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Target controlled anaesthesia

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https://www.readbyqxmd.com/read/27867133/fiberoptic-bronchoscopy-and-remifentanil-target-controlled-infusion-in-critically-ill-patients-with-acute-hypoxaemic-respiratory-failure-a-descriptive-study
#1
Saïda Rezaiguia-Delclaux, Florent Laverdure, Talna Kortchinsky, Léa Lemasle, Audrey Imbert, François Stéphan
INTRODUCTION: Sedation optimizes patient comfort and ease of execution during fiberoptic bronchoscopy (FOB). Our objective was to describe the safety and efficacy of remifentanil-TCI during FOB in non-intubated, hypoxaemic, thoracic-surgery ICU patients. METHODS: Consecutive spontaneously breathing adults requiring FOB after thoracic surgery were included if they had hypoxaemia (PaO2/FiO2 < 300mmHg or need for non-invasive ventilation [NIV]) and prior FOB failure under topical anaesthesia...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27798452/double-injection-technique-assisted-by-a-nerve-stimulator-for-ultrasound-guided-supraclavicular-brachial-plexus-block-results-in-better-distal-sensory-motor-block-a-randomised-controlled-trial
#2
Quehua Luo, Weifeng Yao, HaiHua Shu, Ming Zhong
BACKGROUND: To evaluate the efficacy of a nerve stimulator when used with ultrasound-guided double injection in supraclavicular brachial plexus block. OBJECTIVES: We hypothesised that targeting the inferior trunk of the plexus guided by a nerve stimulator would obtain a higher success rate of ulnar nerve blockade than the traditional double-injection technique. DESIGN: A blinded randomised controlled study. SETTING: Conducted at the University Hospital from October 2015 to January 2016...
October 27, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27785790/laboratory-evaluation-of-a-novel-anaesthesia-delivery-device
#3
A Paul, J N Clark, I E Salama, B J Jenkins, N Goodwin, A R Wilkes, P F Mahoney, J E Hall
Here, we describe proof of concept of a novel method for delivering volatile anaesthetics, where the liquid anaesthetic (sevoflurane or isoflurane) is formulated into an emulsion that is contained in a compact, lightweight device through which carrier gas flows. Release of anaesthetic is achieved by stirring of the formulation, allowing controlled and responsive release of anaesthetic at a variety of fixed flow rates between 0.5 l.min(-1) and 5 l.min(-1) , with ventilated, non-ventilated and draw-over breathing systems...
October 26, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27731501/deliberate-hypotension-with-propofol-under-anaesthesia-for-functional-endoscopic-sinus-surgery-fess
#4
REVIEW
Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon
BACKGROUND: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Small bleeding areas can reduce operative visibility and result in destruction of surrounding structures. Deliberate hypotension (lowering the mean arterial blood pressure to between 50 and 65 mm Hg in normotensive patients) using a range of pharmacological agents during general anaesthesia reduces blood loss in many operations. This review was originally published in 2013 and updated in February 2016...
October 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27659556/brief-isoflurane-anaesthesia-affects-differential-gene-expression-gene-ontology-and-gene-networks-in-rat-brain
#5
Damon A Lowes, Helen F Galley, Alessandro P S Moura, Nigel R Webster
Much is still unknown about the mechanisms of effects of even brief anaesthesia on the brain and previous studies have simply compared differential expression profiles with and without anaesthesia. We hypothesised that network analysis, in addition to the traditional differential gene expression and ontology analysis, would enable identification of the effects of anaesthesia on interactions between genes. Rats (n=10 per group) were randomised to anaesthesia with isoflurane in oxygen or oxygen only for 15min, and 6h later brains were removed...
September 19, 2016: Behavioural Brain Research
https://www.readbyqxmd.com/read/27554392/in-vivo-measurement-in-pigs-of-wash-in-kinetics-of-xenon-at-its-site-of-action
#6
Oliver Adolph, Gebhard Froeba
BACKGROUND: Xenon (Xe) in many respects is an ideal anaesthetic agent. Its blood/gas partition coefficient is lower than that of any other anaesthetic, enabling rapid induction of and emergence from anaesthesia. While the whole body kinetics during wash-in of inhalational anaesthesia is well known, data describing the pharmacokinetics of xenon in the cerebral compartment at the site of action are still largely missing. METHODS: In order to illuminate xenon´s cerebral pharmacokinetics, we anaesthetised five pigs and measured arterial, mixed- and sagittal sinus-venous blood, as well as end-expiratory gas concentrations of xenon by gas chromatography-mass spectrometry (GCMS) up to 30 minutes after starting the anaesthetic gas mixture...
August 23, 2016: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/27552990/endovenous-laser-ablation-versus-mechanochemical-ablation-with-clarivein-%C3%A2-in-the-management-of-superficial-venous-insufficiency-lama-trial-study-protocol-for-a-randomised-controlled-trial
#7
Clement C M Leung, Daniel Carradice, Tom Wallace, Ian C Chetter
BACKGROUND: Endovenous thermal techniques, such as endovenous laser ablation (EVLA), are the recommended treatment for truncal varicose veins. However, a disadvantage of thermal techniques is that it requires the administration of tumescent anaesthesia, which can be uncomfortable. Non-thermal, non-tumescent techniques, such as mechanochemical ablation (MOCA) have potential benefits. MOCA combines physical damage to endothelium using a rotating wire, with the infusion of a liquid sclerosant...
August 24, 2016: Trials
https://www.readbyqxmd.com/read/27377616/comparison-of-lidocaine-tetracaine-cream-and-lidocaine-prilocaine-cream-for-local-anaesthesia-during-laser-treatment-of-acne-keloidalis-nuchae-and-tattoo-removal-results-of-two-randomized-controlled-trials
#8
K Greveling, E P Prens, N Ten Bosch, M van Doorn
BACKGROUND: Pain is a common adverse effect during dermatological laser procedures. Currently, no standard topical anaesthetic cream exists for deeper dermal laser procedures. OBJECTIVE: To compare the efficacy of lidocaine/tetracaine cream and lidocaine/prilocaine cream in reducing self-reported pain during deeper dermal laser treatments of acne keloidalis nuchae (AKN) and tattoos. METHODS: We conducted two randomized, double-blind, controlled clinical trials with intra-patient, split-lesion design: Study A in patients with AKN (n=15), and Study B in patients with black tattoos (n=15)...
July 5, 2016: British Journal of Dermatology
https://www.readbyqxmd.com/read/27367754/withdrawn-target-controlled-infusion-versus-manually-controlled-infusion-of-propofol-for-general-anaesthesia-or-sedation-in-adults
#9
REVIEW
Kate Leslie, Ornella Clavisi, Joshua Hargrove
No abstract text is available yet for this article.
July 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27341380/xenon-elimination-kinetics-following-brief-exposure
#10
Maximilian S Schaefer, Thomas Piper, Hans Geyer, Julia Schneemann, Martin Neukirchen, Mario Thevis, Peter Kienbaum
Xenon is a modern inhalative anaesthetic with a very low solubility in tissues providing rapid elimination and weaning from anaesthesia. Besides its anaesthetic properties, Xenon promotes the endogenous erythropoietin biosynthesis and thus has been enlisted as prohibited substance by the World Anti-Doping Agency (WADA). For effective doping controls, knowledge about the elimination kinetics of Xenon and the duration of traceability are of particular importance. Seventy-seven full blood samples were obtained from 7 normal weight patients undergoing routine Xenon-based general anaesthesia with a targeted inspiratory concentration of 60% Xenon in oxygen...
June 24, 2016: Drug Testing and Analysis
https://www.readbyqxmd.com/read/27329989/target-controlled-inhalation-anaesthesia-a-cost-benefit-analysis-based-on-the-cost-per-minute-of-anaesthesia-by-inhalation
#11
Sébastien Ponsonnard, Antoine Galy, Jérôme Cros, Armelle Marie Daragon, Nathalie Nathan
BACKGROUND: End-tidal target-controlled inhalational anaesthesia (TCIA) with halogenated agents (HA) provides a faster and more accurately titrated anaesthesia as compared to manually-controlled anaesthesia. This study aimed to measure the macro-economic cost-benefit ratio of TCIA as compared to manually-controlled anaesthesia. METHODS: This retrospective and descriptive study compared direct drug spending between two hospitals before 2011 and then after the replacement of three of six anaesthesia machines with TCIA mode machines in 2012 (Aisys carestation(®), GE)...
June 18, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27228959/a-randomised-clinical-trial-comparing-the-flexible-fibrescope-and-the-pentax-airway-scope-aws-%C3%A2-for-awake-oral-tracheal-intubation
#12
C Mendonca, A Mesbah, A Velayudhan, R Danha
We compared awake fibreoptic intubation with awake intubation using the Pentax Airway Scope(®) in 40 adult patients. Sedation was achieved using a target-controlled remifentanil infusion of 1-5 ng.ml(-1) and midazolam. The airway was anaesthetised with lidocaine spray and gargle. The total procedure time - a composite of sedation time, topical anaesthesia time and intubation time - was recorded. The operator's impression of the ease of the procedure and the patients' reported comfort were recorded on a 0-100 mm visual analogue scale...
August 2016: Anaesthesia
https://www.readbyqxmd.com/read/27164016/inhaled-anaesthetics-and-nitrous-oxide-complexities-overlooked-things-may-not-be-what-they-seem
#13
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
https://www.readbyqxmd.com/read/27152471/model-based-drug-administration-current-status-of-target-controlled-infusion-and-closed-loop-control
#14
Merel H Kuizenga, Hugo E M Vereecke, Michel M R F Struys
PURPOSE OF REVIEW: Drug administration might be optimized by incorporating pharmacokinetic-dynamic (PK/PD) principles and control engineering theories. This review gives an update of the actual status of target-controlled infusion (TCI) and closed-loop computer-controlled drug administration and the ongoing research in the field. RECENT FINDINGS: TCI is becoming mature technology clinically used in many countries nowadays with proven safety. Nevertheless, changing populations might require adapting the established PK/PD models...
August 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27106691/the-median-effective-concentration-ec50-of-propofol-with-different-doses-of-fentanyl-during-colonoscopy-in-elderly-patients
#15
Shiyang Li, Fang Yu, Huichen Zhu, Yuting Yang, Liqun Yang, Jianfeng Lian
BACKGROUND: Propofol and fentanyl are the most widely administered anesthesia maintaining drugs during colonoscopy. In this study, we determined the median effective concentration (EC50) of propofol required for colonoscopy in elderly patients, and the purpose of this study was to describe the pharmacodynamic interaction between fentanyl and propofol when used in combination for colonoscopy in elderly patients. METHODS: Ninety elderly patients scheduled for colonoscopy were allocated into three groups in a randomized, double-blinded manner as below, F0...
2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27048387/impact-of-effect-site-concentration-of-propofol-on-cardiac-systolic-function-assessed-by-tissue-doppler-imaging
#16
Chung-Sik Oh, Yungu Lee, Woon-Seok Kang, Seong-Hyop Kim
OBJECTIVE: To evaluate the relationship between effect-site concentration (CE) of propofol during total intravenous anaesthesia (TIVA) and cardiac systolic function using tissue Doppler imaging (TDI) in patients undergoing cardiovascular procedures. METHODS: Stepwise increments of CE of propofol of 1.0, 2.0, 3.0 and 4.0 µg/ml (modified Marsh model) were achieved using a target-controlled infusion device. Transthoracic echocardiographic assessments using TDI were performed for each CE of propofol and corresponding systolic myocardial velocity (s'), mean arterial blood pressure (MAP), heart rate (HR) and bispectral index (BIS) were evaluated...
June 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27044652/evaluation-and-optimisation-of-propofol-pharmacokinetic-parameters-in-cats-for-target-controlled-infusion
#17
A Cattai, T Pilla, P Cagnardi, A Zonca, P Franci
The aim of this study was to develop and evaluate a pharmacokinetic model-driven infusion of propofol in premedicated cats. In a first step, propofol (10 mg/kg) was administered intravenously over 60 seconds to induce anaesthesia for the elective neutering of seven healthy cats, premedicated intramuscularly with 0.3 mg/kg methadone, 0.01 mg/kg medetomidine and 2 mg/kg ketamine. Venous blood samples were collected over 240 minutes, and propofol concentrations were measured via a validated high-performance liquid chromatography assay...
May 14, 2016: Veterinary Record
https://www.readbyqxmd.com/read/27029663/spontaneous-ventilation-using-propofol-tci-for-microlaryngoscopy-in-adults-a-retrospective-audit
#18
A W G Booth, K Vidhani
We conducted a retrospective audit of 285 adult elective microlaryngoscopy cases in our institution over a three-and-a-half year period. Conventional anaesthesia with intubation and mechanical ventilation was the most common technique, used in 71% of cases. Tubeless spontaneous ventilation during total intravenous anaesthesia with a target-controlled infusion of propofol (SVTCI) was the most common alternative. Spontaneous ventilation with target-controlled infusion was used for 79 (27.7%) anaesthetic inductions and was continued through the maintenance phase for 60 patients (21...
March 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/26977029/the-effects-of-different-methods-of-anaesthesia-for-laparoscopic-radical-gastrectomy-with-monitoring-of-entropy
#19
RANDOMIZED CONTROLLED TRIAL
Aihua Jiang, Lin-Jing Chen, Yu-Xia Wang, Ming-Chuan Li, Yong-Bo Ding
AIM: To investigate the effects of methods of total intravenous anaesthesia (TIVA) and combined intravenous and inhaled anaesthesia (CIIA) for laparoscopic radical gastrectomy under the same anaesthetic depth monitored by entropy indices. PATIENTS AND METHODS: One hundred patients undergoing laparoscopic radical gastrectomy were randomly distributed into group I (anaesthetized by TIVA) and group II (anaesthetized by CIIA), each group including 50 patients. TIVA was performed with propofol and remifentanil by means of target controlled infusion (TCI) for the patients in group I...
March 2016: Anticancer Research
https://www.readbyqxmd.com/read/26833994/clinical-effects-of-midazolam-or-lidocaine-co-induction-with-a-propofol-target-controlled-infusion-tci-in-dogs
#20
Enzo Minghella, Adam Auckburally, Patricia Pawson, Marian E Scott, Derek Flaherty
OBJECTIVE: To evaluate the propofol requirement, cardiovascular and respiratory variables using midazolam or lidocaine with a propofol target-controlled infusion (PTCI) for induction of anaesthesia in healthy dogs. STUDY DESIGN: Prospective, randomized, controlled blinded clinical trial. ANIMALS: Sixty client-owned dogs [American Society of Anesthesiologists (ASA) I-II] undergoing surgical procedures. METHODS: Thirty minutes after premedication with acepromazine (0...
September 2016: Veterinary Anaesthesia and Analgesia
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