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Delayed awakening

José M Beleña, Mónica Núñez, Alfonso Vidal, Diego Anta
BACKGROUND AND AIMS: To compare the use of remifentanil and alfentanil to suppress intraoperative adrenergic response of pain and the influence of these drugs on the recovery profile in patients undergoing laparoscopic cholecystectomy using a total intravenous anesthesia (TIVA) technique. MATERIAL AND METHODS: One hundred patients undergoing elective laparoscopic cholecystectomy were randomized to be managed with either remifentanil (group R) or alfentanil (group A)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
Thisciane Ferreira Pinto, Francisco Girleudo Coutinho da Silva, Veralice Meireles Sales de Bruin, Pedro Felipe Carvalhedo de Bruin
Night eating syndrome (NES) is characterized by caloric intake ≥ 25% of total daily after dinner and/or by two or more weekly nocturnal awakenings accompanied by food ingestion. Causes of NES are not entirely clear and seem to involve a desynchronization between the circadian rhythms of food ingestion and sleep, resulting in a delayed pattern of food intake. Estimates of the prevalence of NES in the general population are around 1.5%, and although much higher frequencies have been described in obese individuals, a causal relationship between NES and obesity is not clearly established...
October 2016: Revista da Associação Médica Brasileira
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
Aymeric Petit, Laurent Karila, Candice Estellat, Delphine Moisan, Michel Reynaud, Marie-Pia D'Ortho, Michel Lejoyeux, Fanny Levy
BACKGROUND: The relationship between sleep disorders and Internet addiction has been little work. Given the importance of these disorders, we felt it appropriate to make a synthesis of available data and to establish causality or accountability between Internet addiction and the onset of sleep disorders. METHODS: A literature review was then performed. We selected scientific articles in English and French, published between 1987 and 2016 by consulting the databases Medline, Embase, PsycINFO and Google Scholar...
December 2016: La Presse Médicale
Katie Zanyk-McLean, Kelly N Sawyer, Ryan Paternoster, Rebekah Shievitz, William Devlin, Robert Swor
Post cardiac arrest, neuroprognostication remains a complex and clinically challenging issue for critical care providers. For this reason, our primary objective in this study was to determine the frequency of survival and favorable neurological outcomes in post-cardiac arrest patients with delayed time to awakening. To assess whether early withdrawal of care may adversely impact survival, we also sought to describe the time to withdrawal of care of non-surviving patients. We performed a retrospective study of patients resuscitated after cardiac arrest in two large academic community hospitals...
November 18, 2016: Therapeutic Hypothermia and Temperature Management
Nina Smyth, Lisa Thorn, Frank Hucklebridge, Angela Clow, Phil Evans
The cortisol awakening response (CAR) is typically measured in the domestic setting. Moderate sample timing inaccuracy has been shown to result in erroneous CAR estimates and such inaccuracy has been shown partially to explain inconsistency in the CAR literature. The need for more reliable measurement of the CAR has recently been highlighted in expert consensus guidelines where it was pointed out that less than 6% of published studies provided electronic-monitoring of saliva sampling time in the post-awakening period...
December 2016: Psychoneuroendocrinology
Martin Soehle, Christina F Wolf, Melanie J Priston, Georg Neuloh, Christian G Bien, Andreas Hoeft, Richard K Ellerkmann
BACKGROUND: During awake craniotomy, the patient's language centers are identified by neurological testing requiring a fully awake and cooperative patient. Hence, anesthesia aims for an unconscious patient at the beginning and end of surgery but an awake and responsive patient in between. We investigated the plasma (Cplasma) and effect-site (Ceffect-site) propofol concentration as well as the related Bispectral Index (BIS) required for intraoperative return of consciousness and begin of neurological testing...
September 27, 2016: Journal of Neurosurgical Anesthesiology
Ji Young Yoo, Jong Yeop Kim, Hyun Jeong Kwak, Dong Chul Lee, Go Wun Kim, Sook Young Lee, Yun Jeong Chae
PURPOSE: Prevention of cough during emergence after nasal surgery is important for avoiding surgical site bleeding. We investigated the remifentanil effect-site concentration in 50% (EC50) of the elderly patients undergoing nasal surgery for smooth emergence without cough and compared it with that of adult patients. METHODS: Twenty-two elderly (aged 65-80 years) and 25 adult patients (aged 20-60 years) with an American Society of Anesthesiologists physical status I/II undergoing nasal surgery were enrolled...
2016: Clinical Interventions in Aging
P A Geoffroy, J-A Micoulaud Franchi, R Lopez, I Poirot, A Brion, S Royant-Parola, B Etain
OBJECTIVES: Sleep complaints are very common in bipolar disorders (BD) both during acute phases (manic and depressive episodes) and remission (about 80 % of patients with remitted BD have poor sleep quality). Sleep complaints during remission are of particular importance since they are associated with more mood relapses and worse outcomes. In this context, this review discusses the characterization and treatment of sleep complaints in BD. METHODS: We examined the international scientific literature in June 2016 and performed a literature search with PubMed electronic database using the following headings: "bipolar disorder" and ("sleep" or "insomnia" or "hypersomnia" or "circadian" or "apnoea" or "apnea" or "restless legs")...
September 23, 2016: L'Encéphale
Pavla Peřinová, Eva Feketeová, David Kemlink, Petra Kovalská, Karolína Chlebušová, Jiří Nepožitek, Veronika Ibarburu, Eva Králíková, Soňa Nevšímalová, Karel Šonka
Narcolepsy-cataplexy (NC) is a chronic neurological disease with suggested autoimmune etiopathogenesis. Nicotine stimulates central nervous system and smoking increases the risk of autoimmune diseases. Assessment of smoking habits and its correlation to clinical parameters among 87 adult NC patients (38 male, 49 female) included night polysomnography and multiple sleep latency test. In our sample, 43.7% NC patients were regular smokers, and 19.5% former smokers compared to 22.2%, and 12.6%, respectively, in the general population...
2016: Prague Medical Report
Steven A Branstetter, William J Horton, Melissa Mercincavage, Orfeu M Buxton
INTRODUCTION: Sleep disruption is common among smokers, however, extant studies primarily explore differences between smokers and nonsmokers. The time to smokers' first cigarette of the day (TTFC) after waking, a strong indicator of addiction severity, is inversely associated with numerous health outcomes. The present study tests the hypotheses that, in a representative sample of daily smokers, the severity of nicotine addiction is associated with shorter habitual sleep duration and excessive daytime sleepiness...
December 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Y N Yoncheva, F X Castellanos, T Pizinger, K Kovtun, M-P St-Onge
Delayed sleep and meal times promote metabolic dysregulation and obesity. Altered coordination of sleeping and eating times may impact food-reward valuation and interoception in the brain, yet the independent and collective contributions of sleep and meal times are unknown. This randomized, in-patient crossover study experimentally manipulates sleep and meal times while preserving sleep duration (7.05±0.44 h for 5 nights). Resting-state functional magnetic resonance imaging scans (2 × 5-minute runs) were obtained for four participants (three males; 25...
November 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Tso-Chou Lin, Chih-Cherng Lu, Che-Hao Hsu, Joseph V Pergolizz, Cheng-Chang Chang, Meei-Shyuan Lee, Shung-Tai Ho
Delayed extubation occurs after isoflurane anesthesia, especially following prolonged surgical duration. We aimed to determine the arterial blood concentrations of isoflurane and the correlation with end-tidal concentrations for predicting emergence from general anesthesia.Thirty-four American Society of Anesthesiologists physical status class I-II gynecologic patients were included. General anesthesia was maintained with a fixed 2% inspiratory isoflurane in 6 L/minute oxygen, which was discontinued after surgery...
July 2016: Medicine (Baltimore)
D A Aver'yanov, A A Lukash, M Yu Prokudin, Ia B Skiba, B Shchegolev
In some cases after elective neurosurgical procedures we use technique of delayed awakening of patients. Prolonged sedation however can hide the development of epileptic seizures and lead to the status epilepticus formation. This article is a demonstration and discussion of a clinical case of nonconvulsive status epilepticus during delayed awakening of the patient due to prolonged sedation after elective neurosurgical interventionsforsupratentorial brain tumor Presented case suggests the presence of significant risk of nonconvulsive status epilepticus during prolonged sedation...
March 2016: Anesteziologiia i Reanimatologiia
Ju Lynn Ong, June C Lo, Nicholas I Y N Chee, Giovanni Santostasi, Ken A Paller, Phyllis C Zee, Michael W L Chee
OBJECTIVES: Acoustic stimulation synchronized to slow waves (SWs) can enhance these sleep features and facilitate memory consolidation during nocturnal sleep. Here, we investigated whether a similar benefit could be accrued following stimulation during an afternoon nap. We also evaluated the event-related dynamics of associated EEG spectral changes and their correlation with memory performance. METHODS: Sixteen healthy young adults (mean age: 22 ± 1.4 years; nine males) were studied under two conditions: stimulation (STIM) and no stimulation (SHAM), in counter-balanced order...
April 2016: Sleep Medicine
Beth A Malow, Heidi V Connolly, Shelly K Weiss, Ann Halbower, Suzanne Goldman, Susan L Hyman, Terry Katz, Niru Madduri, Amy Shui, Eric Macklin, Ann M Reynolds
OBJECTIVE: To pilot a clinician-based outcome measure that provides complementary information to objective measures and parent-based questionnaires for insomnia in children with autism spectrum disorders (ASD). METHOD: The authors developed a Pediatric Sleep Clinical Global Impressions Scale (CGI). Questions included (1) the child's ability to fall asleep and remain sleeping independently (i.e., apart from parents); (2) bedtime resistance; (3) sleep onset delay; (4) night awakening; (5) parental satisfaction with their child's current sleep patterns; (6) family functioning as affected by their child's current sleep patterns; and (7) clinician's overall concern with the child's sleep...
June 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
Nicolas Belin, Anne-Laure Clairet, Sidney Chocron, Gilles Capellier, Gaël Piton
Tramadol is a weak opioid analgesic indicated for the treatment of moderate to severe pain. Tramadol intoxication can be lethal, and this drug is frequently involved in voluntary overdose. Classically, tramadol intoxication is associated with neurological and respiratory side effects. In contrast, cardiac effects are poorly documented in the literature. We report a case of severe tramadol intoxication, with plasma concentration 20 times the toxic threshold, complicated by refractory cardiogenic shock, successfully treated by extra corporeal life support (ECLS) with a favorable cardiac outcome and ECLS weaning at day 10...
May 30, 2016: Cardiovascular Toxicology
Ullhas Sudhakarrao Misal, Suchita Annasaheb Joshi, Mudassir Mohd Shaikh
Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important...
May 2016: Anesthesia, Essays and Researches
Luiz A Del Ciampo, Adriana L Louro, Ieda R L Del Ciampo, Ivan S Ferraz
INTRODUCTION: Sleep is an important physiological condition that plays a role in the physical and emotional development of adolescents. The aim of the study is to determine some sleep characteristics of adolescents living in the city of Ribeirão Preto (SP). METHODS: This is a cross-sectional descriptive study conducted at 14 schools in the city of Ribeirão Preto (SP) including adolescents aged 10-19 years using a questionnaire about sleep habits. The χ2 test was used to determine differences between genders with the aid of the EPI-INFO 7 software, with the level of significance set at p<0...
May 6, 2016: International Journal of Adolescent Medicine and Health
Marine Paul, Wulfran Bougouin, Guillaume Geri, Florence Dumas, Benoit Champigneulle, Stéphane Legriel, Julien Charpentier, Jean-Paul Mira, Claudio Sandroni, Alain Cariou
PURPOSE: Although prolonged unconsciousness after cardiac arrest (CA) is a sign of poor neurological outcome, limited evidence shows that a late recovery may occur in a minority of patients. We investigated the prevalence and the predictive factors of delayed awakening in comatose CA survivors treated with targeted temperature management (TTM). METHODS: Retrospective analysis of the Parisian Region Out-of-Hospital CA Registry (2008-2013). In adult comatose CA survivors treated with TTM, sedated with midazolam and fentanyl, time to awakening was measured starting from discontinuation of sedation at the end of rewarming...
July 2016: Intensive Care Medicine
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