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low flow anaesthesia

Rajasree Omanakutty Amma, Subha Ravindran, Rachel Cherian Koshy, K M Jagathnath Krishna
BACKGROUND AND AIMS: With the availability of modern workstations and heightened awareness on the environmental effects of waste anaesthesia gases, anaesthesiologists worldwide are practicing low flow anaesthesia (LFA). Although LFA is being practiced in India, hard evidence on the current practice of the same from anaesthesiologists practicing in India is lacking and hence, we conducted this survey. METHODS: A questionnaire containing 16 questions was distributed among a subgroup of anaesthesiologists who attended the 2014 National Conference of Indian Society of Anaesthesiologists...
October 2016: Indian Journal of Anaesthesia
Preeti Verma, Sunil K Prajapati, Rajbharan Yadav, Danielle Senyschyn, Peter R Shea, Natalie L Trevaskis
Vesicular and colloidal delivery systems can be designed to control drug release spatially and temporally to improve drug efficacy and side effect profiles. Niosomes (vesicles prepared from nonionic surfactants in aqueous media) are gaining interest as an alternative vesicular delivery system as they offer advantages such as biocompatibility, chemical stability, low cost, high purity, and versatility. However, the physical stability of niosomes, like other vesicular systems, is limited by vesicle fusion, aggregation, and leakage...
November 7, 2016: Molecular Pharmaceutics
Aurélie Maiguy-Foinard, Stéphanie Genay, Damien Lannoy, Christine Barthélémy, Gilles Lebuffe, Bertrand Debaene, Pascal Odou, Bertrand Décaudin
OBJECTIVE: The aims are to identify critical parameters influencing the drug mass flow rate of infusion delivery to patients during multidrug infusion and to discuss their clinical relevance. DATA SOURCES: A review of literature was conducted in January 2016 using Medline, Google Scholar, ScienceDirect, Web of Science and Scopus online databases. DATA EXTRACTION: References relating to the accuracy of fluid delivery via gravity-flow intravenous (IV) infusion systems and positive displacement pumps, components of IV administration sets, causes of flow rate variability, potential complications due to flow rate variability, IV therapies especially at low flow rates and drug compatibilities were considered relevant...
February 2017: Anaesthesia, Critical Care & Pain Medicine
Jan Hendrickx, Philip Peyton, Rik Carette, Andre De Wolf
This review re-examines existing pharmacokinetic and pharmacodynamic concepts of inhaled anaesthetics. After showing where uptake is hidden in the classic FA/FI curve, it is argued that target-controlled delivery of inhaled agents warrants a different interpretation of the factors affecting this curve (cardiac output, ventilation and blood/gas partition coefficient). Blood/gas partition coefficients of modern agents may be less important clinically than generally assumed. The partial pressure cascade from delivered to inspired to end-expired is re-examined to better understand the effect of rebreathing during low-flow anaesthesia, including the possibility of developing a hypoxic inspired mixture despite existing machine standards...
September 2016: European Journal of Anaesthesiology
Rossiana I Bojinova, Katarzyna Konieczka, Peter Meyer, Margarita G Todorova
BACKGROUND: A variety of factors have been linked to perioperative visual loss during or directly after nonocular and ocular surgeries. Prolonged immobilization, biochemical factors and hemodynamic instability have been discussed as factors in the pathogenesis of this devastating complication. Perioperative visual loss in four consecutive patients, all featuring Flammer syndrome, is reported herein. To our knowledge, we present the first case series, which associates perioperative visual loss with Flammer syndrome...
February 4, 2016: BMC Anesthesiology
K Hallén, O Stenqvist, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) has the potential to increase the elimination rate of anaesthetic gases and has been shown to shorten time to wake-up and post-operative recovery time after inhalation anaesthesia. In this bench test, we describe a technique to achieve isocapnia during hyperventilation (HV) by adding carbon dioxide (CO2) directly to the breathing circuit of a standard anaesthesia apparatus with standard monitoring equipment. METHODS: Into a mechanical lung model, carbon dioxide was added to simulate a CO2 production (V(CO2)) of 175, 200 and 225 ml/min...
May 2016: Acta Anaesthesiologica Scandinavica
Lorenzo Ball, Maddalena Dameri, Paolo Pelosi
Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induction of general anaesthesia prolongs the time window for safe intubation, reducing the risk of hypoxia and overweighs the potential risk of reabsorption atelectasis...
September 2015: Best Practice & Research. Clinical Anaesthesiology
J Jokela, A Haapaniemi, J Ojala, A Mäkitie, R Saarinen
No abstract text is available yet for this article.
August 2016: Clinical Otolaryngology
Lily A Gutnik, Joseph Dielman, Anna J Dare, Margarita S Ramos, Robert Riviello, John G Meara, Gavin Yamey, Mark G Shrime
BACKGROUND: In recent years, funds for global health have risen substantially, particularly for infectious diseases. Although conditions amenable to surgery account for 28% of the global burden of disease, the external funds directed towards global surgical delivery, capacity building, and research are currently unknown and presumed to be low. We aimed to describe external funds given to these efforts from the USA, the world's largest donor nation. METHODS: We searched the United States Agency for International Development (USAID), National Institute of Health (NIH), Foundation Center, and registered US charitable organisations databases for financial data on any giving exclusively to surgical care in low-income and middle-income countries (LMICs)...
April 27, 2015: Lancet
S Badiger, M John, R A Fearnley, I Ahmad
BACKGROUND: Awake fibre-optic intubation is a widely practised technique for anticipated difficult airway management. Despite the administration of supplemental oxygen during the procedure, patients are still at risk of hypoxia because of the effects of sedation, local anaesthesia, procedural complications, and the presence of co-morbidities. Traditionally used oxygen-delivery devices are low flow, and most do not have a sufficient reservoir or allow adequate fresh gas flow to meet the patient's peak inspiratory flow rate, nor provide an adequate fractional inspired oxygen concentration to prevent desaturation should complications arise...
October 2015: British Journal of Anaesthesia
C Vayssière, L Sentilhes, A Ego, C Bernard, D Cambourieu, C Flamant, G Gascoin, A Gaudineau, G Grangé, V Houfflin-Debarge, B Langer, V Malan, P Marcorelles, J Nizard, F Perrotin, L Salomon, M-V Senat, A Serry, V Tessier, P Truffert, V Tsatsaris, C Arnaud, B Carbonne
Small for gestational age (SGA) is defined by weight (in utero estimated fetal weight or birth weight) below the 10th percentile (professional consensus). Severe SGA is SGA below the third percentile (professional consensus). Fetal growth restriction (FGR) or intra-uterine growth restriction (IUGR) usually correspond with SGA associated with evidence indicating abnormal growth (with or without abnormal uterine and/or umbilical Doppler): arrest of growth or a shift in its rate measured longitudinally (at least two measurements, 3 weeks apart) (professional consensus)...
October 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Maria Horwitz, Jan G Jakobsson
BACKGROUND: The pharmacokinetics for sevoflurane and desflurane makes them suitable for low-flow anesthesia. The aim of the present study was to assess the use of desflurane and sevoflurane at constant vaporizer settings and fixed low fresh gas flows. METHODS: One hundred ASA 1-2 patients undergoing elective laparoscopic surgery were randomized into 4 groups (25 patients each): a fixed fresh gas flow 1.0 or 0.5 L/min with desflurane (D1.0 and D0.5) or sevoflurane (S1...
February 2016: Minerva Anestesiologica
Philippe Laberge, Nicholas Leyland, Ally Murji, Claude Fortin, Paul Martyn, George Vilos, Nicholas Leyland, Wendy Wolfman, Catherine Allaire, Alaa Awadalla, Sheila Dunn, Mark Heywood, Madeleine Lemyre, Violaine Marcoux, Frank Potestio, David Rittenberg, Sukhbir Singh, Grace Yeung
BACKGROUND: Abnormal uterine bleeding (AUB) is the direct cause of a significant health care burden for women, their families, and society as a whole. Up to 30% of women will seek medical assistance for the problem during their reproductive years. OBJECTIVE: To provide current evidence-based guidelines on the techniques and technologies used in endometrial ablation (EA), a minimally invasive technique for the management of AUB of benign origin. METHODS: Members of the guideline committee were selected on the basis of individual expertise to represent a range of practical and academic experience in terms of both location in Canada and type of practice, as well as subspecialty expertise and general background in gynaecology...
April 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Jae Yeon Lee, Seok Hwa Choi
BACKGROUND: The induction of the pneumoperitoneum increases intraabdominal pressure (IAP), causing splanchnic ischemia, whereas its deflation normalizes IAP and splanchnic blood flow. We investigated the oxidant-antioxidant status of dogs who underwent low pressure (7 mm Hg), standard pressure (12 mm Hg), and high pressure (15 mm Hg) pneumoperitoneum. RESULTS: Twenty-four beagle dogs (12 males and 12 females), 4-6 years old, weighing 8-11 kg were used. The animals were assigned to one of four groups (n = 6 dogs)...
2015: Acta Veterinaria Scandinavica
Aleksander Sobolewski, Ewa Kublik, Daniel A Swiejkowski, Jan Kamiński, Andrzej Wróbel
Behavioural reactions to sensory stimuli vary with the level of arousal, but little is known about the underlying reorganization of neuronal networks. In this study, we use chronic recordings from the somatosensory regions of the thalamus and cortex of behaving rats together with a novel analysis of functional connectivity to show that during low arousal tactile signals are transmitted via the ventral posteromedial thalamic nucleus (VPM), a first-order thalamic relay, to the primary somatosensory (barrel) cortex and then from the cortex to the posterior medial thalamic nucleus (PoM), which plays a role of a higher-order thalamic relay...
May 2015: European Journal of Neuroscience
Asha Tyagi, Vineeta Venkateswaran, Ajai Kumar Jain, Uttam Chandra Verma
Background. This study aimed to evaluate and compare total cost of sevoflurane and propofol for 1.0 MAC-hour of anaesthesia, employing three anaesthetic techniques. Methods. Adult patients scheduled for surgical procedures under general anaesthesia anticipated to last approximately an hour were randomized into three groups (n = 15 each), to receive anaesthesia using one of the following techniques: low flow technique involving induction with propofol, followed by sevoflurane delivered using initial fresh gas flows of 6 L/min till MAC reached 1...
2014: Anesthesiology Research and Practice
Sara Diab, John F Fraser
Bronchoscopy is an important diagnostic and therapeutic intervention for a variety of patients displaying pulmonary pathology. The heterogeneity of the patients undergoing bronchoscopy affords a challenge for providing minimal and safe respiratory support during anesthesia. Currently, options are intubation and general anesthesia versus frequently inadequate sedation or local anaesthesia with low flow oxygen through nasal prongs or mouthpiece. The advent of high flow nasal cannula allows the clinician to have a "middle man" that allows high flow oxygen delivery as well as a degree of respiratory support, which in some cases has been noted to be between 3 and 4 cm of continuous positive airway pressure-like effect...
2014: Case Reports in Critical Care
Benno von Bormann, Sirilak Suksompong, Jürgen Weiler, Rolf Zander
Background. Pure oxygen ventilation during anaesthesia is debatable, as it may lead to development of atelectasis. Rationale of the study was to demonstrate the harmlessness of ventilation with pure oxygen. Methods. This is a single-centre, one-department observational trial. Prospectively collected routine-data of 76,784 patients undergoing general, gynaecological, orthopaedic, and vascular surgery during 1995-2009 were retrospectively analysed. Postoperative hypoxia, unplanned ICU-admission, surgical site infection (SSI), postoperative nausea and vomiting (PONV), and hospital mortality were continuously recorded...
2014: PeerJ
Ji Seon Jeong, Sung Wook Yoon, Sung Lark Choi, Sung Hwan Choi, Bong Yeong Lee, Mi Ae Jeong
OBJECTIVE: To investigate emergence times with different fresh gas flow rates, following desflurane anaesthesia. METHODS: Patients undergoing surgery with desflurane anaesthesia were randomly assigned to receive fresh gas flow rates of 100% oxygen during emergence of 2 l/min (group D2), 4 l/min (group D4) or 6 l/min (group D6). Time to eye opening, spontaneous movement and extubation (emergence time) were assessed after desflurane discontinuation. The end-tidal concentration of desflurane and bispectral index were recorded at each of these timepoints...
December 2014: Journal of International Medical Research
P Schramm, A-H Treiber, M Berres, G Pestel, K Engelhard, C Werner, D Closhen
Trendelenburg positioning in combination with pneumoperitoneum during robotic-assisted prostatic surgery possibly impairs cerebrovascular autoregulation. If cerebrovascular autoregulation is disturbed, arterial hypertension might induce cerebral hyperaemia and brain oedema, while low arterial blood pressure can induce cerebral ischaemia. The time course of cerebrovascular autoregulation was investigated during use of the Trendelenburg position and a pneumoperitoneum for robotic-assisted prostatic surgery using transcranial Doppler ultrasound...
January 2014: Anaesthesia
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