A device to detect leakage at the patient end of total intravenous anaesthesia

Author(s):  
Rajkumar Chandran ◽  
Kalindi De Sousa ◽  
Seok Hwee Koo ◽  
Yin Yu Lim ◽  
Lei Shang ◽  
...  
1997 ◽  
Vol 25 (4) ◽  
pp. 358-364
Author(s):  
W. Rushatamukayanunt ◽  
T. Tritrakarn

A comparison between midazolam and midazolam-flumazenil for total intravenous anaesthesia in combination with topical anaesthesia and muscle relaxants was performed in a double-blind, parallel study in 40 patients scheduled for microlaryngoscopy with or without bronchoscopic procedures using jet ventilation with oxygen. A single intravenous injection of midazolam 0.3 mg/kg, lignocaine spray and muscle relaxants provided adequate anaesthesia and good operative conditions throughout the procedures, which took 20 to 30 minutes. Patients who had placebo at the end of the procedures had a longer recovery and a high incidence of airway obstruction (20%). Administration of flumazenil provided prompt awakening in 19 of 20 patients (95%) within five minutes, resulting in rapid and favourable recovery without resedation or other side-effects, while only three of 20 (15%) patients in the placebo-treated group had improved consciousness within five minutes. The simplicity and reliability of the midazolam-flumazenil technique is attractive. We consider it worthy of further investigation for wider application in clinical practice.


1983 ◽  
Vol 27 (2) ◽  
pp. 113-116 ◽  
Author(s):  
R. J. Fragen ◽  
E. H. J. H. Hanssen ◽  
P. A. F. Denissen ◽  
L. H. D. J. Booij ◽  
J. F. Crui.

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e014629 ◽  
Author(s):  
Feng Chen ◽  
Guangyou Duan ◽  
Zhuoxi Wu ◽  
Zhiyi Zuo ◽  
Hong Li

ObjectiveNeurological dysfunction remains a devastating postoperative complication in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), and previous studies have shown that inhalation anaesthesia and total intravenous anaesthesia (TIVA) may produce different degrees of cerebral protection in these patients. Therefore, we conducted a systematic literature review and meta-analysis to compare the neuroprotective effects of inhalation anaesthesia and TIVA.DesignSearching in PubMed, EMBASE, Science Direct/Elsevier, China National Knowledge Infrastructure and Cochrane Library up to August 2016, we selected related randomised controlled trials for this meta-analysis.ResultsA total of 1485 studies were identified. After eliminating duplicate articles and screening titles and abstracts, 445 studies were potentially eligible. After applying exclusion criteria (full texts reported as abstracts, review article, no control case, lack of outcome data and so on), 13 studies were selected for review. Our results demonstrated that the primary outcome related to S100B level in the inhalation anaesthesia group was significantly lower than in the TIVA group after CPB and 24 hours postoperatively (weighted mean difference (WMD); 95% CI (CI): −0.41(–0.81 to –0.01), −0.32 (−0.59 to −0.05), respectively). Among secondary outcome variables, mini-mental state examination scores of the inhalation anaesthesia group were significantly higher than those of the TIVA group 24 hours after operation (WMD (95% CI): 1.87 (0.82 to 2.92)), but no significant difference was found in arteriovenous oxygen content difference, cerebral oxygen extraction ratio and jugular bulb venous oxygen saturation, which were assessed at cooling and rewarming during CPB.ConclusionThis study demonstrates that anaesthesia with volatile agents appears to provide better cerebral protection than TIVA for patients undergoing cardiac surgery with CPB, suggesting that inhalation anaesthesia may be more suitable for patients undergoing cardiac surgery.


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