The comparison of sedation quality of dexmedetomidine with midazolam using bispectral index and Ramsay sedation score in tympanoplasty under monitored anesthesia care

2020 ◽  
Vol 7 (1) ◽  
pp. 111
Author(s):  
JitendraHomdas Ramteke ◽  
Renu Upadhyay ◽  
DineshKumar Sahu
Keyword(s):  
Bispectral Index ◽  
Sedation Score ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Ramsay Sedation Score

Comparison of a Lower-lipid Propofol Emulsion with the Standard Emulsion for Sedation during Monitored Anesthesia Care

2004 ◽  
Vol 100 (5) ◽  
pp. 1072-1075 ◽  
Author(s):  
Dajun Song ◽  
Mohamed A. Hamza ◽  
Paul F. White ◽  
Stephanie I. Byerly ◽  
Stephanie B. Jones ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Bispectral Index ◽  
Sedation Score ◽  
Intravenous Sedation ◽  
Anesthesia Care ◽  
Loading Dose ◽  
Monitored Anesthesia Care ◽  
Pain On Injection ◽  
Hemodynamic Variables ◽  
Recovery Times

Background The currently used emulsion formulations of 1% propofol contain 10% soybean oil. However, a new emulsion of 1% propofol (Ampofol) containing 50% less lipid has recently become available for clinical investigation. This study was designed to compare the pharmacodynamic properties of Ampofol with those of a standard formulation (Diprivan) when administered for intraoperative sedation. Methods Sixty healthy outpatients undergoing minor operations with local anesthesia were randomly assigned to receive either Ampofol (n = 31) or Diprivan (n = 29) for intravenous sedation. The sedation was initiated with an intravenous loading dose of propofol, 0.75 mg/kg, followed by an initial infusion rate of 50 microg x kg(-1) x min(-1) to achieve an Observer's Assessment of Alertness/Sedation score of 3. The targeted level of sedation was maintained with a variable-rate propofol infusion during the operation. The onset times to achieving a sedation score of 3, the severity of pain on injection of the loading dose, intraoperative hemodynamic variables, and electroencephalographic Bispectral Index values were recorded. In addition, recovery times, postoperative pain and nausea, and patient satisfaction with the sedative medication were assessed. Results There were no significant differences between Ampofol and Diprivan with respect to onset times, dosage requirements, Bispectral Index values, hemodynamic variables, recovery times, or patient satisfaction scores. The incidence of moderate pain on injection was higher in the Ampofol group (26%vs. 7% with Diprivan; P < 0.05). Conclusions Ampofol was equipotent to Diprivan with respect to its sedative properties during monitored anesthesia care. Although both groups received pretreatment with intravenous lidocaine, Ampofol was associated with more pain on injection.

Bispectral Index Monitoring during Sedation with Sevoflurane, Midazolam, and Propofol

2001 ◽  
Vol 95 (5) ◽  
pp. 1151-1159 ◽  
Author(s):  
Andra E. Ibrahim ◽  
Julie K. Taraday ◽  
Evan D. Kharasch
Keyword(s):  
Bispectral Index ◽  
Anesthetic Management ◽  
Sedation Score ◽  
Digit Symbol ◽  
Quality Of Recovery ◽  
Digit Symbol Substitution ◽  
Prediction Probability ◽  
Symbol Substitution ◽  
Wide Variability

Background Bispectral Index (BIS) has been used to measure sedation depth. Ideally, to guide anesthetic management, range of BIS scores at different sedation levels should not overlap, and BIS should be independent of drug used. This study assessed ability of BIS to predict sedation depth between sevoflurane, propofol, and midazolam. Quality of recovery was also compared. Methods Patients undergoing surgery with local or regional anesthesia and sedation were randomized to sevoflurane (n = 23), midazolam (n = 21), or propofol (n = 22). Sedation was titrated to Observers's Assessment of Alertness-Sedation score of 3 (responds slowly to voice). BIS and Observers's Assessment of Alertness-Sedation were measured every 5 min. BIS prediction probability (PK) was compared between drugs. Recovery was assessed by BIS and Digit Symbol Substitution and memory tests. Results Bispectral Index of responders to voice was significantly different from nonresponders (86 +/- 10 vs. 74 +/- 14, mean +/- SD; P < 0.001) However, wide variability and overlap in BIS were observed (25th-75th percentile, responders vs. non-responders: 79-96 vs. 65-83). BIS of responders was different for sevoflurane versus propofol and midazolam. BIS was a better predictor of propofol sedation than sevoflurane or midazolam (PK = 0.87 +/- 0.11, 0.76 +/- 0.01, and 0.69 +/- 0.02, respectively; P < 0.05). At 10 min after the procedure, 76, 48, and 24% of sevoflurane, propofol, midazolam patients, respectively, returned to baseline Digit Symbol Substitution scores (P < 0.05). Excitement-disinhibition occurred in 70, 36, and 5% of sevoflurane, propofol, and midazolam patients, respectively (P < 0.05). Conclusion Individual BIS scores demonstrate significant variability, making it difficult to predict sedation depth. The relation between BIS and sedation depth may not be independent of anesthetic agent. Quality of recovery was similar between drugs, but excitement occurred frequently with sevoflurane.

Bispectral Index and the incidence of apnea during monitored anesthesia care

2005 ◽  
Vol 12 (2) ◽  
pp. 81-84 ◽  
Author(s):  
R SOTO ◽  
E FU ◽  
R SMITH ◽  
R MIGUEL
Keyword(s):  
Bispectral Index ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care

Anästhesie bei ophthalmologischen Operationen – eine Standortbestimmung

2016 ◽  
Vol 73 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Jens Moll ◽  
Mark Kaufmann
Keyword(s):  
Anesthesia Care ◽  
Monitored Anesthesia Care

Zusammenfassung. Ein Grossteil der opthalmologischen Eingriffe kann heute in Lokoregionalanästhesie mit «Monitored Anesthesia Care» (MAC) durchgeführt werden. Allgemeinanästhesieverfahren sind hauptsächlich im pädiatrischen Segment, bei spezifischer Comorbidität und bei langdauernden Eingriffen mit völlig ruhiggestelltem OP-Gebiet notwendig. Kataraktoperationen bei mehrheitlich geriatrischen Patienten gehören aufgrund Ihrer Häufigkeit zur sogenannten «Hochvolumen-Chirurgie»: In Anbetracht des niedrigen perioperativen Risikos bei dieser Patientengruppe sind angepasste, optimierte Prozesse sinnvoll. Eine fokussierte Prämedikation und Information dieser Patienten gewährleistet eine gute perioperative Compliance. Präoperative Untersuchungen sollen bei dieser Patientengruppe nur in Abhängigkeit von relevanter Comorbidität durchgeführt werden. Neben der klassischen Anästhesiesprechstunde stehen heute für gesundheitlich kompensierte Patienten auch neue Verfahren wie eine internetbasierte Prämedikationsvisite zur Verfügung. Das intraoperative Anästhesieverfahren hängt von den Erfordernissen des Chirurgen und den Erwartungen und Kooperationsmöglichkeiten des Patienten ab.

scholarly journals Negative-pressure-related diffuse alveolar hemorrhage after monitored anesthesia care for vertebroplasty: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Negative Pressure ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Unknown Etiology ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
X Ray ◽  
Chest X Ray

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.

SNORING IS ASSOCIATED WITH UNEXPECTED PATIENT HEAD MOVEMENT DURING MONITORED ANESTHESIA CARE VITREORETINAL SURGERY

Retina ◽  
2012 ◽  
Vol 32 (7) ◽  
pp. 1324-1327 ◽  
Author(s):  
Colin A. Mccannel ◽  
Eric J. Olson ◽  
Mark J. Donaldson ◽  
Sophie J. Bakri ◽  
Jose S. Pulido ◽  
...  
Keyword(s):  
Head Movement ◽  
Vitreoretinal Surgery ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care
Sign in / Sign up

Export Citation Format

Share Document