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Propofol monitoring

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https://www.readbyqxmd.com/read/29908049/imaging-sublingual-microcirculatory-perfusion-in-pediatric-patients-receiving-procedural-sedation-with-propofol-a-pilot-study
#1
M A Riedijk, D M J Milstein
OBJECTIVE: Procedural sedation with propofol is widely used in the pediatric population. A well-known side effect of propofol is a decrease of peripheral vascular resistance resulting in hypotension, but little is known about the effects on the microcirculation in humans. We aimed to evaluate the effects of propofol on the sublingual microcirculatory perfusion by continuous video imaging in pediatric patients undergoing procedural sedation. METHODS: Patients admitted to the Pediatric Intensive Care Unit for procedural sedation were recruited...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29907211/comparison-of-dexmedetomidine-versus-propofol-on-hemodynamics-in-surgical-critically-ill-patients
#2
Ya-Fei Chang, Anne Chao, Po-Yuan Shih, Yen-Chun Hsu, Chen-Tse Lee, Yu-Wen Tien, Yu-Chang Yeh, Lee-Wei Chen
BACKGROUND: Sedation with dexmedetomidine and propofol may cause hypotension or bradycardia. This study aimed to compare the effects of dexmedetomidine and propofol on hemodynamics and clinical outcomes in surgical intensive care unit (ICU) patients after major abdominal surgery. MATERIALS AND METHODS: Enrolled patients were randomly allocated to the dexmedetomidine or propofol group. Cardiac index was measured using a continuous noninvasive cardiac output monitor on the basis of chest bioreactance...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29902969/bispectral-index-to-guide-induction-of-anesthesia-a-randomized-controlled-study
#3
Dirk Rüsch, Christian Arndt, Leopold Eberhart, Scarlett Tappert, Dennis Nageldick, Hinnerk Wulf
BACKGROUND: It is unknown to what extent hypotension frequently observed following administration of propofol for induction of general anesthesia is caused by overdosing propofol. Unlike clinical signs, electroencephalon-based cerebral monitoring allows to detect and quantify an overdose of hypnotics. Therefore, we tested whether the use of an electroencephalon-based cerebral monitoring will cause less hypotension following induction with propofol. METHODS: Subjects were randomly assigned to a bispectral index (BIS)-guided (target range 40-60) or to a weight-related (2 mg...
June 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29902418/propofol-versus-remifentanil-which-one-is-more-effective-in-reducing-blood-loss-during-orthognathic-surgery-a-randomized-clinical-trial
#4
Majid Eshghpour, Sahand Samieirad, Alireza Sharifian Attar, Hamed Kermani, Sadaf Seddigh
PURPOSE: Propofol and remifentanil are 2 useful drugs used in induced hypotensive anesthesia. The purpose of this study was to compare the effects of these drugs on intraoperative blood loss, transfusion requirements, and hemodynamic status during standardized orthognathic surgical procedures. MATERIALS AND METHODS: In this double-blind randomized clinical trial, 50 consecutive healthy patients with Class III skeletal deformity were candidates for bimaxillary orthognathic surgery at Qaem Hospital, Mashhad University of Medical Sciences (Mashhad, Iran), from November 2016 until December 2017...
May 21, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29870425/ect-a-new-look-at-an-old-friend
#5
Pavan Kumar Kadiyala, Lakshmi Deepthi Kadiyala
PURPOSE OF REVIEW: Electroconvulsive therapy (ECT) as a treatment option in psychiatry is advancing day by day. This review discusses new advancements in ECT with regards to anesthetic variables, stimulus, and response variables along with their impact on clinical outcomes. RECENT FINDINGS: Anesthetic variables influence clinical efficacy and patient tolerance of ECT. Although etomidate or a ketamine-propofol combination may be the first choice for many clinicians, the search for ideal induction agent continues...
June 4, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29870424/do-we-really-need-an-anesthesiologist-for-routine-colonoscopy-in-american-society-of-anesthesiologist-1-and-2-patients
#6
Joshua W Sappenfield, Jeffrey D White
PURPOSE OF REVIEW: In an era where healthcare costs are being heavily scrutinized, every expenditure is reviewed for medical necessity. Multiple national gastroenterology societies have issued statements regarding whether an anesthesiologist is necessary for routine colonoscopies in American Society of Anesthesiologist (ASA) 1 and 2 patients. RECENT FINDINGS: A large percentage of patients are undergoing screening colonoscopy without any sedation at all, which would not require an independent practitioner to administer medications...
June 4, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29850571/effects-of-total-intravenous-anesthesia-and-low-and-high-flow-anesthesia-implementation-on-middle-ear-pressure
#7
Ayca Dumanli Ozcan, Aysun Ersen Yungul, Togay Muderris, Hulya Kasikara, Helin Sahinturk, Orhan Kanbak, Abdulkadir But
Background: The middle ear is an air-filled lacuna in the temporal bone. Inhaled anesthetic agents increase the pressure of this lacuna. Therefore, attention must be paid in choosing not only anesthetic agents but also anesthetic method. Aim: This study compared the effects of high-flow total intravenous anesthesia (TIVA) and low- and high-flow desflurane anesthesia on middle ear pressure. Study Design: Randomized prospective double-blind study...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29793605/safety-and-clinical-effect-of-i-v-infusion-of-cyclopropyl-methoxycarbonyl-etomidate-abp-700-a-soft-analogue-of-etomidate-in-healthy-subjects
#8
B I Valk, A R Absalom, P Meyer, S Meier, I den Daas, K van Amsterdam, J A Campagna, S P Sweeney, M M R F Struys
BACKGROUND: Cyclopropyl-methoxycarbonyl metomidate, or ABP-700, is a second generation analogue of etomidate, developed to retain etomidate's beneficial haemodynamic and respiratory profile but diminishing its suppression of the adrenocortical axis. The objective of this study was to characterise the safety and efficacy of 30-min continuous infusions of ABP-700, and to assess its effect on haemodynamics and the adrenocortical response in healthy human volunteers. METHODS: Five cohorts involving 40 subjects received increasing infusion doses of ABP-700, propofol 60 μg kg-1  min-1 or placebo...
June 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29793588/adaptation-of-non-linear-mixed-amount-with-zero-amount-response-surface-model-for-analysis-of-concentration-dependent-synergism-and-safety-with-midazolam-alfentanil-and-propofol-sedation
#9
J-Y Liou, C-K Ting, W-N Teng, M S Mandell, M-Y Tsou
BACKGROUND: The non-linear mixed amount with zero amounts response surface model can be used to describe drug interactions and predict loss of response to noxious stimuli and respiratory depression. We aimed to determine whether this response surface model could be used to model sedation with the triple drug combination of midazolam, alfentanil and propofol. METHODS: Sedation was monitored in 56 patients undergoing gastrointestinal endoscopy (modelling group) using modified alertness/sedation scores...
June 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29739183/comparison-between-cerebral-state-index-and-bispectral-index-during-desflurane-anesthesia
#10
Sang-Hyeon Cho, Sung-Su Kim, Dong-Min Hyun, Hyeong-Suk Yoon, JungWoo Han, Jin Sun Kim
Background: Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different EEG signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia. Methods: Thirty-three patients were recruited...
May 9, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29739131/intravenous-anesthetic-propofol-affects-synaptic-responses-in-cerebellar-purkinje-cells
#11
Kwan Young Lee, Yujin Jang, Min Hee Lee, Young Im Kim, Sung-Cherl Jung, Seung-Yun Han, Se Hoon Kim, Hyung Seo Park, Dong Kwan Kim
Objective: Propofol is an intravenously administered anesthetic that enhances γ-aminobutyric acid-mediated inhibition in the central nerve system. Other mechanisms may also be involved in general anesthesia. Propofol has been implicated in movement disorders. The cerebellum is important for motor coordination and motor learning. The aim of the present study was to investigate the propofol effect on excitatory synaptic transmissions in cerebellar cortex. Methods: Excitatory postsynaptic currents by parallel fiber stimulation and complex spikes by climbing fiber stimulation were monitored in Purkinje cells of Wister rat cerebellar slice using whole-cell patch-clamp techniques...
May 31, 2018: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29722285/optimal-neuromuscular-blocking-effects-of-remifentanil-during-tracheal-intubation-under-general-anesthesia
#12
So Young Kwon, Si Wook Chung, Jin Deok Joo
Objective This study was performed to determine the effect of the remifentanil dose on the onset time of rocuronium with electromyography. Methods This retrospective comparative study included 75 patients undergoing general anesthesia for elective surgery. Patients received lidocaine (40 mg) and propofol (2 mg/kg) followed by rocuronium (0.6 mg/kg) with either saline infusion (Group S), remifentanil at 0.5 µg/kg/minute (Group R 0.5), or remifentanil at 1.0 µg/kg/minute (Group R 1.0). Neuromuscular block was monitored by train-of-four (TOF) electromyography, and the times taken to reach TOF 0 and TOF ratio (TOFR) 25% were recorded...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29716493/an-international-survey-evaluating-factors-influencing-the-use-of-total-intravenous-anaesthesia
#13
G T C Wong, S W Choi, D H Tran, H Kulkarni, M G Irwin
The purpose of this study was to evaluate factors influencing the use of propofol-based total intravenous anaesthesia (TIVA)since despite TIVA being a well-established technique, it is used far less frequently than volatile anaesthesia. Questions were formulated after reviewing the literature for perceived disadvantages of TIVA and meeting with a focus group consisting of both senior and junior anaesthestists from our department. Once the survey had been formulated, specialist anaesthetists from professional colleges and societies from several countries were invited to complete the survey on an electronic web-based platform to allow evaluation of the respondent's rating of the importance of a range of factors in their decision not to use TIVA for a particular case...
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29704050/the-pringle-maneuver-reduces-the-infusion-rate-of-rocuronium-required-to-maintain-surgical-muscle-relaxation-during-hepatectomy
#14
Akira Kajiura, Osamu Nagata, Masamitsu Sanui
INTRODUCTION: We investigated the continuous infusion rates of rocuronium necessary to obtain the surgical muscle relaxation before, during, and after the Pringle maneuver on patients who underwent hepatectomy. METHODS: Fifteen patients were induced by total intravenous anesthesia with propofol. After obtaining the calibration of acceleromyography, the patient was intubated with rocuronium 0.6 mg/kg. Fifteen minutes after initial rocuronium injection, the continuous infusion was started at 7...
June 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#15
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#16
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699707/anaesthetic-management-of-a-paediatric-patient-with-congenital-fibre-type-disproportion-myopathy
#17
F Buisán, O de la Varga, M Flores, J Sánchez-Ruano
Congenital fibre type disproportion (CFTD) is a rare type of myopathy that is characterised by muscle weakness and hypotonia during childhood. Clinical features include motor delay, feeding difficulties, limb weakness, joint contractures, and scoliosis. A report is presented of the anaesthetic management of a 3-year-old girl with CFTD myopathy associated with a mutation of the TPM3 gene, scheduled for adenotonsillectomy because of obstructive sleep apnoea hypopnoea syndrome (OSAHS). The main concerns were the possible susceptibility to malignant hyperthermia, the risk of anaesthesia-induced rhabdomyolysis, a greater sensitivity to non-depolarising muscle relaxants, and the presence of OSAHS...
April 23, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29693947/use-of-sugammadex-in-a-patient-with-myotonic-dystrophy-undergoing-laparoscopic-cholecystectomy
#18
Rieko Uno, Shoko Matsuda, Kohei Murao, Kumiko Nakamura, Michiyo Shirakawa, Koh Shingu
A 37-year-old female patient with myotonic dystrophy was scheduled for laparoscopic cholecystectomy for gall stone under general anesthesia with continuous propofol infusion. Rocuronium was administered with careful monitoring using TOF- Watch®, measuring train-of-four count (Tc), TOF ratio (Tr), and posttetanic count The total amount of rocuronium was 70 mg ; 0.6 mg .kg⁻1 for anesthetic induction and 0.3 mg .kg⁻1 when Tc exceeded 1. When the operation was completed, Tc was 4, Tr was uncountable and she showed reaction to calling her name...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29671874/pain-assessment-by-pupil-dilation-reflex-in-response-to-noxious-stimulation-in-anaesthetized-adults
#19
D Wildemeersch, N Peeters, V Saldien, M Vercauteren, G Hans
BACKGROUND: In response to noxious stimulation, pupillary dilation reflex (PDR) occurs even in anaesthetized patients. The aim of the study was to evaluate the ability of pupillometry with an automated increasing stimulus intensity to monitor intraoperative opioid administration. METHODS: Thirty-four patients undergoing elective surgery were enrolled. Induction by propofol anaesthesia was increased progressively until the sedation depth criteria (SeD) were attained...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29662089/time-rescaling-reproduces-eeg-behavior-during-transition-from-propofol-anesthesia-induced-unconsciousness-to-consciousness
#20
S Boussen, A Spiegler, C Benar, M Carrère, F Bartolomei, P Metellus, R Voituriez, L Velly, N Bruder, A Trébuchon
General anesthesia (GA) is a reversible manipulation of consciousness whose mechanism is mysterious at the level of neural networks leaving space for several competing hypotheses. We recorded electrocorticography (ECoG) signals in patients who underwent intracranial monitoring during awake surgery for the treatment of cerebral tumors in functional areas of the brain. Therefore, we recorded the transition from unconsciousness to consciousness directly on the brain surface. Using frequency resolved interferometry; we studied the intermediate ECoG frequencies (4-40 Hz)...
April 16, 2018: Scientific Reports
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