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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28227981/assessment-of-sedation-analgesia-by-means-of-poincare%C3%AC-analysis-of-the-electroencephalogram
#12
Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia, Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia, Jose D Bolanos, Xavi Borrat, Jose F Valencia, Montserrat Vallverdu, Pere Caminal, Pedro L Gambus, Daniel 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/28220762/drug-detection-in-breath-non-invasive-assessment-of-illicit-or-pharmaceutical-drugs
#13
Phillip Trefz, Svend Kamysek, Patricia Fuchs, Pritam Sukul, Jochen Schubert, Wolfram Miekisch
Breath analysis not only holds great potential for the development of new non-invasive diagnostic methods, but also for the identification and follow up of drug levels in breath. This is of interest for both, forensic and medical science. On the one hand, the detection of drugs of abuse in exhaled breath - similar to the well-known breath alcohol tests - would be highly desirable as an alternative to blood or urine analysis in situations such as police controls for drugged driving. The noninvasive detection of drugs and their metabolites is thus of great interest in forensic science, especially since marijuana is becoming legalized in certain parts of the U...
February 21, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28219129/-effects-of-sevoflurane-and-desflurane-on-pharmacodynamics-of-rocuronium-in-children
#14
D X Kang, Y Q Rao, B Ji, J Li
Objective: To observe the intraoperative influences on pharmacodynamics of rocuronium in children inhaling sevoflurane and desflurane for 40 min balance. Methods: Ninety children (ASAⅠ-Ⅱ) undergoing elective surgery with general anesthesia in Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University from July 2015 to May 2016 were randomly assigned into six groups (n=15): Sevoflurane group (group S1 and S2), Desflurane group (group D1 and D2) and Propofol group (group P1 and P2)...
February 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28217049/effectiveness-of-sodium-thiopentone-propofol-and-etomidate-as-an-ideal-intravenous-anesthetic-agent-for-modified-electroconvulsive-therapy
#15
Altaf Hussain Mir, Nida Farooq Shah, Mehraj Ud Din, Shabir Ahmad Langoo, Fayaz Ahmad Reshi
INTRODUCTION: Electroconvulsive therapy (ECT) is a well-established psychiatric treatment in which seizures are electrically induced in patients for therapeutic effects. ECT can produce severe disturbances in the cardiovascular system and a marked increase in cerebral blood flow and intracranial pressure. These cardiovascular changes may be altered using various anesthetic drugs. AIM AND OBJECTIVES: This study was undertaken to compare the effects of intravenous (IV) sodium thiopentone, propofol, and etomidate, used as IV anesthetic agents in modified ECT as regards, induction time and quality of anesthesia, alteration of hemodynamics, seizure duration, and recovery time...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216706/monitored-anaesthesia-care-comparison-of-nalbuphine-dexmedetomidine-versus-nalbuphine-propofol-for-middle-ear-surgeries-a-double-blind-randomised-trial
#16
Srinivasa Rao Nallam, Sunil Chiruvella, Anjineswar Reddy
BACKGROUND AND AIMS: Middle ear surgeries (MESs) are usually performed under sedation with local anaesthesia and can be well tolerated by the patient with minimal discomfort. In the present study, we compare the effect of nalbuphine/dexmedetomidine combination with nalbuphine/propofol on sedation and analgesia in monitored anaesthesia care. METHODS: One hundred adult patients undergoing MESs under monitored anaesthesia care (MAC) were randomly allocated into two groups...
January 2017: Indian Journal of Anaesthesia
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
#17
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
#18
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
#19
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
#20
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
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