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PubMed2005

[Early postoperative complications in patients with Moyamoya disease--a comparison of inhaled anesthesia with total intravenous anesthesia (TIVA)].

BACKGROUND: Moyamoya disease is a rare neurovascular disorder that requires special anesthetic managements during revascularization procedures. We have investigated the incidence of early postoperative complications under inhaled anesthesia in comparison with total intravenous anesthesia (TIVA) retrospectively. METHODS: Seventy-two patients undergoing revascularization procedures were divided into two groups, one with inhaled anesthesia (n = 23) and the other with TIVA (n = 49). Surgical procedures were performed under normocapnia, proper body temperature, and all patients were prevented from anemia by homologous transfusion. To avoid the variance in anesthetic managements, 39 patients under 15 years of age were picked up and divided in the same way as above. Early postoperative complications including transient ischemic attack and cerebral infarction during the first 2 weeks after operation were investigated. RESULTS: In all patients, early postoperative complications occurred in 48% of inhaled anesthesia group and in 49% of TIVA group. In patients under 15, these complications occurred in 44% and in 57%, respectively. There was no significant difference in the incidence of complications between the two anesthetic groups. CONCLUSIONS: Several previous studies reported the excellence of TIVA for revascularization procedure on the basis of regional blood flow because inhaled anesthesia may provoke intracerebral steal in moyamoya disease. Our investigation in this study revealed that both anesthetic methods have no significant difference in postoperative complications during the first 2 weeks after operation. Thus further study should be needed to verify the safety of inhalation anesthetics in patients with moyamoya disease.

Adolescent↗
PubMed1981

Failure of bacterial filters to reduce the incidence of pneumonia after inhalation anesthesia.

The authors prospectively studied 520 patients undergoing inhalation anesthesia to evaluate the efficacy of low resistance 0.22-micron bacterial filters in preventing postoperative pneumonias. Patients undergoing elective thoracic, upper abdominal and lower abdominal surgeries were randomly assigned preoperatively to filtered and nonfiltered anesthesia circuits by a study nurse. A second study nurse, who was unaware of patient assignments, followed each patient for five postoperative days to identify possible pulmonary complications. Both groups of patients were similar in age, sex distribution, smoking history, prior pulmonary disease, types and duration of surgery, ASA physical status classification, and receipt of intraoperative antibiotics. No differences in rates of postoperative pneumonia were observed between patients assigned to filtered and nonfiltered circuits (16.7 per cent vs. 18.3 per cent, respectively, P = 0.73). Also no differences were observed when the incidences of other outcome criteria such as postoperative fever, abnormal chest x-ray, sputum production, or abnormal pulmonary physical exam findings were evaluated. The results suggest that bacterial gas filters do not influence the incidence of postoperative pneumonias and that routine use of these devices for this purpose is not cost-effective.

Anesthesia, Inhalation↗
PubMed1986

Techniques of inhalation anesthesia in ruminants and swine.

This article reviews the implementation of inhalation anesthesia in large and small ruminants and swine. A brief discussion of the general considerations for inhalation anesthesia of large animals is followed by a review of the pharmacology of inhalation agents, induction procedures commonly used when anesthetizing ruminants and swine, methods of assessing depth of anesthesia and maintenance of anesthesia, and anesthetic machines and delivery systems appropriate for use in large and small ruminants and swine.

Anesthesia, Inhalation↗
PubMed1990

[The recovery period following total intravenous anesthesia using propofol and alfentanil versus inhalation anesthesia using nitrous oxide and enflurane at 1.3 MAC].

Recovery of motor and mental functions were investigated in two groups with 20 young patients each. One group received total intravenous anaesthesia (TIVA) with propofol and alfentanil for urological surgery and the other group received nitrous oxide-oxygen anaesthesia in combination with 1.3 MAC of enflurane for lumbar nucleotomy. The following parameters were investigated before and up to 100 minutes after extubation: simple and discriminating motor activities, vigilance and short and long term memory. --Simple and in discriminating motor actions show a significantly faster recovery was seen in the TIVA group during the first 20 minutes after extubation compared to the enflurane-treated patients. Speech-related functions were particularly inhibited in the inhalational anaesthesia group. After 30 to 40 minutes the propofol-alfentanil group was able to meet all requirements while patients with inhalational anaesthesia needed 80 minutes to reach the same level. Recovery of short and long-term memory was also significantly shorter in the TIVA group. This clearly indicates a faster return of mental and motor functions following total intravenous anaesthesia with propofol and alfentanil. However the large dosages of alfentanil may be a problem with regard to post-anaesthetic respiratory depression. Further studies with larger numbers of patients will be necessary to evaluate the potential side effects of continuous propofol/alfentanil infusion. Presently, safety demands require, at least a sixty-minute post anaesthesia monitoring for patients receiving this new anaesthesia method.

Adult↗