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https://www.readbyqxmd.com/read/28994673/an-innovative-technique-to-improve-safety-of-volatile-anesthetics-suction-from-the-cardiopulmonary-bypass-circuit
#1
Francesco De Simone, Luigi Cassarà, Salvatore Sardo, Elena Scarparo, Omar Saleh, Caetano Nigro Neto, Alberto Zangrillo, Giovanni Landoni
CONTEXT: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28938276/anesthesia-with-dexmedetomidine-and-low-dose-isoflurane-increases-solute-transport-via-the-glymphatic-pathway-in-rat-brain-when-compared-with-high-dose-isoflurane
#2
Helene Benveniste, Hedok Lee, Fengfei Ding, Qian Sun, Ehab Al-Bizri, Rany Makaryus, Stephen Probst, Maiken Nedergaard, Elliot A Stein, Hanbing Lu
BACKGROUND: The glymphatic pathway transports cerebrospinal fluid through the brain, thereby facilitating waste removal. A unique aspect of this pathway is that its function depends on the state of consciousness of the brain and is associated with norepinephrine activity. A current view is that all anesthetics will increase glymphatic transport by inducing unconsciousness. This view implies that the effect of anesthetics on glymphatic transport should be independent of their mechanism of action, as long as they induce unconsciousness...
September 22, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28861655/inhaled-anesthetic-agent-sedation-in-the-icu-and-trace-gas-concentrations-a-review
#3
REVIEW
Jennifer Herzog-Niescery, Hans-Martin Seipp, Thomas Peter Weber, Martin Bellgardt
There is a growing interest in the use of volatile anesthetics for inhalational sedation of adult critically ill patients in the ICU. Its safety and efficacy has been demonstrated in various studies and technical equipment such as the anaesthetic conserving device (AnaConDa™; Sedana Medical, Uppsala, Sweden) or the MIRUS™ system (Pall Medical, Dreieich, Germany) have significantly simplified the application of volatile anesthetics in the ICU. However, the personnel's exposure to waste anesthetic gas during daily work is possibly disadvantageous, because there is still uncertainty about potential health risks...
August 31, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28837406/evaluation-of-waste-isoflurane-gas-exposure-during-rodent-surgery-in-an-australian-university
#4
Kelly R Johnstone, Cora Lau, Jane L Whitelaw
Biomedical researchers use of inhalational anesthetics has increased in recent years. Use of isoflurane as an inhalational anesthetic may result in human exposure to waste anesthetic gas. Potential health effects from exposure include genotoxic and hepatotoxic effects with some evidence of teratogenic and reproductive effects. Research suggests that exposure to waste anesthetic gas within human hospital settings has improved substantially but exposures to biomedical researchers and veterinarians still requires improvement...
August 24, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/27684327/use-of-a-low-flow-digital-anesthesia-system-for-mice-and-rats
#5
Amelia R Adelsperger, Krista J Bigiarelli-Nogas, Irina Toore, Craig J Goergen
A traditional vaporizer depends on flowing gas and atmospheric pressure for passive anesthetic vaporization. Newly developed direct injection vaporizers utilize a syringe pump to directly administer volatile anesthetics into a gas stream. Unlike a traditional vaporizer, it can be used at very low flow rates, making it ideal for use on mice and rats. The equipment's capability to use low flow rates could result in a substantial cost savings due to the reduced need for anesthetic agents, compressed gas, and charcoal scavenging filters(1)...
September 7, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27542098/precautionary-practices-for-administering-anesthetic-gases-a-survey-of-physician-anesthesiologists-nurse-anesthetists-and-anesthesiologist-assistants
#6
James M Boiano, Andrea L Steege
Scavenging systems and administrative and work practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants...
October 2, 2016: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/27273061/postoperative-environmental-anesthetic-vapour-concentrations-following-removal-of-the-airway-device-in-the-operating-room-versus-the-postanesthesia-care-unit
#7
COMPARATIVE STUDY
Sara K Cheung, Timur Özelsel, Saifee Rashiq, Ban C Tsui
PURPOSE: This study was designed to compare waste anesthetic gas (WAG) concentrations within patients' breathing zones after removal of the patient's airway device in the postanesthesia care unit (PACU) vs in the operating room (OR). METHODS: Following Research Ethics Board approval and patient consent, we recruited patients undergoing surgery who received volatile anesthesia via an endotracheal tube or supraglottic airway. Patients had their airway device removed in the OR or in the PACU depending on the attending anesthesiologist's preference...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26632785/comparison-of-traditional-and-integrated-digital-anesthetic-vaporizers
#8
COMPARATIVE STUDY
Frederick W Damen, Amelia R Adelsperger, Katherine E Wilson, Craig J Goergen
Recent efforts have focused on mitigating anesthetic gas emissions during laboratory animal experiments. A recently developed, digitally controlled, integrated digital vaporizer (IDV) using a syringe pump has been designed to use and administer anesthetic gas to mice and rats more efficiently. The entire IDV system can be placed on a laboratory bench, requires fewer charcoal filters to act as passive scavengers when used at a low gas flow rate, and does not need compressed gas to operate, a requirement for traditional passive systems...
November 2015: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/26072157/automated-gas-control-with-the-maquet-flow-i
#9
Rik Carette, Andre M De Wolf, Jan F A Hendrickx
The FLOW-i anesthesia machine (Maquet, Solna, Sweden) can be equipped with automated gas control (AGC), an automated low flow tool with target control of the inspired oxygen concentration (FIO2) and end-expired concentration (FA) of a potent inhaled anesthetic. We examined the performance and quantitative aspects of the AGC. After IRB approval and individual informed consent, anesthesia in 24 ASA I-II patients undergoing abdominal or gynecological surgery was maintained with sevoflurane in O2/air with a target FIO2 of 40 % and a target sevoflurane FA (FAsevo) of 2...
June 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/25333593/a-technique-for-administering-xenon-gas-anesthesia-during-surgical-procedures-in-mice
#10
Arne Mathias Ruder, Michaela Schmidt, Alessia Ludiro, Marco A Riva, Peter Gass
Carrying out invasive procedures in animals requires the administration of anesthesia. Xenon gas offers advantages as an anesthetic agent compared with other agents, such as its protection of the brain and heart from hypoxia-induced damage. The high cost of xenon gas has limited its use as an anesthetic in animal experiments, however. The authors designed and constructed simple boxes for the induction and maintenance of xenon gas and isoflurane anesthesia in small rodents in order to minimize the amount of xenon gas that is wasted...
November 2014: Lab Animal
https://www.readbyqxmd.com/read/24471666/a-ten-year-audit-of-fresh-gas-flows-in-a-new-zealand-hospital-the-influence-of-the-introduction-of-automated-agent-delivery-and-comparisons-with-other-hospitals
#11
COMPARATIVE STUDY
R R Kennedy, R A French
Reducing fresh gas flow (FGF) rates with volatile anaesthetics reduces waste, with positive financial and environmental consequences. We have audited FGF since 2001 by analysis of data collected from anaesthetic machines. We recently introduced Aisys(®) (GE Healthcare, Madison, WI, USA) machines that allow automated control of end-tidal levels of volatile anaesthetics. In 2009 the mean FGF was 1.27 l/minute, which was lower than 2001 (2.05 l/minute) and 2006 (1.43 l/minute) and similar to two other New Zealand hospitals...
January 2014: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/24108253/automated-real-time-fresh-gas-flow-recommendations-alter-isoflurane-consumption-during-the-maintenance-phase-of-anesthesia-in-a-simulator-based-study
#12
Isaac Luria, Samsun Lampotang, Wilhelm Schwab, Lou Ann Cooper, David Lizdas, Nikolaus Gravenstein
BACKGROUND: The Low Flow Wizard (LFW) provides real-time guidance for user optimization of fresh gas flow (FGF) settings during general inhaled anesthesia. The LFW can continuously inform users whether it determines their FGF to be too little, efficient, or too much, and its color-coded recommendations respond in real time to changes in FGF performed by users. Our study objective was to determine whether the LFW feature, as implemented in the Dräger Apollo workstation, alters FGF selection and thereby volatile anesthetic consumption without affecting patient care...
November 2013: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24051641/monitoring-and-mitigating-isoflurane-emissions-during-inhalational-anesthesia-of-mice
#13
Thomas E Todd, Jennifer M Morse, Todd J Casagni, Robert W Engelman
Establishing a program to monitor waste anesthetic gas (WAG) in order to limit personnel exposure requires measuring the levels of WAG emitted and determining the effectiveness of scavenging methods to reduce such levels. In this study, the authors used infrared spectroscopy to measure levels of WAG emitted while anesthetizing mice with isoflurane for 15 min. They evaluated four different WAG scavenging conditions during induction and maintenance anesthesia: two conditions that used passive techniques and two that used active techniques...
October 2013: Lab Animal
https://www.readbyqxmd.com/read/23915295/a-novel-approach-to-scavenging-anesthetic-gases-in-rodent-surgery
#14
Jeffrey C Nesbitt, Dale A Krageschmidt, Michael C Blanco
Laboratory animal procedures using gas anesthetics may amass elevated waste gas concentrations in operating rooms if controls are not implemented for capturing and removing the vapors. Area sampling using an infrared analyzer indicated isoflurane concentrations likely to exceed occupational exposure guidelines. Our study showed environmental concentrations of oxygen as high as 40% and isoflurane concentrations >100 ppm when no controls or merely passive controls were utilized. These extraneous isoflurane emissions were determined to be originating from the pre-procedural induction process as well as the gas delivery nose cone...
2013: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/23804997/quantitative-chemical-analysis-of-surgical-smoke-generated-during-laparoscopic-surgery-with-a-vessel-sealing-device
#15
Michele Gianella, Dieter Hahnloser, Julien M Rey, Markus W Sigrist
BACKGROUND: Exposure to surgical smoke in the operation room has been a long-standing concern. Smoke generated by the interaction between lasers or electrocautery devices with biological tissue contains several toxic and carcinogenic substances, but only a few studies so far have provided quantitative data necessary for risk assessment. METHODS: With laser and Fourier-transform infrared spectroscopy, we investigated the chemical composition of smoke produced with a vessel-sealing device in an anoxic environment during laparoscopic surgery...
April 2014: Surgical Innovation
https://www.readbyqxmd.com/read/23592609/technical-communication-the-effect-of-the-double-mask-on-anesthetic-waste-gas-levels-during-pediatric-mask-inductions-in-dental-offices
#16
Matt M Kurrek, Steven L Dain, Alexander Kiss
A significant portion of office-based general anesthesia for pediatric patients is performed in dental offices and involves mask inductions with inhaled drugs. This can lead to significant pollution with waste gases. We assessed occupational exposure to anesthetic drugs during pediatric general anesthesia in dental offices and assessed the effectiveness of the "double mask." Nine freestanding dental offices had measurements of anesthetic waste gas levels taken before and immediately after implementation of a double-mask system...
July 2013: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/23442753/reducing-wastage-of-inhalation-anesthetics-using-real-time-decision-support-to-notify-of-excessive-fresh-gas-flow
#17
Bala G Nair, Gene N Peterson, Moni B Neradilek, Shu Fang Newman, Elaine Y Huang, Howard A Schwid
BACKGROUND: Reduced consumption of inhalation anesthetics can be safely achieved by reducing excess fresh gas flow (FGF). In this study the authors describe the use of a real-time decision support tool to reduce excess FGF to lower, less wasteful levels. METHOD: The authors applied a decision support tool called the Smart Anesthesia Manager™ (University of Washington, Seattle, WA) that analyzes real-time data from an Anesthesia Information Management System to notify the anesthesia team if FGF exceeds 1 l/min...
April 2013: Anesthesiology
https://www.readbyqxmd.com/read/23241038/environmental-implications-of-anesthetic-gases
#18
REVIEW
Jeffrey S Yasny, Jennifer White
For several decades, anesthetic gases have greatly enhanced the comfort and outcome for patients during surgery. The benefits of these agents have heavily outweighed the risks. In recent years, the attention towards their overall contribution to global climate change and the environment has increased. Anesthesia providers have a responsibility to minimize unnecessary atmospheric pollution by utilizing techniques that can lessen any adverse effects of these gases on the environment. Moreover, health care facilities that use anesthetic gases are accountable for ensuring that all anesthesia equipment, including the scavenging system, is effective and routinely maintained...
2012: Anesthesia Progress
https://www.readbyqxmd.com/read/23113075/nitrous-oxide-levels-in-operating-and-recovery-rooms-of-iranian-hospitals
#19
Sh Sadigh Maroufi, Mj Gharavi, M Behnam, A Samadikuchaksaraei
BACKGROUND: Nitrous oxide (N(2)O) is the oldest anesthetic in routine clinical use and its occupational exposure is under regulation by many countries. As studies are lacking to demonstrate the status of nitrous oxide levels in operating and recovery rooms of Iranian hospitals, we aimed to study its level in teaching hospitals of Tehran University of Medical Sciences. METHODS: During a 6-month period, we have measured the shift-long time weighted average concentration of N(2)O in 43 operating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences...
2011: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/22492186/life-cycle-greenhouse-gas-emissions-of-anesthetic-drugs
#20
Jodi Sherman, Cathy Le, Vanessa Lamers, Matthew Eckelman
BACKGROUND: Anesthesiologists must consider the entire life cycle of drugs in order to include environmental impacts into clinical decisions. In the present study we used life cycle assessment to examine the climate change impacts of 5 anesthetic drugs: sevoflurane, desflurane, isoflurane, nitrous oxide, and propofol. METHODS: A full cradle-to-grave approach was used, encompassing resource extraction, drug manufacturing, transport to health care facilities, drug delivery to the patient, and disposal or emission to the environment...
May 2012: Anesthesia and Analgesia
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