigorov MV

    2016-01-01

    Background: Perioperative pain after abdominal surgery is difficult to manage. Despite the advent of multimodal analgesia techniques, the opioids remain the cornerstone of treatment. Since the opioids’ adverse effects are of concern immediate postoperatively, music as a modality that would influence human behavior, is of interest as an adjunct for acute pain management. Our hypothesis was that listening to instrumental music during the perioperative period reduces the pain level and decreases...

  8. The role of prostacyclin in the mesenteric traction syndrome during anesthesia for abdominal aortic reconstructive surgery.

    Science.gov (United States)

    Gottlieb, A; Skrinska, V A; O'Hara, P; Boutros, A R; Melia, M; Beck, G J

    1989-03-01

    Mesenteric traction syndrome consists of sudden tachycardia, hypotension, and cutaneous hyperemia, and frequently occurs during mesenteric traction in patients undergoing abdominal aortic aneurysm (AAA) reconstructive surgery. The etiology and clinical impact of this phenomenon are unknown, but the symptoms suggest a release of vasoactive materials from the mesenteric vascular bed. Thirty-one patients who underwent AAA surgery were studied. Mesenteric traction was accompanied by a decrease in systolic (p = 0.005) and diastolic (p less than 0.05) blood pressures, and in systemic vascular resistance (p less than 0.005), and was accompanied by an increase in heart rate (HR) (p less than 0.005), and cardiac output (p = 0.01). These hemodynamic changes coincided with an increase (p less than 0.001) in plasma concentrations of 6-keto-prostaglandin F1 (6-K-PGF1). No apparent change was found in prostaglandin E2, thromboxane B2, and histamine concentrations. The concentration of 6-K-PGF1 was correlated with diastolic blood pressure (r = -0.52, p less than 0.005) and HR (r = 0.65, p less than 0.001). Cutaneous hyperemia was observed in 58% of the patients. In an additional six patients, who had taken aspirin daily before AAA surgery, no significant changes were observed in the hemodynamic measurements or 6-K-PGF1 concentrations. These data suggest that mesenteric traction syndrome may be mediated at least in part by a selective release of prostacyclin.

  9. [Anesthesia in the pleuropulmonary complications surgery of tuberculosis: a 79 cases study].

    Science.gov (United States)

    Kane, O; Diouf, E; Beye, M D; Diarra, O; Ndoye Diop, M; Diouf, M; Ndiaye, M; Ka Sall, B

    2003-01-01

    Reported is a retrospective study carried out from Aristide Le Dantec Hospital in patients who underwent pleuropulmonary surgery after tuberculosis complication, from June 1995 to June 1999. The aim of this study was to evaluate the anaesthesiology procedures and outcomes of tuberculosis pleuropulmonary complications surgery. Seventy nine patients were studied. Their mean age was 34.63 years, and the sex ratio was 3.14. They all underwent general anaesthesia procedures with barbituric, morphinics et myorelaxants drugs. The peroperative complications noted were distributed as follow: 50 cases of haemorrhage needing transfusion, 18 cases of hypotension associated to the anaesthesia. In the intensive care period, we have noticed 30 atelectasia cases associated to a spastic bronchopathy, 3 cases of pulmonary oedema and 1 case of pulmonary infarctus. In the postoperative period, 8 cases of hemodynamic instability occurred, including 5 cases of cardiovascular collapsus treated by filling, and 2 septic shocks cases. An infectious bronchopneumopathy was noticed on 11 patients with two cases of septicaemia. The mortality rate was 6.3% (5 cases of death). The pleuropulmonary surgery in tuberculosis complication is very haemorrhagic, and therefore require an adequate preoperative preparation.

  10. Influence of anesthesia and surgery on the expression of transport receptors and catabolic enzymes of amyloid β-protein in aged rats

    Directory of Open Access Journals (Sweden)

    Yong-zhe LIU

    2014-10-01

    Full Text Available Objective To investigate the expression changes in transport receptor and catabolic enzymes of amyloid β-protein (Aβ in the brain of aged rats after surgery. Methods One hundred healthy SD rats were randomly divided into 4 groups according to their ages: aged control group (n=10, aged surgery group (n=40, young control group (n=10, and young surgery group (n=40. Rats in surgery group underwent hepatic lobectomy under anesthesia with 2% sevoflurane, followed by a 2-hour continuous anesthesia after the surgery, and then sacrificed on the 1st, 3rd, 7th and 15th day after surgery to obtain specimens. The expression of low-density lipoprotein receptor-related protein 1 (LRP-1 and receptor for advanced glycation end products (RAGE in the hippocampus, and the expression of insulin-degrading enzyme (IDE and neprilysin (NEP in the cerebral cortex were determined by immunohistochemistry. The mRNA expression of IDE and NEP in the hippocampus was determined with RT-PCR. Results Compared with aged control group, the expression of LRP-1, NEP and NEP mRNA decreased and the expression of RAGE increased at each time point, the expression of IDE decreased at 1st and 15th day after surgery, and the expression of IDE mRNA decreased at 3rd and 7th day and increased at 15th day after surgery in aged surgery group (P<0.05, P<0.01. Compared with young control group, the expression of IDE mRNA decreased and expressions of RAGE and NEP mRNA increased at each time point, the expression of LRP-1 decreased at 3rd, 7th and 15th day, the expression of IDE decreased at 1st, 3rd day and increased at 15th day, and the expression of NEP increased at 1st day and decreased at 3rd, 7th and 15th day after surgery in young surgery group (P<0.05, P<0.01. Conclusion The procedure of anesthesia and surgery could significantly inhibit the outward transport and enzymatic degradation of Aβ in the brain of aged rats, and this effect is less evident in young rats. DOI: 10.11855/j

  11. Anestesia subtenoniana en cirugía de estrabismo Sub-Tenon's anesthesia in strabismus surgery

    Directory of Open Access Journals (Sweden)

    Rosa M. Naranjo Fernández

    2004-12-01

    Full Text Available Se realizó un estudio descriptivo, retrospectivo de 30 pacientes con el diagnóstico de estrabismo que acudieron al Servicio de Oftalmología Pediátrica y Estrabismo del Hospital Oftalmológico Docente "Ramón Pando Ferrer" y fueron operados con la técnica de anestesia subtenoniana desde abril de 2003 hasta mayo de 2004; se analizaron las variables: edad, entidad diagnostica y grado de dolor. Se encontró que el rango de edad que predominó fue de 20 a 39 años, la esotropía como el diagnóstico más frecuente, el grado de dolor fue significativo en la tracción muscular y la técnica anestésica subtenoniana resultó efectiva independientemente de la técnica quirúrgica aplicada, sin complicaciones y con buena analgesia.A descriptive and retrospective study of 30 patients with the diagnosis of strabismus that were operated on at the Service of Pediatric Ophthalmology and Strabismus of "Ramón Pando Ferrer" Ophthalmological Hospital by the technique of sub-Tenon's anesthesia from April 2003 to May 2004 was conducted.The following variables were analyzed: age, diagnostic entity and pain degree. It was found a predominance of the age range 20-39. Esotropia was the most frequent diagnosis. The pain degree was significant in the muscular traction and the sub-Tenon's anesthetic technique proved to be effective independently of the surgical technique applied, without complications and with good analgesia.

  12. EPIDURAL COMBINED INTRAVENOUS ANESTHESIA AND TOTAL INTRAVENOUS ANESTHESIA IN UPPER ABDOMINAL SURGERY%硬膜外复合静脉全麻与全凭静脉麻醉在上腹部手术中的比较

    Institute of Scientific and Technical Information of China (English)

    朱洪远; 刘充卫; 姜华华

    2011-01-01

    [目的]比较硬膜外复合静脉全麻与全凭静脉麻醉对上腹部手术患者血流动力学、静脉麻醉药用量、术后苏醒、躁动及术后疼痛的影响.[方法]80例择期行上腹部手术患者完全随机分为硬膜外复合全麻组(A组)与全凭静脉麻醉组(B组).观察记录不同时间点两组患者血流动力学、静脉麻醉药用量、术后苏醒时间、躁动例数及术后疼痛VAS评分.[结果]两组患者术前术中血流动力学变化比较,差异无统计学意义.拔管后B组患者MAP和HR明显比A组增加,差异有统计学意义(P<0.05).A组患者丙泊酚、芬太尼、顺苯阿曲库铵用量明显比B组少,差异有统计学意义(P<0.01),术后清醒早,拔管时间明显缩短、躁动例数明显减少、术后镇痛良好.[结论]胸段硬膜外复合静脉全麻用于上腹部手术是一种安全、经济、有效并利于患者术后恢复快通道麻醉的首选麻醉方法.%[Objective] To compare the epidural combined intravenous anesthesia and total intravenous anesthesia on hemodynamics, drug dosage, intravenous anesthesia postoperative effects of waking up, restlessness and postoperative pain of patients with upper abdominal surgery. [Methods] 80 patients with elective abdominal operation on a row totally were randomly divided into epidural combined with General anesthesia Croup (group A) and total intravenous anaesthesia group (Group B). We recorded the blood flow dynamics in patients with two groups at various points the dosage, intravenous anesthesia, postoperative recovery time, number of restlessness and postoperative VAS pain score. [ Results] We compared the hemodynamic changes in patients of the two groups before surgery, and there was significant difference between the two groups. MAP and HR in Group B after extubation significantly increased than the group A (P < 0.05). The propofol, fentanyl and CIS-Atracurium dosage of benzene in Group A were significantly lower than in the B group

  13. Comparison of dexmedetomidine and clonidine as an adjuvant to ropivacaine for epidural anesthesia in lower abdominal and lower limb surgeries

    Directory of Open Access Journals (Sweden)

    Sruthi Arunkumar

    2015-01-01

    Full Text Available Background: The quality and duration of analgesia is improved when a local anesthetic is combined with alpha 2 adrenergic agonist. Though, the effects of clonidine on local anesthetics have been extensively studied, there are limited studies demonstrating the effects of epidural dexmedetomidine on local anesthetics. The aim of our study is to compare the effect of clonidine and dexmedetomidine when used as an adjuvant to epidural ropivacaine in lower abdominal and lower limb surgeries. Materials and Methods: Patients were randomized into two groups-group ropivacaine with clonidine (RC received 15 ml of 0.75% ropivacaine with 1 μg/kg clonidine and group ropivacaine with dexmedetomidine (RD received 15 ml of 0.75% ropivacaine with 1 μg/kg dexmedetomidine epidurally. Onset of sensory analgesia using cold swab, onset of motor blockade using Bromage scale, time to 2 dermatome regression of sensory level, time to first demand for analgesia, sedation using Ramsay sedation scale, intra operative hemodynamic parameters and complications were assessed. Results: The onset (RD-8.53 ± 1.81, RC-11.93 ± 1.96 and duration of sensory blockade (RD-316 ± 31.5, RC-281 ± 37, sedation were found to be significantly better in the dexmedetomidine group. No significant difference was found in terms of onset of motor blockade and hemodynamic changes. Conclusion: Dexmedetomidine at doses of 1 μg/kg is an effective adjuvant to ropivacaine for epidural anesthesia, which is comparable to clonidine.

  14. Surgery

    Science.gov (United States)

    ... days or even weeks after the surgical procedure. Spinal anesthesia and epidural anesthesia are specific types of regional ... childbirth. Headaches occasionally develop in the days after spinal anesthesia but usually can be treated effectively. General anesthesia ...

  15. Intraoperative cardiac arrest during anesthesia:a retrospective study of 218 274 anesthetics undergoing non-cardiac surgery in a US teaching hospital

    Institute of Scientific and Technical Information of China (English)

    AN Jian-xiong; Li-Ming Zhang; Erin A.Sullivan; GUO Qu-lian; John P.Williams

    2011-01-01

    Background Patient safety has been gained much more attention in recent years.The authors reviewed patients who had cardiac arrest in the operating rooms undergoing noncardiac surgery between January 1989 and December 2001 at the University of Pittsburgh Medical Center,USA.The main objectives of the study were to determine the incidence of intraoperative cardiac arrest,to identify possible causes of cardiac arrest and to explore amenable modifications.Methods With approval by the University of Pittsburgh Institutional Review Board,patients experienced cardiac arrest during surgery were retrieved from medical records,surgical operation and anesthesia records and pathological reports by searching the Medical Archival Retrieval System (MARS),a hospital electronic searching system.Cases of cardiac arrest were collected over a period of thirteen years from the Pre byteria University Hospital (PUH),USA.Results We found 23 cases of intraoperative cardiac arrests occurred in 218 274 anesthesia cases (1.1 per 10 000).Fourteen patients (60.8%) died in the operating room,leading to a mortality rate from all causes of 0.64 per 10 000 anesthetics.Immediate overall survival rate after arrest was 39% (9/23).Half of the patients (12/23) were emergency cases with 41% survival rate (5/12).One fourth of the arrests were trauma patients (6/23).Most arrest patients (87%,20/23) were American Society of Anesthesiologists Physical Status (ASA PS) Ⅳ and Ⅴ,while only three patients were ASA PS-Ⅰ,Ⅱ and Ⅲ,respectively.One case was attributable to an anesthesia-related cardiac arrest and recovered after successful resuscitation.Conclusions Most intraoperative cardiac arrests were not due to anesthesia-related causes.Anesthesia-related cardiac arrests might have a higher survival rate when compared to other possible causes of cardiac arrest in the operating room.

  16. [Calcium antagonists in anesthesia. Additive analgesia using nimodipine in heart surgery].

    Science.gov (United States)

    von Bormann, B; Boldt, J; Sturm, G; Kling, D; Weidler, B; Lohmann, E; Hempelmann, G

    1985-09-01

    Stress and pain induced by surgical trauma seem to be attenuated when calcium antagonists have been applied. In order to ascertain the effect of nimodipine, a new strong acting calcium channel blocker on plasma levels of various stress hormones twenty patients undergoing cardiovascular surgery where investigated in two groups. Ten patients received high-dose fentanyl anaesthesia (mean: 2,45 mg fentanyl/patient), whereas another ten patients were treated with 0,1 mg fentanyl/patient in addition to nimodipine 1,0 micrograms/kgbw X min (from onset of anaesthesia until start of extracorporeal circulation). Between the two groups were no significant differences with respect to perioperative course and postoperative demand for analgetics. Plasma levels of ACTH, somatotropin, glucose and free glycerol were markedly elevated in all patients (n = 20) intra- and postoperatively, whereas cortisol and prolactin remained unchanged. The present data suggest an additive analgesic effect of nimodipine during surgery. This phenomenon is possibly due to a blocking effect of calcium channel blockers on nociceptive nerves. The present model assumes that calcium is essential in pain perception and that decreased calcium would result in analgesia.

  17. Anesthesia information management systems

    OpenAIRE

    Feri Štivan; Janez Benedik; Tomaž Lužar

    2014-01-01

    Introduction: The use of anesthesia information management systems (AIMS) is on the increase. This is particularly true for academic anesthesia departments. The main reasons for slow adoption of these systems in the past are financial barriers associated with implementation of these systems and their not so traditionally obvious potential to improve patient care. In addition, a major obstacle to acceptance of this technology is the concern of users over the impact of the electronic anesthesia...

  18. [Anesthesia for non-specific surgery in a post-transplantation patient].

    Science.gov (United States)

    Steib, A; Freys, G; Otteni, J C

    1993-01-01

    The increase of non specific surgeries in transplanted patients may be related to the better survival achieved by the efficacy of immunosuppressive therapy and improved surgical and intensive care conditions. Therefore, the anaesthetist may be mandated to give anaesthesia in such patients, treated in hospitals which are not involved in transplantation procedures. The ignorance of the main physiologic and pharmacological changes in the new grafted organ as well as the knowledge of high risks of rejection or infection contribute to the anxiety often encountered in front of these patients. The denervated heart is unable to respond to stimulations requiring the integrity of autonomic neural mechanisms. Modulation of cardiac output depends on intrinsic activity (Frank-Starling mechanism) and therefore of end diastolic volume (preload). The denervated transplanted lung shows inability to elicit cough reflex; the latter is totally abolished in case of tracheal anastomosis. These physiologic changes have no deleterious effects on early cardiac and pulmonary functions following transplantation. In the same way, renal, liver or pancreatic functions are restored after respective replacement. However chronic rejection occurs frequently in 50% of patients in a mean time of 5 years following surgery except for liver transplanted patients which seem to be better protected. It results in a progressive decrease in organ function tests. The preoperative assessment requires primary contact with the transplant center. This communication should give precious information about the last biological and functional results as well as about the immunosuppressive therapy. Standard preoperative investigations include measurements of haemoglobin, urea, electrolyte and creatinine concentrations, liver tests, ECG, chest X-ray and coagulation pattern. Previsible difficult intubation should be detected in case of previous pancreas transplantation. Immunosuppressive therapy and other treatments

  19. [Hospital day-surgery: comparative evaluation of 3 general anesthesia techniques].

    Science.gov (United States)

    Rossi, A E; Lo Sapio, D; Oliva, O; Vitale, O; Ebano, A

    1995-06-01

    For the voluntary interruption of pregnancy, three anaesthetic techniques have been compared being a random assigned to three groups of 40 patients. Induction of anaesthesia was based on fentanyl 0.005 mg/kg+midazolam 0.2 mg/kg or fentanyl 0.005 mg/kg = propofol 2.5 mg/kg or ketamina 0.5 mg/kg+propofol 2.0 mg/kg. Anaesthesia was maintained delivering in spontaneous-assisted ventilation N2O 70% in O2. In addition to the intraoperative conditions, quality and rapidity of some neurofunctional aspects of the recovery have been evaluated using the Steward Score and the Coin Counting Test respectively. Our data suggest fentanyl-propofol association as the safest one as regards the needs of one-day surgery.

  20. Study on the anesthetic effect of combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children

    Institute of Scientific and Technical Information of China (English)

    Jing Liu

    2016-01-01

    Objective:To analyze the anesthetic effect of combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children.Methods:A total of118 cases of children with inguinal hernia who received laparoscopic surgery in our hospital from August 2012 to August 2014 were enrolled as research subjects and randomly divided into observation group 59 cases and control group 59 cases. Control group received conventional tracheal intubation intravenous general anesthesia, observation group received combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing, and then differences in respiratory and circulatory indicators, awareness-related indicators, G-6PD, PFK and inflammatory factor levels and oxidative stress levels between two groups were compared.Results:HR and MAP values of observation group at T1 and T2 were lower than those of control group, and SpO2 value was higher than that of control group; intraoperative Ppeak, Pplat, Raw, D(A-a)O2 and RI levels of observation group were lower than those of control group, and levels of Cdyn and OI were higher than those of control group; intraoperative G-6PD, PFK, CRP and IL-6 levels of observation group were lower than those of control group, and IL-10 level was higher than that of control group; intraoperative NO, SOD and GSH levels of observation group were higher than those of control group, and levels of ET-1, CAT and blood glucose were lower than those of control group.Conclusion:Combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children can effectively stabilize respiratory and circulatory level, reduce intraoperative systemic inflammation and oxidative stress state and contribute to early postoperative rehabilitation.

  1. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral ...

  2. Robotics and regional anesthesia.

    Science.gov (United States)

    Wehbe, Mohamad; Giacalone, Marilu; Hemmerling, Thomas M

    2014-10-01

    Robots in regional anesthesia are used as a tool to automate the performance of regional techniques reducing the anesthesiologist's workload and improving patient care. The purpose of this review is to show the latest findings in robotic regional anesthesia. The literature separates robots in anesthesia into two groups: pharmacological robots and manual robots. Pharmacological robots are mainly closed-loop systems that help in the titration of anesthetic drugs to patients undergoing surgery. Manual robots are mechanical robots that are used to support or replace the manual gestures performed by anesthesiologists. Although in the last decade researchers have focused on the development of decision support systems and closed-loop systems, more recent evidence supports the concept that robots can also be useful in performing regional anesthesia techniques. Robots can improve the performance and safety in regional anesthesia. In this review, we present the developments made in robotic and automated regional anesthesia, and discuss the current state of research in this field.

  3. Anestesia local e sedação para cirurgia de implante coclear: uma alternativa possível Local anesthesia for cochlear implant surgery: a possible alternative

    Directory of Open Access Journals (Sweden)

    Rogério Hamerschmidt

    2010-10-01

    Full Text Available Aanestesia geral sempre foi motivo de dúvida dos pacientes que vão ser submetidos a qualquer cirurgia, especialmente o implante coclear. Como já realizamos as cirurgias otológicas com anestesia local e sedação, julgamos perfeitamente possível a realização da cirurgia do implante coclear também com esse tipo de anestesia, diminuindo os riscos, a morbidade e os custos para o hospital. OBJETIVOS: Estudo prospectivo para demonstrar a técnica anestésica e cirúrgica utilizada em três casos de adultos submetidos ao implante coclear, avaliando a segurança e a eficácia de tal técnica. MATERIAL E MÉTODOS: Foram feitas três cirurgias de implante coclear, duas com implante Cochlear e uma com Med-EL, sem intercorrências transoperatórias, durante a telemetria e no pós-operatório imediato. RESULTADOS: Os três pacientes adultos tiveram alta hospitalar aproximadamente três horas após a cirurgia, deambulando, sem eventos nauseosos, relatando um pós-operatório mais fácil do que esperavam, mesmo no momento da telemetria intraoperatória. CONCLUSÃO: Anestesia local e sedação é uma alternativa para casos selecionados de pacientes para o implante coclear, principalmente naqueles de mais idade ou que apresentem contraindicação para a anestesia geral, os riscos e a morbidade são menores.The aim of this paper is to illustrate the possibility of performing a cochlear implant surgery with local anesthesia and sedation, the anesthetic technique and the advantages of that in comparison to a general anesthesia. AIMS: prospective study demonstrating the possibility of doing cochlear implant surgery under local anesthesia and sedation. MATERIALS AND METHODS: we describe three successful cases operated under local anesthesia, including neural telemetry and the conditions the patient presented after the surgery, with a very good recovery and no complications during and after the procedure. RESULTS: these three surgeries show the possibility of

  4. Single shot spinal anesthesia with very low hyperbaric bupivacaine dose (3.75 mg) for hip fracture repair surgery in the elderly. A randomized, double blinded study.

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    Errando, C L; Peiró, C M; Gimeno, A; Soriano, J L

    2014-11-01

    Single shot spinal anesthesia is used worldwide for hip fracture repair surgery in the elderly. Arterial hypotension is a frequent adverse effect. We hypothesized that lowering local anesthetics dose could decrease the incidence of arterial hypotension, while maintaining quality of surgical anesthesia. In a randomized double blinded study, 66 patients over the age of 65 years, with hip fracture needing surgical repair, were assigned to B0.5 group 7.5mg hyperbaric bupivacaine 5mg/ml (control group), and B0.25 group 3.75mg hyperbaric bupivacaine 2.5mg/ml (study group). Sensory and motor block level, and hemodynamic parameters including blood presure, heart rate and vasopressor dose administration were registered, along with rescue anesthesia needs, the feasibility of surgery, its duration, and regression time of sensory anesthesia to T12. After exclusions, 61 patients were included in the final analysis. Arterial hypotension incidence was lower in the B0.25 group (at the 5, 10, and 15min determinations), and a lower amount of vasopressor drugs was needed (mean accumulated ephedrine dose 1.6mg vs. 8.7mg in the B0.5 group, p<0.002). Sensory block regression time to T12 was shorter in the B0.25 group, mean 78.6±23.6 (95% CI 51.7-110.2)min vs. 125.5±37.9 (95% CI 101.7-169.4)min in the B0.5 group, p=0.033. All but one patient in the B0.25 group were operated on under the anesthetic procedure first intended. No rescue anesthesia was needed. Lowering bupivacaine dose for single shot spinal anesthesia for hip fracture repair surgery in elderly patients was effective in decreasing the occurrence of arterial hypotension and vasopressor use, while intraoperative quality remained. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Anesthesia and Intensive care implications for pituitary surgery: Recent trends and advancements

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    Sukhminder Jit Singh Bajwa

    2011-01-01

    Full Text Available The advancements in neuro-endocrine surgical interventions have been well supported by similar advancements in anesthesiology and intensive care. Surgery of the pituitary tumor poses unique challenges to the anesthesiologists and the intensivists as it involves the principles and practices of both endocrine and neurosurgical management. A multidisciplinary approach involving the endocrine surgeon, neurosurgeon, anesthesiologist, endocrinologist and intensivist is mandatory for a successful surgical outcome. The focus of pre-anesthetic checkup is mainly directed at the endocrinological manifestations of pituitary hypo or hyper-secretion as it secretes a variety of essential hormones, and also any pathological state that can cause imbalance of pituitary secretions. The pathophysiological aspects associated with pituitary tumors mandate a thorough airway, cardiovascular, neurologic and endocrinological assessment. A meticulous preoperative preparation and definite plans for the intra-operative period are the important clinical components of the anesthetic strategy. Various anesthetic modalities and drugs can be useful to provide a smooth intra-operative period by countering any complication and thus providing an uneventful recovery period.

  6. [Total intravenous anesthesia (TIVA) in geriatric surgery. S-(+)-ketamine versus alfentanil].

    Science.gov (United States)

    Adams, H A; Beigl, B; Schmitz, C S; Baltes-Götz, B

    1995-12-01

    In this prospective, randomized study, two regimens of total intravenous anaesthesia (TIVA), with propofol and S(+)-ketamine (S-ketamine) and with propofol and alfentanil, were compared with reference to endocrine stress response, circulatory effects and recovery. METHODS. The investigation was conducted in two groups of 20 ASA I-III patients over 60 years of age who were scheduled for endoprothetic orthopaedic surgery. After oral premedication with midazolam, patients received a TIVA with body-weight-adjusted doses of propofol, and S-ketamine or alfentanil as the analgesic component. For CPPV (PEEP 5 mbar), air and oxygen (FiO2 33%) were used. For muscle relaxation, patients of both groups received vecuronium in body-weight-adjusted doses. Blood samples were taken through a central venous line at seven time points before induction of anaesthesia and on the first morning after the operation also for analysis of epinephrine, norepinephrine (by HPLC/ECD), and ADH, ACTH and cortisol (by RIA). In addition, SAP, HR, arterial oxygen saturation, recovery from anaesthesia and side effects were observed. RESULTS. The two groups had comparable group mean values for age (S-ketamine group 71 years, alfentanil-group 70 years), other biometric data, and duration of anaesthesia and operation (Table 1). Plasma levels of epinephrine, norepinephrine (Table 2, Fig. 1), ADH (Table 2, Fig. 2) ACTH and cortisol (Table 2, Fig. 3) were higher in the S-ketamine-group (P eustress" might be beneficial in this group of patients. On the other hand, TIVA with propofol and alfentanil showed sympatholytic properties, with negative circulatory effects and a remarkable reduction of endocrine stress response. This might be beneficial in patients with hypertension and states of endocrine hyperfunction. Both regimens were accompanied by such typical side effects as dreams, delayed recovery, reduced ventilation, and emesis, which should also be considered.

  7. The application of transcutaneous CO2 pressure monitoring in the anesthesia of obese patients undergoing laparoscopic bariatric surgery.

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    Shijiang Liu

    Full Text Available To investigate the correlation and accuracy of transcutaneous carbon dioxide partial pressure (PTCCO2 with regard to arterial carbon dioxide partial pressure (PaCO2 in severe obese patients undergoing laparoscopic bariatric surgery. Twenty-one patients with BMI>35 kg/m(2 were enrolled in our study. Their PaCO2, end-tidal carbon dioxide partial pressure (PetCO2, as well as PTCCO2 values were measured at before pneumoperitoneum and 30 min, 60 min, 120 min after pneumoperitoneum respectively. Then the differences between each pair of values (PetCO2-PaCO2 and. (PTCCO2-PaCO2 were calculated. Bland-Altman method, correlation and regression analysis, as well as exact probability method and two way contingency table were employed for the data analysis. 21 adults (aged 19-54 yr, mean 29, SD 9 yr; weight 86-160 kg, mean 119.3, SD 22.1 kg; BMI 35.3-51.1 kg/m(2, mean 42.1,SD 5.4 kg/m(2 were finally included in this study. One patient was eliminated due to the use of vaso-excitor material phenylephrine during anesthesia induction. Eighty-four sample sets were obtained. The average PaCO2-PTCCO2 difference was 0.9 ± 1.3 mmHg (mean ± SD. And the average PaCO2-PetCO2 difference was 10.3 ± 2.3 mmHg (mean ± SD. The linear regression equation of PaCO2-PetCO2 is PetCO2 = 11.58+0.57 × PaCO2 (r(2 = 0.64, P<0.01, whereas the one of PaCO2-PTCCO2 is PTCCO2 = 0.60 + 0.97 × PaCO2 (r(2 = 0.89. The LOA (limits of agreement of 95% average PaCO2-PetCO2 difference is 10.3 ± 4.6 mmHg (mean ± 1.96 SD, while the LOA of 95% average PaCO2-PTCCO2 difference is 0.9 ± 2.6 mmHg (mean ± 1.96 SD. In conclusion, transcutaneous carbon dioxide monitoring provides a better estimate of PaCO2 than PetCO2 in severe obese patients undergoing laparoscopic bariatric surgery.

  8. 人工智能辅助手术的麻醉管理%Anesthesia management of artificial intelligence-assisted surgery

    Institute of Scientific and Technical Information of China (English)

    丁玲玲; 袁维秀; 米卫东; 张宏

    2013-01-01

    Background With the development of minimally invasive surgery in our country,to da Vinci robotic surgical system has been developed to carry out complex and difficult surgery.As the representative of artificial intelligence-assisted surgery systems in clinical surgery more widely,prolonged anesthesia artificial intelligence assisted surgery increases the complexity of the anesthesia presents new challenges.Objective This paper analyzed and summarized the anesthetic management strategies of artificial intellgence-assisted surgery systems.Content This paper reviewed preoperative evaluation,type of anesthesia and anesthetic management of the central nervous system and other aspects in patients in artificial intelligence surgical system.Trend Artificial intelligenc-assisted surgery is an important advance in minimally invasive surgery.The effects about respiratory,circulatory and nervous system need to be further summarized.%背景 随着微创外科在我国的发展,以达芬奇手术机器人系统为代表的人工智能辅助手术系统在临床外科的应用越来越广泛,已发展到可以进行复杂高难度的手术操作.长时间人工智能辅助手术增加了麻醉的复杂性,对麻醉提出了新挑战. 目的 对人工智能辅助手术系统的麻醉管理策略分析总结. 内容 对人工智能辅助手术患者的麻醉术前评估、麻醉方法的选择以及对患者术中呼吸、循环、内环境、中枢神经系统的管理等方面进行综述. 趋势 人工智能辅助手术是微创外科的重要进步,其手术中对呼吸、循环、神经系统的影响待进一步总结.

  9. Effect of the duration of food withholding prior to anesthesia on gastroesophageal reflux and regurgitation in healthy dogs undergoing elective orthopedic surgery.

    Science.gov (United States)

    Viskjer, Sivert; Sjöström, Lennart

    2017-02-01

    OBJECTIVE To compare the incidence of and risk factors for gastroesophageal reflux (GER) and regurgitation associated with preanesthetic food withholding for periods of 18 hours (overnight) and 3 hours in healthy dogs undergoing elective orthopedic surgery. ANIMALS 82 healthy (American Society of Anesthesiologists physical status classification I or II) client-owned dogs. PROCEDURES Food was withheld for 18 hours (18-hour group [n = 41]) or each dog was allowed to consume half its daily ration of canned food approximately 3 hours (3-hour group [n = 41]) prior to induction of anesthesia. In each anesthetized dog, a pH catheter was introduced through the oropharynx into the distal portion of the esophagus; the pH was continuously recorded throughout the period of anesthesia. Gastroesophageal reflux was defined as pH food withholding. Regurgitation was significantly associated with duration of GER and duration of preanesthetic food withholding. During anesthesia, 25 (61%) dogs in the 3-hour group had GER and 12 (48%) of those dogs regurgitated gastric content; 18 (43.9%) dogs in the 18-hour group had GER and 2 (11.1%) of those dogs regurgitated gastric content. The mean lowest pH measured in the refluxate in the 3-hour group (2.3) was significantly greater than that in the 18-hour group (1.3). CONCLUSIONS AND CLINICAL RELEVANCE Among the study dogs undergoing orthopedic surgery, consumption of a light meal 3 hours prior to anesthesia was associated with significantly greater odds of reflux and regurgitation, compared with overnight food withholding.

  10. Case series: Dexmedetomidine and ketamine for anesthesia in patients with uncorrected congenital cyanotic heart disease presenting for non-cardiac surgery

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    Rakhee Goyal

    2013-01-01

    Full Text Available The number of patients with uncorrected congenital cyanotic heart disease is less but at times some may present for non-cardiac surgery with a high anesthetic risk. Some of these may even be adults with compromised cardiopulmonary physiology posing greater challenges to the anesthesiologist. The authors have used a combination of dexmedetomidine and ketamine for anesthesia for non cardiac surgery in five patients with cyanotic heart disease and right to left shunt (3-Eisenmenger′s syndrome, 2-Tetralogy of Fallot. The sympathoinhibitory effects of dexmedetomidine were balanced with the cardiostimulatory effects of ketamine, thereby maintaining good cardiovascular stability. The analgesia was good and there was no postoperative agitation.This drug combination was effective and safe for patients with cyanotic heart disease for non cardiac surgeries.

  11. Knee microfracture surgery

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    Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

  12. Lung surgery

    Science.gov (United States)

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  13. The application of laryngeal mask in anesthesia of minor surgeries in pediatric surgery%喉罩在儿外科短小手术麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    贾兰芹

    2016-01-01

    Objective:To investigate the application effect of laryngeal mask in anesthesia of minor surgeries in pediatric surgery. Methods:60 pediatric patients with elective minor surgery were selected,they were divided into the laryngeal mask group and the tracheal intubation group on average,we compared the anesthetic effect and complications of the two groups.Results:The time of extubation of the tracheal intubation group was longer than the laryngeal mask group,the incidence of postoperative restlessness and sore throat of the tracheal intubation group were higher than the control group(P<0.05).Conclusion:The effect of laryngeal mask in anesthesia of minor surgeries in pediatric surgery is good and the complication is low.%目的:探讨喉罩在儿外科短小手术麻醉中的应用效果.方法:收治择期外科短小手术小儿60例,平均分为喉罩组和气管插管组,比较两组麻醉效果及并发症情况.结果:气管插管组拔管时间较喉罩组长;咽痛和术后躁动发生率较喉罩组高(P<0.05).结论:小儿外科短小手术喉罩麻醉效果好,麻醉后并发症少.

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

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    Hedenstierna Göran

    2011-05-01

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

  15. Effects of Addition of Systemic Tramadol or Adjunct Tramadol to Lidocaine Used for Intravenous Regional Anesthesia in Patients Undergoing Hand Surgery.

    Science.gov (United States)

    Yektaş, Abdulkadir; Gümüş, Funda; Karayel, Abdulhalim; Alagöl, Ayşin

    2016-01-01

    Intravenous regional anesthesia (IVRA) is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages. The present study aimed to investigate the effects of addition of systemic tramadol or adjunct tramadol to lidocaine for IVRA in patients undergoing hand surgery. American Society of Anesthesiologists (ASA) I-II patients (n = 60) who underwent hand surgery were included. For this purpose, only lidocaine (LDC), lidocaine+adjunct tramadol (LDC+TRA group), or lidocaine+systemic tramadol (LDC+SysTRA group) was administered to the patients for IVRA and the groups were compared in terms of onset and recovery time of sensory and motor blocks, quality of anesthesia, and the degree of intraoperative and postoperative pain. The onset time of sensorial block was significantly shorter in the LDC+TRA group than that in the LDC+SysTRA group. The motor block recovery time was significantly shorter in the LDC+SysTRA group than that in the LDC+TRA and LDC groups. Administration of tramadol as an adjunct showed some clinical benefits by providing a shorter onset time of sensory and motor block, decreasing pain and analgesic requirement, and improving intraoperative conditions during IVRA. It was determined that systemic tramadol administration had no superiority.

  16. Effects of Addition of Systemic Tramadol or Adjunct Tramadol to Lidocaine Used for Intravenous Regional Anesthesia in Patients Undergoing Hand Surgery

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    Abdulkadir Yektaş

    2016-01-01

    Full Text Available Intravenous regional anesthesia (IVRA is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages. The present study aimed to investigate the effects of addition of systemic tramadol or adjunct tramadol to lidocaine for IVRA in patients undergoing hand surgery. American Society of Anesthesiologists (ASA I-II patients (n=60 who underwent hand surgery were included. For this purpose, only lidocaine (LDC, lidocaine+adjunct tramadol (LDC+TRA group, or lidocaine+systemic tramadol (LDC+SysTRA group was administered to the patients for IVRA and the groups were compared in terms of onset and recovery time of sensory and motor blocks, quality of anesthesia, and the degree of intraoperative and postoperative pain. The onset time of sensorial block was significantly shorter in the LDC+TRA group than that in the LDC+SysTRA group. The motor block recovery time was significantly shorter in the LDC+SysTRA group than that in the LDC+TRA and LDC groups. Administration of tramadol as an adjunct showed some clinical benefits by providing a shorter onset time of sensory and motor block, decreasing pain and analgesic requirement, and improving intraoperative conditions during IVRA. It was determined that systemic tramadol administration had no superiority.

  17. Effect of thoracic epidural anesthesia on oxygen delivery and utilization in cardiac surgical patients scheduled to undergo off-pump coronary artery bypass surgery: A prospective study

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    Suryaprakash Sharadaprasad

    2011-01-01

    Full Text Available To evaluate the effect of thoracic epidural anesthesia (TEA on tissue oxygen delivery and utilization in patients undergoing cardiac surgery. This prospective observational study was conducted in a tertiary referral heart hospital. A total of 25 patients undergoing elective off-pump coronary artery bypass surgery were enrolled in this study. All patients received thoracic epidural catheter in the most prominent inter-vertebral space between C7 and T3 on the day before operation. On the day of surgery, an arterial catheter and Swan Ganz catheter (capable of measuring cardiac index was inserted. After administering full dose of local anesthetic in the epidural space, serial hemodynamic and oxygen transport parameters were measured for 30 minute prior to administration of general anesthesia, with which the study was culminated. A significant decrease in oxygen delivery index with insignificant changes in oxygen extraction and consumption indices was observed. We conclude that TEA does not affect tissue oxygenation despite a decrease in arterial pressures and cardiac output.

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

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    Parvin Sajedi

    2013-01-01

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

  19. Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial

    DEFF Research Database (Denmark)

    Rafiq, Sulman; Steinbrüchel, Daniel Andreas; Wanscher, Michael Jaeger

    2014-01-01

    BACKGROUND: To evaluate if an opiate sparing multimodal regimen of dexamethasone, gabapentin, ibuprofen and paracetamol had better analgesic effect, less side effects and was safe compared to a traditional morphine and paracetamol regimen after cardiac surgery. METHODS: Open-label, prospective...... significantly lower average pain scores from the day of surgery throughout the third postoperative day. Extensive nausea and vomiting, was found in no patient in the multimodal group but in 13 patients in the morphine group, p ...-significant rise in the multimodal group, 33.0±53.4 vs. 19.9±48.5, p = 0.133. Patients in the multimodal group suffered less major in-hospital events in crude numbers: myocardial infarction (MI) (1 vs. 2, p = 0.54), stroke (0 vs. 3, p = 0.075), dialysis (1 vs. 2, p = 0.54), and gastrointestinal (GI) bleeding (0 vs...

  20. Prognostic factors for death and survival with or without complications in cardiac arrest patients receiving CPR within 24 hours of anesthesia for emergency surgery

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    Siriphuwanun V

    2014-10-01

    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, Chiang Mai, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Purpose: To determine prognostic factors for death and survival with or without complications in cardiac arrest patients who received cardiopulmonary resuscitation (CPR within 24 hours of receiving anesthesia for emergency surgery. Patients and methods: A retrospective cohort study approved by the Maharaj Nakorn Chiang Mai University Hospital Ethical Committee. Data used were taken from records of 751 cardiac arrest patients who received their first CPR within 24 hours of anesthesia for emergency surgery between January 1, 2003 and October 31, 2011. The reviewed data included patient characteristics, surgical procedures, American Society of Anesthesiologist (ASA physical status classification, anesthesia information, the timing of cardiac arrest, CPR details, and outcomes at 24 hours after CPR. Univariate and polytomous logistic regression analyses were used to determine prognostic factors associated with the outcome variable. P-values of less than 0.05 were considered statistically significant. Results: The outcomes at 24 hours were death (638/751, 85.0%, survival with complications (73/751, 9.7%, and survival without complications (40/751, 5.3%. The prognostic factors associated with death were: age between 13–34 years (OR =3.08, 95% CI =1.03–9.19; ASA physical status three and higher (OR =6.60, 95% CI =2.17–20.13; precardiopulmonary comorbidity (OR =3.28, 95% CI =1.09–9.90; the condition of patients who were on mechanical ventilation prior to receiving anesthesia (OR =4.11, 95% CI =1.17–14.38; surgery in the upper abdominal site (OR =14.64, 95% CI =2.83–75.82; shock prior to cardiac arrest (OR =6.24, 95% CI =2.53–15

  1. Acute Paraplegia After General Anesthesia

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    Gholam Hossein Ghaedi

    2011-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  3. Hand Surgery: Anesthesia

    Science.gov (United States)

    ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ...

  4. Effect of Different Anesthesia on Deep Venous Thrombosis after Orthopedic Surgery%不同麻醉方法对骨科手术患者深静脉血栓形成的影响

    Institute of Scientific and Technical Information of China (English)

    姚杰; 孟尽海; 王文娟; 刘斐; 吴燕; 王春生

    2013-01-01

    Objective To investigate the effects of different anesthesia on deep venous thrombosis (DVT) after orthopedic surgery. Methods Charts from consecutive patients who underwent orthopedic surgery from January 1 , 2008, to December 31 , 2010, at a large Chinese teaching hospital were reviewed using standardized case report forms. The incidence of DVT after orthopedic surgery in general anesthesia, spinal - epidural anesthesia and regional block anesthesia were compared. Results This investigation included 4892 patients and 204 patients developed DVT (incidence = 4.17% ). The incidence of DVT in the group of general anesthesia was higher than in those of spinal - epidural anesthesia, regional block anesthesia and no anesthesia (P 0.05). The counts of white blood cell, neutrophil and monocyte of the group after general anesthesia were higher than those of spinal - epidural anesthesia and regional block anesthesia(P<0. 05 ). Conclusion The incidence of DVT in the group of general anesthesia is higher than spinal -epidural anesthesia. In addition, regional block anesthesia and no anesthesia were similar. Inflammatory cell in the group of general anesthesia are higher than that in group of spinal - epidural anesthesia, regional block anesthesia and no anesthesia.%目的 研究不同麻醉方法对深静脉血栓(DVT)的影响.方法 以4892例骨科住院患者病例资料为研究对象进行回顾性分析,比较全身麻醉组、椎管内麻醉组、区域阻滞组DVT的发生率.结果 4892例患者中204例发生DVT,总发生率为4.17%,全麻组DVT的发生率高于椎管内组、区域阻滞组和未行麻醉组(P<0.01);椎管内组DVT的发生率高于区域阻滞组(P<0.05).区域阻滞组和未行麻醉组DVT的发生率相当,差异无统计学意义(P>0.05).全身麻醉组患者术后白细胞、中性粒细胞、单核细胞计数高于椎管内麻醉组和区域阻滞麻醉组(P<0.05).结论 全身麻醉后患者深静脉血栓的发生率最高,

  5. Accuracy of Neutrophil Gelatinase-Associated Lipocalin in Detecting Acute Kidney Injury after Urogenital Robotic Assisted Laparoscopic Surgery under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Orsolya MIHÁLY

    2012-06-01

    Full Text Available The aim of this study was to demonstrate the accuracy of NGAL in detecting acute kidney injury (AKI after urogenital robotic surgery in general anesthesia. Methods: A prospective longitudinal observational study, which included patients scheduled for elective robotic surgery under general anesthesia. The serum and urine NGAL at induction, 6 hours and 12 hours were determined. Serum creatinine was measured preoperatively and daily 4 days postoperatively. AKI was defined as the absolute growth of serum creatinine by 0.3 mg/dl over baseline within 48 hours postoperatively. Results: 24 patients were enrolled in the study. AKI occurred in 38% of patients. Serum NGAL increased significantly at 6 hours and 12h, compared to baseline, with a higher increase in the group of patents without AKI. There were no significant results for urine NGAL. A link was observed between the values of serum NGAL, with associated significance p<0.0001. The correlations between urine NGAL were not significant. The predictive value of NGAL, analyzed by cross-tabulation, OR was 3 for baseline value and 5.33 for the values measured at 6 hours and 12 hours, but with no statistical significance. Conclusions: The modifications of the NGAL levels, measured at 6 hours and 12 hours from the induction of anesthesia, were significant with more importance at 6 hours and in patients without AKI. Serum NGAL had no predictive value for AKI, but the risk to develop AKI was 3 times higher for baseline determination and 5 times at 6 and 12 hours.

  6. A Prospective, Comparative Study of the Pain of Local Anesthesia Using 2% Lidocaine, 2% Lidocaine With Epinephrine, and 2% Lidocaine With Epinephrine-Bupivicaine Mixture for Eyelid Surgery.

    Science.gov (United States)

    Han, Jung-Woo; Nah, Seung Kwan; Lee, Sang Yeul; Kim, Chang Yeom; Yoon, Jin Sook; Jang, Sun Young

    A mixture of 2% lidocaine with epinephrine and bupivacaine was developed to achieve the fast-onset anesthetic effect of lidocaine and the long-lasting effect of bupivacaine. The authors compared pain scores between 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture during local anesthesia for eyelid surgeries. This was a double-blind, randomized, prospective, comparative study. In total, 120 consecutive patients (43 males, 77 females, mean age = 47.2 ± 21.2) who underwent bilateral eyelid surgery under subcutaneous anesthesia were asked to report pain scores for each eye during the first injection of anesthesia. Each patient was randomly assigned to receive 1 of the 3 anesthetic agents in 1 eyelid, and 1 of the remaining 2 agents in the other. The pH values of the 2% lidocaine, 2% lidocaine with epinephrine, and 2% lidocaine with epinephrine-bupivicaine mixture were 6.23 ± 0.21, 4.21 ± 0.37, and 3.87 ± 0.19, respectively. The pain scores of each were 4.3 ± 1.8, 5.1 ± 1.8, and 5.7 ± 1.9, respectively. The 2% lidocaine with epinephrine produced a statistically significantly higher pain score than 2% lidocaine (p = 0.044, generalized estimating equation method). The mixture also showed a significantly higher pain score than 2% lidocaine (p = 0.003, generalized estimating equation method). Epinephrine seemed to increase subjective pain scores. Compared with 2% lidocaine with epinephrine, 2% lidocaine with epinephrine-bupivicaine mixture was not significantly different in terms of subjective symptoms or pH.

  7. The analgesic effect of nitroglycerin added to lidocaine on quality of intravenous regional anesthesia in patients undergoing elective forearm and hand surgery

    Directory of Open Access Journals (Sweden)

    Hosein Kimiaei Asadi

    2013-01-01

    Full Text Available PURPOSE: To evaluate the effect of nitroglycerine (NTG on sensory and motor block onset and recovery time as well as the quality of tourniquet pain relief, when added to lidocaine (LID for intravenous regional anesthesia in elective forearm and hand surgery. METHODS: A randomized double-blinded clinical trial was performed on 40 patients that were randomly allocated into two groups received lidocaine 3 mg/kg with NTG 200 µg or received only lidocaine 3 mg/kg as the control. RESULTS: There was no difference between the two study groups in hemodynamic parameters before tourniquet inflation, at any time after inflation and after its deflation. There was no difference in the mean of pain score over time between the two groups. The onset time of sensory and motor blockades was shorter in the group received both LID and NTG. The mean recovery time of sensory blockade was longer in the former group. The frequency of opioid injections was significantly lower in those who administered LID and NTG. CONCLUSION: The adjuvant drug of NTG when added to LID is effective in improving the overall quality of anesthesia, shortening onset time of both sensory and motor blockades, and stabling homodynamic parameters in hand and forearm surgery.

  8. A comparison of intraocular pressure and hemodynamic responses to insertion of laryngeal mask airway or endotracheal tube using anesthesia with propofol and remifentanil in cataract surgery

    Directory of Open Access Journals (Sweden)

    Mohsen Ziyaeifard

    2012-01-01

    Full Text Available Background: The aim of this study was to evaluate intraocular pressure (IOP and hemodynamic responses following insertion of laryngeal mask airway (LMA or endotracheal tube (ETT after anesthesia induction with propofol and remifentanil in cataract surgery. Materials and Methods: In a randomized controlled study, 50 adults scheduled for elective cataract extraction procedure under general anesthesia were allocated to LMA insertion (n = 25 or ETT (n = 25 groups. IOP, systolic blood pressure (SBP, diastolic blood pressure (DBP, and heart rate (HR were measured after insertion of the airway device every minute up to 5 min. Results: There were no significant differences between LMA and ETT groups in SBP, DBP, HR, and IOP immediately after airway instrumentation up to 5 min, except in 4th min in DBP, 2nd min in HR, and 5th min in IOP (7.9 ± 2.3 mmHg in LMA and 9.4 ± 2.5 mmHg in ETT group; P = 0.030. There was good surgeon satisfaction for providing acceptable surgical field in both groups (88% in LMA and 80% in ETT group; P = 0.702. Conclusion: Propofol combined with remifentanil provides good and excellent conditions for insertion of LMA or ETT with minimal hemodynamic disturbances in cataract surgery. Considering LMA insertion is less traumatic than ETT, using LMA may be better than ETT for airway securing in these patients.

  9. 非气管插管麻醉在胸腔镜手术中的应用%A review on the application non-intubated anesthesia in video-assisted thoracoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    郝宁; 马珏; 张光燕; 崔建修

    2016-01-01

    背景 电视胸腔镜手术(video-assisted thoracoscopic surgery,VATS)应用传统气管插管全身麻醉机械通气引起的气道损伤及急性肺损伤等并发症影响患者术后恢复和生活质量.近年来非气管插管麻醉行VATS的安全性及可行性受到胸外科医师和麻醉医师的广泛关注. 目的 推进对于VATS期间应用非气管插管麻醉的认识和应用. 内容 回顾近年来国内外关于非气管插管麻醉下行VATS治疗胸科疾病的临床研究情况,总结其安全性、可行性及相对于传统方式的优势和目前存在的问题. 趋向 非气管插管麻醉作为一项新技术在VATS中的应用亟待更多的临床研究.%Background Video-assisted thoracoscopic surgery (VATS) which is conventionally performed under tracheal intubation with double lumen tube to achieve single lung ventilation has many complications and adverse effects following intubated general anesthesia and one-lung ventilation are inevitable,including intubation-related airway trauma ventilation-induced lung injury erc,affecting the recovery and quality of life of those patients.Recently,VATS without tracheal intubation has been extensively performed and evaluated.Objective To promote the cognition and application of non-intubated anesthesia during VATS in recent years.Content Review the clinical researches and applications of nonintubated VATS in thoracic diseases,evaluate the safety,feasibility and advantages compared to the traditional approach.Trend As a new technology in the VATS,non-intubated anesthesia is in urgent need for more clinical research.

  10. ADRB2 gly16gly Genotype, Cardiac Output, and Cerebral Oxygenation in Patients Undergoing Anesthesia for Abdominal Aortic Aneurysm Surgery

    DEFF Research Database (Denmark)

    Staalso, Jonatan Myrup; Rokamp, Kim Zillo; Olesen, Niels D.

    2016-01-01

    BACKGROUND: Gly16arg polymorphism of the adrenergic [beta]2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgic...

  11. Topical anesthesia

    Directory of Open Access Journals (Sweden)

    Mritunjay Kumar

    2015-01-01

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

  12. Jugular bulb oxygen saturation during propofol and isoflurane/nitrous oxide anesthesia in patients undergoing brain tumor surgery.

    Science.gov (United States)

    Jansen, G F; van Praagh, B H; Kedaria, M B; Odoom, J A

    1999-08-01

    We investigated, in brain tumor patients, the jugular bulb venous oxygen partial pressure (PjO2) and hemoglobin saturation (SjO2), the arterial to jugular bulb venous oxygen content difference (AJDO2), and middle cerebral artery blood flow velocity (Vmca) during anesthesia, and the effect of hyperventilation on these variables. Twenty patients were randomized to receive either isoflurane/ nitrous oxide/fentanyl (Group 1) or propofol/fentanyl (Group 2). At normoventilation (PacO2 35 +/- 2 mm Hg in Group 1 and 33 +/- 3 mm Hg in Group 2), SjO2 and PjO2 were significantly higher in Group 1 than in Group 2 (SjO2 60% +/- 6% and 49% +/- 13%, respectively; P = 0.019) (PjO2 32 +/- 3 and 27 +/- 5 mm Hg, respectively; P = 0.027). In Group 2, 5 of 10 patients had SjO2 9 mL/dL. All patients in Group 1 had SjO2 > 50%. During hyperventilation, there were no differences in SjO2, PjO2, or AJDO2 between the two groups. On hyperventilation, there was no correlation between the relative decreases of Vmca and 1/AJDO2 (r = 0.21, P = 0.41). The results indicate during propofol anesthesia, half of the brain tumor patients showed signs of cerebral hypoperfusion, but not during isoflurane/nitrous oxide anesthesia. Furthermore, during PacO2 manipulations, shifts in Vmca are inadequate to evaluate brian oxygen delivery in these patients. During propofol anesthesia at normoventilation, 50% of brain tumor patients showed signs suggesting cerebral hypoperfusion, but this could not be demonstrated during isoflurane/nitrous oxide anesthesia. During PacO2 manipulations, consecutive measurements of the cerebral blood flow velocity may be inadequate to assess cerebral oxygenation.

  13. Awareness under general anesthesia.

    Science.gov (United States)

    Bischoff, Petra; Rundshagen, Ingrid

    2011-01-01

    Awareness while under general anesthesia, and the later recall of what happened during surgery, can be experienced by patients as horrific events that leave lasting mental trauma behind. Patients may have both auditory and tactile perception, potentially accompanied by feelings of helplessness, inability to move, pain, and panic ranging to an acute fear of death. For some patients, the experience of awareness under anesthesia has no sequelae; for others, however, it can lead to the development of post-traumatic stress disorder, consisting of complex psychopathological phenomena such as anxiety, insomnia, nightmares, irritability, and depression possibly leading to suicidality. The literature on the subject was selectively reviewed. In the absence of risk factors awareness phenomena occur in one to two per 1000 operations under general anesthesia (0.1% to 0.2%) and are thus classed as an occasionally occurring critical event. In children, the risk of such phenomena occurring is 8 to 10 times higher. These phenomena are due to an inadequate depth of anesthesia with incomplete unconsciousness. They can be promoted by a number of risk factors that are either patient-related (ASA class III or above, medication abuse), surgery-related (Caesarean section, emergency procedures, surgery at night), or anesthesia-related (anesthesia without benzodiazepines, use of muscle relaxants). Strategies for avoiding awareness phenomena under anesthesia include the training of staff to know about the problem and, specifically, the use of benzodiazepines, the avoidance of muscle relaxants if possible, and shielding the patient from excessive noise. EEG monitoring is effective but provides no guarantee against awareness. If awareness under anesthesia occurs despite these measures, the patient must be given expert, interdisciplinary treatment as soon after the event as possible in order to minimize its potential sequelae.

  14. Modelo de anestesia em coelhos para procedimentos no tórax Anesthesia model in rabbits for thoracic surgery

    Directory of Open Access Journals (Sweden)

    Elias Kallas

    2001-06-01

    minutes. Arterial blood pH was measured at the beginning of the procedure, after thoracotomy and after 30 minutes of selective ventilation. After 30 minutes, left pulmonary expantion was permited and thoracotomy closed without pneumotorax. As soon as the animals started breathing spontaneously the endotracheal canula was removed and crico-thyroid membrane closed with 7-0 polypropilene suture. Two weeks later the animals were submitted to euthanasia with a new lung biopsy and the trachea and laryng examined. During the procedure the animals had no important haemodinamics or gasometric disturbance. The results were good and brought us to the conclusion that it is a simple and effective method of anesthesia for thoracic surgery in rabbits.

  15. The effects of timing of prophylaxis, type of anesthesia, and use of mechanical methods on outcome in major orthopedic surgery - subgroup analyses from 17,701 patients in the XAMOS study

    DEFF Research Database (Denmark)

    Haas, Sylvia; Holberg, Gerlind; Kreutz, Reinhold

    2016-01-01

    was not influenced by the type of anesthesia used. No spinal hematomas were reported in patients receiving neuraxial anesthesia in either treatment group. Use of mechanical thromboprophylaxis in addition to rivaroxaban or SOC pharmacological prophylaxis did not reduce the risk of thromboembolic events further...... dose, type of anesthesia, and concomitant mechanical prophylaxis on clinical outcomes in patients undergoing major orthopedic surgery in routine clinical practice. PATIENTS AND METHODS: In XAMOS, 8,778 patients received rivaroxaban (10 mg once daily) and 8,635 received standard-of-care (SOC......) pharmacological prophylaxis (safety population). Crude incidences of symptomatic thromboembolic and treatment-emergent bleeding events were analyzed according to timing of the first postoperative thromboprophylactic dose, use of general or neuraxial anesthesia, and use of mechanical prophylaxis...

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

    Science.gov (United States)

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

    2015-06-01

    It is recommended that the period of fasting before elective surgery should be shortened to facilitate a rapid recovery by preventing catabolism. We examined the effects of a short period of fasting on metabolism by performing indirect calorimetry (IC) under general anesthesia. A prospective observational study involving 26 consecutive patients who underwent elective surgery and whose metabolism was evaluated using IC during anesthesia was conducted. The patients were divided into two groups, those who fasted for 10 h (group L). Oxygen consumption, the volume of carbon dioxide emissions (VCO2), the respiratory quotient (RQ), resting energy expenditure (REE), and basal energy expenditure (BEE) were compared. The REE, VCO2, and RQ of group L (17.7 ± 2.3 kcal/kg/day, 118.5 ± 20.8 ml/min, and 0.71 ± 0.12, respectively) were significantly lower than those of group S (19.7 ± 2.3 kcal/kg/day, 143.6 ± 30.9 ml/min, and 0.81 ± 0.09, respectively) (P < 0.05). In group L, the relationship between REE and BEE was weaker (r(2) = 0.501) and the BEE-REE slope was less steep (REE = 0.419BEE + 509.477) than those seen in group S (r(2) = 0.749 and REE = 1.113BEE - 376.111, respectively). Our findings suggest that a short period of fasting (<8 h) before surgery is more strongly associated with the conservation of basal metabolism.

  17. Effect comparison of sevoflurane inhalation anesthesia and total intravenous anesthesia in pediatric surgery%七氟醚静吸复合麻醉与全凭静脉麻醉用于小儿手术的效果对比

    Institute of Scientific and Technical Information of China (English)

    贾飞; 陶金

    2016-01-01

    Objective:To explore the effect of sevoflurane inhalation anesthesia and total intravenous anesthesia in pediatric surgery.Methods:30 cases of pediatric surgery were selected.They were randomly divided into the control group and the observation group.The control group was given total intravenous anesthesia.The observation group was given sevoflurane inhalation anesthesia.We compared the anesthetic effect of two groups.Results:In the observation group,there was significant difference in blood pressure change at before induction,in operation and after operation with the control group(P<0.05).The anesthesia indexes of observation group were significantly better than the control group(P<0.05).Conclusion:The effect of sevoflurane inhalation anesthesia and total intravenous anesthesia in pediatric surgery was significant.%目的:探讨七氟醚静吸复合麻醉与全凭静脉麻醉用于小儿手术的临床效果。方法:收治手术患儿30例,随机分为对照组和观察组,对照组采用全凭静脉麻醉,观察组采用七氟醚静吸复合麻醉,比较两组麻醉效果。结果:观察组在诱导前、术中和术后的血压变化与对照组比较,差异有统计学意义(P<0.05);观察组麻醉指标显著优于对照组(P<0.05)。结论:七氟醚静吸复合麻醉用于小儿手术的临床效果显著。

  18. A 13-Year-Old Girl in Trigeminy During Anesthesia for Outpatient Dental Surgery: A Case Report.

    Science.gov (United States)

    Waxman, Bryan Neil

    2015-01-01

    A 13-year-old girl presented to a private office for dental rehabilitation under general anesthesia. The patient had a previous uneventful anesthetic 5 years prior in the same office by another dental anesthesiologist. The patient was highly anxious and would not allow monitors placed prior to induction. After an uneventful mask induction with sevoflurane, nitrous oxide, and oxygen, monitors were placed and a 22-gauge intravenous cannula inserted. The initial rhythm on the electrocardiogram was trigeminy interspersed with normal sinus rhythm. The volatile anesthetic sevoflurane was discontinued immediately, and intravenous anesthesia was started but still the patient was consistently entering trigeminy. The patient was always hemodynamically stable and never hypoxic. An in-depth discussion of the case and discussion of ventricular dysrhythmias is presented.

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

    Dai, Xiaotan; Song, Pingping; Zhang, Baijiang

    2016-05-20

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

  1. Effects of general anesthesia on stress response and inflammatory cytokines in elderly patients undergoing abdominal surgery under the guidance of Narcotrend

    Institute of Scientific and Technical Information of China (English)

    Da-Yong Lin; Yan-Xin Liu; Qian Li

    2016-01-01

    Objective:To investigate the effect of general anesthesia on stress response and inflammatory cytokines in elderly patients undergoing abdominal surgery under the guidance of Narcotrend. Methods:A total of 150 elderly patients with abdominal surgery in our hospital from January 2015 to December 2015 were randomly divided into three groups: D0, D2 and E2 group, each 50 cases. With different depth of anesthesia, the stress response indexes COR, ACTH, CRP and ET-1, the inflammatory factors IL-6 and TNF-α before anesthesia, postoperative 1 h and postoperative 1 d were compared.Results:The differences of Cor, ACTH, CRP and ET-1 in the three groups D0, D2 and E2 were all statistically significant (P<0.05); the differences of Cor, ACTH and CRP at each time point were also statistically significant (P<0.05), Cor in D0 and D2 group were significantly increased postoperative 1 h and 1 d (P<0.05), ACTH in D0, D2 and E2 group were significantly increased postoperative 1 h and 1 d (P<0.05), CRP in D0 group was significantly increased postoperative 1 h and 1 d (P<0.05); The increase amplitude of Cor in D0 and D2 group at each time point was higher than in E2 group (P<0.05), the increase amplitude of ACTH in D2 group at each time point was lower than in D0 and E2 group (P<0.05), the increase amplitude of CRP in D0 group at each time point was higher than in D2 and E2 group (P<0.05), ET-1 in D0 and D2 group had no changes at each time point, while the decrease amplitude of ET-1 in E2 group at each time point was significantly higher than in D0 and D2 group (P<0.05). The differences of IL-6 and TNF-α in the three groups D0, D2 and E2 were all statistically significant (P<0.05); the differences of IL-6 and TNF-α at each time point were also statistically significant (P<0.05), IL-6 and TNF-α in D0 group were significantly increased postoperative 1 h and 1 d (P < 0.05); the increase amplitude of IL-6 and TNF-α in D0 group at each time point was higher than in D2 and E2 group (P<0

  2. Tradition

    DEFF Research Database (Denmark)

    Otto, Ton

    2016-01-01

    “Tradition” and its adjective “traditional” are frequently used terms in sociological and anthropological descriptions to indicate cultural continuity with the past. More specifically, tradition refers to the process of handing down from one generation to the next and also to what is passed on...

  3. Anesthesia Awareness

    Science.gov (United States)

    ... biopsy or a dental procedure Local or regional anesthesia, such as an epidural or spinal block, or a nerve block To reduce your risk of experiencing awareness during procedures with general anesthesia, it is important to tell your physician anesthesiologist ...

  4. Propofol Anesthesia-Induced Seizures

    OpenAIRE

    J Gordon Millichap

    1994-01-01

    A case of a healthy young man who developed seizures and generalized paroxysmal fast activity in the EEG following use of propofol for anesthesia in minor surgery is reported from the Department of Neurology, University of South Alabama, Mobile, AL.

  5. Relief of Injection Pain During Delivery of Local Anesthesia by Computer-Controlled Anesthetic Delivery System for Periodontal Surgery: Randomized Clinical Controlled Trial.

    Science.gov (United States)

    Chang, Hyeyoon; Noh, Jiyoung; Lee, Jungwon; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Ku, Young; Rhyu, In-Chul

    2016-07-01

    Pain from local anesthetic injection makes patients anxious when visiting a dental clinic. This study aims to determine differences in pain according to types of local anesthetizing methods and to identify the possible contributing factors (e.g., dental anxiety, stress, and sex). Thirty-one patients who underwent open-flap debridement in maxillary premolar and molar areas during treatment for chronic periodontitis were evaluated for this study. A randomized, split-mouth, single-masked clinical trial was implemented. The dental anxiety scale (DAS) and perceived stress scale (PSS) were administered before surgery. Two lidocaine ampules for each patient were used for local infiltration anesthesia (supraperiosteal injection). Injection pain was measured immediately after local infiltration anesthesia using the visual analog pain scale (VAS) questionnaire. Results from the questionnaire were used to assess degree of pain patients feel when a conventional local anesthetic technique (CNV) is used compared with a computer-controlled anesthetic delivery system (CNR). DAS and PSS did not correlate to injection pain. VAS scores were lower for CNR than for CNV regardless of the order in which anesthetic procedures were applied. VAS score did not differ significantly with sex. Pearson coefficient for correlation between VAS scores for the two procedures was 0.80, also indicating a strong correlation. Within the limitations of the present study, relief from injection pain is observed using CNR.

  6. Local anesthesia with epinephrine is safe and effective for oral surgery in patients with type 2 diabetes mellitus and coronary disease: a prospective randomized study

    Directory of Open Access Journals (Sweden)

    Marcela Alves dos Santos-Paul

    2015-03-01

    Full Text Available OBJECTIVE: To investigate the variations in blood glucose levels, hemodynamic effects and patient anxiety scores during tooth extraction in patients with type 2 diabetes mellitus T2DM and coronary disease under local anesthesia with 2% lidocaine with or without epinephrine. STUDY DESIGN: This is a prospective randomized study of 70 patients with T2DM with coronary disease who underwent oral surgery. The study was double blind with respect to the glycemia measurements. Blood glucose levels were continuously monitored for 24 hours using the MiniMed Continuous Glucose Monitoring System. Patients were randomized into two groups: 35 patients received 5.4 mL of 2% lidocaine, and 35 patients received 5.4 mL of 2% lidocaine with 1:100,000 epinephrine. Hemodynamic parameters (blood pressure and heart rate and anxiety levels were also evaluated. RESULTS: There was no difference in blood glucose levels between the groups at each time point evaluated. Surprisingly, both groups demonstrated a significant decrease in blood glucose levels over time. The groups showed no significant differences in hemodynamic and anxiety status parameters. CONCLUSION: The administration of 5.4 mL of 2% lidocaine with epinephrine neither caused hyperglycemia nor had any significant impact on hemodynamic or anxiety parameters. However, lower blood glucose levels were observed. This is the first report using continuous blood glucose monitoring to show the benefits and lack of side effects of local anesthesia with epinephrine in patients with type 2 diabetes mellitus and coronary disease.

  7. The effects of different doses of intrathecal meperidine on the incidence and severity of shivering during lower extremity orthopedic surgery under spinal anesthesia: A randomized, placebo-controlled, double blind-clinical trial

    Directory of Open Access Journals (Sweden)

    Azim Honarmand

    2015-01-01

    Conclusions: Using higher dosage of intrathecal meperidine (0.3 mg/kg was more effective than using lower dosage of meperidine (0.1 mg/kg and 0.2 mg/kg in reducing the incidence and severity of shivering during spinal anesthesia in lower extremity orthopedic surgeries.

  8. 高频喷射通气在胸腔镜手术麻醉中的应用及护理配合%Application of high - frequency jet ventilation to the anesthesia in thoracoscopic surgery and nursing cooperation

    Institute of Scientific and Technical Information of China (English)

    周璐; 王广有

    2011-01-01

    目的:探讨高频喷射通气在胸腔镜手术麻醉中的应用效果及护理配合方法.方法:对22例胸腔镜手术患者采用高频喷射通气麻醉,同时给予密切护理配合.结果:本组术后发生低氧血症1例,发生率为4.5%.结论:高频喷射通气应用于胸腔镜手术麻醉效果确切,规范的护理配合可提高麻醉安全性和手术成功率,减少并发症发生.%Objective:To explore the application effect of high- frequency jet ventilation on the anesthesia in thoracoscopic surgery and nursing cooperation approaches. Methods :The anesthesia with high - frequency jet ventilation was applied to 22 patients with thoracoscopic surgery, while the close nursing cooperation was provided. Results:The postoperative hypoxemia occurred in one patient and the incidence was 4.5%. Conclusion:The effect of high frequency jet ventilation is definite when it is applied to the anesthesia in thoracoscopic surgery and standard nursing cooperation can increase the safety of anesthesia and success rate of surgery so as to reduce the incidence of complications.

  9. Our anesthesia experiences with geriatric patients at high risk group undergoing hip surgery under combined psoas compartment-sciatic nerve block

    Directory of Open Access Journals (Sweden)

    Kasım Tuzcu

    2013-09-01

    Full Text Available Aim. The effect of psoas compartment and sciatic nerve block combination on hemodynamic parameters in high risk geriatric patients with hip fracture surgeries was evaluated. Methods. In this study, high risk old patients who underwent psoas compartment block and sciatic nerve block for hip surgery anesthesia were evaluated retrospectively. In Group 1 there were 14 patients with levobupivacaine and lidocaine combination and in Group 2 there were 10 patients with levobupivacaine and prilocaine combination. In our study we evaluated the heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure levels and sedation need between groups, between age over and below 85 years and in all patients. Results. There were no statistically significant difference in heart rate and mean arterial blood pressure levels between groups and age groups (p˃0.05. There were a 6.18% and 16.52% decrease in mean arterial blood pressure in Group 1 and 2 respectively. When we evaluated the whole patients there was a 10.06% decrease in mean arterial blood pressure. Conclusion. We consider that the combination of psoas and sciatic block as an anesthetic method may be a proper option especially in the elderly and high-risk patients who were underwent the hip surgery.

  10. The Safety and Efficacy of Dexmedetomidine versus Sufentanil in Monitored Anesthesia Care during Burr-Hole Surgery for Chronic Subdural Hematoma: A Retrospective Clinical Trial

    Directory of Open Access Journals (Sweden)

    Wenming Wang

    2016-11-01

    Full Text Available Background: Chronic subdural hematoma (CSDH is a very common clinical emergency encountered in neurosurgery. While both general anesthesia (GA and monitored anesthesia care (MAC can be used during CSDH surgery, MAC is the preferred choice among surgeons. Further, while dexmedetomidine (DEX is reportedly a safe and effective agent for many diagnostic and therapeutic procedures, there have been no trials to evaluate the safety and efficacy of DEX vs. sufentanil in CSDH surgery. Objective: To evaluate the safety and efficacy of DEX vs. sufentanil in MAC during burr-hole surgery for CSDH.Methods: In all, 215 fifteen patients underwent burr-hole surgery for CSDH with MAC and were divided into three groups: Group D1 (n=67, DEX infusion at 0.5 μg·kg–1 for 10 min, Group D2 (n=75, DEX infusion at 1 μg·kg–1 for 10 min, and Group S (n=73, sufentanil infusion 0.3 μg·kg–1 for 10 min. Ramsay sedation scale (RSS of all three groups was maintained at 3. Anesthesia onset time, total number of intraoperative patient movements, hemodynamics, total cumulative dose of DEX, time to first dose and amount of rescue midazolam or fentanyl, percentage of patients converted to alternative sedative or anesthetic therapy, postoperative recovery time, adverse events, and patient and surgeon satisfaction scores were recorded.Results: The anesthesia onset time was significantly less in group D2 (17.36±4.23 vs. 13.42±2.12 vs. 15.98±4.58 min, respectively, for D1, D2, S; P<0.001. More patients in groups D1 and S required rescue midazolam to achieve RSS=3 (74.63% vs. 42.67% vs. 71.23%, respectively, for D1, D2, S; P<0.001. However, the total dose of rescue midazolam was significantly higher in group D1 (2.8±0.3 vs. 1.9±0.3 vs. 2.0±0.4 mg, respectively, for D1, D2, S; P<0.001. The time to first dose of rescue midazolam was significantly longer in group D2 (17.32±4.47 vs. 23.56±5.36 vs. 16.55±4.91 min, respectively, for D1, D2, S; P<0.001. Significantly fewer

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

    Science.gov (United States)

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

    1996-11-01

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

  12. Psychological aspects of pediatric anesthesia

    OpenAIRE

    Drašković Biljana; Simin Jovana M.; Kvrgić Ivana M.

    2015-01-01

    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 developmenta...

  13. The Study about risk evaluation by Local anesthesia single-port thoracoscopic surgery%局麻单孔胸腔镜手术风险评估

    Institute of Scientific and Technical Information of China (English)

    白峰; 杨剑飞; 张小雷

    2014-01-01

    目的:通过局麻单孔胸腔镜手术并发症发生率与文献报道并发症发生率,传统胸腔穿刺术并发症发生率比较,评估局麻单孔胸腔镜手术风险。方法:随机筛选本院局麻单孔胸腔镜手术的患者200例,作为试验组,同时随机筛选同期行胸腔穿刺术患者200例,作为对照组,观察试验组和对照组以及文献报道并发症发生率。结果:试验组与对照组并发症发生率无显著统计学意义。结论:临床上严格掌握手术指征因其并发症发生率与传统胸腔穿刺术无显著差异,可以推广局麻单孔胸腔镜手术治疗。%Objective:The risk evaluation about Local anesthesia single-port thoracoscopic surgery to find a better therapy by the Study. Methods:With block randomization screening 200 patients used the Local anesthesia single-port thoracoscopic surgery, as the experimental group and the control group 200 used the therapy of pleurocentesis, from 2009-6 to 2014-2. To observe the normal tissue complication probability between the experimental group and the control group. Result:The experimental group overmatches the control group and has not statistical significant. Conclusion:Ours therapy is worthy for extending in clinic because it's better safe, effective and less side-effect.

  14. The Study about risk evaluation by Local anesthesia single-port thoracoscopic surgery%局麻单孔胸腔镜手术风险评估

    Institute of Scientific and Technical Information of China (English)

    白峰; 杨剑飞; 张小雷

    2014-01-01

    通过局麻单孔胸腔镜手术并发症发生率与文献报道并发症发生率,传统胸腔穿刺术并发症发生率比较,评估局麻单孔胸腔镜手术风险。方法:随机筛选本院局麻单孔胸腔镜手术的患者200例,作为试验组,同时随机筛选同期行胸腔穿刺术患者200例,作为对照组,观察试验组和对照组以及文献报道并发症发生率。结果:试验组与对照组并发症发生率无显著统计学意义。结论:临床上严格掌握手术指征因其并发症发生率与传统胸腔穿刺术无显著差异,可以推广局麻单孔胸腔镜手术治疗。%The risk evaluation about Local anesthesia single-port thoracoscopic surgery to find a better therapy by the Study. Methods:With block randomization screening 200 patients used the Local anesthesia single-port thoracoscopic surgery, as the experimental group and the control group 200 used the therapy of pleurocentesis, from 2009-6 to 2014-2. To observe the normal tissue complication probability between the experimental group and the control group. Result:The experimental group overmatches the control group and has not statistical significant. Conclusion:Ours therapy is worthy for extending in clinic because it's better safe, effective and less side-effect.

  15. 小儿手外科臂丛麻醉联合异丙酚泵注的临床效果分析%Clinical Effect Analysis of Pediatric Hand Surgery Brachial Plexus Anesthesia Combined With Propofol Infusion

    Institute of Scientific and Technical Information of China (English)

    乔辉

    2016-01-01

    目的:研究小儿手外科臂丛麻醉联合异丙酚泵注的临床效果。方法试验对象:我院2014年2月~2016年1月收治的83例小儿手外科患儿。患儿分组方法:随机数字表法。83例患儿分为臂丛麻醉组和联合麻醉组两个组别。臂丛麻醉组采取臂丛麻醉;联合麻醉组采取臂丛麻醉联合异丙酚泵注麻醉。观察指标:(1)麻醉效果;(2)麻醉不良反应率;(3)患儿心率、呼吸、血压的差异。结果(1)联合麻醉组相比于臂丛麻醉组麻醉效果更高,χ2检验结果 P <0.05;(2)联合麻醉组相比于臂丛麻醉组麻醉不良反应率相似,χ2检验结果 P >0.05;(3)联合麻醉组相比于臂丛麻醉组心率、呼吸、血压更低,t 检验结果P <0.05。结论小儿手外科臂丛麻醉联合异丙酚泵注的临床效果确切,可有效提升麻醉效果,减轻对小儿生命体征的影响,且不增加麻醉不良反应,安全性高。%Objective To study the pediatric hand surgery brachial plexus anesthesia combined with propofol infusion clinical results. Methods Subjects: 83 cases of children with pediatric hand surgery in admitted in our hospital from February 2014 to January 2016. Children grouping method:random number table. 83 cases were divided into groups and brachial plexus anesthesia group two groups. Brachial plexus anesthesia take brachial plexus anesthesia, brachial plexus anesthesia group received anesthesia combined with propofol infusion anesthesia: (1) Anesthesia. (2) Anesthesia adverse reaction rate. (3) The difference in heart rate, respiration, blood pressure. Results (1) Anesthesia group compared to the higher brachial plexus anesthesia anesthetic effect, χ2 test results P0.05. (3) Anesthesia group compared to the brachial plexus anesthesia heart rate, respiration, lower blood pressure, t test results P<0.05. Conclusion Pediatric hand surgery brachial plexus anesthesia combined with propofol

  16. [The effect of combination epidural anesthesia techniques in upper abdominal surgery on the stress reaction, pain control and respiratory mechanics].

    Science.gov (United States)

    Wiedemann, B; Leibe, S; Kätzel, R; Grube, U; Landgraf, R; Bierwolf, B

    1991-11-01

    Twenty-eight patients undergoing upper abdominal operations (mainly selective proximal vagotomy [SPV]) were referred for assessment of the hormonal metabolic reaction (adrenocorticotropic hormone [ACTH], arginine vasopressin [AVP], cortisol, and glucose), the postoperative pain reaction, and respiration according to the method of anesthesia (group 1: neuroleptanesthesia [NLA], group 2: NLA in combination with epidural opiate analgesia, group 3: NLA in combination with local anesthesia). To alleviate postoperative pain piritramide was systematically administered in group 1, whereas in groups 2 and 3 a thoracic epidural catheter was injected with morphine or bupivacaine. Postoperative analgesia was better in patients with epidural administration than in those with systemic application. On the 1st and 2nd postoperative days the vital capacity was statistically significantly higher by 10%-15% in groups 2 and 3 than in group 1. As expected, the neurohormonal and metabolic stress response was highest in all patients in the intraoperative and immediate postoperative phases: ACTH, AVP, and glucose levels were in most cases significantly higher compared with the initial values. However, cortisol levels decreased intraoperatively, probably as a result of the generally used induction agent etomidate. Comparison of the three methods of anesthesia revealed that all mean hormone levels analyzed in group 2 patients were lower both intraoperatively and 2 h postoperatively, which implies that epidurally administered morphine reduces the stress reaction, probably indirectly through additional selective alleviation of pain at the spinal cord level. The various differences in hormonal reactions of patients in groups 1 and 3 gave no clear evidence, however, of possible mitigation of the stress reaction by epidural local anesthetics in upper abdominal operations.

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

    Science.gov (United States)

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

    2013-03-01

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

  18. Anesthesia information management systems

    Directory of Open Access Journals (Sweden)

    Feri Štivan

    2014-08-01

    Full Text Available Introduction: The use of anesthesia information management systems (AIMS is on the increase. This is particularly true for academic anesthesia departments. The main reasons for slow adoption of these systems in the past are financial barriers associated with implementation of these systems and their not so traditionally obvious potential to improve patient care. In addition, a major obstacle to acceptance of this technology is the concern of users over the impact of the electronic anesthesia record on malpractice exposure.Conclusions: The experience reported by departments using AIMS indicates that these systems are useful for managing malpractice risk. AIMS can enhance the efficiency and effectiveness of preoperative, intraoperative, and post-operative anesthesia care. However, AIMS are able to increase the quality of care and improve operating room efficiency only with careful planning, installation, and customization. Strengths, weaknesses, opportunities and threats (SWOT analysis performed for AIMS could help departments in making better decisions when implementing AIMS.

  19. Effects of propofol or sevoflurane anesthesia induction on hemodynamics in patients undergoing fiberoptic intubation for cervical spine surgery: A randomized, controlled, clinical trial

    Directory of Open Access Journals (Sweden)

    Chiara Robba

    2017-01-01

    Conclusion: Anesthesia induction with both propofol or sevoflurane is safe and effective. However, total IV anesthesia induction is associated with more pronounced MAP drop which can worsen spinal cord hypoperfusion.

  20. The Effectiveness of Intravenous Dexmedetomidine on Perioperative Hemodynamics, Analgesic Requirement, and Side Effects Profile in Patients Undergoing Laparoscopic Surgery Under General Anesthesia

    Science.gov (United States)

    Panchgar, Vinayak; Shetti, Akshaya N.; Sunitha, H. B.; Dhulkhed, Vithal K.; Nadkarni, A. V.

    2017-01-01

    Background: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively. Dexmedetomidine is one of the α2 agonist drugs which acts at both supraspinal and spinal level and modulate the transmission of nociceptive signals in the central nervous system. The basic effect of dexmedetomidine on the cardiovascular system is to decrease the heart rate and systemic vascular resistance with additional feature of opioid sparing effect. This drug has become an ideal adjuvant during general anesthesia, especially when stress is expected. Hence, the drug was studied in laparoscopic surgeries. Aims and Objectives: (a) To study the effect of dexmedetomidine on hemodynamic parameters during perioperative period in patients undergoing laparoscopic surgery. (b) To study the postoperative sedation score and analgesic requirement. (c) To study the side effect profile of dexmedetomidine. Settings and Design: Randomized double blind controlled trial. Subjects and Methods: After obtaining the Institutional Ethical Clearance, the study was conducted. Forty patients of American Society of Anesthesiologists Class I and II were enrolled in this randomized study. The patients were randomly divided into two groups; group normal saline (NS) and group dexmedetomidine. Patient received either NS or dexmedetomidine in group NS and group dexmedetomidine, respectively, depending upon the allocation. The infusion rate was adjusted according to; loading dose (1 μg/kg) over 10 min and maintenance dose (0.5 μg/kg/h) and

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  5. The Effect of Comparison of Iso.urane Anesthesia and Sufentanil Intravenous Anesthesia in Laparoscopic Surgery of Gynecology%妇科腹腔镜手术中应用异氟醚复合麻醉与舒芬太尼静脉麻醉的效果比较

    Institute of Scientific and Technical Information of China (English)

    曹磊

    2012-01-01

    Objective: To evaluate the effect of comparison of isoflurane anesthesia and sufentanil intravenous anesthesia in laparoscopic surgery of gynecology. Methods: 80 patients with laparoscopic surgery of gynecologyin our hospital were randomly divided into study group and control group, with 40 cases in each group, study group were given Sufentanil target controlled infusion intravenous anesthesiaAnd control group were given Isoflurane anesthesia, blood pressure, heart rate, oxygen saturation in different anesthesia time and recovery time of anesthesia were observed. Results: After induction of anesthesia, mean arterial pressure(MAP), heart rate(HR) decreased significantly compared with before induction, the difference was statistically significant(P<0.05); the MAP and HR of study group were lower than the control group in endotracheal intubation, after intubation, and 15 min intraoperative, the difference was statistically significant; the oxygen saturation of two groups had no significant difference in the whole process of anesthesia and surgery; spontaneous breathing recovery time postoperative and extubation time time of study group were shorter than the control group, the difference was statistically significant(P<0.05). Conclusion: The intravenous sufentanil anesthesia in laparoscopic surgery, can control heart rate, blood pressure better than isoflurane anesthesia, patients recover faster after surgery, anesthesia is safety and stability.%目的 探讨妇科腹腔镜手术中芬太尼静脉麻醉与异氟醚静吸复合麻醉的应用效果.方法 收集本院收治的择期妇科腹腔镜手术患者80 例,全部患者随机分为研究组与对照组,各40 例,研究组40 例患者给予舒芬太尼靶控输注静脉麻醉,对照组40 例患者给予异氟醚吸入麻醉,观察两组患者不同麻醉时段血压、心率、血氧饱和度变化,及两组术后麻醉苏醒时间等.结果 两组麻醉诱导后平均动脉压、心率均较诱导前明显

  6. 剖宫产手术中布比卡因与罗哌卡因的麻醉效果对比分析%The Comparative Analysis of Bupivacaine and Ropivacaine Anesthesia Efficacy in Cesarean Surgery

    Institute of Scientific and Technical Information of China (English)

    尤琪

    2015-01-01

    Objective The bupivacaine and ropivacaine anesthesia efficacy in cesarean surgeryis are to be compared and analyzed. Methods Chose 37 patients operated with cesarean surgery in hospital from June 2013 to July 2014 and separate them into study group and control group at random. 20 patients in study group are given ropivacaine anesthesia treatment,while 17 patients in control group were given bupivacaine anesthesia treatment. And then observe and compare the anesthesia quality,patients’motion obstruction and emotion obstruction in two groups. Results The anesthesia taking effect time,the time to reach the highest block plane in study group are much longer than those in control group with shorter enduring time; besides,the anesthesia effect in study group is much better than that in control group; there is a differential between the two groups,such a differential has statistic value(P<0.05). Conclusion Bupivacaine is much more effective in treatment of cesarean surgery patients,it has advantages of quick anesthesia taking-effect time,slow anesthesia taking-effect time and shorter anesthesia enduring time,which is beneficial to prevent from complications occurrence,such as hypotension.%目的:探究剖宫产手术中采用罗哌卡因和布比卡因麻醉的具体效果。方法选取2013年6月~2014年7月收治的37例剖宫产手术患者,随机分组,实验组20例患者采用罗哌卡因的麻醉,对照组17例患者选择布比卡因的麻醉,对比两组患者的麻醉质量,运动阻滞和感觉阻滞。结果实验组患者的起效时间和达到最高阻滞的平面时间长于对照组,且维持时间较短,麻醉效果好于对照组,差异有统计学意义(P<0.05)。结论剖宫产在手术中采用罗哌卡因进行麻醉,麻醉效果好,起效时间慢,持续时间短,不容易有低血压等症并发症的出现。

  7. Anesthesia and pulmonary hypertension.

    Science.gov (United States)

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

    2012-01-01

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

  8. ESTRATEGIA ANESTÉSICA PARA LA CIRUGÍA CON EL CORAZÓN LATIENDO. CINCO AÑOS DE EXPERIENCIA EN EL CARDIOCENTRO ERNESTO CHE GUEVARA / Anesthesia strategy for surgery with beating heart. Five years of experience at the “Ernesto Che Guevara” Cardiology Hospital

    Directory of Open Access Journals (Sweden)

    Ignacio R. Fajardo Egozcue

    2009-06-01

    Full Text Available Introduction and Objectives: The anesthesia in coronary surgery, using high sustained doses of fentanyl, leads to protracted postoperative extubation and stay. The assessment of an anesthesiastrategy for coronary surgery without extracorporeal circulation, in order to reduce the use of opioids and make possible an early extubation and a shorter post-surgical stay, was the objective of thiswork. Methods: 732 patients who underwent surgical myocardial revascularization without heartlung machine, from February 2003 to December 2007, using general anesthesia with intermittent boluses of fentanyl, with or without associated epidural anesthesia, were studied. Results: 625 surgical operations with general anesthesia in boluses and 107 adding peridural anesthesia were carried out. The average amount of fentanyl was 34.7 ml per patient in the first group and 24.9 ml when adding peridural anesthesia. Twenty seven patients were extubated in the operating room. The total average time was 8.6 hours (8.8 hours in the group where the anesthesia in boluses wasused and 6.7 hours for those with peridural anesthesia associated. The total average stay at the Intensive Care Unit was 40.1 hours. Conclusions: The intermittent anesthesia reduced the amount of fentanyl used in 86.6 percent when compared to the high sustained doses reported in a previous study. This made possible the early extubation of the patients, which increased due to the use of peridural anesthesia, and a decrease in average stay of the patient at the Intensive Care Unit.

  9. Effect of Intravenous Acetaminophen on Post-Anesthesia Care Unit Length of Stay, Opioid Consumption, Pain, and Analgesic Drug Costs After Ambulatory Surgery

    Science.gov (United States)

    Khobrani, Moteb A.; Camamo, James M.; Patanwala, Asad E.

    2017-01-01

    Objectives The primary objective was to assess whether the use of intravenous acetaminophen (APAP) in the ambulatory surgery setting is associated with a decreased length of stay in the post-anesthesia care unit (PACU). The secondary outcomes evaluated were pain scores, opioid consumption, and total cost of analgesics used in the PACU. Methods This was a retrospective cohort study conducted in adult patients (18 years of age or older) who received an eye, ear, nose, or throat (EENT) procedure at an outpatient surgery center between January 2014 and January 2015. Patients were consecutively included until the desired sample was reached during two six-month time periods: 1) intravenous APAP available on the formulary (APAP group) and 2) intravenous APAP not available on the formulary (non-APAP group). Results The cohort included 174 patients who received an EENT procedure (87 patients in the APAP group and 87 patients in the non-APAP group). The median PACU length of stay was 66 minutes (interquartile range [IQR], 48–92) in the APAP group and 71 minutes (IQR, 52–89) in the non-APAP group (P = 0.269). Mean pain score categories in the APAP versus non-APAP group were mild (85% versus 53%, respectively; P < 0.001), moderate (13% versus 33%, respectively; P = 0.002), and severe (2% versus 14%, respectively; P = 0.005). The median opioid consumption in morphine equivalents was 9 mg (IQR, 5–13) in the APAP group and 8 mg (IQR, 5–12) in the non-APAP group (P = 0.081). The total cost of analgesics used in the PACU was significantly greater in the APAP group ($15 versus $1; P < 0.001). Conclusions Intravenous APAP use in EENT ambulatory surgery is not associated with decreased PACU length of stay. However, it may decrease postoperative pain following EENT procedures. PMID:28163558

  10. Reduction in pulmonary complications in high risk patients undergoing surgery for total hip replacement under general anesthesia by preoperative intensive inspiratory muscle training:A randomized controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    Bingqiang Ma; Hongguang Bao

    2009-01-01

    Objective: To evaluate the effects of preoperative inspiratory muscle training (IMT) on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia. Methods: Thirty two high-risk paticnts undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical trial, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment (CT). The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization. Results: Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis (P = 0.25). Median duration of postoperative hospitalization was 13 days (range, 10~17 days) in the IMT group versus 16 days (range, 11~23 days) in the CT group (Mann-Whitney U statistics, Z =-2.22, P = 0.03). Mean postoperative inspiratory pressure was 5% higher in the IMT group. Conclusion: Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.

  11. Comparison of incidence and risk factors of delirium between general and regional anesthesia in elderly patients after lower extremity surgery

    Directory of Open Access Journals (Sweden)

    ilke Kupeli

    2016-03-01

    Conclusion: We found that the incidence of delirium is 12.5% in elderly patients undergoing total hip or knee arthroplasty and femur fracture surgery. Advanced age and polypharmacy are risk factors of delirium. Delirium increases the hospital stay and cost. [Cukurova Med J 2016; 41(1.000: 34-40

  12. The effect of Adernalinated lidpcaine on Blood Pressure, Heart rate and Bleeding during DCR surgery in General Anesthesia

    Directory of Open Access Journals (Sweden)

    M. Shakhrezaee

    2005-01-01

    Full Text Available Background and purpose : NLD obstraction causes chronic or acute Dacryiocytits resistant epiphora. Current treatment is DCR for persistent conection between lscrimal sac and nasal cavity. Vasocontrictor drugs are used facilitasing the operation.Materials and methods : Being approved in the ethics committee of the Mazandaran University of Medical Sciences the study performed on 57 patients ASAL, II whom were divided in to two groups; Adrenaline group, no=23 and non adrenaline group no= 34. 10-15-ml adrenalin 1/200000 was injected at surgical area, before surgery in AG. BP, PR and bleeding were recorded during before and 1, 3, 5, 10,… min during the surgery. The results were analysed using t-test, and paired t-test at a significance level of< 0.05.Results : Maximum BP was measured at 3 minuts after adrenaline injection. The average of bleeding in adrenaline group was 38.3 ml and in nonadernaline group was 49.16 ml(P=0.007. The time of surgery in adrenalin group is shorter than non adrenaline group(P=0.003.Conclusion : Althragh adrenaline decreased the bleeding during surgery and facilitated the procedure, it is potentially dangerous for patients with cardiovascular disease during DCR syrgery.

  13. The evaluation of effects two different doses of hydrocortisone on the intensity of perioperative shivering in elective surgery under spinal anesthesia: A double-blind randomized controlled trial study

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    Mohammadreza Safavi

    2016-01-01

    Full Text Available Background: Post- and intra-operative shivering is one of the most complications of spinal anesthesia so recommend a suitable drug with at least complications for prevention and control of postoperative shivering. This current study aimed to compare the preventive effect of hydrocortisone on intra- and post-operative shivering in patients undergoing surgery with spinal anesthesia. Materials and Methods: In a clinical trial study, ninety patients who candidate for surgery with spinal anesthesia were selected and randomly divided into three groups. The first and second groups were received 1 mg/kg and 2 mg/kg hydrocortisone, respectively, and the third group was received normal saline, and postoperative shivering was compared between the three groups. Results: The investigation of the incidence of inter- and post-operative shivering in patients in the three groups revealed that within the study period, 31 patients suffered from shivering among which 9, 5, and 17 cases were in 1 mg/kg hydrocortisone group, 2 mg/kg hydrocortisone group, and placebo group, respectively, and according to the Chi-square test, the difference among the three groups was significant (P = 0.004. Conclusion: According to the obtained results, the overall conclusion of the study is that using hydrocortisone at least with the dose of 1 mg/kg as a preventive drug reduced the incidence of intra- and post-operative shivering with spinal anesthesia.

  14. Regional anesthesia in transurethral resection of prostate (TURP surgery: A comparative study between saddle block and subarachnoid block

    Directory of Open Access Journals (Sweden)

    Susmita Bhattacharyya

    2015-01-01

    Full Text Available Background: Spinal anesthesia is the technique of choice in transurethral resection of prostate (TURP. The major complication of spinal technique is risk of hypotension. Saddle block paralyzed pelvic muscles and sacral nerve roots and hemodynamic derangement is less. Aims and objectives: To compare the hemodynamic changes and adequate surgical condition between saddle block and subarachnoid block for TURP. Material and methods: Ninety patients of aged between 50 to 70 years of ASA-PS I, II scheduled for TURP were randomly allocated into 2 groups of 45 in each group. Group A patients were received spinal (2 ml of hyperbaric bupivacaine and Group B were received saddle block (2 ml of hyperbaric bupivacaine. Baseline systolic, diastolic and mean arterial pressure, heart rate, oxygen saturation were recorded and measured subsequently. The height of block was noted in both groups. Hypotension was corrected by administration of phenylephrine 50 mcg bolus and total requirement of vasopressor was noted. Complications (volume overload, TURP syndrome etc. were noted. Results: Incidence of hypotension and vasopressor requirement was less (P < 0.01 in Gr B patients.Adequate surgical condition was achieved in both groups. There was no incidence of volume overload, TURP syndrome, and bladder perforation. Conclusion: TURP can be safely performed under saddle block without hypotension and less vasopressor requirement.

  15. Onset and duration of anesthesia for local anesthetic combinations commonly used in forefoot surgery; surprise results with sequential blocks.

    Science.gov (United States)

    Blazer, Marie Mantini; Petrozzi, Rocco; Harris, Samantha Y; Greer, Hillary; Goldfarb, Jacqueline; Biernacki, Tomasz; Kawalec, Jill S

    2015-06-01

    Local anesthetic nerve blocks are frequently used for postoperative analgesia and to the best of our knowledge no studies have evaluated the effects of injecting bupivacaine into an area previously injected with lidocaine. Sensation was tested in three groups of subjects receiving local anesthetic digital blocks. Group A received bupivacaine 0.25% plain. Group B received a 1:1 mixture of lidocaine 1% plain and bupivacaine 0.25%. Group C received an initial block of lidocaine 1% plain sequentially followed by bupivacaine 0.25% 1h later. Bupivacaine exhibited a delayed onset and the longest duration when compared to the other two groups. The group receiving the 1:1 mixture showed a rapid onset that resembled that of lidocaine and a shortened duration that did not resemble bupivacaine. The group receiving the sequential injections showed that even after a 1h interval following the lidocaine infiltration, there was a deleterious effect on duration of action of the bupivacaine. Using bupivacaine as a post-surgical block in the presence of residual lidocaine from a preoperative block is not warranted as once again, the extended duration of bupivacaine is mitigated. Bupivacaine alone as an initial operative block affords clinically acceptable onset of anesthesia while also providing extended duration of action.

  16. EEG Signals Analysis Using Multiscale Entropy for Depth of Anesthesia Monitoring during Surgery through Artificial Neural Networks

    Directory of Open Access Journals (Sweden)

    Quan Liu

    2015-01-01

    Full Text Available In order to build a reliable index to monitor the depth of anesthesia (DOA, many algorithms have been proposed in recent years, one of which is sample entropy (SampEn, a commonly used and important tool to measure the regularity of data series. However, SampEn only estimates the complexity of signals on one time scale. In this study, a new approach is introduced using multiscale entropy (MSE considering the structure information over different time scales. The entropy values over different time scales calculated through MSE are applied as the input data to train an artificial neural network (ANN model using bispectral index (BIS or expert assessment of conscious level (EACL as the target. To test the performance of the new index’s sensitivity to artifacts, we compared the results before and after filtration by multivariate empirical mode decomposition (MEMD. The new approach via ANN is utilized in real EEG signals collected from 26 patients before and after filtering by MEMD, respectively; the results show that is a higher correlation between index from the proposed approach and the gold standard compared with SampEn. Moreover, the proposed approach is more structurally robust to noise and artifacts which indicates that it can be used for monitoring the DOA more accurately.

  17. 快通道麻醉在小儿腹股沟区手术中的临床应用价值探讨%Clinical application value discussion of fast-track anesthesia in pediatric groin area surgery

    Institute of Scientific and Technical Information of China (English)

    何林

    2016-01-01

    Objective To evaluate the clinical value of fast-track anesthesia in pediatric surgery in the groin area.Methods This study for my children hospital in February 2012 120 routine surgery groin area in February 2015 - admitted, and randomly divided into control group (60 cases) and observation group (60 cases). The control group received conventional anesthesia, the observation group to take fast-track anesthesia.Results The group of children and mean arterial pressure after 30min 60min after extubation, heart rate, plasma glucagon, cortisol were significantly better than the control group (P<0.05).Conclusion The fast-track anesthesia in pediatric surgery in the groin area and promoting surgery, with a high clinical value.%目的:探讨快通道麻醉在小儿腹股沟区手术中的临床应用价值。方法本次研究对象为我院2012年2月至2015年2月收治的120例行腹股沟区手术的患儿,并随机分成对照组(60例)和观察组(60例)。对照组采取常规麻醉方法,观察组采取快通道麻醉方法。结果观察组患儿术后30min和拔管后60min的平均动脉压、心率、血浆胰高血糖素、血浆皮质醇均显著优于对照组(P <0.05)。结论快通道麻醉在小儿腹股沟区手术中有利于促进手术疗效,具有很高的临床应用价值。

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

    Institute of Scientific and Technical Information of China (English)

    孙明

    2012-01-01

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

  19. Comparative Study on Anesthesia Effects of Bupivacaine and Ropivacaine in Cesarean Section Surgery%剖宫产手术中布比卡因与罗哌卡因的麻醉效果对比分析

    Institute of Scientific and Technical Information of China (English)

    何乃维

    2016-01-01

    Objective Comparatively study on anesthesia efects of Bupivacaine and Ropivacaine in cesarean section surgery.MethodsFrom January 2015 to November 2015, 49 cases of patients who were operated with cesarean section surgery in our hospital were divided into two groups according to diferent anesthesia treatment methods; 24 patients in control group were given about Bupivacaine anesthesia, while another 25 patients in study group were given about Ropivacaine anesthesia, and then to compare anesthesia taking-effect time, blocking-maintenance time, sensory-blocking take-effect time, blocking recovery time and side-effect incidence between two groups.Results Anesthesia taking-efect time, blocking-maintenance time, sensory-blocking take-efect time and blocking recovery time in study group were shorter than those in control group. And what’s more, the incidence rate of side-efect in study group was lower than that in control group; there were statisticaly significant diferences(P<0.05).Conclusion Ropivacaine is much more efective in anesthesia application of cesarean section surgery than Bupivacaine with lower side-efect incidence; thus, it is quite worthwhile to be attended.%目的:对比分析剖宫产手术中布比卡因与罗哌卡因的麻醉效果。方法选取2015年1~11月剖宫产手术患者49例纳入研究,按不同麻醉药物分组。术中麻醉采用布比卡因者24例,设对照组;采用罗哌卡因者25例,设研究组。组间比较麻醉起效时间、阻滞维持时间、感觉阻滞起效时间及阻滞恢复时间,不良反应率。结果两组中研究组麻醉起效时间、阻滞维持时间、感觉阻滞起效时间及阻滞恢复时间更短,不良反应率更低,差异有统计学意义(P<0.05)。结论剖宫产手术中采用罗哌卡因麻醉,其麻醉效果较布比卡因佳,麻醉不良反应较少。

  20. Clinical observation of intravenous anesthesia for hysteroscopic surgery%静脉麻醉用于宫腔镜电切术的临床观察

    Institute of Scientific and Technical Information of China (English)

    刘冬俊; 夏雪

    2015-01-01

    Objective To investigate the feasibility of intravenous anesthesia and the proper drug compatibility during hysteroscopic surgery. Methods A total of 120 patients underwent hysteroscopic surgery from January 2015 to August 2015 were randomly divided into 3 groups. P group was only injected with propofol (2 mg/kg), F group was treated with fentanyl (0.0015 mg/kg), and S group was given sufentanil (0.15μg/kg) before intravenous injection of propofol. The sys-tolic/diastolic blood pressure and the heart rate were observed and recorded during hysteroscopic surgery. The dosage of propofol and the number of patients needed chin or auxiliary breathing were compared. Lower abdominal pain condition (Prince-Henry) in awake state immediately (W0), 15 min (W1), 30 min (W2), 1 h (W3),2 h (W4) and 6 h (W5) after awake state were recorded. Results SBP, DBP and HR of F group and S group were obviously lower (P0.05) during W4-W5. Conclusion Intravenous anesthesia can be applied to the short-term hysteroscopic surgery, especially, small dose of sufentanil combined with propofol is more safe and ideal.%目的 探讨静脉麻醉在宫腔镜电切术中应用的可行性及恰当的药物配伍. 方法 选择我院2015年1~8月拟行宫腔镜电切术的患者120例,随机分为3组:P组仅静脉注射丙泊酚2 mg/kg,F组先静注芬太尼0.0015 mg/kg, S组则先静注舒芬太尼0.15μg/kg后再静注丙泊酚.观察并记录给药前、麻醉后扩宫颈前、扩宫颈时、术毕时患者的收缩压、舒张压、心率,比较丙泊酚用量和术中需托下颌或辅助呼吸的例数.记录清醒即刻(W0)、清醒后15 min (W1)、清醒后30 min(W2)、1 h(W3)、2 h(W4)及6 h(W5)下腹疼痛的情况(Prince-Henry). 结果 扩宫颈时,与P组比较,F组和S组的SBP、DBP、HR均明显降低(P0.05). 结论 静脉麻醉可以应用于短时的宫腔镜手术,尤以小剂量的舒芬太尼复合丙泊酚的应用更加安全理想.

  1. Outcome of endodontic surgery: a meta-analysis of the literature--part 1: Comparison of traditional root-end surgery and endodontic microsurgery.

    Science.gov (United States)

    Setzer, Frank C; Shah, Sweta B; Kohli, Meetu R; Karabucak, Bekir; Kim, Syngcuk

    2010-11-01

    The aim of this study was to investigate the outcome of root-end surgery. The specific outcome of traditional root-end surgery (TRS) versus endodontic microsurgery (EMS) and the probability of success for comparison of the 2 techniques were determined by means of meta-analysis and systematic review of the literature. An intensive search of the literature was conducted to identify longitudinal studies evaluating the outcome of root-end surgery. Three electronic databases (Medline, Embase, and PubMed) were searched to identify human studies from 1966 to October 2009 in 5 different languages (English, French, German, Italian, and Spanish). Relevant articles and review papers were searched for cross-references. Five pertinent journals (Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxillofacial Surgery) were individually searched back to 1975. Three independent reviewers (S.S., M.K., and F.S.) assessed the abstracts of all articles that were found according to predefined inclusion and exclusion criteria. Relevant articles were acquired in full-text form, and raw data were extracted independently by each reviewer. Qualifying papers were assigned to group TRS or group EMS. Weighted pooled success rates and relative risk assessment between TRS and EMS were calculated. A comparison between the groups was made by using a random effects model. Ninety-eight articles were identified and obtained for final analysis. In total, 21 studies qualified (12 for TRS [n = 925] and 9 for EMS [n = 699]) according to the inclusion and exclusion criteria. Weighted pooled success rates calculated from extracted raw data showed 59% positive outcome for TRS (95% confidence interval, 0.55-0.6308) and 94% for EMS (95% confidence interval, 0.8889-0.9816). This difference was statistically significant (P < .0005). The relative risk ratio

  2. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Administration of Anesthesia Administration ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...

  3. Continuing a long tradition: the Canadian Journal of Surgery at 60.

    Science.gov (United States)

    McAlister, Vivian C; Harvey, Edward J

    2017-09-01

    As 2017 marks the 60th anniversary of the Canadian Journal of Surgery, its editors in chief take a look back at the history leading to the creation of the journal and at how CJS maintains its original partnerships in order to continue its mission. Organized surgery has existed in Canada for more than 3 centuries. The CJS is the longest surviving of more than 20 journals reporting surgical endeavours. The editors rededicate its mission to the highest standard possible.

  4. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  5. Anesthesia Basics

    Science.gov (United States)

    ... the Risks? en español Conceptos básicos sobre la anestesia What Is Anesthesia? No doubt about it, getting ... down into three main categories: general, regional, and local. All of these can be given through various ...

  6. General Anesthesia

    Science.gov (United States)

    ... unconscious and unable to feel pain during medical procedures. General anesthesia usually uses a combination of intravenous drugs ... 1998-2017 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

  7. The effects of sevoflurane inhalation anesthesia and spinal canal anesthe-sia on cognitive function in patients with urinary surgery in the elderly%七氟醚吸入全麻和椎管内麻醉对老年泌尿外科手术患者认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    蔡云亮; 王新; 潘春杰; 朱红; 陈文

    2014-01-01

    Objective To observe the effects of sevoflurane inhalation anesthesia and spinal canal anesthesia on cogni-tive function in patients with urinary surgery in the elderly. Methods Researched 68 patients that undergoing elective urinary surgery in elderly patients, and then randomly divided into the sevoflurane inhalation anesthesia group (group A) and spinal canal anesthesia group (group B). The two groups were recorded time of anesthesia operation, surgical blood loss and transfusion volume, low blood pressure and the number of hypoxemia occurred, at last used the simple mental state examination (MMSE) to evaluate two groups of patients with 1 d before anesthesia and postoperative 1 d, 3 d, 7 d cognitive function. Results Two groups of anesthesia operation in time, surgical blood loss and transfusion volume, low blood pressure and the number of hypoxemia occurred had no significant differences(P>0.05). Two groups of postoper-ative 1 d, 3 d MMSE score were significantly lower than before operation, and the group A was significantly lower than group B, the differences were statistically significant(P 0.05); The incidence of POCD postoperative 1 d and 3 d in groupA were significantly higher than that of group B, with significant difference (P0.05). Conclusion Sevoflurane inhalation anesthesia is spinal canal anesthesia cognitive dysfunction occurred more often in patients with elderly urinary surgery.%目的:探讨七氟醚吸入全麻和椎管内麻醉对老年泌尿外科手术患者认知功能的影响。方法研究68例择期泌尿手术的老年患者随机均分为七氟醚吸入全麻组(A组)和椎管内麻醉组(B组),分别记录两组麻醉时间、手术出血量、术中输液量、低血压和低氧血症发生次数,同时采用简易精神状况检查量表(MMSE)评估两组患者麻醉前1d及术后1d、3d、7d的认知功能。结果两组麻醉时间、手术出血量、术中输液量、低血压和低氧血症发生次数比较

  8. Comparison of the performance of 'Intubating LMA' and 'Cobra PLA' as an aid to blind endotracheal tube insertion in patients scheduled for elective surgery under general anesthesia.

    Science.gov (United States)

    Darlong, Vanlal; Chandrashish, Chakravarty; Chandralekha; Mohan, Virender Kumar

    2011-03-01

    Supraglottic airways (SGA) through which blind endotracheal intubation is made possible is an area of considerable interest. Our study aimed at comparing the Cobra Perilaryngeal Airway (CPLA) with the Intubating Laryngeal Mask Airway (ILMA) with regard to the performance of the former as a conduit for facilitating blind endotracheal intubation. American Society of Anesthesiologists (ASA) I-II patients consenting to the study, with no predictors of difficult airway, scheduled for elective surgery were randomized into two groups of 30 each. Anesthesia was induced with fentanyl, propofol and vecuronium. CPLA was inserted in Group I and ILMA in Group II. Fibreoptic scoring of the laryngeal view was done through the SGA. Blind intubation through either CPLA or ILMA was then carried out with cuffed polyvinyl chloride (PVC) tube in Group I and ILMA-tracheal tube in Group II. Demographic and surgical data were comparable between the two groups. The success rate of intubation (87% through CPLA and 90% through ILMA) (p value 1), number of attempts made and the fibreoptic scores (p value 0.12) were comparable between the two groups. Insertion time was significantly longer in Group I as compared with Group II (9 s vs. 4 s; p value 0.004). Trauma and sore throat were more common in Group I (p value -0.1, 0.19 respectively). Hemodynamic monitoring showed more tachycardia during CPLA insertion as compared with ILMA (p value 0.006). We conclude that CPLA can be used as an effective conduit for blind endotracheal intubation with cuffed PVC tube and has comparable efficacy in tracheal intubation as that with ILMA. Copyright © 2011. Published by Elsevier B.V.

  9. Effect of anesthesia on intraoperative penile erection during urologic surgery%麻醉对泌尿外科术中阴茎勃起的影响

    Institute of Scientific and Technical Information of China (English)

    李元; 魏新川

    2013-01-01

    Background Intraoperative penile erection is a relatively rare complication during urologic surgery,but it can render the procedure difficult.Although the mechanism of intraoperative penile erection is unclear,anesthetic methods and anesthetics have been shown to affect its occurrence and development.Objective The purpose of this paper is to improve clinicians' understanding for the effects of anesthesia on intraoperative penile erection.Content This review summarizes the mechanism of intraoperative penile erection,possible effects of anesthetic methods and anesthetic drugs on intraoperative penile erection.Trend Applying appropriate anesthetic methods and anesthetics may effectively prevent the occurrence and development of the intraoperative penile erection.%背景 术中阴茎勃起是泌尿外科手术中发生率较低的一种并发症,一旦发生可使手术操作困难.虽然至今对于术中阴茎勃起的机制仍然不完全清楚,但是已有的研究表明麻醉方法和麻醉药可影响术中阴茎勃起的发生和发展. 目的 旨在增加临床医生关于麻醉对术中阴茎勃起影响的认识. 内容 系统阐述了术中阴茎勃起的机制,麻醉方法和麻醉药对术中阴茎勃起的可能影响. 趋向 使用恰当的麻醉方法和麻醉药可有效阻止术中阴茎勃起的发生和发展.

  10. Assessment of the time-dependent need for stay in a high dependency unit (HDU) after major surgery by using data from an anesthesia information management system.

    Science.gov (United States)

    Betten, Jan; Roness, Aleksander Kirkerud; Endreseth, Birger Henning; Trønnes, Håkon; Tyvold, Stig Sverre; Klepstad, Pål; Nordseth, Trond

    2016-04-01

    Admittance to a high dependency unit (HDU) is expensive. Patients who receive surgical treatment with 'low anterior resection of the rectum' (LAR) or 'abdominoperineal resection of the rectum' (APR) at our hospital are routinely treated in an HDU the first 16-24 h of the postoperative (PO) period. The aim of this study was to describe the extent of HDU-specific interventions given. We included patients treated with LAR or APR at the St. Olav University Hospital (Trondheim, Norway) over a 1-year period. Physiologic data and HDU-interventions recorded during the PO-period were obtained from the anesthesia information management system (AIMS). HDU-specific interventions were defined as the need for respiratory support, fluid replacement therapy >500 ml/h, vasoactive medications, or a need for high dose opioids (morphine >7.5 mg/h i.v.). Sixty-two patients were included. Most patients needed HDU-specific interventions during the first 6 h of the PO period. After this, one-third of the patients needed one or more of the HDU-specific interventions for shorter periods of time. Another one-third of the patients had a need for HDU-specific therapies for more than ten consecutive hours, primarily an infusion of nor-epinephrine. Most patients treated with LAR or APR was in need of an HDU-specific intervention during the first 6 h of the PO-period, with a marked decline after this time period. The applied methodology, using an AIMS, demonstrates that there is great variability in individual patients' postoperative needs after major surgery, and that these needs are dynamic in their nature.

  11. Clinical study of OSAHS surgery under general anesthesia without muscle relaxants%无肌松药全身麻醉用于鼾症手术的临床研究

    Institute of Scientific and Technical Information of China (English)

    张玉琴; 孟凡民; 王红国; 王高宏; 栾秀坤

    2013-01-01

    目的 尝试在鼾症(OSAHS)手术全身麻醉维持中免用肌松药的可行性,探讨其临床价值.方法 选择ASA Ⅰ~Ⅱ级悬雍垂腭咽成形术(UPPP)鼾症患者180例,随机分为A、B、C三组(每组n=60),均以瑞芬太尼、丙泊酚及氯化琥珀胆碱静脉快诱导,经鼻明视或盲探气管插管,A组以瑞芬太尼、丙泊酚维持麻醉,B、C组分别在A组基础上加用阿曲库铵、维库溴铵维持麻醉.观察记录三组患者各时点循环和呼吸功能指标及术中肌松程度、体动次数、麻醉苏醒时间、拔管时间、不良反应及并发症等.结果 三组气管插管成功率100%,麻醉维持平稳,无体动反应,均顺利完成手术;A组拔管前后清醒彻底,呼吸功能和肌力正常,无麻醉并发症发生,B、C组清醒后有不同程度肌松药残余,须使用新斯的明拮抗,拔管后分泌物增多、出血、心动过缓、低氧血症、舌后坠、喉痉挛、呼吸道梗阻、支气管痉挛发生率明显高于A组(P<0.01).结论 瑞芬太尼-丙泊酚无肌松药全凭静脉麻醉维持用于鼾症手术安全有效,可明显缩短麻醉恢复时间,提高麻醉恢复质量,降低麻醉恢复期风险,减少并发症发生.%Objective To invertigate the feasibilityand clinical efficacy of OSAHS surgery under general anesthesia without muscle relaxants. Methods Totally 180 ASA Ⅰ or Ⅱ OSAHS cases underwent UPPP surgery were randomly divided into 3groups(n =60) , general anesthesia was induced with Remifentanil, Propofol and Succinylcholine, and maintained with Propofol and Remifentanil at group A. Group B, C added atracurium, vecuronium to maintain anesthesia, on the basis of group A. Observed and recorded the three groups of patients at each time point circulatory and respiratory function parameters and the number of intraoperative muscle relaxants degree of body movement, anesthesia time, time to extubation, adverse reactions and complications. Results All patients of the

  12. The effect of impregnated autogenous epidural adipose tissue with bupivacaine, methylprednisolone acetate or normal saline on postoperative radicular and low back pain in lumbar disc surgery under spinal anesthesia; A randomized clinical trial study FNx01

    Directory of Open Access Journals (Sweden)

    Saeid Abrishamkar

    2011-01-01

    Full Text Available Background: Low Back Pain (LBP and radicular leg pain (RLP after lumbar disc surgery are great challenges that prevent patients and neurosurgeons in making a surgical decision. By spinal anesthesia, LBP and RLP diminish up to 2 to 3 hours postoperatively. The aim of this study was to determine the effect of impregnated epidural adipose tissue (EAT with bupivacaine or methylprednisolone acetate on reduction of late postoperative pain after spinal anesthesia. Methods: This study was performed on lumbar disc herniation surgery under spinal anesthesia. Sixty six patients entered our study who were divided into three groups, EAT impregnated with bupivacaine (group 1, methylprednisolone acetate (group2 and normal saline (control group. The LBP and RLP were evaluated during the first 24 hours postoperatively and 14 days later by visual analogue scale (VAS. Results: Of 66 patients, 53% were female and 47% male. The average (SE LBP in the first 6 hours after surgery based on VAS were 1.59 ± 0.90 in group one, 2.36 ± 2.38 in group 2 and 3.09 ± 1.41 in control group but the VAS for RLP in this period were 1.95 ± 1.13, 1.31 ± 1.39 and 2.40 ± 1.09, respectively. The average LBP and RLP did not show any differences after 14 days postoperatively. Conclusions: According to our data bupivacaine was effective on LBP relief and steroid was effective on RLP relief during the first 12 hours after surgery.

  13. The effect of impregnated autogenous epidural adipose tissue with bupivacaine, methylprednisolone acetate or normal saline on postoperative radicular and low back pain in lumbar disc surgery under spinal anesthesia; A randomized clinical trial study*

    Science.gov (United States)

    Abrishamkar, Saeid; Rafiei, Ahmad Reza; Sabouri, Masih; Moradi, Siamak; Tabesh, Homayoun; Rahmani, Payman; Hekmatnia, Ali; Torkashvand, Mostafa; Eshraghi, Noorolah; Baghershahi, Ghasem

    2011-01-01

    BACKGROUND: Low Back Pain (LBP) and radicular leg pain (RLP) after lumbar disc surgery are great challenges that prevent patients and neurosurgeons in making a surgical decision. By spinal anesthesia, LBP and RLP diminish up to 2 to 3 hours postoperatively. The aim of this study was to determine the effect of impregnated epidural adipose tissue (EAT) with bupivacaine or methylprednisolone acetate on reduction of late postoperative pain after spinal anesthesia. METHODS: This study was performed on lumbar disc herniation surgery under spinal anesthesia. Sixty six patients entered our study who were divided into three groups, EAT impregnated with bupivacaine (group 1), methylprednisolone acetate (group2) and normal saline (control group). The LBP and RLP were evaluated during the first 24 hours postoperatively and 14 days later by visual analogue scale (VAS). RESULTS: Of 66 patients, 53% were female and 47% male. The average (SE) LBP in the first 6 hours after surgery based on VAS were 1.59 ± 0.90 in group one, 2.36 ± 2.38 in group 2 and 3.09 ± 1.41 in control group but the VAS for RLP in this period were 1.95 ± 1.13, 1.31 ± 1.39 and 2.40 ± 1.09, respectively. The average LBP and RLP did not show any differences after 14 days postoperatively. CONCLUSIONS: According to our data bupivacaine was effective on LBP relief and steroid was effective on RLP relief during the first 12 hours after surgery. PMID:22091284

  14. Optimal Technique in Cardiac Anesthesia Recovery

    NARCIS (Netherlands)

    Svircevic, V.

    2014-01-01

    The aim of this thesis is to evaluate fast-track cardiac anesthesia techniques and investigate their impact on postoperative mortality, morbidity and quality of life. The following topics will be discussed in the thesis. (1.) Is fast track cardiac anesthesia a safe technique for cardiac surgery?

  15. Cirurgia a laser e anestesia Cirugía a láser y anestesia Laser surgery and anesthesia

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    Odilar Paiva Filho

    2004-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As cirurgias com a utilização do laser apresentam riscos para o paciente e para a equipe médica. O objetivo deste artigo é apresentar noções básicas sobre o laser e regras para aumentar a segurança dos procedimentos com sua utilização. CONTEÚDO: O presente artigo contém noções de física aplicadas ao laser, regras de segurança e a conduta em caso de ocorrência de eventos adversos com a utilização do laser. CONCLUSÕES: Concluímos que, quando manipulado por profissionais treinados, e respeitadas as normas de segurança, o laser é útil e seguro, tanto para o paciente quanto para a equipe médica.JUSTIFICATIVA Y OBJETIVOS: Las cirugías con la utilización del láser presentan riesgos para el paciente y para el grupo médico. El objetivo de este artículo es mostrar nociones básicas sobre el láser y reglas para aumentar la seguridad de los procedimientos con su utilización. CONTENIDO: El presente artículo contiene nociones de física aplicadas al láser, reglas de seguridad y la conducta en caso de ocurrencia de eventos adversos con la utilización del láser. CONCLUSIONES: Concluimos que, cuando manipulado por profesionales entrenados, y respetadas las normas de seguridad, el láser es útil y seguro, tanto para el paciente cuanto para el equipo médico.BACKGROUND AND OBJECTIVES: Laser surgeries pose risks both to patients and the medical staff. This article aimed at presenting basic notions for laser usage and rules for improving laser procedures safety. CONTENTS: Notions of physics applied to laser, safety rules and procedures in case of adverse events with laser application are presented. CONCLUSIONS: When operated by trained professionals, and provided safety rules are followed, laser is useful and safe both for patients and the medical staff.

  16. Administration of Anesthesia

    Science.gov (United States)

    ... a Surgeon What We Do Administration of Anesthesia Administration of Anesthesia Oral and maxillofacial surgeons are extensively ... Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral and maxillofacial surgeons are extensively ...

  17. Clinical observation of two methods of anesthesia in traumatic brain injury surgery%两种麻醉方式在颅脑损伤手术中的临床观察

    Institute of Scientific and Technical Information of China (English)

    胡春江

    2016-01-01

    目的:探讨两种不同麻醉方式在颅脑损伤手术中的麻醉效果。方法选取来宾市中医医院2011年3月至2014年12月收治的64例颅脑外伤患者作为研究对象,按照随机数字表法将所有患者分为对照组和观察组,对照组患者采取静吸复合麻醉,观察组患者采取全凭静脉麻醉,比较两组患者麻醉期间不同时间点的心率和平均动脉压变化情况及两组患者苏醒时间、自主呼吸恢复时间、拔管时间。结果对照组患者在不同时间点其心率和平均动脉压比较差异有统计学意义( P﹤0.05),观察组患者不同时间点其心率和平均动脉压比较差异未见统计学意义(P﹥0.05);两组患者自主呼吸恢复时间比较差异未见统计学意义(P﹥0.05),而在苏醒时间和拔管时间方面观察组患者显著低于对照组( P﹤0.05)。结论全凭静脉麻醉在颅脑损伤患者手术治疗时其血流动力学未见明显变化,且苏醒时间和拔管时间短。%Objective TO investiGate tHe effect Of tWO different anestHesia On surGery Of traumatic brain injury. Methods FrOm MarcH 2011 tO December 2014,64 cases Of brain trauma in traditiOnaL CHi-nese medicine HOspitaL Of Laibin Were randOmLy divided intO cOntrOL GrOup and ObservatiOn GrOup,tHe cOn-trOL GrOup Was Given inHaLatiOn anestHesia,and tHe ObservatiOn GrOup Was Given tOtaL intravenOus anestHe-sia. THe Heart rate and mean arteriaL pressure cHanGes in different pOint Of time and durinG anestHesia re-cOvery time,recOvery time Of spOntaneOus breatHinG and eXtubatiOn time Were cOmpared. Results THere Were siGnificant differences in Heart rate and mean arteriaL pressure at different time pOints in tHe cOntrOL GrOup( P﹤0. 05 ),and tHere Were nO siGnificant differences in Heart rate Or mean arteriaL pressure at dif-ferent time pOints in tHe ObservatiOn GrOup( P﹥0. 05 );tHe spOntaneOus breatHinG recOvery time Had nO siGnificant difference betWeen tHe t

  18. Influence of intraoperative magnetic resonance imaging used in neurosurgery on anesthesia

    Directory of Open Access Journals (Sweden)

    Mao-wei GONG

    2011-09-01

    Full Text Available Objective To observe the influcences of intraoperative magnetic resonance imaging(iMRI used in neurosurgery on anesthesia.Methods Sixty patients with glioma were randomly divided into two groups(30 each,the patients in iMRI group underwent craniotomy and glioma ablation under the guidance of iMRI and functional neuro-navigation,and in N group with the functional neuro-navigation only.The patients’ general status and concerning parameters were observed and recorded,including anesthesia duration,preparation time for surgery,duration of surgery,blood loss,volume of fluid administration,number of patients who needed blood transfusion,preoperative and postoperative hemoglobin,postoperative body temperature,dosage of muscle relaxant,and the unforeseen incidents related to iMRI and anesthesia.Results No significant differences existed between the two groups(P > 0.05 in patients’ general status,anesthesia duration,blood loss,volume of fluid administration,numbers of patients who needed blood transfusion,preoperative and postoperative hemoglobin,and body temperature.However,the preparation time for and duration of surgery were longer,the dosage of muscle relaxant was larger in iMRI group than in N group(P < 0.05.No inadvertent incident related to iMRI and anesthesia occurred in both groups.Conclusions The application of iMRI in neurosurgery may improve the accuracy in operative manipulation and make the tumor resection more thorough,but it may prolong duration of surgery.Other perimoperative care related to iMRI surgery is similar to that of traditional functional neuro-navigation surgery.Besides the basic rules of neurosurgery anesthetic management for neurosurgery,anesthetist should focus on anesthetic adjustment for a long operation.

  19. 七氟醚联合骶管麻醉在患儿下腹部手术中的应用%Sevoflurane Combined with Caudal Anesthesia in Pediatric Abdominal Surgery

    Institute of Scientific and Technical Information of China (English)

    赵会奇

    2015-01-01

    目的:探讨七氟醚联合骶管麻醉在患儿下腹部手术中的应用。方法收集2012年4月至2014年4月于本院行下腹部手术的患儿88例资料,将患儿按照随机数字表法分为两组,对照组患者应用七氟醚麻醉,观察组患者行七氟醚联合骶管麻醉,观察比较两组患者各时点平均动脉压(MAP)、心率(HR),诱导时间及苏醒时间比较情况。结果麻醉后观察组各时点MAP、HR均低于对照组,差异均有统计学意义(均P<0.05)。结论小儿下腹部手术应用七氟醚联合骶管麻醉,获得明显效果。%Objective To investigate the sevoflurane combined caudal anesthesia in pediatric abdominal surgery applications.Methods Data selected at random from April 2012 to April 2014 to 88 cases in children under hospital abdominal surgery,according to a random number table is divided into two groups,the application of the patients in the control group sevoflurane anesthesia,patients in the observation group of seven desflurane combined caudal anesthesia,two groups were compared at each time point were observed in mean arterial pressure(MAP),heart rate (HR),the induction time and wake time comparison situation.Results Observation group at al time points after anesthesia MAP,HR values were lower than the control group,the difference was statisticaly significant(P<0.05). Conclusion Pediatric abdominal surgery under sevoflurane combined caudal anesthesia,achieve significant results.

  20. Interspinous spacer versus traditional decompressive surgery for lumbar spinal stenosis: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Ai-Min Wu

    Full Text Available BACKGROUND: Dynamic interspinous spacers, such as X-stop, Coflex, DIAM, and Aperius, are widely used for the treatment of lumbar spinal stenosis. However, controversy remains as to whether dynamic interspinous spacer use is superior to traditional decompressive surgery. METHODS: Medline, Embase, Cochrane Library, and the Cochrane Controlled Trials Register were searched during August 2013. A track search was performed on February 27, 2014. Study was included in this review if it was: (1 a randomized controlled trial (RCT or non-randomized prospective comparison study, (2 comparing the clinical outcomes for interspinous spacer use versus traditional decompressive surgery, (3 in a minimum of 30 patients, (4 with a follow-up duration of at least 12 months. RESULTS: Two RCTs and three non-randomized prospective studies were included, with 204 patients in the interspinous spacer (IS group and 217 patients in the traditional decompressive surgery (TDS group. Pooled analysis showed no significant difference between the IS and TDS groups for low back pain (WMD: 1.2; 95% CI: -10.12, 12.53; P = 0.03; I2 = 66%, leg pain (WMD: 7.12; 95% CI: -3.88, 18.12; P = 0.02; I2 = 70%, ODI (WMD: 6.88; 95% CI: -14.92, 28.68; P = 0.03; I2 = 79%, RDQ (WMD: -1.30, 95% CI: -3.07, 0.47; P = 0.00; I2 = 0%, or complications (RR: 1.39; 95% CI: 0.61, 3.14; P = 0.23; I2 = 28%. The TDS group had a significantly lower incidence of reoperation (RR: 3.34; 95% CI: 1.77, 6.31; P = 0.60; I2 = 0%. CONCLUSION: Although patients may obtain some benefits from interspinous spacers implanted through a minimally invasive technique, interspinous spacer use is associated with a higher incidence of reoperation and higher cost. The indications, risks, and benefits of using an interspinous process device should be carefully considered before surgery.

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

    Institute of Scientific and Technical Information of China (English)

    夏燕飞; 黄浩; 周嘉莉; 罗妙妙

    2012-01-01

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

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

    Science.gov (United States)

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

    1991-05-01

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

  3. Analisis Gas Darah pada Kucing yang Mengalami Laparohisterotomi dengan Anestesi Xylazin-Ketamin dan Xylazin-Propofol (BLOOD GAS ANALYSIS OF XYLAZIN- KETAMIN AND XYLAZIN-PROPOFOL FOR ANESTHESIA TO LAPARO-HISTEROTOMY SURGERY IN CAT

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    Ira Sari Yudaniayanti

    2012-03-01

    Full Text Available The aim of this research was to study the safety application of xylazine-ketamine and xylazinepropofolrecurrent dosage combination as anesthesia for laparo-histerotomy surgery in cat. Thisresearch used 10 female cats, 12-18 months of age, followed randomly divided into two groups, P1:atropine 0,04 mg/kgBW/SC + xylazine 2 mg/kg BW/IM + ketamine 20 mg/kg BW/IM; P2 : atropine0,04mg/kg BW/SC + xylazine 2 mg/kg BW/IM + Propofol 20 mg/kg BW/IV. The blood of the allgroups was taken from vena femuralis at 0 minute (before treatment, 15, 30, 45 and 60 minutesduring anesthesia for measurement of blood gas value pH, pCO2 and HCO3. After all animals wereanesthetized, the animals were treated laparo-histerotomy surgery. The data were analyzed byusing Randomized Complete Block Design (RCBD. The result showed both of groups were notsignificantly difference (p>0,05 to blood gas values for pH, pCO2 dan HCO3. Besides, both groupsanaesthetic agent perfectly caused metabolic acidosis with respiratory alkalosis compensationperfectly, therefore it is relatively safe to use as anaesthetic agent for surgery that needs long timeprocedure, as laparo-histerotomy.

  4. The anesthesia analysis of the conversion video-assisted thoracic surgery to thoracotomy in pulmonary carcinoma%胸腔镜下肺癌中转手术的麻醉因素分析

    Institute of Scientific and Technical Information of China (English)

    Lairong Sun; Wenmin Xie

    2011-01-01

    Objective: The aim of this study was to anesthesia analyse the factors of conversing video-assisted thoracic surgery to thoracectomy in pulmonary carcinoma. Methods: Double-lumen tube bronchial catheter intubation and interstitial positive pressure ventilation (IPPV) were used in all patients with video-assisted thoracic surgery after fast-speed venous induced anesthesia. IPPV, positive expiratory pressure (PEEP) and continuous positive airway pressure (CPAP) in collapse lobes of lung were used in one lung ventilation, and ventilation parameters were adjusted. Results: Two hundred and fifity-two patients double-lumen bronchial tube intubation used by fiberscope was located very well. The level of oxygen saturation of blood (SpO2), end-tidal carbon dioxide pressure (PETCO2) could be maintained normal. 5 cases were forced to converse video-assisted thoracic surgery to thoracotomy because of 2 cases pulmonary adhesion, 2 cases severe pulmonary dysfunc-tion and 1 case abnormal anatomy respectively. Conclusion: Long one lung ventilation such as pulmonary adhesion, severe pulmonary dysfunction and abnormal anatomy should be considered to be relative contraindication.

  5. Comparison of time required for traditional versus virtual orthognathic surgery treatment planning.

    Science.gov (United States)

    Wrzosek, M K; Peacock, Z S; Laviv, A; Goldwaser, B R; Ortiz, R; Resnick, C M; Troulis, M J; Kaban, L B

    2016-09-01

    Virtual surgical planning (VSP) is a tool for predicting complex surgical movements in three dimensions and it may reduce preoperative laboratory time. A prospective study to compare the time required for standard preoperative planning versus VSP was conducted at Massachusetts General Hospital from January 2014 through January 2015. Workflow data for bimaxillary cases planned by both standard techniques and VSP were recorded in real time. Time spent was divided into three parts: (1) obtaining impressions, face-bow mounting, and model preparation; (2) occlusal analysis and modification, model surgery, and splint fabrication; (3) online VSP session. Average times were compared between standard treatment planning (sum of parts 1 and 2) and VSP (sum of parts 1 and 3). Of 41 bimaxillary cases included, 20 were simple (symmetric) and 21 were complex (asymmetry and segmental osteotomies). Average times for parts 1, 2, and 3 were 4.43, 3.01, and 0.67h, respectively. The average time required for standard treatment planning was 7.45h and for VSP was 5.10h, a 31% time reduction (Porthognathic surgery cases.

  6. A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

    Directory of Open Access Journals (Sweden)

    Ahmet Dag

    2011-01-01

    Full Text Available OBJECTIVE: This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations. METHODS: A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n = 99 or a regular diet (n = 100. Patients’ characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed. RESULTS: The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3, defecation (3.4±0.77 vs. 4.38±1.18 and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81 were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5 was shorter in the early feeding group. CONCLUSIONS: The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions.

  7. Application of fast-track anesthesia in the surgery for colorectal cancer in elderly patients%快通道麻醉在老年结直肠肿瘤手术中的应用

    Institute of Scientific and Technical Information of China (English)

    吴世贵; 刘吉生; 陈尔标

    2014-01-01

    Objective To discuss the clinical effects of fast-track anesthesia in the surgery for colorectal can-cer in elderly patients. Methods Ninety-two elderly patients with colorectal cancer undergoing laparoscopic surgery were randomly divided into observation group (n=46) and control group (n=46). The observation group was given fast-track anesthesia, and the control group was given general inhalation anesthesia. And then the Steward scores and neuroendocrine changes were compared between the two groups. Results There were more patients with Steward≥4 after operation in the observation group than that in the control group (P0.05). However, the plasma cortisol and glucose concentrations after the incision, in the end of surgery, and 1 h postoperative were significantly lower in the observation group than those in the control group (P0.05),而麻醉开始后观察组患者在切皮后、手术结束时以及术后1 h血浆皮质醇及血糖均显著低于对照组(P<0.05或P<0.01);观察组术后出现恶心、呕吐发生率显著低于对照组(P<0.01)。结论快通道麻醉能够使患者获得较快的术后苏醒,同时降低了麻醉及手术操作对患者神经内分泌系统功能的影响,减少了麻醉损伤,且术后恶心呕吐等不良反应发生率较低,值得推广应用。

  8. A Comparison of Training Experience, Training Satisfaction, and Job Search Experiences between Integrated Vascular Surgery Residency and Traditional Vascular Surgery Fellowship Graduates.

    Science.gov (United States)

    Colvard, Benjamin; Shames, Murray; Schanzer, Andres; Rectenwald, John; Chaer, Rabih; Lee, Jason T

    2015-10-01

    The first 2 integrated vascular residents in the United States graduated in 2012, and in 2013, 11 more entered the job market. The purpose of this study was to compare the job search experiences of the first cohort of integrated 0 + 5 graduates to their counterparts completing traditional 5 + 2 fellowship programs. An anonymous, Web-based, 15-question survey was sent to all 11 graduating integrated residents in 2013 and to the 25 corresponding 5 + 2 graduating fellows within the same institution. Questions focused on the following domains: training experience, job search timelines and outcomes, and overall satisfaction with each training paradigm. Survey response was nearly 81% for the 0 + 5 graduates and 64% for the 5 + 2 graduates. Overall, there was no significant difference between residents and fellows in the operative experience obtained as measured by the number of open and endovascular cases logged. Dedicated research time during the entire training period was similar between residents and fellows. Nearly all graduates were extremely satisfied with their training and had positive experiences during their job searches with respect to starting salaries, numbers of offers, and desired practice type. More 0 + 5 residents chose academic and mixed practices over private practices compared with 5 + 2 fellowship graduates. Although longer term data are needed to understand the impact of the addition of 0 + 5 graduating residents to the vascular surgery work force, preliminary survey results suggest that both training paradigms (0 + 5 and 5 + 2) provide positive training experiences that result in excellent job search experiences. Based on the current and future need for vascular surgeons in the work force, the continued growth and expansion of integrated 0 + 5 vascular surgery residency positions as an alternative to traditional fellowship training is thus far justified. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    OpenAIRE

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

    2012-01-01

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

  10. 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

  11. Spinal morphine anesthesia and urinary retention.

    Science.gov (United States)

    Mahan, K T; Wang, J

    1993-11-01

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

  12. What Is Elective Surgery? (For Parents)

    Science.gov (United States)

    ... Surgery How to Find Affordable Health Care Financial Management During Crisis Anesthesia Basics Preparing Your Child for Anesthesia Word! Surgery ... Have Surgery? Health Care: What Do You Know? Anesthesia Basics Contact ... Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  13. Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.

    Science.gov (United States)

    Tortorici, Silvia; Difalco, Paolo; Caradonna, Luigi; Tetè, Stefano

    2014-05-01

    In this study, we compared outcomes of traditional apicoectomy versus modern apicoectomy, by means of a controlled clinical trial with a 5-year follow-up. The study investigated 938 teeth in 843 patients. On the basis of the procedure performed, the teeth were grouped in 3 groups. Differences between the groups were the method of osteotomy (type of instruments used), type of preparation of retrograde cavity (different apicoectomy angles and instruments used for root-end preparation), and root-end filling material used (gray mineral trioxide aggregate or silver amalgam). Outcome (tooth healing) was estimated after 1 and 5 years, postoperatively. Clinical success rates after 1 year were 67% (306 teeth), 90% (186 teeth), and 94% (256 teeth) according to traditional apicoectomy (group 1), modern microsurgical apicoectomy using burns for osteotomy (group 2) or using piezo-osteotomy (group 3), respectively. After 1 year, group comparison results were statistically significant (P < 0.0001). Linear trend test was also statistically significant (P < 0.0001), pointing out larger healing from group 1 to group 3. After 5 years, teeth were classified into 2 groups on the basis of root-end filling material used. Clinical success was 90.8% (197 teeth) in the silver amalgam group versus 96% (309 teeth) in the mineral trioxide aggregate group (P < 0.00214). Multiple logistic regression analysis found that surgical technique was independently associated to tooth healing. In conclusion, modern apicoectomy resulted in a probability of success more than 5 times higher (odds ratio, 5.20 [95% confidence interval, 3.94-6.92]; P < 0.001) compared with the traditional technique.

  14. [Spinal anesthesia versus general anesthesia in the surgical treatment of inguinal hernia. Cost-effectiveness analysis].

    Science.gov (United States)

    Fernández-Ordóñez, M; Tenías, J M; Picazo-Yeste, J

    2014-05-01

    To compare the costs related to the clinical effectiveness of general anesthesia versus spinal anesthesia in inguinal hernioplasty ambulatory surgery. An observational, retrospective cohort study measurement and analysis of cost-effectiveness, in the ambulatory surgery unit of a general hospital. All patients over 18 years of age diagnosed with primary inguinal hernia and scheduled for unilateral hernioplasty between January 2010 and December 2011 were included. Duration of anesthetic induction, length of stay in both the operating room, and in the post-anesthesia care unit, the anesthetic effectiveness (the incidence of adverse effects and the patient's comfort level), and variable economic costs associated with the use of drugs, as well as the use of human resources, were compared. The final analysis included 218 patients, 87.2% male, with a mean age of 53 years (range: 18-85 years). Of these, 139 (63.76%) received subarachnoid anesthesia and 79,(36.2%) general anesthesia. The length of time a patient remained in the post-anesthesia care unit was 337.6±160.2min in the subarachnoid anesthesia group, and 210.0±97.5min for the general anesthesia group (P<.001). Costs of drugs for general anesthesia were higher than that for subarachnoid anesthesia (86.2±8.3 vs. 18.7±7.2). The total cost difference between the 2 techniques was €115.8 more for subarachnoid anesthesia (P<.001). Both techniques showed similar effectiveness. The overall costs for subarachnoid anesthesia were greater than for the general. The cost-effectiveness of general anesthesia is better for outpatient inguinal hernia repair surgery. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

    张会娟

    2015-01-01

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

  16. A Comparative Study Inhalation and Total Intravenous Anesthesia for Complex Orthopedic Surgery in ;Elderly%静吸复合与全凭静脉麻醉用于老年骨科手术的比较研究

    Institute of Scientific and Technical Information of China (English)

    谷旭鹏

    2014-01-01

    目的:比较老年骨科手术中采用七氟烷静吸复合麻醉与全凭静脉麻醉的疗效。方法:选取68例行内固定手术患者,分为观察组和对照组各34例,观察组采用全凭静脉麻醉,对照组采用七氟烷静吸复合麻醉。分析血流动力学变化及术后麻醉恢复情况。结果:观察组SBP、DBP在血压最低时与基础值比较,差异有统计学意义(P<0.05);对照组SBP在切皮及血压最低时较基础值比较,差异有统计学意义(P<0.05),HR在切皮及血压最高时较基础值差异有统计学意义(P<0.05);术后恢复情况两组比较差异有统计学意义(P<0.05)。结论:在老年骨科手术中采用七氟烷静吸复合麻醉患者,术后麻醉恢复效果更好,更减轻患者的痛苦,提高患者的生命质量,值得广大医学工作者在临床中大力推广使用。%Objective:To compare the elderly orthopedic surgery using sevoflurane inhalation anesthesia efficacy and total intravenous anesthesia. Method:68 patients with routine internal fixation surgery were randomly divided into observation group and control group,the observation group accepted total intravenous anesthesia,and the control group used sevoflurane inhalation anesthesia. To analyze hemodynamic changes and postoperative anesthesia recovery. Result:SBP,DBP of the observation group at the lowest blood pressure were significantly different compared with baseline (P<0.05). Incision and control blood pressure in the lowest SBP compared to baseline values was significantly different (P<0.05). HR highest compared to baseline differences in incision and blood pressure were statistically different(P<0.05). Postoperative recovery cases the difference was significant(P<0.05). Conclusion:In elderly orthopedic surgery sevoflurane inhalation anesthesia,postoperative anesthesia recovery is better,and more to alleviate the suffering of patients and improve the quality of life of patients

  17. Summary on the Anesthesia Experience of Thoracic Surgery with Davinci Robot System%达芬奇机器人胸科手术的麻醉经验总结

    Institute of Scientific and Technical Information of China (English)

    王维; 隋波; 冯泽国; 李永旺; 马涛; 马玉恒; 田雷

    2011-01-01

    [Objective]To summarize the anesthesia management experience of 41 cases of Davinci robotic assisted thoracic surgery. [ Methods ]Forty one patients underwent Davinci robotic thoracic surgery. The anesthesia process and complications were analyzed and summarized. [Results]All patients completed the operation successfully. A case of lung cancer was not enrolled in the statistical analysis for the conversion to open surgery. The other patients completed Davinci robotic assisted thoracic surgery. No one died during the surgery. After one-lung ventilation, pulse blood oxygen saturation(SpO2) decreased transiently. The time of anesthesia was (161. 5 ± 44. 9)min. The surgical duration was (148. 1 ±44. 3)min. The time of CO2 pneumothorax was (143. 1 ± 39. 2)min. PaCO2 decreased obviously after one-lung ventilation, but significantly increased 60min after CO2 pneumothorax( P <0. 05). The pH value decreased to 7. 3 ± 0. 17 at 180min( P <0. 05) and was corrected by little sodium bicarbonate. Blood pressure of all patients decreased to (69. 8 ± 10. DmmHg after CO2 pneumothorax and could be controlled by rapid infusion and vasoactive agents. [Conclusions] Anesthesia management of Davinci robotic assisted thoracic surgery is complicated. CO2 pneumothorax and one-lung ventilation have more effect on hemodynamics and respiratory function, so they should be handled promptly and is a new challenge for anesthesia management.%[目的]总结41例达芬奇机器人胸科手术的麻醉管理经验.[方法]实施全麻下达芬奇机器人胸科手术41例,对麻醉过程及麻醉并发症进行分析总结.[结果]所有患者均顺利完成手术,其中1例肺癌患者中转开胸,未纳入统计,其余患者均完成全达芬奇机器人手术,围术期无死亡病例.单肺通气后27例患者脉搏血氧饱和度(SpO2)一过性下降.麻醉时间(161.5±44.9)min,手术时间(148.1±44.3)min,二氧化碳(CO2)气胸时间(143.1±39.2)min.动脉氧分压(PaO2)在单肺通气

  18. Design and Organization of the Dexamethasone, Light Anesthesia and Tight Glucose Control (DeLiT Trial: a factorial trial evaluating the effects of corticosteroids, glucose control, and depth-of-anesthesia on perioperative inflammation and morbidity from major non-cardiac surgery

    Directory of Open Access Journals (Sweden)

    Tang WH Wilson

    2010-06-01

    Full Text Available Abstract Background The perioperative period is characterized by an intense inflammatory response. Perioperative inflammation promotes postoperative morbidity and increases mortality. Blunting the inflammatory response to surgical trauma might thus improve perioperative outcomes. We are studying three interventions that potentially modulate perioperative inflammation: corticosteroids, tight glucose control, and light anesthesia. Methods/Design The DeLiT Trial is a factorial randomized single-center trial of dexamethasone vs placebo, intraoperative tight vs. conventional glucose control, and light vs deep anesthesia in patients undergoing major non-cardiac surgery. Anesthetic depth will be estimated with Bispectral Index (BIS monitoring (Aspect medical, Newton, MA. The primary outcome is a composite of major postoperative morbidity including myocardial infarction, stroke, sepsis, and 30-day mortality. C-reactive protein, a measure of the inflammatory response, will be evaluated as a secondary outcome. One-year all-cause mortality as well as post-operative delirium will be additional secondary outcomes. We will enroll up to 970 patients which will provide 90% power to detect a 40% reduction in the primary outcome, including interim analyses for efficacy and futility at 25%, 50% and 75% enrollment. Discussion The DeLiT trial started in February 2007. We expect to reach our second interim analysis point in 2010. This large randomized controlled trial will provide a reliable assessment of the effects of corticosteroids, glucose control, and depth-of-anesthesia on perioperative inflammation and morbidity from major non-cardiac surgery. The factorial design will enable us to simultaneously study the effects of the three interventions in the same population, both individually and in different combinations. Such a design is an economically efficient way to study the three interventions in one clinical trial vs three. Trial registration This trial is

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

    Institute of Scientific and Technical Information of China (English)

    曾春红

    2015-01-01

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

  20. Anesthesia for the homeless.

    Science.gov (United States)

    Benedict, S; Fehder, W P

    1993-06-01

    Healthcare for the homeless is often crisis-oriented and fragmented. Homelessness may be associated with ongoing healthcare problems such as tuberculosis, human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), and substance abuse. The purpose of this study was to identify the anesthesia services required by homeless individuals from an urban area. The anesthesia records of all individuals (N = 40) identified as being homeless and receiving care at one New York City medical center during a 12-month period were reviewed. Approximately one-half (47.5%) of the 40 patients in the study did not require general anesthesia but intubation only. Most of these intubations were for cardiac/respiratory arrests of unknown cause, drug/alcohol overdose, or multiple trauma. Of the 21 patients requiring surgery, 15 had emergency procedures such as splenectomy, appendectomy, exploratory laparotomy, incarcerated hernia repair, and reduction of fractures. The findings of this study support previous research which indicates that most homeless people enter into care for emergency rather than elective services.

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

    Institute of Scientific and Technical Information of China (English)

    焦妮妮; 刘静

    2015-01-01

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

  2. Anesthesia of patients for hepatobiliary and gastrointestinal surgery with da Vinci S robotics%达芬奇机器人肝胆胃肠手术麻醉研究

    Institute of Scientific and Technical Information of China (English)

    隋波; 王维; 马涛; 李冠华; 袁建广; 马玉恒; 田雷; 周宁新; 米卫东

    2011-01-01

    目的 总结达芬奇机器人肝胆胃肠手术251例麻醉临床经验.方法 对2008年1月-2011年6月251例达芬奇机器人肝胆胃肠手术麻醉过程及麻醉并发症进行分析总结.结果 251例全程机器人手术麻醉,麻醉时间(456.5±92.4)min,手术时间(414.6±83.6)min,气腹时间(408.7±46.8)min,麻醉手术中血流动力学稳定,气腹时间多于180min者PaCO2比术前基线值明显增加(P<0.05),气腹时间多于360min者动脉血pH比术前基线值明显降低(P<0.05),9例中转开腹未列入本组统计.结论 达芬奇机器人腹部手术中患者血流动力学平稳,但气腹时间明显延长,易发生酸碱失衡.%Objective To summarize the clinical anesthesia experiences with 251 cases who underwent hepatobiliary and gastrointestinal surgery with da Vinci S robotics. Methods Anesthesia of 251 patients who underwent hepatobiliary and gastrointestinal surgery with da Vinci S robotics from January 2008 to June 2011 and its complications were analyzed and summarized. Results All patients were anesthetized and underwent surgery with robotics. The anesthesia time was 456.5 ± 92.4min, the operation time was 414.6 ± 83.6min, and the CO2 pneumoperitoneum time was 408.7 ± 46.8min. The hemodynamics of patients was stable during operation. The PaCO2 was significantly higher after 180min of pneumoperitoneum than before operation(P<0.05), while the pH was significantly lower after 360min of pneumoperitoneum than before operation(P<0.05). Nine cases were transferred for laparotomy. Conclusion The hemodynamics of patients is stable during anesthesia of patients for abdominal operation with da vinci S robotics. The time of CO2 pneumoperitoneum is significantly longer than other surgical procedures, and thus often leading to acid-base disturbance.

  3. Effect of video-assisted thoracoscopic surgery and traditional open surgery on the inflammatory cytokine and immune function in patients with non-small cell lung carcinoma

    Institute of Scientific and Technical Information of China (English)

    Bing Lv; Yongzhong Tao; Jing Wu; Bin Zhong; Fuchao Luo; Yang Liu; Zexue Zhang

    2016-01-01

    Objective:To explore the effect of video-assisted thoracoscopic surgery (VATS) and traditional open surgery (TOS) on the inflammatory cytokine and immune function in patients with non-small cell lung carcinoma.Methods: A total of 68 patients with non-small cell lung carcinoma were included in the study and divided into VATS group and TOS group according to different surgical methods with 34 cases in each group. The operation time, intraoperative amount of bleeding, incision length, and lymph node dissection number after operation in the two groups were compared. The levels of serum IL-6 and CRP after operation in the two groups were detected and compared. The immunological function status before and after operation in the two groups was analyzed.Results: The operation time and intraoperative amount of bleeding in VATS group were significantly reduced, and the incision length was significantly shortened when compared with TOS group. IgG, CD4+, and CD8+ levels, and CD4+/CD8+ after operation in the two groups were significantly reduced when compared with before treatment, and those in TOS group were significantly lower than those in VATS group. IL-6 and CRP levels 1d after operation in the two groups were significantly elevated when compared with before operation, and those in TOS group were significantly higher than those in VATS group. IL-6 and CRP levels 5d after operation in VATS group were not significantly different from those before operation, while those in TOS group were significantly elevated when compared with before operation.Conclusions:VATS in the treatment of non-small cell lung carcinoma has a significant efficacy, can significantly alleviate the inflammatory reaction, and is beneficial to protect the immunological function.

  4. Attitudes to cosmetic surgery among ethnic minority groups in Britain: cultural mistrust, adherence to traditional cultural values, and ethnic identity salience as protective factors.

    Science.gov (United States)

    Swami, Viren; Hendrikse, Sinead

    2013-01-01

    Previous work has suggested that ethnic minority women have more negative attitudes to cosmetic surgery than British Whites, but reasons for this are not fully understood. To overcome this dearth in the literature, the present study asked 250 British Asian and 250 African Caribbean university students to complete measures of attitudes to cosmetic surgery, cultural mistrust, adherence to traditional cultural values, ethnic identity salience, self-esteem, and demographics. Preliminary analyses showed that there were significant between-group differences only on cultural mistrust and self-esteem, although effect sizes were small (d values = .21-.37). Further analyses showed that more negative attitudes to cosmetic surgery were associated with greater cultural mistrust, stronger adherence to traditional values, and stronger ethnic identity salience, although these relationships were weaker for African Caribbean women than for British Asians. These results are discussed in relation to perceptions of cosmetic surgery among ethnic minority women.

  5. [Systematic recording of perioperative events associated with anesthesia as quality indicator in ambulatory anesthesia].

    Science.gov (United States)

    García-Aguado, R; Vivó Benlloch, M; Arcusa Mon, M J; Peiró Alós, C; Zaragoza Fernández, C; Castaño Conesa, S; Grau Real, F

    2000-03-01

    To analyze the quality of several anesthetic techniques used for major outpatient surgery in our hospital, by quantifying for each the relative risk (RR) of adverse events during anesthesia and in the postoperative period. One thousand seventeen patients who underwent surgery between 18 May 1998 and 23 October 1998 were studied retrospectively. The mean age of the patients was 52.27 +/- 24.65 yr; 44.18% were ASA I, 40.56% were ASA II, 14.56% ASA III and 0.67% ASA IV. Mean time of surgery was 33 +/- 16.49 min and mean recovery time until discharge was 77.3 +/- 93.4 min. Admission was necessary for 0.6% of the patients and re-admission for 0.3%. General anesthesia was used with 19%, anesthetic monitoring with 17%, regional anesthesia (including peribulbar) with 46% and local anesthesia plus sedation with 16.6%. In 95% of the cases, no adverse events occurred during anesthesia; in 94.8% no such events occurred during the early recovery period. During surgery and postoperative recovery, intradural anesthesia was associated with significantly greater RR of adverse events in comparison with general anesthesia (6.6 and 2.2 respectively) and in comparison with monitored anesthesia (7.2 and 3.3). No differences in RR were found between general anesthesia and monitored anesthesia. Problems were slight to moderate in severity and mainly related to nausea and vomiting (2%). Recording perioperative events permits evaluation of the quality of anesthesic procedures. Intradural anesthesia is associated with more complications.

  6. The application of surface anesthesia endotracheal intubation without muscle relaxant in the epiglottis vocal cords surgery anesthesia%表面麻醉下无肌松药气管插管在会厌声带手术麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    来伟; 丁国友; 帅君; 肖荣; 吴林纳; 江丽丽

    2015-01-01

    目的:评价表面麻醉下无肌松药气管插管在会厌声带手术麻醉中的临床应用。方法全麻下择期行会厌、声带手术80例,随机分为2组:麻醉诱导中,肌松药气管插管组(Ⅰ组)予以静脉注射顺式阿曲库铵0.1 mg/kg后行气管插管;表面麻醉气管插管组(Ⅱ组)采用逐步口咽及气管内表面麻醉后行气管插管。记录2组麻醉诱导中气管插管前后各时间点的平均动脉压( MAP)和心率( HR)。评价两组气管插管评分分级情况,比较两组手术时间、术中丙泊酚和瑞芬太尼用量、手术结束至自主呼吸恢复和气管拔管时间,记录两组术后拔管期间的意识状态评分( OAA/S),术后麻醉不良反应、术中知晓情况和患者麻醉满意度。结果两组共78名患者完成临床研究。两组MAP和HR变化相同,组间差异无统计学意义。两组气管插管条件相似,手术时间、全麻用药量比较差异无统计学意义( P均>0.05)。与Ⅰ组比较,无肌松药的Ⅱ组术后自主呼吸恢复迅速拔管更快,差异有统计学意义( P<0.05)。Ⅱ组术后气管拔管时和拔管后5 min OAA/S评分显著高于Ⅰ组,术后不良反应发生也明显少于Ⅰ组,整体麻醉满意度高。结论表面麻醉下无肌松药气管插管可以为会厌、声带手术麻醉提供良好的气道管理,缩短术后气管拔管时间,麻醉安全性更高。%Objective To evaluate the clinical application of surface anesthesia without muscle relaxant endotracheal intuba-tion in epiglottis vocal cords surgery anesthesia.Methods Eighty patients undergoing elective epiglottis vocal cords surgery by general anesthesia, were randomly divided into two groups:In the anesthesia induction, the group of endotracheal intubation with muscle relax-ants (groupⅠ)was treated with intravenous cisatracurium 0.1 mg/kg before endotracheal intubation.The group of surface

  7. The day of surgery for your child

    Science.gov (United States)

    Same-day surgery - child; Ambulatory surgery - child; Surgical procedure - child ... The anesthesia and surgery team will talk with you and your child before surgery. You may meet with them at an appointment before ...

  8. Anesthesia management of patients with laparoscopic cholecystectomy based on fast track surgery%基于快速康复理念下腹腔镜胆囊切除手术患者的麻醉管理

    Institute of Scientific and Technical Information of China (English)

    薛官国

    2015-01-01

    目的:初步探讨基于快速康复理念下腹腔镜胆囊切除手术患者麻醉管理方案的作用。方法将38例拟行腹腔镜胆囊切除手术患者按随机数字法分为两组,各19例。试验组:采用联合麻醉,全身麻醉+硬膜外阻滞麻醉;对照组:常规全身麻醉,测定并比较两组患者行麻醉前、气腹成功时、手术开始15min时及术毕时的血糖、血清皮质醇浓度水平,并记录术后苏醒时间、排气时间及相关不良反应等指标。结果对照组患者在各时间点的血清皮质醇浓度水平较麻醉前均变化明显,且显著高于试验组患者同时间点的水平(P<0.05),各时间点的血糖变化类似于血清皮质醇浓度(P<0.05);相比对照组患者,试验组患者术后排气时间提前,住院时间缩短(P<0.05),且两组相关不良反应的差异有统计学意义(P<0.05)。结论快速康复理念指导下麻醉管理能够有效减轻腹腔镜胆囊切除手术患者的应激反应,加速快速康复。%Objective To investigate the effect of anesthesia management of patients with laparoscopic cholecystectomy(LC) based on fast track surgery(FTS). Methods A randomized controlled clinical trial was carried out, 38 patients were randomly divided into test group(n=19,epidural block anesthesia and general anesthesia) and control group (n=19,general anesthesia). The blood glucose(Glu)and serum cortisol were tested at the following four time pointsbefore anesthesia, at pneumoperitoneum, 15 min after surgery and completing operation. Awakening time, evacuation time post operation and adverse events were observed and compared. Results Compared with before anesthesia, serum cor-tisol and Glu were increased at various time point in control group (P<0.05), there were statistical differences in two groups (P<0.05). Awakening time and evacuation time post operation of test group were earlier than control group (P<0.05). There were

  9. 围手术期心理暗示对妇科椎管内麻醉手术患者心理因素的影响%Perioperative psychological hints on gynecologic the spinal canal anesthesia surgery patients psychological factors

    Institute of Scientific and Technical Information of China (English)

    杨润亭; 杨淑霞; 薛淑英

    2012-01-01

    Objective With SCL-90 scale evaluation perioperative psychological hints on gynecologic the spinal canal anesthesia surgery patients psychological factors.Methods The random sampling method,276 patients with spinal canal anesthesia to the control group and the patients into gynecological the control group,receive the traditional preoperative, during,and after the traditional nursing care,except to the psychological suggestion, with SCL-90 scale measurement two groups of patients psychological state.Results In the experimental group in somatization,interpersonal relationship,dep ression,anxiety,fear and other psychological status significantly better than the control group.Conclusion Gynecologic intraspinal anesthesia patients in peri operation period to implement psychological suggestion therapy can alleviate patients' fear,depression,anxiety and other psychological symptoms,enhancing patient safety through operation of confidence.%目的 用SCL - 90量表评价围手术期心理暗示对妇科椎管内麻醉手术患者心理因素的影响.方法 采用随机抽样的方法,将276例需椎管内麻醉的妇科患者分为对照组和实验组,对照组接受传统术前、术中、术后护理,实验组除传统护理外给予心理暗示,用SCL - 90量表测量两组病人心理状态.结果 实验组在躯体化、人际关系、抑郁、焦虑、恐惧等方面心理状态明显好于对照组.结论 对妇科椎管内麻醉患者围手术期实施心理暗示疗法能减轻患者抑郁、恐惧、焦虑等心理症状,增强了患者安全度过手术期的信心.

  10. Comparisons of different methods of anesthesia and analgesia on the levels of glycometabolism rate-limiting enzymes in erythrocytes and plasma glucose and stress hormones in patients undergoing esophagus surgery

    Institute of Scientific and Technical Information of China (English)

    Xiaokun Zhan; Xiongxiong Pan; Yinbin Pan; Jie Sun; Yanning Qian

    2008-01-01

    Objective: To compare the effects of different methods of anesthesia and analgesia on the activities of phosphofmctokinase(PFK), glucose-6-phosphate dehydrogenase(G-tPD) and aldose reductase(AR) in erythrocytes and levels of plasma glucose and stress hormones in patients undergoing esophagus surgery. Methods: Sixty-two patients scheduled for esophagus surgery were randomly divided into three groups: group I (n = 20) receiving only general anesthesia(GA) followed by intravenous patient controlled analgesia(PCA) with fentanyl 15 μg/kg. The other two groups receiving both general anesthesia combined with thoracic epidural anesthesia (GEA) and either intravenous PCA with fentanyl 15 μg/kg (group Ⅱ, n = 21) or thoracic epidurai analgesia(TEA) with 0.125% ropivaeaine and 0.0002% fentanyl mixture(group Ⅲ, n = 21) after the operation. Venous blood samples were collected for measurements of PFK, G-tPD and AR activities in erythrocytes and plasma glucose, conisol, epinephrine and norepinephrine before induction (T,1), 60 rain following the incision (T,2), 60 min(T,3) after operation, on the lst(T,4) and 2nd postoperative day(T5). Results: The activities of PFK decreased(P<0.01 or P=0.004) and the activities of G-tPD and AR increased(P<0.01) in groups Ⅰ and Ⅱ on T,4 compared with those on T,1. Between the two groups, the activities of these enzymes in group Ⅱ changed less than those of group Ⅰ (P<0.01 or P<0.05). These enzymes activities changed slightly in group Ⅲ on T,4(P>0.05). There were significant differences between group Ⅲ and the other two groups(P<0.01 or P<0.05). The levels of plasma glucose increased significantly on T,2(P<0.01), reached peak values on T,4(P<0.01) and fell on T,5 in the three groups. Compared to those of groups Ⅰ and Ⅱ, the values of plasma glucose in group Ⅲ were lower on T,4 and T,5(P<0.05 or P<0.01). The cortisol concentration in each group increased significantly at T,2(P<0.01 or P<0.05), and

  11. To Compare Efficacy of Hypnosis and Intravenous Sedation in Controlling of Important Variables of Vital Signs and Evaluate the Patient Anxiety Before and after Topical Anesthesia in Ophthalmic Surgery

    Directory of Open Access Journals (Sweden)

    Faranak Behnaz

    2016-07-01

    Full Text Available Background: Stress is one of the most important problems among preoperative patients. In order to reduce these signs and symptoms, some medications are used for patients. The aim of this study was to compare the efficacy of hypnosis to intravenous sedation on controlling the important variables of vital signs and to evaluate the patient anxiety before and after regional or topical anesthesia in ophthalmic surgery.Materials and Methods: This study was designed as a double-blind stratified randomized clinical trial.  Hypnotism was administered to hypnotism group, and midazolam, fentanyl, and propofol were given intravenously to the IV sedation group. The patients were monitored and the baseline variables consisted of mean arterial pressure, pulse rate, respiratory rate, and O2 saturation were registered every 15 minutes during surgery. Patient anxiety was measured via Spielbeger`s State Anxiety Index (STAI score before and after surgery.Results: 90 patients were participated in the study, with 50% (n=45 assigned to hypnosis group and 50% (N=45 assigned to IV sedation group. Patients characteristics, including age, gender, and body mass index (BMI duration of surgery were similar among the groups (P>0.05. Spielbeger`s State Anxiety Index (STAI score before and after surgery were not significantly different in both groups (P>0.05. Heart rate, respiratory rate, mean arterial pressure were lower among hypnosis group as well as this group had higher O2 saturation during surgery (P<0.05.Conclusion: Hypnosis can be an effective means of controlling vital signs at different intervals of starting the ophthalmic surgery compared to intravenous sedation. In the hypnosis group anxiety was similar to IV sedation group, but O2 saturation was more desirable. 

  12. 腹股沟疝手术中的局部麻醉应用分析%The Analysis of Local Anesthesia Application in Surgery Treatment of Inguinal Hernia

    Institute of Scientific and Technical Information of China (English)

    张凯

    2015-01-01

    Objective The local anesthesia application in surgery treatment of inguinal hernia is to be analyzed. Methods Choose 32 inguinal hernia patients who are treated in hospital from October 2013 to November 2014 and separate them into study group and control group according to their hospitalization sequence.Patients in study group are given local anesthesia treatment; while patients in control group are given epidural anesthesia treatment,and then compare treatment efficacy of the two groups. Results The result shows that the anesthesia taking-effect time and anesthesia lasting time, and operation timein study group are much more favorable than control group,there is a clinical treatment efficacy differential between the two groups, and such a differential has statistic value(P < 0.05). Besides, patients’ complication incidence and il ness recurrence in study group are less than patients in control group;there is a clinical treatment efficacy differential between the two groups, and such a differential has statistic value(P<0.05). Conclusion Local anesthesia treatment is of efficacy in treatment of inguinal hernia, the anesthesia taking-effect time is fast and over-lasting, and complication incidence of local anesthesia treatment is quite few;thus, it is quite worthwhile to be promoted clinical y.%目的探讨腹股沟疝手术中的局部麻醉应用分析。方法选取2013年10月~2014年11月我院接诊的32例腹股沟疝手术患者,按照入院的先后顺序分为两组,实验组和对照组,实验组采用局部麻醉,对照组采用硬膜外麻醉,观察两组患者的治疗效果。结果实验组患者的麻醉起效时间、麻醉持续时间、手术时间明显优于对照组,差异显著,有统计学意义(P<0.05);实验组患者的并发症的发生率、复发率明显低于对照组,差异显著,有统计学意义(P<0.05)。结论腹股沟疝手术应用局部麻醉的效果显著,麻醉起效快、麻醉时间

  13. Spinal and epidural anesthesia

    Science.gov (United States)

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

  14. 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 | ...

  15. Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing.

    Science.gov (United States)

    French, Katy E; Guzman, Alexis B; Rubio, Augustin C; Frenzel, John C; Feeley, Thomas W

    2016-09-01

    With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13% and 28% across the 11 procedures. TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 38例胸腔镜手术患者单肺通气的麻醉体会%Experience in anesthesia of 38 patients undergoing video-assisted thoracic surgery with one-lung ventilation

    Institute of Scientific and Technical Information of China (English)

    俞学锋; 胡四毛; 陆小龙; 王盘如

    2012-01-01

    目的 探讨电视胸腔镜手术时患者呼吸的管理及麻醉处理.方法 对38例电视胸腔镜手术的患者临床资料进行回顾性分析,麻醉诱导时采用双腔气管插管,术中行单肺通气.结果 单肺通气时一过性低氧血症(SpO2<90%)8例,通过调整呼吸参数,改吸入纯氧等措施,SpO2逐渐回升至正常.手术均顺利完成,无麻醉意外及围手术期死亡.结论 胸腔镜手术的麻醉处理关键是双腔支气管插管位置准确,确保双肺分隔,加强围术期呼吸循环监测,避免低氧血症,为胸腔镜手术创造良好的条件.%Objective To discuss the influence factors on respiratory management for patients undergoing video - assisted thoraco-scopic surgery and related anesthesia management. Methods Clinical data with 38 patients received video - assisted thoracoscopic surgery ventilated by double - lumen tube intubation were retrospectively analysed. Results Transient hypoxemia happened in 8 cases during single lung ventilation ( SpO2 <90% ). By adjusting respiratory parameters and oxygen inhalation, SpO2 could be improved and the value achieved above 96%. There were 3 cases of ventricular premature beats, but they all recovered after treatment. All operations were successfully performed without anesthesia and perioperation death. Conclusion The accuracy of the location of double lumen endobronchial intubation is the key of anesthesia treatment with video - assisted thoracoscopic surgery, which ensures double lung separation. The perioperative respiratory and circulatory monitoring should be strengthened, and hypoxemia should be prevented for creating good conditions for video - assisted thoracoscopic surgery.

  17. 吸入七氟醚用于小儿唇腭裂手术麻醉的可行性与安全性%Sevoflurane inhalation anesthesia used in pediatric cleft lip/palate surgery the feasibility and safety

    Institute of Scientific and Technical Information of China (English)

    张文清; 林玉霜

    2012-01-01

      objective to application suction sevoflurane scheme with cleft lip and palate patients to the implementation of the clinical effect of preoperative anesthesia effect analysis. Methods from 88 cases with cleft lip and palate cases of children, which is divided into control group and observation group, average each group of 44 cases, two groups of children are receiving surgery. Using vein pump note propofol and fentanyl red to control implementation with preoperative anesthesia; In the use of sevoflurane in observation group with preoperative anesthesia implementation. Results observation group was better than control children anesthesia effect of children; Eyelash reflection time, pain reflex time, revival time significantly shorter than control group; Two groups were not observed the anesthetic lead to adverse reactions. Conclusion using suction sevoflurane scheme with cleft lip and palate patients to the implementation of preoperative anesthesia safe and reliable.%  目的对应用吸入七氟醚方案对患有唇腭裂的患儿实施术前麻醉的临床效果效果进行研究分析。方法抽取88例患有唇腭裂的患儿病例,将其分为对照组和观察组,平均每组44例,两组患儿均接受手术治疗。采用静脉泵注丙泊酚与瑞芬太尼对照组患儿实施术前麻醉;在采用七氟醚对观察组患儿实施术前麻醉。结果观察组患儿麻醉效果明显优于对照组患儿;睫毛反射时间、疼痛反射时间、苏醒时间明显短于对照组;两组均未观察到麻醉药物导致的不良反应。结论应用吸入七氟醚方案对患有唇腭裂的患儿实施术前麻醉安全可靠。

  18. Anesthesia for Surgery for Aortic Coarctation and Intracardiac Malformation%主动脉缩窄合并心内畸形同期手术治疗的麻醉处理

    Institute of Scientific and Technical Information of China (English)

    曹维福

    2016-01-01

    Objective To explore the anesthesia management for the surgery for aortic coarctation and intracardiac malformation.Methods A retrospective analysis was conducted on 28 cases of patients with aortic coarctation associated with intracardiac malformation who undergone aortic coarctation and intracardiac malformation surgery in terms of anesthesia, monitoring, circulation management and vital organ protection. ResultsDuring the anaesthetic period, hemodynamic indexes stayed stable, pulmonary artery pressure control were satisfactory, and there was no low cardiac output syndrome. During the surgical period, the average aortic cross-clamp time was (30.1±8.7) min and the average extracorporeal circulation time was (53.1±11.5) min. There was no anesthetic death or serious complication like paraplegia or acute renal failure.Conclusion The anesthesia management in the combined surgical treatment of aortic coarctation and intracardiac malformation is complicated. The maintenance of stable cardiac function and hemodynamic indexes, the regulation of pulmonary artery pressure and the prevention & cure of vital organ dysfunction are important links to the successful anesthesia.%目的:探讨主动脉缩窄合并心内畸形同期手术治疗的麻醉处理方法。方法回顾性分析28例主动脉缩窄合并心内畸形患者同期施行主动脉缩窄及合并的心内畸形矫正术的麻醉、监测、循环管理和重要器官保护的情况。结果麻醉期间血流动力学维持稳定,肺动脉压力控制满意,无1例发生低心排综合征。手术期间平均阻断主动脉时间(30.1±8.7)min,平均体外循环时间(53.1±11.5)min。无麻醉死亡,未发生截瘫、急性肾功能衰竭等严重并发症。结论主动脉缩窄合并心内畸形同期手术治疗的麻醉处理较复杂,维护心功能和血流动力学的稳定、调控肺动脉压力和防治重要器官功能不全是麻醉成功的重要环节。

  19. Treatment observation of gaseous distention in ketamine anesthesia surgery in children%小儿氯胺酮麻醉术中发生胃胀气治疗观察

    Institute of Scientific and Technical Information of China (English)

    许鸿英; 陈海敬; 王建波

    2014-01-01

    Objective:To explore the effect of using stomach tube into the suction pressure reducing method in the treatment of gaseous distention in ketamine anesthesia surgery in children.Methods:At the beginning of the operation,when gaseous distention and after stomach tube import,the breathing rate and blood oxygen saturation were recorded and analyzed.Using the method of turning insert prevented gastric discount,hands twist inserted alternately with a direction such as clockwise.We stoped inserting when we see a lot of bubble emission tube exit.We can see A large number of gas liquid mixture when we used aspirator to pumping.Results:After gastric tube import relief,the abdominal pressure was lower,it solved the difficulty in breathing.Conclusion:Using stomach tube into the suction pressure reducing method in the treatment of gaseous distention in ketamine anesthesia surgery in children is an effective method to solve the difficulty in breathing.The incidence rate of gaseous distention of using Ketamine anesthesia was significantly higher than that of using ketamine combined with fentanyl anesthesia.%目的:探讨小儿氯胺酮麻醉术中发生胃胀气时使用胃管导入吸引减压法的疗效。方法:记录和分析41例患儿手术开始时、发生胃胀气时及胃管导入后的呼吸频率、血氧饱和度。使用捻转插入的方法来防止胃管打折,双手配合向一个方向,如顺时针交替捻转插入,当看到胃管出口有大量气泡涌出时停止插入,以吸引器抽吸,可见大量气液混合物抽出。结果:经胃管导入减压后,腹腔压力降低,明显解决了呼吸困难的状况。结论:氯胺酮麻醉术中发生胃胀气时使用胃管导入吸引减压,是解决这种呼吸困难状况有效的方式。使用单纯氯胺酮麻醉术中胃胀气发生率明显高于氯胺酮复合芬太尼麻醉。

  20. The Effect of Ginger Extract on the Incidence and Severity of Nausea and Vomiting After Cesarean Section Under Spinal Anesthesia.

    Science.gov (United States)

    Zeraati, Hossein; Shahinfar, Javad; Imani Hesari, Shiva; Masrorniya, Mahnaz; Nasimi, Fatemeh

    2016-10-01

    Nausea and vomiting are one of the most common complications of cesarean sections under spinal anesthesia. Recently, the use of drugs to treat nausea and vomiting has decreased, and nonpharmaceutical and alternative traditional medicine are often preferred. This study aimed to determine the effect of ginger extract on the incidence and severity of nausea and vomiting after cesarean section under spinal anesthesia. In this double-blind randomized clinical trial, 92 pregnant women, each of whom underwent a cesarean section under spinal anesthesia, were divided in two groups: a control group and an intervention group. The intervention group received 25 drops of ginger extract in 30 cc of water, and the control group received 30 cc of water one hour before surgery. The incidence and severity of nausea and vomiting were assessed during the surgery and two and four hours after the surgery using a self-report scale. Data analysis was performed using SPSS software and statistical tests. There was no statistically significant difference between the two groups in terms of maternal age, duration of fasting, duration of surgery, and confounding factors (P > 0.05). According to an independent t-test, there was a significant relationship between the two groups in terms of the incidence and mean severity score of nausea and vomiting during the cesarean section (P 0.05). The findings of this study showed that ginger extract can be used for the prevention of nausea and vomiting during cesarean section under spinal anesthesia.

  1. Comparison of harmonic blade versus traditional approach in canine patients undergoing spinal decompressive surgery for naturally occurring thoracolumbar disk extrusion

    Science.gov (United States)

    Hettlich, Bianca F.; Cook, Laurie; London, Cheryl; Fosgate, Geoffrey T.

    2017-01-01

    Objectives To assess feasibility of the harmonic Osteovue blade (HOB) for use in the soft tissue approach for dogs undergoing hemilaminectomy and to compare outcomes between dogs undergoing HOB or traditional approach (TRAD). Methods A prospective randomized clinical trial was performed using 20 client-owned dogs with thoracolumbar intervertebral disk extrusion requiring hemilaminectomy. Dogs were randomly assigned to HOB or TRAD. Neurologic function and pain scores were assessed pre-operatively. Intraoperative blood loss and surgical approach time as well as postoperative pain and wound healing scores were recorded. Additionally, neurologic recovery and owner perceived quality of life were recorded at day 10 and 30 postoperative. Results There was no significant difference in sex distribution, weight, age, preoperative neurological grade and pain score, and perioperative outcome measures between groups. Intraoperative total blood loss was minimal for HOB and TRAD (median: 0 ml (range 0–9) and 2.2 ml (range 0–6.8), respectively; p = 0.165) and approach times were similar (median: 7 min (range 5–12) and 8 min (range 5–13), respectively; p = 0.315). While changes in wound healing scores were similar, changes in postoperative pain scores and neurological function were significantly improved in the HOB compared to the TRAD group. Postoperative complications in the HOB group consisted of automutilation of part of the incision and development of a small soft, non-painful subcutaneous swelling in 1 dog each. Conclusions The HOB is a safe and effective tool for the soft tissue approach for routine spinal surgery in dogs and is associated with decreased pain and increased neurological function post-surgery. PMID:28253289

  2. 全麻鼻内镜术后应用普米克令舒雾化吸入的护理%The Nursing of General Anesthesia Nasal Endoscopic Surgery Patients with Inhaling Pulmicort

    Institute of Scientific and Technical Information of China (English)

    邬燕平; 刘伟

    2011-01-01

    Objective:Observation of ultrasonic atomizer inhaled Pulmicort respules adjuvant therapy nasal endoscopy surgery patients complicating odynophagia and cracked curative effect and nursing. Methods: Select 68 cases of general anesthesia nasal endosciouc surgery patients do application of ultrasonic atomizer inhaled Pulmicort respules adjuvant therapy,and corresponding nursing.Results:68 patients had the odynophagia,cracked alleviate time is 2d 24 example,3d 36 cases,4d 6 cases,5d 2 cases.60 case excellence, 8 cases effectively, invalid to 0.Conclusion:ultrasonic atomizer inhaled Pulmicort respules to improve general anesthesia nasal endoscopic surgery patients odynophagia, cracked complications have clinical significance.%目的:观察超卢雾化吸入普米克令舒辅助治疗全麻鼻内镜手术后患者并发吞咽痛及声音嘶哑的疗效与护理.方法:选取68例全麻行鼻内镜手术患者应用超声雾化吸入普米克令舒进行辅助治疗,并采取相应的护珲措施.结果:68例患者术后吞咽痛、声音嘶哑缓解时间为2d24例,3d 36例,4d 6例,5d 2例.60例显效,8例有效,无效为0.结论:超声雾化吸入普米克令舒对改善全麻鼻内镜术后患者吞咽痛、声音嘶哑并发症具有临床意义.

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

    Science.gov (United States)

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

    2016-07-01

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

  4. Anesthesia for outpatient female sterilization.

    Science.gov (United States)

    Fishburne, J I

    1983-04-01

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

  5. 喉罩麻醉在婴儿麻醉中的应用效果和安全性分析%Clinical effect and safety analysis of laryngeal mask anesthesia for children's surgeries

    Institute of Scientific and Technical Information of China (English)

    贺永峰; 王晓娟

    2012-01-01

    目的 探讨喉罩麻醉在婴儿外科手术中的麻醉效果与安全性.方法 将2010年1月至2011年12月在本院行外科手术的76例患儿随机分成两组:实验组38例;对照组38例.实验组采用喉罩+七氟醚吸入麻醉;对照组采用气管插管+静吸复合麻醉.观察比较两组患儿所需的手术时间、苏醒时间、拔管时间,拔管后并发症的发生情况,平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)的变化情况.结果 两组患者手术时间差异无统计学意义(P>0.05);实验组患儿所需的苏醒时间、拔管时间均显著性短于对照组(P<0.05);拔管呛咳、喉头水肿、吞咽困难、术后躁动等并发症的发生率均显著性小于对照组(P<0.05);两组患儿各时间点SpO2指标值差异均无统计学意义(P>0.05);实验组患儿在喉罩置入或插管即刻(T1)、喉罩移开或拔管即刻(T3)MAP、HR指标值均比对照组稳定(P<0.05).结论 喉罩麻醉应用于婴儿外科手术效果良好.%Objective To investigate the clinical value and safety of laryngeal mask anesthesia for children's surgeries. Methods Seventy-six patients admitted to our hospital from January 2010 to December 2011 were randomly divided into two groups, treatment group (n=38) and control group (n=38)- The control group was given trache-al intubation anesthesia with isoflurane combined anesthesia; but the treatment group was given laryngeal mask anesthesia with sevoflurane inhalation anesthesia. The total operation time, the awakening time, the extubation time, the incidence of complications after extubation, mean arterial blood pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) in the two groups was observed and compared. Results The total of operation time in the treatment group was similar as that in the control group. The awakening time, and extubation time in the treatment group were significantly lower than those in the control group (P<0.05). The incidence

  6. The effects of local anesthesia and epidural anesthesia on immune function in patients undergoing benign breast tumor surgery%局部浸润麻醉和硬膜外麻醉对乳腺良性肿瘤切除患者免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    季蒙; 陶军; 王庆利; 黎笔熙

    2013-01-01

    Objective To investigate the effects of local anesthesia and epidural anesthesia on immune function in patients undergoing benign breast tumor surgery.Methods 62 patients undergoing benign breast tumor surgery were selected and divided into two groups,local anesthesia group (n =31),epidural anesthesia group (n=31).Peripheral vein blood was obtained before anaesthesia(T1),at 30 rain(T2),60 min (T3)and 90 min(T4)during anaesthesia for detecting CD3+,CD4+,CD8+,and natural killer cells by flow cytometry,IL-12,IFN-γ,IL-4,TNF-α by ELISA,lgG,lgA,lgM by immunodiffusion.Results In epidural anesthesia group,the level of lgG,lgA and lgM at T1 reduced compared with those at T0(P<0.05).There were significant different in the level of lgG,lgA and lgM at T1 between two groups(P<0.05).In epidural anesthesia group,at T2 and T3,CD4+ increased and natural killer cells decreased significantly compared with those at T1 (P<0.05).In local anesthesia group,the level of IL-12,IFN-γ and TNF-α at T3 increased compared with those at T0(P<0.05).There were significant different in the level of IL-12,IFN-γ and TNF-α at T3 between two groups(P<0.05).Meanwhile,there were significant different in the level of TNF-α at T2 between two groups(P<0.05).Conclusion This study indicates that local anesthesia has less effects on immune function than that of epidural anesthesia in patients undergoing benign breast tumor surgery.%目的 比较局部浸润麻醉和硬膜外麻醉对乳腺良性肿瘤切除患者免疫功能的影响.方法 将入选的62例行乳腺良性肿瘤切除患者随机分成硬膜外麻醉组和局部浸润麻醉组各31例,分别测定麻醉前(T0)及麻醉后30 min(T1)、60 min(T2)及90 min(T3)的血清T细胞亚群自然杀伤细胞、免疫蛋白浓度以及细胞因子浓度,并对测定结果进行统计学比较.结果 硬膜外麻醉组在T1时的lgG、lgA及lgM水平均较T0明显降低(P<0.05),且在T1时硬膜外麻醉组的lgG、lgA及lgM水平也

  7. Mortality in anesthesia: a systematic review

    Directory of Open Access Journals (Sweden)

    Leandro Gobbo Braz

    2009-01-01

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

  8. Nutritional intake after colorectal surgery: a comparison of a traditional and a new post-operative regimen.

    Science.gov (United States)

    Wara, P; Hessov, I

    1985-11-01

    The energy and protein intake was studied for 12 days after colorectal surgery in 36 patients. Eighteen patients followed a traditional management with nasogastric suction until bowel movements occurred after which a liquid diet, protective diet and normal food were successively administered. In a subsequent period a new regimen was introduced. Nasogastric suction was not used. Instead, 18 patients received liquid diet from the first post-operative day and normal food, when the patient wanted to eat it. In addition, the nutritional intake was supplemented by protein-enriched refreshing drinks and milk products between the meals. The new regimen was tolerated without discomfort and resulted in a significant increase in protein intake (43 g/day vs. 26 g/day, p<0.001) and energy intake (78% vs. 71% of the basal metabolic rate, p<0.05). The increase was most pronounced in the first 4 days after the operation. Finally, the weight loss was significantly lower on the new regimen (1.8 kg vs. 3.9 kg, p<0.001).

  9. Psychological aspects of pediatric anesthesia.

    Science.gov (United States)

    Drasković, Biljana; Simin, Jovana M; Kvrgić, Ivana M

    2015-01-01

    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.

  10. Anesthesia for fetoscopic intervention

    Directory of Open Access Journals (Sweden)

    Jamil S Anwari

    2014-01-01

    Full Text Available This is the first case report on anesthesia for fetoscopy performed in Saudi Arabia. Epidural anesthesia was given to the mother in her late second trimester for the fetoscopic intervention. The anesthesia related issues such as physiological and anatomical changes in pregnancy, tocolytic medications and their interactions with anesthesia, anesthetizing/sedating the primary patient are discussed.

  11. 丙泊酚联合瑞芬太尼喉罩通气与氯胺酮麻醉在小儿眼科手术的比较%COMPARISON OF PROPOFOL COMBINED WITH REMIFENTANIL AND LARYNGEAL MASK ANES-THESIA AND KETAMINE INTRAVENOUS ANESTHESIA IN CHILDREN OPHTHALMOLOGIC SURGER-Y

    Institute of Scientific and Technical Information of China (English)

    郑育娟; 敖利; 史金鳞; 白耀武; 钱金洪; 高秀江

    2014-01-01

    Objective To explore the feasibility and safety of propofol combined with remifentanil with la-ryngeal mask in pediatric ophthalmology surgery by comparison of propofol combined with remifentanil and laryngeal mask anesthesia and ketamine intravenous anesthesia .Methods Sixty-six children ,aged 1 to 8 , ASA Ⅰ toⅡ ,scheduled for ophthalmology surgery were randomly divided into two groups :remifentanil group (group A) and ketamine group (group B) .The children in group A were given propofol 3mg /kg and remifentanil 2μg /kg by intravenous injection slowly ,then inserted the laryngeal mask and assisted mechanical ventilation after body movement disappeared and jaw slack ,the anesthesia was maintained by remifentanil 0 .25~0 .3μg /(kg・min)and propofol 810mg /(kg・min) .The children in group B were giv-en intramuscular injection of ketamine 6 -8mg /kg and intravenous injection of propofol 2 -3 mg /kg , and the spontaneous breathing were kept and given oxygen mask 2L /min .The anesthesia was maintained by propofol 8-10mg /(kg・min)and intermittent intravenous injection of ketamine 0 .5 -1 mg /kg ac-cording to surgery requires .The changes of HR (heart rate) ,MAP (mean arterial pressure) ,SpO2 were recorded and analyzed at the time point before anesthesia (T1 ) ,after anesthesia 5 min (T2 ) ,at the start of surgery (T3 ) ,after surgery began 10 min (T4 ) and at the end of surgery (T5 ) in two groups .And the op-erative time ,the length of time of children Aldrete score to 9 points ,the stay time of anesthesia recovery room (PACU) and perioperative adverse reactions were also recorded and analyzed .Results The changes of HR and MAP in group A during surgery were significantly better than that in group B (P0 .05) .Compared with group B ,the length of time of children Aldrete score to 9 points and the stay time of PACU in group A were significantly shortened (P<0 .05) .In the incidence of postoperative agitation ,nausea and vomi-ting ,children in group A was

  12. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

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

  13. Similar Risk of Cardiopulmonary Adverse Events Between Propofol and Traditional Anesthesia for Gastrointestinal Endoscopy: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Wadhwa, Vaibhav; Issa, Danny; Garg, Sushil; Lopez, Rocio; Sanaka, Madhusudhan R; Vargo, John J

    2017-02-01

    Even though propofol use for gastrointestinal endoscopic procedures has increased over the past decade, there is a perception that it causes a higher rate of cardiopulmonary adverse events. The aim of this study was to compare the sedation-related adverse events associated with use of propofol vs nonpropofol agents for endoscopic procedures. We also wanted to determine the influence of duration or complexity of the procedures and endoscopist-directed (gastroenterologist) vs non-gastroenterologist-directed sedation on the outcomes. A search was conducted using Medline, EMBASE, and the Cochrane controlled trials registry. The following cardiopulmonary adverse events were assessed: hypoxia, hypotension, and arrhythmias. The procedures were divided into 2 groups based on the procedure length: a nonadvanced endoscopic procedure group consisting of esophagogastroduodenoscopy, colonoscopy, and sigmoidoscopy, and an advanced endoscopic procedures group including endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography, balloon enteroscopy, and endoscopic submucosal dissection. Pooled odds ratios for complications were calculated for all the procedures combined and then separately for the 2 groups. Random-effects models were used for 2-proportion comparisons. Of the 2117 citations identified, 27 original studies qualified for this meta-analysis and included 2518 patients. Of these, 1324 received propofol, and 1194 received midazolam, meperidine, pethidine, remifentanil, and/or fentanyl. Most of the included studies were randomized trials of moderate quality and nonsignificant heterogeneity (Cochran Q, 26.07; P = .13). Compared with traditional sedative agents, the pooled odds ratio with the use of propofol for developing hypoxia for all the procedures combined was 0.82 (95% confidence interval [CI], 0.63-1.07), and for developing hypotension was 0.92 (95% CI, 0.64-1.32). In the nonadvanced endoscopic procedure group, those who received propofol were 39

  14. Guardian喉罩用于中度肥胖手术患者的全麻通气效果%Efficacy of Guardian laryngeal mask airway on ventilation in patients moderate obese undergoing surgery under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    黄翠凤; 尤新民; 蔡玉红; 程志军; 季惠

    2014-01-01

    Objective: To assess the efficacy of Guardian laryngeal mask airway(GLMA)on ventilation in patients moderate obese patients undergoing surgery under general anesthesia. Methods:Eighty ASA I orⅡpatients of aged 18-65 years weigh-ing 65-100 kg(BMI 35-0.05)。G组气道密封压为(32±5) cmH2O。纤支镜证实GLAM位置好。结论:GLAM气道密封性可靠,通气效果好,心血管功能稳定,拔除后不良反应发生少,可安全有效地用于中度肥胖患者外科手术的全麻通气。

  15. 连续腰麻与腰-硬联合麻醉用于下肢手术的临床对比研究%Clinical comparative study of continuous spinal anesthesia and combined epidural-spinal anesthesia used for lower limb surgery

    Institute of Scientific and Technical Information of China (English)

    浦鹏飞; 阎位明; 桑达; 艾莎杜

    2012-01-01

    Objective To explore the clinical anesthetic effect, postoperative complications of continuous spinal anesthesia, through the continuous spinal anesthesia (CSA) and combined epidural-spinal anesthesia (CESA) used for lower limb surgery. Methods 70 patients who underwent lower limb surgery were collected and randomly divided into CSA group and CESA group, with 35 cases in each group. Both groups were punctured at L2_3 or L3_4 vertebral gap, after the success of the CSA group, spinocath tube were placed 1-2 cm to subarachnoid and then injected 0.5% Levobupivacaine 1.2 mL, for the CESA group injected 0.5% Levobupivacaine 2 mL through the needle who within the needle of combined epidural-spinal anesthesia, then placed a catheter 3-4 cm to the head-end epidural through the needle. The changes of blood pressure and heart rate parameters, sensory and motor block parameters, the Bromage score, plus the adjuvant drugs, adverse reactions and complications of patients before anesthesia and after anesthesia between the two groups were observed and recorded. Results Between two groups, the minimum value of mean arterial pressure after anesthesia was significantly decreased than preoperative (P 0.05); the adverse reactions and auxiliary medicine dosage in CESA group were significantly more than those in CSA group (P < 0.05). Conclusion Continuous spinal anesthesia applied in lower limb operation has good effects of anesthesia, hemodynamic stability, strong controllability and less adverse reactions, etc, especially for elderly patients with lower limb operation.%目的 旨在通过应用连续腰麻(CSA)和腰-硬联合麻醉(CESA)行下肢手术的对比,探讨CSA的临床麻醉效果、术后并发症等情况.方法 收集拟行骨科下肢手术的患者70例,随机分为CSA组和CESA组,各35例.两组患者均选择L2~3或L3~4椎间隙穿刺,成功后CSA组向蛛网膜下腔置入Spinocath管1~2 cm并注入0.5%左旋布比卡因1.2 mL,CESA组通过腰-硬联合麻

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

    Institute of Scientific and Technical Information of China (English)

    姚猛飞; 何丽云

    2011-01-01

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

  17. Presbycusis: reversible with anesthesia drugs?

    Science.gov (United States)

    Kocher, Carl A

    2009-02-01

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

  18. Evaluation of Anesthesia Management of Pediatric Cardiac Surgery with Cardiopulmonary Bypass on Piglets%小儿体外循环心脏手术麻醉管理方法在幼猪中的应用评价

    Institute of Scientific and Technical Information of China (English)

    王晓凑; 薛庆华; 晏馥霞; 李立环; 李守军; 胡盛寿

    2012-01-01

    Objective To evaluate the effectiveness and safety of anesthesia management of pediatric cardiac on piglets with low temperature and low flow eardiopulmonary bypass ( CPB). Methods Forty - two general - type piglets were utilized, with ketamine and atropine intramuscular injection as basal anaesthesia,fentanyl,pipecuronium bromide,midazolam were intravenously injected and sevoflurane was inhaled for anesthesia induction and maintenance. Mechanical ventilation was discontinued after full flow CPB,0.49 kPa pressure of adjustable pressure limiting valve was used to keep lungs slightly inflated. Airway secretions were suctioned regularly and manual ventilation was given to expand lungs once the circulation restarted, and then full mechanical ventilation was reinstated. Internal environment disorder was rectified according to the result of arterial blood gases analysis, and dopamine and dobutamine were intravenously injected by pump in order to maintain circulation steadiness, while arrhythmias was corrected according to their types. Haemodynamics, arterial blood gas analysis, breath parameters , duration of anesthesia, CPB and aorta arrest were monitored and recorded. Results One piglet died of heart arrest after CPB, while other 41 cases went through and completed the experiments. Durations of aortic cross clamp,CPB,and anesthesia maintain were (125 ±8) min, (184 ± 10) min, (335 ±17) min,separately. Conclusion Anesthesia management of pediatric cardiac surgery with CPB on piglets has preferable anesthesia effectiveness and safety.%目的 评价小儿心脏手术的麻醉管理技术应用于幼猪低温低流量体外循环(CPB)心脏手术的全麻效果及其安全性.方法 普通幼猪42只,基础麻醉采用氯胺酮加硫酸阿托品肌肉注射,麻醉诱导和维持采用芬太尼、哌库溴铵和咪达唑仑静脉注射,并辅助吸入七氟烷;CPB全流量后停止机械通气,给予可调压力限制阀0.49 kPa压力静态膨肺,主动脉开放后吸

  19. Comparative study on two brachial plexus anesthesia methods in the emergency surgery of hand trauma%急诊手外伤术中2种臂丛麻醉方法的对比研究

    Institute of Scientific and Technical Information of China (English)

    董桃花

    2014-01-01

    目的:比较急诊手外伤术中2种臂丛麻醉方法的效果和安全性。方法:选取2012年10月-2014年5月间我院收治的急诊手外伤并需行手术治疗患者80例,按随机数字法分为A和B两组,每组40例患者。麻醉用药均为0.3%罗哌卡因和1.2%利多卡因的混合液。A组患者接受腋路两点阻滞法麻醉,用量为25 ml;B组患者接受肌间沟两点阻滞法麻醉,用量亦为25 ml。比较两组患者在麻醉前后的血压和心率变化、麻醉效果、不良反应的发生情况和Ramsay镇静评分得分。结果:两组患者麻醉后的血压均出现下降,且A组患者麻醉后的血压高于B组患者,差异有统计学意义(P<0.05)。两组患者麻醉前后的心率无明显变化,麻醉效果也无明显差异。A组的总不良反应发生率为2.5%,显著低于B组的15%,差异有统计学意义(P<0.01)。A组中Ramsay镇静评分得分为2~4分的患者比例为80%,高于B组的62.5%,差异有统计学意义(P<0.05)。结论:急诊手外伤术中臂丛麻醉不会对患者的心率造成明显影响,腋路两点阻滞法麻醉的镇静效果较肌间沟两点阻滞法麻醉更好,可更有效地控制患者的血压、减少不良反应的发生。%Objective: To compare the effect and safety of two brachial plexus anesthesia methods in the emergency surgery of hand trauma. Methods: Eighty cases of patients with emergency hand trauma, who were admitted to our hospital during October, 2012-May, 2014 and needed operation, were randomly divided into group A and B with 40 patients each. The anesthetic agent used was a mixture of 0.3%ropivacaine and 1.2%lidocaine. Patients in group A underwent axillary two block anesthesia with dosage of 25 ml while patients in group B received interscalene two block anesthesia with dosage of 25 ml. Blood pressure and heart rate before and after anesthesia, anesthesia effect, incidence of adverse reaction and Ramsay

  20. The Experience of Anesthesia and the Practice of Transesophageal Echocardiography in Thoracoscopy-assisted Mitral Valve Surgery%胸腔镜直视微创二尖瓣手术24例麻醉体会

    Institute of Scientific and Technical Information of China (English)

    卢静; 兰志勋; 蔡兵; 胡云霞; 苏文杰

    2015-01-01

    目的:总结胸腔镜直视微创二尖瓣手术的麻醉经验,并评价经食道超声在术中的应用价值。方法:24例行胸腔镜直视微创二尖瓣手术的患者,以咪唑安定、依托咪酯、顺式阿曲库铵和舒芬太尼麻醉诱导,以丙泊酚与瑞芬太尼,间断给予舒芬太尼、咪唑安定、顺式阿曲库铵及吸入七氟醚作麻醉维持。术前以经食道超声评价病变特征、确定手术类型,术中指导上腔静脉引流管的放置,术后监测心脏排气,评价手术效果。结果:24例患者均成功完成手术,其中行二尖瓣置换术者17例,二尖瓣成形术7例。2例患者食道超声术中监测二尖瓣成形不满意,改为瓣膜置换术成功。未出现瓣周漏、血肿、空气栓塞等并发症。结论:对胸腔镜直视下微创二尖瓣手术患者,选择合适的麻醉方式,并全程进行经食道超声监测,能为手术成功提供充分保障、避免并发症。%Objective :To discuss the experience of anesthesia and the clinical practice of transesophageal echocardio‐graphy (TEE) in thoracoscopy‐assisted mitral valve surgery .Methods :24 patients who underwent thoracoscopy‐assis‐ted mitral valve surgery were retrospectively analyzed .The induction of anesthesia was performed with midazolam , etomidate ,cis‐atracurium and sufentanil ,and the anesthesia was maintained with propofol and remifentanil .TEE was used to determine the lesion characteristics ,guide operation ,monitor the air exhaust and evaluate the effect of opera‐tion .Results:17 patients underwent mitral valve replacement and 7 patients underwent mitral valvuloplasty successful‐ly .2 patients underwent mitral valve replacement due to dissatisfied repair effect based on TEE evaluation .No compli‐cations were found in all patients .Conclusion:Appropriate anesthesia programs contributed to the process of operation and TEE guidance provided detailed information during

  1. Cirugía de catarata con anestesia tópica en pacientes con condiciones especiales Results of catact surgery with topical anesthesia in patients with special conditions

    Directory of Open Access Journals (Sweden)

    Henry Pérez González

    2012-06-01

    Full Text Available Objetivo: Determinar los resultados de la cirugía de catarata por técnica de Blumenthal con anestesia tópica en pacientes con condiciones especiales en el Centro Oftalmológico "José Martí", Uruguay. Métodos: Se realizó un estudio descriptivo, longitudinal prospectivo. El universo estuvo constituido por 99 pacientes con necesidad de cirugía de catarata, evaluados en la unidad de rehabilitación básica funcional durante el año 2010, la muestra por 67 pacientes mayores de 18 años portadores de alguna "condición especial" sometidos a cirugía con uso de anestesia tópica, previa evaluación y entrenamiento. Resultados: Los principales motivos de derivación a la unidad fueron los trastornos auditivos (44,78 % y las crisis nerviosas (25,37 %. El 44,78 % de los pacientes presentó una edad mayor a los 79 años, 53,74 % eran hombres y prevaleció la catarata senil (85,07 %. La única complicación intraoperatoria fue la rotura de cápsula posterior (1,49 % y el edema corneal transitorio en el posoperatorio, observado en un 7,46 %. El 77,61 % alcanzó una buena agudeza visual posterior a la cirugía. Conclusiones: Los resultados de la cirugía de catarata con uso de anestesia tópica en pacientes con condiciones especiales fueron satisfactorios. Se observó una notable mejoría de la agudeza visual con un mínimo de complicaciones.Objective: To determine the results of cataract surgery with Blumenthal technique and topical anesthesia in patients with special conditions in “José Martí” Ophthalmological Center in Uruguay during 2010. Methods: A prospective, longitudinal and descriptive was carried out. The universe of study was 99 patients needing cataract surgery after being evaluated by the Basic Functional Rehabilitation Unit during 2010. The sample was 67 patients over 18 years-old carrying a “special condition”, who underwent cataract surgery with topical anesthesia, after evaluation and training. Results: The main reasons for

  2. Anesthesia care for the professional singer.

    Science.gov (United States)

    Meacham, Ryan K; Schindler, Joshua

    2015-06-01

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

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

    Science.gov (United States)

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

    2013-04-06

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

  4. 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

  5. The observation of the utilization of SLIPA laryngeal mask in anesthesia of facial wrinkle removal surgery%SLIPA 喉罩在颜面部除皱手术麻醉中的应用观察

    Institute of Scientific and Technical Information of China (English)

    李霞; 吴新民

    2013-01-01

    目的探讨SLIPA喉罩用于颜面部除皱手术麻醉的安全性和有效性。方法选择40例择期行颜面部除皱手术患者,采用随机数字表法,分为喉罩全麻组(A组)和气管导管全麻组(B组),每组20例,两组均采用全凭静脉复合全身麻醉,麻醉诱导后置入喉罩、气管导管后行机械通气。观测记录两组患者插管前(T1)、喉罩置入或插管后即刻(T2)、喉罩或气管导管拔出后2 min(T3):心率(HR)、动脉压(SBP)、脉搏血氧饱和度(SPO2)、呼气末二氧化碳分压(PETCO2)、平均气道压(Pmeat)、气道峰压值(Ppeak);观察拔除喉罩和气管导管后恶心、呕吐、呛咳、声嘶、咽喉痛、返流误吸情况。结果 A组咽喉痛发生率明显低于B组(P <0.05)。两组恶心、呕吐、声嘶、呛咳发生率差异无统计学意义(P >0.05);两组均未发生返流误吸。A组3个时间段SBP、HR差异无统计学意义(P >0.05),B组T2、T3时间段HR、SBP差异有统计学意义(P<0.05),两组SPO2、PETCO2、Pmeat、Ppeak差异无统计学意义(P >0.05)。结论 SLIPA喉罩全麻用于颜面部除皱手术,操作简便安全,对血流动力学影响小,可明显减少全麻气管插管引起的并发症。%Objective To investigate the safety and efficacy of using the SLIPA laryngeal mask in anesthesia of facial w rinkle removal surgery .Methods 40 cases patients ,taking the facial w rinkle removal surgery e-lectively ,were divided equally into two groups with the method of the random digits table .Group A use la-ryngeal mask anesthesia and group B use endotracheal catheter anesthesia Both groups were given the in-travenous general anesthesia ,inserted the laryngeal mask after induction of anesthesia ,and then took the mechanical ventilation after the endotracheal tube .The heart rate (HR) ,arterial pressure (SBP) ,pulse saturation of blood oxygen (SPO2

  6. [Transdermal nitroglycerin before induction of anesthesia prevents redistribution hypothermia in patients under general anesthesia].

    Science.gov (United States)

    Morioka, N; Ozaki, M; Matsukawa, T; Suzuki, H

    1998-12-01

    Initial anesthesic-induced hypothermia results largely from core-to-peripheral redistribution of heat. Administration of transdermal nitroglycerin induces vasodilation. Such vasodilation, induced well before induction of anesthesia, might redistribute heat to peripheral tissues. Minimal redistribution hypothermia might accompany subsequent induction of anesthesia. We studied 32 patients undergoing gastrointestinal surgery. Thirty minutes before induction of anesthesia, they were randomly assigned to: 1. transdermal nitroglycerin 10 mg; 2. transdermal nitroglycerin 5 mg; and, 3. control. Core temperature during the first hour of anesthesia decreased significantly more in the control patients than in those given either dose of nitroglycerin. Vasodilation induced by transdermal nitroglycerin before induction of anesthesia significantly decreased subsequent redistribution hypothermia. Drug-induced modulation of vascular tone thus produces clinically important alterations in intraoperative core temperature.

  7. Information processing during general anesthesia: Evidence for unconscious memory

    NARCIS (Netherlands)

    A.E. Bonebakker (Annette); B. Bonke (Benno); J. Klein (Jan); G. Wolters (G.); Th. Stijnen (Theo); J. Passchier (Jan); P.M. Merikle (P.)

    1996-01-01

    textabstractMemory for words presented during general anesthesia was studied in two experiments. In Experiment 1, surgical patients (n=80) undergoing elective procedures under general anesthesia were presented shortly before and during surgery with words via headphones. At the earliest convenient

  8. the Application of Laryngeal Mask Airway (LMA) Anesthesia in 182 Cases of Breast Surgery%喉罩通气全麻在182例乳腺手术中的应用

    Institute of Scientific and Technical Information of China (English)

    纵春华; 王昌合

    2013-01-01

    Objective To evaluate the safety and feasibility of Laryngeal Mask Airway (LMA) anesthesia in breast surgery. Method 182 cases of ASA classificationⅠ-Ⅱlevel option forward line breast surgery patients,random divided into treatment group and control group, intraoperative routine inspection mean arterial pressure (MAP) and heart rate (HR), blood oxygen saturation (SpO2), breathe out the carbon dioxide concentration (PETCO2), and other indicators in different periods, record the change of each index and postoperative complications related to the case. Result The time value of MAP and HR of the treatment group is better than control group, and tube drawing and follow-up of adverse reaction rate is low, the difference has statistical significance (P<0.05). Conclusion Laryngeal mask airway anesthesia for breast surgery operation is simple, stress response is small, circulatory and respiratory stability, facilitates airway management, rapid recovery and fewer complications throat, safe and reliable.%  目的探讨喉罩通气全麻在乳腺手术时的安全性及可行性。方法182例ASA分级Ⅰ-Ⅱ级择期行乳腺手术的患者,随机分为治疗组和对照组,术中常规检查平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、呼气末二氧化碳浓度(PETCO2)等指标,记录不同时期各指标的变化及术后相关并发症的情况。结果治疗组患者HR、MAP各时间段的数值均优于对照组,且拔管时及随访的不良反应发生率较低,差异具有统计学意义(P<0.05)。结论喉罩通气全麻用于乳腺手术操作简便,应激反应小,循环、呼吸稳定,便于呼吸道管理,苏醒快且咽喉并发症少,安全可靠。

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  10. A comparative study of the efficacy of endovenous laser treatment of the incompetent great saphenous under general anesthesia with external air cooling with and without tumescent anesthesia.

    Science.gov (United States)

    Hernández Osma, Esteban; Mordon, Serge R; Marqa, Mohamad Feras; Vokurka, Jiri; Trelles, Mario A

    2013-02-01

    This clinical study reports our experience with endovenous laser treatment (ELT) in which external air cooling is used without classic tumescent anesthesia. Two hundred thirty-two patients underwent ELT under general sedation. In group A (n = 192), ELT was performed with air cooling but without the concurrent use of tumescent anesthesia. In group B (n = 40), patients were treated using the traditional tumescent technique. The parameters were similar for both groups: 980-nm diode laser, power of 15 W, and pulse duration of 1 second. The laser fiber and catheter were manually withdrawn in 3-mm increments. Ultrasound was performed to reevaluate vein closure at the end of surgery and 2 and 8 weeks and 1 year after. During follow-up, complications such as burns, dyschromia, pain, and dysesthesia, as well as time used for surgery were recorded. A 96% closure rate was obtained in groups A and B at 2 and 8 weeks. This rate remained stable 1 year after the ELT procedure. Except for a higher percentage of ecchymoses in group B (55%) than in group A (0%) (p cooling, ELT took 17.5 minutes to perform for the whole leg, compared with 38.5 minutes when using tumescent anesthesia (p cooling method and is as efficacious as ELT done with tumescent anesthesia but takes significantly less time to perform. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Gemperlé, M

    1977-02-01

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

  12. Continuous Spinal Anesthesia for Obstetric Anesthesia and Analgesia

    Directory of Open Access Journals (Sweden)

    Ivan Veličković

    2017-08-01

    Full Text Available The widespread use of continuous spinal anesthesia (CSA in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used. Small doses of drug can be administered and extension of labor analgesia for emergency cesarean delivery may occur more rapidly compared to continuous epidural techniques.

  13. Effect of dexmedetomidine on stress response to anesthesia and surgery in the elderly%右美托咪定对老年患者全麻手术应激反应的影响

    Institute of Scientific and Technical Information of China (English)

    施正元

    2011-01-01

    Objective To investigate the effect of dexmedetomidine on stress response to anesthesia and surgery in the elderly. Methods Fourty selective laparoscopic cholecystectomy(LC) under general anesthesia was performed in 40 elder patients, who were randomly divided into two groups of D(20 cases, dexmedetomidine 0. 4 μg/kg was infused before anesthesoa induction) and C (20 cases equal volume of normal saline was infused as the control). MAP and HR were recorded before induction(TO),during intubation(Tl),pneumoperitoneum(T2) and extubation(T3),and at 5 min after extubation(T4). Plasma cortisol(Cor) and angiotension II (Ang- II ) were measured as well Results MAP, HR and Cor at Tl and T2 were lower in group D than those in group C(P<0. 05). So did MAP and Cor at T3 and Ang-II at T4(F<0. 05). Conclusion Dexmedetomidine 0. 4 μg/kg infused before anesthesia induction can attenuate stress response to anesthesia and surgery and reduce the adverse cardiovascular events in the elderly undergoing LC.%目的 探讨全麻诱导前静脉注射右美托咪定对减轻老年患者全麻下行腹腔镜胆囊切除术应激反应的影响.方法 择期行腹腔镜下胆囊切除术的老年患者40例随机均分为D组(静脉泵注右美托咪定0.4 μg/kg)和C组(等容量0.9%氯化钠溶液).于麻醉诱导前(To)、气管插管时(T1)、开始气腹时(T2)、拔气管导管时(T3)和拔管5 min后(T4)各时间点抽取非静脉输液侧肘静脉血,放免法测定血浆皮质醇(Cor)和血管紧张素Ⅱ(Ang-Ⅱ)值,并记录各时间点的平均动脉压(MAP)和心率(HR)的变化.结果 D组T1和T2时的MAP、HR、Cor均明显低于C组(P<0.05);T3时的MAP和Cor明显低于C组(P<0.05),T4时的Ang-Ⅱ也明显低于C组(P<0.05).结论 全麻诱导前静脉注射右美托咪定能明显减轻老年患者全麻下行腹腔镜胆囊切除术的应激反应,从而可减少老年患者发生心脑血管意外的风险.

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

    Institute of Scientific and Technical Information of China (English)

    刘晶; 廖信芳; 胡祖荣; 贾杰; 黄希照; 邓恋

    2012-01-01

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

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

    Science.gov (United States)

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

    1998-06-01

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

  16. 丙泊酚复合瑞芬太尼全凭静脉麻醉在美容外科手术中的应用%Total intravenous anesthesia of propofol-remifentanil for patients of cosmetic surgery

    Institute of Scientific and Technical Information of China (English)

    张知园; 方伟武

    2015-01-01

    目的 探讨丙泊酚复合瑞芬太尼全凭静脉麻醉在美容手术中的麻醉效果和可控性.方法 选择美国麻醉师协会(ASA)Ⅰ-Ⅱ级住院择期美容手术100例,完全随机分为丙泊酚复合瑞芬太尼全凭静脉麻醉组(T组)和静吸复合麻醉组(C组),各50例.观察受术者术中心血管药物使用和体动发生情况,术毕苏醒、拔管、离室时间、术后不良反应、低氧血症(血氧饱和度<95%)发生情况以及麻醉满意度.结果 C组苏醒时间、拔管时间、离室时间分别为(12.2±3.6)、(13.8±4.6)、(18.3士5.8)min,均长于T组(6.7±2.6)、(7.8±3.3)、(9.6±3.8) min,差异有统计学意义(P<0.05).T组术中麻黄碱使用率及体动发生率分别为12.0%(6/50)、8.0%(4/50),均高于C组2.0%(1/50)、2.0%(1/50),差异有统计学意义(P<0.05).T组术后不良反应发生率较低,其中嗜睡、烦躁、恶心呕吐发生率分别为4.0%(2/50)、2.0%(1/50)、16.0%(8/50),明显低于C组16.0%(8/50)、14.0%(7/50)、34.0%(17/50),差异有统计学意义(P<0.05).两组术后寒战发生率差异无统计学意义(P>0.05).C组术后麻醉满意为52.0%(26/50),低于T组的84.0% (42/50),差异有统计学意义(P<0.05).结论 丙泊酚复合瑞芬太尼全凭静脉麻醉效果确切,术后麻醉恢复快,不良反应及并发症少,安全、可操作.%Objective To explore the effect of propofol-remifentanil total intravenous anesthesia in cosmetic surgery and the controllability of anesthesia.Methods According to the American Society of Anesthesiologists (ASA),levels Ⅰ-Ⅱ hospitalized patients for elective cosmetic surgery (100 cases) were randomly divided into two groups,namely propofol-remifentanil total intravenous anesthesia group (Group T) and combined intravenous inhalational anesthesia group (Group C),50 cases each.Observatory items of patients included intraoperative cardiovascular drug use,body movement,waking-up time,extubation time,leaving time

  17. Colorectal Surgery in Patients with General Anesthesia the Incidence of Muscle Relaxant Residual after Extubation and its Countermeasures%结直肠手术患者全麻拔管后肌松残余发生率及其应对措施

    Institute of Scientific and Technical Information of China (English)

    陈晓峰; 刘学连; 王淑荣; 魏玲; 马显亮; 史学梅

    2015-01-01

    Objective To study the patients with colorectal surgery the incidence of muscle relaxant residual after general anesthesia and its countermeasures.Methods Our hospital 100 cases of colorectal patients under general anesthesia to collate data analysis colorectal surgery, using neuromuscular monitoring and assessment of the patient monitoring NMB incidence of residual NMB and analyzing the prevention of postoperative residual NMB measures to patients.Results Postoperatively in patients with colorectal surgery anesthesia with objective evaluation method of the incidence of muscle relaxant residual after extubation was 63%, the residual group with the muscle relaxant residual muscle relaxant in patients' body quality, age, type of nondepolarizing agent has more significant difference (P<0.05); should pay attention to during the process of surgery anesthesia management, maximum limit reduce the incidence of postoperative muscle relaxant residual, prevent the occurrence of complications.Conclusion Patients with colorectal surgery anesthesia significantly higher incidence of postoperative residual of muscle relaxant, so pay attention to the patients in the process of surgery anesthesia management, strengthen the monitoring.%目的:探讨结直肠手术患者全麻拔管后肌松残余的发生率及其应对措施。方法将我院100例全身麻醉结直肠手术患者资料进行整理分析,同时使用肌松监测仪监测肌松及评估患者肌松残余的发生率,并分析预防患者出现术后肌松残余的措施。结果结直肠手术全麻患者术后用客观评估法拔管后肌松残余的发生率为63%,肌松残余组与非肌松残余组在患者体质量、年龄、肌松剂类型方面比较有显著差别(P<0.05);手术过程中要注意麻醉管理,最大限度降低术后肌松残余发生率,防止并发症的发生。结论结直肠手术全麻患者术后肌松残余的发生率明显升高,所以要注意患者手术过

  18. Effects of music therapy under general anesthesia in patients ...

    African Journals Online (AJOL)

    2016-12-13

    Dec 13, 2016 ... music). Hemodynamic parameters, quality of arousal, pain experienced, patientLs satisfaction, ... general anesthesia, which could have a better out- come with ... ing theatre of visceral surgery in Sahloul teaching hospital over ...

  19. The Clinical Evaluation of Sevoflurane Anesthesia Applied in Laparoscopic Surgery%七氟醚麻醉腹腔镜手术中应用的临床评价

    Institute of Scientific and Technical Information of China (English)

    司徒颖芬

    2016-01-01

    目的:观察七氟醚用于腹腔镜手术麻醉诱导和维持时血流动力学变化。方法:选择72例腹腔镜手术患者,随机均分为两组,分别使用七氟醚和异丙酚麻醉诱导与维持,记录所有患者手术前、吸七氟醚/异丙酚5 min后、插管时、插管5 min后、气腹时、放气腹时、拔管后的收缩压(SBP)、心率(HR)及平均动脉压(MAP)、血氧饱和度(SpO2)情况并进行比较;比较拔管时间、清醒时间、止痛时间的差异。结果:不同麻醉剂诱导后,七氟醚试验组在麻醉5 min及插管时HR、MAP指标与手术前比较均有微小下降,但差异均无统计学意义(P>0.05)。而异丙酚对照组麻醉5 min后HR、MAP显著下降,插管时迅速回升;插管5 min后又逐渐回降,不同手术阶段比较差异均有统计学意义(P0.05)。两组患者清醒时间、拔管时间、止痛时间比较差异均无统计学意义(P>0.05)。结论:七氟醚对血流动力学的干扰更小,麻醉维持更稳定,且苏醒快,不良反应少,是值得临床推广应用的一种安全实用的吸入麻醉方法,适用于腹腔镜手术的麻醉。%Objective: To observe the hemodynamic changes when Sevoflurane anesthesia is used for induction and maintenance in laparoscopic surgery.Method: 72 patients with laparoscopic surgery were chose, and they were divided into two groups randomly,and done induce and maintenance with Sevoflurane and Propofol anesthesia. The systolic blood pressure (SBP), heart rate (HR) mean arterial pressure (MAP), blood oxygen saturation (SpO2) of two group of patients were recorded and compared at the time of before the operation, Sevoflurane/suction Propofol after 5 min, when intubation, intubation after 5 min, when pneumoperitoneum, when put the pneumoperitoneum and after extubation. And the extubation time, awake time after extubation and analgesic time were compared.Result:After different anesthetic

  20. 新生儿复杂先天性心脏病外科手术麻醉围术期处理%Anesthesia management strategy for neonate surgery with complex congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    蒋怡燕; 乔彬; 吴莉莉; 林晓娜

    2012-01-01

    目的 探讨新生儿复杂先天性心脏病外科手术麻醉围术期处理策略.方法 85例患者体重1.9~5(3.45)kg.右肺动脉起源主动脉并室间隔缺损(VSD)2例,降主动脉缩窄并VSD、动脉导管未闭(PDA)8例,主动脉弓离断并VSD+PDA 6例,VSD合并房间隔缺损(ASD)+PDA 20例,右室双出口8例,完全性大动脉错位21例,肺动脉近似闭锁法洛四联症9例,完全性肺静脉异位引流11例.患儿术前30 min口服咪唑安定0.5 mg/kg,东茛菪碱0.02~0.04 mg/kg肌注.有心衰者给予静脉持续输注多巴胺3~5 μg/(kg·min).大血管错位/室间隔完整者不吸入高氧,并给予前列腺素E1 5~10 ng/(kg·min),持续输注直至建立体外循环.患儿入手术室后开放外周静脉,监测心电图、脉搏血氧饱和度和无创血压.以芬太尼5 μg/kg,维库溴铵0.1 mg/kg静注诱导,经鼻气管内插管,压力控制模式(PCV)进行机械呼吸,采用静吸复合方法维持麻醉,术中连续监测动脉压、中心静脉压、血气、电解质、血糖、乳酸和心排量,并给予及时纠正.重度肺动脉高压术后压力下降不满意者吸入伊洛前列素,心脏复跳后有房室传导阻滞者置入左心室临时起搏器.结果 85例麻醉成功行动、静脉穿剌置管术建立术中监测及血管通道,麻醉效果满意,术后6~8 h麻醉清醒,24~72 h脱离呼吸机.没有出现由麻醉引起的术中血流动力学明显改变和并发症.2例因严重低心排,心力衰竭,经抢救无效于第2 d死亡.2例大动脉错位因冠状动脉畸形,术后吻合口出血,心功能不全当天死亡.结论 新生儿麻醉处理策略要从其生理和解剖特点出发,把握其麻醉特点对开展新生儿复杂心血管手术安全是有保障的.%Objective To investigate anesthesia management strategy for neonate surgery with complex congenital heart disease ( CHD ). Methods 85 cases weight of 1.9 -4.5 kg ( mean of 3.45 kg ). The diagnosis of these neonates included 2

  1. Anesthesia information management systems.

    Science.gov (United States)

    Williams, Joe R

    2005-06-01

    Documentation is the last component of anesthesia patient management to be affected by technology. Anesthesia information management systems (AIMS) have been introduced in a limited number of practice sites. The automated systems provide unbiased reporting of most patient information. This results in improved patient care and possible medical legal advantages. AIMS also allow anesthesia departments to monitor their business related activity.

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

    Institute of Scientific and Technical Information of China (English)

    李宁; 张义龙; 赵国军; 宋有鑫; 任磊; 李建玲

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李宁; 张义龙; 赵国军; 宋有鑫; 任磊; 李建玲

    2016-01-01

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

  4. Clinical effect of ropivacaine combined with spinal-epidural anesthesia in anorectal surgery%罗哌卡因腰麻-硬膜外联合麻醉用于肛肠手术的疗效分析

    Institute of Scientific and Technical Information of China (English)

    方传奇

    2015-01-01

    目的 观察罗哌卡因腰麻-硬膜外联合麻醉方法用于肛肠手术的临床效果,并评价该方法的安全性.方法 回顾性分析我院2010年1月至2013年12月期间进行肛肠手术82例患者的临床资料,应用随机数字表将患者分为丁哌卡因组和罗哌卡因组,每组各41例.均采用以腰部L3、L4间隙作为穿刺点的腰麻-硬膜外联合麻醉方法,丁哌卡因组和罗哌卡因组患者分别以0.2 ml/s的速度推注0.375%的丁哌卡因2ml和罗哌卡因溶液2ml.比较两组患者的麻醉满意度以及麻醉效果.结果 两组患者麻醉后进行手术期间均未再追加药物,手术完成顺利.两组患者感觉阻滞起效时间、最大感觉阻滞平面以及感觉阻滞持续时间比较差异无统计学意义(P均>0.05);但罗哌卡因组感觉最大运动阻滞程度评分[(1.8±0.4)分]较丁哌卡因组[(2.9±0.3)分]低,且运动阻滞起效时间晚[(9.8±0.6) min与(3.5±0.4)min],两组比较差异有统计学意义(t=2.4236、t=2.4265,P均<0.05).对于麻醉的满意度无显著性差异,麻醉程度均能满足施行手术的肌松要求.结论 罗哌卡因腰麻-硬膜外联合麻醉方法用于肛肠手术能够满足围术期无痛无感的要求,值得在肛肠手术时借鉴应用.%Objective To explore and analysis the clinical effect of ropivacaine combined with spinalepidural anesthesia in anorectal surgery and to evaluate the safety of this method.Methods We retrospective analyzed the clinical information of 82 patients who conducted with selective anorectal surgery in the First People's Hospital of Shangqiu from January 2010 to December 2013.The patients were randomly divided into bupivacaine group and ropivacaine group,and each group of 41 cases.Both groups took the way of combined with spinal-epidural anesthesia to waist L3/L4 point gap.Bupivacaine and ropivacaine group were traited at a rate of 0.2 ml/s bolus of 0.375% bupivacaine and ropivacaine solution of 2 ml

  5. Information processing during general anesthesia: Evidence for unconscious memory

    OpenAIRE

    Bonebakker, Annette; Bonke, Benno; Klein, Jan; Wolters, G.; Stijnen, Theo; Passchier, Jan; Merikle, P.

    1996-01-01

    textabstractMemory for words presented during general anesthesia was studied in two experiments. In Experiment 1, surgical patients (n=80) undergoing elective procedures under general anesthesia were presented shortly before and during surgery with words via headphones. At the earliest convenient time after surgery (within 5 h) and 24 h later, memory was tested by asking patients to complete auditorily presented word stems with the first word that came to mind and to leave out words they reme...

  6. Effect of dexmedetomidine on tracheal extubation response in patients undergoing thyroid surgery after general anesthesia%右美托咪定对甲状腺手术患者全身麻醉拔管反应的影响

    Institute of Scientific and Technical Information of China (English)

    马立靖; 马璨; 任宪凤; 林长赋

    2012-01-01

    目的 观察右美托咪定对甲状腺手术患者全身麻醉拔管反应的影响.方法 择期全凭静脉麻醉下行甲状腺手术患者42例,ASA分级Ⅰ~Ⅱ级,按随机数字表法将患者分为两组:右美托咪定组和对照组,每组21例.两组麻醉诱导和维持相同,右美托咪定组于麻醉诱导前15 min静脉泵注右美托咪定0.6μg/kg( 10 min泵注完毕),术中继之以0.4μg/(kg·h)持续泵注;对照组以同样方式泵注等量0.9%氯化钠.记录患者收缩压、舒张压和心率变化,手术时间,苏醒时间,拔管时间,定向力恢复时间,恢复至Aldrete改良评分≥9分时间,苏醒时耐管评分,苏醒期躁动率及不良反应.结果 两组患者手术时间、苏醒时间、拔管时间、定向力恢复时间和恢复至Aldrete改良评分≥9分时间比较差异无统计学意义(P>0.05).右美托咪定组拔管即刻及拔管后1、3、5 min时收缩压、舒张压、心率低于同时点对照组(P< 0.05或<0.01).右美托咪定组患者苏醒时耐管评分优良率[95.2%(20/21)]明显高于对照组[28.6% (6/21)] (P< 0.05),苏醒期躁动率(0)明显低于对照组[28.6%(6/21) ](P< 0.05).两组苏醒期均无不良反应发生.结论 麻醉诱导前静脉泵注右美托咪定0.6μg/kg( 10 min泵注完毕),术中继之以0.4μg/(kg·h)持续泵注可有效降低甲状腺手术患者拔管期的心血管反应,增强患者气管导管耐受性,降低患者苏醒期躁动率,有利于患者平稳舒适苏醒.%Objective To investigate the effect of dexmedetomidine on tracheal extubation response in patients undergoing thyroid surgery after general anesthesia.Methods Forty-two patients who ASA classification Ⅰ - Ⅱ,were performed thyroid surgery under total intravenous anesthesia.They were divided into dexmedetomidine group and control group by random number table with 21 cases each.Both groups patients anesthesia induction and maintenance with the same methods,dexmedetomidine group

  7. Total Extraperitoneal Preperitoneal Laparoscopic Hernia Repair Using Spinal Anesthesia

    OpenAIRE

    Molinelli, Bruce M.; Tagliavia, Alfonso; Bernstein, David

    2006-01-01

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

  8. Nonoperating room anesthesia for the gastrointestinal endoscopy suite.

    Science.gov (United States)

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

    2014-06-01

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

  9. Total Extraperitoneal Preperitoneal Laparoscopic Hernia Repair Using Spinal Anesthesia

    OpenAIRE

    2006-01-01

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

  10. [General anesthesia].

    Science.gov (United States)

    Feiss, P

    2001-04-30

    General anaesthesia is a reversible loss of consciousness induced and maintained with a hypnotic drug given either by venous injection and infusion, or by inhalation. A potent opioid is usually associated to inhibit the transmission of pain and thus to lessen sympathetic and endocrine reactions to nociceptive stimuli. Myorelaxation is used to facilitate tracheal intubation and surgery. Whatever the anaesthetic protocol use, the patient and anaesthesia machine require close monitoring. In addition to vital signs, the depth of anaesthesia may be monitored using automated electroencephalographic analysis and myorelaxation should always be monitored using a nerve stimulator, but pain or analgesia evaluation is only based on clinical signs of sympathetic stimulation. Because anaesthesia-related death and morbidity have decreased considerably, future improvements in outcome should concern perioperative comfort, i.e. prevention of cognitive disturbances, nausea, vomiting and pain.

  11. The application of monitored anesthesia care (MAC) in vitreoretinal surgery%监护麻醉管理在眼科玻璃体视网膜手术中的应用

    Institute of Scientific and Technical Information of China (English)

    孙建娣; 任传路

    2011-01-01

    Objective To evaluate the application of monitored anesthesia care ( MAC ) in vitreoretinal surgery. Methods Monitored anesthesia care ( MAC ) with midazolam, fentanyl and propofol was performed in 60 ASA Ⅰ orⅡ patients in vitreoretinal surgery. With regular monitoring of SpO2 , RR, BP and ECG , sedation depth was made in accordance with Ramsay scores by the incidence of RR < 8 bpm lasting over 60 sec or SpO2 < 90% lasting over 30 sec or HR <50 bpm or body movement response. Postoperative symptoms as nausea and vomiting in patients were recorded and their satisfaction after surgery was also assessed. Results During MAC management procedure, BP remained stable, the incidence rates of HR<50 bpm, RR < 8 bpm lasting over 60 sec and SpO2 < 90% lasting over 30 sec were 1.7%( 1/60 ), 3.3%( 2/60 ) and 5% ( 3/60 ) respectively. Body movement occurred in 6 patients during the process of surgery, and 2 female patients had symptoms of postoperative nausea and vomiting. Postoperative satisfaction scores were ( 2.4 ± 0. 6 ) min. Conclusion MAC with midazolam, fentanyl and propofol can be safely and effectively used in vitreoretinal surgery with high satisfaction of patients by lightening or relieving anxiety and fearful pain and other nociceptive stimulus in patients.%目的 探讨监护麻醉管理(MAC)在眼科玻璃体视网膜手术中的应用.方法 60例美国麻醉师协会(ASA)分级Ⅰ、Ⅱ级眼科玻璃体视网膜手术患者使用咪达唑仑、芬太尼、丙泊酚行MAC,术中所有患者中常规作血氧饱和度(SpO2)、呼吸、无创血压和心电图监测,行镇静深度评分,工具为睡眠障碍镇静评分标准(Ramsay评分);记录SpO2<90%超过30 s 、呼吸频率(RR)<8 bpm超过60 s、血压(BP)<80/50 mmHg、心率(HR)<50 bpm的发生率以及术中的体动反应,观察围麻醉期恶心、呕吐发生率,术后患者满意度评估.结果 MAC过程中BP平稳,HR<50 bpm超过30 s发生率为1.7%(1/60),RR低于8 bpm超过60 s的发生率为3

  12. Single-Port Endoscopic Thoracic Sympathectomy with Monitored Anesthesia Care: A More Promising Procedure for Palmar Hyperhidrosis.

    Science.gov (United States)

    Ning, Ye; Wang, Yanan; Tao, Xiandong; Tang, Hua; Jiang, Jingjing; Li, Yonghua; Sun, Guangyuan; Xue, Lei; Zhao, Xuewei

    2015-09-01

    Thoracic sympathectomy is considered the most effective method to treat palmar hyperhidrosis. We presented a novel procedure for thoracic sympathectomy treating palmar hyperhidrosis which could be performed under monitored anesthesia care. The aim of this study was to evaluate the continuing efficacy and safety of this innovative surgery. From May 2011 to May 2014, we performed the single-port endoscopic thoracic sympathectomy (ETS) with a flexible thoracoscopy in 32 patients under monitored anesthesia care. All patients were followed up until today. Under monitored anesthesia, all patients were awake during the procedure. A proper sedation and local anesthesia make it possible for patients to communicate with surgeons. The symptoms disappeared immediately when the sympathectomy was done. No surgical complications occurred during the procedure. All patients were discharged from the hospital on the first morning of postoperative day. Compared with the traditional approach, the advantages of less operative costs, fewer hospital days, and better recovery were suggested. Single-port ETS with flexible thoracoscopy under monitored anesthesia is a promising procedure for palmar hyperhidrosis.

  13. 局麻下行小切口修补腹股沟疝的临床观察%Clinical Observation of Inguinal Hernia Repair With Minimal Access Surgery Under Local Anesthesia

    Institute of Scientific and Technical Information of China (English)

    祁青华

    2014-01-01

    目的:分析局麻下行小切口修补腹股沟疝的疗效。方法将92例腹股沟疝患者随机分为研究组和对照组各46例,分别给予局麻下小切口修补术及传统疝修补术,分析两组治疗效果。结果研究组手术时间、术中出血量、住院时间、术后疼痛评分和并发症发生率均显著优于对照组。结论局麻下行小切口修补腹股沟疝临床疗效显著,操作简单,创伤小,有利于患者较快康复。%Objective To analyze the clinical effect of small incision of inguinal hernia repair operation under local anesthesia. Methods 92 cases inguinal hernia patients were divided into study group and control group, 46 in each group. They were applied in small incision repair and traditional hernia repair operation respectively. The clinical effect of two groups were compared. Results The operative time, blood loss, hospital stay, postoperative pain scores and complication rates were significantly better than the control group. Conclusion Small incision under local anesthesia used in inguinal hernia repair operation is effective.

  14. Optimizing anesthesia techniques in the ambulatory setting

    NARCIS (Netherlands)

    E. Galvin

    2007-01-01

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

  15. 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...

  16. 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...

  17. [Automated anesthesia record system].

    Science.gov (United States)

    Zhu, Tao; Liu, Jin

    2005-12-01

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

  18. Effects of A Thai Traditional Music Listening Program on Acute Pain Alleviation and Early Ambulation among Patients during the First 48 hours after Open Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Phanicha Phosida

    2016-09-01

    Full Text Available Background: To study the effects of listening to a Thai traditional music program on acute pain alleviation among patients during the first 48 hours after open abdominal surgery. Objective: A cross over research design in adult patients’ aged 18-60 years at Siriraj Hospital. Methods: The sample was selected by purposive sampling based on inclusion criteria and assigned into the following two groups by simple random sampling: the group receiving the Thai traditional music program (experimental group and the group receiving routine care (control group. This study employed a cross over design with 44 samples in a private surgical ward at Siriraj Hospital, Bangkok. Pain was assessed before and after the intervention. Data were collected by the following three sets of instruments: 1 the demographic and treatment background form; 2 the Thai Short - Form McGill Pain Questionnaire with the vital sign form and 3 the post abdominal surgery early ambulation form. Results: The patients in the experimental group had lower mean pain descriptor scores, mean present pain intensity scores and mean Visual Analog Scale scores after the Thai traditional music program than before the intervention at 48 hours after abdominal surgery with statistical significance (t = 14.11, t = 17.41 and t = 16.47 (p < .001, respectively. When compared between groups, the patients in the experimental group had lower mean pain descriptor scores, mean present pain intensity scores and mean Visual Analog Scale scores than the control group at 48 hours with statistical significance (F = 138.71, F = 170 and F = 298.97 (p < .001, respectively. Furthermore, on the first and second postoperative days as well as the sum of both days, the experimental group was also found to have better early ambulation mean scores than the control group with statistical significance (F = 10.67, p < .002, F = 41.36, p < .001, F = 44.47, p < .001, respectively. Conclusion: The findings suggest that a Thai

  19. 麻醉药物和手术对幼龄大鼠术后空间学习记忆功能的影响%Effect of Anesthesia and Surgery on Postoperative Spatial Working Memory

    Institute of Scientific and Technical Information of China (English)

    陈晨; 唐霓; 左云霞

    2014-01-01

    Objective To investigate the differences of postoperative spatial working memory following sevo⁃flurane or propofol anesthesia alone and their combination with surgeries respectively in young rats. Methods After 5-day training in Morris water maze, 46 healthy male SD rats were randomly assigned to 5 groups: propo⁃fol group(group P), sevoflurane group(group S), propofol plus surgery group(group PS), sevoflurane plus surgery group(group SS), control group(group C). The rats of group P were induced by intravenous injection of 15 mg/kg propofol, and anesthesia was maintained with 50 mg/(kg·h) propofol for 2 hours. 4% sevoflurane was inhaled for inducing anesthesia, and then the inhaled concentration of sevoflurane was decreased to 2% and maintained for 2 hours in group S. The rats of group C inhaled the mixture of air/oxygen (fraction of inspired oxygen, 30%) for 2 hours. The surgery was exploratory laparotomy. The spatial working memory was assessed 24 h after regaining consciousness using Morris water maze. Results The percentage of target quadrant time was 27.88 ± 9.00%, 29.22 ± 8.28%, 28.33 ± 5.27%, 28.17 ± 4.22%, 24.79 ± 3.43% respectively in group P, group S, group PS, group SS and group C. Compared with group C, the percentages of target quadrant time were not significantly declined in group P, group S, group PS and group SS(P>0.05), and there were no significant differences neither between group P and group PS nor between group S and group SS in day1 after regaining consciousness(P>0.05). Com⁃pared with group C ,the spatial working memory was not significantly impaired in group P, group S, group PS, group SS respectively in day 7 and day30 after regaining consciousness(P>0.05), and there were no significant differences neither between group P and group PS nor between group S and group SS(P>0.05). Conclusion Anesthesia with propofol or sevoflurane alone and their combination with minor abdominal surgery respectively did not result in impaired long

  20. 采用七氟烷或丙泊酚/瑞芬太尼全身麻醉行妇科手术临床研究%Clinical study of sevoflurane or propofol/remifentanil general anesthesia undergoing gynecological surgery

    Institute of Scientific and Technical Information of China (English)

    吴迪

    2014-01-01

    Objective To study the effect of sevoflurane or propofol/remifentanil general anesthesia undergoing gynecological surgery.Methods A total of 80 patients scheduled for selected gynecological surgery were divided into sevoflurane group or propofol/remifentanil group by random digits table method and 40 cases in each group.The induction of anesthesia was conducted with midazolam,propofol,sulfentanil,and rocuronium.After tracheal intubation,anesthesia was maintained with sevoflurane in sevoflurane group,and with propofol/remifentanyl target-controlled infusion in propofol/remifentanil group.Bispectral index was monitored in each group,and which was maintained 40-60.Blood pressure and heart rate was observed.At the end of operation,all anesthetics were discontinued,and the time of consciousness recovery,tracheal extubation,orientation was recorded.The incidence of agitation,nausea and vomiting within 24 h after surgery and the use of rescue drugs such as epinephrine,atropine or urapidil was recorded.Results No statistically significant difference was observed with respect to the time of consciousness recovery,tracheal extubation,orientation between two groups (P > 0.05).The use of atropine and epinephrine in sevoflurane group was lower than that in propofol/remifentanil group [7.5%(3/40) vs.22.5%(9/40),20.0%(8/40) vs.32.5%(13/40)],and there was significant difference(P < 0.05),and the use of urapidil in sevoflurane group was higher than that in pmpofol/remifentanil group [22.5% (9/40) vs.2.5% (1/40)],and there was significant difference (P < 0.01).There was no statistically significant differences with respect to the incidence of agitation,nausea and vomiting within 24 h after surgery between two groups (P >0.05).Conclusion Propofol/remifcntanil and sevoflurane both provide satisfactory anesthesia for gynecological surgery.%目的 观察七氟烷吸入麻醉或丙泊酚/瑞芬太尼全凭静脉麻醉行妇科手术的临床麻醉效果.方法 80例

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

    Institute of Scientific and Technical Information of China (English)

    杨戈雄; 袁杰; 高爽; 李滔; 滕煜; 马军令

    2014-01-01

    Objective To investigate the effect and feasibility of anesthesia without muscle relaxant in nasal endoscopic opera-tion.Methods 120 patients with ASAⅠ-Ⅱundergoing nasal endoscopic operation were randomly divided into normal muscle relaxant use group ( group Ⅰ) and intubation without muscle relaxant maintenance group ( groupⅡ) , 60 cases in each.GroupⅠwas treated with vecuronium 0.08-0.1 mg/kg induced, in patients with body movement or per 40min intravenous infusion of 0.05 mg/kg maintai-ning muscle relaxation;group Ⅱtracheal intubation after complex full airway surface anesthesia but without muscle relaxants mainte-nance during operation.Blood pressure ( MAP) , heart rate ( HR) , pulse oxygen saturation ( SpO2 ) , end tidal carbon dioxide partial pressure ( PetCO2 ) were recorded in each time point in the two groups before anesthesia ( T0 ) , 2 min after anesthesia induction ( T1 ) , 2 min after endotracheal intubation ( T2 ) , 2 min after the start of operation ( T3 ) , 20 min after the start of operation ( T4 ) , and 5 min after extubation ( T5) .The body movement frequency intraoperation , recovery time from anesthesia and extubation time, adverse reac-tions and complications and intraoperative additional infusion dosage of remifentanil and propofol were compared between the two groups.Results In both groups, T0 ~T4 each observation point,HR, MAP, SpO2 and PetCO2 changes were not significantly different (P>0.05).Breathing the air after 5 min(T5), SPO2 in group Ⅱwere higher than those in groupⅠ, PetCO2 in groupⅡlower than that in groupⅠ, there were significant differences between the two groups (P<0.05).In groupⅡ,anesthesia recovery time and ex-tubation time were significantly shorter than those in group Ⅰ( P <0.01).There were no adverse reaction and complication. Conclusions The effect of nasal endoscopic surgery under tracheal intubation general anesthesia without muscle relaxant is reliable, safe and feasible.%目的:探讨在无肌

  2. 低流量单肺通气对肺癌手术患者呼吸功能的影响%Effects of low flow anesthesia on respiratory function during one lung ventilation in patients with lung cancer surgery

    Institute of Scientific and Technical Information of China (English)

    胡彦艳; 秦丹丹; 叶凤青; 黄中华; 李静; 黄爱兰

    2013-01-01

    Objective To investigate the effects of low flow anesthesia on respiratory function during one lung ventilation in patients with lung cancer surgery. Methods A total of 40 ASA I or II grade patients, scheduled for lung cancer surgery under one lung ventilation ( OLV) were randomly divided into two groups with 20 each: normal flow anesthesia group( Group A) and low flow anesthesia group( Group B). Before OLV, two groups received high oxygen flow of 4 L/min and inhaled 1 % enflurane for ten minutes, then the oxygen flow was decreased to 3 L/min in group A and 1 L/min in group B, and two groups received high flow fresh gas of 4 L/min per 60 minutes for 5 minutes during OLV. The inhalation of enflurane was stopped at 30 min before operation cease and then the oxygen flow was recovered to 4 L/min until operation cease. Peak airway pressure( Ppeak) , mean airway pressure( Pmean) , airway resistance( Raw) , lung compliance( Cdyn) , arterial oxygen pressure( PaO2) , carbon dioxide pressure( PaCO2 ) were recorded before OLV(T0) and at 10 min(T1 ) , 30 min(T2) , 60 min(T3) min after OLV, 30 min (T4) after two lung ventilation. Results Ppeak, Pmean, Raw were increased (all P <0. 01) and Cdyn, PaO2 were decreased from T1 to T3 when compared with T0 in two groups (all P <0. 01) , there was no significant difference in other parameters from T0 to T4 between the two groups. Conclusion Low flow anesthesia has little effect on respiratory function in patients with lung cancer surgery. Low flow anesthesia can be safely used for one-lung ventilation.%目的 观察低流量单肺通气对肺癌手术患者呼吸功能的影响.方法 40例需单肺通气的择期肺癌手术患者,ASA Ⅰ~Ⅱ级,随机分为常流量组(A组)和低流量组(B组),各20例.两组单肺通气前吸入高流量(4 L/min)的氧气和1%安氟醚,10 min后将A组氧气流量调为3L/min,B组调为1L/min,两组每60 min给予高流量(4 L/min)的新鲜气体吸入5 min,手术结束前30 min停止吸入

  3. A holistic view of anesthesia-related neurotoxicity in children

    Directory of Open Access Journals (Sweden)

    Clausen NG

    2015-11-01

    Full Text Available Nicola G Clausen, Tom G Hansen Department of Anesthesia and Intensive Care, Odense University Hospital, Odense, Denmark Introduction: Animal studies (including in nonhuman primates have shown that most general anesthetics cause enhanced neuroapoptosis in the immature brain with subsequent long-term neurocognitive deficits later in life. Whether human neurons are equally affected is yet unknown, but a final answer to this issue is still pending. To date, most human studies within the field are of observational nature and the results are conflicting. Some studies indicate an association between exposure to anesthesia and surgery while others do not. Objective: This review summarizes results from preclinical and observational studies. Controversies and challenges regarding the interpretation of these results are presented. Crucial aspects of neurocognitive safety during pediatric anesthesia and surgery are highlighted. International initiatives aiming to improve the safe conductance of pediatric anesthesia are introduced. Conclusion: So far, anesthesia-related neurotoxicity in humans remains an area of concern but it cannot be completely excluded. Clinical practice should not be changed until there are definite proofs that anesthetic exposure causes neurocognitive impairment later in life. Withholding necessary and timely surgeries as a consequence of any such concerns could result in worse harm. Focus of current research should also be redirected to include other factors, than merely anesthetics and surgery, that influence the neurocognitive safety of children perioperatively. Keywords: pediatric anesthesia, neurotoxicity, anesthesia safety, neurocognitive development 

  4. Effects of relaxation training combined music therapy on patients undergoing surgery with local anesthesia%放松训练联合音乐疗法在局麻手术病人中的应用研究

    Institute of Scientific and Technical Information of China (English)

    温秀芬; 陈云超; 张晖; 高虹; 张雪燕; 徐光芸; 骆如香

    2014-01-01

    Objective To investigate the effects of relaxation training combined music therapy on postoperative psychological ,pain sensitivity ,and hemodynamic of patients undergoing surgery with local anesthesia .Method 120 patients were randomly divided into 2 group:experimental group and control group ,60 cases in each group .Pa-tients in group experimental received routine care and relaxation training combined with music therapy ,in the anoth-er hand ,patients in group control only received routine care .The changes of pain sensitivity and anxiety levels were observed before surgery and postoperative .changes of heart rate and blood pressure of both group were observed in the day before surgery ,before entering the operating room ,during the surgery and postoperative .Result The SAS and postoperative VAS score of group experimental was significantly lower than that of group control and systolic blood pressure ,diastolic blood pressure and heart rate in postoperative 30 min of group experimental were lower those in group control ether (P 0 .05) .systolic pressure ,diastolic blood pressure and heart rate of patients in both group before entering the operating room were higher than those in the day before sur-gery (P0 .05) .In group control , compared with the data before entering the operating room ,there were there were no significant differences of sys-tolic blood pressure ,diastolic blood pressure ,heart rate among the data before entering the operating room ,during and after the surgery (P> 0 .05) .Conclusion The therapy of relaxation training combined with music could reduce anxiety and pain sensitivity and helps to maintain stable vital signs of anesthesia during and after the surgery in pa-tients with local anesthesia .%目的:探讨放松训练联合音乐疗法对局麻手术患者术中、术后的心理、疼痛敏感度及血流动力学的影响。方法将120例患者按手术安排顺序单双数分为实验组与对照组,每组各60

  5. Psychological impact of unexpected explicit recall of events occurring during surgery performed under sedation, regional anaesthesia, and general anaesthesia: data from the Anesthesia Awareness Registry.

    Science.gov (United States)

    Kent, C D; Mashour, G A; Metzger, N A; Posner, K L; Domino, K B

    2013-03-01

    Anaesthetic awareness is a recognized complication of general anaesthesia (GA) and is associated with post-traumatic stress disorder (PTSD). Although complete amnesia for intraprocedural events during sedation and regional anaesthesia (RA) may occur, explicit recall is expected by anaesthesia providers. Consequently, the possibility that there could be psychological consequences associated with unexpected explicit recall of events during sedation and RA has not been investigated. This study investigated the psychological sequelae of unexpected explicit recall of events during sedation/RA that was reported to the Anesthesia Awareness Registry. The Registry recruited subjects who self-identified as having had anaesthetic awareness. Inclusion criteria were a patient-reported awareness experience in 1990 or later and availability of medical records. The sensations experienced by the subjects during their procedure and the acute and persistent psychological sequelae attributed to this explicit recall were assessed for patients receiving sedation/RA and those receiving GA. Among the patients fulfilling the inclusion criteria, medical record review identified 27 sedation/RA and 50 GA cases. Most patients experienced distress (78% of sedation/RA vs 94% of GA). Approximately 40% of patients with sedation/RA had persistent psychological sequelae, similar to GA patients. Some sedation/RA patients reported an adverse impact on their job performance (15%), family relationships (11%), and friendships (11%), and 15% reported being diagnosed with PTSD. Patients who self-reported to the Registry unexpected explicit recall of events during sedation/RA experienced distress and persistent psychological sequelae comparable with those who had reported anaesthetic awareness during GA. Further study is warranted to determine if patients reporting distress with explicit recall after sedation/RA require psychiatric follow-up.

  6. Clinical observation of remifentanil anaesthesia combined with epidural anesthesia in thoracic surgery%瑞芬太尼全麻复合硬膜外麻醉用于开胸手术的临床观察

    Institute of Scientific and Technical Information of China (English)

    王全胜; 岳谦

    2010-01-01

    Objective To investigate the effect and safety of remifentanil anaesthesia combined with epidural anesthesia in thoracic surgery. Methods Two hundred patients, ASA Ⅰ - Ⅱ grade, undergoing thoracotmy were randomly allocated to two groups:Remifentanil group (group R) and Fentanyl group (group F). Two groups were given combined general-epidural anesthesia. Patients in group R received remifentanil. Group F received fentanyl. The blood pressure, heart rate, blood oxygen saturation and plasma cortisol were measured before the operation (T0), 1 min (T1) and 5 min (T2) after tracheal intubation, skin incision(T3) and 5 min after the operation (T4). The endotracheal extubation time and conscious recovery were recorded. Results Compared with group R, the incidence of endotracheal intubation reaction in group F is significantly higher (group F-14/26,53.8% ;group R-4/26,15.4% ;P<0.05 ).All the patients in group R were extubated and recovered conscious completely at 7 min after operation. 6 patients in group F were extubated at 25 min after operation and 3 of them recovered recognition completely one hour later. Conclusion Remifentanil have a faster recovery after surgery than fentanyl, and it can effectively inhibit tracheal intubation stress response. Remifentanil anaesthesia combined with epidural anesthesia can provide perfect acesodyne and maintain steady circulation.%目的 观察瑞芬太尼全麻复合硬膜外麻醉在开胸手术中的应用效果和安全性. 方法 200例择期行开胸手术患者,ASA Ⅰ~Ⅱ级,按完全随机分组方法分为两组,瑞芬太尼组(R组)与芬太尼组(F组),均采用硬膜外复合气管插管全麻,R组与F组分别采用瑞芬太尼和芬太尼麻醉,观察术前(T0)、气管插管后1 min(T1)、5 min(T2)、切皮(T3)和术后5 min(T4)的血压、心率、血氧饱和度和血中皮质醇水平,记录术后拔管时间及患者的认知能力恢复情况. 结果 两组气管插管反应发生率相比较,F组(14

  7. Awareness and recall in outpatient anesthesia.

    Science.gov (United States)

    Wennervirta, Johanna; Ranta, Seppo O-V; Hynynen, Markku

    2002-07-01

    We studied the incidence of awareness and explicit recall during general anesthesia in outpatients versus inpatients undergoing surgery. During a 14.5-mo period, we structurally interviewed 1500 outpatients and 2343 inpatients. Among outpatients, there were five cases of awareness and recall (one with clear intraoperative recollections and four with doubtful intraoperative recollections). Of the inpatients, six reported awareness and recall (three with clear and three with doubtful intraoperative recollections). The incidence of clear intraoperative recollections was 0.07% in outpatients and 0.13% in inpatients. The difference in the incidence was not significant. Among outpatients, those with awareness and recall were given smaller doses of sevoflurane than those without awareness and recall (P awareness and recall are rare complications of general anesthesia, and outpatients are not at increased risk for this event compared with inpatients undergoing general anesthesia. Rapid recovery from general anesthesia is a crucial element of outpatient surgery. However, this practice may predispose a patient to receive less anesthetic, with increased risk for awareness and recall. We have shown that outpatients undergoing an operation using general anesthesia are not at increased risk for awareness compared with inpatients.

  8. Potential anesthesia protocols for space exploration missions.

    Science.gov (United States)

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

    2013-03-01

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

  9. 氯胺酮复合布托啡诺静脉麻醉在小儿日间手术中的应用%The application of ketamine combined with butorphanol intravenous anesthesia for pediatric day surgery

    Institute of Scientific and Technical Information of China (English)

    张虓宇; 张成密; 陈锡明; 王英伟; 赵璇

    2014-01-01

    目的 研究氯胺酮复合布托啡诺静脉麻醉在小儿日间手术中应用的临床效果.方法 选择美国麻醉医师协会(ASA)分级Ⅰ或Ⅱ级行腹股沟疝修补术、包皮环切术的患儿(1岁~6岁)200例,按随机数字表法分为2组(每组100例):氯胺酮复合生理盐水组(KS组)和氯胺酮复合布托啡诺组(KB组).KS组患儿静脉给予氯胺酮2 mg/kg复合生理盐水2 ml行麻醉诱导,KB组患儿则给予氯胺酮2 mg/kg复合2 ml含有30 μg/kg的布托啡诺,若患儿术中出现明显的体动反应,则静脉追加氯胺酮1 mg/kg.记录呼吸、血流动力学变化、苏醒时间、术后CHEOPS疼痛评分(术后即刻、术后1、2、4、8、12、24 h)和镇静评分(术后15、30、60 min)及氯胺酮用量.结果 KB组的氯胺酮用量(42.2±12.9) mg较KS组(75.0±25.3) mg明显减少;且术后平均CHEOPS评分显著降低、术后镇静评分显著较高;麻醉后复苏室内苏醒时间显著延长(P <0.05),但并不延长出室时间.两组患儿的呼吸与血流动力指标差异无统计学意义.结论 氯胺酮复合布托啡诺静脉麻醉能够安全应用于小儿日间手术,减少大剂量氯胺酮所致的副作用,又可以提供较为完善的镇痛与镇静作用,减少小儿苏醒期躁动的发生.%Objective To compare the effects of ketamine combined with butorphanol for intravenous anesthesia with ketamine separately for pediatric day surgery.Methods In this double-blind trial,200 pediatric patients (ASA physical status 1 or 2,1 to 6 years old) undergoing inguinal hernia repair or circumcisions undergoing intravenous anesthesia were randomly allocated into two groups.Intravenous anesthesia was induced with 2 mg/kg ketamine combined with 2 ml saline (group KS,n=100) or 2 mg/ kg ketamine combined with 30 μg/kg butorphanol in the volume of 2 ml respectively (group KB,n=100).Repeat doses of ketamine 1 mg/kg were administered when the patients had motor responses.Total dosage of ketamine

  10. Application of Midazolam-Ketamine by intravenous anesthesia and caudal block in inguinal hernia surgery in children%咪达唑仑-氯胺酮静脉麻醉复合骶管阻滞在小儿腹股沟疝手术中的应用效果评价

    Institute of Scientific and Technical Information of China (English)

    胡俊; 杨文庆; 阚智勇

    2011-01-01

    目的 比较咪达唑仑-氯胺酮静脉麻醉复合骶管阻滞在小儿腹股沟疝手术中的麻醉效果.方法 选择80例腹股沟疝手术患儿,分为复合骶管阻滞组(1组)和单纯静脉麻醉组(2组).1组咪哒唑仑-氯胺酮静脉麻醉后行骶管阻滞,2组单纯咪哒唑仑-氯胺酮静脉麻醉,术中视情况间断推注氯胺酮维持麻醉效果.分别记录两组在麻醉前(TO)、手术后20分钟(T1)及术毕时平均动脉压(MAP)、血氧饱和度(SPO2)、心率(HR)、术中氯胺酮用量、术后苏醒时间、术后麻醉不良反应等.结果 两组SpO2、HR、MAP差异无统计学意义(P>0.05),1组术中氯胺酮用量明显少于2组(P0.05).结论 咪达唑仑-氯胺酮静脉麻醉复合骶管阻滞应用于小儿腹股沟疝手术具有显著的麻醉效果.%Objective To evaluate the effect of Midazolam plus Ketamine by intravenous anesthesia and caudal block in inguinal hernia surgery in children. Methods Eighty cases of inguinal hernia were randomly divided into two groups. Group 1 underwent sacral block after intravenous anesthesia, group 2 underwent intravenous anesthesia only. Anesthesia was maintained by intermittent bolus injection of Ketamine during the surgery appropriately. The mean arterial blood pressure ( MAP) , oxygen saturation (SpO2) , heart rate ( HR) , intraoperative dosage of Ketamine and postoperative recovery time, postoperative adverse reactions were recorded before anesthesia and 20 minutes after surgery. Results SpO2, HR, MAP between the two groups were not statistically different ( P > 0. 05 ). The intraoperative dosage of Ketamine in group 1 was significantly less than that in group 2 (P 0.05). Conclusion Midazolam plus Ketamine by intravenous anesthesia combined with caudal block is safe and effective in inguinal hernia surgery in children.

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

    Science.gov (United States)

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

    2017-02-15

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

  12. 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.

  13. Gabapentin Does Not Appear to Improve Postoperative Pain and Sleep Patterns in Patients Who Concomitantly Receive Regional Anesthesia for Lower Extremity Orthopedic Surgery: A Randomized Control Trial

    Science.gov (United States)

    Amin, Shawn; Reilly, Mark C.; Shulman, Steven

    2017-01-01

    In recent years, gabapentin has gained popularity as an adjuvant therapy for the treatment of postoperative pain. Numerous studies have shown a decrease in pain score, even with immediate postoperative activity, which is significant for early post-op ambulation and regaining functionality sooner. However, studies have been in conclusive in patients undergoing lower extremity orthopedic surgery. For this reason, we hoped to study the effect of gabapentin on postoperative pain in patients undergoing total knee arthroplasty, total hip arthroplasty, or a hip fracture repair. This was done in the setting