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At least 919 records · Page 51Linked to original sources
PubMed1997

[The use of propofol in carotid surgery].

OBJECTIVE: To compare two anesthetic techniques in carotid surgery. The first technique was propofol in continuous perfusion throughout the procedure (group A) and the other used etomidate for anesthetic induction and isoflurane for maintenance (group B). PATIENTS AND METHODS: The patients were assigned randomly either to group A (n = 23) to receive propofol in continuous perfusion for induction (0.8-1 mg/kg) and for maintenance (4-6 mg/kg/h) or to group B (n = 25) to receive etomidate (0.25 mg/kg) for induction and isoflurane 0.6-0.8% for maintenance. Ventilation was maintained with O2/N2O. Systolic and diastolic arterial pressures (SAP and DAP) and heart rate were measured at baseline, during induction (minutes 1, 2, 3, 5 and 10), immediately before and 1 minute after interruption of carotid flow, once flow had been released and after extubation. Other variables recorded were time until awakening and extubation, presence of pain, degree of well-being, need for analgesics and vasodilators, perioperative complications and time until hospital release. RESULTS: The variations in hemodynamic parameters during induction and during maintenance were similar for both techniques. Orotracheal intubation increased SAP in both groups. Time until eye opening and awakening were shorter in group A but the difference was not statistically significant. CONCLUSIONS: The use of propofol for induction and maintenance during carotid surgery was as safe as conventional anesthetic technique with etomidate and isoflurane.

Aged↗
PubMed1997

[Changes in epidural pressure during total intravenous anesthesia with propofol, fentanyl and ketamine].

Although ketamine elevates cerebrospinal fluid pressure (CSFP) with an increase in cerebral blood flow, sedatives such as benzodiazepines, barbiturates and opioids have been reported to inhibit it. In this study, we evaluated the changes in epidural pressure (EP) as a good index for CSFP during total intravenous anesthesia with propofol-fentanyl-ketamine (PFK) compared to isofluranenitrous oxide anesthesia (GOI). Twelve patients for gastrectomy were allocated to two groups: PFK (n = 6) and GOI group (n = 6). In PFK group, epidural pressure did not increase during the anesthesia, and was significantly lower than in GOI group (30 and 180 min after induction of anesthesia, and 0, 30 and 60 min after stopping anesthetic administration). The present data suggest that PFK may safely be used for patients with intracranial hypertension.

Aged↗
PubMed1997

Anaesthesiological indications and contraindications of minimally invasive surgery.

Spreading of laparoscopic techniques caused changes in anaesthesiological contraindications. In the first period laparoscopy was contraindicated in ischemic heart disease (IHD). Early mobilisation and short postoperative period are positive goals, IHD was taken out of contraindications. Present study compares changes in circulatory, blood gas and acid-base balance values during laparoscopic cholecystectomy (LC) in groups of patients ASA I-II. and ASA III. with IHD. There were 30 patients in group ASA I-II, 30 patients with IHD in category of ASA III. investigated during LC. Fifteen patients of both groups went under Propofol-Fentanyl (TIVA) anaesthesia, others were on Propofol-Fentanyl-N2O (IVA) protocol. All of them got also Atracurium. Pulse rate, mean arterial pressure, O2 saturation and end tidal CO2, blood gases and acid-base state were recorded before induction, after CO2 insufflation, after desufflation, 1 and 3 hours postoperatively. After CO2 insufflation there was a moderate tachycardia in both ASA III. groups (74/min-->88/min). In all groups pCO2 increased (40-->48 mmHg) but normalised till the 3rd postoperative hours (42 mmHg). Ventricular extrasystoles appeared in 3 ASA III. patients in IVA group. Three high risk patients had serious metabolic acidosis postoperatively. Present time the ischaemic heart disease does not contraindicates laparoscopic interventions. TIVA with Propofol is better choice because of its favourable effects on circulation and acid-base balance. Using N2O caused higher grade of intestinal distension. The cardio-respiratory, blood gas parameters and acid-base balance have to be monitorised in perioperative period of laparoscopic surgery.

Acid-Base Equilibrium↗
PubMed1998

[Anesthesia for a child with congenital sensory neuropathy with anhydrosis].

We gave anesthesia twice to a 4-year-old boy with congenital sensory neuropathy with anhydrosis. At the first surgery, anesthesia was induced with midazolam and maintained with nitrous oxide, oxygen and sevoflurane 0.5-0.8% under mask breathing. Surgery was performed without any trouble but the patient vomited postoperatively for three days. Next time, anesthesia was induced and maintained with propofol under mask. The patient often moved during surgery, and therefore, we changed from propofol to oxygen and sevoflurane 1.0-1.5% anesthesia. Nitrous oxide was not used. After the surgery, no vomiting occurred.

Anesthesia, Inhalation↗
PubMedDate not supplied

[Brugada syndrome and anesthesia. Apropos of a case].

We describe a patient with a tentative diagnosis of Brugada syndrome who was given general anesthesia without complications. We review the main characteristics of Brugada syndrome.

Anesthesia, Inhalation↗
PubMed1992

Serum potassium after enflurane-succinylcholine induction of anesthesia in children receiving rectal midazolam as premedication.

The administration of succinylcholine causes an increase in serum potassium (K+) concentrations in healthy patients. The purpose of this study was to investigate serum K+ changes following intravenous succinylcholine in children and to evaluate the effect of rectal midazolam pretreatment on these changes. Forty healthy children between the ages of 2 and 7 yr, and who were to undergo oral surgical procedures under general anesthesia were randomly assigned to receive either placebo (saline) or 0.25, 0.35, or 0.45 mg/kg midazolam administered rectally as premedication 30 min before induction of inhalational anesthesia. Blood was drawn after induction with enflurane and at 1, 2, 3, 4, and 5 min after administration of 1 mg/kg succinylcholine to determine changes in serum K+. Although the results indicate a significant increase in serum K+ after succinylcholine in all groups, midazolam pretreatment failed to cause any observable attenuation in the hyperkalemic response.

Administration, Rectal↗
PubMedDate not supplied

Evaluation of intraocular pressure in association with cardiovascular parameters in normocapnic dogs anesthetized with sevoflurane and desflurane.

The objective of this study was to determine intraocular pressure (IOP) and cardiac changes in normocapnic dogs maintained under controlled ventilation and anesthetized using sevoflurane or desflurane. Sixteen healthy adult mixed-breed dogs, seven males and nine females, weighing 10-15 kg were used. The dogs were randomly assigned to one of two groups composed of eight animals anesthetized with sevoflurane (SEVO) or desflurane (DESF). In both groups, anesthesia was induced with propofol (10 mg/kg), and neuromuscular blockade was achieved with rocuronium (0.6 mg/kg/h i.v.). No premedication was given. Ventilation was adjusted to maintain end-tidal carbon dioxide partial pressure at 35 mmHg. Anesthesia was maintained with 1.5 minimum alveolar concentration (MAC) of sevoflurane or desflurane. In both groups IOP was measured by applanation tonometry (Tono-Pen) before induction of anesthesia. IOP, mean arterial pressure (MAP), heart rate (HR), cardiac index (CI) and central venous pressure (CVP) were also measured 45 min after the beginning of inhalant anesthesia and then every 20 min for 60 min. A one-way repeated measures anova was used to compare data within the same group and Student's t-test was used to assess differences between groups. P < 0.05 was considered statistically significant. Measurements showed normal IOP values in both groups, even though IOP increased significantly from baseline during the use of desflurane. IOP did not differ between groups. CI in the desflurane group was significantly greater than in the sevoflurane group. Sevoflurane and desflurane have no clinically significant effects on IOP, MAP, HR, CI or VCP in the dog.

Anesthetics, Inhalation↗
PubMed2002

[The effect of normobaric oxygen inhalation and halothane anesthesia on the level of interstitial striatal dopamine of rats using in vivo microdialysis study].

We investigated the effect of normobaric oxygen inhalation on the level of interstitial dopamine and its metabolites in in vivo brain striatum of awake, free moving rats using microdialysis techniques. Rats were implanted a microdialysis probe to the right striatum of the brain and administered pure oxygen for 1 hour, and dialysates from the probe were examined every 20 minutes by HPLC. Normobaric oxygen inhalation reduced the amount of dopamine derived from the dialysate and increased that of metabolites. Halothane anesthesia with oxygen showed a slight effect on the changes induced by oxygen inhalation, whereas halothane significantly increased the level of dopamine metabolites. Pretreatment with glutathione failed to prevent increase of dopamine metabolites. We hypothesized that oxygen inhalation and halothane anesthesia might increase the level of dopamine metabolites in different mechanisms, and the changes induced by oxygen inhalation might not be the result of simple oxidative stress in rat striatum.

Administration, Inhalation↗
PubMed2000

Propofol/sufentanil anesthesia suppresses the metabolic and endocrine response during, not after, lower abdominal surgery.

UNLABELLED: We investigated the influence of propofol/sufentanil anesthesia on metabolic and endocrine responses during, and immediately after, lower abdominal surgery. Twenty otherwise healthy patients undergoing abdominal hysterectomy for benign myoma received either continuous infusions of propofol supplemented with sufentanil (0.01 microg. kg(-1). min(-1), n = 10) or enflurane anesthesia (enflurane, n = 10). Plasma concentrations of glucose, lactate, free fatty acids, triglycerides, insulin, glucagon, cortisol, epinephrine, and norepinephrine were measured before, during, and 2 h after surgery. Pre- and postoperative endogenous glucose production (R(a) glucose) was analyzed by an isotope dilution technique by using [6,6-(2)H(2)] glucose. Propofol/sufentanil anesthesia prevented the increase in plasma cortisol and catecholamine concentrations and attenuated the hyperglycemic response during surgery without showing any difference after the operation. Mediated through a higher glucagon/insulin quotient (propofol/sufentanil 15 +/- 7 versus enflurane 8 +/- 4 pg/microU, P < 0.05), the R(a) glucose postoperatively increased more in the propofol/sufentanil than in the enflurane group (propofol/sufentanil 15.6 +/- 2.0 versus enflurane 13.4 +/- 2.2 micromol. kg(-1). min(-1), P < 0.05). IMPLICATIONS: The concept of stress-free anesthesia using propofol combined with sufentanil is valid only during surgery. The metabolic endocrine stress response 2 h after the operation is more pronounced than after inhaled anesthesia.

Anesthesia, Intravenous↗
PubMed1993

[Anesthesiologic aspects of minimally invasive surgery].

Minimal invasive, or more specifically laparoscopic surgery is now the standard procedure in an increasing number of surgical specialties. Inflating the abdomen with CO2 for long periods confronts the anesthesiologist with a number of problems that influence the choice of anesthetic and the monitoring deemed necessary. The increased intraabdominal pressure (IAP) and for some operations the extreme Trendelenburg position can disturb alveolar ventilation and compromise oxygenation. Pulse oximetry is therefore required to recognize and counteract these effects. The insufflated CO2 is absorbed into the blood to an unpredictable extent, and must be eliminated via the lungs by increasing the minute ventilation. Only capnometry or serial blood gas analyses can provide the information needed to correctly adjust the respiration. The endocrine stress reactions to laparoscopic surgery do not appear to be less pronounced than after conventional operations; only the interleukin-6 response to laparoscopic cholecystectomy is reduced compared to the subcostal incision. But minimal invasive surgery offers an advantage at least for cholecystectomy in that there is less impairment of postoperative respiratory function. General anesthesia will be the method of choice for laparoscopic surgery in all but a few procedures in which regional anesthesia is an acceptable alternative. Balanced anesthesia or total intravenous anesthesia is to be preferred, and the drugs employed should have rapid elimination kinetics with a short recovery time, since wound closure time is drastically reduced. Inhalational anesthesia alone may inhibit hypoxic pulmonary vasoconstriction thereby unduly increasing oxygen desaturation. The necessary degree of muscle relaxation still remains to be defined.

Anesthesia, Conduction↗
PubMed1987

Lung mechanics and neuromuscular output during CO2 inhalation after airway anesthesia.

Airway anesthesia with aerosolized lidocaine has been associated with an increase in minute ventilation (VE) during CO2 inhalation. The increase in VE may be due to increased neuromuscular output or decreased mechanical load on breathing. To evaluate this we measured VE, breathing pattern, mouth occlusion pressure, and lung mechanics in 20 normal subjects during room-air breathing and then inhalation of 6% CO2-94% O2, before and after airway anesthesia. Measurements of lung mechanics included whole-lung resistance, dynamic and static compliance, and functional residual capacity. Airway anesthesia had no detectable effect on any measurements during room-air breathing. During CO2 inhalation, airway anesthesia produced increases in VE and mean inspiratory flow rate (VT/TI) and more negative inspiratory pleural pressure but had no detectable effect on lung mechanics or mouth occlusion pressure. Pleural pressure was more negative during the latter 25% of inspiration. We concluded that airway receptors accessible to airway anesthesia play a role in determining neuromuscular output during CO2 inhalation.

Adult↗
PubMed1991

[Intranasal midazolam in pediatric ophthalmology].

Intranasal midazolam was tested in pediatric patients undergoing ophthalmological examination. 15 children aged 3.5 months to 10 years received 0.35-0.5 mg.kg-1 intranasal midazolam in association with a corneal anesthesia. The onset of sedation was rapid and permitted adequate ocular examination in all cases. In 8 of 15 cases where surgery followed immediately, the induction of inhalational anesthesia was easier. No local or general adverse reaction was noted. This non-invasive method of anesthesia may be compared to the intrarectal administration of midazolam, but the rapid onset of sedation and a cleaner route seem more suitable in surgical environment.

Administration, Intranasal↗