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automated anaesthesia

Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
March 8, 2017: Current Opinion in Anaesthesiology
Domenico Ventrella, Francesco Dondi, Francesca Barone, Federica Serafini, Alberto Elmi, Massimo Giunti, Noemi Romagnoli, Monica Forni, Maria L Bacci
BACKGROUND: The similarities between swine and humans in physiological and genomic patterns, and the great correlation in size and anatomy, make pigs extremely useful in preclinical studies. New-born piglets can represent a model for congenital and genetic diseases in new-born children. It is known that piglets may have significant differences in clinicopathological results compared to adult pigs. Therefore, adult laboratory reference intervals cannot be applied to piglets. The aim of this study was to compare haematological and chemical variables in piglets of two ages and determinate age-related reference intervals for commercial hybrid young pigs...
January 17, 2017: BMC Veterinary Research
Quan Liu, Yi-Feng Chen, Shou-Zen Fan, Maysam F Abbod, Jiann-Shing Shieh
Electroencephalography (EEG) has been widely utilized to measure the depth of anaesthesia (DOA) during operation. However, the EEG signals are usually contaminated by artifacts which have a consequence on the measured DOA accuracy. In this study, an effective and useful filtering algorithm based on multivariate empirical mode decomposition and multiscale entropy (MSE) is proposed to measure DOA. Mean entropy of MSE is used as an index to find artifacts-free intrinsic mode functions. The effect of different levels of artifacts on the performances of the proposed filtering is analysed using simulated data...
December 19, 2016: Medical & Biological Engineering & Computing
Larysa Duniec, Piotr Nowakowski, Jakub Sieczko, Marcin Chlebus, Tomasz Łazowski
BACKGROUND: The conventional, loss of resistance technique for identification of the epidural space is highly dependent on the anaesthetist's personal experience and is susceptible to technical errors. Therefore, an alternative, automated technique was devised to overcome the drawbacks of the traditional method. The aim of the study was to compare the efficacy of epidural space identification and the complication rate between the two groups - the automatic syringe and conventional loss of resistance methods...
2016: Anaesthesiology Intensive Therapy
Yvette Ellen, Paul Flecknell, Matt Leach
To manage pain effectively in people and animals, it is essential to recognise when pain is present and to assess its intensity. Currently there is very little information regarding the signs of post-surgical pain or its management in guinea pigs. Studies from other rodent species indicate that behaviour-based scoring systems can be used successfully to detect pain and evaluate analgesic efficacy. This preliminary study aimed to establish whether behaviour-based scoring systems could be developed to assess post-surgical pain in guinea pigs...
2016: PloS One
Giuseppe Faragò, V Caldiera, C Antozzi, A Bellino, A Innocenti, E Ciceri
OBJECTIVES: Spinal dural arteriovenous fistulas (SDAVFs) are acquired diseases that represent the majority of all arteriovenous spinal shunts, leading to progressive and disabling myelopathy. Treatment is focused on accurately disconnecting the fistula point. We present our experience with the double-cone-beam CT fusion technique successfully applied to evaluate treatment results in a series of SDAVFs. METHODS: Between November 2011 and December 2015 we performed double-DynaCT acquisition (pre- and post-embolisation) in 12 cases of SDAVF...
August 26, 2016: European Radiology
Robert S Kirsner, Marco Romanelli
The growing trends of ageing populations and increasing prevalence of diabetes have given rise to an expanding number of problematic acute and chronic wounds. Over the past two decades, the use of negative pressure wound therapy (NPWT) with and without instillation of topical wound solutions has expanded to include treatment of a large variety of wounds. Additionally, the use of NPWT specifically designed for use over closed surgical incisions has been associated with favourable results. The recent introduction of an automated epidermal harvesting system, which neither creates a donor site wound nor requires the use of a surgeon, operating room or anaesthesia, has facilitated the use of epidermal grafting...
September 2016: International Wound Journal
A Restoux, S Grassin-Delyle, N Liu, C Paugam-Burtz, J Mantz, M Le Guen
BACKGROUND: Automated titration of propofol and remifentanil guided by the bispectral index (BIS) has been used for numerous surgical procedures. Orthotopic liver transplantation (OLT) uniquely combines major changes in circulating volume, an anhepatic phase, and ischaemia-reperfusion syndrome. We assessed the behaviour of this automated controller during OLT. METHODS: Adult patients undergoing OLT were included in this pilot study. Consumption of propofol and remifentanil was calculated for each surgery period (dissection, anhepatic, and liver reperfusion phases)...
September 2016: British Journal of Anaesthesia
M Joshua Daniel, Prakash H Muddegowda, Chezhiansubash, Jyothi B Lingegowda, Niranjan Gopal, Krishna Prasad
INTRODUCTION: Red Cell Exchange (RCE) is removal of a patient's red blood cells while replacing with donor red blood cells either manually or using automated systems. RCE is beneficial in patients with Sickle Cell Disease (SCD) either during sickling crisis or prior to major surgical procedures to bring down the sickling percentage as high sickling percentage during prolonged anaesthesia may lead to vaso-occlusive crisis. It is also employed in patients infested with malaria and babesiosis where parasitic index remain high despite medical management...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Matthieu Biais, Laurent Stecken, Aurélie Martin, Stéphanie Roullet, Alice Quinart, François Sztark
Non-invasive respiratory variations in arterial pulse pressure using infrared-plethysmography (PPVCNAP) are able to predict fluid responsiveness in mechanically ventilated patients. However, they cannot be continuously monitored. The present study evaluated a new algorithm allowing continuous measurements of PPVCNAP (PPVCNAPauto) (CNSystem, Graz, Austria). Thirty-five patients undergoing vascular surgery were studied after induction of general anaesthesia. Stroke volume was measured using the Vigileo(TM)/FloTrac(TM)...
June 16, 2016: Journal of Clinical Monitoring and Computing
Antoine Lamer, Mathieu Jeanne, Grégoire Ficheur, Romaric Marcilly
Data stored in operational databases are not reusable directly. Aggregation modules are necessary to facilitate secondary use. They decrease volume of data while increasing the number of available information. In this paper, we present four automated engines of aggregation, integrated into an anaesthesia data warehouse. Four instances of clinical questions illustrate the use of those engines for various improvements of quality of care: duration of procedure, drug administration, assessment of hypotension and its related treatment...
2016: Studies in Health Technology and Informatics
Nadine Hachach-Haram, Nicola Bystrzonowski, Muholan Kanapathy, Oliver Smith, Keith Harding, Ash Mosahebi, Toby Richards
Current wound management through the use of a split-thickness skin graft often requires hospital admission, a period of immobility, attentive donor site wound care and pain management. This study evaluates the feasibility of using a novel epidermal graft-harvesting device (CelluTome) that allows pain-free epidermal skin grafting in the outpatient clinic setting. A prospective series of 35 patients was performed in 2 centres, involving 10 acute and 25 chronic wounds. All patients were subjected to epidermal grafting in the outpatient specialist clinic, without the use of anaesthesia, and allowed to return home after the procedure...
February 2017: International Wound Journal
Cornelia Schwennen, Nina Kolbaum, Karl-Heinz Waldmann, Doris Höltig
Piglet castration under isoflurane-anaesthesia could represent an alternative to the practice of castration without anaesthesia. The objective of this study was to evaluate practicality and effectiveness of an automated isoflurane-anaesthesia for castration. A field study on three different farms in Germany (farm A, B: 200 sows; C: 540 sows) was performed. In total, 1429 (1166 anaesthetised and 263 conventionally castrated) male piglets (age: 1-8 days; bodyweight: 0.7-3.7 kg) were monitored. All piglets were treated with nonsteroidal anti-inflammatory drugs directly before castration...
January 2016: Berliner und Münchener Tierärztliche Wochenschrift
Aurélien Bataille, Jacques-Florian Letourneulx, Alain Charmeau, Pascale Lemedioni, Philippe Léger, Thierry Chazot, Morgan Le Guen, Pierre Diemunsch, Marc Fischler, Ngai Liu
BACKGROUND: In obese patients, the incidence of postoperative nausea and vomiting (PONV) following sleeve gastrectomy under titration of total intravenous anaesthesia (TIVA) and the relevance of risk factors to indicate prophylaxis is unknown. OBJECTIVES: The hypothesis was that after automated TIVA, prophylaxis reduces PONV following laparoscopic sleeve gastrectomy. Our objective was to determine the incidence of PONV and evaluate the efficacy of dexamethasone and ondansetron as prophylaxis when automated intravenous anaesthesia is employed...
December 2016: European Journal of Anaesthesiology
Malin Jonsson Fagerlund, Johannes Krupp, Michael A Dabrowski
Propofol is a widely used general anaesthetic with muscle relaxant properties. Similarly as propofol, the new general anaesthetic AZD3043 targets the GABAA receptor for its anaesthetic effects, but the interaction with nicotinic acetylcholine receptors (nAChRs) has not been investigated. Notably, there is a gap of knowledge about the interaction between propofol and the nAChRs found in the adult neuromuscular junction. The objective was to evaluate whether propofol or AZD3043 interact with the α1β1δε, α3β2, or α7 nAChR subtypes that can be found in the neuromuscular junction and if there are any differences in affinity for those subtypes between propofol and AZD3043...
2016: Pharmaceuticals
Fatma Gulcin Ozturk Arikan, Guldem Turan, Asu Ozgultekin, Zubeyir Sivrikaya, Bekir Cem Cosar, Dondu Nisa Onder
TOF (train-of-four) monitoring provides objective data in application of neuromuscular blocking agent. Thus, applicator-based differences are eliminated and optimum muscle relaxation is maintained during operation. In the present study, we aimed to compare the effects of target-controlled infusion system and standard TOF monitoring, on use of rocuronium. ASA I-II patients, who were aged between 18 and 75 years and scheduled for elective abdominal surgery at Haydarpaşa Numune Training and Research Hospital, were enrolled in the study...
October 2016: Journal of Clinical Monitoring and Computing
S C Reston, P Basanagoudar, A D McNair, A H Deakin, A W G Kinninmonth
UNLABELLED: There are concerns about the risk of iatrogenic infection when employing local anaesthetic techniques with post-operative intra-articular infusions in total knee arthroplasty. This study aimed to determine the efficacy of intact epidural filters in preventing transit of bacteria and to develop a technique of administration which would prevent membrane rupture. Filter efficacy was assessed using a standardised test suspension of Pseudomonas aeruginosa. Twenty millilitres of suspension was injected through isolated epidural filters (n=10) or filters with 40cm of catheter tubing attached (n=30)...
January 2016: Knee
Thomas E Serena
Chronic wounds continue to present a significant challenge to health-care providers across the globe. Unlike acute wounds, chronic wounds do not proceed through an orderly process of repair. In recent years, a number of wound healing treatments, such as dermal replacement scaffolds and negative pressure wound therapy, have promoted wound healing by stimulating the formation of granulation tissue. However, until recently there were few modalities designed to promote epithelialisation of a fully granulated wound...
April 2015: Journal of Wound Care
B L Sng, H Wang, P N Assam, A T Sia
Hypotension occurs commonly during spinal anaesthesia for caesarean section, associated with maternal and fetal adverse effects. We developed a double-vasopressor automated system with a two-step algorithm and continuous non-invasive haemodynamic monitoring using the Nexfin device. The system delivered 25 μg phenylephrine every 30 s when systolic blood pressure was between 90% and 100% of baseline, or 2 mg ephedrine at this blood pressure range and heart rate < 60 beats.min(-1) ; and 50 μg phenylephrine or 4 mg ephedrine when systolic blood pressure was < 90% of baseline with the same heart rate criterion...
June 2015: Anaesthesia
Siri Nelson, Ronny Andersen, Sven-Harald Anderssen
BACKGROUND: The Directorate of Health recommends hearing screening of all neonates with the aid of otoacoustic emissions (OAE). The goal is to achieve initiation of treatment before the child is six months old. Congenital hearing loss occurs in 1-3 per 1,000 newborns, and the purpose of this study was to identify the prevalence in a large Norwegian dataset. METHOD AND MATERIAL: During the period 1 January 2000-31 December 2009, all children who were born in Østfold county, 29,485 neonates in total, were offered hearing screening with the aid of otoacoustic emissions...
January 27, 2015: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
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