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Remifentanil extubation

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https://www.readbyqxmd.com/read/27826208/sedation-with-a-remifentanil-infusion-to-facilitate-rapid-awakening-and-tracheal-extubation-in-an-infant-with-a-potentially-compromised-airway
#1
Jeffrey Naples, Mark W Hall, Joseph D Tobias
Sedation is generally required during endotracheal intubation and mechanical ventilation in infants and children. While there are many options for the provision of sedation, the most commonly used agents such as midazolam and fentanyl demonstrate a context-sensitive half-life, which may result in a prolonged effect when these agents are discontinued following a continuous infusion. We present a 20-month-old infant who required endotracheal intubation due to respiratory failure following seizures. At the referring hospital, multiple laryngoscopies were performed with the potential for airway trauma...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27793243/anesthesia-in-pregnant-women-with-hellp-syndrome-case-report
#2
Eduardo Barbin Zuccolotto, Eugenio Pagnussatt Neto, Glínia Cavalcante Nogueira, José Roberto Nociti
BACKGROUND AND OBJECTIVES: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. CASE REPORT: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27788524/insufficient-sedation-and-severe-side-effects-after-fast-administration-of-remifentanil-during-insure-in-preterm-newborns
#3
Ellen H M de Kort, Lidwien M Hanff, Daniella Roofthooft, Irwin K M Reiss, Sinno H P Simons
BACKGROUND: Neonatal intubation is stressful and should be performed with premedication. In the case of an INSURE (intubation/surfactant/extubation) procedure a short duration of action of the premedication used is needed to facilitate fast extubation. Given its pharmacological profile, remifentanil seems a suitable candidate. OBJECTIVES: The aim here was to evaluate the effect and side effects of remifentanil as a premedication for preterm neonates undergoing INSURE...
October 28, 2016: Neonatology
https://www.readbyqxmd.com/read/27737350/early-postoperative-recovery-after-intracranial-surgical-procedures-comparison-of-the-effects-of-sevoflurane-and-desflurane
#4
Erhan Gökçek, Ayhan Kaydu, Mehmet Salim Akdemir, Ferit Akil, Ibrahim Ozkan Akıncı
PURPOSE: To compared the effects of sevoflurane and desflurane on early anesthesia recovery in patients undergoing to craniotomy for intracranial lesions. METHODS: After IRB approval, the study included 50 patients aged 18-70 years who had ASA physical statuses of I-II and were scheduled for intracranial surgery. Patients were randomly divided into two groups: sevoflurane and desflurane. Anaesthesia was routinely induced in all patients followed by desflurane 5%-6% or sevoflurane 1%-2%...
September 2016: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/27708522/anesthesia-for-endoscopic-retrograde-cholangiopancreatography-target-controlled-infusion-versus-standard-volatile-anesthesia
#5
Youssef Motiaa, Mustapha Bensghir, Abdelhamid Jaafari, Mohammed Meziane, Redouane Ahtil, Noureddine Drissi Kamili
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used both for diagnosis and for the treatment of biliary and pancreatic diseases. ERCP has some anesthetic implications and specific complications. The primary outcome aim was to compare two protocols in terms of time of extubation. We also compared anesthetic protocols in terms of hemodynamic and respiratory instability, antispasmodics needs, endoscopist satisfaction, and recovery room stay. METHODS: Patients were randomized into two groups standard anesthesia group (Gr: SA) in whom induction was done by propofol, fentanyl and cisatracurium and maintenance was done by a mixture of oxygen, nitrousoxide (50%:50%) and sevoflurane; and intravenous anesthesia group to target concentration (Gr: TCI) in whom induction and maintenance of anesthesia were done with propofol with a target 0...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/27672319/effect-site-concentration-of-remifentanil-for-preventing-cough-during-emergence-in-elderly-patients-undergoing-nasal-surgery-a-comparison-with-adult-patients
#6
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
https://www.readbyqxmd.com/read/27591471/anesthesia-in-a-patient-with-stiff-person-syndrome
#7
Ozgur Yagan, Kadir Özyilmaz, Ahmet Özmaden, Özgür Sayin, Volkan Hanci
Stiff Person Syndrome (SPS), typified by rigidity in muscles of the torso and extremities and painful episodic spasms, is a rare autoimmune-based neurological disease. Here we present the successful endotracheal intubation and application of TIVA without muscle relaxants on an SPS patient. A 46 years old male patient was operated with ASA-II physical status because of lumber vertebral compression fracture. After induction of anesthesia using lidocaine, propofol and remifentanil tracheal intubation was completed easily without neuromuscular blockage...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27583920/comparison-of-relative-oxycodone-consumption-in-surgical-pleth-index-guided-analgesia-versus-conventional-analgesia-during-sevoflurane-anesthesia-a-randomized-controlled-trial
#8
Young Ju Won, Byung Gun Lim, So Hyun Lee, Sangwoo Park, Heezoo Kim, Il Ok Lee, Myoung Hoon Kong
BACKGROUND: The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27555126/recovery-of-laryngeal-nerve-function-with-sugammadex-after-rocuronium-induced-profound-neuromuscular-block
#9
Vittorio Pavoni, Lara Gianesello, Cristiana Martinelli, Andrew Horton, Alessandra Nella, Gabriele Gori, Martina Simonelli, Giuseppe De Scisciolo
STUDY OBJECTIVE: The aim of this study was to evaluate the efficacy of sugammadex in reversing profound rocuronium-induced neuromuscular block at the laryngeal adductor muscles using motor-evoked potentials (mMEPs). DESIGN: A prospective observational study. SETTING: University surgical center. PATIENTS: Twenty patients with American Society of Anesthesiologists physical class I-II status who underwent propofol-remifentanil anesthesia for the surgery of the thyroid gland...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27522215/a-sequential-anesthesia-technique-for-surgical-repair-of-unilateral-vocal-fold-paralysis
#10
Eric B Rosero, Esra Ozayar, Ted Mau, Girish P Joshi
Thyroplasty with arytenoid adduction, a combined procedure for treatment of unilateral vocal fold paralysis, is typically performed under local anesthesia with sedation to allow for intraoperative voice assessment. However, the need for patient immobility and suppression of laryngeal responses to surgical manipulation can make sedation-analgesia challenging. We describe our first 26 consecutive cases undergoing thyroplasty and arytenoid adduction with a standardized technique consisting of a combination of general anesthesia with tracheal intubation followed by sedation-analgesia...
August 13, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27484339/effects-of-remifentanil-and-remifentanil-alfentanil-administration-on-emergence-agitation-after-brief-ophthalmic-surgery-in-children
#11
Yi Hwa Choi, Kyung Mi Kim, Soo Kyung Lee, Yi Seul Kim, Seon Ju Kim, Woon Suk Hwang, Jin Huan Chung
BACKGROUND: Sevoflurane is commonly usedin pediatric anesthesia due to its non-irritating airway properties, and rapid induction and emergence. However, it is associated with emergence agitation (EA) in children. EA may cause injury to the child or damage to the surgical site and is a cause of stress to both caregivers and families. The efficacy of remifentanil and additional alfentanil on EA in the pediatric patients underwent ophthalmic surgery with sevofluraneanesthesiawas not well evaluated to date...
August 2, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27461767/bispectral-index-under-propofol-anesthesia-in-children-a-comparative-randomized-study-between-tiva-and-tci
#12
Nicolas Louvet, Agnès Rigouzzo, Nada Sabourdin, Isabelle Constant
BACKGROUND: In children, only a few studies have compared different modes of propofol infusion during a total intravenous anesthesia (TIVA) with propofol and remifentanil. The aim of this study was to compare Bispectral Index (BIS) profiles (percentage of time spent at adequate BIS values) between four modes of propofol infusion: titration of the infusion rate on clinical signs (TIVA0 ), titration of the infusion rate on the BIS (TIVABIS ), target controlled infusion (TCI) guided by the BIS either with the Kataria model (TCI KBIS ) or the Schnider model (TCI SBIS )...
September 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27424874/end-tidal-desflurane-concentration-for-tracheal-extubation-in-adults
#13
A Reyes, M López, F de la Gala, M I Canal Alonso, S Agustí, M Zaballos
OBJECTIVE: To determine the end-tidal desflurane concentration required for tracheal extubation in anaesthetised adults. MATERIAL AND METHODS: After hospital Ethics Committee approval, eighteen ASA I-II adult patients (19-65 years of age), who had been scheduled for elective ambulatory surgery were included in the study. Anaesthesia was induced with propofol 2.5mg.kg(-1), fentanyl 2μg.kg(-1), and rocuronium 0.6mg.kg(-1) for intubation. Maintenance of anaesthesia was provided by desflurane in oxygen and air (40:60), and remifentanil at 0...
July 14, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27377361/does-general-anesthesia-have-a-clinical-impact-on-intraocular-pressure-in-children
#14
Julia Termühlen, Antje Gottschalk, Nicole Eter, Esther M Hoffmann, Hugo Van Aken, Ulrike Grenzebach, Verena Prokosch
BACKGROUND: Reliable measurement of intraocular pressure (IOP) is crucial in pediatric patients with suspected glaucoma. General anesthesia (GA) is usually needed in infants to allow a thorough examination. However, anesthesia itself may influence IOP, depending on the type used and the depth of sedation. The purpose of this study was to evaluate the normal distribution of IOP during GA in healthy children and to analyze differences in IOP relative to the anesthetics used and the measurement time point...
September 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27343794/perioperative-management-of-a-morbidly-obese-pregnant-patient-undergoing-cesarean-section-under-general-anesthesia-case-report
#15
Márcio Luiz Benevides, Verônica Cristina Moraes Brandão, Jacqueline Ivonne Arenas Lovera
BACKGROUND AND OBJECTIVES: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50kg/m(2), who underwent cesarean section under general anesthesia. CASE REPORT: Pregnant woman in labor, 35 years of age, body mass index 59.8kg/m(2). Cesarean section was indicated due to the presumed fetal macrosomia...
July 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27310976/optimal-effect-site-concentration-of-remifentanil-for-preventing-cough-during-removal-of-the-double-lumen-endotracheal-tube-from-sevoflurane-remifentanil-anesthesia-a-prospective-clinical-trial
#16
Sook Young Lee, Ji Young Yoo, Jong Yeop Kim, Dae Hee Kim, Jung Dong Lee, Go Un Rho, Hyungbae Park, Sung Yong Park
Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27247916/anesthetic-considerations-of-sporadic-inclusion-body-myositis-in-an-elderly-man-with-orthopedic-trauma
#17
Dominik T Steck, Christine Choi, Suneeta Gollapudy, Paul S Pagel
INTRODUCTION: Sporadic inclusion body myositis (IBM) is an inflammatory myopathy characterized by progressive asymmetric extremity weakness, oropharyngeal dysphagia, and the potential for exaggerated sensitivity to neuromuscular blockers and respiratory compromise. The authors describe their management of a patient with IBM undergoing urgent orthopedic surgery. CASE PRESENTATION: An 81-year-old man with IBM suffered a left intertrochanteric femoral fracture after falling down stairs...
April 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27189295/comparison-of-dexmedetomidine-and-remifentanil-on-airway-reflex-and-hemodynamic-changes-during-recovery-after-craniotomy
#18
Hyunzu Kim, Kyeong Tae Min, Jeong Rim Lee, Sang Hee Ha, Woo Kyung Lee, Jae Hee Seo, Seung Ho Choi
PURPOSE: During emergence from anesthesia for a craniotomy, maintenance of hemodynamic stability and prompt evaluation of neurological status is mandatory. The aim of this prospective, randomized, double-blind study was to compare the effects of dexmedetomidine and remifentanil on airway reflex and hemodynamic change in patients undergoing craniotomy. MATERIALS AND METHODS: Seventy-four patients undergoing clipping of unruptured cerebral aneurysm were recruited...
July 2016: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27188105/-a-case-of-general-anesthesia-for-a-cardiac-transplanted-patient-undergoing-inguinal-hernia-repair-under-laparoscopic-surgery
#19
Mitsuko Inoue, Yasue Hayashi, Yuki Fujita, Motoko Shimizu, Arisa Hotta, Ai Nakamoto, Noriko Yoshikawa, Naoko Ohira, Shigeki Tatekawa
A 52-year-old man was scheduled for the repair of inguinal hernia recurrence. When he was 48 years of age, he received a heart transplantation due to severe heart failure resulting from ischemic heart disease. When he was 50 years old, he suffered from inguinal hernia, and it was repaired under spinal anesthesia. During this surgery, he experienced pain because of the inadequate effect of anesthesia, but his blood pressure and heart rate were stable. We suspected that this was because of denervation of the heart...
April 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27185668/median-effective-concentration-of-remifentanil-in-target-controlled-infusion-for-smooth-tracheal-extubation-during-emergence-from-general-anesthesia-in-elderly-patients
#20
Ying Yao, Cong Yu, Ye Yuan, Guijin Huang, Sisi Li
STUDY OBJECTIVE: To determine the median effective concentration (EC50) of remifentanil during targeted-controlled infusion for smooth tracheal extubation during emergence from total intravenous anesthesia in elderly patients. DESIGN: Prospective, Dixon up-and-down method. SETTING: Postoperative emergence. PATIENTS: Twenty-four American Society of Anesthesiologists grade I-II female elderly patients undergoing elective jaw cyst surgery...
June 2016: Journal of Clinical Anesthesia
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