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Volatile anesthetics desflurane

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https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#1
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27871537/-1-8-million-and-counting-how-volatile-agent-education-has-decreased-our-spending-1000-per-day
#2
Scott A Miller, Carol A Aschenbrenner, Justin R Traunero, Loren A Bauman, Samuel S Lobell, Jeffrey S Kelly, John E Reynolds
STUDY OBJECTIVE: Volatile anesthetic agents comprise a substantial portion of every hospital's pharmacy budget. Challenged with an initiative to lower anesthetic drug expenditures, we developed an education-based intervention focused on reducing volatile anesthetic costs while preserving access to all available volatile anesthetics. When postintervention evaluation demonstrated a dramatic year-over-year reduction in volatile agent acquisition costs, we undertook a retrospective analysis of volatile anesthetic purchasing data using time series analysis to determine the impact of our educational initiative...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27844299/comparison-of-pneumotachography-and-anemometery-for-flow-measurement-during-mechanical-ventilation-with-volatile-anesthetics
#3
Jarred R Mondoñedo, Jacob Herrmann, John S McNeil, David W Kaczka
Volatile anesthetics alter the physical properties of inhaled gases, such as density and viscosity. We hypothesized that the use of these agents during mechanical ventilation would yield systematic biases in estimates of flow ([Formula: see text]) and tidal volume (V T) for two commonly used flowmeters: the pneumotachograph (PNT), which measures a differential pressure across a calibrated resistive element, and the hot-wire anemometer (HWA), which operates based on convective heat transfer from a current-carrying wire to a flowing gas...
November 14, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27828800/safety-and-efficacy-of-volatile-anesthetic-agents-compared-with-standard-intravenous-midazolam-propofol-sedation-in-ventilated-critical-care-patients-a-meta-analysis-and-systematic-review-of-prospective-trials
#4
Angela Jerath, Jonathan Panckhurst, Matteo Parotto, Nicholas Lightfoot, Marcin Wasowicz, Niall D Ferguson, Andrew Steel, W Scott Beattie
BACKGROUND: Inhalation agents are being used in place of intravenous agents to provide sedation in some intensive care units. We performed a systematic review and meta-analysis of prospective randomized controlled trials, which compared the use of volatile agents versus intravenous midazolam or propofol in critical care units. METHODS: A search was conducted using MEDLINE (1946-2015), EMBASE (1947-2015), Web of Science index (1900-2015), and Cochrane Central Register of Controlled Trials...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27826417/desflurane-impairs-outcome-of-organotypic-hippocampal-slices-in-an-in-vitro-model-of-traumatic-brain-injury
#5
Matthias Krings, Anke Höllig, Jingjin Liu, Linda Grüsser, Rolf Rossaint, Mark Coburn
Decreased mortality and disability after traumatic brain injury is a significant medical challenge. Desflurane, a widely used volatile anesthetic has proven to be neuroprotective in a variety of in vitro and in vivo models of ischemic brain injury. The aim of this study was to investigate whether desflurane exhibits neuroprotective properties in an in vitro model of traumatic brain injury. Organotypic hippocampal slice cultures were prepared from brains of 5-7-day-old C57/BL6 mouse pups. After 14 days of culture, the slices were subjected to a focal mechanical trauma and thereafter incubated with three different concentrations of desflurane (2, 4 and 6%) for 2, 24 and 72 hours...
March 2016: Medical Gas Research
https://www.readbyqxmd.com/read/27765559/the-use-of-isoflurane-and-desflurane-as-inhalational-agents-for-glioblastoma-surgery-a-survival-analysis
#6
J P Cata, K B Hagan, S D O Bhavsar, R Arunkumar, R Grasu, A Dang, R Carlson, B Arnold, Y Potylchansky, I Lipski, T McHugh, F Jimenez, A T Nguyen, L Feng, T F Rahlfs
BACKGROUND: Several studies have examined the impact of anesthetics on cancer recurrence. Isoflurane but not desflurane has protumoral effects. We hypothesize the use of isoflurane but not desflurane during surgery for primary GBM is an independent predictor of disease progression and mortality. METHODS: 378 adult patients were included in the study. The progression free survival (PFS) and overall survival (OS) rates at 1 and 5years were compared in patients who had either desflurane or isoflurane alone or in combination with propofol infusion...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27639372/occupational-exposure-to-anesthetics-leads-to-genomic-instability-cytotoxicity-and-proliferative-changes
#7
Kátina M Souza, Leandro G Braz, Flávia R Nogueira, Marajane B Souza, Lahis F Bincoleto, Aline G Aun, José E Corrente, Lídia R Carvalho, José Reinaldo C Braz, Mariana G Braz
Data on the genotoxic and mutagenic effects of occupational exposure to the most frequently used volatile anesthetics are limited and controversial. The current study is the first to evaluate genomic instability, cell death and proliferative index in exfoliated buccal cells (EBC) from anesthesiologists. We also evaluated DNA damage and determined the concentrations of the anesthetic gases most commonly used in operating rooms. This study was conducted on physicians who were allocated into two groups: the exposed group, which consisted of anesthesiologists who had been exposed to waste anesthetic gases (isoflurane, sevoflurane, desflurane and nitrous oxide - N2O) for at least two years; and the control group, which consisted of non-exposed physicians matched for age, sex and lifestyle with the exposed group...
September 2016: Mutation Research
https://www.readbyqxmd.com/read/27562558/from-the-cover-volatile-anesthetics-transiently-disrupt-neuronal-development-in-neonatal-rats
#8
Julie K Drobish, Zoe S Gan, Amanda D Cornfeld, Maryellen F Eckenhoff
Volatile anesthetics can cause neuronal and glial toxicity in the developing mammalian brain, as well as long-term defects in learning and memory. The goals of this study were to compare anesthetics using a clinically relevant exposure paradigm, and to assess the anesthetic effects on hippocampal development and behavior. Our hypothesis was that volatile anesthetics disrupt hippocampal development, causing neurobehavioral defects later in life. Bromodeoxyuridine (BrdU) was administered to rats on postnatal day (P)1, and the rats were exposed to volatile anesthetics (isoflurane, sevoflurane, or desflurane) for 2 h on P2...
December 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/27428242/retrospective-cohort-investigation-of-perioperative-upper-respiratory-events-in-children-undergoing-general-anesthesia-via-a-supraglottic-airway-a-comparison-of-sevoflurane-and-desflurane
#9
Hyun-Joung No, Bon-Wook Koo, Ah-Young Oh, Kwang-Suk Seo, Hyo-Seok Na, Jung-Hee Ryu, Soo-Won Lee
Desflurane is the most pungent of the currently used volatile anesthetics. We assessed whether the incidence of perioperative upper respiratory events in children undergoing general anesthesia via a supraglottic airway is higher with desflurane than with sevoflurane as maintenance anesthetic.We retrospectively reviewed and analyzed the electronic medical records of consecutive children 1 to 15 years of age who underwent general anesthesia via a supraglottic airway at Seoul National University Bundang Hospital between June 2013 and June 2015...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27392660/evaluating-the-efficiency-of-desflurane-reflection-in-two-commercially-available-reflectors
#10
Hagen Bomberg, Marcel Wessendorf, Martin Bellgardt, Max Veddeler, Stefan Wagenpfeil, Thomas Volk, Heinrich V Groesdonk, Andreas Meiser
With the AnaConDa™ and the MIRUS™ system, volatile anesthetics can be administered for inhalation sedation in intensive care units. Instead of a circle system, both devices use anesthetic reflectors to save on the anesthetic agent. We studied the efficiency of desflurane reflection with both devices using different tidal volumes (VT), respiratory rates (RR), and 'patient' concentrations (CPat) in a bench study. A test lung was ventilated with four settings (volume control, RR × VT: 10 × 300 mL, 10 × 500 mL, 20 × 500 mL, 10 × 1000 mL)...
July 8, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27309971/perioperative-complications-of-obese-patients
#11
Thomas Kiss, Thomas Bluth, Marcelo Gama de Abreu
PURPOSE OF REVIEW: The perioperative care of obese patients can often be challenging, as the presence of comorbidities is common in this patient population. In this article, we present recent data on perioperative complications of obese patients and discuss relevant details for daily practice, including drug dosing, airway management, and mechanical ventilation. RECENT FINDINGS: The volatile agent desflurane reduces extubation time, without major effects on postoperative anesthesia care unit discharge time, incidence of postoperative nausea and vomiting, or postoperative pain scores compared with other volatile anesthetics...
August 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27273061/postoperative-environmental-anesthetic-vapour-concentrations-following-removal-of-the-airway-device-in-the-operating-room-versus-the-postanesthesia-care-unit
#12
Sara K Cheung, Timur Özelsel, Saifee Rashiq, Ban C Tsui
PURPOSE: This study was designed to compare waste anesthetic gas (WAG) concentrations within patients' breathing zones after removal of the patient's airway device in the postanesthesia care unit (PACU) vs in the operating room (OR). METHODS: Following Research Ethics Board approval and patient consent, we recruited patients undergoing surgery who received volatile anesthesia via an endotracheal tube or supraglottic airway. Patients had their airway device removed in the OR or in the PACU depending on the attending anesthesiologist's preference...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27222158/adsorbent-comparisons-for-anesthetic-gas-capture-in-hospital-air-emissions
#13
Mina Mehrata, Carol Moralejo, William A Anderson
For the development of emission control strategies, activated carbon, zeolite, molecular sieves, and a silica gel were tested for adsorption of the newer anesthetic gases isoflurane, sevoflurane, and desflurane from air. The activated carbon Norit GCA 48 was selected for the best performance, and adsorption isotherms at room temperature were developed for the three anesthetics. Equilibrium capacities for this carbon were in the range of 500 to 1,000 mg g(-1) for these anesthetics at partial pressures ranging from 5 to 45 Torr, with the most volatile compound (desflurane) showing the least favorable adsorption...
August 23, 2016: Journal of Environmental Science and Health. Part A, Toxic/hazardous Substances & Environmental Engineering
https://www.readbyqxmd.com/read/27203279/which-anesthesia-regimen-is-best-to-reduce-morbidity-and-mortality-in-lung-surgery-a-multicenter-randomized-controlled-trial
#14
Beatrice Beck-Schimmer, John M Bonvini, Julia Braun, Manfred Seeberger, Thomas A Neff, Tobias J Risch, Frank Stüber, Andreas Vogt, Walter Weder, Didier Schneiter, Miodrag Filipovic, Milo Puhan
BACKGROUND: One-lung ventilation during thoracic surgery is associated with hypoxia-reoxygenation injury in the deflated and subsequently reventilated lung. Numerous studies have reported volatile anesthesia-induced attenuation of inflammatory responses in such scenarios. If the effect also extends to clinical outcome is yet undetermined. We hypothesized that volatile anesthesia is superior to intravenous anesthesia regarding postoperative complications. METHODS: Five centers in Switzerland participated in the randomized controlled trial...
August 2016: Anesthesiology
https://www.readbyqxmd.com/read/27183886/increasing-cumulative-exposure-to-volatile-anesthetic-agents-is-associated-with-poorer-neurodevelopmental-outcomes-in-children-with-hypoplastic-left-heart-syndrome
#15
Laura K Diaz, J William Gaynor, Shannon J Koh, Richard F Ittenbach, Marsha Gerdes, Judy C Bernbaum, Elaine H Zackai, Robert R Clancy, Mohamed A Rehman, Jeffrey W Pennington, Nancy Burnham, Thomas L Spray, Susan C Nicolson
OBJECTIVES: Despite improved survival in children with hypoplastic left heart syndrome (HLHS), significant concern persists regarding their neurodevelopmental (ND) outcomes. Previous studies have identified patient factors, such as prematurity and genetic syndromes, to be associated with worse ND outcomes. However, no consistent relationships have been identified among modifiable management factors, including cardiopulmonary bypass strategies, and ND outcomes after cardiac surgery in infancy...
August 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27065094/effects-of-volatile-anesthetics-on-mortality-and-postoperative-pulmonary-and-other-complications-in-patients-undergoing-surgery-a-systematic-review-and-meta-analysis
#16
Christopher Uhlig, Thomas Bluth, Kristin Schwarz, Stefanie Deckert, Luise Heinrich, Stefan De Hert, Giovanni Landoni, Ary Serpa Neto, Marcus J Schultz, Paolo Pelosi, Jochen Schmitt, Marcelo Gama de Abreu
BACKGROUND: It is not known whether modern volatile anesthetics are associated with less mortality and postoperative pulmonary or other complications in patients undergoing general anesthesia for surgery. METHODS: A systematic literature review was conducted for randomized controlled trials fulfilling following criteria: (1) population: adult patients undergoing general anesthesia for surgery; (2) intervention: patients receiving sevoflurane, desflurane, or isoflurane; (3) comparison: volatile anesthetics versus total IV anesthesia or volatile anesthetics; (4) reporting on: (a) mortality (primary outcome) and (b) postoperative pulmonary or other complications; (5) study design: randomized controlled trials...
June 2016: Anesthesiology
https://www.readbyqxmd.com/read/27062561/evaluation-of-genotoxicity-of-general-anesthesia-maintained-with-desflurane-in-patients-under-minor-surgery
#17
Flávia R Nogueira, Leandro G Braz, Leonardo R de Andrade, Ana Lygia R de Carvalho, Luiz A Vane, Norma Sueli P Módolo, Aline G Aun, Kátina M Souza, José Reinaldo C Braz, Mariana G Braz
There is controversy over the genotoxic effects of volatile anesthetics. The available literature on the genotoxicity of desflurane, one of the newest volatile halogenated agents used for general anesthesia maintenance, is scarce. This study aimed to evaluate the genotoxic potential of desflurane in 15 patients without comorbidities, of both sexes, who underwent minor surgeries lasting at least 90 min. Patients enrolled in the study received desflurane anesthesia (6%); blood samples were collected before anesthesia induction (T0), 90 min after the beginning of anesthesia (T1), and on the day following surgery (T2)...
May 2016: Environmental and Molecular Mutagenesis
https://www.readbyqxmd.com/read/27028996/volatile-anaesthetics-enhance-the-metastasis-related-cellular-signalling-including-cxcr2-of-ovarian-cancer-cells
#18
Masae Iwasaki, Hailin Zhao, Tanweer Jaffer, Sandeep Unwith, Laura Benzonana, Qingquan Lian, Atsuhiro Sakamoto, Daqing Ma
The majority of ovarian cancer patients relapse after surgical resection. Evidence is accumulating regarding the role of surgery in disseminating cancer cells; in particular anaesthesia may have an impact on cancer re-occurrence. Here, we have investigated the metastatic potential of volatile anaesthetics isoflurane, sevoflurane and desflurane on ovarian cancer cells. Human ovarian carcinoma cells (SKOV3) were exposed to isoflurane (2%), sevoflurane (3.6%) or desflurane (10.3%) for 2 hours. Metastatic related gene expression profiles were measured using the Tumour Metastasis PCR Array and qRT-PCR...
May 3, 2016: Oncotarget
https://www.readbyqxmd.com/read/26946305/regulatory-effects-of-anesthetics-on-nitric-oxide
#19
REVIEW
Wenguo Fan, Qin Liu, Xiao Zhu, Zhi Wu, Dongpei Li, Fang Huang, Hongwen He
Nitric oxide (NO) is a free radical gas in the biological system, which is produced by nitric oxide synthase (NOS) family. NO acts as a biological mediator and plays important roles in different systems in humans. The NO/NOS system exerts a broad spectrum of signaling functions involved in vasodilation, inflammation, oxidative stress, cardioprotection and neuroprotection. It has been demonstrated that intravenous and volatile anesthetics (such as propofol, ketamine, midazolam, isoflurane, sevoflurane, and desflurane, etc...
April 15, 2016: Life Sciences
https://www.readbyqxmd.com/read/26735317/economic-and-environmental-considerations-during-low-fresh-gas-flow-volatile-agent-administration-after-change-to-a-nonreactive-carbon-dioxide-absorbent
#20
Richard H Epstein, Franklin Dexter, David P Maguire, Niraj K Agarwalla, David M Gratch
BACKGROUND: Reducing fresh gas flow (FGF) during general anesthesia reduces costs by decreasing the consumption of volatile anesthetics and attenuates their contribution to greenhouse gas pollution of the environment. The sevoflurane FGF recommendations in the Food and Drug Administration package insert relate to concern over potential toxicity from accumulation in the breathing circuit of compound A, a by-product of the reaction of the volatile agent with legacy carbon dioxide absorbents containing strong alkali such as sodium or potassium hydroxide...
April 2016: Anesthesia and Analgesia
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