scholarly journals Anaesthetic protocol for paediatric glaucoma examinations: the prospective EyeBIS Study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045906
Author(s):  
Nina Pirlich ◽  
Franz Grehn ◽  
Katja Mohnke ◽  
Konrad Maucher ◽  
Alexander Schuster ◽  
...  
Keyword(s):  
Airway Management ◽  
General Anaesthesia ◽  
Mixed Linear Model ◽  
Primary Outcome Measure ◽  
Ophthalmological Examination ◽  
Depth Of Anaesthesia ◽  
Haemodynamic Parameters ◽  
Young Infants ◽  
Scientific Meetings ◽  
Healthy Eyes

IntroductionNeonates and young infants with diagnosed or highly suspected glaucoma require an examination under anaesthesia to achieve accurate intraocular pressure (IOP) measurements, since crying or squinting of the eyes may increase IOP and lead to falsely high values. IOP considerably depends on perioperative variables such as haemodynamic factors, anaesthetics, depth of anaesthesia and airway management. The aim of this paper is to report the design and baseline characteristics of EyeBIS, which is a study to develop a standardised anaesthetic protocol for the measurement of IOP under anaesthesia in childhood glaucoma, by investigating the link between the magnitude of IOP and depth of anaesthesia.Methods and analysisThis is a single-centre, prospective cohort study in 100 children with diagnosed or highly suspected glaucoma all undergoing ophthalmological examination under general anaesthesia. 20 children, who undergo general anaesthesia for other reasons, are included as controls. The primary outcome measure is the establishment of a standardised anaesthetic protocol for IOP measurement in childhood glaucoma by assessing the relationship between IOP and depth of anaesthesia (calculated as an electroencephalography variable, the bispectral index), with special emphasis on airway management and haemodynamic parameters. The dependence of IOP under anaesthesia on airway management and haemodynamic parameters will be described, using a mixed linear model. Restricting the model to patients with healthy eyes will allow to determine a 95% reference region, in which 95% of the measurement values of patients with healthy eyes can be expected.Ethics and disseminationThe study has been approved by the local ethics committee of the Medical Association of Rhineland-Palatine (Ethik-Kommisssion der Landesaerztekammer Rheinland-Pfalz), Germany (approval number: 2019-14207). This work will be disseminated by publication of peer-reviewed manuscripts, presentation in abstract form at national and international scientific meetings and data sharing with other investigators.Trial registration numberClinicalTrials.gov Registry (NCT03972852).

Basic principles of anaesthesia of small mammals: part 2

2020 ◽  
Vol 25 (3) ◽  
pp. 1-8
Author(s):  
Stefania Scarabelli ◽  
Giordano Nardini
Keyword(s):  
Health Status ◽  
General Anaesthesia ◽  
Surgical Procedures ◽  
Small Mammals ◽  
Local Anaesthetic ◽  
Perioperative Management ◽  
Anaesthetic Techniques ◽  
Depth Of Anaesthesia ◽  
Basic Principles ◽  
Volatile Agents

Several anaesthetic protocols are reported in the literature for small mammals; it is however fundamental that drugs used and perioperative management are based on each patient individually, considering several factors such as temperament, health status and the procedure to be performed. Alpha-2 agonists, benzodiazepines and opioids are the drugs most commonly used for sedation and premedication in small mammals. General anaesthesia can be induced with injectable agents, such as propofol and alfaxalone, but inhalant anaesthetics delivered by mask or in an induction chamber are still quite commonly used, particularly in smaller patients. Volatile agents are generally preferred for maintenance of anaesthesia, as easy control of the depth of anaesthesia is achievable. Endotracheal intubation is not always possible in these species, but practice and the use of an endoscope can facilitate the procedure. Analgesia should be provided for surgical procedures, and local anaesthetic techniques are warranted whenever possible.

Comparison of two depth of anaesthesia monitors during general anaesthesia: Electrophysiological and clinical assessment

2012 ◽  
Vol 99 (2) ◽  
pp. 111-117
Author(s):  
Cs Molnár ◽  
Zs Kovács ◽  
É. Simon ◽  
J. Gál ◽  
B. Mikos ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Clinical Assessment ◽  
Depth Of Anaesthesia

Effect of tramadol use during general anaesthesia on depth of anaesthesia

2005 ◽  
Vol 30 (5) ◽  
pp. 93-93 ◽  
Author(s):  
O CUVAS ◽  
B CETINSOY ◽  
B BALTACI ◽  
O CUVAS ◽  
B DIKMEN
Keyword(s):  
General Anaesthesia ◽  
Depth Of Anaesthesia

scholarly journals Clinical, Biochemical and Haemodynamic Effects of the Intrathecal Ketamine for Ovariohysterectomy in Bitches

2012 ◽  
Vol 56 (3) ◽  
pp. 299-303 ◽  
Author(s):  
Sadik Yayla ◽  
Cihan Kacar ◽  
Duygu Kaya ◽  
Oguz Merhan ◽  
Ozgur Aksoy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Biochemical Parameters ◽  
Haemodynamic Effects ◽  
Spinal Needle ◽  
Depth Of Anaesthesia ◽  
Depressive Effect ◽  
Haemodynamic Parameters ◽  
Cardiac Functions ◽  
Ketamine Hcl

Abstract The purpose of the study was to evaluate the effects of intrathecal (IT) ketamine HCl anesthesia on clinical values and some haemodynamic and biochemical parameters in bitches. An IT ketamine (10 mg/kg) was administered to 30 bitches with a spinal needle (18-22 G) in the lumbosacral space. The haemodynamic parameters were monitored and some biochemical values were assessed (blood gase, oxygen-haemoglobin, and electrolyte levels). The length and depth of anaesthesia was determined with a pinprick test, touching to the ligamenta lata uteri and incision. Anaesthesia took effect in less than 1 min in all dogs and has lasted an average of 95.9 min. In spite of the fact that the dogs recovered completely from the effects of dissociative anaesthesia, the anaesthesia in the some extremities was observed to be continued for an average of 17 min longer. The use of IT ketamine HCl raised blood pressure and did not have a depressive effect on respiratory and cardiac functions. It was concluded that ketamine HCl could be an appropriate alternative for ovariohysterectomy operations in bitches when the quality of the anaesthesia and the prevention of bradycardia and hypotension are considered.

Is spinal anaesthesia in young infants really safer and better than general anaesthesia?

2018 ◽  
Vol 31 (3) ◽  
pp. 302-307 ◽  
Author(s):  
Nicola Disma ◽  
Natasha Clunies-Ross ◽  
George A. Chalkiadis
Keyword(s):  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Young Infants ◽  
Better Than

scholarly journals A Cohort and Database Study of Airway Management in Patients Undergoing Thyroidectomy for Retrosternal Goitre

2014 ◽  
Vol 42 (6) ◽  
pp. 700-708 ◽  
Author(s):  
N. Gilfillan ◽  
C. M. Ball ◽  
P. S. Myles ◽  
J. Serpell ◽  
W. R. Johnson ◽  
...  
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
General Anaesthesia ◽  
Thyroid Surgery ◽  
Good Evidence ◽  
Anaesthetic Induction ◽  
Tracheal Compression ◽  
Induction Technique ◽  
Failed Airway ◽  
Symptoms And Signs

Patients undergoing thyroid surgery with retrosternal goitre may raise concerns for the anaesthetist, especially airway management. We reviewed a multicentre prospective thyroid surgery database and extracted data for those patients with retrosternal goitre. Additionally, we reviewed the anaesthetic charts of patients with retrosternal goitre at our institution to identify the anaesthetic induction technique and airway management. Of 4572 patients in the database, 919 (20%) had a retrosternal goitre. Two cases of early postoperative tracheomalacia were reported, one in the retrosternal group. Despite some very large goitres, no patient required tracheostomy or cardiopulmonary bypass and there were no perioperative deaths. In the subset of 133 patients managed at our institution over six years, there were no major adverse anaesthetic outcomes and no patient had a failed airway or tracheomalacia. In the latter cohort, of 32 (24%) patients identified as having a potentially difficult airway, 17 underwent awake fibreoptic tracheal intubation, but two of these were abandoned and converted to intravenous induction and general anaesthesia. Eleven had inhalational induction; two of these were also abandoned and converted to intravenous induction and general anaesthesia. Of those suspected as having a difficult airway, 28 (87.5%) subsequently had direct laryngoscopy where the laryngeal inlet was clearly visible. We found no good evidence that thyroid surgery patients with retrosternal goitre, with or without symptoms and signs of tracheal compression, present the experienced anaesthetist with an airway that cannot be managed using conventional techniques. This does not preclude the need for multidisciplinary discussion and planning.

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