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https://www.readbyqxmd.com/read/28928557/a-comparative-evaluation-of-intravenous-dexmedetomidine-and-fentanyl-in-breast-cancer-surgery-a-prospective-randomized-and-controlled-trial
#1
Sakshi Goyal, Kewal Krishan Gupta, Vikram Mahajan
BACKGROUND AND AIM: Recent studies have advised narcotic less anaestheic techniques for breast cancer surgeries due to altered immune system by use of opioids. So we planned this study to compare the efficacy of dexmedtomidine with fentanyl in breast cancer surgery in terms of haemodynamic stability, anaesthetic sparing effects, recovery profile and postoperative analgesia. MATERIAL AND METHODS: In this randomized prospective controlled trial, a total of 60 female patients were randomly assigned into two groups...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28924371/comparison-of-the-analgesic-properties-of-sevoflurane-and-desflurane-using-surgical-pleth-index-at-equi-minimum-alveolar-concentration
#2
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/28916989/comparison-of-the-recovery-profile-between-desflurane-and-sevoflurane-in-patients-undergoing-bariatric-surgery-a-meta-analysis-of-randomized-controlled-trials
#3
REVIEW
Preet Mohinder Singh, Anuradha Borle, Jason McGavin, Anjan Trikha, Ashish Sinha
Early and clear recovery from anesthesia is the crux for preventing perioperative complications in the obese undergoing bariatric surgery. Volatile inhalation agents by virtue of high lipid solubility are expected to produce residual anesthetic effects. Prospective randomized trials comparing desflurane and sevoflurane used for anesthesia maintenance (electroencephalograph guided) during bariatric surgery published till 1st of July 2017 were searched in the medical database. Comparisons were made for surrogate markers of recovery from anesthesia that included time to eye-opening (TEo), time to tracheal-extubation (TEx), and Aldrete scores on immediately shifting to recovery (Ald-I)...
September 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28888583/food-and-drug-administration-warning-on-anesthesia-and-brain-development-implications-for-obstetric-and-fetal-surgery
#4
Olutoyin A Olutoye, Byron Wycke Baker, Michael A Belfort, Oluyinka O Olutoye
There has been growing concern about the detrimental effects of certain anesthetic agents on the developing brain. Preclinical studies in small animal models as well as nonhuman primates suggested loss or death of brain cells and consequent impaired neurocognitive function following anesthetic exposure in neonates and late gestation fetuses. Human studies in this area are limited and currently inconclusive. On Dec. 14, 2016, the US Food and Drug Administration issued a warning regarding impaired brain development in children following exposure to certain anesthetic agents used for general anesthesia, namely the inhalational anesthetics isoflurane, sevoflurane, and desflurane, and the intravenous agents propofol and midazolam, in the third trimester of pregnancy...
September 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28879896/a-comparison-of-the-recovery-profiles-of-desflurane-and-isoflurane-anesthesia-in-patients-undergoing-elective-supratentorial-craniotomy-a-randomized-controlled-trial
#5
Aparanjit P Paul, Aditya Vedantam, Grace Korula, Ari G Chacko
CONTEXT: Few studies have compared recovery profiles of desflurane and isoflurane for patients undergoing elective supratentorial craniotomy. It is not known if the choice of inhalational agent can affect the duration of transient postoperative neurological deficits in these patients. AIMS: To compare the effect of desflurane and isoflurane on time-to-emergence and time-to-recovery of transient postoperative neurological deficits in patients undergoing supratentorial craniotomy...
September 2017: Neurology India
https://www.readbyqxmd.com/read/28877873/the-in-vitro-zebrafish-heart-as-a-model-to-investigate-the-chronotropic-effects-of-vapor-anesthetics
#6
Matthew R Stoyek, Michael K Schmidt, Florentin M Wilfart, Roger P Croll, Frank M Smith
In addition to their intended clinical actions, all general anesthetic agents in common use have detrimental intra- and post-surgical side effects on organs and systems including the heart. The major cardiac side effect of anesthesia is bradycardia, which increases the probability of insufficient systemic perfusion during surgery. These side effects also occur in all vertebrate species so far examined, but the underlying mechanisms are not clear. The zebrafish heart is a powerful model for studying cardiac electrophysiology, employing the same pacemaker system and neural control as do mammalian hearts...
September 6, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28861655/inhaled-anesthetic-agent-sedation-in-the-icu-and-trace-gas-concentrations-a-review
#7
REVIEW
Jennifer Herzog-Niescery, Hans-Martin Seipp, Thomas Peter Weber, Martin Bellgardt
There is a growing interest in the use of volatile anesthetics for inhalational sedation of adult critically ill patients in the ICU. Its safety and efficacy has been demonstrated in various studies and technical equipment such as the anaesthetic conserving device (AnaConDa™; Sedana Medical, Uppsala, Sweden) or the MIRUS™ system (Pall Medical, Dreieich, Germany) have significantly simplified the application of volatile anesthetics in the ICU. However, the personnel's exposure to waste anesthetic gas during daily work is possibly disadvantageous, because there is still uncertainty about potential health risks...
August 31, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28858134/desflurane-versus-sevoflurane-in-pediatric-anesthesia-with-a-laryngeal-mask-airway-a-randomized-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Eun-Hee Kim, In-Kyung Song, Ji-Hyun Lee, Hee-Soo Kim, Hyun-Chang Kim, Soo-Hyuk Yoon, Young-Eun Jang, Jin-Tae Kim
BACKGROUND: Desflurane with a laryngeal mask airway may have advantages during ambulatory anesthesia. However, desflurane-induced airway irritability makes the use of desflurane challenging, especially in children. This study compared desflurane with sevoflurane maintenance anesthesia in terms of respiratory events and the emergence characteristics in children with a laryngeal mask airway. METHODS: This randomized controlled trial evaluated 200 children undergoing strabismus surgery allocated to desflurane or sevoflurane groups...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28857808/effect-of-bronchoconstriction-induced-ventilation-perfusion-mismatch-on-uptake-and-elimination-of-isoflurane-and-desflurane
#9
Moritz Kretzschmar, Alf Kozian, James E Baumgardner, Joao Batista Borges, Göran Hedenstierna, Anders Larsson, Thomas Hachenberg, Thomas Schilling
BACKGROUND: Increasing numbers of patients with obstructive lung diseases need anesthesia for surgery. These conditions are associated with pulmonary ventilation/perfusion (VA/Q) mismatch affecting kinetics of volatile anesthetics. Pure shunt might delay uptake of less soluble anesthetic agents but other forms of VA/Q scatter have not yet been examined. Volatile anesthetics with higher blood solubility would be less affected by VA/Q mismatch. We therefore compared uptake and elimination of higher soluble isoflurane and less soluble desflurane in a piglet model...
August 30, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28831619/important-role-of-calcium-chloride-in-preventing-carbon-monoxide-generation-during-desflurane-degradation-with-alkali-hydroxide-free-carbon-dioxide-absorbents
#10
Takahiro Ando, Atsushi Mori, Rie Ito, Kimitoshi Nishiwaki
We investigated whether calcium chloride (CaCl2), a supplementary additive in carbon dioxide (CO2) absorbents, could affect carbon monoxide (CO) production caused by desflurane degradation, using a Japanese alkali-free CO2 absorbent Yabashi Lime(®)-f (YL-f), its CaCl2-free and 1% CaCl2-added derivatives, and other commercially available alkali-free absorbents with or without CaCl2. The reaction between 1 L of desflurane gas (3-10%) and 20 g of desiccated specimen was performed in an artificial closed-circuit anesthesia system for 3 min at 20 or 40 °C...
August 22, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28800884/ionic-mechanisms-of-the-action-of-anaesthetics-on-sinoatrial-node-automaticity
#11
REVIEW
Akiko Kojima, Hiroshi Matsuura
Although various general anaesthetics affect the heart rate in clinical settings, their precise mechanisms remain to be fully elucidated. Because the heart rate is determined by automaticity of the cardiac pacemaker sinoatrial node and its regulation by autonomic nervous system, it is important to clarify the effect of anaesthetics on sinoatrial node automaticity. The spontaneous electrical activity of sinoatrial node is generated by a complex but coordinated interaction of multiple ionic currents, such as the hyperpolarisation-activated cation current (If), T-type and L-type Ca(2+) currents (ICa,T and ICa,L), Na(+)/Ca(2+) exchange current (INCX), and rapidly and slowly activating delayed rectifier K(+) currents (IKr and IKs)...
August 8, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28791477/electroencephalographic-effect-of-age-adjusted-1-mac-desflurane-and-sevoflurane-in-young-middle-aged-and-elderly-patients
#12
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/28757832/sugammadex-versus-two-doses-of-neostigmine-for-reversal-of-rocuronium-in-gastric-sleeve-surgery
#13
Abdulhamid Alsaeed, Fahad Bamehriz, Sharaf Eldin, Tareq Alzahrani, Abdullah Alharbi, Abdelazeem Eldawlatly
BACKGROUND AND AIM: The aim of this prospective randomized trial is to compare the quality of reversal of rocuronium with either sugammadex (SUG) versus 2.5 mg or 5 mg neostigmine (NEO). PATIENTS AND METHODS: A total of 110 patients with body mass index >40 underwent elective gastric sleeve surgery were enrolled in this study. Exclusion criteria included patients with co-existing muscular and cardiovascular diseases. Patients were randomly allocated to one of the following groups: group A (SUG), Group B (NEO 2...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28745667/-prevention-and-correction-of-cognitive-dysfunction-after-general-anesthesia
#14
A Yu Novikov, V A Kovalev, N V Vinichuk, Yu A Chernyh, I E Golub, L V Sorokina
AIM: To evaluate clinical efficacy of intraoperative use of cytoflavin in the prevention and correction of cognitive functions in surgical patients with no history of neurological and psychosomatic disorders. MATERIAL AND METHODS: The study included 60 female patients who underwent surgery on the thyroid gland. Patients were stratified into two equal groups matched for main indices. Patients of the main group received infusions of cytoflavin (20 ml in 200 ml of 5% glucose solution)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28714298/effect-of-sugammadex-on-coagulation-as-detected-by-rotational-thromboelastometry-in-morbidly-obese-patients
#15
Michele Carron, Diana Bertini, Tancredi Prandini, Francesca Fanton, Mirto Foletto, Carlo Ori, Egle Perissinotto, Paolo Simioni
BACKGROUND: Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). METHODS: Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (n = 30/group) at the end of surgery under desflurane anesthesia...
July 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28655953/effect-of-nitrous-oxide-on-bispectral-index-values-at-equi-minimum-alveolar-concentrations-of-sevoflurane-and-desflurane
#16
Rajeeb Kumar Mishra, Charu Mahajan, Hemanshu Prabhakar, Indu Kapoor, Parmod Kumar Bithal
BACKGROUND AND AIMS: Bispectral index (BIS) values may be anaesthetic agent-specific, depending on their ability to suppress the electroencephalogram (EEG) signals. We carried out a prospective, randomised clinical trial to study the effect of nitrous oxide (N2O) on the BIS values at an equi-minimum alveolar concentration (MAC) of sevoflurane and desflurane. METHODS: Sixty adult patients undergoing spine surgery were randomised into two groups; Group S (sevoflurane; n = 30) and Group D (desflurane; n = 30) for the maintenance of anaesthesia in oxygen and air or oxygen and N2O mixture (FiO2-0...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28625437/inhalation-versus-intravenous-anaesthesia-for-adults-undergoing-on-pump-or-off-pump-coronary-artery-bypass-grafting-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
REVIEW
Regina El Dib, José E Guimarães Pereira, Arnav Agarwal, Huda Gomaa, Ana Patricia Ayala, Andresa Graciutti Botan, Leandro Gobbo Braz, Luciane Dias de Oliveira, Luciane Cruz Lopes, Preethy J Mathew
STUDY OBJECTIVE: To compare the use of inhalation versus intravenous anaesthesia for adults undergoing on-pump or off-pump coronary artery bypass grafting. DESIGN: A systematic review. SETTING: A hospital-affiliated university. MEASUREMENTS: The following databases were searched: the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 10), MEDLINE, EMBASE, and LILACS (from inception to October 2016). We used the GRADE approach to rate overall certainty of the evidence...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28618676/re-the-effect-of-sevoflurane-versus-desflurane-on-postoperative-catheter-related-bladder-discomfort-in-patients-undergoing-transurethral-excision-of-a-bladder-tumour-a-randomized-controlled-trial
#18
https://www.readbyqxmd.com/read/28611600/changes-in-alpha-frequency-and-power-of-the-electroencephalogram-during-volatile-based-general-anesthesia
#19
Darren Hight, Logan J Voss, Paul S Garcia, Jamie Sleigh
Oscillations in the electroencephalogram (EEG) at the alpha frequency (8-12 Hz) are thought to be ubiquitous during surgical anesthesia, but the details of how this oscillation responds to ongoing changes in volatile anesthetic concentration have not been well characterized. It is not known how often alpha oscillations are absent in the clinical context, how sensitively alpha frequency and power respond to changes in anesthetic concentration, and what effect increased age has on alpha frequency. Bipolar EEG was recorded frontally from 305 patients undergoing surgery with sevoflurane or desflurane providing general anesthesia...
2017: Frontiers in Systems Neuroscience
https://www.readbyqxmd.com/read/28607337/safety-aspects-of-desflurane-anesthesia-and-laryngeal-mask-airway
#20
Marco Rossi, Antonio Corcione, Clelia Esposito, Massimo Micaglio, Roberta Monzani, Carlo Ori
Laryngeal mask (LM) and inhaled anesthesia combination is often deemed unsuitable. Actually the evolution of surgical procedures towards minimal invasiveness, the search of improved productivity, and the contemporary need for patient safety and faster recovery, push the anesthetists to get interested in their use in the daily practice. An Expert Panel composed by anesthetists coming from university and tertiary hospitals undertook to write an Expert Opinion on the correct management of LM and desflurane in adult patients, with a view to issuing a simple operative protocol for their combined intraoperative usage...
June 12, 2017: Minerva Anestesiologica
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