scholarly journals A comparative study of propofol based total intravenous anesthesia and sevoflurane based volatile induction and maintenance anesthesia on post-operative recovery profile in elective tonsillectomy

2021 ◽  
Vol 12 (12) ◽  
pp. 147-154
Author(s):  
Sarfaraz Ahmed ◽  
Athar Siddique ◽  
Kalyani Malshetwar ◽  
Nitesh Nagbhire ◽  
S. D. Yennawar
Keyword(s):  
Day Surgery ◽  
Pediatric Age Group ◽  
Recovery Profile ◽  
Extubation Time ◽  
Significant Difference ◽  
Eye Opening ◽  
Operative Recovery ◽  
Post Operative Nausea ◽  
Volatile Induction ◽  
Rapid Emergence

Background: Tonsillectomies are common surgeries in day-to-day surgery practice particularly in pediatric age group. Recent trend is to conduct tonsillectomy surgery on a day care basis. It is important to use the best anesthetic option with the least recovery time to reduce the hospital stay of patient. Aims and Objectives: The aim of the study was to compare recovery profile and side effects of Sevoflurane and Propofol as an anesthetic agent for tonsillectomy. Materials and Methods: A total of 60 patients undergoing elective tonsillectomy were selected for the study. Each patient was randomly allocated to either the propofol (Group P) or the sevoflurane group (Group S). Time of surgery (From start to end of surgery), time of anesthesia (From the start of induction to end of surgery), time between the end of anesthesia and the spontaneous eye opening, and time between the end of anesthesia and the following of verbal commands. Time to extubation, time between the end of anesthesia, and the orientation to his or her name and the incidence of post-operative nausea and vomiting were compared in both the groups. Results: The eye opening in Group P patients was found to be 8.9+1.21 min and that in Group S was 6.6+1.25 which was found to be statistically significant. The following of verbal commands in Group P was found to occur at 10.13+1.28 min, while that in Group S was found to be at 7.63+1.25 min, which was statistically significant. The time for extubation in Group P was found to be 11.17+1.29 min, while that in Group S was found to be 8.67+1.24 min, which was statistically significant. The duration for complete orientation in Group P was found to be 12.2+1.27 min, while that in Group S was found to be 9.43+1.04 min, which came out to be statistically significant. Hemodynamic parameters were found to be comparable in both the groups with no statistically significant difference in between then at any point of time (P>0.05). Conclusion: Sevoflurane is a useful alternative to propofol in providing anesthesia where rapid emergence and recovery of cognitive functions are desired.

scholarly journals DEXMEDETOMIDINE REDUCES AGITATION AND PROVIDES SMOOTH EXTUBATION AFTER PAEDIATRIC ADENOTONSILLECTOMY

2020 ◽  
pp. 1-5
Author(s):  
Mehak Gul ◽  
Umar Nisar Shah ◽  
Mohd Rafi Denthoo ◽  
Basharat Ahad
Keyword(s):  
Pain Score ◽  
Normal Saline ◽  
Pediatric Patients ◽  
Tracheal Extubation ◽  
Sevoflurane Anesthesia ◽  
Emergence Agitation ◽  
Rescue Analgesia ◽  
Extubation Time ◽  
Operative Recovery ◽  
Post Operative Nausea

OBJECTIVES : To study the role of dexmedetomidine on emergence agitation and its effect on extubation in paediatric adenotonsillectomy. Our study involves the assessment of postoperative pain by Objective Pain Scale and need for rescue analgesia and other untoward events in PACU. The study also included the comparision of post operative recovery time by Modified Aldrete Recovery Score using dexmedetomidine and normal saline in adenotonsillectomy for pediatric patients. METHODS : After induction of general anesthesia patient was put on controlled ventilation and maintained on sevoflurane 1.5-2% with 66% O2 and 33% N2O. At the end of surgery patients received either dexmedetomidine or normal saline over a period of 5 minutes, sevoflurane and nitrous oxide were discontinued, and residual muscle relaxation was reversed. Tracheal extubation time (time from anesthetic gas discontinue to tracheal extubation) and emergence time (time from anesthetic gas discontinue to eye opening on command) were recorded. Incidence of untoward airway events after extubation were also noted. The subject’s postoperative behaviour was assessed using Pediatric Anesthesia Emergence Delirium (PAED). In PACU, the intensity of pain was assessed by using an observational pain score (OPS). Any untoward events were noted and patient was shifted as per modified PACU score. RESULTS: In this randomized comparative study, single dose of dexmedetomidine (0.5mcg/kg) was found to be associated with a statistically significant decrease in the incidence of emergence agitation along with smooth extubation in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia. In addition, lower incidence of post-operative nausea and vomiting, lower pain score and shorter duration of stay in post-anesthesia care unit were observed. Although it was seen that the extubation was prolonged in the dexmedetomidine group in comparison to the placebo. CONCLUSION: Dexmedetomidine reduces emergence agitation and provides smooth extubation in pediatric adenotonsillectomy patients on sevoflurane anesthesia.

scholarly journals Comparison Between Sevoflurane and Propofol With Remifentanil Anesthesia Avoid Neuromuscular Blocking Agent After Intubation in Thyroid Operation

2021 ◽  
Author(s):  
Chunyao Yang ◽  
Jing Sun ◽  
Xihua Lu ◽  
Chen Yang
Keyword(s):  
Sore Throat ◽  
Recovery Period ◽  
Blocking Agent ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agent ◽  
Nausea And Vomiting ◽  
Thyroid Operation ◽  
Recovery Profile ◽  
Extubation Time ◽  
Significant Difference

Abstract Background: The goal of the study is to compare sevoflurane and propofol with remifentanil anesthesia avoid neuromuscular blocking agent after intubation in thyroid operation with intra-operative neuromonitoring.Methods: 80 patients scheduled to receive thyroid operation were randomly assigned to sevofluraneor propofol anesthesia maintained group. The time of rocuronium recovery profile were monitored. Adverse events such as sinus bradycardia, tachycardia, hypertension, hypotension and movement were recorded. Analyze the time from anesthetic stop to the extubation time and operation time. Record the incidence rate of sore throat, drowsiness, agitation, nausea and vomiting after extubation. Record the first neuromonitoring time and the number of successful neuromonitoring.Results: There were significant differences in the recovery profile of rocuronium between sevoflurane and propofol group(P<0.05). The incidence of hypotension was similar between sevoflurane and propofol group. There was no significant difference of sinus braducardia between the two groups. The incidence of movement was less in sevoflurane compared to propofol(12.% vs. 47.5%, P=0.002). The propofol group had longer extubation time than sevoflurane group(13.10±1.52 vs. 8.07±1.07 min, P=0.001).The incidence of sore throat, drowsiness, agitation, nausea and vomiting in the two groups was similar during the recovery period, and the difference was not statistically significant. There was no significant difference of neuromonitoring between the two groups.Conclusion: Sevoflurane has advantage with less movement adverse effects in thyroid surgery with intra-operative neuromonitoring compared to propofol when associated with remifentanil 0.1μg/kg/min in general anesthesia.Trial registration: Chinese Clinical Trial Registry (ChiCTR1800017166, 15 July 2018)

scholarly journals Application of Dexmedetomidine combined with Propofol Intravenous Anesthesia in Laparoscopic Day Surgery in Pediatric Urology

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Xiao-dan Wang ◽  
Bin Yang ◽  
Lin-lin Fan ◽  
Na Guo ◽  
Hao-bin Song
Keyword(s):  
Inflammatory Cytokines ◽  
Analgesic Effect ◽  
Day Surgery ◽  
Pediatric Urology ◽  
Control Group ◽  
Drug Reactions ◽  
Intravenous Anesthesia ◽  
Extubation Time ◽  
Significant Difference ◽  
Experimental Group

Objectives: To evaluate the sedative and analgesic effects of dexmedetomidine combined with propofol intravenous anesthesia in laparoscopic day surgery in pediatric urology. Methods: Eighty male children with cryptorchidism and hydrocele who underwent laparoscopic daytime surgery in our hospital from January 2019 to January 2021 were selected and randomly divided into two groups: the experimental group and the control group. Children in the experimental group ranged in age from 5.7 to 11.3, with an average of 8.52±2.17 years old, while those in the control group ranged in age from 5.3 to 12.0, with an average of 8.60±2.07 years old. There were 12 cases of cryptorchidism and 28 cases of hydrocele in the experimental group, and 14 cases of cryptorchidism and 26 cases of hydrocele in the control group. Children in the control group received conventional propofol intravenous combined anesthesia, while those in the experimental group were given dexmedetomidine (2-5 ug/kg) intranasally on the basis of conventional propofol intravenous anesthesia. The anesthetic effect, analgesic effect, serum levels of inflammatory cytokines before and after surgery and adverse drug reactions in the two groups were compared and analyzed. Results: The awakening time, extubation time and retention time in the resuscitation room of the experimental group were shorter than those of the control group, with a statistically significant difference (P<0.05); The VAS pain scores of the experimental group were significantly lower than those of the control group at 15minutes, 12hour and 24hour after awakening, with a statistically significant difference (P<0.05). In addition, the levels of TNF-a, CRP, IL-6 and other inflammatory factors in the control group were significantly higher compared with those in the experimental group 24h after surgery, with a statistical significance (TNF-a, P=0.02; CRP, P=0.00; IL-6, P=0.03); The incidence of adverse drug reactions in the experimental group was 17.5%, while that in the control group was 12.5%, which was not statistically significant (P=0.53). Conclusion: Dexmedetomidine combined with intravenous propofol anesthesia may be helpful to shorten the extubation time, the recovery time and the stay time in the anesthesia resuscative room, improve the analgesic effect, and may reduce the inflammatory response and the expression of serum inflammatory cytokines, with no significant increase in side effects. doi: https://doi.org/10.12669/pjms.38.1.4378 How to cite this:Wang X, Yang B, Fan L, Guo N, Song H. Application of Dexmedetomidine combined with Propofol Intravenous Anesthesia in Laparoscopic Day Surgery in Pediatric Urology. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.4378 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A Study of The Effect of Aminophylline on Clinical Recovery and Bis Readings After Total Intravenous Anesthesia

2021 ◽  
pp. 6012-6016
Author(s):  
Ghison I. Kadhim
Keyword(s):  
Recovery Time ◽  
Total Intravenous Anesthesia ◽  
Orthopedic Procedures ◽  
P Value ◽  
Skin Closure ◽  
Intravenous Anesthesia ◽  
Extubation Time ◽  
Significant Difference ◽  
Group A ◽  
Eye Opening

Background: In anesthesia and intensive care we face a lot of respiratory problems that require the use of bronchodilators such as aminophylline which is accused of antagonizing of the action of adenosine which acts as neuromodulator in the CNS. Objective: To test the hypothesis that aminophylline increases BIS readings and decreases recovery time after total intravenous anesthesia. Methods: We tested the hypothesis on 50 patients who were to be operated upon for orthopedic procedures. We induced anesthesia using bollous dose of propofol 2.5 mg/kg and bollous remifentanil 1.5 mcg/kg and didn't use any muscle relaxant. Anesthesia was maintained using propofol and remifentanil infusion in the rate of 100 mcg/kg/min and 0.2 mcg/kg/min respectively with 100% O2 with BIS readings in the range of 40 – 60. After skin closure, patients were divided into group A (given aminophylline 4 mg/kg), and group P (given same volume of normal saline). Vital signs and BIS values were recorded. Time to eye opening and extubation time and time to reach BIS value of 95 were measured. Results: Significant difference was found in BIS readings (p value < 0.001). Time to eye opening and extubation times were significantly shorter in group A than group P (p value < 0.001). Conclusion: Aminophylline decreases recovery time and increases BIS readings after TIVA.

scholarly journals Implications of anesthetic techniques on patients' recovery in laparoscopic cholecystectomy

2009 ◽  
Vol 66 (6) ◽  
pp. 421-426 ◽  
Author(s):  
Biljana Stosic ◽  
Miroslav Stojanovic ◽  
Radmilo Jankovic ◽  
Milan Radojkovic ◽  
Nebojsa Ignjatovic
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Time Duration ◽  
Significant Difference ◽  
Orientation Time ◽  
Eye Opening ◽  
The Times ◽  
Volatile Induction

Background/Aim. Different techniques of general anesthesia are used for laparoscopic cholecystectomy (LC). The aim of the study was to establish the best anesthetic technique for achieving better results during awakening affecting not only patient's recovery, but activities of anesthesiological team, as well. Methods. The study was conducted as a prospective comparative clinical trial. The patients (n=90) were classified according to the applied anesthetic technique into two groups: Volatile Induction and Maintenance Anesthesia (VIMA) with sevofluran and Target Controlled Infusion (TCI). The results relating to parameters of recovery after anesthesia and surgery were compared between these two groups. The following parameters were analyzed: demographic patients' characteristics, duration of anesthesia, the times to eye opening, to respond to a command, to extubation, and to orientation, from the last anesthetic dose receiving until post anesthesia discharge (PAD), frequency of postoperative nausea, vomiting and agitation (PONVA). Results. In the examined groups there were no statistically significant differences in the duration of anesthesia (68.29 ? 6.47 vs 66.29 ? 11.97 min, p = 0.327). The time to eye opening was significantly shorter in the group VIMA compared to the group TCI (4.49 ? 1.20 vs 7.42 ? 1.25 min, p = 0.000), as well as the time to respond to a command (5.93 ? 1.12 vs 8.47 ? 1.08 min, p = 0.000). The patients anesthetized with VIMA technique were statistically significantly extubated earlier (6.84 ? 1.19 vs 9.69 ? 1.31 min, p = 0.000). Considering orientation time, there was also statistically significant difference between the two groups (7.51 ? 0.97 vs 11.60 ? 1.75 min, p = 0.000). There was no statistically significant difference in PAD time duration (19.42 ? 5.99 vs 20.80 ? 1.59 min, p = 0.142). There were no statistically significant differences in PONVA events between the examined groups. Conclusion. This study showed that VIMA technique with sevofluran in LC provides faster and more qualitative recovery of patients. Thus this technique should be applied in everyday anesthesiological procedures in LC, as well as in other minimally invasive videoendoscopic surgical procedures.

scholarly journals Post-operative Recovery of Morbidly Obese Patients under General Anaesthesia Using Desflurane versus Sevoflurane

2020 ◽  
Vol 14 (2) ◽  
pp. 116-119
Author(s):  
Md Mahbub Ul Alam ◽  
Abhay Patwary ◽  
Most Sarmin Sultana ◽  
Md Nurunnabi ◽  
Md Abdul Wahab
Keyword(s):  
General Anaesthesia ◽  
Armed Forces ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Verbal Command ◽  
Extubation Time ◽  
Group A ◽  
Eye Opening ◽  
Group B ◽  
Operative Recovery

Introduction: Laparoscopic sleeve gastrectomy (LSG) is commonly performed under general anaesthesia. LSG operation has become one of the most effective treatments of morbidly obese patients. There are several modalities of inducing and maintenance of general anaesthesia (GA). Objectives: To compare the post-operativerecovery of morbidly obese patient using desflurane versus sevoflurane with remifentanyl infusion as maintenance of anaesthesia. Materials and Methods: This prospective randomized singlecentre analytic study was carried out in Jaber Al Ahmed Armed Forces Hospital, Kuwait from July 2015 to July 2017. Total 60 morbidly obese patients(BMI>40kg/m2) undergoing LSG under GA were randomly selected into two equal groups(Group-A and Group-B).Group-A received desflurane, Group-B received sevoflurane and both groups receivedremifentanyl infusion as maintenance of GA. To maintain hemodynamic stability and bispectral index score in the range of 40-60, using volatile anaesthetic either desflurane 2-6% or sevoflurane 1-2% with airand oxygen 50: 50 during maintenance. Early recovery criteria were response to painful stimuli,obeying verbal command, spontaneous eye-opening, extubation time, handgrip, and orientation assessed by answering name and location. Intermediate recovery was assessed by modified Aldrete’sscore at PACU. Results: No significant differences in perioperative heart rate, systolic blood pressure, and diastolic blood pressurewas found between two groups. Group-A patients had significantly faster eye-opening (9.7±4.3 vs 18.5±6.6),voluntary head rising on command (3.46±2.1 vs 7.38±4.52) shorter extubation time(12.2±8.1 vs 24.2±12), and orientation in time(16.2±8.2 vs 31.2±12.9)as compared to Group-B. Conclusion: Volatile anaestheticdesflurane provided better post-operative recovery than sevoflurane in morbidly obese patients undergoing LSG with GA. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 116-119

scholarly journals Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit

2018 ◽  
Vol 7 (4) ◽  
pp. 197-203 ◽  
Author(s):  
Roghieh Nazari ◽  
Saeed Pahlevan Sharif ◽  
Kelly A Allen ◽  
Hamid Sharif Nia ◽  
Bit-Lian Yee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Injury Severity ◽  
Repeated Measure ◽  
Neck Stiffness ◽  
Significant Difference ◽  
Eye Opening ◽  
Different Levels

Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients’ inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning.

scholarly journals Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Ahmed Salman ◽  
Norma Osama Zayed ◽  
Ahmed Mansour ◽  
Ramy Howaidi ◽  
Ahmed Gamaleldin Foly ◽  
...  
Keyword(s):  
Short Form ◽  
Cardiovascular Responses ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Randomized Controlled ◽  
Arterial Blood ◽  
Extubation Time ◽  
Significant Difference

Background: Both tracheal intubation and extubation are associated with dangerous consequences such as tachycardia, hypertension, myocardial ischemia and arrhythmias. The aim was to evaluate pre–extubation two different doses of fentanyl on hemodynamic stabilization and delayed recovery in mastectomy. Methodology: The randomized controlled double–blind study was conducted on 126 patients aged 16–60 years, with controlled hypertension, receiving chemotherapy before surgery and underwent mastectomy for breast cancer. Patients were randomly allocated into 3 equal groups. Before extubation, patients received 10 ml saline in group (C), 1 µg/kg fentanyl in Group–F1: and 2 µg/kg fentanyl in Group–F2. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at T1 (after maintenance of anesthesia), T2 (after giving the test drug), T3 (immediately after extubation), T4 (5 min. after extubation) and T5 (15 min after extubation). Results: MAP was significantly lower in fentanyl groups compared to Group–C at T2 and T3 without significant deference between fentanyl groups. HR was significantly lower in fentanyl groups compared to Group–C and in Group–F2 compared to Group–F1 at T3, T4 and T5. Time of extubation was significantly prolonged in Group–F2 compared to Group–F1 and Group–C without a significant difference between Group–F1 and Group–C. Conclusions: Pre–extubation fentanyl 1 µg/kg blunted cardiovascular responses to extubation without respiratory depression or prolonged recovery. Pre–extubation fentanyl 2 µg/kg provide more control in HR but with delay in the extubation time compared to 1 µg/kg of fentanyl. Key words: Pre–Extubation, Fentanyl, Mastectomy, Hemodynamics, Recovery Preregistration: The study was registered in the Ethical Committee of Faculty of Medicine, Cairo University, Cairo, Egypt (approval number: 281) Citation: Salman A, Zayed NO, Mansour A, Howaidi R, Foly AG, ElSharkawy MS, Abdelgalil AS. Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study. Anaesth. pain intensive care 2021;25(2):143-149. DOI: 10.35975/apic.v25i2.1462. Abbreviations: CST=Craniosacral therapy; SMT=Sensorimotor training; NCLBP=Nonspecific chronic low back pain; VAS=Visual analogue scale; ODI=Oswestry disability index, BDI-II=Beck depression inventory-II, and SF-36=Short Form-36; CSF=cerebral spinal fluid; CSS=craniosacral system; PRM=primary respiratory movements Received: 27 June 2020, Reviewed: 24 July 2020, Accepted: 27 July 2020

scholarly journals A profile and treatment outcome of seasonal hyper-acute panuveitis

1970 ◽  
Vol 2 (1) ◽  
pp. 35-38 ◽  
Author(s):  
E Shrestha
Keyword(s):  
Visual Acuity ◽  
Medical Treatment ◽  
Visual Outcome ◽  
P Value ◽  
Fisher Exact Test ◽  
Mean Values ◽  
Exact Test ◽  
Pediatric Age Group ◽  
Significant Difference ◽  
The Mean

Introduction: Seasonal hyper-acute panuveitis (SHAPU) is a sight-threatening disease and its management is challenging. Objective: To study the profile and evaluate the visual outcome of the patients of clinicallydiagnosed cases of SHAPU after treatment. Subjects and methods: A retrospective interventional hospital-based study was carried out involving 21 subjects with clinically-diagnosed SHAPU. The data were retrieved from the record section of the hospital and analyzed. The variables studied were demographic pattern, clinical condition, duration of presentation and visual acuity before and after the treatment. Statistics: The data were analyzed using Epi Info version 2000. Percentage prevalence, mean values with standard deviation, relative risk, 95% CI and p value were calculated. P value of < 0.05 was considered to be significant. Results: Among the 21 cases, the numbers of male and female were 11 (52.4 %) and 10 (46.7 %) respectively. A comparative analysis of gender in children and adults did not show any significant difference (RR=0.47, 95% CI = 0.22 - 1.01, Fisher exact test: p = 0.14). The mean for all ages was 7 ± 12.68 years, while the mean age in pediatric cases was 4.5 ± 3.91 years. Thirteen (61.9%) cases occurred in children below fifteen years. Fifteen (71.4 %) cases reported during September and October. Presenting visual acuity of all cases was less than 3/60. All of them received medical treatment. By the end of the 4th week, seven (33.3 %) patients regained vision to 6/18. Conclusion: SHAPU is more prevalent in pediatric age group. It is equally prevalent among males and females. The visual acuity can improve with early medical treatment. Keywords: SHAPU; panuveitis; steroid; phthisis bulbi DOI: 10.3126/nepjoph.v2i1.3702 Nep J Oph 2010;2(1) 35-38

Sign in / Sign up

Export Citation Format

Share Document