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Sedation sevoflurane

Patrick Kellner, Mattia Müller, Tobias Piegeler, Philipp Eugster, Christa Booy, Martin Schläpfer, Beatrice Beck-Schimmer
BACKGROUND: Patients experiencing acute lung injury (ALI) often need mechanical ventilation for which sedation may be required. In such patients, usually the first choice an intravenously administered drug. However, growing evidence suggests that volatile anesthetics such as sevoflurane are a valuable alternative. In this study, we evaluate pulmonary and systemic effects of long-term (24-hour) sedation with sevoflurane compared with propofol in an in vivo animal model of ALI. METHODS: Adult male Wistar rats were subjected to ALI by intratracheal lipopolysaccharide (LPS) application, mechanically ventilated and sedated for varying intervals up to 24 hours with either sevoflurane or propofol...
October 24, 2016: Anesthesia and Analgesia
Christopher F Tirotta, Tuan Nguyen, Steven Fishberger, Evelio Velis, Melissa Olen, Lourdes Lam, Danielle R Madril, Jessica Hughes, Richard G Lagueruela
BACKGROUND: Dexmedetomidine is a selective alpha-2 adrenergic agonist with sedative, analgesic, and anxiolytic properties. Dexmedetomidine has not been approved for use in pediatrics. Dexmedetomidine has been reported to depress sinus node and atrioventricular nodal function in pediatric patients; it has been suggested that the use of dexmedetomidine may not be desirable during electrophysiological studies. AIM: We hypothesize that the use of dexmedetomidine does not inhibit the induction of supraventricular tachyarrhythmias (SVT) during electrophysiological studies and does not inhibit the ablation of such arrhythmias...
October 25, 2016: Paediatric Anaesthesia
L X Quan, H X An, D X Wang
OBJECTIVE: To observe the effects of 0.4 μg/(kg×h) dose of dexmedetomidine on intra-operative wake-up test in children patients undergoing scoliosis surgery. METHODS: Sixty patients for posterior scoliosis correction (ASA I-II, aged 5-16 years) from March 2013 to April 2015 were enrolled in this prospective, double-blinded, randomized, placebo-controlled study, The patients were randomly classified into two groups to receive dexmedetomidine (group RD, n=30) or saline solution (group R, n=30)...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Khaled Elbahrawy, Alaa El-Deeb
BACKGROUND: Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis, immediate anticoagulation, and intervention to restore mesenteric blood flow adequately. AIMS: To investigate the effect of rectus sheath block (RSB) for postoperative analgesia in patients with mesenteric vascular occlusion. SETTINGS AND DESIGN: Forty patients with mesenteric vascular occlusion, American Society of Anesthesiologists physical status I or II or III, scheduled for laparotomy were enrolled in this study...
September 2016: Anesthesia, Essays and Researches
Cameron Ratliff, Rebecca S Sayre, Mauricio Lepiz
A hand-reared, 53-kg, female, 30-day-old black rhinoceros ( Diceros bicornis ) calf presented for magnetic resonance imaging and computed tomography after demonstrating neurologic signs. The rhino was premedicated intramuscularly with butorphanol and midazolam, yielding satisfactory sedation. Induction was achieved using intravenous propofol until the trachea could be intubated. Anesthesia was maintained with sevoflurane in 100% oxygen (mean end-tidal concentration of 2 ± 0.5%). Mean values recorded during anesthesia included were heart rate, end-tidal carbon dioxide, respiratory rate, noninvasive blood pressure, and pulse oximetry...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Andreas Ranft, Daniel Golkowski, Tobias Kiel, Valentin Riedl, Philipp Kohl, Guido Rohrer, Joachim Pientka, Sebastian Berger, Alexander Thul, Max Maurer, Christine Preibisch, Claus Zimmer, George A Mashour, Eberhard F Kochs, Denis Jordan, Rüdiger Ilg
BACKGROUND: The neural correlates of anesthetic-induced unconsciousness have yet to be fully elucidated. Sedative and anesthetic states induced by propofol have been studied extensively, consistently revealing a decrease of frontoparietal and thalamocortical connectivity. There is, however, less understanding of the effects of halogenated ethers on functional brain networks. METHODS: The authors recorded simultaneous resting-state functional magnetic resonance imaging and electroencephalography in 16 artificially ventilated volunteers during sevoflurane anesthesia at burst suppression and 3 and 2 vol% steady-state concentrations for 700 s each to assess functional connectivity changes compared to wakefulness...
November 2016: Anesthesiology
Matthieu Jabaudon, Pierre Boucher, Etienne Imhoff, Russell Chabanne, Jean-Sébastien Faure, Laurence Roszyk, Sandrine Thibault, Raiko Blondonnet, Gael Clairefond, Renaud Guérin, Sébastien Perbet, Sophie Cayot, Thomas Godet, Bruno Pereira, Vincent Sapin, Jean-Etienne Bazin, Emmanuel Futier, Jean-Michel Constantin
RATIONALE: Sevoflurane improves gas exchange, reduces alveolar edema and inflammation in preclinical studies of lung injury but its therapeutic effects have never been investigated in acute respiratory distress syndrome (ARDS). OBJECTIVES: To assess whether sevoflurane would improve gas exchange and inflammation in ARDS. METHODS: We did a parallel, open-label single center randomized controlled trial at 3 intensive care units from a french university hospital between April, 2014, and February, 2016...
September 9, 2016: American Journal of Respiratory and Critical Care Medicine
Friederike A Sandbaumhüter, Regula Theurillat, Rima N Bektas, Annette P N Kutter, Regula Bettschart-Wolfensberger, Wolfgang Thormann
Ketamine is often used for anesthesia in veterinary medicine. One possible comedication is the sedative α2-agonist medetomidine. Advantages of that combination are the compensation of side effects of the two drugs and the anesthetic-sparing effect of medetomidine. In vitro studies showed that medetomidine has an inhibitive effect on the formation of norketamine. Norketamine is the first metabolite of ketamine and is also active. It is followed by others like 6-hydroxynorketamine and 5,6-dehydronorketamine (DHNK)...
October 7, 2016: Journal of Chromatography. A
Safinaz Karabayirli, Kadriye Serife Ugur, Ruveyda Irem Demircioglu, Bunyamin Muslu, Burhanettin Usta, Huseyin Sert, Nebil Ark
To compare dexmedetomidine with remifentanil in functional endoscopic sinus surgery (FESS) in regards to intra-operative bleeding, anesthetic consumption and post-operative recovery. Randomized, double blind study. Tertiary care medical center. Fifty patients with nasal polyposis who had been scheduled for FESS were randomly divided into two groups. In group D (n = 25), dexmedetomidine 1 µg/kg infused intravenous (IV) over 10 min before anesthesia induction, followed by a continuous of 0.7 µg/kg/h infusion during operation...
July 28, 2016: European Archives of Oto-rhino-laryngology
Marie Muyldermans, Serge Jennes, Stuart Morrison, Olivier Soete, Pierre-Michel François, Elkana Keersebilck, Thomas Rose, Olivier Pantet
OBJECTIVE: To describe a case of partial nephrogenic diabetes insipidus in a burned patient after prolonged delivery of low inspired concentrations of sevoflurane via an Anesthetic Conserving Device. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. DATA SYNTHESIS: A 34-year-old man was admitted with burns covering 52% of his total body surface area...
July 13, 2016: Critical Care Medicine
Aviva C Berkowitz, Aryeh M Ginsburg, Raymond M Pesso, George L D Angus, Amiee Kang, Dov B Ginsburg
BACKGROUND: Postoperative airway compromise following cervical spine surgery is a potentially serious adverse event. Residual effects of anesthesia and perioperative opioids that can cause both sedation and respiratory depression further increase this risk. Ketamine is an N-methyl-d-aspartate (NMDA) receptor antagonist that provides potent analgesia without noticeable respiratory depression. We investigated whether intraoperative ketamine administration could decrease perioperative opioid requirements in trauma patients undergoing cervical spine surgery...
February 2016: Middle East Journal of Anesthesiology
Julia Termühlen, Antje Gottschalk, Nicole Eter, Esther M Hoffmann, Hugo Van Aken, Ulrike Grenzebach, Verena Prokosch
BACKGROUND: Reliable measurement of intraocular pressure (IOP) is crucial in pediatric patients with suspected glaucoma. General anesthesia (GA) is usually needed in infants to allow a thorough examination. However, anesthesia itself may influence IOP, depending on the type used and the depth of sedation. The purpose of this study was to evaluate the normal distribution of IOP during GA in healthy children and to analyze differences in IOP relative to the anesthetics used and the measurement time point...
September 2016: Paediatric Anaesthesia
Derya Acar, Ezgi Karakaş Erkılıç, Tülin Gümüş, Duygu Şahin, Aylin Sepici Dinçel, Orhan Kanbak
OBJECTIVE: The aim of this study is to compare the effects of 3 different kinds of anaesthesia on stress response induced by surgery. METHODS: Sixty patients aged between 25-70 American Society of Anesthesiologists (ASA) I-II group to undergo inguinal herniography were included in this study. Patients were randomly divided into 3 groups of 20. Group 1 received general anaesthesia with sevoflurane/air/remifentanil, patients in Group 2 received total intravenous anaesthesia (TIVA) with propofol/air/remifentanil and Group 3 received spinal anaesthesia induced by hyperbaric bupivacaine, adjoined by remifentanil sedation...
April 2015: Turkish Journal of Anaesthesiology and Reanimation
L F Miles, K R Joshi, E H Ogilvie, C G Densem, A A Klein, M O'Sullivan, G Martinez, C D Sudarshan, Y Abu-Omar, J F Irons
Reported data suggest that 99% of transfemoral, transcatheter aortic valve implantations in the UK are performed under general anaesthesia. This before-and-after study is the first UK comparison of conscious sedation vs. general anaesthesia for this procedure. Patients who underwent general anaesthesia received tracheal intubation, positive pressure ventilation, radial arterial and central venous access and urinary catheterisation. Anaesthesia was maintained with propofol or sevoflurane. Patients who received conscious sedation had a fascia iliaca and ilioinguinal nerve block and low-dose remifentanil infusion, without invasive monitoring or urinary catheterisation...
August 2016: Anaesthesia
Shirishkumar G Chavan, Gourish P Shinde, Swati P Adivarekar, Sandhya H Gujar, Surita Mandhyan
BACKGROUND: Dexmedetomidine, an α2 agonist, when used as an adjuvant in general anesthesia attenuates stress response to various noxious stimuli, maintains perioperative hemodynamic stability and provides sedation without adversely affecting recovery in postoperative period. MATERIALS AND METHODS: Sixty patients were randomly divided into two groups of 30 each. In Group A, dexmedetomidine was given intravenously as loading dose of 1 μg/kg over 10 min, and normal saline was given in Group B patients...
May 2016: Anesthesia, Essays and Researches
Gurcan Gungor, Pervin Sutas Bozkurt, Haydar M Yener, Yetkin Z Yilmaz, Elif Sarı, Ahmet Atas, Selma Yilar, Duygu Hayir
BACKGROUND: Otoacoustic emission (OAE) tests are important evaluation tools for diagnosis of peripheral auditory pathology. Sedation or general anesthesia may be required for the performance of the OAE tests. The aim of this retrospective study was to compare the effects of anesthetic agents, propofol and ketamine, on OAEs in children. METHODS: Fifty healthy children who underwent tonsillectomy and/or adenoidectomy under general anesthesia were included in this study...
July 2016: Paediatric Anaesthesia
Alessandra Moretto, Vittorio Scaravilli, Valentina Ciceri, Mariagrazia Bosatra, Federica Giannatelli, Bianca Ateniese, Milena Mariani, Anna Cereda, Simone Sosio, Alberto Zanella, Antonio Pesenti, Angelo Selicorni
Cornelia De Lange syndrome (CdLS) is a rare congenital disease characterized by typical facial dysmorphism, developmental disability, and limb deficiency defects. Various congenital malformations and medical complications have been described with gastroesophageal reflux as the major one. CdLS patients often require multiple high-risk anesthetic procedures. At San Gerardo Hospital (Monza, Italy) the management of CdLS patients is routinely organized through a standard protocol and a dedicated pediatric anesthesia team has been implemented...
June 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Hagen Bomberg, Heinrich V Groesdonk, Martin Bellgardt, Thomas Volk, Andreas Meiser
INTRODUCTION: With the AnaConDa™ system, inhalational sedation in the intensive care unit has become popular. The device can be used with common intensive care unit ventilators and is inserted between the Y-piece and the patient. Liquid isoflurane or sevoflurane are delivered by a syringe pump. 90 % of anesthetic exhaled by the patient is absorbed by a reflector and resupplied during the next inspiration. The new Mirus™ system also uses a reflector. Its control unit identifies end-tidal concentrations from the flow, injects anesthetics during early inspiration, controls anesthetic concentrations automatically, and can also apply desflurane...
2016: SpringerPlus
Choon L Bong, Angela S H Yeo, Teddy Fabila, Josephine S K Tan
BACKGROUND: Recent concerns regarding possible long-term effects of early anesthesia exposure on neurodevelopment in children have provided an impetus to explore alternative anesthetic techniques using potentially neuroprotective agents. Dexmedetomidine has not been implicated in anesthesia-induced neurotoxicity and has been shown to be neuroprotective in preclinical studies. We describe a case series of 50 neonates and infants who received dexmedetomidine sedation with caudal anesthesia instead of general endotracheal anesthesia for inguinal hernia surgery...
June 2016: Paediatric Anaesthesia
B Bhaskara, V P Dayananda, Sudheesh Kannan, R S Raghavendra Rao, R Ramachandraiah
BACKGROUND AND AIMS: Unique post-partum endocrine hormone oxytocin secreted during breastfeeding (BF) has amnestic, sedative properties and down-regulates stress responses. This study was done to assess the effect of BF on consumption of propofol, sevoflurane and haemodynamic stability in women. METHODS: Study was conducted on 120 women aged 20-30 years of American Society of Anesthesiologists I and II physical status scheduled for tubectomy under general anaesthesia who were randomly allocated to three groups 40 of each; BF, withhold feeding (WF), and non-feeding (NF) groups...
March 2016: Indian Journal of Anaesthesia
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