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Sander O Hacker

Publications and source records attributed to Sander O Hacker.

2 recordsLinked to original sources

A comparison of target-controlled infusion versus volatile inhalant anesthesia for heart rate, respiratory rate, and recovery time in a rat model.

We conducted this study to determine whether heart rate, respiratory rate, and recovery time differed significantly between rats receiving target-controlled infusion (TCI) and those under volatile inhalant anesthesia. TCI rats received intravenous propofol at an average effect site concentration of 11.3 microg/ml or propofol plus ketamine (5 mg/ml of propofol) at an average effect site concentration of 8.7 microg/ml. Inhalant anesthesia rats received isoflurane (average, 1.8%) delivered in medical-grade air. We used a tail-clamp response test to determine when a surgical plane of anesthesia was attained. Anesthesia was continued for 1 h from the first negative tail-clamp test. During this time the test was repeated every 10 min to confirm that a surgical plane of anesthesia was being maintained. Anesthesia then was discontinued, and the animals were monitored continuously until they recovered. Average heart rate was higher for rats during anesthesia with isoflurane compared with TCI propofol-ketamine (P =0.0053). Average respiratory rate was higher for TCI regimens compared with isoflurane anesthesia, with male rats having consistently faster respiratory rates than females (P <0.001). Recovery time was longer for both TCI regimens compared with isoflurane (P <0.001). Once venous access was accomplished, TCI anesthesia with propofol or propofol combined with a low dose of ketamine was comparable to an isoflurane inhalant regimen in ease of administration and control of the anesthetic event when used in rats for procedures of 1-h duration. Respiratory rate was increased and recovery time was longer for rats receiving the TCI regimens.

Anesthesia Recovery Period↗

Multiservice laparoscopic surgical training using the daVinci surgical system.

BACKGROUND: The daVinci surgical system affords surgeons a magnified three-dimensional videoscopic view of the operative field and precise articulating laparoscopic instruments. The learning curve for this advanced surgical robotics system is poorly characterized. METHODS: Twenty-three surgeons representing seven surgical subspecialties participated in a surgical robotics training program consisting of standardized daVinci system training (phase 1) followed by self-guided learning in a porcine model (phase 2). RESULTS: The average number of recorded procedures performed per surgeon during phase 2 was 5.5. The mean daVinci system set-up time was 45 minutes and decreased by an average of 56.1% by the third successive set-up (r = -0.702, P <0.005). Operative times decreased 39.0% by the third successive practice operation (r = -0.860, P <0.0005). CONCLUSIONS: New use of the daVinci robot is associated with a rapid learning curve and preclinical animal model training is effective in developing surgical robotics skills.

Animals↗