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Total intravenous anesthesia

Safinaz Karabayirli, Onder Surgit, Hulya Kasikara, Cemile Koca Bicer, Merve Ergin, Ruveyda Irem Demircioglu, Bunyamin Muslu
BACKGROUND: The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N2O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP). MATERIALS AND METHODS: One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4-6 vol% in oxygen/N2O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil...
October 24, 2016: Acta Chirurgica Belgica
Evelien Kuiper-Prins, Gerthe Femke Kerkhof, Catharina Gertrudis Maria Reijnen, Pieter Jan van Dijken
A 12-day-old boy presented with duskiness 4 h after circumcision with local anesthesia: infiltration with lidocaine (6 mL 1 %) and topical EMLA cream (2.5 % lidocaine/2.5 % prilocaine). He had no respiratory distress, but a strikingly dark skin. A blood sample showed dark, chocolate brown blood with a raised methemoglobin of 49.8 % (normal <1.5 %) and a lactate of 10 mmol/L. A diagnosis of methemoglobinemia was made. The patient was treated with oxygen administration, but methemoglobin concentration was still 45 % 1 h later...
December 2016: Drug Saf Case Rep
Chetna Shamshery, Ashish Kannaujia, Rajashree Madabushi, Dinesh Singh, Divya Srivastava, Shobhana Jafa
BACKGROUND: Central neuraxial blockade (CNB) is an established technique of providing anesthesia for surgeries of the lower limb and abdomen. Hypotension is the most common side effect of CNB. It was hypothesized that by supplementing the initial burst of vasopressin following hypovolemia, hypotension following combined spinal epidural anesthesia (CSEA) could be avoided. MATERIALS AND METHODS: A total of 122 patients undergoing lower limb and abdomen surgeries were included in the study, with 61 patients randomized into two groups - I and II...
September 2016: Anesthesia, Essays and Researches
Venkatesh Selvaraj
BACKGROUND: Clonidine is an effective adjuvant to local anesthetics in peripheral nerve blocks. We studied the effect of clonidine as an adjuvant in wound infiltration for postoperative analgesia. AIM: To evaluate the role of clonidine as an adjuvant to bupivacaine in wound infiltration in terms of quality and duration of postoperative analgesia in patients undergoing total abdominal hysterectomy. SETTINGS AND STUDY DESIGN: Prospective, randomized, double-blinded study...
September 2016: Anesthesia, Essays and Researches
Nitesh Patel, Ayesha Bryant, Kensi Duncan, Promil Kukreja, Mark F Powell
PURPOSE: Intrathecal morphine provides superior pain control for patients undergoing cesarean delivery when compared to intravenous opioid patient-controlled analgesia. However, no study has assessed the overall cost associated with each modality as a primary outcome. The aim of this study is to determine the overall cost of each modality for the first 24 h post cesarean delivery. METHODS: Charts of patients undergoing cesarean delivery at our institution from January 1, 2014 to December 31, 2014 were reviewed...
October 14, 2016: Journal of Anesthesia
G D L Jorge, R R Tártaro, C A F Escanhoela, I D F S F Boin
BACKGROUND: Biliary complications are important causes of morbidity and mortality in patients undergoing hepatic surgery. The aim of the study was to evaluate late liver alterations after a long period of choledochal clamping in Wistar rats. METHODS: Ten male Wistar rats, weighing 304 grams, anesthetized with sodium thiopental (25 mg/kg) and xylazine (10 mg/kg) intravenously, were distributed into 2 groups: the choledochal clamping group (CCG) and the operation sham group (OSG), with 5 animals each submitted to an abdominal incision...
September 2016: Transplantation Proceedings
Stefan Rampp, Leonhard Rensch, Sebastian Simmermacher, Torsten Rahne, Christian Strauss, Julian Prell
OBJECTIVE Brainstem auditory evoked potentials (BAEPs) have been used for intraoperative monitoring of the auditory nerve for many years. However, BAEPs yield limited information about the expected postoperative hearing quality and speech perception. The auditory steady-state response (ASSR) enables objective audiograms to be obtained in patients under anesthesia. These ASSRs could be used for intraoperative estimation of hearing classes to improve the postoperative outcome and quality of life. Studies investigating the clinical use of ASSRs during total intravenous anesthesia are currently lacking...
October 14, 2016: Journal of Neurosurgery
Sarah E Bigby, Jennifer E Carter, Sébastien Bauquier, Thierry Beths
Anesthesia protocols for patients with intracranial lesions need to provide hemodynamic stability, preserve cerebrovascular autoregulation, avoid increases in intracranial pressure, and facilitate a rapid recovery. Propofol total intravenous anesthesia (TIVA) maintains cerebral blood flow autoregulation and is considered superior to inhalant agents as an anesthetic protocol for patients with intracranial lesions. A propofol-based TIVA subsequent to premedication with medetomidine and diazepam was used in a king penguin ( Aptenodytes patagonicus ) undergoing magnetic resonance imaging of the brain after a new onset of seizures...
September 2016: Journal of Avian Medicine and Surgery
YanQiu Liu, YiMin Ren, Hong Gao, Li Zeng, ShaoFeng Lin, KaiQiang Zhang
OBJECTIVE: This research studied the influence of different blood lipid components on the rate of alveolar-capillary uptake of sevoflurane. METHOD: 104 patients aged 20 - 50 years undergoing elective operations under general anesthesia were mechanically ventilated through endotracheal intubation after intravenous injections of midazolam, vecuronium, fentanyl, and etomidate. They inhaled 2% sevoflurane at an oxygen flow of 2 L/min, then the inspired concentrations (FI) and expired concentrations (FA of sevoflurane were recorded at 1, 3, 5, 7, 10, 15, 20, and 30 minutes...
October 10, 2016: International Journal of Clinical Pharmacology and Therapeutics
Abigail C Mancuso, Kelsey Lee, Ran Zhang, Elizabeth A Hoover, Colleen Stockdale, Abbey J Hardy-Fairbanks
OBJECTIVES: Safety of outpatient dilation and evacuations with intravenous (iv) sedation without intubation has been demonstrated, but there is a paucity of data on deep iv sedation on an inpatient second trimester surgical termination population. The purpose of this study is to evaluate complications of deep sedation with propofol without the use of intubation during second trimester surgical terminations in an inpatient teaching institution. STUDY DESIGN: A retrospective chart review of all obstetrical and anesthetic data from inpatient dilation and evacuations between gestational ages 15 0/7 and 24 0/7 during the years 2002 to 2015...
October 3, 2016: Contraception
Janelle Rekman, Christopher Wherrett, Sean Bennett, Miso Gostimir, Sara Saeed, Kristina Lemon, Richard Mimeault, Fady K Balaa, Guillaume Martel
BACKGROUND: Liver resection can be associated with significant blood loss and transfusion. Whole blood phlebotomy is an under-reported technique, distinct from acute normovolemic hemodilution, the goal of which is to minimize blood loss in liver operation. This work sought to report on its safety and feasibility and to describe technical considerations. METHODS: Consecutive patients who had an elective liver resection and concurrent phlebotomy between 2013 and 2016 were examined prospectively...
October 3, 2016: Surgery
Cameron Ratliff, Rebecca S Sayre, Mauricio Lepiz
A hand-reared, 53-kg, female, 30-day-old black rhinoceros ( Diceros bicornis ) calf presented for magnetic resonance imaging and computed tomography after demonstrating neurologic signs. The rhino was premedicated intramuscularly with butorphanol and midazolam, yielding satisfactory sedation. Induction was achieved using intravenous propofol until the trachea could be intubated. Anesthesia was maintained with sevoflurane in 100% oxygen (mean end-tidal concentration of 2 ± 0.5%). Mean values recorded during anesthesia included were heart rate, end-tidal carbon dioxide, respiratory rate, noninvasive blood pressure, and pulse oximetry...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Ajisha Aravindan, Rajeshwari Subramanium, Anjolie Chhabra, Priyankar K Datta, Vimi Rewari, Suresh C Sharma, Rakesh Kumar
STUDY OBJECTIVE: This study was designed to know whether addition of magnesium sulfate (MgSO4) or diltiazem to total intravenous anesthesia (TIVA) (propofol) aided reduction in blood loss during functional endoscopic sinus surgery (FESS). The secondary outcomes measured were surgeon's assessment of the surgical field and hemodynamics. DESIGN: Randomized, double-blinded, placebo-controlled trial. SETTING: Operating room. PATIENTS: Forty-five American Society of Anesthesiologists I and II adult patients (18-60years) undergoing FESS...
November 2016: Journal of Clinical Anesthesia
Pertti Pere, Jukka Harju, Pekka Kairaluoma, Veikko Remes, Päivi Turunen, Per H Rosenberg
STUDY OBJECTIVE: Comparison of local anesthetic infiltration (LAI), spinal anesthesia (SPIN) and total intravenous anesthesia (TIVA) for open inguinal herniorrhaphy. We hypothesized that patients receiving LAI could be discharged faster than SPIN and TIVA patients. DESIGN: Randomized, prospective trial. SETTING: University hospital day-surgery center. PATIENTS: 156 adult male patients (ASA 1-3) undergoing day-case open inguinal herniorrhaphy...
November 2016: Journal of Clinical Anesthesia
Saipriya Tewari, Poonam Bhadoria, Sonia Wadhawan, Sudha Prasad, Amit Kohli
STUDY OBJECTIVE: Day care surgery is an important arena for monitors of anesthetic depth where minimizing drug use is essential for rapid turnover. Underdosage, on the other hand, carries the risks of intraoperative awareness and pain. Transvaginal oocyte retrieval (TVOR), often performed under total intravenous anesthesia using propofol and fentanyl in Indian patients, is a procedure of special interest because, in addition to the above concerns, toxic effects of propofol on oocytes have been described...
November 2016: Journal of Clinical Anesthesia
Menekse Oksar, Onur Koyuncu, Selim Turhanoglu, Muhyittin Temiz, Mustafa Cemil Oran
OBJECTIVE: To evaluate and compare intercostal-iliac transversus abdominis plane (TAP) and oblique subcostal TAP (OSTAP) blocks for multimodal analgesia in patients receiving laparoscopic cholecystectomy. DESIGN: A prospective, randomized, double-blinded clinical study. SETTING: Operating room, postoperative recovery area, and ward. PATIENTS: In total, 60 laparoscopic cholecystectomy patients (43 women, 17 men, American Society of Anesthesiologists grades I-II) were enrolled from the general surgery department of our tertiary care center...
November 2016: Journal of Clinical Anesthesia
Seunguk Bang, Jihyun Chung, Jaejung Jeong, Hahyeon Bak, Dongju Kim
BACKGROUND: The fascia iliaca compartment block (FICB) provides an analgesic effect in patients with femur fractures. However, the postoperative pain after hip surgery is different from that after femur fracture, because of the difference in the degree and location of tissue trauma. Whether FICB provides effective postoperative analgesia in patients undergoing total hip arthroplasty is not well understood. Moreover, there is no prospective randomized study to evaluate FICB as a postoperative analgesia in hemiarthroplasty...
September 2016: Medicine (Baltimore)
Joana Chaves Gonçalves Rodrigues de Carvalho, Francisco Javier Tercero Machin, Luis San Roman Manzanera, Jordi Blasco Andaluz, Sílvia Herrero Nogués, Núria Peix Soriano, Victor Obach Baurier, Enrique Jesus Carrero Cardenal
BACKGROUND AND OBJECTIVES: Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributable to their reported safety and effectiveness. We describe the unique and rare case of a dural arteriovenous fistula treated by transarterial embolization and complicated by an intraventricular hemorrhage...
September 24, 2016: Revista Brasileira de Anestesiologia
Manuel J Richter, Ralf Ewert, Christian Warnke, Henning Gall, Simon Classen, Friedrich Grimminger, Eckhard Mayer, Werner Seeger, Hossein-Ardeschir Ghofrani
BACKGROUND: In patients with severe pulmonary arterial hypertension, subcutaneous or catheter-based intravenous application of prostanoids carries a risk of local side effects or systemic infections, which limits their use and acceptance. Recently, a fully implantable pump for continuous application of intravenous treprostinil was approved in Germany. However, surgery is a major risk for patients with severe pulmonary arterial hypertension. The purpose of this study was to investigate the safety of a fully implantable pump inserted under local or general anesthesia in patients with severe pulmonary hypertension...
September 26, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Yun-Sic Bang, Young Uk Kim, Dawoon Oh, Eui Yong Shin, Soo Kyoung Park
PURPOSE: Palonosetron has potent and long-acting antiemetic effects for postoperative nausea and vomiting (PONV). The aim of this study was to prospectively evaluate the efficacy of palonosetron when used with total intravenous anesthesia (TIVA) using propofol and remifentanil for the prevention of PONV in patients undergoing laparoscopic gynecologic surgery. METHODS: This prospective double-blind study comprised 100 female American Society of Anesthesiologist physical status I and II patients who were undergoing laparoscopic gynecologic surgery under TIVA...
September 20, 2016: Journal of Anesthesia
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