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Target controlled anaesthesia

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https://www.readbyqxmd.com/read/29098683/effect-of-sufentanil-on-bispectral-index-in-the-elderly
#1
T de Valence, N Elia, C Czarnetzki, L Dumont, M R Tramèr, C Lysakowski
We examined the impact of adding sufentanil during anaesthesia induction with propofol on bispectral index values in elderly patients (≥ 65 years). Patients were randomly assigned to receive a target-controlled sufentanil infusion (effect-site concentration of 0.3 ng.ml(-1) ) or matching placebo, followed by a target-controlled propofol induction (initial effect-site concentration of 0.5 μg.ml(-1) ; step-wise increase of 0.5 μg.ml(-1) ) until loss of consciousness defined as an Observer's Assessment of Alertness/Sedation score < 2...
November 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29045562/attenuation-of-high-frequency-30-200%C3%A2-hz-thalamocortical-eeg-rhythms-as-correlate-of-anaesthetic-action-evidence-from-dexmedetomidine
#2
G Plourde, F Arseneau
Background: Gamma (30-80 Hz) and high-gamma (80-200 Hz) thalamocortical EEG rhythms are involved in conscious processes and are attenuated by isoflurane and propofol. To explore the hypothesis that this attenuation is a correlate of anaesthetic action, we characterized the effect dexmedetomidine, a selective adrenergic α-2 agonist with lesser hypnotic potency, on these rhythms. Methods: We recorded local field potentials from barrel cortex and ventroposteromedial thalamic nucleus in ten previously instrumented rats to measure spectral power (30-50 Hz, 51-75 Hz, 76-125 Hz, 126-200 Hz bands) during baseline, at four dexmedetomidine plasma concentrations obtained by i...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028921/smartpilot%C3%A2-view-guided-anaesthesia-improves-postoperative-outcomes-in-hip-fracture-surgery-a-randomized-blinded-controlled-study
#3
D Leblanc, M Conté, G Masson, F Richard, A Jeanneteau, G Bouhours, J M Chrétien, L Rony, E Rineau, S Lasocki
Background: Both under-dosage and over-dosage of general anaesthetics can harm frail patients. We hypothesised that computer-assisted anaesthesia using pharmacokinetic/pharmacodynamic models guided by SmartPilot® View (SPV) software could optimise depth of anaesthesia and improve outcomes in patients undergoing hip fracture surgery. Methods: This prospective, randomized, single-centre, blinded trial included patients undergoing hip fracture surgery under general anaesthesia...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28899891/effect-of-anesthesia-depth-on-postoperative-clinical-outcome-in-patients-with-supratentorial-tumor-depth-study-protocol-for-a-randomized-controlled-trial
#4
Qianyu Cui, Yuming Peng, Xiaoyuan Liu, Bo Jia, Jia Dong, Ruquan Han
INTRODUCTION: Recent studies have shown that deep anaesthesia is associated with poor outcomes. However, no randomised controlled trials have been conducted to test the causality in patients undergoing brain tumour resection. METHODS AND ANALYSIS: DEPTH is a multicenter, randomised, parallel-group, blind trial. The depth of general anaesthesia will be monitored using the bispectral index (BIS). Patients elected for supratentorial tumour resection will be randomly allocated to the deep or the light anaesthesia group in which the target BIS value is 35 or 50, respectively...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28895379/the-analgesic-potency-dose-of-remifentanil-to-minimise-stress-response-induced-by-intubation-and-measurement-uncertainty-of-surgical-pleth-index
#5
Ji H Park, Dong-Hee Kim, Sun-Kook Yoo, Hyun-Jun Lim, Joo-Won Lee, Won-Sik Ahn, Eun-Kyung Lee, Byung-Moon Choi, Gyu-Jeong Noh
BACKGROUND: The aim of this study was to evaluate the analgesic potency dose of remifentanil to maintain surgical pleth index (SPI) values at less than 50 after intubation in patients undergoing general anaesthesia with target-controlled infusion of propofol and remifentanil. METHODS: We randomly allocated 120 patients to receive one of three remifentanil target effect-site concentrations (5, 7, or 9 ng⋅ml-1) during intubation. The target effect-site concentrations of propofol were adjusted within a range of 2...
September 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28891056/performance-of-the-minto-model-for-the-target-controlled-infusion-of-remifentanil-during-cardiopulmonary-bypass
#6
Y J Cho, W Y Jo, H Oh, C-H Koo, J Oh, J-Y Cho, K-S Yu, Y Jeon, T K Kim
We studied the predictive performance of the Minto pharmacokinetic model during cardiopulmonary bypass in patients undergoing cardiac surgery. Patients received remifentanil target-controlled infusion using the Minto model during total intravenous anaesthesia with propofol. From 56 patients, 275 arterial blood samples were drawn before, during and after bypass to determine the plasma concentration of remifentanil, and the predicted concentrations were recorded at each time. For pooled data, the median prediction error and median absolute prediction error were 21...
October 2017: Anaesthesia
https://www.readbyqxmd.com/read/28882741/tracheal-extubation-with-suction-vs-positive-pressure-during-emergence-from-general-anaesthesia-in-adults-a-randomised-controlled-trial
#7
Joël L'Hermite, Olivier Wira, Chritel Castelli, Jean-Emmanuel de La Coussaye, Jacques Ripart, Philippe Cuvillon
BACKGROUND: After general anaesthesia (GA) in adults, the optimal tracheal extubation technique (positive pressure or suctioning) remains debated. The primary endpoint of this study was to assess the effects of these techniques on onset time of desaturation (SpO2<92%). METHODS: Sixty-nine patients with a body mass index<30 scheduled for elective orthopaedic surgery were allocated to positive pressure (PP) or suctioning (SUC) group. GA was standardised with propofol and remifentanil via target-controlled infusion...
September 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28865915/anaesthetic-depth-control-using-closed-loop-anaesthesia-delivery-system-vs-target-controlled-infusion-in-patients-with-moderate-to-severe-left-ventricular-systolic-dysfunction
#8
V Mahajan, T Samra, G D Puri
OBJECTIVES: To compare the efficacy of anaesthetic depth control using Closed Loop Anaesthesia Delivery System (CLADS) and Target Controlled Infusion (TCI) in patients with moderate to severe left ventricular dysfunction (LVSD). DESIGN: Randomized control trial. PATIENTS: Forty ASA III/IV adult patients with moderate to severe LVSD scheduled for open heart surgery. INTERVENTIONS: Propofol was administered using CLADS or TCI for maintaining BIS of 50...
August 30, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28760591/the-hairy-lizard-heterothermia-affects-anaesthetic-requirements-in-the-arabian-oryx-oryx-leucoryx
#9
Mads F Bertelsen, Osama Mohammed, Tobias Wang, Paul R Manger, David Michael Scantlebury, Khairi Ismael, Nigel C Bennett, Abdulaziz Alagaili
OBJECTIVE: To study the effect of heterothermia on anaesthetic drug requirements in semi-free ranging Arabian oryx and to assess the temperature quotient (Q10) of oxygen consumption. STUDY DESIGN: Prospective observational study and controlled metabolic experiment. ANIMALS: Sixty-eight anaesthetic events in 59 Arabian oryx from Mahazat As-Sayd protected area, Saudi Arabia METHODS: Anaesthesia was induced by remote injection of 25 mg ketamine, 10 mg midazolam and 0...
March 6, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28758184/motor-evoked-potentials-and-bis-guided-anaesthesia-in-image-guided-mini-invasive-neurosurgery-of-supratentorial-tumors-nearby-the-cortico-spinal-tract
#10
Roberto Cordella, Eleonora Orena, Francesco Acerbi, Elena Beretta, Dario Caldiroli, Francesco Dimeco, Carla Carozzi
AIM: to describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. MATERIAL AND METHODS: 24 patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting Bispectral Index (BIS) in the 40-60 intervals. Stimulating intensity of transcranial motor evoked potentials (tMEP), BIS index, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T)...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28743959/continual-conscious-bioluminescent-imaging-in-freely-moving-somatotransgenic-mice
#11
Rajvinder Karda, Dany P Perocheau, Natalie Suff, Joanne Ng, Juliette M K M Delhove, Suzanne M K Buckley, Samantha Richards, John R Counsell, Henrik Hagberg, Mark R Johnson, Tristan R McKay, Simon N Waddington
Luciferase bioimaging in living animals is increasingly being applied in many fields of biomedical research. Rodent imaging usually involves anaesthetising the animal during data capture, however, the biological consequences of anaesthesia have been largely overlooked. We have evaluated luciferase bioimaging in conscious, unrestrained mice after neonatal intracranial or intravascular administration of lentiviral, luciferase reporter cassettes (biosensors); we present real-time analyses from the first day of life to adulthood...
July 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28584352/intravenous-clonidine-as-a-part-of-balanced-anaesthesia-for-controlled-hypotension-in-functional-endoscopic-sinus-surgery-a-randomised-controled-trial
#12
Meghna Jiwanmall, Anita Shirley Joselyn, Subramani Kandasamy
BACKGROUND AND AIMS: Controlled hypotension with balanced anaesthesia minimises blood loss. This study was done to evaluate the effectiveness of intravenous clonidine as a single bolus dose to establish controlled hypotension during functional endoscopic sinus surgery (FESS). METHODS: This randomised, double-blind, placebo-controlled study was done in a tertiary hospital in India. Sixty American Society of Anesthesiologists physical status I and II patients (18-65 years) undergoing FESS were randomly allocated to one of the two groups...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28548279/significant-decreases-in-blood-propofol-concentrations-during-adrenalectomy-for-phaeochromocytoma
#13
Tatsunori Watanabe, Haruhiko Hiraoka, Takuya Araki, Daisuke Nagano, Tohru Aomori, Tomonori Nakamura, Koujirou Yamamoto, Hiroshi Baba
AIM: The kinetics of propofol are influenced by cardiac output. The aim of this study was to examine changes in blood propofol concentrations during phaeochromocytoma surgery using target-controlled infusion (TCI) anaesthesia with propofol. METHODS: This is a prospective observational study. Ten patients with phaeochromocytoma who underwent unilateral adrenalectomy were included. Cardiac output was measured using an arterial pressure-based cardiac output analysis method...
October 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28543518/green-discolouration-of-urine-following-propofol-infusion-in-a-dog
#14
D Flaherty, A Auckburally
A three-year-old, female neutered Weimaraner was presented with a history of neck pain and tetraparesis. MRI revealed an extradural mass at the level of C3 vertebra, which was thought to be a spinal abscess, and the dog was scheduled for surgical exploration the following morning. Overnight the dog developed an exaggerated ventilatory pattern, with paradoxical inward movement of the thorax on inspiration. Arterial blood gas analysis revealed respiratory acidosis and ventilator support was initiated to prevent excessive respiratory fatigue...
September 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28541533/predictive-performance-of-the-modified-marsh-and-schnider-models-for-propofol-in-underweight-patients-undergoing-general-anaesthesia-using-target-controlled-infusion
#15
Y H Lee, G H Choi, K W Jung, B H Choi, J Y Bang, E K Lee, B M Choi, G J Noh
Background: : In our preliminary study, the modified Marsh (M-Marsh) model caused an inadvertent underdosing of propofol in underweight patients. However, the predictive performance of the M-Marsh and Schnider models incorporated in commercially available target-controlled infusion (TCI) pumps was not evaluated in underweight patients. Methods: : Thirty underweight patients undergoing elective surgery were randomly allocated to receive propofol via TCI using the M-Marsh or Schnider models...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28534702/factors-affecting-recovery-from-anaesthesia-with-propofol-remifentanil-target-controlled-infusion-in-laparoscopic-surgery
#16
Shao-Hua Liu, Ming Tian
Objective This study was performed to analyse factors influencing the effect-site concentration (Ce) of propofol at return of consciousness (ROC) with target-controlled infusion of propofol-remifentanil after laparoscopic surgery. Methods In total, 112 patients who underwent laparoscopic surgery under general anaesthesia were given propofol at the target concentration of 3.5 µg/ml. Remifentanil (Ce: 4.0 ng/ml) and 0.9 mg/kg of rocuronium were administered when the Observer's Assessment of Alertness/Sedation score reached 1...
June 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28525631/primary-leiomyosarcoma-of-inferior-vena-cava-adjacent-to-hepatic-veins-complete-off-pump-resection-and-inferior-vena-cava-graft-reconstruction-with-application-of-external-skin-surface-cooling
#17
Michael Malyshev, Sergey Zotov, Anton Malyshev, Andrey Rostovykh
OBJECTIVES: Resection of a leiomyosarcoma of the inferior vena cava (IVC) requires venovenous bypass, especially if IVC clamping above the hepatic veins is planned. This report describes the application of external skin surface cooling for off-pump resection of a primary IVC leiomyosarcoma adjacent to the hepatic veins with graft IVC reconstruction in conditions of suprahepatic caval clamping and uninterrupted Pringle's manoeuvre. METHODS: A 62-year-old woman presented with IVC leiomyosarcoma adjacent to the hepatic veins...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28520886/use-of-an-anaesthesia-workstation-barrier-device-to-decrease-contamination-in-a-simulated-operating-room
#18
S Hunter, D Katz, A Goldberg, H-M Lin, R Pasricha, G Benesh, B Le Grand, S DeMaria
Background.: Strategies to achieve reductions in perioperative infections have focused on hand hygiene among anaesthestists but have been of limited efficacy. We performed a study in a simulated operating room to determine whether a barrier covering the anaesthesia workstation during induction and intubation might reduce the risk of contamination of the area and possibly, by extension, the patient. Methods.: Forty-two attending and resident anaesthetists unaware of the study design were enrolled in individual simulation sessions in which they were asked to induce and intubate a human simulator that had been prepared with fluorescent marker in its oropharynx as a marker of potentially pathogenic bacteria...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28508237/development-of-a-unifying-target-and-consensus-indicators-for-global-surgical-systems-strengthening-proposed-by-the-global-alliance-for-surgery-obstetric-trauma-and-anaesthesia-care-the-g4-alliance
#19
REVIEW
Adil Haider, John W Scott, Colin D Gause, Mira Meheš, Grace Hsiung, Albulena Prelvukaj, Dana Yanocha, Lauren M Baumann, Faheem Ahmed, Na'eem Ahmed, Sara Anderson, Herve Angate, Lisa Arfaa, Horacio Asbun, Tigistu Ashengo, Kisembo Asuman, Ruben Ayala, Stephen Bickler, Saul Billingsley, Peter Bird, Matthijs Botman, Marilyn Butler, Jo Buyske, Angelo Capozzi, Kathleen Casey, Charles Clayton, James Cobey, Michael Cotton, Dan Deckelbaum, Miliard Derbew, Catherine deVries, Jeanne Dillner, Max Downham, Natalie Draisin, David Echinard, Sohier Elneil, Ahmed ElSayed, Abigail Estelle, Allen Finley, Erica Frenkel, Philip K Frykman, Florin Gheorghe, Julian Gore-Booth, Richard Henker, Jaymie Henry, Orion Henry, Laura Hoemeke, David Hoffman, Iko Ibanga, Eric V Jackson, Pankaj Jani, Walter Johnson, Andrew Jones, Zeina Kassem, Asuman Kisembo, Abbey Kocan, Sanjay Krishnaswami, Robert Lane, Asad Latif, Barbara Levy, Dimitrios Linos, Peter Linz, Louis A Listwa, Declan Magee, Emmanuel Makasa, Michael L Marin, Claude Martin, Kelly McQueen, Jamie Morgan, Richard Moser, Robert Neighbor, William M Novick, Stephen Ogendo, Akinyinka Omigbodun, Bisola Onajin-Obembe, Neil Parsan, Beverly K Philip, Raymond Price, Shahnawaz Rasheed, Marjorie Ratel, Cheri Reynolds, Steven M Roser, Jackie Rowles, Lubna Samad, John Sampson, Harshadkumar Sanghvi, Marchelle L Sellers, David Sigalet, Bruce C Steffes, Erin Stieber, Mamta Swaroop, John Tarpley, Asha Varghese, Julie Varughese, Richard Wagner, Benjamin Warf, Neil Wetzig, Susan Williamson, Joshua Wood, Anne Zeidan, Lewis Zirkle, Brendan Allen, Fizan Abdullah
After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#20
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
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