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Remifentanil extubation

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https://www.readbyqxmd.com/read/29239148/effects-of-closed-loop-intravenous-anesthesia-guided-by-the-bispectral-index-in-adult-patients-on-emergence-delirium-a-randomized-controlled-study
#1
Antonella Cotoia, Lucia Mirabella, Renata Beck, Pompeo Matrella, Valentina Assenzo, Thierry Chazot, Gilda Cinnella, Ngai Liu, Michele Dambrosio
BACKGROUND: Emergence delirium (ED) is an acute change in cognition after general anesthesia (GA) occurring in operative room, recovery room or in postanesthesia care. The automated propofolremifentanil titration by Bispectral index (BIS) (AutoTIVA) avoids period of deep (BIS<40) anesthesia and could potentially decrease the ED. The aim of this study was to evaluate ED in surgical patients under AutoTIVA, manual titration of propofol-remifentanil (ManualTIVA) or volatile BIS-guided GA...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29193472/intellectual-disability-is-a-risk-factor-for-delayed-emergence-from-total-intravenous-anaesthesia
#2
H Higuchi, S Maeda, M Ishii-Maruhama, Y Honda-Wakasugi, A Yabuki-Kawase, T Miyawaki
BACKGROUND: Previous studies have suggested that ID influences the depth of general anaesthesia (GA) and delays emergence from GA. In this retrospective cohort study, we investigated whether ID affects the time taken to emerge from GA. METHODS: We selected dental patients who underwent GA at the Department of Dental Anaesthesiology, Okayama University Hospital, using predefined inclusion and exclusion criteria, before dividing the selected participants into ID and non-ID (control) groups...
November 29, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29165753/clinical-research-on-airway-intervention-before-tracheal-extubation-after-general-anesthesia-on-snoring-children
#3
Q Yang, Z-H Liu, Y-L Chang
OBJECTIVE: To analyze the method and the effect of airway intervention before tracheal extubation in post-anesthesia cure unit (PACU) after anesthesia when removing the tonsil under general anesthesia and adenoidectomy under nasal endoscope on children with snoring. PATIENTS AND METHODS: 46 cases diagnosed as snoring were executively selected in this study. The cases were randomly divided into the control group (n = 22) and the observation group (n = 24). For airway intervention after general anesthesia during the recovery period, the control group was treated with intravenous injection of 0...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29132458/-efficacy-of-analgesic-and-sedative-treatments-in-children-with-mechanical-ventilation-in-the-pediatric-intensive-care-unit
#4
Xiao-Fang Cai, Fu-Rong Zhang, Long Zhang, Ji-Min Sun, Wen-Bin Li
OBJECTIVE: To compare the efficacy and safety of different analgesic and sedative treatments in children with mechanical ventilation in the pediatric intensive care unit (PICU). METHODS: Eighty children with mechanical ventilation in the PICU who needed analgesic and sedative treatments were equally and randomly divided into midazolam group and remifentanil+midazolam group. The sedative and analgesic effects were assessed using the Ramsay Scale and the Face, Legs, Activity, Cry and Consolability (FLACC) Scale...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29121294/low-dose-buprenorphine-infusion-to-prevent-postoperative-hyperalgesia-in-patients-undergoing-major-lung-surgery-and-remifentanil-infusion-a-double-blind-randomized-active-controlled-trial
#5
Marco Mercieri, Stefano Palmisani, Roberto A De Blasi, Antonio D'Andrilli, Alessia Naccarato, Barbara Silvestri, Sara Tigano, Domenico Massullo, Monica Rocco, Roberto Arcioni
Background: Postoperative secondary hyperalgesia arises from central sensitization due to pain pathways facilitation and/or acute opioid exposure. The latter is also known as opioid-induced hyperalgesia (OIH). Remifentanil, a potent μ-opioid agonist, reportedly induces postoperative hyperalgesia and increases postoperative pain scores and opioid consumption. The pathophysiology underlying secondary hyperalgesia involves N-methyl-D-aspartate (NMDA)-mediated pain pathways. In this study, we investigated whether perioperatively infusing low-dose buprenorphine, an opioid with anti-NMDA activity, in patients receiving remifentanil infusion prevents postoperative secondary hyperalgesia...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29119207/anesthesia-in-a%C3%A2-child-with-suspected-peroxisomal-disorder
#6
J S Englbrecht, M Maas
We present the case of an 8‑year-old female child with suspected peroxisomal disorder requiring general anesthesia for adenotomy, paracentesis and brainstem-evoked response audiometry. Peroxisomes are small intracellular organelles that catalyse key metabolic reactions. Peroxisomal disorders are a heterogeneous group of rare genetic diseases. Anesthesia can be challenging as adrenal insufficiency, mental retardation, muscle weakness, risk of pulmonary aspiration, airway complications, seizure disorders and altered pharmacokinetics and pharmacodynamics can occur in these patients but guidelines for anesthesia do not exist due to the heterogeneity and rarity of these diseases and case reports are rare...
November 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29104660/target-controlled-infusion-of-propofol-and-remifentanil-combined-with-dexmedetomidine-reduces-functional-endoscopic-sinus-surgery-bleeding
#7
Deng-Feng Ding, Li-Fang Wu, Ping Wang, Yuan-Xu Jiang, Yao-Wen Luo, Zhong-Liang Dai, Xue-Ping Zhang, Ya-Li Li
The aim of the present study was to investigate the effects of target-controlled infusion (TCI) of propofol and remifentanil combined with dexmedetomidine on functional endoscopic sinus surgery (FESS) bleeding and surgical field. 62 patients scheduled to undergo FESS were randomly divided into experimental group (intravenous 0.5 µg kg-1 h-1 dexmedetomidine after 0.5 µg kg-1 bolus within 15 min until the end of surgery) or control group (intravenous saline administration at the same dose). All patients underwent endotracheal intubation under general anesthesia with TCI of propofol and remifentanil for anesthesia induction and maintenance...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29076978/effects-of-transcutaneous-electrical-acupoint-stimulation-on-the-stress-response-during-extubation-after-general-anesthesia-in-elderly-patients-undergoing-elective-supratentorial-craniotomy-a-prospective-randomized-controlled-trial
#8
Wen-Ya Bai, Yan-Chao Yang, Xiu-Fei Teng, Yu-Xiao Wan, Wei Wei, Jun-Chao Zhu
BACKGROUND: Elderly patients have an increased risk of a stress response during extubation after general anesthesia. In this study, we aimed to investigate whether transcutaneous electrical acupoint stimulation (TEAS) might decrease the stress response and improve the quality of recovery in elderly patients after elective supratentorial craniotomy. MATERIALS AND METHODS: In this prospective randomized controlled study, patients were randomly assigned to either a TEAS group (n=37) or a control group (n=38)...
October 25, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28882741/tracheal-extubation-with-suction-vs-positive-pressure-during-emergence-from-general-anaesthesia-in-adults-a-randomised-controlled-trial
#9
Joël L'Hermite, Olivier Wira, Chritel Castelli, Jean-Emmanuel de La Coussaye, Jacques Ripart, Philippe Cuvillon
BACKGROUND: After general anaesthesia (GA) in adults, the optimal tracheal extubation technique (positive pressure or suctioning) remains debated. The primary endpoint of this study was to assess the effects of these techniques on onset time of desaturation (SpO2<92%). METHODS: Sixty-nine patients with a body mass index<30 scheduled for elective orthopaedic surgery were allocated to positive pressure (PP) or suctioning (SUC) group. GA was standardised with propofol and remifentanil via target-controlled infusion...
September 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28810649/effect-of-dexmedetomidine-combined-with-sufentanil-on-preventing-emergence-agitation-in-children-receiving-sevoflurane-anesthesia-for-cleft-palate-repair-surgery
#10
Ke Luo, Jun-Mei Xu, Lin Cao, Ju Gao
The aim of the present study was to observe whether dexmedetomidine (DEX) combined with sufentanil decreased emergence agitation (EA) in children receiving sevoflurane anesthesia for cleft palate repair surgery. Children undergoing elective cleft palate repair surgery were randomly allocated into the DEX + sufentanil group (group DS; n=50) and the normal saline + fentanyl group (group SF; n=50). Patients in group DS were treated with 0.5 µg/kg DEX prior to induction of anesthesia, whereas patients in group SF received an equal volume of normal saline...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28774327/could-remifentanil-reduce-duration-of-mechanical-ventilation-in-comparison-with-other-opioids-for-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#11
Yibing Zhu, Yinhua Wang, Bin Du, Xiuming Xi
BACKGROUND: Sedation and analgesia are commonly required to relieve anxiety and pain in mechanically ventilated patients. Fentanyl and morphine are the most frequently used opioids. Remifentanil is a selective μ-opioid receptor that is metabolized by unspecific esterases and eliminated independently of liver or renal function. Remifentanil has a rapid onset and offset and a short context-sensitive half-life regardless of the duration of infusion, which may lead to reductions in weaning and extubation...
August 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28693245/effects-of-remifentanil-on-hemodynamics-liver-function-and-icam-1-expression-in-liver-cancer-patients-undergoing-surgery
#12
Qi Jiang, Xiuling Song, Zheng Chen, Conghui Wang, Huiyu Luo
The objective of the present study was to investigate the effects of remifentanil on hemodynamics, liver function, and expression of intercellular adhesion molecule-1 (ICAM-1) in patients with liver cancer undergoing surgery. A total of 60 patients who underwent liver cancer resection in The First People's Hospital of Xiangyang, Hubei University of Medicine from January 2014 to January 2016 were selected, including 33 males and 27 females, with an average age of 54.12±4.77 years. Patients were randomly divided into the control group and experimental group (n=30 each)...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28614221/correlation-of-mdr1-gene-polymorphisms-with-anesthetic-effect-of-sevoflurane-remifentanil-following-pediatric-tonsillectomy
#13
Nian-Jun Shi, Wei-Xia Zhang, Ning Zhang, Li-Na Zhong, Ling-Ping Wang
BACKGROUND: The motive of this study was to investigate the collaboration between MDR1 gene polymorphisms and anesthetic effects following pediatric tonsillectomy. METHODS: All together 178 children undergoing tonsillectomy with preoperative sevoflurane-remifentanil anesthesia were selected. In order to determine MDR1 gene polymorphisms of 3435C > T, 1236C > T, and 2677G > T/A, polymerase chain reaction-restriction fragment length polymorphism was used...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28591053/use-of-sugammadex-in-a-patient-with-progressive-muscular-atrophy-and-in-a-patient-with-amyotrophic-lateral-sclerosis-case-report
#14
Jae Hwa Yoo, Soon Im Kim, Sun Young Park, Mi Roung Jun, Yong Eun Kim, Hyoung June Kim
INTRODUCTION: We herein present 2 cases involving the combination of rocuronium and sugammadex in patients with motor neuron disease. The patients were a 54-year-old man with progressive muscular atrophy who underwent removal of internal fixators in the arm and leg, and a 66-year-old woman with amyotrophic lateral sclerosis who underwent skin grafting in the left lower leg. General anesthesia was induced with propofol, rocuronium, and remifentanil and maintained with desflurane and remifentanil...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28580080/postoperative-nausea-and-vomiting-after-thyroidectomy-a-comparison-between-dexmedetomidine-and-remifentanil-as-part-of-balanced-anesthesia
#15
Eun Kyung Choi, Yijun Seo, Dong Gun Lim, Sungsik Park
BACKGROUND: Postoperative nausea and vomiting (PONV) is the major complication related to general anesthesia, occurring in 60-80% of patients after thyroidectomy. The objective of this study was to compare the effects of an intraoperative dexmedetomidine infusion with remifentanil, as anesthetic adjuvants of balanced anesthesia, on PONV in patients undergoing thyroidectomy. METHODS: Eighty patients scheduled for thyroidectomy were randomized into the following two groups: 1) The dexmedetomidine group (Group D), who received an initial loading dose of dexmedetomidine (1 µg/kg over 10 min) during the induction of anesthesia, followed by a continuous infusion at a rate of 0...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28560111/clonidine-or-remifentanil-for-adequate-surgical-conditions-in-patients-undergoing-endoscopic-sinus-surgery-a-randomized-study
#16
Laurent Bairy, Marie Vanderstichelen, Jacques Jamart, Edith Collard
BACKGROUND: Deliberate hypotension is one way to achieve a bloodless surgical field in endoscopic sinus surgery (ESS). We compared two anaesthesia regimens to induce deliberate hypotension and attempted to determine the most efficient one. METHODS: Fifty-nine patients undergoing ESS were minimized into two groups. In the CLO group, patients received I.V. sufentanil 0.15 µg/kg together with I.V. clonidine 2-3 µg/kg. In the REMI group, patients received remifentanil at a rate of up to 1 µg/kg/min...
2017: PeerJ
https://www.readbyqxmd.com/read/28551058/-anesthesia-recovery-comparison-between-remifentanil-propofol-and-remifentanil-desflurane-guided-by-bispectral-index-%C3%A2-monitoring
#17
Raphael Grossi Rocha, Eduardo Giarola Almeida, Lara Moreira Mendes Carneiro, Natália Farias de Almeida, Walkíria Wingester Vilas Boas, Renato Santiago Gomez
BACKGROUND AND OBJECTIVES: There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS(®)). METHODS: Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES)...
May 25, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28489797/a-previously-published-propofol-remifentanil-response-surface-model-does-not-predict-patient-response-well-in-video-assisted-thoracic-surgery
#18
Hsin-Yi Wang, Chien-Kun Ting, Jing-Yang Liou, Kun-Hui Chen, Mei-Young Tsou, Wen-Kuei Chang
Modern anesthesia usually employs a hypnotic and an analgesic to produce synergistic sedation and analgesia. Two remifentanil-propofol interaction response surface models were used to predict sedation using Observer's Assessment of Alertness/Sedation (OAA/S) scores; one predicts an OAA/S <2 and the other <4. We hypothesized that both models would predict regained responsiveness (RR) after video-assisted thoracic surgery (VATS) to reduce total anesthesia time and make early extubation clinically relevant...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28458576/continuous-postoperative-infusion-of-remifentanil-inhibits-the-stress-responses-to-tracheal-extubation-of-patients-under-general-anesthesia
#19
Guoliang Zhao, Xiaoyue Yin, Ya Li, Jianlin Shao
PURPOSE: The study aimed to assess the combined effects of parecoxib with three different doses of remifentanil and its effect on the stress and cough responses following tracheal extubation under general anesthesia. METHODS: A total of 120 patients with American Society of Anesthesiologists (ASA) scores of I or II, undergoing selective thyroidectomy with total intravenous anesthesia (propofol-remifentanil) and tracheal intubation, were randomly allocated to be treated with an intravenous injection of parecoxib and a continuous infusion of remifentanil at 0...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28425334/remifentanil-for-sedation-of-children-with-traumatic-brain-injury
#20
James L Hungerford, Nicole O'Brien, Melissa Moore-Clingenpeel, Eric A Sribnick, Cheryl Sargel, Mark Hall, Jeffrey R Leonard, Joseph D Tobias
OBJECTIVE: To determine whether remifentanil would provide adequate sedation while allowing frequent and reproducible neurologic assessments in children admitted to the pediatric intensive care unit (PICU) with traumatic brain injury (TBI) during mechanical ventilation. DESIGN: Retrospective review. SETTING: Tertiary care PICU. PATIENTS: Thirty-eight patients over a 30-month period. MEASUREMENTS AND MAIN RESULTS: Median age was 9 years (interquartile range [IQR] 2...
January 1, 2017: Journal of Intensive Care Medicine
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