scholarly journals Changes in Angular Deviations under General Anesthesia for Strabismus Surgery with Objective Anesthetic Depth Control

2018 ◽  
Vol 59 (9) ◽  
pp. 848
Author(s):  
Chang Zoo Kim ◽  
Ki Yup Nam ◽  
Seung Uk Lee ◽  
Sang Joon Lee
Keyword(s):  
General Anesthesia ◽  
Strabismus Surgery ◽  
Anesthetic Depth ◽  
Depth Control

Comparing General Anesthesia with Preemptive IV Atropine vs General Anesthesia with Single Injection Peribulbar Block with Levobupivacaine 0.5% or Lidocaine 2% for Prevention of Oculocardiac Reflex in Children Undergoing Strabismus Surgery: Randomized Control Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hani Ali Ezzat ◽  
Galal Adel ElKady ◽  
Melad Ragaey Zekry ◽  
Dalia Ahmed Ibrahim ◽  
Abeer Sameer Salem
Keyword(s):  
General Anesthesia ◽  
General Anaesthesia ◽  
Pain Control ◽  
Strabismus Surgery ◽  
Minor Role ◽  
Oculocardiac Reflex ◽  
Post Operative Pain ◽  
Peribulbar Block ◽  
Successful Group ◽  
Clinically Significant

Abstract Background Strabismus is one of the common health problems among the children. The incidence of the oculocardiac reflex decreases with age and tends to be more pronounced in young, healthy patients, which is clinically significant for pediatric as it is observed with greatest incidence in young healthy neonates and infants undergoing strabismus surgery. Objective to prevent and attenuate the oculocardiac reflex in children age group from (2yrs to 14 yrs) undergoing surgical correction for strabismus. Patients and Methods Three groups were allocated Group C received general anaesthesia combined with pre emptive atropine, Group L received general anaesthesia combined with Peribulbar block with Lidocaine 2 % and Group LB which received general anaesthesia combined with peribulbar block with Levobupivacaine 0.5%. Results In Our study we found that group L which received peribulbar lidocaine 2 % was the most successful group regarding blocking the occurrence of the OCR and with acceptable post operative pain control results. Conclusion In Our study the use of peribulbar block with lidocaine 2 % in combinations with General anaesthesia is very effective against the incidence of OCR in children undergoing strabismus surgery and superior to the Iv pre emptive Atropine with higher surgeon satisfaction while the use of peribulbar levobupivacaine 0.5% combined with general anaesthesia has a great role in post operative pain control with superior patient satisfaction, on the other hand the atropine is a very important emergency drug but our study found that it has a very minor role in both preventing the OCR and post operative pain control in addition to subjecting the patients to the tachycardia and other complications like dryness of the mouth and blushing so its not recommended by our study.

scholarly journals The Effect of Subtenons Lidocaine on Emergence Agitation after General Anesthesia in Pediatric Strabismus Surgery

2016 ◽  
Vol 12 (6) ◽  
pp. 48
Author(s):  
Agolli. L ◽  
Shuteriqi. B
Keyword(s):  
General Anesthesia ◽  
Normal Saline ◽  
Recovery Room ◽  
Eye Contact ◽  
Saline Group ◽  
Strabismus Surgery ◽  
Emergence Agitation ◽  
Surrounding Environment ◽  
Lidocaine Injection ◽  
In The Beginning

Objectives: To study the effect of subtenon lidocaine injection at the end of intervention on the post-operative emergence agitation in pediatric strabismus surgery under general anesthesia with sevofluran. Material: We studied 191 children patients undergoing muscle surgery for strabismus from 2-6 years old. Children were (prospectively) randomized to one of the four groups. These groups include: A –Group Sevofluran fentanyl; B –Group sevoflurane fentanyl, Subtenon lidocaine injection; C – Group Propofol, fentanyl, sevofluran; and D – Group Propofol, fentanyl, Sevoflurane, Subtenon lidocaine injection. In the beginning of the induction of anesthesia, children received dexametasone and metoclopropamide. At the end of the surgery, children received either lidocaine (2%) or normal saline (1ml) into the subtenons space. This was conducted on the recovery room using five scoring scale. These scale include: 1- the child makes eye contact, 2- Purposeful response after repeated stimuli, 3 – the child is aware of the surrounding environment, 4- severe restlessness, and 5 – The child is inconsolable. The degree of emergence agitation was observed. Furthermore, the score 4 and 5 was considered as an emergence agitation. Results: There are no differences regarding age and weight. The incidence of emergence agitation was significantly lower in the groups which were receiving subtenon lidocaine compared with saline group injections (p< 0.05). Conclusions: A lidocaine injection into subtenon space reduces the emergence agitation after general anesthesia in pediatric strabismus surgery.

scholarly journals Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiang-hua Shen ◽  
Min Ye ◽  
Qian Chen ◽  
Yan Chen ◽  
Hai-lin Zhao ◽  
...  
Keyword(s):  
Circadian Rhythms ◽  
General Anesthesia ◽  
Closed Loop ◽  
Depth Of Anesthesia ◽  
Drug Infusion ◽  
Anesthetic Depth ◽  
Time Points ◽  
Target Controlled Infusion ◽  
Medical University ◽  
Narcotrend Index

Abstract Background The effects of circadian rhythms on drug metabolism and efficacy are being increasingly recognized. However, the extent to which they affect general anesthesia remains unclear. This study aims to investigate the effects of circadian rhythms on anesthetic depth and the concentrations of propofol target-controlled infusion (TCI). Methods Sixty patients undergoing laparoscopic surgeries were sequentially assigned to four groups. Group ND (n = 15): Propofol TCI with Narcotrend monitor during the day (8:00–18:00), Group NN (n = 15): Propofol TCI with Narcotrend monitor during the night (22:00–5:00), Group CLTD (n = 15): Propofol closed-loop TCI guided by bispectral index (BIS) during the day (8:00–18:00), Group CLTN (n = 15): Propofol closed-loop TCI guided by BIS during the night (22:00–5:00). The Narcotrend index, mean arterial pressure (MAP) and heart rate (HR) were compared between group ND and NN at 7 time points, from 5 min before induction to the end of operation. The propofol TCI concentrations, MAP and HR were compared between group CLTD and CLTN at 7 time points, from 5 min after induction to the end of operation. Results The Narcotrend index, MAP, and HR in group NN were lower than those in group ND from the beginning of mechanical ventilation to the end of operation (p < 0.05). The propofol TCI concentrations in group CLTN were lower than those in group CLTD from the beginning of operation to the end of operation (p < 0.05). Conclusion Circadian rhythms have a significant effect on the depth of anesthesia and drug infusion concentrations during propofol TCI. When using general anesthesia during night surgery, the propofol infusion concentration should be appropriately reduced compared to surgery during the day. Trial registration The present study was registered on the ClinicalTrials.gov website (NCT02440269) and approved by the Medical Ethics Committee of Southwest Hospital of Third Military Medical University (ethics lot number: 2016 Research No. 93). All patients provided informed written consent to participate in the study.

scholarly journals Risk Factors Associated with Postoperative Discomfort After Ambulatory Strabismus Surgery Under General Anesthesia

2020 ◽  
Vol Volume 13 ◽  
pp. 947-953
Author(s):  
Jingxia Huang ◽  
Jing Lin ◽  
Yun Xiong ◽  
Zhonghao Wang ◽  
Yanling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Strabismus Surgery ◽  
Factors Associated ◽  
Postoperative Discomfort

Inspired Oxygen Fraction of 0.8 Does Not Attenuate Postoperative Nausea and Vomiting after Strabismus Surgery

2005 ◽  
Vol 103 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Tanja A. Treschan ◽  
Christian Zimmer ◽  
Christoph Nass ◽  
Bernd Stegen ◽  
Joachim Esser ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Intravenous Administration ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Oxygen Fraction ◽  
Significant Difference ◽  
Inspired Oxygen

Background Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placebo-controlled study, the authors tested whether an inspired oxygen fraction of 0.8 decreases PONV in patients undergoing strabismus surgery and whether oxygen is more effective than ondansetron. Methods With approval of the authors' institutional review board, 210 patients were randomly assigned to receive one of three treatments: (1) 30% inspired oxygen in air plus intravenous administration of saline, (2) 80% inspired oxygen in air plus intravenous administration of saline, or (3) 30% inspired oxygen in air plus 75 microg/kg ondansetron intravenously during induction. General anesthesia was standardized and included etomidate, alfentanil, and mivacurium for induction and sevoflurane for maintenance. PONV was evaluated 6 and 24 h postoperatively by an investigator unaware of treatment assignment. Results Overall postoperative incidence of nausea and vomiting was 41% for inspired oxygen fraction of 0.3 plus placebo, 38% for inspired oxygen fraction of 0.8 plus placebo, and 28% for inspired oxygen fraction of 0.3 plus ondansetron, respectively (P = 0.279). Therefore, there was no statistically significant difference of PONV incidence among groups. Conclusions An inspired oxygen fraction of 0.8 during general anesthesia with sevoflurane does not decrease PONV in patients undergoing strabismus repair. Ondansetron also did not significantly decrease PONV in our study setting.

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 A Novel Approach to Study the Effects of Anesthesia on Respiratory Signals by using the EEG Signals

2017 ◽  
Vol 6 (2) ◽  
pp. 117
Author(s):  
Mohd Suhaib Kidwai ◽  
S. Hasan Saeed
Keyword(s):  
General Anesthesia ◽  
Phase Synchronization ◽  
Eeg Signals ◽  
Drug Induced ◽  
Anesthetic Depth ◽  
Brain Signals ◽  
Novel Approach ◽  
Respiratory Parameters ◽  
Single Coupling ◽  
Separate Subsystem

General anesthesia plays a crucial role in many surgical procedures. It is a drug-induced, reversible state characterized by unconsciousness, anti-nociception or analgesia, immobility and amnesia. On rare occasions, however, the patient can remain unconscious longer than intended, or may regain awareness during surgery. There are no precise measures for maintaining the correct dose of anesthetic, and there is currently no fully reliable instrument to monitor depth of anesthesia. Although a number of devices for monitoring brain function or sympathetic output are commercially available, the anesthetist also relies on clinical assessment and experience to judge anesthetic depth. The undesirable consequences of overdose or unintended awareness might in principle be ameliorated by improved control if we could understand better the changes in function that occur during general anesthesia. Coupling functions prescribe the physical rule specifying how the inter-oscillator interactions occur. They determine the possibility of qualitative transitions between the oscillations, e.g. routes into and out of phase synchronization. Their decomposition can describe the functional contribution from each separate subsystem within a single coupling relationship. In this way, coupling functions offer a unique means of describing mechanisms in a unified and mathematically precise way. It is a fast growing field of research, with much recent progress on the theory and especially towards being able to extract and reconstruct the coupling functions between interacting oscillations from data, leading to useful applications in cardio respiratory interactions.<br />In this paper, a novel approach has been proposed for detecting the changes in synchronism of brain signals, taken from EEG machine. During the effect of anesthesia, there are certain changes in the EEG signals. Those signals show changes in their synchronism. This phenomenon of synchronism can be utilized to study the effect of anesthesia on respiratory parameters like respiration rate etc, and hence the quantity of anesthesia can be regulated, and if any problem occurs in breathing during the effect of anesthesia on patient, that can also be monitored

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