scholarly journals Continuous postoperative infusion of remifentanil inhibits the stress responses to tracheal extubation of patients under general anesthesia

2017 ◽  
Vol Volume 10 ◽  
pp. 933-939 ◽  
Author(s):  
Guoliang Zhao ◽  
Xiaoyue Yin ◽  
Ya Li ◽  
Jianlin Shao
Keyword(s):  
General Anesthesia ◽  
Stress Responses ◽  
Tracheal Extubation

Comparative study of hemodynamic effects, quality of extubation and emergence - agitation response of the patients with dexmedetomidine versus lignocaine during and following the endotracheal extubation

2021 ◽  
Vol 19 (3) ◽  
pp. 91-95
Author(s):  
Manasi Panat ◽  
Keyword(s):  
Comparative Study ◽  
Stress Responses ◽  
Tracheal Extubation ◽  
Emergence Agitation ◽  
Quality Of Recovery ◽  
Group 12 ◽  
The Difference ◽  
Group D ◽  
Endotracheal Extubation

Background: Endotracheal extubation is the translaryngeal removal of a tube from the trachea via the nose or mouth. It is associated with hemodynamic changes because of reflex sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation. Various drugs and techniques have been tried to attenuate the airway and stress responses during tracheal extubation. In present study, we have compared the effects of dexmedetomidine and intravenous lignocaine on the hemodynamic and recovery profiles during endotracheal extubation. Material and Methods: Present study was prospective randomised comparative study, conducted in patients from age group of 18-45 years, ASA grade I/II, scheduled for elective abdominal surgeries. The patients were categorised into two different groups using the sealed envelope method as Group D and group L. Results: In present study, patients were divided in following 2 groups with 50 patients in each group as group D (Dexmedetomidine) and group L (Lignocaine). Age, gender, mean BMI were comparable in both groups and difference was not significant statistically. The difference between mean heart rate, systolic BP, diastolic BP and mean arterial BP during extubation, after extubation at 1, 3, 5, 10, 15, 20, 25, 30 minutes in dexmedetomidine group and lignocaine group was statistically significant. In Dexmedetomidine group, 12% of the patients had no cough during extubation, 72% of the patients had smooth extubation with minimal cough while in Lignocaine group, 22% of the patients had smooth extubation with minimal cough, 74 % of the patients had moderate cough during extubation. Statistical analysis of the Emergence agitation score shows better results in group D. Conclusion: Administration of Dexmedetomidine before tracheal extubation was more effective in maintaining the hemodynamic stability, facilitated smooth tracheal extubation and had a better quality of recovery as compared to Lignocaine.

Administration of Oxygen Before Tracheal Extubation Worsens Gas Exchange After General Anesthesia in a Pig Model

2002 ◽  
Vol 95 (6) ◽  
pp. 1772-1776 ◽  
Author(s):  
Alexander Loeckinger ◽  
Axel Kleinsasser ◽  
Christian Keller ◽  
Andreas Schaefer ◽  
Christian Kolbitsch ◽  
...  
Keyword(s):  
Gas Exchange ◽  
General Anesthesia ◽  
Tracheal Extubation ◽  
Pig Model

scholarly journals Comparison of Surgical Stress Responses During Spinal and General Anesthesia in Curettage Surgery

2014 ◽  
Vol 4 (3) ◽  
Author(s):  
Fereshteh Amiri ◽  
Ali Ghomeishi ◽  
Seyed Mohammad Mehdi Aslani ◽  
Sholeh Nesioonpour ◽  
Sara Adarvishi
Keyword(s):  
General Anesthesia ◽  
Stress Responses ◽  
Surgical Stress

Anesthesia Clinical Outcome and Management in Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy: A Retrospective Analysis

2021 ◽  
Vol 104 (9) ◽  
pp. 1542-1548
Keyword(s):  
General Anesthesia ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Anesthetic Management ◽  
Tracheal Extubation ◽  
Anesthetic Technique ◽  
Total Blood ◽  
Icu Length Of Stay ◽  
Intraoperative Hypotension

Background: Anesthetic technique and outcome of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is not well established. Objective: To evaluate the anesthetic management of CRS with HIPEC and to analyze whether supplement epidural anesthesia will provide any benefit on the outcomes. Materials and Methods: All patients that underwent CRS with HIPEC between January 2008 and December 2017 at King Chulalongkorn Memorial Hospital were retrospective reviewed. Patients were divided into two groups, 1) received a combination of epidural and general anesthesia (EGA), and 2) received general anesthesia (GA) to compare intraoperative hemodynamic stability, postoperative pain control, time to tracheal extubation, and postoperative complications between groups. Results: Twenty patients had EGA, and 14 patients had GA. EGA group had significant more incidences of intraoperative hypotension at 70% versus 21.4%, which required more use of vasopressor at 65% versus 21.4% (p<0.05). There was no statistical difference between groups in total blood loss, time to extubation, and ICU length of stay. There were no significant differences in the pain score at 12 and 24 hours postoperative. Epidural complications were not detected. There was no mortality within 30 days. Conclusion: Adding epidural analgesia to GA in CRS with HIPEC increased the incidence of hypotension and did not reduce the pain or duration of extubation. Keywords: Anesthesia; Epidural; HIPEC; Outcome

scholarly journals Recovery Profiles of Sevoflurane and Desflurane with or without M-Entropy Guidance in Obese Patients: A Randomized Controlled Trial

2021 ◽  
Vol 11 (1) ◽  
pp. 162
Author(s):  
Yu-Ming Wu ◽  
Yen-Hao Su ◽  
Shih-Yu Huang ◽  
Po-Han Lo ◽  
Jui-Tai Chen ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Operating Room ◽  
Medical Center ◽  
Controlled Trial ◽  
Clinical Signs ◽  
Tracheal Extubation ◽  
Number Needed To Treat ◽  
Obese Patients ◽  
Anesthetic Depth ◽  
Eye Opening

Obesity increases the risk of prolonged emergence from general anesthesia due to the delayed release of anesthetic agents from body fat. This trial aimed to evaluate the effects of sevoflurane and desflurane along with anesthetic depth monitoring on emergence time from anesthesia in obese patients. Adults with a body mass index ≥ 30 kg·m−2 undergoing laparoscopic sleeve gastrectomy at a medical center were randomized into four groups: sevoflurane or desflurane anesthesia with or without M-Entropy guidance on anesthetic depth in a ratio of 1:1:1:1. In the M-Entropy guidance groups, the dosage of sevoflurane and desflurane was adjusted to achieve response and state entropy values between 40 and 60 during surgery. In the non-M-Entropy guidance groups, the dosage of anesthetics was titrated according to clinical signs. Primary outcome was time to spontaneous eye opening. A total of 80 participants were randomized. Compared to sevoflurane, desflurane anesthesia significantly reduced the time to spontaneous eye opening [mean difference (MD): −129 s; 95% confidence interval (CI): −211, −46], obeying commands (−160; −243, −77), tracheal extubation (−172; −266, −78), and leaving operating room (−148; −243, −54). M-Entropy guidance further reduced time to eye opening (MD: −142 s; 99.2% CI: −276, −8), tracheal extubation (−199; −379, −19), and leaving operating room (−190; −358, −23) in the desflurane but not the sevoflurane group. M-Entropy guidance significantly reduced the risk of agitation during emergence, i.e., risk difference: −0.275 (95% CI: −0.464, −0.086); and number needed to treat: 4. Compared to sevoflurane, using desflurane to maintain general anesthesia accelerated the return of consciousness in obese patients. M-Entropy guidance further hastened awakening in patients using desflurane and prevented emergence agitation.

scholarly journals The Effects of Epidural Anesthesia and Analgesia on Cluster of Differentiation and Cytokines in Patients after Gastric Cancer Resection

2018 ◽  
Author(s):  
Si Liang ◽  
MD Liping Wang ◽  
MD Hong Chen ◽  
MD Yang Xu ◽  
MD Yu Wang
Keyword(s):  
Gastric Cancer ◽  
General Anesthesia ◽  
Stress Responses ◽  
Length Of Hospital Stay ◽  
Postoperative Nausea And Vomiting ◽  
Cancer Resection ◽  
Vas Scores ◽  
Ifn Γ ◽  
Cluster Of Differentiation ◽  
Gastric Cancer Resection

Abstract Background: Epidural use can prevent peri-operative neuro-endocrine stress responses, improve pain after surgery, and reduce opioid volume which lead to immunosuppression. Methods: Forty cases of patients with gastric cancer were finally enrolled into the study. Patients who received general anesthesia (GA group, n=20), a combination of general anesthesia and peri-operative epidural use (EGA group, n=20), were given intravenous analgesia or epidural analgesia, respectively. We collected visual analogue scale (VAS) scores, length of hospital stay, the first passage of flatus time and incidence of postoperative nausea and vomiting (PONV). We also collected the Cluster of Differentiation (CD)3+, CD4+, CD8+, CD4+/CD8+, Interleukin (IL)-4, IL-6, Interferon (IFN)-γ before surgery, as well as the postoperative days 1, 3 ,7. Results: VAS scores and PONV in GA group were higher than EGA group in the postoperative 3 days. CD3+, CD4+, CD4+/CD8+ were declined in the postoperative 3 days, and nearly recovered to the baseline in the seventh days after surgery in both of the two groups. CD3+ in the GA group decreased more than EGA group. IL-4, IL-6, IFN-γ were increased in the postoperative 3 days, and nearly recovered to the baseline in the seventh days after surgery in both of the two groups, IL-4, IL-6 in the GA group increased more than EGA group. IFN-γ in the EGA group increased more than GA group. Conclusions: A combination of general anesthesia and peri-operative epidural use can relieve postoperative pain and PONV. A combination of general anesthesia and peri-operative epidural use decreases immunosuppression in gastric cancer resection.

scholarly journals Occurrence and Severity of Catheter-Related Bladder Discomfort of General Anesthesia Plus Epidural Anesthesia vs. General Anesthesia in Abdominal Operation With Urinary Catheterization: A Randomized, Controlled Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Shunxiang Sun ◽  
Cheng Wang ◽  
Jun Zhang ◽  
Pengfei Sun
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Tracheal Extubation ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Urinary Catheterization ◽  
Abdominal Operation ◽  
Randomized Controlled ◽  
Male Patients

Background: This randomized, controlled study aimed to investigate the effect of general anesthesia plus epidural anesthesia on catheter-related bladder discomfort (CRBD) in patients who underwent abdominal operation with urinary catheterization.Methods: A total of 150 patients scheduled for abdominal operation under anesthesia with urinary catheterization were randomized to receive general anesthesia plus epidural anesthesia (N = 74, GA + EA group) or general anesthesia (N = 76, GA group). The occurrence and severity of CRBD, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded at 0 hour (h), 0.5, 1, and 3 h after tracheal extubation. Besides, postoperative adverse events were assessed.Results: The occurrence and severity of CRBD at 0, 0.5, 1, and 3 h were all reduced in GA + EA group compared to GA group (all P &lt; 0.05). Meanwhile, subgroup analyses showed that the reduction of occurrence and severity of CRBD in GA + EA group compared to GA group was more obvious in male patients and patients ≥50 years. Besides, SBP at 0, 0.5, 1, and 3 h, as well as DBP at 0, 0.5, and 3 h were all decreased in GA + EA group compared to GA group (all P &lt; 0.05), while HR was increased at 0 h in GA + EA group compared to GA group (P = 0.034). Moreover, the occurrence of pain, severity of pain and occurrence of vomiting were similar between GA + EA group and GA group (all P &gt; 0.05).Conclusion: General anesthesia plus epidural anesthesia decreases CRBD occurrence and severity with tolerable safety compared with general anesthesia in patients who undergo abdominal operation with urinary catheterization.

Evaluation of inflammatory and hemostatic surgical stress responses in male cats after castration under general anesthesia with or without local anesthesia

2012 ◽  
Vol 73 (11) ◽  
pp. 1824-1831 ◽  
Author(s):  
Elena R. Moldal ◽  
Jolle Kirpensteijn ◽  
Annemarie T. Kristensen ◽  
H. Andreas Haga ◽  
Ane Nødtvedt ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Stress Responses ◽  
Surgical Stress
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