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Sedation sevoflurane

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https://www.readbyqxmd.com/read/29756489/sevoflurane-exerts-brain-protective-effects-against-sepsis-associated-encephalopathy-and-memory-impairment-through-caspase-3-9-and-bax-bcl-signaling-pathway-in-a-rat-model-of-sepsis
#1
Nurdan Bedirli, Emin Umit Bagriacik, Guldal Yilmaz, Zerrin Ozkose, Mustafa Kavutçu, Aslı Cavunt Bayraktar, Abdulkadir Bedirli
Objective We compared the effects of sevoflurane and isoflurane on systemic inflammation, sepsis-associated encephalopathy, and memory impairment in a rat sepsis model of cecal ligation and puncture (CLP)-induced polymicrobial peritonitis. Methods Twenty-four rats were assigned to sham, CLP, CLP + sevoflurane, and CLP + isoflurane groups. At 72 hours after CLP, the rats underwent behavior tests. Serum cytokines were evaluated. Brain tissue samples were collected for determination of glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase; the wet/dry weight ratio; myeloperoxidase (MPO) and malondialdehyde (MDA); apoptotic gene release; and histologic examinations...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29707324/non-intubated-thoracoscopic-bullectomy-under-sedation-is-safe-and-comfortable-in-the-perioperative-period
#2
Jinwook Hwang, Jae Seung Shin, Joo Hyung Son, Too Jae Min
Background: Non-intubated thoracoscopic surgery can be performed under sedation using adjuvant regional anesthesia, however, the benefits of non-intubated thoracoscopic surgery under sedation have not yet been completely verified. In this study, we compare the perioperative safety and pain complaints of sedation without intubation in thoracoscopic bullectomy with that of conventional general anesthesia with double-lumen intubation and mechanical ventilation. Methods: Forty-one patients with primary spontaneous pneumothorax who were scheduled for thoracoscopic bullectomy were enrolled in this study...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29559484/extracorporeal-membrane-oxygenation-ecmo-for-near-fatal-asthma-refractory-to-conventional-ventilation
#3
Usman Maqsood, Nehal Patel
We describe a case of near-fatal asthma, treated successfully by initiation of extracorporeal membrane oxygenation (ECMO). A 29-year-old woman, known asthmatic on steroid inhalers, inhaled/nebulised bronchodilators, long-term oral prednisolone, theophylline and montelukast, presented with acute shortness of breath. She deteriorated following initial treatment with nebulised bronchodilators and magnesium sulfate requiring intubation and mechanical ventilation. Severe bronchospasm ensued following mechanical ventilation and peak airway pressures remained at 55 cm H2 O with intrinsic positive end expiratory pressure(PEEP) of 14 cm H2 O...
March 20, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29557840/an-exploratory-study-of-sevoflurane-as-an-alternative-for-difficult-sedation-in-critically-ill-children
#4
Santiago Mencía, Alba Palacios, Miriam García, Ana M Llorente, Olga Ordóñez, Blanca Toledo, Jesús López-Herce
OBJECTIVES: To analyze the effectiveness of inhaled sevoflurane in critically ill children with challenging sedation. DESIGN: Prospective case series. SETTING: Two PICUs of university hospitals in Spain. INTERVENTIONS: Prospective observational study and exploratory investigation conducted in two PICUs in Madrid, Spain, over a 6-year period. Children treated with inhaled sevoflurane due to difficult sedation were included...
March 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29557378/neuroprotective-effect-of-bispectral-index-guided-fast-track-anesthesia-using-sevoflurane-combined-with-dexmedetomidine-for-intracranial-aneurysm-embolization
#5
Chao-Liang Tang, Juan Li, Zhe-Tao Zhang, Bo Zhao, Shu-Dong Wang, Hua-Ming Zhang, Si Shi, Yang Zhang, Zhong-Yuan Xia
Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1...
February 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29524200/prevalence-of-discordant-elevations-of-state-entropy-and-bispectral-index-in-patients-at-amnestic-sevoflurane-concentrations-a-historical-cohort-study
#6
Richard H Epstein, Joni M Maga, Michael E Mahla, Eric S Schwenk, Marc J Bloom
BACKGROUND: Processed electroencephalogram (EEG) monitors help assess the hypnotic state during general anesthesia or sedation. Maintaining the bispectral index (BIS) or state entropy (SE) between 40 and 60 has been recommended to mitigate anesthesia awareness. Nonetheless, SEs > 70 were frequently observed at end-tidal sevoflurane concentrations unlikely to allow awareness. We sought to determine the prevalence of elevated discordant measurements during BIS and SE monitoring. METHODS: Electronic data collected over 11 months at two academic hospitals were retrospectively reviewed...
May 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29455032/sevoflurane-for-procedural-sedation-in-critically-ill-patients-a-pharmacokinetic-comparative-study-between-burn-and-non-burn-patients
#7
Sebastien Perbet, Daniel Bourdeaux, Alexandre Lenoire, Claire Biboulet, Bruno Pereira, Malha Sadoune, Benoit Plaud, Jean-Marie Launay, Jean-Etienne Bazin, Valerie Sautou, Alexandre Mebazaa, Pascal Houze, Jean-Michel Constantin, Matthieu Legrand
BACKGROUND: Sevoflurane has anti-inflammatory proprieties and short lasting effects making it of interest for procedural sedation in critically ill patients. We evaluated the pharmacokinetics of sevoflurane and metabolites in severely ill burn patients and controls. The secondary objective was to assess potential kidney injury. METHODS: Prospective interventional study in a burn and a surgical intensive care unit; 24 mechanically ventilated critically ill patients (12 burns, 12 controls) were included...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29416248/a-prospective-randomized-study-comparing-recovery-following-anesthesia-with-a-combination-of-intravenous-dexmedetomidine-and-desflurane-or-sevoflurane-in-spinal-surgeries
#8
Yogita Patil, Suyog Bagade, Nilesh Patil, Nalini Jadhav
Background and Aims: Desflurane and sevoflurane are inhalational anesthetics which provide stable intraoperative hemodynamics and rapid emergence from anesthesia. Dexmedetomidine is an α2-agonist with sedative and hypnotic effects. We compared recovery following anesthesia with a combination of a continuous intravenous infusion of dexmedetomidine and desflurane or sevoflurane in cases of spine surgeries because no such data are available from India. Material and Methods: It was a single-blind, prospective, randomized study...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29416243/sevoflurane-sparing-effect-of-dexmedetomidine-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#9
Preeti Sharma, Satinder Gombar, Vanita Ahuja, Aditi Jain, Usha Dalal
Background and Aims: Sevoflurane is an excellent but expensive anesthetic agent for laparoscopic cholecystectomy. To decrease sevoflurane consumption during surgery adjuvants like dexmedetomidine may be used. Dexmedetomidine is a recently introduced drug which alleviates the stress response of surgery, produces sedation and analgesia. We aimed to evaluate sevoflurane sparing effect of dexmedetomidine in patients undergoing laparoscopic cholecystectomy under entropy-guided general anesthesia (GA)...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29390298/comparison-of-hemodynamic-effects-of-sevoflurane-and-ketamine-as-basal-anesthesia-by-a-new-and-direct-monitoring-during-induction-in-children-with-ventricular-septal-defect-a-prospective-randomized-research
#10
RANDOMIZED CONTROLLED TRIAL
Ding Han, Ya-Guang Liu, Shoudong Pan, Yi Luo, Jia Li, Chuan Ou-Yang
BACKGROUND: Sevoflurane and ketamine are commonly used to obtain sedation and facilitate intravenous anesthetic induction in children undergoing cardiac surgery who are uncooperative. We used a new and direct systemic hemodynamic monitoring technique pressure recording analytical method and compared the hemodynamic effects of sevoflurane and ketamine to facilitate intravenous anesthetic induction. METHODS: Forty-four children with ventricular septal defect (2.2 ± 1...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388094/a-technical-review-of-the-history-development-and-performance-of-the-anaesthetic-conserving-device-anaconda-for-delivering-volatile-anaesthetic-in-intensive-and-post-operative-critical-care
#11
REVIEW
Ron Farrell, Glen Oomen, Pauric Carey
There is a shift in critical care to adopt volatile anaesthetics as sedatives for certain patients using mechanical ventilation. Accompanying this shift is a growing body of literature describing the advantages or disadvantages of using isoflurane or sevoflurane for long term sedation. This practise requires a cost effective, efficient and safe means to deliver these drugs that can simultaneously operate with modern critical care ventilators and ventilation protocols while protecting the care environment and care workers from excessive exposure to the drugs...
January 31, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29376749/beneficial-effects-of-inhaled-nitric-oxide-with-intravenous-steroid-in-an-ischemia-reperfusion-model-involving-aortic-clamping
#12
Waldemar Gozdzik, Stanisław Zielinski, Marzena Zielinska, Kornel Ratajczak, Piotr Skrzypczak, Sylwia Rodziewicz, Andrzej Kübler, Kalle Löfström, Piotr Dziegiel, Mateusz Olbromski, Barbara Adamik, Stanislaw Ryniak, Piotr Harbut, Johanna Albert, Claes Frostell
This study evaluated the effects of inhaled nitric oxide (iNO) therapy combined with intravenous (IV) corticosteroids on hemodynamics, selected cytokines, and kidney messenger RNA toll-like receptor 4 (mRNA TLR4) expression in ischemia-reperfusion injury animal model. The primary endpoint was the evaluation of circulatory, respiratory, and renal function over time. We also investigated the profile of selected cytokines and high-mobility group box 1 (HMGB1) protein, as well as renal mRNA TLR4 activation determined by quantitative real-time polymerase chain reaction analysis...
January 2018: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/29341401/the-prediction-probabilities-for-emergence-from-sevoflurane-anesthesia-in-children-a-comparison-of-the-perfusion-index-and-the-bispectral-index
#13
Pei-Pei Liu, Chi Wu, Jun-Zheng Wu, Ma-Zhong Zhang, Ji-Jian Zheng, Yang Shen, Pan He, Ying Sun
BACKGROUND: Predicting recovery of consciousness is one of the most essential functions of anesthesia depth monitors in anesthesia practice. Perfusion index and bispectral index are 2 indicators of the anesthesia depth monitoring with different working principles. The progression of the anesthesia emergence stages reflected by those monitors has not been well understood, especially in pediatric patients. The goals of this study were to compare the prediction probabilities of perfusion index and bispectral index in predicting awakening and in differentiating the different levels of arousal during emergence after sevoflurane anesthesia in children undergoing open inguinal hernia repairs...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29304735/effect-of-single-dose-dexmedetomidine-on-postoperative-recovery-after-ambulatory-ureteroscopy-and-ureteric-stenting-a-double-blind-randomized-controlled-study
#14
I I Shariffuddin, W H Teoh, S Wahab, C Y Wang
BACKGROUND: Ambulatory surgery has recently gain popularity, as it is a good method of optimizinghospital resources utilization. To support ambulatory surgery, anaesthetic goals nowrevolve around patients' early recovery with minimal pain and nausea, expedientdischarge home and prompt resumption of activities of daily living. In this study, weevaluated the effect of a single pre-induction dose of dexmedetomidine on anaestheticrequirements, postoperative pain and clinical recovery after ambulatory ureteroscopy andureteric stenting under general anaesthesia...
January 5, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29280254/characterization-of-the-functional-near-infrared-spectroscopy-response-to-nociception-in-a-pediatric-population
#15
Vanessa A Olbrecht, Yifei Jiang, Luigi Viola, Charlotte M Walter, Hanli Liu, Charles D Kurth
BACKGROUND: Near-infrared spectroscopy can interrogate functional optical signal changes in regional brain oxygenation and blood volume to nociception analogous to functional magnetic resonance imaging. AIMS: This exploratory study aimed to characterize the near-infrared spectroscopy signals for oxy-, deoxy-, and total hemoglobin from the brain in response to nociceptive stimulation of varying intensity and duration, and after analgesic and neuromuscular paralytic in a pediatric population...
February 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29245269/volatile-sedation-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#16
REVIEW
Ha Yeon Kim, Ja Eun Lee, Ha Yan Kim, Jeongmin Kim
BACKGROUND: Volatile sedation in the intensive care unit (ICU) may reduce the number of adverse events and improve patient outcomes compared with intravenous (IV) sedation. We performed a systematic review and meta-analysis comparing the effects of volatile and IV sedation in adult ICU patients. METHODS: We searched the PubMed, Embase, Cochrane Central Register, and Web of Science databases for all randomized trials comparing volatile sedation using an anesthetic-conserving device (ACD) with IV sedation in terms of awakening and extubation times, lengths of ICU and hospital stay, and pharmacologic end-organ effects...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29187413/impact-of-inhalational-versus-intravenous-anaesthesia-on-early-delirium-and-long-term-survival-in-elderly-patients-after-cancer-surgery-study-protocol-of-a-multicentre-open-label-and-randomised-controlled-trial
#17
Yue Zhang, Hui-Juan Li, Dong-Xin Wang, Hui-Qun Jia, Xu-De Sun, Ling-Hui Pan, Qing-Shan Ye, Wen Ouyang, Zhen Jia, Fang-Xiang Zhang, Yong-Qing Guo, Yan-Qiu Ai, Bin-Jiang Zhao, Xu-Dong Yang, Qin-Gong Zhang, Ning Yin, Hong-Yu Tan, Zhi-Heng Liu, Jian-Bo Yu, Daqing Ma
INTRODUCTION: Elderly patients who have solid organ cancer often receive surgery. Some of them may develop delirium after surgery and delirium development is associated with worse outcomes. Furthermore, despite all of the advances in medical care, the long-term survival in cancer patients is far from optimal. Evidences suggest that choice of anaesthetics during surgery, that is, either inhalational or intravenous anaesthetics, may influence outcomes. However, the impact of general anaesthesia type on the occurrence of postoperative delirium is inconclusive...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132231/the-use-of-desflurane-for-neurosurgical-procedures-in-rhesus-macaque-macaca-mulatta
#18
Henri Gmj Bertrand, Charlotte Sandersen, Paul A Flecknell
Volatile agents are widely used to anaesthetise laboratory non-human primates as they allow a rapid induction and recovery as well as an easy adjustment of the anaesthesia plan. Desflurane is currently the volatile agent with the lowest solubility in blood, and hence enables the most rapid onset of anaesthesia and most rapid recovery. This study aimed to investigate the suitability of desflurane for maintenance of general anaesthesia in rhesus macaques undergoing elective experimental neurosurgery. Fourteen primates (five males and nine females) were sedated with ketamine (10 mg kg-1 ) and anaesthesia was induced with propofol (usually 8 mg kg-1 IV)...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/29121298/human-neural-correlates-of-sevoflurane-induced-unconsciousness
#19
B J A Palanca, M S Avidan, G A Mashour
Sevoflurane, a volatile anaesthetic agent well-tolerated for inhalation induction, provides a useful opportunity to elucidate the processes whereby halogenated ethers disrupt consciousness and cognition. Multiple molecular targets of sevoflurane have been identified, complementing imaging and electrophysiologic markers for the mechanistically obscure progression from wakefulness to unconsciousness. Recent investigations have more precisely detailed scalp EEG activity during this transition, with practical clinical implications...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29039138/the-role-of-gaba-receptor-agonists-in-anesthesia-and-sedation
#20
REVIEW
Janette Brohan, Basavana G Goudra
GABA (γ-aminobutyric acid) receptors, of which there are two types, are involved in inhibitory synapses within the central nervous system. The GABAA receptor (GABAAR) has a central role in modern anesthesia and sedation practice, which is evident from the high proportion of agents that target the GABAAR. Many GABAAR agonists are used in anesthesia practice and sedation, including propofol, etomidate, methohexital, thiopental, isoflurane, sevoflurane, and desflurane. There are advantages and disadvantages to each GABAAR agonist currently in clinical use...
October 2017: CNS Drugs
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