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Target controlled anaesthesia

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https://www.readbyqxmd.com/read/29761867/airway-physical-examination-tests-for-detection-of-difficult-airway-management-in-apparently-normal-adult-patients
#1
REVIEW
Dominik Roth, Nathan L Pace, Anna Lee, Karen Hovhannisyan, Alexandra-Maria Warenits, Jasmin Arrich, Harald Herkner
BACKGROUND: The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. OBJECTIVES: The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29757924/placebo-versus-low-dose-ketamine-infusion-in-addition-to-remifentanil-target-controlled-infusion-for-conscious-sedation-during-oocyte-retrieval-a-prospective-double-blinded-randomised-controlled-trial
#2
Hélène I Morue, Shalini Raj-Lawrence, Sarah Saxena, Anne Delbaere, Edgard Engelman, Luc A Barvais
BACKGROUND: Currently, there is no gold standard for monitored anaesthesia care during oocyte retrieval. OBJECTIVE: In our institution, the standard is a conscious sedation technique using a target-controlled infusion (TCI) of remifentanil, titrated to maintain a visual analogue pain score less than 30 mm. This protocol is well accepted by patients but is associated with frequent episodes of respiratory depression. The main objective of this study was to evaluate whether the addition of a continuous intravenous infusion of ketamine could reduce these episodes...
April 30, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29720751/effect-site-concentration-of-propofol-at-induction-and-recovery-of-anaesthesia-a-correlative-dose-response-study
#3
Vasanth Sukumar, Arathi Radhakrishnan, Venkatesh H Keshavan
Background and Aims: Sound knowledge about effect site concentration (Ce) of propofol aids in smooth induction, maintenance and early recovery. We studied the correlation between Ce of propofol at loss of response to verbal command and recovery concentration using target-controlled infusion (TCI) in Indian patients who underwent spine surgeries. Methods: Ninety patients undergoing spine surgeries were included. Total intravenous anaesthesia (TIVA) technique with TCI for propofol using modified Marsh model was used...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29720748/target-controlled-infusion-total-intravenous-anaesthesia-and-indian-patients-do-we-need-our-own-data
#4
EDITORIAL
Goverdhan Dutt Puri
No abstract text is available yet for this article.
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29720416/behavioural-changes-controlled-by-catecholaminergic-systems-explain-recurrent-loss-of-pigmentation-in-cavefish
#5
Helena Bilandžija, Lindsey Abraham, Li Ma, Kenneth J Renner, William R Jeffery
Multiple cave populations of the teleost Astyanax mexicanus have repeatedly reduced or lost eye and body pigmentation during adaptation to dark caves. Albinism, the complete absence of melanin pigmentation, is controlled by loss-of-function mutations in the oca2 gene. The mutation is accompanied by an increase in the melanin synthesis precursor l-tyrosine, which is also a precursor for catecholamine synthesis. In this study, we show a relationship between pigmentation loss, enhanced catecholamine synthesis and responsiveness to anaesthesia, determined as a proxy for catecholamine-related behaviours...
May 16, 2018: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/29661412/pharmacokinetic-pharmacodynamic-model-for-propofol-for-broad-application-in-anaesthesia-and-sedation
#6
D J Eleveld, P Colin, A R Absalom, M M R F Struys
BACKGROUND: Pharmacokinetic (PK) and pharmacodynamic (PD) models are used in target-controlled-infusion (TCI) systems to determine the optimal drug administration to achieve a desired target concentration in a central or effect-site compartment. Our aim was to develop a PK-PD model for propofol that can predict the bispectral index (BIS) for a broad population, suitable for TCI applications. METHODS: Propofol PK data were obtained from 30 previously published studies, five of which also contained BIS observations...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661382/comparison-of-target-controlled-infusion-and-manual-infusion-for-propofol-anaesthesia-in-children
#7
J Mu, T Jiang, X B Xu, V M Yuen, M G Irwin
BACKGROUND: One major criticism of prolonged propofol-based total i.v. anaesthesia (TIVA) in children is the prolonged recovery time. As target-controlled infusion (TCI) obviates the need to manually calculate the infusion rate, the use of TCI may better match clinical requirements, reduce propofol dose, and shorten recovery time. METHODS: Children of ASA grade 1, aged 1-12 yr, were recruited and randomly assigned to TCI or manual infusion. Children in the TCI group had propofol delivered by TCI...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29599632/comparison-of-the-effects-of-dexmedetomidine-on-the-induction-of-anaesthesia-using-marsh-and-schnider-pharmacokinetic-models-of-propofol-target-controlled-infusion
#8
Wan Mohd Nazaruddin Wan Hassan, Hai Siang Tan, Rhendra Hardy Mohamed Zaini
Background: The study aimed to determine the effects of dexmedetomidine on the induction of anaesthesia using different models (Marsh and Schnider) of propofol target-controlled infusion (TCI). Methods: Sixty-four patients aged 18-60 years, American Society of Anaesthesiologists (ASA) class I-II who underwent elective surgery were randomised to a Marsh group ( n = 32) or Schnider group ( n = 32). All the patients received a 1 μg/kg loading dose of dexmedetomidine, followed by TCI anaesthesia with remifentanil at 2 ng/mL...
February 2018: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29579636/determination-of-dexmedetomidine-by-uhplc-ms-ms-and-its-application-to-evaluate-the-effect-of-dexmedetomidine-concentration-on-the-target-controlled-infusion-concentration-of-propofol
#9
Zhuoling Zheng, Shuyu Zhang, Wudi Ma, Lingyi Zhang, Ling Huang, Wenqi Huang, Min Huang, Zhongxing Wang, Jiali Li
The combination of dexmedetomidine (DEX) and propofol (PPF) is extensively used in the field of anaesthesiology. This study aimed to develop and validate a rapid, simple and sensitive ultra high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for the determination of DEX in human plasma. The method was applied to evaluate the effect of DEX concentration on the target-controlled infusion (TCI) concentration of PPF. Analytes were separated on a Waters XTERRA® MS C18 column with a mobile phase of acetonitrile-methanol-water containing 0...
May 30, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29480502/dental-treatment-and-caries-prevention-preceding-treatment-under-general-anaesthesia-in-healthy-children-and-adolescents-a-retrospective-cohort-study
#10
M Grindefjord, J Persson, L Jansson, G Tsilingaridis
AIM: This was to examine healthy children and adolescents treated under general anaesthesia (GA) and a matched control group not receiving GA to compare treatment and preventive care received prior to GA treatment. METHODS: This retrospective cohort study included 71 healthy subjects and 213 age- and gender-matched control subjects. The treatment group had been consecutively referred from the Public Dental Health Service (PDS) in Stockholm to the Department of Paediatric Dentistry, Eastman Institute, Stockholm during 2006-2007...
April 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29397124/simplified-algorithm-for-the-prevention-of-postoperative-nausea-and-vomiting-a-before-and-after-study
#11
G Dewinter, W Staelens, E Veef, A Teunkens, M Van de Velde, S Rex
BACKGROUND: Poor adherence to guidelines aimed at reducing the incidence of postoperative nausea and vomiting (PONV) is well known. In a before-and-after study, we tested the effectiveness of a simplified algorithm for PONV prophylaxis on the incidence of PONV. METHODS: In the first audit, we examined the adherence to our institutional guidelines for PONV prevention. In response to the results of this audit, we introduced a simplified algorithm for PONV prevention [female patients receiving triple prophylaxis (dexamethasone and ondansetron plus either a target-controlled infusion with propofol or droperidol) and male patients receiving double prophylaxis, dexamethasone, and ondansetron]...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29386974/target-controlled-infusion-propofol-versus-sevoflurane-anaesthesia-for-emergency-traumatic-brain-surgery-comparison-of-the-outcomes
#12
Wan Mohd Nazaruddin Wan Hassan, Yusnizah Mohd Nasir, Rhendra Hardy Mohamad Zaini, Wan Fadzlina Wan Muhd Shukeri
Background: The choice of anaesthetic techniques is important for the outcome of traumatic brain injury (TBI) emergency surgery. The objective of this study was to compare patient outcomes for target-controlled infusion (TCI) of propofol and sevoflurane anaesthesia. Methods: A total of 110 severe TBI patients, aged 18-60, who underwent emergency brain surgery were randomised into Group T (TCI) ( n = 55) and Group S (sevoflurane) ( n = 55). Anaesthesia was maintained in Group T with propofol target plasma concentration of 3-6 μg/mL and in Group S with minimum alveolar concentration (MAC) of sevoflurane 1...
October 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29227351/impact-of-pectoral-nerve-block-on-postoperative-pain-and-quality-of-recovery-in-patients-undergoing-breast-cancer-surgery-a-randomised-controlled-trial
#13
Yoshinori Kamiya, Miki Hasegawa, Takayuki Yoshida, Misako Takamatsu, Yu Koyama
BACKGROUND: In recent years, thoracic wall nerve blocks, such as the pectoral nerve (PECS) block and the serratus plane block have become popular for peri-operative pain control in patients undergoing breast cancer surgery. The effect of PECS block on quality of recovery (QoR) after breast cancer surgery has not been evaluated. OBJECTIVES: To evaluate the ability of PECS block to decrease postoperative pain and anaesthesia and analgesia requirements and to improve postoperative QoR in patients undergoing breast cancer surgery...
March 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29222034/management-of-invasive-candidiasis-and-candidaemia-in-critically-ill-adults-expert-opinion-of-the-european-society-of-anaesthesia-intensive-care-scientific-subcommittee
#14
REVIEW
R-A O'Leary, S Einav, M Leone, K Madách, C Martin, I Martin-Loeches
OBJECTIVE: The global burden of invasive fungal disease is increasing. Candida albicans remains the leading cause of fungal bloodstream infections, although non-albicans candidal infections are emerging. Areas of controversy regarding diagnosis and management are hampering our ability to respond effectively to this evolving threat. The purpose of this narrative review is to address current controversies and provide recommendations to supplement guidelines. DIAGNOSIS OF INVASIVE CANDIDIASIS: Diagnosis of invasive candidiasis requires a combination of diagnostic tests and patient risk factors...
April 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29189318/standardised-noxious-stimulation-guided-individual-adjustment-of-remifentanil-target-controlled-infusion-to-prevent-haemodynamic-responses-to-laryngoscopy-and-surgical-incision-a-randomised-controlled-trial
#15
Aline Defresne, Luc Barvais, François Clement, Vincent Bonhomme
BACKGROUND: The surgical plethysmographic index (SPI) is one of the available indexes of the nociception-antinociception (NAN) balance. Individually adjusting the NAN balance to prevent somatic responses to noxious stimulation remains a challenge. OBJECTIVES: To assess whether guiding remifentanil administration according to the SPI response to a calibrated noxious stimulus (NANCAL) can blunt the haemodynamic response to tracheal intubation and surgical incision...
March 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29098683/effect-of-sufentanil-on-bispectral-index-in-the-elderly
#16
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...
February 2018: Anaesthesia
https://www.readbyqxmd.com/read/29045562/attenuation-of-high-frequency-30-200-hz-thalamocortical-eeg-rhythms-as-correlate-of-anaesthetic-action-evidence-from-dexmedetomidine
#17
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...
December 1, 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
#18
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-de-pth-on-p-ostoperative-clinical-ou-t-come-in-patients-with-supratentorial-tumor-depth-study-protocol-for-a-randomized-controlled-trial
#19
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
#20
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
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