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MAC Anesthesia

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https://www.readbyqxmd.com/read/28211120/the-effect-of-sevoflurane-on-electrocorticographic-spike-activity-in-pediatric-patients-with-epilepsy
#1
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...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28181336/impact-of-high-concentrations-of-sevoflurane-on-laryngeal-reflex-responses
#2
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...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28128087/direct-insertion-of-muscle-fibers-is-not-restricted-to-facial-skin
#3
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
#4
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/prolonged-exposure-to-volatile-anesthetic-isoflurane-worsens-the-outcome-of-polymicrobial-abdominal-sepsis
#5
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...
December 20, 2016: 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
#6
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
#7
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
https://www.readbyqxmd.com/read/27857689/the-safety-and-efficacy-of-dexmedetomidine-vs-sufentanil-in-monitored-anesthesia-care-during-burr-hole-surgery-for-chronic-subdural-hematoma-a-retrospective-clinical-trial
#8
Wenming Wang, Lei Feng, Fenfen Bai, Zongwang Zhang, Yong Zhao, Chunguang Ren
Background: Chronic subdural hematoma (CSDH) is a very common clinical emergency encountered in neurosurgery. While both general anesthesia (GA) and monitored anesthesia care (MAC) can be used during CSDH surgery, MAC is the preferred choice among surgeons. Further, while dexmedetomidine (DEX) is reportedly a safe and effective agent for many diagnostic and therapeutic procedures, there have been no trials to evaluate the safety and efficacy of DEX vs. sufentanil in CSDH surgery. Objective: To evaluate the safety and efficacy of DEX vs...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27856360/sensitivity-to-isoflurane-anesthesia-increases-in-autism-spectrum-disorder-shank3-%C3%A2-c-mutant-mouse-model
#9
Changsheng Li, Michele Schaefer, Christy Gray, Ya Yang, Orion Furmanski, Sufang Liu, Paul Worley, C David Mintz, Feng Tao, Roger A Johns
Autism is a heterogeneous developmental disorder characterized by impaired social interaction, impaired communication skills, and restricted and repetitive behavior. The abnormal behaviors of these patients can make their anesthetic and perioperative management difficult. Evidence in the literature suggests that some patients with autism or specific autism spectrum disorders (ASD) exhibit altered responses to pain and to anesthesia or sedation. A genetic mouse model of one particular ASD, Phelan McDermid Syndrome, has been developed that has a Shank3 haplotype truncation (Shank3(+/Δc))...
November 14, 2016: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/27756208/effect-of-the-severity-of-liver-dysfunction-on-the-minimum-alveolar-concentration-of-sevoflurane-responding-to-an-electronic-stimulation-in-cirrhotic-patients
#10
Yan Yin, Hong Xiao, Jirimutuya Han, Weiyi Zhang, Jianguo Cheng, Tao Zhu
BACKGROUND: It has been observed that patients with liver dysfunction need lower dose anesthetic compared patients with normal liver function. The minimum amount of volatile anesthetic to achieve an optimal depth of anesthesia for these patients is still unclear. In this study, Minimum alveolar concentration (MAC) of the sevoflurane was determined using an electric stimulation and the effect of severity of liver dysfunction on the MAC was observed in cirrhotic patients. METHODS: Thirty patients undergoing upper abdominal surgery were divided into the following groups: group N (normal liver function), group A (Child-Pugh grade A) and group B (Child-Pugh grade B-C)...
October 18, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27716699/perioperative-management-of-patients-with-left-ventricular-assist-devices-undergoing-noncardiac-surgery
#11
Meredith Degnan, Jessica Brodt, Yiliam Rodriguez-Blanco
AIM: The aim of this study was to describe our institutional experience, primarily with general anesthesiologists consulting with cardiac anesthesiologists, caring for left ventricular assist device (LVAD) patients undergoing noncardiac surgery. MATERIALS AND METHODS: This is a retrospective review of the population of patients with LVADs at a single institution undergoing noncardiac procedures between 2009 and 2014. Demographic, perioperative, and procedural data collected included the type of procedure performed, anesthetic technique, vasopressor requirements, invasive monitors used, anesthesia provider type, blood product management, need for postoperative intubation, postoperative disposition and length of stay, and perioperative complications including mortality...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27640893/monitored-anesthesia-care-for-subcutaneous-cardioverter-defibrillator-implantation-a-single-center-experience
#12
Michael K Essandoh, Andrew J Otey, Mahmoud Abdel-Rasoul, Erica J Stein, Katja R Turner, Nicholas C Joseph, Emile G Daoud
BACKGROUND: To date, general anesthesia has been suggested as the preferred approach for implantation of a subcutaneous implantable cardioverter-defibrillator (S-ICD). The purpose of this study was to assess the use of monitored anesthesia care (MAC) for S-ICD implantation. The goals were to assess adequate sedation and analgesia (efficacy endpoints) and major perioperative airway or hemodynamic compromise (safety endpoints). The authors hypothesized that MAC may provide adequate sedation and analgesia and no major perioperative airway or hemodynamic compromise during S-ICD implantation and multiple defibrillation threshold (DFT) testing...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27569026/using-a-pulse-oximeter-to-determine-clinical-depth-of-anesthesia-investigation-of-the-utility-of-the-perfusion-index
#13
Anirudh Krishnamohan, Viraj Siriwardana, Justin J Skowno
BACKGROUND: Peripheral vasodilation is a well-recognized side effect of general anesthesia, and induces changes in the amplitude of the pulse plethysmograph (PPG) waveform. This can be continuously quantitaed using the Perfusion Index (PI), a ratio of the pulsatile to nonpulsatile signal amplitude in the PPG waveform. We hypothesized that the perfusion index would rise with the induction of anesthesia in children, and fall with emergence, and performed a prospective, observational study to test this...
November 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27565476/same-day-discharge-following-treatment-with-the-pipeline-embolization-device-using-monitored-anesthesia-care
#14
Mario Zanaty, Badih Daou, Nohra Chalouhi, Robert M Starke, Edgar Samaniego, Colin Derdeyn, Pascal Jabbour, David Hasan
OBJECTIVE: The Pipeline Embolization Device has been used shown safe under Monitored Anesthesia Care (MAC). We present the results of the first study assessing the safety and feasibility of same-day discharge in patients undergoing treatment with the PED, using MAC. METHODS: A total of 130 patients with 143 CAs were identified. Patients were treated under MAC with PED. All patients were counseled pre-operatively about the elective nature of the procedure and the same-day discharge...
August 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27546368/are-there-any-effects-of-sevoflurane-and-desflurane-anaesthesia-on-blood-glucose-levels-in-acute-hyperglycemic-diabetic-rats
#15
B Dikmen, A H Arpaci, D Kalayci, I Gunes, E Beskardes, O Kurtipek, M Arslan
AIM: The aim of this study was to investigate blood glucose level of desflurane and sevoflurane on blood glucose in diabetic rats undergoing acute hyperglycemia. MATERIALS AND METHODS: In this study, 30 male Wistar albino rats were included. Diabetes was induced by a single IP injection of streptozotocin. After the effects of chronic diabetes encountered, diabetic rats were randomly assigned into diabetic control (group DC), diabetic hyperglycemia group (group DH), diabetic hyperglycemia group with desflurane (group DH-D), and diabetic hyperglycemia group with sevoflurane (group DH-S) groups...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27495961/outcome-after-general-anesthesia-versus-monitored-anesthesia-care-in-transfemoral-transcatheter-aortic-valve-replacement
#16
Paola D'Errigo, Marco Ranucci, Remo Daniel Covello, Fausto Biancari, Stefano Rosato, Marco Barbanti, Francesco Onorati, Corrado Tamburino, Gennaro Santoro, Claudio Grossi, Francesco Santini, Katia Bontempi, Danilo Fusco, Fulvia Seccareccia
OBJECTIVE: To evaluate outcomes of monitored anesthesia care (MAC) compared with general anesthesia (GA) in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). DESIGN: Secondary analysis from the observational and prospective OBSERVANT (OBservational Study of Effectiveness of avR-taVi procedures for severe Aortic steNosis Treatment) study. SETTING: Multicenter study, including Italian hospitals performing TAVR interventions...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27493596/a-systematic-review-of-factors-associated-with-utilization-of-monitored-anesthesia-care-for-gastrointestinal-endoscopy
#17
Megan A Adams, Ashraf Saleh, Joel H Rubenstein
Utilization of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased markedly over the past decade, leading to significant additional health care expenditures. However, the extent to which certain patient-, provider-, and facility-level factors lead to MAC utilization is unclear. A systematic review of 13 studies evaluating influential factors associated with MAC utilization for colonoscopy and/or esophagogastroduodenoscopy was conducted. Multiple studies revealed significant increases in MAC utilization since the early 2000s, with substantial regional variation...
June 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27484227/dexmedetomidine-ketamine-versus-dexmedetomidine-midazolam-fentanyl-for-monitored-anesthesia-care-during-chemoport-insertion-a-prospective-randomized-study
#18
Eun Hee Chun, Myeong Jae Han, Hee Jung Baik, Hahck Soo Park, Rack Kyung Chung, Jong In Han, Hun Jung Lee, Jong Hak Kim
BACKGROUND: Dexmedetomidine as a sole agent showed limited use for painful procedures due to its insufficient sedative/analgesic effect, pronounced hemodynamic instability and prolonged recovery. The aim of this study was to compare the effects of dexmedetomidine-ketamine (DK) versus dexmedetomidine-midazolam-fentanyl (DMF) combination on the quality of sedation/analgesia and recovery profiles for monitored anesthesia care (MAC). METHODS: Fifty six patients undergoing chemoport insertion were randomly assigned to group DK or DMF...
August 2, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27465213/comparison-of-isoflurane-and-sevoflurane-in-cardiac-surgery-a-randomized-non-inferiority-comparative-effectiveness-trial
#19
Philip M Jones, Daniel Bainbridge, Michael W A Chu, Philip S Fernandes, Stephanie A Fox, Ivan Iglesias, Bob Kiaii, Ronit Lavi, John M Murkin
PURPOSE: Volatile anesthetics possess cardioprotective properties, but it is unknown if the cardioprotective effects extend equally to all members of the class. Although sevoflurane is a relatively newer anesthetic than isoflurane, its introduction into practice was not preceded by a head-to-head comparison with isoflurane in a trial focusing on clinically important outcomes. Our objective was to determine whether sevoflurane was non-inferior to isoflurane on a clinically important primary outcome in a heterogeneous group of adults undergoing cardiac surgery...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27382810/comparison-of-intraoperative-ketamine-vs-fentanyl-use-decreases-postoperative-opioid-requirements-in-trauma-patients-undergoing-cervical-spine-surgery
#20
COMPARATIVE STUDY
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
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