The changes in Bispectral index during recovery period in tracheal intubation general Anesthesia with or without tracheal-laryngopharynx topical Anesthesia

Abstract Background Endotracheal intubation is known to pose significant physiological, pharmacokinetic, and dynamic changes and postoperative respiratory complications in patients under general anesthesia. Method An RCT trial was organized by the Third Affiliated Hospital at Sun Yat-sen University, China. Patients were eligible for inclusion in the trial if they were over 60 years old and had upper-abdominal surgery during the induction of anesthesia and had enrolled in endotracheal intubations. The primary end point included cardiovascular reactions during the induction of anesthesia and endotracheal intubations and cough events during the recovery period. In the test group, 2 g of lidocaine/prilocaine cream (and in the control group, 2 g of Vaseline) were laid over the surface of the tracheal tube cuff. Results The systolic blood pressure (F value = 62.271, p < 0.001), diastolic blood pressure (F value = 150.875, p < 0.001), and heart rate (F value = 75.627, p < 0.001) of the test group were significantly lower than the control group. Cough events during the recovery period in the test group were better (spontaneous cough, χ2 value = 10.591, p < 0.001; induced cough, χ2 value =10.806, p < 0.001). Conclusion In older patients, coughing and cardiovascular reactions under anesthesia and endotracheal intubations were reduced, as a result of using lidocaine/prilocaine cream on the surface of the tracheal tube cuff. Trial registration International Clinical Trials Network NCT02017392, 2013-12-16.

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Intravenous droperidol decreases the bispectral index during general anesthesia using sevoflurane and desflurane with remifentanil

European Journal of Anaesthesiology ◽

10.1097/00003643-201406001-00453 ◽

2014 ◽

Vol 31 ◽

pp. 160

Author(s):

Y. Adachi

Keyword(s):

General Anesthesia ◽

Bispectral Index

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Submental method for orotracheal intubation in treating facial trauma

Sao Paulo Medical Journal ◽

10.1590/s1516-31801998000500010 ◽

1998 ◽

Vol 116 (5) ◽

pp. 1829-1832 ◽

Cited By ~ 6

Author(s):

Luiz Carlos Manganello-Souza ◽

Nicolas Tenorio-Cabezas ◽

Luiz Piccinini Filho

Keyword(s):

Tracheal Intubation ◽

General Anesthesia ◽

Surgical Intervention ◽

Orotracheal Intubation ◽

Facial Trauma ◽

Facial Fractures ◽

Surgical Team ◽

Visible Scar ◽

Alternative Method

OBJECTIVE: To demonstrate an alternative method for intubating patients with fractures of maxilla and nose, prior to surgery. DESIGN: Cases Report. PARTICIPANTS: We studied 10 patients with facial fractures that affected maxilla and nose. INTERVENTION: The patients were submitted to surgery under general anesthesia and submental oro-tracheal intubation. RESULTS: This type of intubation allowed the surgical team to work on the whole face of the patient and left no visible scar. CONCLUSION: This procedure is indicated for patients with fractures of maxilla and nose who need surgical intervention under general anesthesia.

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Comparison of Anesthesia Depth Monitoring using Conventional and Bispectral Index on Incidence and Severity of Nausea and Vomiting after Urological Surgeries

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.v.6n.2p.25 ◽

2018 ◽

Vol 6 (2) ◽

pp. 25

Author(s):

Reihan Shenasi ◽

Hamzeh Hoseinzadeh ◽

Hasan Mohammadpor-Anvari ◽

Davod Aghamohammadi ◽

Reza Sari-Motlagh

Keyword(s):

General Anesthesia ◽

Bispectral Index ◽

Postoperative Nausea ◽

Operating Time ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Control Group ◽

Anesthetic Drugs ◽

Urological Surgery ◽

Anesthesia Depth

Bispectral index parameter is used to guide the titration of general anesthesia. This monitoring improves recovery times and hospital discharges, as well as minimizes adverse events. The objective of this study is the comparison of anesthesia depth monitoring by conventional and bispectral index on nausea and vomiting after urological surgery. 180 participants who were scheduled for abdominal urological surgery were studied. Patients before induction of anesthesia were randomize into two groups with and without bispectral index monitoring. Incidence and severity of nausea and vomiting were recorded every 30 minutes for 2 hours and every 6 hours to 24 hours after surgery. The incidence of postoperative nausea and vomiting in Bispectral index group is 14.4% and 8.9% and in control group 28.9% and 23.3%, respectively. The risk of nausea and vomiting after surgery was reduced by 14.5% and 14.4%, respectively in patients monitored with bispectral index.INTRODUCTIONNausea is the conscious perception of medulla stimulation that is associated with vomiting center and create vomiting response (1). General anesthesia with the use of inhalants can cause nausea and vomiting after surgery (Postoperative nausea and vomiting, PONV). The incidence of PONV is reported about 20-30 percent (2). It seems that multiple-factor can cause PONV and few items such as anesthetic drugs, kind of surgery and personal risk factors is effective on PONV. These factors make into two categories that includes factors out of control by anesthesiologists and factors can control by anesthesiologists.1. Factors out of control by anesthesiologists: some of these factors are age, gender, past history of PONV and motion sickness, smoking, kind of surgery, operating time and anesthesia time, anxiety of patients and parents. 2. Factors controlled by anesthesiologists: these factors are associated of anesthesia settings, including premedications, kind of anesthesia, anesthesia drugs during surPublishedby Australian

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A COMPARISON OF EFFECT OF NEBULISED KETAMINE AND NEBULISED MAGNESIUM SULPHATE IN REDUCTION OF INCIDENCE AND SEVERITY OF POSTOPERATIVE SORE THROAT - A PROSPECTIVE RANDOMIZED DOUBLE BLINDED STUDY

10.36106/gjra/4004006 ◽

2021 ◽

pp. 38-40

Author(s):

M. Selvi Annie Geeta ◽

M. Ramesh Ram

Keyword(s):

Tracheal Intubation ◽

General Anesthesia ◽

Sore Throat ◽

Magnesium Sulphate ◽

Success Rates ◽

Postoperative Sore Throat ◽

It Effectiveness ◽

Duration Of Surgery ◽

The Mean ◽

Group B

Introduction: Postoperative sore throat (POST) is a common occurrence following general anesthesia with endotracheal intubation. The incidence of POST is estimated to be 21%-65% in various studies. Irritation and inammation of the air way are considered to be the cause of POST. Although considered a minor and self limiting complication, it may cause a signicant patient morbidity, dissatisfaction and increased the length of duration of hospital stay. Various pharmacological and non pharmacological methods have been tried to decrease POST with varying success rates. Among the interventions, the use of ketamine gargle or lozenges has highest success rates, but the problem with this is the bitter taste of the drug and the risk of aspiration, so aerosol route of drug administration gained popularity among the anesthesiologists with good acceptance from the patients. It is known that N-methyl-D-aspartate (NMDA) receptors have a role in nociception and inammation. Hence, this study is aimed at using the aerosol route of magnesium sulphate and ketamine and to nd it effectiveness in preventing POST. Aim Of The Study: To evaluate the effect of nebulized ketamine and nebulized magnesium sulphate for attenuation of postoperative sore throat in patients undergoing surgeries under general anesthesia with tracheal intubation. Materials And Methods: This study was done in the Department of Anesthesiology in collaboration with the Department of Surgery in Kanyakumari Government Medical College from January 2019 to December 2019. Patient planned for surgery under general anesthesia except head, neck & ENT surgeries were selected and randomized into two groups (35 each). Each group received nebulisation for 15 min before induction of general anaesthesia. Group M: Nebulization with 500mg magnesium sulphate in 5ml NS. Group K: Nebulization with 50mg ketamine in 5ml NS. The Parameters related to the study such as duration of laryngoscopy, time taken to intubate, duration of surgery, number of attempts to intubate were recorded. Incidence and severity of sore throat were assessed by four point scale. Incidence of sore throat is assessed for 24 hours. Complication were recorded. Results: We found that the demographic parameters were comparable and statistically insignicant. The mean duration of laryngoscopy difference between the two groups Group M - 24.54± 1.12 seconds and Group K - 24.49 ±1.15 seconds was not statistically signicant P= 0.834 (P>0.05). The mean time taken to intubate in Group M - 27.54± 1.12 seconds and Group K - 27.54± 1.12 seconds was not statistically signicant with P=1.000 respectively (P>0.05). The mean duration of surgery in Group M - 90.71±15.67 minutes and the Group K - 88.20 ±16.53 minutes between the two groups was not statistically signicant P= 0.516 (P>0.05). The mean difference of number of attempts taken to intubate between the two groups was statistically insignicant P=0.771 (P>0.05). The overall incidence of sore throat in Group M was 91% and in Group B was 34%. The severity of sore throat between Group M and Group K is statistically signicant at 2, 4, 6 hrs at grade 1 and grade 2. Conclusion: On the basis of our result, we can suggest that the use of perioperative ketamine nebulization when compared magnesium sulphate nebulization reduces the incidence and severity of post-operative sore throat at 4th and 6th hour during postoperative period in patients who had received general anesthesia with tracheal intubation.

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Solid Organ Biopsies

The Pediatric Procedural Sedation Handbook ◽

10.1093/med/9780190659110.003.0038 ◽

2018 ◽

pp. 246-249

Author(s):

Jennifer Biber ◽

Jenna Wheeler

Keyword(s):

Adverse Events ◽

General Anesthesia ◽

Operating Room ◽

Local Anesthesia ◽

Deep Sedation ◽

Recovery Period ◽

Contingency Planning ◽

Solid Organ ◽

Sedation And Analgesia ◽

Pediatric Sedation

While solid organ biopsies are routinely done on adults with only local anesthesia or minimal sedation, children frequently require deep sedation or general anesthesia to achieve acceptable conditions (stillness, anxiolysis, analgesia) to facilitate these procedures. This is more frequently being done with pediatric sedation/anesthesia outside the operating room. Issues unique to sedation for these procedures are pain, the need for relative patient immobility (both during the procedure and following it), and the nonstandard positioning required during the procedure. Regardless of the medications chosen, adequate monitoring should occur during the procedure as well as during the recovery period. With a good sedation plan for both sedation and analgesia, adequate monitoring, and contingency planning for adverse events, this can safely be performed in institutions with highly motivated and organized sedation services.

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The Use of Bispectral Index Monitoring Does Not Change Intraoperative Exposure to Volatile Anesthetics in Children

Journal of Clinical Medicine ◽

10.3390/jcm9082437 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2437

Author(s):

Cornelius A. Sullivan ◽

Chinyere Egbuta ◽

Raymond S. Park ◽

Karina Lukovits ◽

David Cavanaugh ◽

...

Keyword(s):

General Anesthesia ◽

Bispectral Index ◽

Volatile Anesthetics ◽

Day Surgery ◽

Primary Objective ◽

Recovery Profile ◽

The Face ◽

End Tidal ◽

Discharge Criteria

The exposure of infants and children to volatile anesthetics, such as sevoflurane, has been a topic of concern with respect to the potential risk for long term neurocognitive effects. The primary objective of this study was to determine whether the perioperative utilization of Bispectral Index (BIS) monitoring alters the sevoflurane delivery and exposure to children. This is a prospective randomized trial of two groups of healthy ambulatory day surgery patients (2 to 12 years). The patients in both groups had the BIS applied soon after the induction of general anesthesia, but only the anesthesiologists in the group randomized to BIS visible were able to see the BIS values. All of the patients received general anesthesia with sevoflurane. This study found no difference in the overall exposure to sevoflurane between both groups (mean end-tidal sevoflurane level of 1.8 in both groups, P = 084). The duration of time in the recovery room, the time to meet discharge criteria, the Pediatric Agitation Emergence Delirium (PAED) scores and the Face, Legs, Activity, Cry, Consolability (FLACC) scores were not statistically different between the groups. The application and utilization of intraoperative BIS monitoring does not alter the sevoflurane administration nor the discharge readiness nor the recovery profile in healthy ambulatory children.

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Upside-Down Mask Ventilation Technique for a Patient With a Long and Narrow Mandible

Anesthesia Progress ◽

10.2344/0003-3006-61.4.169 ◽

2014 ◽

Vol 61 (4) ◽

pp. 169-170

Author(s):

Takuro Sanuki ◽

Toshihiro Watanabe ◽

Yu Ozaki ◽

Mizuki Tachi ◽

Kensuke Kiriishi ◽

...

Keyword(s):

Tracheal Intubation ◽

General Anesthesia ◽

Basic Skills ◽

Mask Ventilation ◽

Common Cause ◽

Facial Anomalies ◽

Difficult Mask Ventilation ◽

Gas Leak ◽

Ventilation Technique

Abstract Mask ventilation, along with tracheal intubation, is one of the most basic skills for managing an airway during anesthesia. Facial anomalies are a common cause of difficult mask ventilation, although numerous other factors have been reported. The long and narrow mandible is a commonly encountered mandibular anomaly. In patients with a long and narrow mandible, the gaps between the corners of the mouth and the lower corners of the mask are likely to prevent an adequate seal and a gas leak may occur. When we administer general anesthesia for these patients, we sometimes try to seal the airway using several sizes and shapes of commercially available face masks. We have found that the management of the airway for patients with certain facial anomalies may be accomplished by attaching a mask upside down.

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Indirect Laryngeal Surgery in the Clinical Voice Laboratory: The Renewal of a Lost Art

Ear Nose & Throat Journal ◽

10.1177/014556130007900507 ◽

2000 ◽

Vol 79 (5) ◽

pp. 350-361 ◽

Cited By ~ 2

Author(s):

Norman D. Hogikyan ◽

Melissa Pynnonen

Keyword(s):

Cost Effectiveness ◽

General Anesthesia ◽

Recent Literature ◽

Low Cost ◽

Cost Effective ◽

Topical Anesthesia ◽

High Quality ◽

Advantages And Disadvantages ◽

Laryngeal Surgery ◽

Type Of Surgery

Since the advent of precision instruments and safe techniques for direct laryngoscopic surgery under general anesthesia, indirect laryngeal surgery has become very uncommon. A review of the recent literature finds that few authors advocate indirect surgery under topical anesthesia, and many otolaryngologists dismiss this technique as being either of only historical interest or an idiosyncratic method practiced only by a handful of clinicians. The societal mandate for cost-effective healthcare and the availability of relatively low-cost, high-quality endoscopes and video equipment warrant a renewed and broader interest in this type of surgery. In this article, we review a series of 27 indirect surgical procedures performed under topical anesthesia in the clinical voice laboratory. We discuss the indications, outcomes, advantages, and disadvantages of this surgery, and we present a brief analysis of its cost-effectiveness. We conclude that indirect laryngeal surgery in the clinical voice laboratory is an effective, safe, efficient, and less costly alternative to some procedures routinely performed under general anesthesia.

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