scholarly journals Comparative study of effective-site target controlled infusion with standard bolus induction of propofol for laryngeal mask airway insertion

2010 ◽  
Vol 4 (1) ◽  
pp. 177-182 ◽  
Author(s):  
Krairerk Sintavanuruk ◽  
Sukanya Pongruekdee ◽  
Russana Thaharavanich ◽  
Surajak Laosuwan ◽  
Somrat Charuluxananan
Keyword(s):  
Success Rate ◽  
Induction Time ◽  
Quality Score ◽  
Laryngeal Mask Airway Insertion ◽  
Target Controlled Infusion ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Effective Site ◽  
Group 1

Abstract Several studies demonstrated induction of anesthesia with different plasma target-controlled infusion (TCI) of propofol for LMA insertion. However, there has been no study to compare the standard bolus propofol induction with the effective site TCI for LMA insertion. Objective: Compare the efficacy of induction of anesthesia with propofol for LMA insertion between the effective-site TCI, using 6 μg/mL, and the standard bolus propofol dose of 2.5 mg/kg in elective surgical patients. Methods: A randomized, prospective, single-blinded, clinical study was used for this study. Seventy-eight unpremedicated patients, American Society of Anesthesiologists (ASA) physical status I and II undergoing elective surgical procedure were randomly allocated between two groups. Group 1 received the standard bolus propofol dose of 2.5 mg/kg. Group 2 received effective site TCI (Schnider model) dose of 6 μg/mL for LMA insertion. The hemodynamics and anesthetic depth (Bispectral index score) were monitored and recorded during and immediately after LMA insertion. The number of insertion attempted, insertion quality score, induction time, and propofol doses used were recorded and compared between groups. Results: The success rate of first insertion attempt was equal in both groups (92.3%). There was no significant hemodynamic response difference between the groups during pre-induction, induction, insertion, and post insertion period. The BIS score was significantly lower during post insertion period in group 1 (51.4+11.0) than group 2 (58.4+3.2) (p=0.013). The propofol doses in group 2 were significantly lower than in group 1 (110.6+14.8 vs. 153.5+21.5) (p <0.001). Patients in group 2 required significantly more induction time than group 1 (146.9+42.3 vs. 103.4+33.6 (p <0.001). Conclusion: Propofol induction with TCI provided equal success rate as compared with standard bolus propofol induction for LMA insertion and insertion quality score. TCI significantly lowered the propofol consumption when compared with the standard 2.5 mg/kg propofol dose.

scholarly journals Adaptive functional change of the contralateral kidney after partial nephrectomy

2017 ◽  
Vol 313 (2) ◽  
pp. F192-F198 ◽  
Author(s):  
Se Young Choi ◽  
Sangjun Yoo ◽  
Dalsan You ◽  
In Gab Jeong ◽  
Cheryn Song ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Functional Change ◽  
Functional Changes ◽  
Contralateral Kidney ◽  
Before And After ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Group 1

Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; group 1: <30 ml·min−1·1.73 m−2, group 2: 30–45 ml·min−1·1.73 m−2, and group 3: ≥45 ml·min−1·1.73 m−2). Multiple-regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4-yr postoperative period. Patients in group 1 had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 yr after partial nephrectomy were −18.9, −3.6, and 3.9% in groups 1, 2, and 3, respectively, whereas the contralateral GFR changes were 10.8, 25.7, and 38.8%. Age [β: −0.105, 95% confidence interval (CI): −0.213; −0.011, P < 0.05] and preoperative contralateral GFR (β: −0.256, 95% CI: −0.332; −0.050, P < 0.01) were significant predictive factors for increased GFR of the contralateral kidney after 4 yr. The contralateral kidney compensated for the functional loss of the ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in younger patients with decreased contralateral renal function.

scholarly journals Effects of Preoperative Oral Carbohydrate Loading on Preoperative and Postoperative Comfort in Patients Planned to Undergo Elective Cholecystectomy: A Prospective Randomized Controlled Clinical Trial

2020 ◽  
Keyword(s):  
Controlled Clinical Trial ◽  
Fasting Period ◽  
Rich Solution ◽  
The Mean ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Elective Cholecystectomy ◽  
Group 1 ◽  
Operational Time

Background: Cholecystectomy is a widespread abdominal procedure. A period of 8-hour-fasting for this relatively rapid surgery negatively affects the patients’ comfort. Objectives: The current study aimed to evaluate the effects of the presurgical intake of carbohydrate on patients’ comfort. Materials and Methods: This prospective study was carried out on 42 cholecystectomy patients (with the American Society of Anesthesiologists grade of I-II) divided into two groups. The patients in group 1 underwent laparoscopic cholecystectomy after an 8-hour-fasting period. The subjects in group 2 received a carbohydrate-rich solution with 12.5% dextrose before the surgery (125 g of sugar melted in 1 L of water; 800 and 200 mL 8 and 2 h before the surgery, respectively). Thirst, hunger, and nausea at the 9th preoperative hour and 30 min before the surgery in addition to nausea and vomiting at the 2nd, 8th, and 24th postoperative hours were assessed in both groups. Results: The mean age and body mass index (BMI) values of the patients were 48.38±12.68 years and 29.85±5.20 kg/m², respectively. The mean operational time was 36.5 min (range: 26-114 min). No difference was observed between the two groups in terms of age, BMI, and operational time. The investigation 30 min before cholecystectomy revealed that the rates of hungry and thirsty patients were higher in group 1, compared to those reported for group 2 (P=0.003 and P=0.032). Nevertheless, at the 2nd and 8th postoperative hours, the rate of patients complaining of nausea were higher in group 2 in comparison to that of group 1 (P=0.048 and P=0.014). Conclusions: It is suggested that the intake of carbohydrate-rich fluids up to the preoperative 2nd hour decreased presurgical hunger/thirst. The results of this study are in line with the findings of previous studies. It is believed that the intake of CHO-rich solutions up to 2 h before surgery may provide comfort by decreasing hunger/thirst. Nevertheless, it is necessary to take into account a potential rise in a feeling of nausea among these patients.

Anti-Emetic Efficacy of Tropisetron and Metoclopramide

1996 ◽  
Vol 24 (3) ◽  
pp. 266-270 ◽  
Author(s):  
A Yilmazlar ◽  
T Yilmazlar ◽  
E Gürpinar ◽  
N Korun ◽  
O Kutlay
Keyword(s):  
Rescue Medication ◽  
Surgical Patients ◽  
Saline Control ◽  
Double Blind ◽  
Number Of Patients ◽  
Post Operation ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Group 1

Post-operative vomiting, especially in ambulatory surgical patients, remains a troublesome problem. This placebo-controlled, randomized, prospective double-blind trial was designed to evaluate the efficacy of two prophylactic anti-emetic regimens on post-operative vomiting in 1-day thyroid surgery. Altogether 60 elective surgical patients were followed for 4 h post-operatively. All patients were American Society of Anesthesiologists physical status of I or II and aged between 22 and 60 years: group 1 was saline control; in groups 2 and 3, metoclopramide (0.2 mg/kg) or tropisetron (5 mg) was administered, respectively, as an intravenous single dose during induction. Patients were pre-medicated. A standardized anaesthetic technique consisting of thiopentone-succinylcholine for induction and fentanyl-nitrous oxide-halothane-pancuronium for maintenance of anaesthesia was used. A ‘rescue’ anti-emetic was provided in case of continued vomiting or at the patient's request. Anti-emetic inefficacy was defined as request for rescue anti-emetic and/or vomiting episode during the first 4 h post-operation. The number of patients vomiting was 12/20 (60%), 10/20 (50%) and 1/20 (5%) within the first 2 h post-operation in groups 1, 2 and 3, respectively ( P > 0.05 for groups 1 and 2; P < 0.01 for groups 2 and 3; P < 0.001 for groups 1 and 3). In group 2, three patients required rescue medication during the first 2 h post operation, but no signiñcant difference was observed between groups 2 and 3 ( P > 0.05). None of the cases in any of the groups needed any rescue medication during post-operative 2 – 4 h. It is concluded that tropisetron is a highly effective anti-emetic drug in the prophylaxis of post-operative vomiting.

scholarly journals Effects of Sevoflurane, Isoflurane and Propofol Infusions on Post-Operative Recovery Criteria in Geriatric Patients

2005 ◽  
Vol 33 (1) ◽  
pp. 55-60 ◽  
Author(s):  
C Arar ◽  
G Kaya ◽  
B Karamanlioğlu ◽  
Z Pamukçu ◽  
N Turan
Keyword(s):  
Geriatric Patients ◽  
Postoperative Recovery ◽  
Recovery Times ◽  
Eye Opening ◽  
Group 2 ◽  
American Society ◽  
The Times ◽  
Operative Recovery ◽  
American Society Of Anesthesiologists ◽  
Group 1

We compared the effects of sevoflurane, isoflurane and propofol infusions on postoperative recovery criteria in geriatric patients. Sixty patients aged > 65 years, classified as American Society of Anesthesiologists (ASA) group 1 or 2 and undergoing gynaecological or urological procedures were randomized equally into three groups. Group 1 received 1 minimum alveolar concentration (MAC) sevoflurane in a 50% O2/N2O mixture and group 2 received 1 MAC isoflurane in a 50% O2/N2O mixture. Group 3 received a 50% O2/N2O mixture plus propofol total intravenous anaesthesia (8 mg/kg for the first 30 min, followed by 6 mg/kg for maintenance). Recovery criteria comprising the times to spontaneous eye opening, extubation, response to verbal stimuli and orientation were recorded following the discontinuation of anaesthesia. Recovery times were significantly shorter in groups 1 and 3 compared with group 2. We conclude that sevoflurane and propofol had similar effects on recovery criteria and were associated with a faster recovery than isoflurane.

scholarly journals Is Video Laryngoscopy the Optimal Tool for Successful Intubation in a Neonatal Simulation Setting? A Single-Center Experience

2020 ◽  
Vol 10 (01) ◽  
pp. e5-e10 ◽  
Author(s):  
Iram Musharaf ◽  
Sibasis Daspal ◽  
John Shatzer
Keyword(s):  
Health Care ◽  
Success Rate ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Clinical Training ◽  
Video Laryngoscopy ◽  
Care Providers ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Endotracheal intubation is a skill required for resuscitation. Due to various reasons, intubation opportunities are decreasing for health care providers. Objective To compare the success rate of video laryngoscopy (VL) and direct laryngoscopy (DL) for interprofessional neonatal intubation skills in a simulated setting. Methods This was a prospective nonrandomized simulation crossover trial. Twenty-six participants were divided into three groups based on their frequency of intubation. Group 1 included pediatric residents; group 2 respiratory therapists and transport nurses; and group 3 neonatal nurse practitioners and physicians working in neonatology. We compared intubation success rate, intubation time, and laryngoscope preference. Results Success rates were 100% for both DL and VL in groups 1 and 2, and 88.9% for DL and 100% for VL in group 3. Median intubation times for DL and VL were 22 seconds (interquartile range [IQR] 14.3–22.8 seconds) and 12.5 seconds (IQR 10.3–38.8 seconds) in group 1 (p = 0.779); 17 seconds (IQR 8–21 seconds) and 12 seconds (IQR 9–16.5 seconds) in group 2 (p = 0.476); and 11 seconds (IQR 7.5–15.5 seconds) and 15 seconds (IQR 11.5–36 seconds) in group 3 (p = 0.024). Conclusion We conclude that novice providers tend to perform better with VL, while more experienced providers perform better with DL. In this era of decreased clinical training opportunities, VL may serve as a useful tool to teach residents and other novice health care providers.

Parental Presence during Induction of Anesthesia Improves Compliance of the Child and Reduces Emergence Delirium

2021 ◽  
Author(s):  
Diego Gil Mayo ◽  
Pascual Sanabria Carretero ◽  
Luis Gajate Martin ◽  
Jose Alonso Calderón ◽  
Francisco Hernández Oliveros ◽  
...  
Keyword(s):  
Pediatric Surgery ◽  
Pediatric Anesthesia ◽  
Preoperative Anxiety ◽  
Preoperative Preparation ◽  
Parental Presence ◽  
Emergence Delirium ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Preparation Strategy

Abstract Introduction Preoperative stress and anxiety in pediatric patients are associated with poor compliance during induction of anesthesia and a higher incidence of postoperative maladaptive behaviors. The aim of our study was to determine which preoperative preparation strategy improves compliance of the child during induction and decreases the incidence and intensity of emergence delirium (ED) in children undergoing ambulatory pediatric surgery. Materials and Methods This prospective observational study included 638 pediatric American Society of Anesthesiologists I–II patients who underwent ambulatory pediatric surgery, grouped into four preoperative preparation groups: NADA (not premedicated), MDZ (premedicated with midazolam), PPIA (parental presence during induction of anesthesia), and PPIA + MDZ. The results were subsequently analyzed in four age subgroups: Group 1 (0–12 months), Group 2 (13–60 months), Group 3 (61–96 months), and Group 4 (> 96 months). Preoperative anxiety (modified Yale Preoperative Anxiety Scale [m-YPAS]), compliance of the child during induction (Induction Compliance Checklist [ICC]), and ED (Pediatric Anesthesia Emergence Delirium scale) were analyzed in each group. Results Eighty-one percent of patients in the PPIA + MDZ preparation group presented a perfect compliance during the induction of anesthesia (ICC = 0), less preoperative anxiety (mean score m-YPAS = 26), less probability of ED (odds ratio: 10, 5 [3–37.5]; p < 0.05), and less ED intensity compared with the NADA group (1.2 vs. 5.8; p = 0.001). Conclusion PPIA associated with midazolam premedication improves compliance during induction and decreases the incidence and intensity of ED.

THE DIFFERENT TIMING OF ORAL CLONIDINE PREMEDICATION EFFECT ON SEDATION SCORE IN SPINE SURGERY

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Satish Kumar ◽  
Sanjay Kumar
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Ethics Committee ◽  
Sedation Score ◽  
Oral Clonidine ◽  
Adequate Sedation ◽  
Group 2 ◽  
American Society ◽  
Oral Premedication ◽  
Group 1

Background: Premedication is the administration of medication before anaesthesia. It is used to prepare the patient for anaesthesia and to provideoptimal conditions for surgery. Methods: The study of oral premedication dose of clonidine in spinal surgery at different time was conducted on sixty ASA grade-1 patients of eithersex between 20 to 60 years of age undergoing elective spine surgery. This study was performed after approval from ethics committee of the institute.Informed consent was obtained from each patient. Results: Sedation score was recorded preoperatively in both the groups when the patient were shifted to the operation theater according to score givenby American Society of Anaesthesia. In group-1, 25 patients (83.3%) had sedation score of 0 and 5 patients (16.7%) had score of 1. Similarly in group-2, 29 patients (96.7) had a sedation score 0 and only 1 patient (3.3%) had sedation score1. Conclusion: In conclusion this study establishes that the premedication with tab. clonidine 200µg (As tab. clonidine is available in 100µg) 90 minutebefore the surgery or 3.5 hour before the surgery produced adequate sedation Keywords: Clonidine, Sedation, Spine

Decreased Rejection and Improved Survival of First and Second Marrow Transplants for Severe Aplastic Anemia (A 26-Year Retrospective Analysis)

Blood ◽  
1998 ◽  
Vol 92 (8) ◽  
pp. 2742-2749 ◽  
Author(s):  
Anne Stucki ◽  
Wendy Leisenring ◽  
Brenda M. Sandmaier ◽  
Jean Sanders ◽  
Claudio Anasetti ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Graft Rejection ◽  
Marrow Transplant ◽  
Severe Aplastic Anemia ◽  
Probability Of Survival ◽  
Gvhd Prophylaxis ◽  
Group 3 ◽  
Group 2 ◽  
American Society ◽  
Group 1

Abstract Between 1970 and 1996, 333 patients with severe aplastic anemia underwent HLA-matched related marrow transplant after conditioning with cyclophosphamide (CY). Thirty-five percent of patients transplanted between 1970 and 1976 (group 1), 12% of those transplanted between 1977 and 1981 (group 2), and 9% of patients transplanted between 1982 and 1997 (group 3) had graft rejection. Graft rejection occurred later among group 3 patients (median, 180 days) than among those in groups 1 and 2 (medians, 28 and 47 days, respectively; P &lt; .001 group 3 v 2). In group 3, 92% of rejecting patients underwent a second transplant, compared with 78% and 77% in groups 1 and 2, respectively. Group 1 patients received various conditioning regimens before second transplant, whereas most patients of groups 2 and 3 received CY combined with antithymocyte globulin (ATG). Graft-versus-host disease (GVHD) prophylaxis after second transplant consisted of methotrexate (MTX) for all group 1 and 2 patients, whereas group 3 patients received MTX combined with cyclosporine (CSP). Over the three time periods studied, first graft rejection decreased from 35% to 9%, and the proportion of rejecting patients undergoing second transplants increased from 77% to 92%. The 10-year probability of survival after second transplants increased from 5% to 83%. Multivariate analysis showed MTX/CSP GVHD prophylaxis to be a significant factor accounting for the increase in patient survival after second transplant. © 1998 by The American Society of Hematology.

Clinical outcomes of Ahmed glaucoma valve implantation in pediatric glaucoma

2018 ◽  
Vol 29 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Mohammad Pakravan ◽  
Hamed Esfandiari ◽  
Shahin Yazdani ◽  
Azadeh Doozandeh ◽  
Zahra Dastborhan ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Congenital Glaucoma ◽  
Ahmed Glaucoma Valve ◽  
Aphakic Glaucoma ◽  
Group 2 ◽  
Valve Implantation ◽  
Ahmed Glaucoma Valve Implantation ◽  
Group 1

Purpose: To evaluate the outcomes of Ahmed glaucoma valve implantation in refractory primary congenital glaucoma as well as primary procedure in aphakic glaucoma. Method: In this retrospective study, medical records of patients who underwent Ahmed glaucoma valve implantation for refractory glaucoma and aphakic glaucoma were reviewed. Primary outcome measures were the surgical success defined as intraocular pressure ≤21 mm Hg and decreased ≥20% and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity, and intraocular pressure. Results: A total of 62 eyes of refractory primary congenital glaucoma patients (group 1) and 33 eyes of aphakic glaucoma patients (group 2) were included in our study. Mean follow-up was 51 ± 33 months in group 1 and 49 ± 41 months in group 2 (p = 0.82). The cumulative probability of success was 90% in both groups at the first year; however, the success rate was 52.5% in group 1 and 71.5% in group 2 at 5 years’ follow-up visit. In group 1, the mean intraocular pressure ± standard deviation was 33.1 ± 8.6 mm Hg at the baseline and decreased to 17.1 ± 5.3 mm Hg at 1 year and 18.5 ± 6.4 at 3 years postoperatively (all p’s < 0.001). Corresponding values for group 2 were 28.9 ± 6.1, 15.2 ± 4.6, and 16.0 ± 5.9 mm Hg, respectively (all p’s < 0.001). The baseline number of glaucoma medications was 3 ± 0.7 that decreased to 2 ± 0.8 at final follow-up (p = 0.02). Conclusion: Ahmed glaucoma valve implantation has a moderate success rate in the management of refractory primary congenital glaucoma with an increased chance of tube-related complications. The surgical success rate is higher in case of primary Ahmed glaucoma valve implant for aphakic glaucoma with acceptable safety profile.

scholarly journals Outcomes of external dacryocystorhinostomy and endoscopic endonasal dacryocystorhinostomy in the management of nasolacrimal duct obstruction

2015 ◽  
Vol 7 (1) ◽  
pp. 39-46 ◽  
Author(s):  
S Duwal ◽  
R Saiju
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Dence Interval ◽  
External Dacryocystorhinostomy ◽  
Group 2 ◽  
External Dcr ◽  
Group 1

Introduction: Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction. Although external DCR is regarded as the gold standard, endoscopic DCR is evolving as an equally-effective alternative. Objectives To compare the success rate of treating nasolacrimal duct obstruction by endoscopic endonasal method compared to the conventional DCR surgery.Materials and methods This prospective, comparative, non-randomised study was conducted in 2009 - 2010. Thirty consecutive patients undergoing endoscopic endonasal DCR (Group 1) and 30 consecutive patients undergoing external DCR (Group 2) between July 2009 and September 2010 at the oculoplasty unit of the Tilganga institute of ophthalmology were included in this study. A patent lacrimal passage on syringing and symptomatic improvement at six months after surgery was de¿ned as a successful outcome. The intraoperative and postoperative complications were also compared. Results Our study included 31 eyes of 30 patients in Group 1 and 34 eyes of 30 patients in Group 2. The success rate for endoscopic endonasal dacryocystorhinostomy was 90.3 % (95 % con¿dence interval 80 - 100) and external dacryocystorhinostomy was 94.1 % (95 % con¿dence interval 80 - 100). The difference of surgical success among the two methods was not statistically significant (p = 0.7). The rate of intra-operative and post-operative complications was similar in the two methods (p = 0.5). Conclusion: The short term outcomes and complication rates of endoscopic endonasal dacryocystorhinostomy and external dacryocystorhinostomy were similar.

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