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MAC Anesthesia

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https://www.readbyqxmd.com/read/28532922/awake-craniotomy-anesthesia-a-comparison-between-the-monitored-anesthesia-care-versus-the-asleep-awake-asleep-technique
#1
Chikezie I Eseonu, Karim ReFaey, Oscar Garcia, Amballur John, Alfredo Quinones-Hinojosa, Punita Tripathi
BACKGROUND: The commonly used sedation techniques for an awake craniotomy includes monitored anesthesia care(MAC), using an unprotected airway, or the asleep-awake-asleep(AAA) technique, using a partially or totally protected airway. We present a comparative analysis between the MAC and AAA technique evaluating anesthetic management, perioperative outcomes, and complications in a consecutive series of patients undergoing the removal of an eloquent brain lesion. METHODS: Eighty-one patients underwent an awake craniotomy for an intracranial lesion over a nine-year period by a single-surgeon and a team of anesthesiologists...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28520832/evaluation-of-monitored-anesthesia-care-in-sialendoscopy
#2
Oscar Trujillo, Madeleine A Drusin, Parwane P Pagano, Gulce Askin, Rahmatullah Rahmati
Importance: In the United States, sialendoscopy is most often performed under general anesthesia with endotracheal intubation (GETA); however, monitored anesthesia care (MAC) may be a viable alternative. Objective: To investigate patient characteristics and outcomes following sialendoscopy performed under MAC or GETA to assess the potential of MAC as an alternative anesthetic option. Design, Setting, and Participants: A retrospective review of medical records on patients who underwent sialendoscopy between October 1, 2011, and August 31, 2014, was performed...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28443736/brain-resting-state-functional-connectivity-is-preserved-under-sevoflurane-anesthesia-in-patients-with-pervasive-developmental-disorders-a-pilot-study
#3
Lakshmikumar Venkatraghavan, Suparna Bharadwaj, Vincent Wourms, Audrey Tan, Michael T Jurkiewicz, David J Mikulis, Adrian P Crawley
Functional connectivity studies play a huge role in understanding the relationship between the network connections and the behavioral phenotype of patients with pervasive developmental disorders (PDD). Some patients with PDD may not be able to tolerate the imaging procedure while they are awake, and, hence, they often need general anesthesia. General anesthesia is a confounding factor in functional imaging studies due to its effect on the functional connectivity. The objective of this study is to look at the resting-state functional connectivity (RS-FC) under sevoflurane anesthesia in patients with PDDs...
May 2017: Brain Connectivity
https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#4
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28410821/-analgesia-nociception-index-for-perioperative-analgesia-monitoring-in-spinal-surgery
#5
Guldem Turan, Arzu Yıldırım Ar, Yıldız Yigit Kuplay, Oznur Demiroluk, Mustafa Gazi, Nur Akgun, Erhan Celikoglu
BACKGROUND AND OBJECTIVES: The Analgesia Nociception Index is an index used to measure the levels of pain, sympathetic system activity and heart rate variability during general anesthesia. In our study, Analgesia Nociception Index monitoring in two groups who had undergone spinal stabilization surgery and were administered propofol-remifentanil (Total Intravenous Anesthesia) and sevoflurane-remifentanyl anesthesia was compared regarding its significance for prediction of postoperative early pain...
April 11, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28395002/monitored-anesthesia-care-vs-intubation-for-vertebrobasilar-stroke-endovascular-therapy
#6
Ashutosh P Jadhav, Mehdi Bouslama, Amin Aghaebrahim, Leticia C Rebello, Matthew T Starr, Diogo C Haussen, Manasa Ranginani, Matthew K Whalin, Tudor G Jovin, Raul G Nogueira
Importance: No consensus regarding the ideal sedation treatment for stroke endovascular therapy has been reached, and practices remain largely based on local protocols and clinician preferences. Most studies have focused on anterior circulation strokes; therefore, little is known regarding the optimal anesthesia type for vertebrobasilar occlusion strokes. Objective: To compare clinical and angiographic outcomes between monitored anesthesia care (MAC) and general anesthesia (GA) in patients presenting with vertebrobasilar occlusion strokes...
April 10, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28391757/dose-finding-study-comparing-three-treatments-of-remifentanil-in-cats-anesthetized-with-isoflurane-undergoing-ovariohysterectomy
#7
Marcela L Machado, João Henrique N Soares, Maria Alice Kuster de Albuquerque Gress, Douglas Dos Santos E Castro, Kaleizu Teodoro Rosa, Phillipe Bauer de Araujo Doria, Fabio Otero Ascoli
Objectives Three infusion rates of remifentanil were used in isoflurane-anesthetized cats undergoing ovariohysterectomy. The aim of this study was to identify a dosage regimen that would provide optimal anesthetic and surgical conditions, as well as to compare cardiovascular response to surgical stimulation, postoperative analgesia, anesthetic duration and quality of recovery among the tested remifentanil infusion rates. Methods Twenty-seven client-owned, mixed-breed adult healthy female cats were randomized to receive remifentanil 0...
April 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28363074/propofol-as-an-immersion-anesthetic-and-in-a-minimum-anesthetic-concentration-mac-reduction-model-in-goldfish-carassius-auratus
#8
Julie A Balko, Sarah K Wilson, Gregory A Lewbart, Brian R Gaines, Lysa P Posner
Propofol is a novel immersion anesthetic in goldfish ( Carassius auratus ). Objectives were to characterize propofol as an anesthetic and assess its suitability in a minimum anesthetic concentration (MAC) reduction model. Using a crossover design, eight goldfish were submerged in 1, 5, or 10 mg/L propofol. Data included induction time, recovery time, heart rate, opercular rate, and response to supramaximal stimulation. Baseline MAC (Dixon's up-and-down method) was determined, and 15 fish were anesthetized with propofol on 4 consecutive days with MAC determination on the fifth day, weekly, for 1 mo...
March 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28345549/sub-anesthesia-dose-of-isoflurane-in-60-oxygen-reduces-inflammatory-responses-in-experimental-sepsis-models
#9
Yi Huang, Xiao-Xia Wang, Dong-Dong Sun, Ze-Xin Zhang, Wan-Wan Yang, Tian Shao, Han Han, Er-Fei Zhang, Zhong-Shu Pu, Zuo-Xu Hou, Hai-Long Dong, Li-Ze Xiong, Li-Chao Hou
BACKGROUND: Sepsis is a major cause of mortality in Intensive Care Units. Anesthetic dose isoflurane and 100% oxygen were proved to be beneficial in sepsis; however, their application in septic patients is limited because long-term hyperoxia may induce oxygen toxicity and anesthetic dose isoflurane has potential adverse consequences. This study was scheduled to find the optimal combination of isoflurane and oxygen in protecting experimental sepsis and its mechanisms. METHODS: The effects of combined therapy with isoflurane and oxygen on lung injury and sepsis were determined in animal models of sepsis induced by cecal ligation and puncture (CLP) or intraperitoneal injection of lipopolysaccharide (LPS) or zymosan...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28323158/monitoring-the-end-tidal-concentration-of-sevoflurane-for-preventing-awareness-during-anesthesia-meets-panda-a-prospective-clinical-trial
#10
Jiebo Wang, Liangcheng Zhang, Qijian Huang, Guohua Wu, Xianfeng Weng, Zhongmeng Lai, Pengtao Lin
OBJECTIVE: It was hypothesized that monitoring end-tidal sevoflurane (ETS) during endoscopic surgery could reduce the incidence of intraoperative awareness in patients undergoing general anesthesia. Herein, the incidence of intraoperative awareness and other correlative factors was recorded and compared. METHODS: Two thousand five hundred ASA I-III patients aged 18-80 years who underwent general anesthesia were randomly divided into 2 groups (n = 1250): routine care group (R) and ETS concentration group (E)...
March 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28302419/intravenous-15-isoflurane-lipid-nanoemulsion-for-general-anesthesia-in-dogs
#11
Claudio C Natalini, Carolina L Krahn, Priscila B S Serpa, Joanna E Griffith, Ricardo Miyasaka de Almeida
OBJECTIVE: To investigate the efficacy of a new intravenous (IV) nanoemulsified isoflurane formulation for maintenance of general anesthesia in dogs. STUDY DESIGN: Prospective, crossover, experimental study. ANIMALS: Seven healthy, mature, mixed-breed dogs, three male and four female, weighing 11.5 ± 1.5 kg. METHODS: Anesthesia was induced with propofol for instrumentation. Measurements were obtained before administration of either inhaled isoflurane (Iso-I) or IV 15% isoflurane-loaded lipid nanoemulsion (Iso-nano)...
January 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28219129/-effects-of-sevoflurane-and-desflurane-on-pharmacodynamics-of-rocuronium-in-children
#12
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/28217398/comparison-of-intubation-success-and-glottic-visualization-using-king-vision-and-c-mac-videolaryngoscopes-in-patients-with-cervical-spine-injuries-with-cervical-immobilization-a-randomized-clinical-trial
#13
Dhanyasi Shravanalakshmi, Prasanna U Bidkar, K Narmadalakshmi, Suman Lata, Sandeep K Mishra, S Adinarayanan
BACKGROUND: Glottic visualization can be difficult with cervical immobilization in patients with cervical spine injury. Indirect laryngoscopes may provide better glottic visualization in these groups of patients. Hence, we compared King Vision videolaryngoscope, C-MAC videolaryngoscope for endotracheal intubation in patients with proven/suspected cervical spine injury. METHODS: After standard induction of anesthesia, 135 patients were randomized into three groups: group C (conventional C-MAC videolaryngoscope), group K (King Vision videolaryngoscope), and group D (D blade C-MAC videolaryngoscope)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28211120/the-effect-of-sevoflurane-on-electrocorticographic-spike-activity-in-pediatric-patients-with-epilepsy
#14
Shigekazu Tanaka, Yutaka Oda, Masayoshi Ryokai, Takehiro Uda, Noritsugu Kunihiro, Ichiro Kuki, Ryu Okutani
BACKGROUND: Electrocorticogram (ECoG) spike activity is enhanced under general anesthesia with 1.5 minimum alveolar concentration (MAC) sevoflurane compared with lower concentrations in adult patients with epilepsy. However, the effect of concentration of sevoflurane on ECoG in children with epilepsy is less known. AIMS: The primary endpoint was to investigate the effects of sevoflurane on ECoG spike activity in pediatric patients undergoing epilepsy surgery. The secondary endpoint was to examine its effects on baseline ECoG including burst suppression...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28181336/impact-of-high-concentrations-of-sevoflurane-on-laryngeal-reflex-responses
#15
Thomas O Erb, Britta S von Ungern-Sternberg, Jens Moll, Franz J Frei
BACKGROUND: Exaggerated defensive upper airway reflexes, particularly laryngospasm, may cause hypoxemic damage, especially in children. General clinical experience suggests that laryngeal reflex responses are more common under light levels of anesthesia, and previous clinical studies have shown an inverse correlation between laryngeal responsiveness and depth of hypnosis. However, this seems to be less obvious in children anesthetized with sevoflurane. The aim of this study was to assess the impact of high concentrations of sevoflurane on laryngeal and respiratory reflex responses in spontaneously breathing children...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28128087/direct-insertion-of-muscle-fibers-is-not-restricted-to-facial-skin
#16
Uwe Wollina
Facial musculature is divided into masticatory muscles, i.e. M. masseter and M. buccalis, with bony insertions and smaller facial muscles involved in facial expression, which insert into bone and skin. There are four fixed osteocutaneous points of the face, i.e. zygomatic (Mac Gregor), mandibular (Furnas), orbital (Psillakis), and masseteric with an antigravitational effect and functional role in facial expression (1,2). In other body parts, the direct insertion of muscle fibers into skin has not been reported...
December 2016: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28096584/randomized-controlled-study-comparing-the-hemodynamic-response-to-laryngoscopy-and-endotracheal-intubation-with-mccoy-macintosh-and-c-mac-laryngoscopes-in-adult-patients
#17
Faiza Sulaiman Buhari, Venkatesh Selvaraj
BACKGROUND AND AIMS: Earlier studies have shown that the type of laryngoscope blade influences the degree of hemodynamic response to endotracheal intubation. The aim of the study was to evaluate the hemodynamic response to oral endotracheal intubation with C-MAC laryngoscopy and McCoy laryngoscopy compared to that of Macintosh laryngoscopy in adult patients under general anesthesia. MATERIAL AND METHODS: This is a prospective randomized parallel group study. Ninety American Society of Anesthesiologists I patients were randomly allotted into three groups...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28003439/from-the-cover-prolonged-exposure-to-volatile-anesthetic-isoflurane-worsens-the-outcome-of-polymicrobial-abdominal-sepsis
#18
Sophia Koutsogiannaki, Matthew M Schaefers, Toshiaki Okuno, Mai Ohba, Takehiko Yokomizo, Gregory P Priebe, James A DiNardo, Soriano G Sulpicio, Koichi Yuki
Sepsis continues to result in high morbidity and mortality. General anesthesia is often administered to septic patients, but the impacts of general anesthesia on host defense are not well understood. General anesthesia can be given by volatile and intravenous anesthetics. Our previous in vitro study showed that volatile anesthetic isoflurane directly inhibits leukocyte function-associated antigen-1 (LFA-1) and macrophage-1 antigen (Mac-1), critical adhesion molecules on leukocytes. Thus, the role of isoflurane exposure on in vivo LFA-1 and Mac-1 function was examined using polymicrobial abdominal sepsis model in mice...
April 1, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/27924208/local-anesthesia-with-monitored-anesthesia-care-for-patients-undergoing-thyroidectomy-a-case-series
#19
Se Eun Kim, Eugene Kim
Because the current trend favors minimally invasive surgery for thyroid disease, increasing interest has developed for thyroidectomy under local anesthesia with monitored anesthesia care (MAC). Here, we retrospectively reviewed 18 cases of thyroidectomy performed under local anesthesia with MAC in a single center. All of the procedures were performed by a single surgeon, using local lidocaine infiltration around the incisional site and propofol plus remifentanil target-controlled infusion. Sore throat (4/18), hypocalcemia (1/18), and transient voice color change (1/18) were observed, but the patients recovered during the follow-up period...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27900813/anesthesia-maintenance-with-induction-dose-only-sevoflurane-during-pediatric-ophthalmic-examination-comparison-with-standard-low-flow-technique-through-a-randomized-controlled-trial
#20
Priyankar K Datta, Renu Sinha, Bikash Ranjan Ray, Venkateswaran Jambunathan, Riddhi Kundu
BACKGROUND: Sevoflurane is preferred for pediatric day care procedures. However, financial and environmental costs remain major limitations. Induction dose of sevoflurane could itself be sufficient for maintaining anesthesia with low fresh gas flow during short noninvasive procedures. METHODS: Fifty children, aged 1-5 years, scheduled for ophthalmic examination under anesthesia, were randomized into two groups. All children were induced with 8% sevoflurane in O2 : N2 O (40 : 60)...
February 2017: Paediatric Anaesthesia
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