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https://www.readbyqxmd.com/read/29331922/minimum-alveolar-concentration-key-concepts-and-a-review-of-its-pharmacological-reduction-in-dogs-part-1
#1
REVIEW
Rachel Reed, Thomas Doherty
OBJECTIVE: To outline the major components of the minimum alveolar concentration (MAC) and review the literature in regard to pharmacological manipulation of the MAC of halothane, isoflurane, sevoflurane, enflurane, and desflurane in dogs. The pharmacologic agents included are alpha-2 agonists, benzodiazepines, propofol, maropitant, opioids, lidocaine, acepromazine, non-steroidal anti-inflammatory agents, and NMDA antagonists. Part 1 will focus on summarizing the relevance, measurement, and mechanisms of MAC and review the effects of alpha-2 agonists, benzodiazepines, and propofol on MAC...
January 9, 2018: Research in Veterinary Science
https://www.readbyqxmd.com/read/29284864/effect-of-intravenous-magnesium-sulfate-on-the-minimum-alveolar-concentrations-of-desflurane-using-bispectral-index-monitoring-a-prospective-randomized-double-blind-controlled-study
#2
Mohd Rameez Riaz, Vikram Mahajan, Sadaf Syed, Riyaz Ahmad
Background: Magnesium sulfate has been implicated to influence the minimum alveolar concentration (MAC) of various volatile anesthetics, but its effect on desflurane remains unanswered so far. Aim: To study the effect of perioperative intravenous magnesium sulfate on MAC of desflurane using bispectral index (BIS) monitoring. Settings: Operating room of a tertiary care hospital. Design: A prospective, randomized, controlled, double-blind clinical trial...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284842/randomized-comparison-of-isoflurane-versus-sevoflurane-and-desflurane-for-maintenance-of-ambulatory-anesthesia
#3
Pranjali Kurhekar, Krishnagopal Vinod, J Shesha Dhiviya Krishna, M Sethuraman Raghuraman
Background: Ambulatory surgeries demand safe anesthesia with faster recovery which makes it expensive due to the cost of inhalational anesthetic agents such as sevoflurane and desflurane. Isoflurane is inexpensive agent but can cause delayed recovery. The aim of this study was to evaluate cost-benefit ratio of all three agent with respect to recovery and safety profile. Materials and Methods: Patients posted for elective ambulatory surgeries were divided into three groups...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284832/application-of-discharge-criteria-for-home-readiness-using-bispectral-and-supraglottic-airway-devices-in-day-care-surgery-without-using-muscle-relaxants
#4
Joginder Pal Attri, Manjit Singh, Hemchandra Bhatt, Kamal Jyoti, Harjinder Kaur
Introduction: The availability of rapid and short-acting intravenous and volatile anesthetics has facilitated early recovery that is why nowadays ambulatory surgery is becoming more common. If the criteria used to discharge patients from the Postanesthesia Care Unit (PACU) are met in the operating room (OR), it would be appropriate to consider bypassing the PACU and transferring the patient directly to the step-down unit. This process is known as "fast-tracking" after ambulatory surgery...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29239148/effects-of-closed-loop-intravenous-anesthesia-guided-by-the-bispectral-index-in-adult-patients-on-emergence-delirium-a-randomized-controlled-study
#5
Antonella Cotoia, Lucia Mirabella, Renata Beck, Pompeo Matrella, Valentina Assenzo, Thierry Chazot, Gilda Cinnella, Ngai Liu, Michele Dambrosio
BACKGROUND: Emergence delirium (ED) is an acute change in cognition after general anesthesia (GA) occurring in operative room, recovery room or in postanesthesia care. The automated propofolremifentanil titration by Bispectral index (BIS) (AutoTIVA) avoids period of deep (BIS<40) anesthesia and could potentially decrease the ED. The aim of this study was to evaluate ED in surgical patients under AutoTIVA, manual titration of propofol-remifentanil (ManualTIVA) or volatile BIS-guided GA...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29223575/a-comparison-between-inhalational-desflurane-and-total-intravenous-anaesthesia-propofol-and-dexmedetomidine-in-improving-postoperative-recovery-for-morbidly-obese-patients-undergoing-laparoscopic-sleeve-gastrectomy-a-double-blinded-randomised-controlled-trial
#6
Abd-Elazeem Elbakry, Wesam-Eldin Sultan, Ezzeldin Ibrahim
STUDY OBJECTIVE: Laparoscopic sleeve gastrectomy is commonly performed under total intravenous anaesthesia (TIVA) or balanced anaesthesia using an intravenous and inhalation agent. It is still unclear which anaesthesia regimen is better for this group of patients. The present study has been conducted to compare the use of the inhalation anaesthesia technique using desflurane with the TIVA technique, using propofol and dexmedetomidine. DESIGN: Prospective, randomised, double-blinded study...
December 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29214418/choice-of-desflurane-or-propofol-for-the-maintenance-of-general-anesthesia-does-not-affect-the-risk-of-periprocedural-myocardial-damage-in-patients-undergoing-transfemoral-transcatheter-aortic-valve-implantation
#7
Kenta Okitsu, Takeshi Iritakenishi, Tatsuyuki Imada, Michioki Kuri, Sho Carl Shibata, Yuji Fujino
PURPOSE: This study aimed to reveal whether the occurrence of periprocedural myocardial damage (PMD) decreases in patients who received volatile anesthetics to maintain general anesthesia compared with those who received propofol during transcatheter aortic valve implantation (TAVI). METHODS: We included one hundred and forty adult patients who underwent transfemoral TAVI under general anesthesia from January 2015 to March 2017 in this single-center retrospective review...
December 6, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29189279/alkalinized-lidocaine-preloaded-endotracheal-tube-cuffs-reduce-emergence-cough-after-brief-surgery-a-prospective-randomized-trial
#8
Papu Nath, Stephan Williams, Luis Fernando Herrera Méndez, Nathalie Massicotte, François Girard, Monique Ruel
BACKGROUND: Alkalinized lidocaine in the endotracheal tube (ETT) cuff decreases the incidence of cough and throat pain on emergence after surgery lasting more than 2 hours. However, alkalinized lidocaine needs 60-120 minutes to cross the ETT cuff membrane; therefore, its usefulness in shorter duration surgery is unknown. This prospective double-blind randomized controlled trial tested the hypothesis that alkalinized lidocaine would reduce the incidence of emergence cough after surgeries lasting <120 minutes...
November 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29161390/thiopental-to-desflurane-an-anaesthetic-journey-where-are-we-going-next
#9
J R Sneyd
Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and paralysis with manageable off-target effects. The availability of these agents at generic prices inhibits commercial interest and this is reflected in the limited number of current anaesthetic drug development projects...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29152208/correction-argon-attenuates-the-emergence-of-secondary-injury-after-traumatic-brain-injury-within-a-2-hour-incubation-period-compared-to-desflurane-an-in-vitro-study
#10
(no author information available yet)
[This corrects the article on p. 93 in vol. 7, PMID: 28744361.].
July 2017: Medical Gas Research
https://www.readbyqxmd.com/read/29132231/the-use-of-desflurane-for-neurosurgical-procedures-in-rhesus-macaque-macaca-mulatta
#11
Henri Gmj Bertrand, Charlotte Sandersen, Paul A Flecknell
Volatile agents are widely used to anaesthetise laboratory non-human primates as they allow a rapid induction and recovery as well as an easy adjustment of the anaesthesia plan. Desflurane is currently the volatile agent with the lowest solubility in blood, and hence enables the most rapid onset of anaesthesia and most rapid recovery. This study aimed to investigate the suitability of desflurane for maintenance of general anaesthesia in rhesus macaques undergoing elective experimental neurosurgery. Fourteen primates (five males and nine females) were sedated with ketamine (10 mg kg(-1)) and anaesthesia was induced with propofol (usually 8 mg kg(-1) IV)...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/29126612/desflurane-versus-propofol-in-post-operative-quality-of-recovery-of-patients-undergoing-day-laparoscopic-cholecystectomy-prospective-comparative-non-inferiority-study
#12
M Zaballos, A Reyes, J Etulain, C Monteserín, M Rodríguez, E Velasco
OBJECTIVE: Recently, the evaluation of postoperative results has focused on the opinion of the patient as of great relevance. Our objective was to evaluate the quality of recovery by questionnaire (QoR-15) in patients undergoing laparoscopic cholecystectomy, comparing desflurane versus a total intravenous technique with propofol (TIVA). A non-inferiority hypothesis was proposed between both techniques. MATERIAL AND METHODS: Prospective longitudinal cohort study in patients undergoing laparoscopic cholecystectomy in which multimodal management was applied including low pneumoperitoneum pressures, deep neuromuscular block and pain prevention strategy and PONV...
November 7, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29113802/desflurane-inhibits-endothelium-dependent-vasodilation-more-than-sevoflurane-with-inhibition-of-endothelial-nitric-oxide-synthase-by-different-mechanisms
#13
Satoshi Kazuma, Yasuyuki Tokinaga, Yukimasa Takada, Ryu Azumaguchi, Motonobu Kimizuka, Shunsuke Hayashi, Michiaki Yamakage
The effects of desflurane on endothelium-dependent vasodilation remain uncertain, whereas sevoflurane is known to inhibit it. Endothelium-dependent vasodilation is mainly mediated by endothelial nitric oxide synthase. The effects of desflurane on endothelium-dependent vasodilation were compared with those of sevoflurane, and inhibition mechanisms, including phosphorylation of endothelial nitric oxide synthase and the calcium pathway, were evaluated for the two anesthetics. We hypothesized that desflurane would inhibit endothelium-dependent vasodilation in a concentration-dependent manner more than sevoflurane, with inhibition of a calcium pathway...
November 4, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29109639/evaluation-of-the-efficacy-of-desflurane-with-or-without-labetalol-for-hypotensive-anesthesia-in-middle-ear-microsurgery
#14
Neha Gupta, Vandana Talwar, Smita Prakash, Achyut Deuri, Anoop Raj Gogia
Background and Aims: Hypotensive anesthesia technique is used to reduce intraoperative bleeding and to improve the visibility of the operative field. The aim was to evaluate the efficacy of desflurane with and without labetalol for producing hypotensive anesthesia. Material and Methods: Sixty adult patients undergoing elective middle ear surgery were administered general anesthesia and randomly divided into two groups - Group D and Group L. The target mean arterial pressure (MAP) was 55-65 mmHg during hypotensive period...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29094751/evaluation-of-a-novel-waste-anaesthetic-gas-scavenger-device-for-use-during-recovery-from-anaesthesia
#15
R Tallent, J Corcoran, J Sebastian
Volatile anaesthetic agents are a potential occupational health hazard to theatre and recovery staff. Operating theatres and anaesthetic rooms are required to be equipped with scavenging systems, but recovery units often are not. We compared exhaled, spectrophotometric sevoflurane and desflurane concentrations 15 cm from the mouth ('patient breathing zone') and 91 cm laterally to the patient ('nurse work zone') in 120 patients after tracheal extubation who were consecutively allocated to either ISO-Gard mask oxygen/scavenging or standard oxygen mask, 0 min, 10 min and 20 min after arrival in the theatre recovery unit...
November 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29080558/isoflurane-and-postoperative-respiratory-depression-following-laparoscopic-surgery-a-retrospective-propensity-matched-analysis
#16
Alexandre N Cavalcante, Carmelina Gurrieri, Juraj Sprung, Darrell R Schroeder, Toby N Weingarten
Episodes of respiratory depression during the immediate postoperative recovery period (Phase I post-anesthesia recovery) have been associated with respiratory complications during Phase II recovery. Using multivariable analyses in several surgical cohorts, we previously identified potential associations between patient and perioperative factors and increased risk for Phase I respiratory depression. The aim of this study is to use the propensity matched analysis to specifically assess for a potential association between the use of isoflurane and episodes of Phase I respiratory depression after laparoscopic operations...
October 28, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29068578/the-effect-of-desflurane-and-propofol-protocols-on-preconditioning
#17
Didem Onk, Fatih Ozcelik, Ufuk Kuyrukluyıldız, Murat Gunay, Alper Onk, Tulin Akarsu Ayazoglu, Abdulkadir Coban, Aysin Alagol
BACKGROUND: Preconditioning is one of the most powerful mechanisms preventing the myocardial ischemic damage that occurs during coronary artery bypass grafting. OBJECTIVES: We aimed to investigate the effects of different propofol and/or desflurane administration protocols in terms of the prevention of ischaemia-reperfusion damage. MATERIAL AND METHODS: Ninety patients, aged > 18 years, American Society of Anesthesiologists (ASA) category III, scheduled to undergo primary elective coronary artery bypass grafting (CABG), were included in the study...
August 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29068040/electrophysiological-effects-of-desflurane-in-children-with-wolff-parkinson-white-syndrome-a-randomized-crossover-study
#18
H Hino, Y Oda, Y Yoshida, T Suzuki, M Shimada, K Nishikawa
BACKGROUND: We hypothesized that, compared with propofol, desflurane prolongs the antegrade accessory pathway effective refractory period (APERP) in children undergoing radiofrequency catheter ablation for Wolff-Parkinson-White (WPW) syndrome. METHODS: In this randomized crossover study, children aged 4.1-16.1 years undergoing radiofrequency catheter ablation for WPW syndrome were randomly divided into four groups according to the concentration of desflurane and anesthetics used in the first and the second electrophysiological studies (EPS)...
October 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29049251/esmolol-pretreatment-attenuates-heart-rate-increase-and-parasympathetic-inhibition-during-rapid-increases-in-desflurane-concentration-a-preliminary-randomized-study
#19
RANDOMIZED CONTROLLED TRIAL
Ming-Chang Kao, I-Shiang Tzeng, Hsiao-Lung Chan
BACKGROUND: Rapid increases in desflurane concentration can transiently increase the heart rate (HR). Esmolol possesses a high β1-adrenoceptor selectivity and a short duration of action. This preliminary study aimed at investigating the effects of esmolol on the HR and autonomic modulation during a desflurane-induced HR increase. METHODS: American Society of Anesthesiologists physical status I female subjects, aged 20 to 50 years, who were undergoing minor breast surgery were randomly assigned to 2 groups...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29039138/the-role-of-gaba-receptor-agonists-in-anesthesia-and-sedation
#20
REVIEW
Janette Brohan, Basavana G Goudra
GABA (γ-aminobutyric acid) receptors, of which there are two types, are involved in inhibitory synapses within the central nervous system. The GABAA receptor (GABAAR) has a central role in modern anesthesia and sedation practice, which is evident from the high proportion of agents that target the GABAAR. Many GABAAR agonists are used in anesthesia practice and sedation, including propofol, etomidate, methohexital, thiopental, isoflurane, sevoflurane, and desflurane. There are advantages and disadvantages to each GABAAR agonist currently in clinical use...
October 2017: CNS Drugs
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