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https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#1
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28089560/critical-role-of-p2x7-receptors-in-the-neuroinflammation-and-cognitive-dysfunction-after-surgery
#2
Bin Zheng, Renchun Lai, Jun Li, Zhiyi Zuo
Postoperative cognitive dysfunction worsens patient outcome after surgery. Neuroinflammation is a critical neuropathological process for it. We determined the role of P2X7 receptors, proteins that participate in inflammatory response, in the neuroinflammation induction after surgery, and whether the choice of volatile anesthetics affects its occurrence. Eight-week old C57BL/6J or P2X7 receptor knockout male mice were subjected to right carotid arterial exposure under anesthesia with 1.8% isoflurane, 2.5% sevoflurane or 10% desflurane...
January 9, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28079567/cardiac-calcium-release-channel-ryanodine-receptor-2-regulation-by-halogenated-anesthetics
#3
Derek R Laver, John Attia, Christopher Oldmeadow, Anthony W Quail
BACKGROUND: Halogenated anesthetics activate cardiac ryanodine receptor 2-mediated sarcoplasmic reticulum Ca release, leading to sarcoplasmic reticulum Ca depletion, reduced cardiac function, and providing cell protection against ischemia-reperfusion injury. Anesthetic activation of ryanodine receptor 2 is poorly defined, leaving aspects of the protective mechanism uncertain. METHODS: Ryanodine receptor 2 from the sheep heart was incorporated into artificial lipid bilayers, and their gating properties were measured in response to five halogenated anesthetics...
January 12, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28067710/time-and-dose-dependent-effects-of-desflurane-in-sensitized-airways
#4
Jing Zhou, Sohshi Iwasaki, Michiaki Yamakage
BACKGROUND: Although the bronchodilatory actions of volatile anesthetics, such as halothane, isoflurane, and sevoflurane, have been well documented in previous studies, the properties of desflurane remain controversial. The aim of this study was to investigate the effects of desflurane at different concentrations and durations in an ovalbumin-sensitized guinea pig model of airway hyper-responsiveness. METHODS: Ovalbumin-sensitized animals (n = 176) were randomly assigned to 5 groups according to the minimum alveolar concentration (MAC) of desflurane they received: 0...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28045949/influence-of-volatile-anesthesia-on-the-release-of-glutamate-and-other-amino-acids-in-the-nucleus-accumbens-in-a-rat-model-of-alcohol-withdrawal-a-pilot-study
#5
Thomas Seidemann, Claudia Spies, Rudolf Morgenstern, Klaus-Dieter Wernecke, Nicolai Netzhammer
BACKGROUND: Alcohol withdrawal syndrome is a potentially life-threatening condition, which can occur when patients with alcohol use disorders undergo general anesthesia. Excitatory amino acids, such as glutamate, act as neurotransmitters and are known to play a key role in alcohol withdrawal syndrome. To understand this process better, we investigated the influence of isoflurane, sevoflurane, and desflurane anesthesia on the profile of excitatory and inhibitory amino acids in the nucleus accumbens (NAcc) of alcohol-withdrawn rats (AWR)...
2017: PloS One
https://www.readbyqxmd.com/read/27995008/desflurane-inhalation-before-ischemia-increases-ischemia-reperfusion-induced-vascular-leakage-in-isolated-rabbit-lungs
#6
Yoshiaki Oshima, Seiji Sakamoto, Kazumasa Yamasaki, Shinsuke Mochida, Kazumi Funaki, Naoki Moriyama, Akihiro Otsuki, Ryo Endo, Masato Nakasone, Shunsaku Takahashi, Tomomi Harada, Yukari Minami, Yoshimi Inagaki
BACKGROUND: Isoflurane and sevoflurane protect lungs with ischemia-reperfusion (IR) injury. We examined the influence of desflurane on IR lung injury using isolated rabbit lungs perfused with a physiological salt solution. METHODS: The isolated lungs were divided into three groups: IR, desflurane-treated ischemia-reperfusion (DES-IR), and ventilation/perfusion-continued control (Cont) groups (n = 6 per group). In the DES-IR group, inhalation of desflurane at 1 minimum alveolar concentration (MAC) was conducted in a stable 30-min phase...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27973938/anesthetic-management-of-a-patient-with-ehlers-danlos-syndrome
#7
Naohiro Ohshita, Masahiko Kanazumi, Kaname Tsuji, Hiroaki Yoshida, Shosuke Morita, Yoshihiro Momota, Yasuo M Tsutsumi
We describe the case of a 37-year-old woman who had been diagnosed with Ehlers-Danlos syndrome (EDS) 4 years earlier and was scheduled to undergo removal of synovial chondromatosis in the temporomandibular joint. EDS is a heritable connective tissue disorder and has 6 types. In this case, the patient was classified into EDS hypermobility type. The major clinical feature of this type is joint hypermobility. The patient had sprain or subluxation of the elbows and ankles and dislocation of the knees. Anticipated problems during general anesthesia would be affected by the disease type...
2016: Anesthesia Progress
https://www.readbyqxmd.com/read/27930751/correction-comparison-of-anesthesia-controlled-operating-room-time-between-propofol-based-total-intravenous-anesthesia-and-desflurane-anesthesia-in-open-colorectal-surgery-a-retrospective-study
#8
https://www.readbyqxmd.com/read/27930598/the-anhepatic-phase-extended-by-temporary-portocaval-shunt-does-not-affect-anesthetic-sensitivity-and-postoperative-cognitive-function-a-case-control-study
#9
Young Gon Son, Sung Hye Byun, Jong Hae Kim
Temporary portocaval shunt (TPCS) prolongs the duration of the anhepatic phase, during which anesthetic sensitivity is highest among the 3 phases of living donor liver transplantation (LDLT). Cognitive dysfunction has been associated with increased anesthetic sensitivity and poor hepatic function. Therefore, we assessed anesthetic sensitivity to desflurane and perioperative cognitive function in patients undergoing LDLT, in whom the duration of the anhepatic phase was extended by TPCS to test the hypothesis that the prolonged anhepatic phase increases anesthetic sensitivity and causes postoperative cognitive decline...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27909593/our-anaesthetic-experiences-in-patients-undergoing-percutaneous-mitraclip-implantation
#10
Ezgi Erkılıç, Elvin Kesimci, Cihan Döğer, Tülin Gümüş, Süleyman Ellik, Orhan Kanbak
OBJECTIVE: Percutaneous mitraclip implantation system, is a new technique developed for patients with high surgical risks. It is generally performed in a catheterisation laboratory with the guidance of fluoroscopy and transesophageal echocardiography. In this study, we aimed to share our experiences on anaesthetic in patients undergoing mitraclip implantation under general anaesthesia. METHODS: Eighty four patients with severe, symptomatic mitral insufficiency, who had undergone MitraClip implantation under general anaesthesia between July 2012 and March 2015 (54 male, 30 female; mean age: 68...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27909592/effect-of-day-and-night-desflurane-anaesthesia-on-melatonin-levels-in-rats
#11
Figen Datlı Özer, Elvan Öçmen, Pınar Akan, Hale Aksu Erdost, Sezen Korkut, Ali Necati Gökmen
OBJECTIVE: The aim of this study is to investigate the effect of day and night administration of desflurane anaesthesia on melatonin levels in rats. METHODS: Twenty-four 15-day-old rats were included in the study and were divided into four groups. The rats were anaesthetised between 19:00-01:00 (night group) and 07:00-13:00 (day group) with 5.7% desflurane concentration in 6 L min(-1) 100% oxygen. 6 L min(-1) oxygen was administered to the control groups. At the end of 6 h of anaesthesia, blood samples were taken, and rats were sacrificed...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#12
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27877068/comparative-study-of-minimal-fresh-gas-flow-used-in-lack-plus-and-lack-s-circuit-in-spontaneously-breathing-anesthetized-adults
#13
Sunchai Theerapongpakdee, Thepakorn Sathitkarnmanee, Sirirat Tribuddharat, Siwalai Sucher, Maneerat Thananun, Duangthida Nonlhaopol
BACKGROUND: The Lack's circuit is a co-axial Mapleson A breathing system commonly used in spontaneously breathing anesthetized adults but still requires high fresh gas flow (FGF). The Lack-Plus circuit was invented with the advantage of lower FGF requirement. The authors compared the Lack-Plus and Lack's circuit for the minimal FGF requirement with no rebreathing in spontaneously breathing anesthetized adults. METHODS: This was a randomized crossover study. We enrolled 24 adult patients undergoing supine elective surgery, with a body mass index ≤30 kg/m(2) and an American Society of Anesthesiologists physical status I-II...
2016: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/27871572/the-effects-of-sevoflurane-and-desflurane-on-the-hemodynamics-and-respiratory-functions-in-laparoscopic-sleeve-gastrectomy
#14
Hatice Kaya Ozdogan, Suleyman Cetinkunar, Faruk Karateke, Sibel Cetinalp, Muge Celik, Sefa Ozyazici
STUDY OBJECTIVES: Sleeve gastrectomy has been one of the most commonly performed bariatric surgery methods. The study aimed to compare the effects of 2 most commonly used inhalation anesthetics, sevoflurane and desflurane, on the peroperative hemodynamic alterations and postoperative respiratory functions in morbidly obese patients undergoing sleeve gastrectomy. DESIGN: Nonrandomized cohort. SETTINGS: Operating room, postoperative period. PATIENTS: Eighty-four morbidly obese patients with a body mass index greater than 40 kg/m(2) who had scheduled to undergo sleeve gastrectomy operation were prospectively included in the study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871537/-1-8-million-and-counting-how-volatile-agent-education-has-decreased-our-spending-1000-per-day
#15
Scott A Miller, Carol A Aschenbrenner, Justin R Traunero, Loren A Bauman, Samuel S Lobell, Jeffrey S Kelly, John E Reynolds
STUDY OBJECTIVE: Volatile anesthetic agents comprise a substantial portion of every hospital's pharmacy budget. Challenged with an initiative to lower anesthetic drug expenditures, we developed an education-based intervention focused on reducing volatile anesthetic costs while preserving access to all available volatile anesthetics. When postintervention evaluation demonstrated a dramatic year-over-year reduction in volatile agent acquisition costs, we undertook a retrospective analysis of volatile anesthetic purchasing data using time series analysis to determine the impact of our educational initiative...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871505/operating-room-discharge-after-deep-neuromuscular-block-reversed-with-sugammadex-compared-with-shallow-block-reversed-with-neostigmine-a-randomized-controlled-trial
#16
Laurie Putz, Christophe Dransart, Jacques Jamart, Maria-Laura Marotta, Geraldine Delnooz, Philippe E Dubois
OBJECTIVE: To determine if reversing a deep or moderate block with sugammadex, compared with a shallow block reversed with neostigmine, reduces the time to operating room discharge after surgery and the time spent in the postanesthesia care unit. DESIGN: A randomized controlled trial. SETTING: Monocentric study performed from February 2011 until May 2012. PATIENTS: One hundred consenting women with American Society of Anesthesiologists grade I or II were randomized into 2 groups...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27844299/comparison-of-pneumotachography-and-anemometery-for-flow-measurement-during-mechanical-ventilation-with-volatile-anesthetics
#17
Jarred R Mondoñedo, Jacob Herrmann, John S McNeil, David W Kaczka
Volatile anesthetics alter the physical properties of inhaled gases, such as density and viscosity. We hypothesized that the use of these agents during mechanical ventilation would yield systematic biases in estimates of flow ([Formula: see text]) and tidal volume (V T) for two commonly used flowmeters: the pneumotachograph (PNT), which measures a differential pressure across a calibrated resistive element, and the hot-wire anemometer (HWA), which operates based on convective heat transfer from a current-carrying wire to a flowing gas...
November 14, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27828800/safety-and-efficacy-of-volatile-anesthetic-agents-compared-with-standard-intravenous-midazolam-propofol-sedation-in-ventilated-critical-care-patients-a-meta-analysis-and-systematic-review-of-prospective-trials
#18
Angela Jerath, Jonathan Panckhurst, Matteo Parotto, Nicholas Lightfoot, Marcin Wasowicz, Niall D Ferguson, Andrew Steel, W Scott Beattie
BACKGROUND: Inhalation agents are being used in place of intravenous agents to provide sedation in some intensive care units. We performed a systematic review and meta-analysis of prospective randomized controlled trials, which compared the use of volatile agents versus intravenous midazolam or propofol in critical care units. METHODS: A search was conducted using MEDLINE (1946-2015), EMBASE (1947-2015), Web of Science index (1900-2015), and Cochrane Central Register of Controlled Trials...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27826417/desflurane-impairs-outcome-of-organotypic-hippocampal-slices-in-an-in-vitro-model-of-traumatic-brain-injury
#19
Matthias Krings, Anke Höllig, Jingjin Liu, Linda Grüsser, Rolf Rossaint, Mark Coburn
Decreased mortality and disability after traumatic brain injury is a significant medical challenge. Desflurane, a widely used volatile anesthetic has proven to be neuroprotective in a variety of in vitro and in vivo models of ischemic brain injury. The aim of this study was to investigate whether desflurane exhibits neuroprotective properties in an in vitro model of traumatic brain injury. Organotypic hippocampal slice cultures were prepared from brains of 5-7-day-old C57/BL6 mouse pups. After 14 days of culture, the slices were subjected to a focal mechanical trauma and thereafter incubated with three different concentrations of desflurane (2, 4 and 6%) for 2, 24 and 72 hours...
March 2016: Medical Gas Research
https://www.readbyqxmd.com/read/27823923/a-desflurane-and-fentanyl-dosing-regimen-for-wake-up-testing-during-scoliosis-surgery-implications-for-the-time-course-of-emergence-from-anesthesia
#20
Wei-Nung Teng, Mei-Yung Tsou, Pin-Tarng Chen, Jing-Yang Liou, Lu Yu, Dwayne R Westenskow, Chien-Kun Ting
BACKGROUND/PURPOSE: The Stagnara wake-up test assesses neurological deficits during scoliosis surgery, and response surface interaction models for opioids and inhaled agents predicts anesthetic drug effects. We hypothesized that there is an optimal desflurane-fentanyl dosing regimen that can provide a faster and more predictable wake-up time, while also ensuring adequate analgesia during wake-up testing. METHODS: Twenty-three American Society of Anesthesiologists Class I-II scoliosis patients who received desflurane-fentanyl anesthetic regimens were enrolled in this posthoc study, and their intraoperative drug administration data were collected retrospectively...
November 4, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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