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Propofol monitoring

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https://www.readbyqxmd.com/read/28213945/optimization-of-initial-propofol-bolus-dose-for-eeg-narcotrend-index-guided-transition-from-sevoflurane-induction-to-intravenous-anesthesia-in-children
#1
Nils Dennhardt, Dietmar Boethig, Christiane Beck, Sebastian Heiderich, Martin Boehne, Andreas Leffler, Barbara Schultz, Robert Sümpelmann
BACKGROUND: Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. OBJECTIVE: The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI)...
February 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28210094/endoscopic-ultrasound-sedation-in-the-united-kingdom-is-life-without-propofol-tolerable
#2
Jennifer Anne Campbell, Andrew James Irvine, Andrew Derek Hopper
There is compelling evidence to support the quality, cost effectiveness and safety profile of non-anesthesiologist-administered propofol for endoscopic ultrasound (EUS). However in the United Kingdom, it is recommended that the administration and monitoring of propofol sedation for endoscopic procedures should be the responsibility of a dedicated and appropriately trained anaesthetist only. The majority of United Kingdom EUS procedures are performed with opiate and benzodiazepine sedation rather than anaesthetist led propofol lists due to anaesthetist resource availability...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28197775/individual-indicators-of-appropriate-hypnotic-level-during-propofol-anesthesia-highest-alpha-power-and-effect-site-concentrations-of-propofol-at-loss-of-response
#3
Hongling Kang, Hassan Mamdouh Hassan Mohamed, Masaki Takashina, Takahiko Mori, Yuji Fujino, Satoshi Hagihira
BACKGROUND: Electroencephalogram (EEG) waveforms vary widely among individuals, this decreases the usefulness of BIS™ monitors for assessing the effects of propofol. Practically, anesthesia is only seen as too deep when evidence of burst-suppression is seen. We designed an experiment to help towards better assessment of individual anesthetic needs. First, to mark the Ce (effect-site concentration) of propofol at loss of response to calling name and gently shaking shoulders (LOR), we defined Ce-LOR...
February 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28183578/a-case-of-central-diabetes-insipidus-after-ketamine-infusion-during-an-external-to-internal-carotid-artery-bypass
#4
Sharib Gaffar, Jonathan P Eskander, Burton D Beakley, Brian P McClure, Peter Amenta, Nakeisha Pierre
STUDY OBJECTIVE: We report the first teenage case of ketamine-induced transient central diabetes insipidus. CASE SUMMARY: The patient was an 18-year-old woman with moyamoya disease undergoing an external carotid to internal carotid bypass and given a low-dose ketamine infusion. After approximately 2 hours in the supine position, with 0.5 Minimum Alveolar Concentration (MAC) of sevoflurane, a propofol infusion at 50 μg/kg/min, a remifentanil infusion at 0.5 μg/kg/min, and a ketamine infusion at a dose of 10 μg/kg/min, this patient had an excessive urine output...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28177568/the-influence-of-parents-voice-on-the-consumption-of-propofol-for-pediatric-procedural-sedation-a-randomized-controlled-trial
#5
Eva Tschiedel, Victoria Heck, Ursula Felderhoff-Mueser, Christian Dohna-Schwake
BACKGROUND: In pediatric patients, invasive procedures such as the insertion of a central venous catheter or gastroscopy require deep sedation. It is unknown whether listening to parental voice during deep sedation in children can reduce sedative doses. AIM: The aim of this prospective study was to determine the effect of listening to a parent's voice during deep sedation on consumption of sedatives in children. METHODS: Fifty children aged 2-14 years undergoing central line placement or gastroscopy under deep sedation with propofol were randomly assigned to two groups: (A) listening or (B) not listening their parents' recorded voice reading a standardized text by the use of earphones...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28177205/monitoring-depth-of-sedation-evaluating-the-agreement-between-the-bispectral-index-qcon-and-the-entropy-module-s-state-entropy-during-flexible-bronchoscopy
#6
Johannes N Müller, Matthias Kreuzer, Paul S García, Gerhard Schneider, Hubert Hautmann
BACKGROUND: We investigated the correlation and agreement of three depth of anesthesia indices, bispectral index (BIS), qCON and state entropy (SE), during propofol sedation, because there is extensive literature that deals with the comparability of these indices during general anesthesia, but not during sedation. METHODS: We recorded electroencephalogram (EEG) and SE trend data, using the Entropy Module from 21 patients who underwent elective bronchoscopy with target-controlled infusion of propofol...
February 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28171856/the-safety-of-laryngeal-mask-airway-assisted-bronchoscopy-versus-standard-nasal-bronchoscopy
#7
Daniel Alon, Barak Pertzov, Evgeni Gershman, Miryam Frishman, Nader Abdel Rahman, Dror Rosengarten, Mordechai R Kramer
BACKGROUND: The use of laryngeal mask airway (LMA) for fiberoptic bronchoscopy was first described in 1982. The LMA was found to be beneficial in operator view, flexibility, and also in maintaining stable oxygen saturation. Despite its advantages, the use of LMA has not become widespread. OBJECTIVE: The aim of this paper was to evaluate the safety of LMA-assisted bronchoscopy compared to standard nasal bronchoscopy. METHODS: We conducted a prospective randomized trial...
February 8, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28165304/effects-of-acepromazine-and-trazodone-on-anesthetic-induction-dose-of-propofol-and-cardiovascular-variables-in-dogs-undergoing-general-anesthesia-for-orthopedic-surgery
#8
Lindsey A Murphy, Michele Barletta, Lynelle F Graham, Lorna J Reichl, Margaret M Duxbury, Jane E Quandt
OBJECTIVE To compare the doses of propofol required to induce general anesthesia in dogs premedicated with acepromazine maleate or trazodone hydrochloride and compare the effects of these premedicants on cardiovascular variables in dogs anesthetized for orthopedic surgery. DESIGN Prospective, randomized study. ANIMALS 30 systemically healthy client-owned dogs. PROCEDURES 15 dogs received acepromazine (0.01 to 0.03 mg/kg [0.005 to 0.014 mg/lb], IM) 30 minutes before anesthetic induction and 15 received trazodone (5 mg/kg [2...
February 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28147385/presentation-of-a-sedation-standard-using-the-example-of-transesophageal-echocardiographies-tee-in-pediatric-outpatients
#9
H Sauer, J Pfeifer, S Gräber, H Abdul-Khaliq
Introduction Most pediatric patients require deep sedation for a TEE examination. We analyzed the data of our sedation protocols relating to all outpatient TEEs in patients under 18 years of age for the year 2011. On the basis of the data records of a total of 40 patients, we will describe our standard and compare it with the findings of the international literature. Material and Methods In a retrospective analysis, we inspected our sedation protocols in terms of patient-related data, vital parameters, drug applications, occurring complications and necessary interventions as well as nausea and vomiting during the post-sedative monitoring phase...
January 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28107273/influence-of-depth-of-hypnosis-on-pupillary-reactivity-to-a-standardized-tetanic-stimulus-in-patients-under-propofol-remifentanil-target-controlled-infusion-a-crossover-randomized-pilot-study
#10
Nada Sabourdin, Jean-Baptiste Peretout, Eliane Khalil, Marie-Laurence Guye, Nicolas Louvet, Isabelle Constant
BACKGROUND: Pupillometry allows the measurement of pupillary diameter variations in response to nociceptive stimuli. This technique has been used to monitor the balance between analgesia and nociception. Under general anesthesia, the amplitude of pupillary dilation is related to the amount of administered opioids. The objective of this study was to determine whether at a constant infusion rate of opioids, the pupillary response was influenced by depth of hypnosis assessed by the bispectral index (BIS)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28106793/hybrid-intelligent-system-to-perform-fault-detection-on-bis-sensor-during-surgeries
#11
José-Luis Casteleiro-Roca, José Luis Calvo-Rolle, Juan Albino Méndez Pérez, Nieves Roqueñí Gutiérrez, Francisco Javier de Cos Juez
This paper presents a new fault detection system in hypnotic sensors used for general anesthesia during surgery. Drug infusion during surgery is based on information received from patient monitoring devices; accordingly, faults in sensor devices can put patient safety at risk. Our research offers a solution to cope with these undesirable scenarios. We focus on the anesthesia process using intravenous propofol as the hypnotic drug and employing a Bispectral Index (BIS(TM)) monitor to estimate the patient's unconsciousness level...
January 18, 2017: Sensors
https://www.readbyqxmd.com/read/28097611/assessing-nitrous-oxide-effect-using-electroencephalographically-based-depth-of-anesthesia-measures-cortical-state-and-cortical-input
#12
Levin Kuhlmann, David T J Liley
Existing electroencephalography (EEG) based depth of anesthesia monitors cannot reliably track sedative or anesthetic states during n-methyl-D-aspartate (NMDA) receptor antagonist based anesthesia with ketamine or nitrous oxide (N2O). Here, a physiologically-motivated depth of anesthesia monitoring algorithm based on autoregressive-moving-average (ARMA) modeling and derivative measures of interest, Cortical State (CS) and Cortical Input (CI), is retrospectively applied in an exploratory manner to the NMDA receptor antagonist N2O, an adjuvant anesthetic gas used in clinical practice...
January 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28078617/changes-in-the-first-postoperative-night-bispectral-index-of-patients-after-thyroidectomy-with-different-types-of-primary-anesthetic-management-a-randomized-controlled-trial
#13
Wen-Fei Tan, Zhi-Lin Wang, Hong Ma, Feng Jin, Huang-Wei Lu
Despite major advances in anesthesia management and developments in anesthetic agents, postoperative sleep disturbances remain dissatisfactory for many patients. We hypothesized that propofol might have a subtle influence on sleep after thyroidectomy compared to sevoflurane. A randomized, single-blinded, controlled trial was conducted at the First Hospital of China Medical University from October 2014 to October 2015. One hundred and twenty-four patients undergoing thyroidectomy were enrolled and received sevoflurane (sevoflurane group) or propofol (propofol group) as anesthesia maintenance...
January 12, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28076483/sedation-in-colonoscopy-by-using-three-different-propofol-infusion-methods-and-analysis-of-plasma-concentration-levels-a-prospective-comparative-study
#14
Paulo Henrique Boaventura de Carvalho, José Pinhata Otoch, Mohamad Ali Khan, Paulo Sakai, Hugo Gonçalo Guedes, Everson Luiz de Almeida Artifon
Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients. Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies. Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28070653/impact-of-acute-changes-in-perfusion-index-and-blood-pressure-on-the-accuracy-of-non-invasive-continuous-hemoglobin-concentration-measurements-during-induction-of-anesthesia
#15
Junichi Saito, Masato Kitayama, Erika Amanai, Kentaro Toyooka, Kazuyoshi Hirota
PURPOSE: Several factors affect the accuracy of non-invasive continuous hemoglobin concentration (SpHb) measurements. We had previously shown an increase in the perfusion index (PI) following induction of anesthesia which was associated with an increase in the difference between SpHb and total hemoglobin (tHb) (SpHb-tHb). We hypothesized that blunting the increase in PI by maintaining blood pressure during induction of anesthesia would improve the agreement between SpHb and tHb measurements...
January 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28060257/drug-induced-sleep-endoscopy-dise-with-target-controlled-infusion-tci-and-bispectral-analysis-in-obstructive-sleep-apnea
#16
Maximilian Traxdorf, Klaus Tschaikowsky, Claudia Scherl, Judith Bauer, Heinrich Iro, Florian Angerer
The aim of this study was to establish a standardized protocol for drug-induced sleep endoscopy (DISE) to differentiate obstruction patterns in obstructive sleep apnea (OSA). Target-controlled infusion (TCI) of the sedative propofol was combined with real-time monitoring of the depth of sedation using bispectral analysis. In an observational study 57 patients (mean age 44.8 years, ± SD 10.5; mean apnea hypopnea Index (AHI) 30.8/hr, ± SD 21.6, mean BMI 28.2 kg/m(2), ± SD 5.3) underwent cardiorespiratory polysomnography followed by DISE with TCI and bispectral analysis...
December 6, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28050480/comparison-of-dexmedetomidine-propofol-versus-fentanyl-propofol-on-insertion-conditions-of-proseal-laryngeal-mask-airway
#17
Shalaka Sandeep Nellore, Abhijeet Dattatray Waychal, Preeti Sachin Rustagi
INTRODUCTION: Proseal Laryngeal Mask Airway (PLMA) is a newer supraglottic airway device that requires adequate depth of anaesthesia and suppression of upper airway reflexes thereby providing optimal insertion conditions. AIM: To compare dexmedetomidine and fentanyl for co-induction with propofol with respect to PLMA insertion conditions, haemodynamic variation and the total dose requirement of propofol. MATERIALS AND METHODS: This was a prospective randomized double-blinded study conducted in 60 cases of American Society of Anaesthesiologists (ASA) class I/II undergoing elective surgery under general anaesthesia...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28050479/dexmedetomidine-in-attenuation-of-haemodynamic-response-and-dose-sparing-effect-on-opioid-and-anaesthetic-agents-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-study
#18
Nandlal Bhagat, Md Yunus, Habib Md Reazaul Karim, Ranendra Hajong, Prithwis Bhattacharyya, Manorama Singh
INTRODUCTION: Perioperative procedures are stressful and lead to haemodynamic instability with potentially devastating consequences. Dexmedetomidine is found to have many of the desired characteristics that are required in perioperative period. AIM: To evaluate the ability of pre and intraoperative dexmedetomidine to attenuate stress induced haemodynamic responses, quantifying the anaesthetic agents sparing as well as its cost-effectiveness in patients undergoing laparoscopic cholecystectomy...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28045856/a-multiparametric-alarm-criterion-for-motor-evoked-potential-monitoring-during-spine-deformity-surgery
#19
Martín J Segura, María E Talarico, Mariano A Noel
PURPOSE: This is a pilot study to compare changes in the amplitude, area below the curve, number of phases, duration, and latency of the intraoperative transcranial motor evoked potentials (TcMEP) for early detection of impending spinal cord injury. An empirical ratio calculated by a combination of the above-mentioned parameters was also assessed. METHODS: Intraoperative TcMEP recordings from five patients presenting with neuromuscular kyphoscoliosis, idiopathic scoliosis, achondroplasia and lumbar kyphosis, congenital kyphosis, and achondroplasia with cervical instability were reviewed...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28045723/rate-dependent-left-bundle-branch-block-in-an-ambulatory-surgery-patient-a-case-report
#20
Ashraf Farag, Justin Tsai, Sam Deeb, Deidre Putman-Garcia, John D Wasnick, Lydia A Conlay
A 52-year-old woman, ASA II (American Society of Anesthesia classification II) scheduled for cholecystectomy in an ambulatory center, exhibited a wide-complex tachycardia with ectopy on the monitor after induction with propofol and succinylcholine. Blood pressure remained stable; amiodarone was administered for presumed ventricular tachycardia. A 12-lead electrocardiogram (ECG) showed a new left bundle branch block (LBBB) at 98 beats per minute (bpm), which resolved when the heart rate slowed. Surgery was postponed, and both the LBBB and ectopy recurred frequently during the next 24 hours in the intensive care unit, particularly at heart rates >90 bpm...
February 15, 2017: A & A Case Reports
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