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Propofol monitoring

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https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#1
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28422846/application-of-remifentanil-for-conscious-sedation-and-analgesia-in-short-term-ercp-and-est-surgery
#2
Guo-Qiang Sun, Bao-Feng Gao, Guan-Jun Li, Yun-Long Lei, Jie Li
This study aims to observe and evaluate the use of remifentanil in conscious sedation and analgesia for the safety and comfort of patients undergoing short-term endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST).Sixty-eight patients who underwent ERCP and EST were randomly divided into two groups: research group and control group. Patients in the research group were intravenously injected with remifentanil (80-2/3* age) for 1 to 2 minutes, combined with the intravenous injection of propofol (20-30 mg) during the course of treatment...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28410821/-analgesia-nociception-index-for-perioperative-analgesia-monitoring-in-spinal-surgery
#3
Guldem Turan, Arzu Yıldırım Ar, Yıldız Yigit Kuplay, Oznur Demiroluk, Mustafa Gazi, Nur Akgun, Erhan Celikoglu
BACKGROUND AND OBJECTIVES: The Analgesia Nociception Index is an index used to measure the levels of pain, sympathetic system activity and heart rate variability during general anesthesia. In our study, Analgesia Nociception Index monitoring in two groups who had undergone spinal stabilization surgery and were administered propofol-remifentanil (Total Intravenous Anesthesia) and sevoflurane-remifentanyl anesthesia was compared regarding its significance for prediction of postoperative early pain...
April 11, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28410767/non-anesthesiologist-administered-propofol-is-not-related-to-an-increase-in-transcutaneous-co2-pressure-during-flexible-bronchoscopy-compared-to-guideline-based-sedation-a-randomized-controlled-trial
#4
Roberto Mercado-Longoría, Carolina Armeaga-Azoños, Jasel Tapia-Orozco, Julio E González-Aguirre
INTRODUCTION: Evidence for the use of non-anesthesiologist-administered propofol for sedation during flexible bronchoscopy is scarce. The main objective of this study was to determine whether non-anesthesiologist-administered propofol balanced sedation was related to higher transcutaneous CO2 pressure compared with current guideline-based sedation (combination midazolam and opioid). Secondary outcomes were post-procedural recuperation time, patient satisfaction and frequency of adverse events...
April 11, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28382198/adverse-drug-reactions-in-therapeutic-hypothermia-after-cardiac-arrest
#5
Robert Witcher, Amy L Dzierba, Catherine Kim, Pamela L Smithburger, Sandra L Kane-Gill
BACKGROUND: Therapeutic hypothermia (TH) improves survival and neurologic function in comatose survivors of cardiac arrest. Many medications used to support TH have altered pharmacokinetics and pharmacodynamics during this treatment. It is unknown if or at what frequency the medications used during TH cause adverse drug reactions (ADRs). METHODS: A retrospective chart review was conducted for patients admitted to an intensive care unit (ICU) after cardiac arrest and treated with TH from January 2009 to June 2012 at two urban, university-affiliated, tertiary-care medical centres...
March 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28367282/intraoperative-monitoring-of-flash-visual-evoked-potential-under-general-anesthesia
#6
Hironobu Hayashi, Masahiko Kawaguchi
In neurosurgical procedures that may cause visual impairment in the intraoperative period, the monitoring of flash visual evoked potential (VEP) is clinically used to evaluate visual function. Patients are unconscious during surgery under general anesthesia, making flash VEP monitoring useful as it can objectively evaluate visual function. The flash stimulus input to the retina is transmitted to the optic nerve, optic chiasm, optic tract, lateral geniculate body, optic radiation (geniculocalcarine tract), and visual cortical area, and the VEP waveform is recorded from the occipital region...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28364198/drug-induced-sleep-endoscopy-with-target-controlled-infusion-using-propofol-and-monitored-depth-of-sedation-to-determine-treatment-strategies-in-obstructive-sleep-apnea
#7
Clemens Heiser, Phillippe Fthenakis, Alexander Hapfelmeier, Sebastian Berger, Benedikt Hofauer, Winfried Hohenhorst, Eberhard F Kochs, Klaus J Wagner, Guenther M Edenharter
BACKGROUND: Drug-induced sleep endoscopy (DISE) has become an important diagnostic examination tool in the treatment decision process for surgical therapies in the treatment of obstructive sleep apnea (OSA). Currently, there is a variety of regimes for the performance of DISE, which renders comparison and assessment across results difficult. It remains unclear how the different regimes influence the findings of the examination and the resulting conclusions and treatment recommendations...
March 31, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28356683/a-study-on-total-intravenous-anesthesia-in-orthognathic-surgical-procedures
#8
P L Vasundhar, Gokkulakrishnan Sadhasivam, Satya Bhushan, Siva Kalyan, Kho Chai Chiang
AIMS AND OBJECTIVE: To assess the use of propofol for induction and maintenance of anaesthesia among patients undergoing various combinations of orthognathic surgical procedures. MATERIALS AND METHODS: Following Preoperative evaluation, patients were given Fentanyl (2 micrograms/kg) intravenously. Induction (2 mg/kg) and maintenance (10 mg/kg/hr) of anaesthesia was achieved by Propofol infusion. Blood Pressure and heart rate were maintained at >70 or 80 mm Hg and >50 respectively and were monitored continuously...
July 2016: National Journal of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28351497/a-preferential-delivery-method-to-investigate-direct-neuromuscular-blockade-effect-of-inhaled-anesthetics-on-skeletal-muscle
#9
Ling Ye, Pingliang Yang
Inhaled anesthetics can enhance the effect of neuromuscular blocker, but whether inhaled anesthetics such as sevoflurane have a direct effect on skeletal muscle contractility is unknown. Selectively blocking skeletal muscle may prevent the interference effect of central nervous system. So we decided to evaluate a local application of neuromuscular blocker (NMB) atracurium to prevent the general effect on skeletal muscle. In part 1, sevoflurane (a inhaled anesthetic) minimum alveolar concentrations (MAC) of 1...
April 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28328583/case-report-of-a-patient-with-idiopathic-hypersomnia-and-a-family-history-of-malignant-hyperthermia-undergoing-general-anesthesia-an-overview-of-the-anesthetic-considerations
#10
Sena Aflaki, Sally Hu, Rami A Kamel, Frances Chung, Mandeep Singh
The pathophysiologic underpinnings of idiopathic hypersomnia and its interactions with anesthetic medications remain poorly understood. There is a scarcity of literature describing this patient population in the surgical setting. This case report outlines the anesthetic considerations and management plan for a 55-year-old female patient with a known history of idiopathic hypersomnia undergoing an elective shoulder arthroscopy in the ambulatory setting. In addition, this case offers a unique set of considerations and conflicts related to the patient having a family history of malignant hyperthermia...
March 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28306680/anaesthesia-in-patients-with-liver-disease
#11
Malgorzata H Starczewska, Wint Mon, Peter Shirley
PURPOSE OF REVIEW: The purpose of this review is to summarize the most recent up to date research data and recommendations regarding anaesthetic management of patients with liver disease undergoing surgery. The incidence of chronic liver disease (CLD) continues to rise and perioperative mortality and morbidity remains unacceptably high in this group. Meticulous preoperative assessment and carefully planned anaesthetic management are vital in improving outcomes in patients with liver disease undergoing surgery...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28286626/periodic-lateralized-epileptiform-discharges-can-survive-anesthesia-and-result-in-asymmetric-drug-induced-burst-suppression
#12
Edward C Mader, Louis A Cannizzaro, Frank J Williams, Saurabh Lalan, Piotr W Olejniczak
Drug-induced burst suppression (DIBS) is bihemispheric and bisymmetric in adults and older children. However, asymmetric DIBS may occur if a pathological process is affecting one hemisphere only or both hemispheres disproportionately. The usual suspect is a destructive lesion; an irritative or epileptogenic lesion is usually not invoked to explain DIBS asymmetry. We report the case of a 66-year-old woman with new-onset seizures who was found to have a hemorrhagic cavernoma and periodic lateralized epileptiform discharges (PLEDs) in the right temporal region...
February 20, 2017: Neurology International
https://www.readbyqxmd.com/read/28285382/impact-of-deep-sedation-on-the-electrophysiological-behavior-of-pulmonary-vein-and-non-pv-firing-during-catheter-ablation-for-atrial-fibrillation
#13
Ryohsuke Narui, Seiichiro Matsuo, Ryota Isogai, Kenichi Tokutake, Kenichi Yokoyama, Mika Kato, Keiichi Ito, Shin-Ichi Tanigawa, Seigo Yamashita, Michifumi Tokuda, Keiichi Inada, Kenri Shibayama, Satoru Miyanaga, Kenichi Sugimoto, Michihiro Yoshimura, Teiichi Yamane
PURPOSE: Catheter ablation for atrial fibrillation is performed with and without deep sedation, which could affect the arrhythmogenic activity during the procedure. We investigated the impact of sedation on electrophysiological properties in patients with AF who underwent catheter ablation. METHODS: This study consisted of 255 consecutive patients with atrial fibrillation (229 males, persistent: 105 patients) who underwent a single-catheter ablation procedure. The patients were divided into the following two groups according to the depth of sedation during the procedure: group M (mild sedation with flunitrazepam in 138 patients) and group D (deep sedation with propofol in 117 patients)...
March 11, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28274023/evaluation-of-fastrach-laryngeal-mask-airway-as-an-alternative-to-fiberoptic-bronchoscope-to-manage-difficult-airway-a-comparative-study
#14
Radhey Shyam, Ajay Kumar Chaudhary, Pushplata Sachan, Prithvi Kumar Singh, Gyan Prakash Singh, Vinod Kumar Bhatia, Girish Chandra, Dinesh Singh
INTRODUCTION: Awake intubation via Fiberoptic Bronchoscope (FB) is the gold standard for management of difficult airway but patients had to face problems like oxygen desaturation, tachycardia, hypertension and anxiety due to awake state. This study was conducted to assess feasibility of Fastrach Laryngeal Mask Airway (FLMA) to manage difficult airway as a conduit for intubation as well as for ventilation. MATERIALS AND METHODS: After ethical approval and informed consent, 60 patients with difficult airway were randomly enrolled in FB group and FLMA group...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28269717/assessment-of-sedation-analgesia-by-means-of-poincare%C3%AC-analysis-of-the-electroencephalogram
#15
Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia
Monitoring the levels of sedation-analgesia may be helpful for managing patient stress on minimally invasive medical procedures. Monitors based on EEG analysis and designed to assess general anesthesia cannot distinguish reliably between a light and deep sedation. In this work, the Poincaré plot is used as a nonlinear technique applied to EEG signals in order to characterize the levels of sedation-analgesia, according to observed categorical responses that were evaluated by means of Ramsay Sedation Scale (RSS)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28254512/electrocorticographic-delineation-of-human-auditory-cortical-fields-based-on-effects-of-propofol-anesthesia
#16
Kirill V Nourski, Matthew I Banks, Mitchell Steinschneider, Ariane E Rhone, Hiroto Kawasaki, Rashmi N Mueller, Michael M Todd, Matthew A Howard
The functional organization of human auditory cortex remains incompletely characterized. While the posteromedial two thirds of Heschl's gyrus (HG) is generally considered to be part of core auditory cortex, additional subdivisions of HG remain speculative. To further delineate the hierarchical organization of human auditory cortex, we investigated regional heterogeneity in the modulation of auditory cortical responses under varying depths of anesthesia induced by propofol. Non-invasive studies have shown that propofol differentially affects auditory cortical activity, with a greater impact on non-core areas...
February 27, 2017: NeuroImage
https://www.readbyqxmd.com/read/28253863/combined-use-of-dexmedetomidine-and-propofol-in-monitored-anesthesia-care-a-randomized-controlled-study
#17
Kyu Nam Kim, Hee Jong Lee, Soo Yeon Kim, Ji Yoon Kim
BACKGROUD: Although propofol and dexmedetomidine have been widely used for monitored anesthesia care, their adverse effects necessitate the search for better methods. Therefore, we performed this randomized controlled trial to evaluate the combined use of propofol and dexmedetomidine. METHODS: Eighty-seven adult patients undergoing hand surgery under brachial plexus block were randomly allocated to receive 1.6 μg/ml of the target effect site concentration of propofol (P group) and infusion of 0...
March 1, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28238025/anesthetic-management-of-abdominal-radical-trachelectomy-for-uterine-cervical-cancer-during-pregnancy
#18
Jun Terukina, Misako Takamatsu, Takayuki Enomoto, Hiroshi Baba
Abdominal radical trachelectomy has been identified as a surgical option for fertility preservation in cervical cancer patients, particularly in pregnant women who strongly desire to continue their pregnancy. Since this procedure requires operating in the uterus, the hardness of the uterus can affect the ease of surgery. Generally, sevoflurane is used for anesthesia in non-obstetric surgery for pregnant women because uterine relaxation is advantageous for uterine blood flow maintenance. However, the use of sevoflurane during radical trachelectomy has not been thoroughly evaluated...
February 25, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28235515/case-report-neuromuscular-block-induced-by-rocuronium-following-sugammadex-administration
#19
Tugba Askin, Suheyla Unver, Deniz Oguz, Kubra Kutay
We present a case in which rocuronium was applied for muscle relaxation following the administration of sugammadex. An emergency surgery under general anesthesia was planned for a 43-year-old male patient due to an L1 vertebral corpus and right tibia-fibula shaft fracture. Anesthesia was induced with fentanyl, propofol and lidocaine. After applying only 30mg of the total induction dose of rocuronium, it was learned that the neurological examination should be controlled again from the surgeon because of the controversial of the neurological deficit...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235495/use-of-sugammadex-in-an-octagenerian-with-myaesthenia-gravis-undergoing-emergency-laporotomy
#20
Deep Shah, Aynkaran Dharmarajah
BACKGROUND: Myaesthenia Gravis is an autoimmune disorder that results in increased sensitivity to neuromuscular blockers. Anaesthesia and surgery in patients with Myaesthenia Gravis is associated with an increased incidence of complications, including post operative ventilation. We report the successful use of intra-operative train of four ratio monitoring and Sugammadex to reverse rocuronium induced neuromuscular blockade in an elderly octagenarian with Myaesthenia Gravis undergoing an emergency laporotomy...
February 2017: Journal of Clinical Anesthesia
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