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https://www.readbyqxmd.com/read/28930848/nociceptive-stimulation-during-macintosh-direct-laryngoscopy-compared-with-mcgrath-mac-videolaryngoscopy-a-randomized-trial-using-indirect-evaluation-using-an-automated-administration-of-propofol-and-remifentanil
#1
Rathvirak Ing, Ngai Liu, Thierry Chazot, Julien Fessler, Jean François Dreyfus, Marc Fischler, Morgan Le Guen
BACKGROUND: Decrease of the nociceptive stimulation induced by laryngoscopy could be an advantage for patients without risk of difficult intubation. The present study aimed to compare the difference in nociceptive stimulation between the use of a conventional laryngoscope or of a videolaryngoscope. Amount of nociception was assessed indirectly using the peak remifentanil concentration determined by a closed-loop administration of propofol and remifentanil with bispectral index (BIS) as the input signal (target 50)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28928100/effects-of-alfentanil-or-fentanyl-added-to-propofol-for-sedation-in-colonoscopy-on-cognitive-functions-randomized-controlled-trial
#2
Güler Doğanay, Perihan Ekmekçi, Baturay Kansu Kazbek, Hakan Yılmaz, Gülbanu Erkan, Filiz Tüzüner
BACKGROUND/AIMS: To assess the effect of propofol supplemented with alfentanil or fentanyl on cognitive functions for sedation during elective colonoscopy. MATERIALS AND METHODS: Patients (n=150, 18-65 years old, American Society of Anesthesiologists risk group I-III) scheduled undergo elective colonoscopy were included. They were randomized into three groups using the closed envelope methodpropofol-alfentanil (Group A), propofol-fentanyl (Group F), and propofol only (Group P)...
September 19, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28924371/comparison-of-the-analgesic-properties-of-sevoflurane-and-desflurane-using-surgical-pleth-index-at-equi-minimum-alveolar-concentration
#3
Kyoungho Ryu, Keulame Song, Jia Kim, Eugene Kim, Seong-Hyop Kim
Background: Traditionally, minimum alveolar concentration (MAC) has been used as the standard measure to compare the potencies of volatile anesthetics. However, it reflects the spinal mechanism of immobility rather than the subcortical mechanism of analgesia. Recently, the surgical pleth index (SPI) derived from photoplethysmographic waveform was shown to reflect the intraoperative analgesic component. This study was designed to compare the SPI values produced by equi-MAC of two commonly used volatile anesthetics, sevoflurane and desflurane...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28918427/safety-of-monitored-anesthesia-care-using-propofol-based-sedation-for-pleuroscopy
#4
Erik Vakil, Mona Sarkiss, David Ost, Macarena R Vial, Roberto F Casal, Georgie A Eapen, Horiana B Grosu
BACKGROUND: The optimal approach to sedation for pleuroscopy remains undefined. Propofol is the favored sedative-hypnotic for many proceduralists but has a narrow therapeutic window and the risk for oversedation is high. Propofol-based sedation administered by anesthesiologists and the routine use of end-tidal capnography and bispectral index (BIS) monitoring may attenuate risks of complications. OBJECTIVES: The purpose of our study was to evaluate the safety and efficacy of monitored anesthesia care for pleuroscopy...
September 16, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28899924/relationship-between-ugt1a9-gene-polymorphisms-efficacy-and-safety-of-propofol-in-induced-abortions-among-a-chinese-population-a-population-based-study
#5
Ying-Bin Wang, Rong-Zhi Zhang, Sheng-Hui Huang, Shu-Bao Wang, Jian-Qin Xie
This study aimed to investigate the influence of UGT1A9 gene polymorphisms on the efficacy of propofol in patients undergoing the painless induced abortion method. A total of 156 women seeking voluntary pregnancy termination procedures were selected for the study, and subsequently underwent painless induced abortions, following anesthesia by means of propofol administration. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed to detect the polymorphisms of UGT1A9 gene at -440C/T, -1818C/T and -1887T/G loci...
September 12, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28899891/effect-of-anesthesia-depth-on-postoperative-clinical-outcome-in-patients-with-supratentorial-tumor-depth-study-protocol-for-a-randomized-controlled-trial
#6
Qianyu Cui, Yuming Peng, Xiaoyuan Liu, Bo Jia, Jia Dong, Ruquan Han
INTRODUCTION: Recent studies have shown that deep anaesthesia is associated with poor outcomes. However, no randomised controlled trials have been conducted to test the causality in patients undergoing brain tumour resection. METHODS AND ANALYSIS: DEPTH is a multicenter, randomised, parallel-group, blind trial. The depth of general anaesthesia will be monitored using the bispectral index (BIS). Patients elected for supratentorial tumour resection will be randomly allocated to the deep or the light anaesthesia group in which the target BIS value is 35 or 50, respectively...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28895379/the-analgesic-potency-dose-of-remifentanil-to-minimise-stress-response-induced-by-intubation-and-measurement-uncertainty-of-surgical-pleth-index
#7
Ji H Park, Dong-Hee Kim, Sun-Kook Yoo, Hyun-Jun Lim, Joo-Won Lee, Won-Sik Ahn, Eun-Kyung Lee, Byung-Moon Choi, Gyu-Jeong Noh
BACKGROUND: The aim of this study was to evaluate the analgesic potency dose of remifentanil to maintain surgical pleth index (SPI) values at less than 50 after intubation in patients undergoing general anaesthesia with target-controlled infusion of propofol and remifentanil. METHODS: We randomly allocated 120 patients to receive one of three remifentanil target effect-site concentrations (5, 7, or 9 ng⋅ml-1) during intubation. The target effect-site concentrations of propofol were adjusted within a range of 2...
September 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28879332/anesthetic-management-for-simultaneous-drug-induced-sleep-endoscopy-and-maxillomandibular-advancement-in-a-patient-with-obstructive-sleep-apnea
#8
Tae Seong Kuk, Eunsun So, Myong-Hwan Karm, Jimin Kim, Seong In Chi, Hyun Jeong Kim, Kwang-Suk Seo, Sung Woon On, Jin-Young Choi
Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made...
March 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28875137/risk-factor-analysis-of-additional-administration-of-sedative-agent-and-patient-dissatisfaction-in-intravenous-conscious-sedation-using-midazolam-for-third-molar-extraction
#9
Dong-Whan Shin, Jin-Yong Cho, Yoon-Sic Han, Hye-Young Sim, Hee-Sun Kim, Da-Un Jung, Ho Lee
OBJECTIVES: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. MATERIALS AND METHODS: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study...
August 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28872658/evidence-of-hysteresis-in-propofol-pharmacodynamics
#10
P O Sepúlveda, E Carrasco, L F Tapia, M Ramos, F Cruz, P Conget, Q F B Olivares, I Cortínez
It is commonly assumed that loss of responsiveness and recovery of responsiveness occur at similar concentrations of propofol. However, the 'conscious' and 'anaesthetised' conditions produced by general anaesthetics may behave as two bistable states. We hypothesised that loss of responsiveness and recovery of responsiveness occur at different propofol concentrations. Propofol was administered to 19 healthy volunteers by effect-site target-controlled infusion using increasing and decreasing stable concentration steps of 7 min...
September 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28858130/effect-of-bispectral-index-guided-anesthesia-on-consumption-of-anesthetics-and-early-postoperative-cognitive-dysfunction-after-liver-transplantation-an-observational-study
#11
Ying-Hao Cao, Ping Chi, Yan-Xing Zhao, Xi-Chen Dong
The objective of this study was to summarize the incidence of postoperative cognitive dysfunction (POCD) after 7days following liver transplantation (LT), and to evaluate the effectiveness of bispectral index (BIS) guided anesthetic intervention in reducing POCD. Additional serum concentrations of S100β and neuron-specific enolase (NSE) were detected during surgery to determine whether they were reliable predictors of POCD.Patients who underwent LT at Beijing YouAn Hospital Affiliated to Capital University of Medical Science from January 2014 to December 2015 were enrolled...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#12
Sara Pedrosa, Nuno Lareiro, Pedro Amorim
INTRODUCTION: Narcoleptic patients may be at increased risk of prolonged emergence, postoperative hypersomnia, apneic episodes, and sleep paralysis after general anesthesia. Modafinil is the first-line treatment, however, the implication it has on general anesthesia is not clear. This report present 2 cases of narcoleptic patients medicated with modafinil that were submitted to total intravenous anesthesia for neurosurgical procedures. CASE PRESENTATION: Informed consent was obtained from both patients...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28854538/dexmedetomidine-pharmacokinetic-pharmacodynamic-modelling-in-healthy-volunteers-1-influence-of-arousal-on-bispectral-index-and-sedation
#13
P J Colin, L N Hannivoort, D J Eleveld, K M E M Reyntjens, A R Absalom, H E M Vereecke, M M R F Struys
Background: Dexmedetomidine, a selective α 2 -adrenoreceptor agonist, has unique characteristics, such as maintained respiratory drive and production of arousable sedation. We describe development of a pharmacokinetic-pharmacodynamic model of the sedative properties of dexmedetomidine, taking into account the effect of stimulation on its sedative properties. Methods: In a two-period, randomized study in 18 healthy volunteers, dexmedetomidine was delivered in a step-up fashion by means of target-controlled infusion using the Dyck model...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28844933/early-detection-of-brain-death-using-the-bispectral-index-bis-in-patients-treated-by-extracorporeal-cardiopulmonary-resuscitation-e-cpr-for-refractory-cardiac-arrest
#14
Romain Jouffroy, Lionel Lamhaut, Alexandra Guyard, Pascal Philippe, Kim An, Christian Spaulding, Frédéric Baud, Pierre Carli, Benoît Vivien
BACKGROUND: Despite increasing use of extracorporeal cardiopulmonary resuscitation (E-CPR) for treatment of refractory cardiac arrest patients, prognosis remains dismal, often resulting in brain-death. However, clinical assessment of brain-death occurence is difficult in post-cardiac arrest patients, sedated, paralyzed, under mild therapeutic hypothermia (MTH). Our objective was to assess the usefulness of Bispectral-Index (BIS) monitoring at bedside for an early detection of brain-death occurrence in refractory cardiac arrest patients treated by E-CPR...
August 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28840160/investigation-of-data-driven-optical-neuromonitoring-approach-during-general-anesthesia-with-sevoflurane
#15
Gabriela Hernandez-Meza, Meltem Izzetoglu, Ahmet Sacan, Michael Green, Kurtulus Izzetoglu
Anesthesia monitoring currently needs a reliable method to evaluate the effects of the anesthetics on its primary target, the brain. This study focuses on investigating the clinical usability of a functional near-infrared spectroscopy (fNIRS)-derived machine learning classifier to perform automated and real-time classification of maintenance and emergence states during sevoflurane anesthesia. For 19 surgical procedures, we examine the entire continuum of the maintenance-transition-emergence phases and evaluate the predictive capability of a support vector machine (SVM) classifier during these phases...
October 2017: Neurophotonics
https://www.readbyqxmd.com/read/28830480/recorded-time-periods-of-bispectral-index-values-equal-to-zero-predict-neurological-outcome-after-out-of-hospital-cardiac-arrest
#16
Ward Eertmans, Cornelia Genbrugge, Gilles Haesevoets, Jo Dens, Willem Boer, Frank Jans, Cathy De Deyne
BACKGROUND: Prognostication in out-of-hospital cardiac arrest (OHCA) survivors is often difficult. Recent studies have shown the predictive ability of bispectral index (BIS) monitoring to assist with early neuroprognostication. The aim of this study was to investigate whether characteristics of BIS values equal to zero (BIS 0) (i.e. duration and/or uni- versus bilateral presence) instead of simply their occurrence are better indicators for poor neurological outcome after OHCA by aiming at a specificity of 100%...
August 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28791477/electroencephalographic-effect-of-age-adjusted-1-mac-desflurane-and-sevoflurane-in-young-middle-aged-and-elderly-patients
#17
Shinya Kanazawa, Yutaka Oda, Chika Maeda, Ryu Okutani
PURPOSE: We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia. METHODS: One hundred and twenty young (20-30 years), middle-aged (31-65 years), and elderly (66-80 years) patients were randomly allocated to receive either desflurane or sevoflurane (n = 20, each group). General anesthesia was induced with propofol 2 mg/kg bolus and remifentanil 0.25 µg/kg/min, which was stopped after tracheal intubation...
August 8, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28767479/resistance-to-propofol-induction-in-a-patient-taking-modafinil-a-case-report
#18
Timothy N Harwood
After sedation with midazolam, induction of anesthesia with propofol was attempted in a patient taking modafinil. However, even after administration of a total of 6 mg/kg propofol IV, the patient continued to respond to tactile stimulation. Concurrently, the bispectral index was 72. Subsequent administration of low concentration sevoflurane by facemask induced an anesthetic depth that allowed unproblematic insertion of a laryngeal mask airway. Anesthesia for ophthalmologic surgery was maintained with sevoflurane...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28765758/clinical-benefits-of-deep-sedation-with-a-supraglottic-airway-while-monitoring-the-bispectral-index-during-catheter-ablation-of-atrial-fibrillation
#19
Satoru Hida, Masao Takemoto, Akihiro Masumoto, Takahiro Mito, Kazuhiro Nagaoka, Hiroshi Kumeda, Yuki Kawano, Ryota Aoki, Honsa Kang, Atsushi Tanaka, Atsutoshi Matsuo, Kiyoshi Hironaga, Teiji Okazaki, Kiyonobu Yoshitake, Kei-Ichiro Tayama, Ken-Ichi Kosuga
BACKGROUND: Pulmonary vein antrum isolation (PVAI) under sedation has proven to be a useful strategy for catheter ablation of atrial fibrillation (AF). METHODS: To evaluate the clinical benefits of respiratory management using supraglottic airways (SGAs) under deep sedation while monitoring the bispectral (BIS) index during the PVAI and the durations from admission to the catheterization room to starting the radiofrequency energy delivery (Time α), and from starting the radiofrequency energy delivery to completion of the PVAI (Time β), X-ray time, frequency of dislocations of the three-dimensional maps (D3DM), procedure-related complications, and proportion of an AF-free rate 15 months after the PVAI (PAFFR) in patients who received deep sedation without SGAs (Group A: n=48) and those with SGAs (Group B: n=51) were evaluated...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28761693/effect-of-dexmedetomidine-in-the-prophylactic-endoscopic-injection-sclerotherapy-for-oesophageal-varices-a-study-protocol-for-prospective-interventional-study
#20
Hiroki Nishikawa, Yoshinori Iwata, Akio Ishii, Hirayuki Enomoto, Yukihisa Yuri, Noriko Ishii, Yuho Miyamoto, Kunihiro Hasegawa, Chikage Nakano, Ryo Takata, Takashi Nishimura, Kazunori Yoh, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Tomoyuki Takashima, Hiroko Iijima, Shuhei Nishiguchi
BACKGROUND: Dexmedetomidine (DEX) is a novel, highly selective α2-adrenoceptor agonist that elicits sedative, amnestic, sympatholytic and analgesic effects in patients. Several Japanese investigators have reported the clinical usefulness of DEX for sedation in endoscopic therapies for gastrointestinal malignancies; however, there have been limited data regarding the usefulness and safety of DEX for sedation during endoscopic procedures for oesophageal varices (OVs), such as endoscopic injection sclerotherapy (EIS)...
2017: BMJ Open Gastroenterology
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