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Journal articles on the topic 'Induction of anesthesia'
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1
Paduano, Mary, Kaitlen C. Colafrancesco, Sarah A. Wong, Michael S. Caldwell, and Marcos Gridi-Papp. "The Response of Gray Treefrogs to Anesthesia by Tricaine Methanesulfonate (TMS or MS-222)." ISRN Zoology 2013 (November 14, 2013): 1–9. http://dx.doi.org/10.1155/2013/635704.
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The design of anesthetic protocols for frogs is commonly hindered by lack of information. Results from fishes and rodents do not always apply to frogs, and the literature in anurans is concentrated on a few species. We report on the response of treefrogs (Hyla chrysoscelis and H. versicolor) to tricaine methanesulfonate. Body mass did not differ significantly between the species or between sexes. In the first exposure of a frog to TMS, variation in induction time was best explained by species (H. chrysoscelis resisted longer) and body mass (larger animals resisted longer). Multiple exposures revealed a strong effect of individual variation on induction time and a significant increase of induction time with number of previous anesthesia events within the same day. Recovery time was mostly explained by individual variation, but it increased with total time in anesthetic and decreased with induction time. It also increased with number of days since the last series of anesthesias and decreased with number of previous uses of the anesthetic bath. This is one of the first studies of anesthesia in hylids and also one of the first assessments of the factors that influence the variability of the response to anesthesia within a species.
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Özkan, Fatih, Nilüfer Çakır-Özkan, Ahmet Eyibilen, Tamer Yener, and Ünal Erkorkmaz. "Comparison of ketamine-diazepam with ketamine-xylazine anesthetic combinations in sheep spontaneously breathing and undergoing maxillofacial surgery." Bosnian Journal of Basic Medical Sciences 10, no. 4 (2010): 297–302. http://dx.doi.org/10.17305/bjbms.2010.2675.
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The objective of this study was to choose a suitable anesthetic combination for use in experimental surgical models by comparing the anesthetic and cardio-respiratory changes. Fourteen healthy male sheep were randomly assigned to two different drug regimens. In Group 1 the sheep were anesthetized with ketamine + xylazine (22 mg/kg im. + 0.2 mg/kg i.m., respectively). Anesthetic combination of ketamine + diazepam (22 mg/kg im. + 0.4 mg/kg i.m., respectively) was used in Group 2. Heart rate, respiratory rate and mean arterial pressures were evaluated before anesthesia, after induction of anesthesia up to 30 minutes in 5 minute intervals and during recovery. In all sheep, duration of anesthesia induction, duration of anesthesia and duration of recovery were recorded. Quality of induction, anesthesia, analgesia and recovery were evaluated. Cardio-respiratory parameters decreased below baseline values after anesthesia induction in both groups. However, no profound effects on cardio-respiratory functions were observed during study. In Group 2, it was observed that; anesthesia induction time was longer, the depth of anesthesia was inadequate during the osteotomy stage of the surgical procedure and recovery time was longer in comparison to Group 1. Otherwise the quality of anesthesia induction, anesthesia, analgesia and recovery was better in Group 1 than Group 2. These findings indicate that both drug combinations can provide short time anesthesia for minor surgical procedures. Ketamine+xylazine combination can be used as a more suitable anesthetic combination in experimental surgical procedures such as maxillofacial surgery than ketamine+diazepam combination, in sheep.
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Bae, Yu-Kyung, Hyo-Seok Na, Jung-Won Hwang, Young-Jin Lim, and Sang-Hwan Do. "Incidences of Rocuronium Use during Anesthetic Induction in Adult Patients Undergoing Orthopedic Surgery Using Supraglottic Airway Devices: A Retrospective Analysis." Journal of Clinical Medicine 13, no. 17 (2024): 5299. http://dx.doi.org/10.3390/jcm13175299.
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Background/Objectives: Neuromuscular blocking agents (NMBAs) are not usually necessary during the induction of general anesthesia in patients using supraglottic airway (SGA) devices. In this study, we assessed the incidences of rocuronium use in adult patients undergoing general anesthesia using SGA devices. Methods: From September 2022 to August 2023, the medical records of adult patients (≥19 years) who underwent orthopedic surgery using SGA devices were retrospectively investigated. The incidences of rocuronium use during anesthetic induction were analyzed according to the anesthetic induction drug. The association of rocuronium use during anesthesia was analyzed in terms of demographic (age, sex, height, and weight), surgical (surgical time), and anesthetic factors (premedication, anesthetic agent, anesthetic time). Results: In total, 321 patients were enrolled. The incidence rate of rocuronium use during anesthetic induction was 28.3%. In the subgroup analysis, patients receiving total intravenous anesthesia (TIVA) with propofol (PPF) and remifentanil showed a markedly lower incidence (14.4%) than the other anesthetic groups. Premedication or short anesthetic duration was associated with lower incidences of rocuronium use. Demographic and other anesthetic factors did not seem to affect the incidences of rocuronium use during anesthesia. Conclusions: The incidence of rocuronium use during anesthetic induction with SGA devices was significantly lower with the PPF-TIVA compared to that using remimazolam-TIVA or inhalational anesthesia. Premedication with midazolam and shorter operation times were associated with a significantly lower incidence of rocuronium use.
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Shimizu, Yuki, and Teppei Kanda. "Effects of Pre-Anesthesia Anxiety on Propofol Induction Dose in Cats." Animals 11, no. 7 (2021): 2126. http://dx.doi.org/10.3390/ani11072126.
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In humans, peri-anesthesia anxiety reportedly increases the anesthetic requirements for anesthesia induction. However, no studies have been conducted on cats regarding the effects of anxiety on anesthesia induction or anesthetic-mediated physiological changes. Therefore, we intended to investigate the effect of pre-anesthesia anxiety in healthy cats on the propofol dose required for anesthesia induction, and its impact on behavioral and physiological evaluations. The cats were placed in either a calm (CAL) or tense (ANX) environment. We performed physiological and behavioral evaluations before and after each environmental acclimatization period. Anesthesia was induced using propofol. We recorded the total dose of propofol administered for each clinical sign observed during anesthesia induction. The post-acclimatization behavioral evaluation score was significantly higher in the ANX group than the pre-acclimatization score. However, there was no significant difference in the propofol dose required for each clinical sign in the ANX or CAL groups. There were also no significant differences in the physiological evaluations between the ANX and CAL groups. Therefore, pre-anesthesia anxiety felt by cats did not affect propofol-mediated anesthesia induction.
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Miranda, Edinaldo Gonçalves de, Vinícius Pontes do Nascimento, Daniel Reis Waisberg, et al. "Inhalation anesthesia equipment for rats with provision of simultaneous anesthetic and oxygen." Acta Cirurgica Brasileira 26, no. 2 (2011): 140–43. http://dx.doi.org/10.1590/s0102-86502011000200012.
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PURPOSE: To introduce a model of equipment for inhalation anesthesia in rats that offers better control of both flow and losses of ether during induction, maintenance, and recuperation. METHODS: The equipment consists of an air compressor with two outlets, a closed glass induction chamber, a glass reservoir for the anesthetic agent, a pediatric inhalation mask, a three-way stopcock, a Y-connector, and urinary catheters. Three hundred Wistar rats (Rattus norvegicus albinus) were given inhalation anesthesia. The evaluated parameters were equipment operation, duration of each phase of anesthesia, corneal reflex, muscular tonus, respiration during induction and maintenance, and volume of anesthesia. RESULTS: The average time taken for induction was 7.3 minutes; the average anesthetic recuperation time was 6.4 minutes. The amount of anesthetic used varied according to the weight of the animal, with the average volume of ether used being 6.5ml/hour. The availability of oxygen (room air) decreased the recuperation time and averted both respiratory depression and insufficient depth of anesthesia. CONCLUSION: The proposed equipment is practical, inexpensive, and allows for satisfactory control of anesthetic parameters during the entire procedure, making inhalation anesthesia in rats safe and essentially complication free.
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Aurelia Shira Jelita, Elvina Fabiola, Kiran Dhevy Hari Huma, Mahima Farhanah Madsyal, and Liss Dyah Dwi A. "Analisis Anestesi Perioperatif." Jurnal Mahasiswa Ilmu Kesehatan 2, no. 3 (2024): 111–17. https://doi.org/10.59841/jumkes.v2i3.1265.
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Perioperative anesthesia management is divided into preoperative preparation, intraoperative services (during the operation), and postoperative services. Preoperative anesthetic management is the first step in a series of anesthetic procedures carried out on patients who are planned to undergo surgery. Intraoperative anesthesia management is carried out by pre-induction, induction and maintenance assessments. Postoperative anesthetic management consists of discontinuing the anesthetic drug and stabilizing the patient.
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Lu, Bing. "A Collection of Studies on Anesthesia Modalities, Anesthetic Drugs and Circulatory Stability in Elderly Patients." Current Research in Medical Sciences 2, no. 3 (2023): 36–42. http://dx.doi.org/10.56397/crms.2023.09.05.
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With the increase in the proportion of elderly population in the society, China is gradually entering an aging society. Elderly patients may require anesthesia during medical treatment, and considering the relatively high surgical risk of elderly patients, comprehensive consideration must be given to the selection of anesthesia and the use of anesthetic drugs. Induction of general anesthesia is a process in which patients undergo reversible drug inhibition from a physiological state to a surgically operable anesthesia state within a short period of time, but tracheal intubation and anesthesia inhibition can trigger cardiovascular reactions, especially in elderly patients with poor circulatory function, which can lead to hemodynamic fluctuations and affect the stability of circulatory function. As elderly patients age, their organ function decreases, and their reserve function deficiency under anesthetic stress can increase the risk of adverse cardiovascular events. The hemodynamic fluctuations of patients during the induction period of general anesthesia are large, and it is important to reduce the hemodynamic fluctuations and maintain the stability of circulatory function to improve the safety of surgery. At present, the commonly used methods for induction of general anesthesia include manual intravenous push, target-controlled infusion and constant-rate infusion by infusion pump, and the commonly used drugs for induction of general anesthesia include intravenous sedative anesthetics, intravenous analgesics, muscle relaxants and inhaled anesthetics. Based on this paper, we analyze the effects of general anesthesia, epidural anesthesia, lumbar anesthesia, and epidural anesthesia in the application of surgery in elderly patients and general anesthesia induction in the circulatory stability of elderly patients for a review, in order to more accurately and better guide further clinical anesthesia research.
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Rawal, Prabhat, and Uday Bajracharya. "Hemodynamic response to Sevoflurane and Propofol induction: a comparative study." Journal of Society of Anesthesiologists of Nepal 2, no. 1 (2015): 2–7. http://dx.doi.org/10.3126/jsan.v2i1.13549.
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Background: Induction of anesthesia is a critical event and hemodynamic stability is an important factor during this period. Propofol is a commonly used intravenous anesthetic and Sevoflurane is a newly introduced inhalational anesthetic in the context of a developing country. This study compared the hemodynamics on induction of anesthesia with Propofol and Sevoflurane.Methods: A total of 108 American Society of Anesthesiologists physical status I patients undergoing elective surgical procedures under general anesthesia were randomized into two groups. Group ‘P’ patients were induced with intravenous 1% Propofol and Group ‘S’ patients were induced with inhalation of 8% Sevoflurane. Mean arterial pressures and heart rates were recorded at baseline, before induction, during induction and at 1, 3 and 5 minutes after induction of anesthesia before endotracheal intubation.Results: The two groups were comparable with respect to demographics and baseline hemodynamic parameters. There was a significant decrease in mean arterial pressure and heart rate from pre-induction values within both groups during and after induction. The reduction in mean arterial pressure was significantly more in Propofol group transiently during induction. The reduction in heart rate was significantly more in Sevoflurane group at 1, 3 and 5 minutes after induction (P < 0.05).Conclusion: Induction of anesthesia with Propofol demonstrated a greater decrease in mean arterial pressure whereas induction with Sevoflurane was associated with greater reduction in heart rate.Journal of Society of Anesthesiologists of Nepal 2015; 2(1): 2-7
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Kim, Yu-Yil, Hyun-Joo Heo, Ji-Hye Lee, Hyung-Gu Cho, and Geonbo Kim. "Assessing the Safety of Total Intravenous Anesthesia with Remimazolam in General Anesthesia for Transcatheter Aortic Valve Implantation of Severe Aortic Valve Stenosis: A Case Series." Medicina 58, no. 11 (2022): 1680. http://dx.doi.org/10.3390/medicina58111680.
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Background and Objectives: In patients with severe aortic stenosis (sAS), it is crucial to maintain hemodynamic stability during the induction and maintenance of general anesthesia for transcatheter aortic valve implantation (TAVI). In this study, we assessed the efficacy and safety of remimazolam in maintaining hemodynamic stability during anesthetic induction and maintenance. Cases: TAVI was performed on seven patients with sAS, and remimazolam was administered for total intravenous anesthesia (TIVA) of general anesthesia with induction (3.0 mg/kg/h) and maintenance (1.0 mg/kg/h). All patients underwent TAVI without major hemodynamic concerns and later recovered. Conclusions: Remimazolam can be safely used for induction and maintenance of general anesthesia in patients with sAS when performing TAVI.
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Smith, Denise AB, and Jonathan Bath. "Epileptiform activity during induction of anesthesia with sevoflurane prior to elective carotid endarterectomy." Vascular 24, no. 1 (2015): 96–99. http://dx.doi.org/10.1177/1708538115571405.
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The optimal anesthetic technique for carotid endarterectomy is still controversial. For general anesthesia, various induction agents have been used. We present two patients with asymptomatic high-grade carotid stenosis where induction with sevoflurane resulted in epileptiform discharges seen on perioperative electroencephalogram monitoring without adverse clinical sequelae. The occurrence of epileptogenic electroencephalogram during sevoflurane anesthesia has been widely described despite its popular use in pediatric anesthesia. This phenomenon, however, has not been previously described during electroencephalogram monitoring in carotid surgery. The authors suggest that induction anesthesia with sevoflurane should be avoided in this patient population especially where routine electroencephalogram monitoring is not performed.
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Hojo, Takayuki, Makiko Shibuya, Yukifumi Kimura, Yuki Otsuka, and Toshiaki Fujisawa. "Refractory Hypotension During General Anesthesia Despite Withholding Telmisartan." Anesthesia Progress 67, no. 2 (2020): 86–89. http://dx.doi.org/10.2344/anpr-67-02-02.
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Angiotensin receptor blockers (ARBs) are commonly used to treat hypertension. However, similar to angiotensin-converting enzyme inhibitors, ARBs can also cause refractory hypotension during general anesthesia. Therefore, it has been recommended that ARBs be withheld for 24 hours prior to the induction of anesthesia. This is a case report of refractory hypotension requiring the administration of potent vasopressors after the induction of general anesthesia despite withholding telmisartan for 24 hours. In the same patient undergoing a subsequent general anesthetic, telmisartan was withheld for 5 days before induction, leading to mild intraoperative hypotension that responded adequately to phenylephrine. The primary cause of refractory hypotension during the first general anesthetic was suspected to be an insufficient telmisartan washout period. Telmisartan's half-life of 24 hours is notably the longest of all ARBs in current use. This case report demonstrates that refractory hypotension during general anesthesia cannot always be avoided by withholding telmisartan for 24 hours before the induction of anesthesia. Therefore, a washout period greater than 24 hours is preferable for patients taking telmisartan.
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Schisler, Travis, Jose M. Marquez, Ibtesam Hilmi, and Kathirvel Subramaniam. "Pulmonary Hypertensive Crisis on Induction of Anesthesia." Seminars in Cardiothoracic and Vascular Anesthesia 21, no. 1 (2016): 105–13. http://dx.doi.org/10.1177/1089253216652222.
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Anesthesia for lung transplantation remains one of the highest risk surgeries in the domain of the cardiothoracic anesthesiologist. End-stage lung disease, pulmonary hypertension, and right heart dysfunction as well as other comorbid disease factors predispose the patient to cardiovascular, respiratory and metabolic dysfunction during general anesthesia. Perhaps the highest risk phase of surgery in the patient with severe pulmonary hypertension is during the induction of anesthesia when the removal of intrinsic sympathetic tone and onset of positive pressure ventilation can decompensate a severely compromised cardiovascular system. Severe hypotension, cardiac arrest, and death have been reported previously. Here we present 2 high-risk patients for lung transplantation, their anesthetic induction course, and outcomes. We offer suggestions for the safe management of anesthetic induction to mitigate against hemodynamic and respiratory complications.
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Bennett, R. Avery, Juergen Schumacher, Kyra Hedjazi-Haring, and Susan M. Newell. "Cardiopulmonary and anesthetic effects of propofol administered intraosseously to green iguanas." Journal of the American Veterinary Medical Association 212, no. 1 (1998): 93–98. http://dx.doi.org/10.2460/javma.1998.212.01.93.
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Objective To determine cardiopulmonary effects of intraosseous administration of propofol in green iguanas (Iguana iguana). Design Prospective study. Animals 14 green iguanas. Procedure Anesthesia was induced in 4 iguanas with propofol (10 mg/kg [4.5 mg/lb] of body weight, intraosseously). Heart and respiratory rates, functional hemoglobin oxygen saturation (SpO2), end-tidal CO2 concentration, and cloacal temperature were recorded. Ten additional iguanas were given propofol intraosseously for induction (5 mg/kg [2.3 mg/lb]) and maintenance (0.5 mg/kg/min [0.23 mg/lb/min], q 30 min) of anesthesia. Heart and respiratory rates, cloacal temperature, and SpO2 were recorded. Results Mean induction time for the first 4 iguanas was 1.2 minutes. A significant decrease in heart rate was seen 1 minute after induction of anesthesia. All iguanas were apneic, but spontaneous ventilation resumed within 5 minutes. End-tidal CO2 concentration decreased from 46 mm of Hg 4 minutes after induction of anesthesia to 32 mm of Hg 30 minutes after induction of anesthesia. Mean duration of anesthesia was 27 minutes. Mean induction time for the other 10 iguanas was 3 minutes. A significant decrease in heart rate was detected 35 minutes after induction of anesthesia and persisted until 120 minutes. Mean SpO2 value decreased from 79% 5 minutes after induction of anesthesia to 64% 30 minutes after induction of anesthesia. Mean recovery time was 57 minutes. Clinical Implications Propofol is an effective anesthetic agent for use in green iguanas. It is recommended that iguanas be intubated, provided oxygen, and given assisted ventilation after administration of propofol to prevent hypoxemia and hypercapnia. (J Am Vet Med Assoc 1998;212:93–98)
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Van Loon, V. J. F., T. J. Van den Brink, J. P. A. M. Van Loon, C. J. W. Scheffer, and H. J. Bergman. "Influence of romifidine and detomidine on the induction of anesthesia and recovery from total intravenous anesthesia in horses." Vlaams Diergeneeskundig Tijdschrift 83, no. 3 (2014): 125–32. http://dx.doi.org/10.21825/vdt.v83i3.16652.
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In the present study, the quality of the induction of and the recovery from anesthesia was compared in 146 horses undergoing total intravenous anesthesia with guaifenesin, ketamine and detomidine for computed tomography (CT), randomly assigned to receive either romifidine (n = 110) or detomidine (n = 36) during premedication. The induction of anesthesia was performed with a ketamine-midazolam combination. The anesthetic duration was short (mean +/- SD time: 23.5 +/- 8.8 minutes). No significant difference in induction score was observed. However, the recovery quality was significantly better in horses premedicated with romifidine.
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Shehata, Areej, Mostafa Kassem, Mahmoud Kammar, and Howaida Ahmed. "Anesthetic and clinical assessments of I/V propofol versus ketamine in Dogs premedicated with diazepam." Alexandria Journal of Veterinary Sciences 79, no. 1 (2023): 158. http://dx.doi.org/10.5455/ajvs.159481.
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The present anesthetic investigation was aimed to evaluate anesthetic clinico-physiological and hematobiochemical effects in addition to the anesthetic properties of propofol or ketamine premedicated with diazepam . For this purpose, 12 apparently healthy dogs were randomly divided into Two groups: A and B. All dogs were premedicated with Diazepam (0.2mg/kg Bwt/IM) then intravenous anesthesia was induced in group A with propofol intravenous (1mg/kg Bwt) ,while group B with ketamine intravenous (5 mg/kg Bwt). Blood samples were collected from the Two groups 15 minutes before anesthesia induction, then at (15, 30, 45 and 60) minutes after treatments for the hemato-biochemical evaluation, and for clinico-physiological observations. A slight alteration in some physiological parameters and hemato-biochemical values was observed after anesthesia induction, but it still safe to induce general anesthesia in dogs. in conclusion, the present anesthetic investigation showed the longest period of anesthesia with complete muscle relaxation following intravenous ketamine injection than propofol in premedicated dogs with diazepam.
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Purva, M., N. Al Saleh, and M. Hemadri. "Parents in the anesthetic induction room: the preferences of parents in Kuwait." Eastern Mediterranean Health Journal 7, no. 06 (2001): 1078–81. http://dx.doi.org/10.26719/2001.7.6.1078.
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Toascertain whether the parents in Kuwait desire to be present during the induction of anesthesia in their children and to obtain the parents’ views on factors associated with such presence. The parents of 80 children scheduled for surgery under general anesthesia were given asked to complete a questionnaire. An overwhelming 88.75% of parents wished to he present in the anesthetic room during induction. Parents in Kuwait should he allowed to be present during the induction of anesthesia in their child. Protocols should be drafted accordingly and must include other child-friendly measures to reduce anxiety among parents and children in Kuwait.
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Heo, Hyun Joo, Ji Hye Lee, Yu Yil Kim, Ji Hun Park, Hyung Gu Cho, and Geonbo Kim. "The Experience of General Anesthesia with Remimazolam in Patient with Cardiac Tamponade Due to Cardiac Injury by Bone Cement Embolism: A Case Report." Scholars Journal of Medical Case Reports 10, no. 9 (2022): 915–18. http://dx.doi.org/10.36347/sjmcr.2022.v10i09.014.
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Background: In patients with cardiac injury, it is crucial to maintain hemodynamic stability during the induction and maintenance of general anesthesia. Remimazolam provides hemodynamic stability during anesthetic induction. Case Presentation: An 83-year-old female was transferred for emergency surgery after pericardiocentesis with cardiac tamponade resulting from aorta and right atrium injury from bone cement fragments after percutaneous vertebroplasty. She was admitted to the operation room with was given inotropes, vasopressors and blood. Remimazolam was used for induction (6.0 mg/kg/h) and maintenance (1 mg/kg/h) of general anesthesia. The patient underwent surgery without major hemodynamic concerns and later recovered. Conclusion: Remimazolam can be used in patient with cardiac injury with hemodynamic instability for the induction and maintenance of general anesthesia.
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Aktas Yildirim, Serap, Zeynep Tugce Sarikaya, Lerzan Dogan, Halim Ulugol, Bulent Gucyetmez, and Fevzi Toraman. "Arterial Elastance: A Predictor of Hypotension Due to Anesthesia Induction." Journal of Clinical Medicine 12, no. 9 (2023): 3155. http://dx.doi.org/10.3390/jcm12093155.
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Background: Hypotension is common after anesthesia induction and may have adverse outcomes. The aim of this study was to investigate whether arterial elastance (Ea) is a predictor of post-induction hypotension. Methods: Between January and June 2022, the hemodynamic parameters of 85 patients who underwent major surgery under general anesthesia were prospectively evaluated. The noncalibrated pulse contour device MostCare (Vytech, Vygon, Padua, Italy) was used to measure hemodynamic parameters before and after anesthesia induction. The duration of the measurements was determined from one minute before induction to 10 min after induction. Hypotension was defined as a greater than 30% decrease in mean arterial pressure from the pre-induction value and/or systolic arterial pressure of less than 90 mmHg. The patients were divided into post-induction hypotension (−) and (+) groups. For the likelihood of post-induction hypotension, a multivariate regression model was used by adding significantly different pre-induction parameters to the post-induction hypotension group. Results: The incidence of post-induction hypotension was 37.6%. The cut-off value of the pre-induction Ea for the prediction of post-induction hypotension was ≥1.08 mmHg m−2mL−1 (0.71 [0.59–0.82]). In the multivariate regression model, the likelihood of postinduction hypotension was 3.5-fold (1.4–9.1), increased by only an Ea ≥ 1.08 mmHg m−2mL−1. Conclusion: Pre-induction Ea showed excellent predictability of hypotension during anesthetic induction and identified patients at risk of general anesthesia induction-related hypotension.
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Use, Tadasuke, Haruna Nakahara, Ayako Kimoto, et al. "Barbiturate Induction for the Prevention of Emergence Agitation after Pediatric Sevoflurane Anesthesia." Journal of Pediatric Pharmacology and Therapeutics 20, no. 5 (2015): 385–92. http://dx.doi.org/10.5863/1551-6776-20.5.385.
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OBJECTIVES: Emergence agitation (EA) is a common and troublesome problem in pediatric patients recovering from general anesthesia. The incidence of EA is reportedly higher after general anesthesia maintained with sevoflurane, a popular inhalational anesthetic agent for pediatric patients. We conducted this prospective, randomized, double-blind study to test the effect of an intravenous ultra-short–acting barbiturate, thiamylal, administered during induction of general anesthesia on the incidence and severity of EA in pediatric patients recovering from Sevoflurane anesthesia. METHODS: Fifty-four pediatric patients (1 to 6 years of age) undergoing subumbilical surgeries were randomized into 2 groups. Patients received either intravenous thiamylal 5mg/kg (Group T) or inhalational Sevoflurane 5% (Group S) as an anesthetic induction agent. Following induction, general anesthesia was maintained with Sevoflurane and nitrous oxide (N2O) in both groups. To control the intra- and post-operative pain, caudal block or ilioinguinal/iliohypogastric block was performed. The incidence and severity of EA were evaluated by using the Modified Objective Pain Scale (MOPS: 0 to 6) at 15 and 30 min after arrival in the post-anesthesia care unit (PACU). RESULTS: Fifteen minutes after arrival in the PACU, the incidence of EA in Group T (28%) was significantly lower than in Group S (64%; p = 0.023) and the MOPS in Group T (median 0, range 0 to 6) was significantly lower than in Group S (median 4, range 0 to 6; p = 0.005). The interval from discontinuation of Sevoflurane to emergence from anesthesia was not significantly different between the 2 groups. CONCLUSIONS: Thiamylal induction reduced the incidence and severity of EA in pediatric patients immediately after Sevoflurane anesthesia.
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Mekiš, Dušan, and Vesna Sok. "Effects of intravenous and inhalation induction of anesthesia on oxygen delivery in elderly patients undergoing colorectal surgery." Acta Medico-Biotechnica 14, no. 1 (2021): 11–19. http://dx.doi.org/10.18690/actabiomed.209.
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Purpose: The induction of anesthesia with direct laryngoscopy and orotracheal intubation are two interventions, which can influence oxygen delivery. Rapid adjustments of treatment to restore oxygen delivery are crucial to improving the outcomes for patients. The aim of this study was to compare the effects of induction of anesthesia with propofol and sevoflurane on oxygen delivery in elderly patients undergoing colorectal surgery. Methods: We studied forty patients with physical status II or III, according to the American Society of Anesthesiology,who were older than 65 years and undergoing elective surgery for resection of colorectal carcinoma. The patients were randomly divided into the propofol group (P-group) and sevoflurane group (S-group), according to the anesthetic received for the induction of anesthesia. Results: After induction of anesthesia, heart rate, mean arterial pressure, cardiac output and the oxygen delivery index significantly decreased in both groups compared to the baselinevalues. Following induction of anesthesia, the decrease in heart rate was significantly more rapid in the P-group. Immediately after orotracheal intubation, heart rate, mean arterial pressure, cardiac output and the oxygen delivery index significantly increased in the S-group, but one minute later these diferences were not statistically significant. Heart rate, meanarterial pressure, cardiac output and the oxygen delivery index were significantly lower after orotracheal intubation in both groups, compared to baseline.Conclusion: Prpofol and sevoflurane are clinically comparable in the induction of anesthesia in elderly patients according to the effect on oxygen delivery.
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Ibrahim, Tamer Hamed, Ahmed H. Ayoub, Ibrahim Mohamed Ibrahim, Mohamed Abdulmohsen Abdulnaiem Ismaiel, and Raham Hasan Mostafa. "A comparative randomized study of awareness during two anesthetic induction techniques in old aged patients using isolated forearm technique." Anaesthesia, Pain & Intensive Care 26, no. 1 (2022): 81–88. http://dx.doi.org/10.35975/apic.v26i1.1772.
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Background & Objective: Awareness under anesthesia is defined as intraoperative consciousness and/or postoperative recall of surgical events. The isolated forearm technique (IFT) is a technique that has the ability to assess consciousness of the external world through a verbal command during general anesthesia. It provides live information about the presence of consciousness.
 We compared inhalational induction technique versus intravenous induction technique regarding awareness during laryngoscopy and intubation in elderly patients.
 Design: A prospective, randomized trial
 Methodology: A total of 50 patients scheduled for elective surgery under general anesthesia; aged 60 to 80 years were recruited. Patients were randomized into either Group A (inhalational induction group) or Group B (total intravenous induction group). Awareness reaction using IFT technique was observed during laryngoscopy and intubation phase to identify awareness incidence. A patient was considered a responder if IFT score > 2.
 Results: At laryngoscopy and intubation phase, 32% of cases had an awareness reaction in intravenous induction group (Group B): While in the inhalational induction group (Group A), only 8% of cases had an awareness reaction. Additionally, none of the patients, suffered from postoperative explicit recall as detected by modified Brice questionnaire (MBQ).
 Conclusions: On the basis of the results of our study, we conclude that intravenous induction of general anesthesia may subject old aged patients to a higher incidence of awareness when compared to inhalational induction technique.
 Trial Registration: NCT05019560
 Abbreviations: TIVA - Total intravenous anesthesia; IFT - Isolated forearm technique; MBQ - Modified Brice questionnaire; BISTM -Bispectral Index™; ETAC - End-tidal anesthetic concentration; MAC – Minimum alveolar concentration
 Key words: Awareness; The modified Brice questionnaire; Elderly patients; Isolated forearm technique; Sevoflurane; TIVA
 Citation: Ibrahim TH, Ayoub AH, Ibrahim IM, Ismaiel MAA, Mostafa RH. A comparative randomized study of awareness during two anesthetic induction techniques in old aged patients using isolated forearm technique. Anaesth. pain intensive care 2022;26(1):81-88.
 DOI: 10.35975/apic.v26i1.1772
 Received: November 14, 2021, Reviewed: December 18, 2021, Accepted: December 22, 2021
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Muhamad Adli, Dian Irawati, and Dedi Fitri Yadi. "Sevoflurane Insufflation Technique in Retinopathy of Prematurity Patients Underwent Intraocular Laser Photocoagulation: A Serial Case Report." Majalah Anestesia & Critical Care 42, no. 1 (2024): 49–55. http://dx.doi.org/10.55497/majanestcricar.v42i1.313.
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Introduction: Retinopathy of Prematurity (ROP) is a developmental abnormality of the retina and vitreous due to abnormal angiogenesis. The anesthetic considerations in the preterm neonate were based on the physiological immaturity of the various organ systems, associated congenital disorders, which may result in poor tolerance to anesthetic drugs, and also considerations regarding the use of high oxygen concentrations.
 Case Illustration: We are reporting six cases of ROP patients who underwent intraocular laser photocoagulation under Volatile Induction and Maintenance Anesthesia (VIMA) using a nasal cannula. The youngest patient at the time of the procedure was 32 weeks postmenstrual age, and the oldest patient was 36 weeks postmenstrual age, with the lowest weight of 1480 grams and the highest weight of 2770 grams. A gas mixture of oxygen, nitrous oxide, and 3-5 vol% sevoflurane was delivered through a nasal cannula delivered from an anesthesia machine for anesthesia induction and maintenance throughout the procedure. The anesthesia effect was achieved less than five minutes after gas mixture delivery in all patients. Five of six patients showed satisfactory results without any serious adverse effects during and after the procedures, and one of the patients was intubated due to repeated apnea and conversion of the surgical procedure from intraocular laser photocoagulation to vitrectomy. There was no adverse event observed after the procedure.
 Conclusion: The Effective induction and maintenance of anesthesia achieved through sevoflurane insufflation via nasal cannula suggest its viability as a practical and opiod-free alternative for volatile induction and maintenance anesthesia in pediatric procedures.
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Iqbal, Nasir, Muhammad Arif Khan, Zubair Luqman, and Hamad Bin Rashid. "A BIOCHEMICAL STUDY OF DIAZEPAM AS A PRE-ANESTHETIC IN COMBINATION WITH VARIOUS ANESTHETICS DURING ORCHIDECTOMY IN DOGS." Agrobiological Records 3 (November 1, 2020): 24–28. http://dx.doi.org/10.47278/journal.abr/2020.021.
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Diazepam as a Pre-anesthetic with Propofol or Ketamine HCl has vital combinations for the induction of anesthesia in dogs. The main objective of the study was to provide cost effective and safest injectable anesthetic cocktail for induction of anesthesia in dogs and to evaluate undesired effects on liver and kidneys of the anesthetic agent. Experimental dogs (n=12) were placed equally in two groups (A and B). Each animal from group A was administer Diazepam with Propofol blend while that of group B was given Diazepam with Ketamine HCl. Orchidectomy was performed as per standard protocols for considering as a pain module. Physical parameters like temperature (P>0.05), pulse (P<0.05) and respiration (P<0.05) and Biochemical parameters like Renal (P>0.05) and liver functioning test (P<0.05) were performed. This research reveals that Diazepam with Ketamine HCl depicts better results over Diazepam with Propofol. It can be concluded that Diazepam with Ketamine HCl shows a safe, cost effective, ideal and easily obtainable anesthesia with least drastic hazards over kidney and liver. So, Diazepam in combination with Ketamine HCl can be used for induction of anesthesia and to execute major as well as minor surgical exercises on dogs.
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Müller-Suur, Niels, Peter P. Kleemann, Frank Brost, and Miklos B. Halmagyi. "Induction of Ether Anesthesia Using Adjuvants for Emergency Treatment." Prehospital and Disaster Medicine 1, S1 (1985): 288–90. http://dx.doi.org/10.1017/s1049023x00044782.
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Ether is almost a unique anesthetic agent, because it may be given to traumatized patients without any additional oxygen supply. But the significantly high stage of excitement during ether anesthesia can be dangerous, especially in disaster situations.In the Netherlands, Crul developed a training program for application of ether anesthesia combined with droperidol as adjuvant. Incited by Crul's clinical training method, we studied, in comparison with Guedel's Table, the behavior of clinical signs during induction of ether anesthesia, using droperidol, diazepam or ketamine as adjuvants. We controlled especially the duration of induction, as well as the intensity of clinical signs in the stage of excitement.
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Al-Hyani, O. H. "Comparison between tow techniques for induction of general anesthesia : popofol –fentanyl and ketamine fentanyl in dogs." Al-Qadisiyah Journal of Veterinary Medicine Sciences 9, no. 1 (2010): 12. http://dx.doi.org/10.29079/vol9iss1art87.
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This study was conducted to evaluate the anesthetic quality between propofol-fentanyl mixture (P-F)(2 mg/kg+0.004 mg/kg, i.v., respectively)and ketamine-fentanyl mixture (K-F)(10 mg/kg+0.004 mg/kg, i.v., respectively) in six adult dogs premedicated with atropine (0.05 mg/kg, i.m.) and xylazine (2 mg/kg, i.m.).The results revealed the presence of significant difference (p< 0.05) only in the induction of anesthesia, recovery and standing period between both protocols.P-F mixture produced rapid, smooth and free of excitement induction (9.50 ± 0.76 sec) with transit apnea (19.16±2.4 sec). The duration of anesthesia was (23.33 ± 2.10 min), narcosis (32.50± 1.70 min) and anesthesia characterized by good muscle relaxation and abolishment of all reflexes with decrease in R.R. and increase in H R. Recovery was calm and rapid (46.6±2.25 min) and standing time was short (14.16±1.40 min),While anesthesia with K-F mixture characterized by slow and rough induction (29.16±1.53 sec), poor to moderate muscle relaxation and relatively shorter duration of anesthesia (18.83 ± 3.11 min)with narcosis for about(30.83 ± 5.23 min). The reflexes did not abolish completely especially eye reflexes (corneal and palpebral) and the eyes remained open. H.R. was increased but R.R. was decreased. Recovery was long and rough (78.33 ± 4.77 min) and stand time for (47.50±3.09 min).In conclusion, (P-F) mixtures produce excellent induction of general anesthesia rather than (K-F) in dogs and up to know this is the first report on the uses of these mixtures for induction of anesthesia in dogs.
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Kurniyanta, Putu, Putu Pramana Suarjaya, and Fajar Narakusuma. "EFEKTIVITAS TEKNIK ANESTESI LOW FLOW DIBANDINGKAN TEKNIK ANESTESI INHALASI STANDAR PADA ANAK USIA 1-6 TAHUN YANG MENJALANI OPERASI DI PROF. DR. I.G.N.G. NGOERAH DENPASAR." E-Jurnal Medika Udayana 12, no. 6 (2023): 19. http://dx.doi.org/10.24843/mu.2023.v12.i06.p04.
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Since the discovery of sevoflurane, it has been commonly used due to its many advantages, including its safety profile for pediatric anesthesia practice. However, currently no ideal recommendation for how much gas flow should be used during induction in children. High fresh gas flow (FGF) causes waste of anesthetic and oxygen gases, making it both uneconomical and environmentally polluting. To date, there have been very few studies on low FGF in children, so there is no best and efficient method for reducing the need for large amounts of induction gas. The aim of this study is to determine the effectiveness of the low low anesthesia (LFA) technique in reducing sevoflurane volume, induction time, and hemodynamics during surgery in children undergoing surgery. This is a case-control study conducted at Prof. Dr. I.G.N.G Ngoerah Hospital in Denpasar. Forty-six children aged 1 - 6 years underwent elective surgery and were anesthetized with sevoflurane and randomly divided into two groups: the case group using the low-flow anesthesia technique and the control group using the standard anesthesia technique. The case and control groups were statistically similar in terms of demographic data. However, the volume of sevoflurane used from the time of premedication to intubation was significantly different (p > 0.05) between the two groups (35.5 ml vs 44.5 ml). The induction times were not significantly different (209s vs 201s, p<0.05). Additionally, no significant difference was observed regarding hemodynamic stability during anesthesia.
 Keywords : anesthesia induction, hemodynamic stability, low flow anesthesia, sevoflurane
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Carroll, Gwendolyn L., Sandee M. Hartsfield, and Regina Hambleton. "Anesthetic effects of tiletamine-zolazepam, alone or in combination with butorphanol, in goats." Journal of the American Veterinary Medical Association 211, no. 5 (1997): 593–97. http://dx.doi.org/10.2460/javma.1997.211.05.593.
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Objective To evaluate anesthetic effects of tiletamine-zolazepam (TZ), alone or in combination with butorphanol, in goats undergoing laparotomy for embryo collection. Design Randomized clinical trial with crossover design. Animals 9 adult female goats. Procedure Goats were anesthetized twice: once with TZ (5.5 mg/kg [2.5 mg/lb] of body weight, IV) and once with tiletamine-zolazepam and butorphanol (0.1 mg/kg [0.045 mg/lb], IV). Additional doses of TZ (0.5 to 1.0 mg/kg [0.23 to 0.45 mg/lb], IV) were administered as needed to maintain a surgical anesthetic plane. Time to sternal recumbency was recorded, and quality of induction was scored. Arterial pressures, heart rate, respiratory rate, and rectal temperature were recorded every 5 minutes; arterial blood samples were collected every 30 minutes. Oxygen was insufflated if estimated saturation of hemoglobin in peripheral arterial blood with oxygen was < 90%; intermittent positive-pressure ventilation was performed if goats became apneic. Muscle relaxation, quality of anesthesia, and eye signs were scored every 15 minutes during anesthesia. Anesthesia time was recorded, and quality of recovery and degree of postoperative analgesia were scored. Plasma cortisol concentration was measured before induction, immediately after extubation, and 2 hours after extubation. Results Induction was rapid and smooth. Five goats regurgitated, 3 required supplemental oxygen, and 1 required intermittent positive-pressure ventilation, but none of the goats became hypotensive. Muscle relaxation and quality of anesthesia were adequate. Goats recovered from anesthesia without complications. We did not detect any significant differences between anesthetic regimens for any of the variables measured, except bicarbonate concentration and base excess. Clinical Implications TZ at a dose of 5.5 mg/kg was satisfactory for anesthetic induction in goats; additional doses can be given to extend anesthesia time, but addition of butorphanol at a dose of 0.1 mg/kg to this regimen does not seem to provide any measurable benefit. An oxygen source and a means of assisting ventilation should be available. (J Am Vet Med Assoc 1997;211:593–597)
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Li, Fengxian, Changxiong J. Guo, Cheng-Chiu Huang, et al. "Transient Receptor Potential A1 Activation Prolongs Isoflurane Induction Latency and Impairs Respiratory Function in Mice." Anesthesiology 122, no. 4 (2015): 768–75. http://dx.doi.org/10.1097/aln.0000000000000607.
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Abstract Background: Isoflurane is a potent volatile anesthetic; however, it evokes airway irritation and neurogenic constriction through transient receptor potential (TRP) A1 channels and sensitizes TRPV1 channels, which colocalizes with TRPA1 in most of the vagal C-fibers innervating the airway. However, little is known about the precise effects of these two channels on the respiratory function during isoflurane anesthesia. Methods: By using a rodent behavioral model and whole-body plethysmograph, the authors examined the response of Trpa1−/− and Trpv1−/− mice to isoflurane anesthesia and monitored their respiratory functions during anesthesia. Results: This study showed that Trpa1−/− mice (n = 9), but not Trpv1−/− mice (n = 11), displayed a shortened induction latency compared with wild-type mice (n = 10) during isoflurane anesthesia (33 ± 2.0 s in wild-type and 33 ± 3.8 s in Trpv1−/−vs. 17 ± 1.8 in Trpa1−/− at 2.2 minimum alveolar concentrations). By contrast, their response to the nonpungent volatile anesthetic sevoflurane is indistinguishable from wild-type mice (24 ± 3.6 s in wild-type vs. 26 ± 1.0 s in Trpa1−/− at 2.4 minimum alveolar concentrations). The authors discovered that Trpa1−/− mice inhaled more anesthetic but maintained better respiratory function. Further respiration pattern analysis revealed that isoflurane triggered nociceptive reflexes and led to prolonged resting time between breaths during isoflurane induction as well as decreased dynamic pulmonary compliance, an indicator of airway constriction, throughout isoflurane anesthesia in wild-type and Trpv1−/− mice, but not in Trpa1−/− mice. Conclusion: Activation of TRPA1 by isoflurane negatively affects anesthetic induction latency by altering respiratory patterns and impairing pulmonary compliance.
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de Jesus, Jairo Ramos, Ingrid Horlle Schein, Sabrina Tabajara de Souza, Aline Fantinel Pazzim, Karine Gehlen Baja, and Tatiana Lichmann. "Inhalational anesthesia in the penectomy of a Jabuti Piranga (Chelonoidis carbonaria) – a case report." Clínica Veterinária XVIII, no. 107 (2013): 88–98. http://dx.doi.org/10.46958/rcv.2013.xviii.n.107.p.88-98.
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Reptiles represent a challenge for the veterinary anesthesiologist. Anesthesia efficiency requires planning, patience and knowledge for either healthy or diseased patients. The anesthetic success depends on knowledge about the specific requirements of each species and accurate understanding of the anatomy and physiology of these patients. Inhalation anesthesia is effective and presents major advantages in reptiles, for it allows more accurate adjustment of anesthesia depth and permanent control of ventilation, as well as a quicker recovery. The present article reports an inhalational anesthesia performed in a Jabuti Piranga (Chelonoidis carbonaria). Ketamine and butorphanol were used as pre-anesthetic medication and isoflurane was used for anesthesia induction and maintenance in a vaporizer calibrated with a Baraka open circuit. The anesthetic protocol proved effective for the species.
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Yaygingul, Rahime, Ali Belge, Ibrahim Akin, Cengiz Unsal, Osman Bulut, and Nuh Kilic. "Comparison of Clinical and Hemodynamic Effects of Isoflurane and Sevoflurane Anesthesia in Calves." Acta Scientiae Veterinariae 45, no. 1 (2017): 10. http://dx.doi.org/10.22456/1679-9216.80728.
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Background: Inhalation anesthesia is the preferred method for use on many animal species, including ruminants, due to its superiority over the injectable anesthetics. The most commonly used inhalation anesthetics are isoflurane and sevoflurane The aim of the study was to investigate the effects of isoflurane and sevoflurane anesthesia on the cardiovascular system of calves.Materials, Methods & Results: A total of 20 calves (11 male, 9 female) between 1 and 6 months in age and 50 to 85 kg in body weight were used. The calves were divided randomly into two groups of 10 each, with one group being administered isoflurane and the other sevoflurane. An intramuscular dosage of 0.1 mg/kg of xylazine was administered to the calves as premedication. Induction was performed 10 min after calves were given an intramuscular dosage of 4 mg/kg of ketamine. Inhalation anesthesia was maintained with isoflurane or sevoflurane in 100% oxygen saturation. Before anesthesia, after induction and at intervals of 5, 10, 15, 20, 25, 30, 45, and 60 min of anesthesia, the body temperature, heart rate, and respiratory rate of the calves were recorded. Additionally, before anesthesia, after induction and at intervals of 15, 30, 45, and 60 min of anesthesia, serum electrolyte (Na+, Ca++, K+, Mg++) and blood gases (pH, pCO2, pO2, HCO3-, TCO2, O2Sat, HCT) were evaluated from blood samples taken from both groups. The second derivation, durations and amplitudes of the P and T waves, the durations and amplitudes of the QRS complex, and the durations of PQ and QT intervals were evaluated on the ECGs recorded before anesthesia, after induction and during anesthesia. Following anesthesia termination, the extubation time and the time it took for straightening of the head and standing up were recorded. Decrease in heart rate and body temperature were found significant in two of the groups. Decrease in respiratory rate compared to initial values after premedication was statistically significant for both groups. However, during anesthesia, an increase occurred. This incresae in respiration rate was not statistically significant compared to initial values. The incease in the values of pCO2, pO2, HCO3 and the decrease in the values of pH and Hct comparing the initial values was found statistically significant in both groups.Discussion: In ruminants, isoflurane has an induction concentration of 3-5% and an anesthetic concentration of 1.5-3%, while sevoflurane has an induction concentration of 4-6% and an anesthetic concentration of 2.5-4%. In this study, the concentration of isoflurane was 2.3% (2-5) and the of sevoflurane was 4.07% (3-5) for surgery. In the isoflurane group, extubation, straightening of the head and standing up times were 12.40 ± 3.77 min, 20.4 ± 1.57 min, and 30.80 ± 1.89 min, respectively. In the sevoflurane group, extubation, straightening of the head and standing up times were 13.40 ± 4.99, 19.2 ± 1.49, and 28.0 ± 1.83 min, respectively. Although the calves in the isoflurane group were extubated earlier than those of the sevoflurane group, the time elapsed for straightening of the head and standing up were longer than that of the sevoflurane group. The anesthesia protocol provided a smooth anesthetic administration, general anesthesia and awakening. In conclusion, the effects of isoflurane and sevoflurane anesthesia on the cardiovascular and respiratory system were similar, and although the changes that emerged during anesthesia were statistically significant, it was nonetheless found that the changes were within the physiological limits.
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Konstantinov, A. V., S. V. Chistyakov, and I. G. Trifanenkova. "On the question of choosing the optimal method of anesthesia for laser coagulation of the retina in infants with retinopathy of prematurity." Russian ophthalmology of children, no. 1 (April 2, 2021): 5–10. http://dx.doi.org/10.25276/2307-6658-2021-1-5-10.
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Purpose. To evaluate the method of anesthesia used in the Kaluga branch of the Fyodorov Eye Microsurgery Federal State Institution for retinal laser photocoagulation in premature infants with retinopathy of prematurity. Materials and methods. The data of children diagnosed with retinopathy of prematurity was analyzed for the period 2017– 2019. These children underwent retinal laser photocoagulation under general anesthesia at the Kaluga branch of the Fyodorov Eye Microsurgery Federal State Institution. As an anesthetic aid, inhalation monoanesthesia with sevoflurane by the method of «bolus» induction was carried out starting from 6–8 vol% with a Mapleson circuit filled with a gas-narcotic mixture of oxygen and air. Induction with using a face mask with reaching the surface level of the surgical stage of anesthesia was fixed by 4–5 minutes. Then, for better airway patency, the laryngeal mask was fixed. Results. With «bolus» induction, the surgical stage of anesthesia occurred within 3–4 minutes. The patient was in the optimal anesthetic condition for laser surgery during the entire surgical process. The eyeballs had a fixed central position, muscle tone was reduced, breathing was even, and there was no reaction to pain stimulus. No significant changes in the heart rate were revealed when monitoring the parameters of the state of the cardiovascular system during induction was being performed. In children with profound prematurity, a slight increase in heart rate was determined (10–15%) in the intraoperative period. The heart rate returned to its original values at the end of anesthesia. The exit from the narcotic state was characterized by smoothness and was carried out immediately after the elimination of the anesthetic within 4–8 minutes. Severe complications from vital systems and pronounced changes in behavioral reactions were not observed, in the immediate postoperative period. Conclusion. The use of this technology makes it possible to provide high-quality anesthetic treatment for premature infants during laser treatment of ROP, minimize the negative impact of anesthesia on the patient's body and optimize the work of an anesthesiologist. Key words: retinopathy of prematurity, retinal laser photocoagulation, anesthetic aid, sevoflurane, Mapleson's contour, laryngeal mask.
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Sarner, Joel B., Mark Levine, Peter J. Davis, Jerrold Lerman, Ryan D. Cook, and Etsuro K. Motoyama. "Clinical Characteristics of Sevoflurane in Children." Anesthesiology 82, no. 1 (1995): 38–46. http://dx.doi.org/10.1097/00000542-199501000-00006.
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Background For pediatric patients, sevoflurane may be an alternative to halothane, the anesthetic agent used most commonly for inhalational induction. The induction, maintenance, and emergence characteristics were studied in 120 unpremedicated children 1-12 yr of age randomly assigned to receive one of three anesthesia regimens: sevoflurane with oxygen (group S), sevoflurane with nitrous oxide and oxygen (group SN), or halothane with nitrous oxide and oxygen (group HN). Methods Anesthetic was administered (via a Mapleson D, F or Bain circuit) beginning with face mask application in incremental doses to deliver maximum inspired concentrations of 4.5% halothane or 7% sevoflurane. End-tidal concentrations of anesthetic agents and vocal cord position were noted at the time of intubation. Elapsed time intervals from face mask application to loss of the eyelash reflex, intubation, surgical incision, and discontinuation of the anesthetic were measured. Heart rate, systolic, diastolic, and mean blood pressures, and end-tidal anesthetic concentrations were measured at fixed intervals. Anesthetic MAC-hour durations were calculated. The end-tidal concentration of anesthetic was adjusted to 1 MAC (0.9% halothane, 2.5% sevoflurane) for at least the last 10 min of surgery. Intervals from discontinuation of anesthetic to hip flexion or bucking, extubation, administration of first postoperative analgesic, and attaining discharge criteria from recovery room were measured. Venous blood was sampled at anesthetic induction, at the end of anesthesia, and 1, 4, 6, 12, and 18-24 h after discontinuation of the anesthetic for determination of plasma inorganic fluoride content. Results Induction of anesthesia was satisfactory in groups SN and HN. Induction in group S was associated with a significantly greater incidence of excitement (35%) than in the other groups (5%), resulting in a longer time to intubation. The end-tidal minimum alveolar concentration multiple of potent inhalational anesthetic at the time of intubation was significantly greater in patients receiving halothane than in patients receiving sevoflurane. Induction time, vocal cord position at intubation, time to incision, duration of anesthesia, and MAC-hour duration were similar in the three groups. During emergence, the time to hip flexion was similar among the three groups, whereas the time to extubation, time to first analgesic, and time to attaining discharge criteria were significantly greater in group HN than in groups S and SN. Mean heart rate and systolic blood pressure decreased during induction in group HN but not in groups S and SN. The maximum serum fluoride concentration among all patients was 28 microM. Conclusions Sevoflurane with nitrous oxide provides satisfactory anesthetic induction and intubating conditions; however, induction using sevoflurane without nitrous oxide is associated with a high incidence of patient excitement and prolonged time to intubation. There were greater decreases in heart rate and systolic blood pressure during induction with halothane than with sevoflurane; however, these differences may be dose-related. The more rapid emergence with sevoflurane when compared with halothane is consistent with the low solubility of sevoflurane in blood and tissues. Children receiving sevoflurane for up to 9.6 MAC-hours did not develop high serum fluoride concentrations.
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Hodgson, John A., Heine Rivera-Rodriguez, Peter Wu, Jaison Udani, and Jeffrey Weiss. "Point-of-Care Ultrasound Aids in the Management of Patient Taking Semaglutide Before Surgery: A Case Report." A&A Practice 18, no. 3 (2024): e01762. http://dx.doi.org/10.1213/xaa.0000000000001762.
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Semaglutide, a glucagon-like peptide-1 (GLP-1) analog, has various effects on the gastrointestinal tract. In patients undergoing anesthesia delayed gastric emptying time can have sequelae if not identified preoperatively. Modalities include thorough history regarding the last dose administration of a GLP-1 analog and ultrasound of gastric contents before induction of anesthesia. We present a case in which gastric ultrasound identified a patient at increased risk for aspiration on induction and allowed for appropriate alterations in the anesthetic plan.
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Kandearachchi, K. A. M. S. P., A. G. H. Menike, K. G. Madawala, et al. "Spinal Myoclonus a Rare Complication Following Administration of Spinal Anaeasthesia – A Case Report." Sri Lankan Journal of Anaesthesiology 32, no. 1 (2024): 74–78. http://dx.doi.org/10.4038/slja.v32i1.9251.
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Spinal myoclonus is a rare complication following spinal anesthesia. Transient myoclonic jerks are referred as spinal myoclonus and it is diagnosed by exclusion. This case report describes a successful management of spinal myoclonus after spinal anesthesia.A 48 year old, woman who had undergone incision and drainage under spinal anesthesia, developed truncal myoclonus 45 minutes following induction of anesthesia. It was effectively alleviated through administration of IV midazolam.
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Tang, Jun, Lei Chen, Paul F. White, et al. "Recovery Profile, Costs, and Patient Satisfaction with Propofol and Sevoflurane for Fast-track Office-based Anesthesia." Anesthesiology 91, no. 1 (1999): 253–61. http://dx.doi.org/10.1097/00000542-199907000-00034.
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Background Office-based surgery is becoming increasingly popular because of its cost-saving potential Both propofol and sevoflurane are commonly used in the ambulatory setting because of their favorable recovery profiles. This clinical investigation was designed to compare the clinical effects, recovery characteristics, and cost-effectiveness of propofol and sevoflurane when used alone or in combination for office-based anesthesia. Methods One hundred four outpatients undergoing superficial surgical procedures at an office-based surgical center were randomly assigned to one of three general anesthetic groups. In groups I and II, propofol 2 mg/kg was administered for induction followed by propofol 75-150 microg x kg(-1) x min(-1) (group I) or sevoflurane 1-2% (group II) with N2O 67% in oxygen for maintenance of anesthesia In group m, anesthesia was induced and maintained with sevoflurane in combination with N2O 67% in oxygen. Local anesthetics were injected at the incision site before skin incision and during the surgical procedure. The recovery profiles, costs of drugs, and resources used, as well as patient satisfaction, were compared among the three treatment groups. Results Although early recovery variables (e.g., eye opening, response to commands, and sitting up) were similar in all three groups, the times to standing up and to be "home ready" were significantly prolonged when sevoflurane-N2O was used for both induction and maintenance of anesthesia. The time to tolerating fluids, recovery room stay, and discharge times were significantly decreased when propofol was used for both induction and maintenance of anesthesia. Similarly, the incidence of postoperative nausea and vomiting and the need for rescue antiemetics were also significantly reduced after propofol anesthesia. Finally, the total costs and patient satisfaction were more favorable when propofol was used for induction and maintenance of office-based anesthesia Conclusion Compared with sevoflurane-N2O, use of propofol-N2O for office-based anesthesia was associated with an improved recovery profile, greater patient satisfaction, and lower costs. There were significantly more patients who were dissatisfied with the sevoflurane anesthetic technique.
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Williams, Brian A., Michael L. Kentor, John P. Williams, et al. "Process Analysis in Outpatient Knee Surgery." Anesthesiology 93, no. 2 (2000): 529–38. http://dx.doi.org/10.1097/00000542-200008000-00033.
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Background The performance of anesthetic procedures before operating room entry (e.g., with either general or regional anesthesia [RA] induction rooms) should decrease anesthesia-controlled time in the operating room. The authors retrospectively studied the associations between anesthesia techniques and anesthesia-controlled time, evaluating one surgeon performing a single procedure over a 3-yr period. The authors hypothesized that, using the anesthesia care team model, RA would be associated with reduced anesthesia-controlled time compared with general anesthesia (GA) alone or combined general-regional anesthesia (GA-RA). Methods The authors queried an institutional database for 369 consecutive patients undergoing the same procedure (anterior cruciate ligament reconstruction) performed by one surgeon over a 3-yr period (July 1995 through June 1998). Throughout the period of study, anesthesia staffing consisted of an attending anesthesiologist medically directing two nurse anesthetists in two operating rooms. Anesthesia-controlled time values were compared based on anesthesia techniques (GA, RA, or GA-RA) using one-way analysis of variance, general linear modeling using time-series and seasonal adjustments, and chi-square tests when appropriate. P &lt; 0. 05 was considered significant. Results RA was associated with the lowest anesthesia-controlled time (11.4 +/- 1.3 min, mean +/- 2 SEM). GA-RA (15.7 +/- 1.0 min) was associated with lower anesthesia-controlled time than GA used alone (20.3 +/- 1.2 min). Conclusions When compared with GA without an induction room for outpatients undergoing anterior cruciate ligament reconstruction, RA with an induction room was associated with the lowest anesthesia- controlled time. Managers must weigh the costs and time required for anesthesiologists and additional personnel to place nerve blocks or induce GA preoperatively in such a staffing model.
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Wang, Melinda, and Fred Sanford Gorelick. "Ketamine and xylazine effects in murine model of acute pancreatitis." American Journal of Physiology-Gastrointestinal and Liver Physiology 320, no. 6 (2021): G1111—G1122. http://dx.doi.org/10.1152/ajpgi.00023.2021.
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Ketamine and xylazine anesthetic agent administration before acute pancreatitis induction in mice lead to changes in pancreatitis responses independent of acute pancreatitis induction. Future studies should consider the potential effects of anesthesia administration when studying disease processes associated with inflammation and injury.
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Palmer, Lucy M., and Allen F. Mensinger. "Effect of the Anesthetic Tricaine (MS-222) on Nerve Activity in the Anterior Lateral Line of the Oyster Toadfish, Opsanus tau." Journal of Neurophysiology 92, no. 2 (2004): 1034–41. http://dx.doi.org/10.1152/jn.01151.2003.
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Inductive neural telemetry was used to record from microwire electrodes chronically implanted into the anterior lateral line nerve of the toadfish, Opsanus tau. Spontaneous neural activity and the response of lateral line fibers to water current were continually monitored from 17 primary afferent fibers before, during, and after the administration of the anesthetic tricaine (MS-222). Significant decrease in spontaneous and evoked activity and increase in interspike interval was noted when anesthetic concentrations were ≥0.010%. Neural activity returned to control levels within ∼90 min of anesthetic withdrawal. Decreasing the pH of the solution without the anesthetic caused transient heightened sensitivity, indicating that tricaine and not the concurrent drop in pH was responsible for the decrease in sensitivity during anesthesia. During a secondary challenge with the anesthetic 24 h after the first, fibers initially showed faster recovery however overall recovery kinetics were similar. Although high tricaine concentration was correlated with decreased neural sensitivity, the concentrations normally used to maintain anesthesia in the toadfish did not have significant effect on the evoked firing rate. Thus given sufficient time to recover from the induction of surgical anesthesia, it may be possible to maintain the animal under light anesthesia while minimizing the physiological effects of tricaine.
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Dahaba, Ashraf A., Ji Xiu Xue, Guo Guang Zhao, et al. "BIS-Vista™ Occipital Montage in Patients Undergoing Neurosurgical Procedures during Propofol–Remifentanil Anesthesia." Anesthesiology 112, no. 3 (2010): 645–51. http://dx.doi.org/10.1097/aln.0b013e3181cf4111.
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Background Neurosurgical procedures that require a frontal approach could be an impediment for a successful Bispectral Index (BIS) frontal sensor placement. The aim of this study was to explore the utility of using the new BIS-Vista monitor (Aspect Medical Systems, Newton, MA) for occipital sensor placement in the patients undergoing brain neurosurgical procedures during propofol-remifentanil anesthesia. Methods Two BIS Quatro sensors (Aspect Medical Systems, Newton, MA) mounted on the occipital and frontal regions were connected to two BIS-Vista monitors at three anesthesia states: before induction, during anesthesia maintenance, and recovery. Results There were significant differences before induction (P = 0.0002) and at anesthesia maintenance (P = 0.0014) between mean +/- SD occipital (83.4 +/- 4.8, 66.7 +/- 7.2) and frontal (93.1 +/- 3.4, 56.9 +/- 9.1) BIS-Vista values. During anesthesia recovery, there was no difference (P = 0.7421) between occipital (54.6 +/- 9.3) and frontal (53.1 +/- 7.3) BIS-Vista values. Bland and Altman analysis revealed a BIS-Vista negative-bias (limits of agreement) of -9.7 (+1.1, -20.5) before anesthesia induction, +9.8 positive-bias (+22.8, -1.7) during anesthesia maintenance, and -0.9 bias (+10.9, -12.8) during anesthesia recovery. Conclusion We demonstrated that not only the regional limits of agreement are too wide to allow data of the two montages to be used interchangeably but also the variation is a function of anesthetic depth. However, keeping in mind a relatively consistent BIS-Vista -10 bias before induction and +10 bias during anesthesia maintenance with limits of agreement of approximately +/-11 BIS units, approximately double the clinically acceptable less than 10 BIS units level of agreement, BIS-Vista off-label occipital montage might be helpful in following a trend of propofol-remifentanil anesthesia in individual cases where frontal access is particularly difficult.
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Reis, Thaysa de Sousa, Daniella Bastos de Araújo, Clarissa Araújo da Paz, et al. "Etomidate as an anesthetic in Colossoma macropomum: Behavioral and electrophysiological data complement each other as a tool to assess anesthetic safety." PLOS ONE 19, no. 8 (2024): e0305093. http://dx.doi.org/10.1371/journal.pone.0305093.
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The use of anesthetic agents in the management of fish in fish farming or ornamental fish breeding aims to minimize stress and promote animal welfare. Therefore, this study aims to investigate behavioral, electrocardiographic, and ventilatory characteristics of tambaquis exposed to anesthetic baths with etomidate. The study was conducted with juvenile tambaquis (27.38 ± 3.5g) n = 99, at etomidate concentrations of 2–4 mg.L -1, analyzing induction and anesthetic recovery behavior (experiment I), electrocardiogram (experiment II), and opercular movement (experiment III). Fish exposed to high concentrations of etomidate reached the stage of general anesthesia faster, however, the recovery time was longer, characterizing a dose-dependent relationship. Cardiorespiratory analyzes demonstrated a reduction in heart rate (69.19%) and respiratory rate (40.70%) depending on the concentration of etomidate used during anesthetic induction. During the recovery period, there was cardiorespiratory reversibility to normality. Therefore, etomidate proved to be safe as an anesthetic agent for this species at concentrations of 2 to 3 mg.L -1 for short-term anesthesia, but at higher doses the animals showed slow reversibility of anesthesia in a gradual manner and without excitability. The hemodynamic effect due to the rapid decrease in heart rate includes a negative factor of using higher concentrations of etomidate for Colossome macropomum anesthesia.
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Schumacher, Juergen, Scott B. Citino, Kelly Hernandez, Julie Hutt, and Brandon Dixon. "Cardiopulmonary and anesthetic effects of propofol in wild turkeys." American Journal of Veterinary Research 58, no. 9 (1997): 1014–17. http://dx.doi.org/10.2460/ajvr.1997.58.09.1014.
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Abstract Objective To determine safety, anesthetic variables, and cardiopulmonary effects of IV infusion of propofol for induction and maintenance of anesthesia in wild turkeys. Animals 10 healthy, adult wild turkeys. Procedure Anesthesia was induced by IV administration of propofol (5 mg/kg of body weight) over 20 seconds and was maintained for 30 minutes by constant IV infusion of propofol at a rate of 0.5 mg/kg/min. Heart and respiratory rates, arterial blood pressures, and arterial blood gas tensions were obtained prior to propofol administration (baseline values) and again at 1, 2, 3, 4, 5, 10, 15, 20, 25, and 30 minutes after induction of anesthesia. All birds were intubated immediately after induction of anesthesia, and end-tidal CO2 concentration was determined at the same time intervals. Supplemental oxygen was not provided. Results Apnea was observed for 10 to 30 seconds after propofol administration, which induced a decrease in heart rate; however, the changes were not significant. Compared with baseline values, respiratory rate was significantly decreased at 4 minutes after administration of propofol and thereafter. Systolic, mean, and diastolic pressures decreased over the infusion period, but the changes were not significant. Mean arterial blood pressure decreased by 30% after 15 minutes of anesthesia; end-tidal CO2 concentration increased from baseline values after 30 minutes; PO2 was significantly decreased at 5 minutes after induction and thereafter; PCO2 was significantly (P< 0.05) increased after 15 minutes of anesthesia; and arterial oxygen saturation was significantly (P < 0.05) decreased at the end of anesthesia. Two male turkeys developed severe transient hypoxemia, 1 at 5 and the other at 15 minutes after induction. Time to standing after discontinuation of propofol infusion was 11 ± 6 minutes. Recovery was smooth and unremarkable. Conclusion Propofol is an effective agent for IV induction and maintenance of anesthesia in wild turkeys, and is useful for short procedures or where the use of inhalational agents is contraindicated. (Am J Vet Res 1997;58:1014–1017)
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Hanss, Robert, Björn Buttgereit, Peter H. Tonner, et al. "Overlapping Induction of Anesthesia." Anesthesiology 103, no. 2 (2005): 391–400. http://dx.doi.org/10.1097/00000542-200508000-00023.
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Background Overlapping induction (OI), i.e., induction of anesthesia with an additional team while the previous patient is still in the operating room (OR), was investigated. Methods The study period was 60 days in two followed by three ORs during surgical Block Time (7:30 am until 3:00 pm). Patients were admitted the day before surgery and were thus available and did not have surgery that day unless there was a time reduction. Facilities were already constructed. Number of cases, Nonsurgical Time (Skin Suture Finish until next Procedure Start Time), Turnover Time, and Anesthesia Control Time plus Turnover Time were studied. In addition, economic benefit was calculated. Results Three hundred thirty-five cases were studied. Using OI, the time of care of regularly scheduled cases was shortened, and the number of cases performed within OR Block Time increased (151 to 184 cases; P &lt; 0.05). Nonsurgical Time (in h:min) decreased (1:08 +/- 0:26 to 0:57 +/- 0:18; P &lt; 0.001), Turnover Time decreased (0:38 +/- 0:24 to 0:25 +/- 0:15; P &lt; 0.05), and Anesthesia Control Time plus Turnover Time decreased (0:43 +/- 0:23 to 0:28 +/- 0:18; P &lt; 0.001). Subgroup analysis showed a significant benefit of OI only in three ORs. In three ORs, economic benefit can be gained at a case mix index greater than 0.3 besides additional costs. Conclusions Overlapping induction increased productivity and profit despite the expense of additional staff. Subgroup analysis emphasizes the importance of the number of ORs involved in OI.
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Chapman, Niels N., and Bruce F. Cullen. "ANESTHESIA INDUCTION AND MAINTENANCE." Anesthesiology Clinics of North America 14, no. 1 (1996): 173–95. http://dx.doi.org/10.1016/s0889-8537(05)70395-3.
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Koyama, Yuhei, and Shinsuke Hamaguchi. "Challenging treatment of severe hypotension following tracheal intubation in a patient with primary hyperparathyroidism: A case report." Medicine 103, no. 35 (2024): e39510. http://dx.doi.org/10.1097/md.0000000000039510.
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Rationale: Primary hyperparathyroidism (PHPT), which is characterized by increased parathyroid hormone secretion, typically manifests as hypercalcemia and hypertension. Here, we report a case of severe hypotension following tracheal intubation during anesthesia induction in a patient with PHPT, in contrast to the expected hypertensive response. Patient concerns: A 52-year-old man presented with nausea after eating, leg pain when walking, and headaches. Diagnosis: Based on the blood test and computed tomography results, he was diagnosed with PHPT. Interventions: The patient underwent parathyroidectomy under general anesthesia. After induction anesthesia and tracheal intubation, severe acute hypotension and tachycardia suddenly developed. To treat hypotensive shock, we immediately administered ephedrine and phenylephrine and infused Ringer solution. Outcomes: The symptoms of hypotensive shock were alleviated by this intervention. Lessons: We speculate that the cause of his severe hypotension was vasodilation due to the transient release of parathyroid hormone from mechanical stimulation by anesthetic procedures, such as tracheal intubation, combined with hypercalcemia-induced severe dehydration. Moreover, we speculate that fluid resuscitation stabilized his condition and helped achieve a successful surgical outcome. The possibility of severe hypotension after anesthesia induction should be anticipated, and management of cases with severe dehydration should be optimized during the anesthetic management of patients with PHPT.
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Abid AL-Redah, Sameer A., and Neeran F. Hassan. "Efficacy of tramadol as analgesic and mixed with ketamine, xylazine as anesthetic in rabbits." Kufa Journal For Veterinary Medical Sciences 2, no. 1 (2011): 1–11. http://dx.doi.org/10.36326/kjvs/2011/v2i14039.
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This study were performed to evaluate the efficacy of Tramadol as analgesic and efficacy of using Tramadol in combination with other drugs like Ketamine and Xylazine in anesthetic protocols in rabbits. 15 adult New Zealand white rabbits divided to 3 equal groups were anesthetized intramuscularly in one syringe, group 1 with Tramadol 15 mg/kg B.W, group 2 with Tramadol 15mg/Kg B.W and Ketamine 30mg/Kg B.W, group 3 with Tramadol 15mg/Kg B.W and Ketamine 30mg/Kg B.W and Xylazine 5mg/Kg B.W, physiologic parameters were evaluated including : body temperature, heart rate, respiratory rate, muscle relaxation, analgesia and stages of anesthesia ( Induction of anesthesia, surgical anesthesia and recovery time).The most significant changes were reported in G3 (T15K30X5) and this combination is useful regimen clinically for anesthetize rabbits due to the fast of induction anesthesia and the long surgical duration of anesthesia.
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LIANG, YUE, ZHENGRU WANG, LIUYANG LI, et al. "Comparison of the anesthesia effects of ketamine, dexmedetomidine and tiletamine-zolazepam with or without tramadol in cats." Medycyna Weterynaryjna 77, no. 09 (2021): 6555–2021. http://dx.doi.org/10.21521/mw.6555.
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This study investigated the analgesia effects of intramuscular injection of ketamine, dexmedetomidine and tiletamine-zolazepam combined with tramadol (KDZT) and compared the efficacy of this combination with that of ketamine, dexmedetomidine and tiletamine-zolazepam (KDZ) in Chinese local mongrel cats. Ten cats were tested twice as a comparison between the two groups, and the interval between the two groups was more than a week. The animals received ketamine (10 mg/kg), dexmedetomidine (10 μg/kg) and zoletil (5 mg/kg) combined with or without tramadol (2 mg/kg) for anesthesia in separate tests. Heart rate, respiration rate, non-invasive systolic pressure, hemoglobin oxygen saturation, rectal temperature, subjective pain scores and venous blood-gas were measured simultaneously. The induction time, recovery time of the righting reflex, standing and walking, the time during the anesthesia period were recorded. Cardiopulmonary variables changed after injection, some of which were significantly different from baselines before anesthesia induction. Values regarding blood gas changed after intramuscular administration, and significant differences were found between two groups at one of the timepoints. Both KDZT and KDZ provided adequate analgesia in cats. The induction period of two anesthetic mixtures was within 1-3 min and could effectively maintain anesthesia for 75-175 min. The change of physiological parameters remained within a biologically acceptable range and was not significantly different between the two groups. The use of KDZT resulted in better anesthesia, with shorter anesthesia induction period and longer anesthesia period compared with KDZ. No side effects were observed, no rescue analgesic was required.
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Schelling, Gustav, Daniela Hauer, Shahnaz Christina Azad, et al. "Effects of General Anesthesia on Anandamide Blood Levels in Humans." Anesthesiology 104, no. 2 (2006): 273–77. http://dx.doi.org/10.1097/00000542-200602000-00012.
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Background The endocannabinoid system includes G-protein-coupled cannabinoid receptors, the endocannabinoids N-arachidonoylethanolamine (anandamide) and 2-arachidonoylglycerol, and multiple enzymes involved in the biosynthesis and degradation of endocannabinoids, including the anandamide metabolizing enzyme fatty acid amide hydrolase. Endocannabinoids play an important role in the physiologic control of sleep, pain processing, and emesis. The authors therefore investigated the effects of general anesthesia on the endocannabinoid system in humans. Methods The authors measured whole blood levels of anandamide in 12 patients after induction of general anesthesia with etomidate (an agent shown to have no effect on anandamide levels) and maintenance of anesthesia with the volatile agent sevoflurane as well as in 12 patients undergoing total intravenous anesthesia with propofol, a known inhibitor of fatty acid amide hydrolase in the mouse brain. Anandamide levels were measured using high-performance liquid chromatography-tandem mass spectrometry at four time points (before and at 10, 20, 30, and 40 min after induction of anesthesia). Results Patients of the sevoflurane group showed a significant decline in anandamide levels from induction of anesthesia to 40 min after induction, whereas anandamide levels in patients of the propofol group remained unchanged (type III sum of squares = 1725.66, F = 162.60, P &lt; 0.001, repeated-measures analysis of variance). Conclusion General anesthesia influences the endocannabinoid system in a drug-dependent way, which may explain side effects of general anesthetics such as psychomimetic and antiemetic properties of propofol and the high incidence of postoperative nausea and vomiting after volatile anesthetics. These findings suggest new targets for anesthetic drug development.
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Khoirul Umamah, Henry Sudiyanto, and Dwiharini Puspitaningsih. "EFEKTIFITAS ANESTESI SPINAL TERHADAP HEMODINAMIK PASIEN SECTIO CAESAREA." Medica Majapahit (JURNAL ILMIAH KESEHATAN SEKOLAH TINGGI ILMU KESEHATAN MAJAPAHIT) 17, no. 1 (2025): 43–51. https://doi.org/10.55316/mm.v17i1.1124.
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Caesarea section surgery uses a spinal anesthesia technique that has many advantages including a faster drug effect, deeper sensory and motoric blockade, a simple technique, minimal impact on the baby, and a small risk of anesthetic drug toxicity. This study is aimed at identifying the relationship and changes in spinal anesthesia to the hemodynamics of patients undergoing a caesarean section at the Central Surgery Facility of Bhayangkara Hospital H.S. Samsoeri Mertojoso Surabaya. This research is a correlation study with the method used, i.e. with a quantitative method with a cross - sectional approach. The independent variables used are spinal anesthesia and the dependent variables that are used are blood pressure, MAP, and pulmonary pressure. The results of the study showed a pre-induction hemodynamic change with the 5th minute after induction. In the 10th and 15th minutes tended to indicate normal state. In correlation tests showed that there was a relationship between the time of pre-induction administration and the 5-th minute of induction in the systolic blood pressure variables and MAP values, but in diastolic and pulmonary blood pressure there was no relationship or correlations at the time. Correlation test results indicated a positive direction of the relationship. The changes before and after the hemodynamics of a caesarean section are caused by the administration of anesthetic drugs, so it can be said that spinal anesthesia has been associated with the haemodynamic changes of a Caesarea section.
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Wagner, Ann E., Colin I. Dunlop, Etta M. Wertz, and Philip L. Chapman. "Evaluation of five common induction protocols by comparison of hemodynamic responses to surgical manipulation in halothane-anesthetized horses." Journal of the American Veterinary Medical Association 208, no. 2 (1996): 252–57. http://dx.doi.org/10.2460/javma.1996.208.02.252.
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Design— To determine whether hemodynamic responses of halothane-anesthetized horses undergoing surgical procedures depended on anesthetic induction protocols used, and to determine whether hemodynamic responses to surgical manipulation could be detected. Design— Prospective experimental study without controls. Animals— 36 clinically normal horses. Procedure— Horses were allotted to 5 groups according to anesthetic induction protocol: acepromazine/guaifene-sin/thiamylal, acepromazine/guaifenesin/ketamine, xyla-zine/guaifenesin/thiamylal, xylazine/guaifenesin/ketamine, and xylazine/diazepam/ketamine. Anesthesia was maintained with halothane. Hemodynamic measurements and blood gas values were obtained prior to the start of surgery, during surgery, and after surgery. Results— Few differences in hemodynamic measurements existed between horses in which anesthesia was induced by 5 anesthetic induction protocols, whether prior to the start of surgery or for pooled values for all 3 measurement periods. Hemodynamic responses to surgical manipulation were marked and included increased mean arterial pressure and systemic vascular resistance, and decreased cardiac index and oxygen delivery. Clinical Implications— Choice of anesthetic induction protocol has little impact on hemodynamic function during surgery in halothane-anesthetized horses. Surgical stimulation may increase blood pressure, but does not improve cardiac index or oxygen delivery. (J Am Vet Med Assoc 1996;208:252-257)
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Cornick, Janyce L., and James Jensen. "Anesthetic management of ostriches." Journal of the American Veterinary Medical Association 200, no. 11 (1992): 1661–66. http://dx.doi.org/10.2460/javma.1992.200.11.1661.
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Summary We evaluated and characterized several anesthetic induction protocols used to facilitate intubation and anesthetic maintenance with isoflurane in 7 adult ostriches and 1 juvenile ostrich. Induction protocols included iv administration of zolazepam/tiletamine, iv administration of diazepam/ketamine with and without xylazine, iv administration of xylazine/ketamine, im administration of carfentanil or xylazine/carfentanil, and mask induction with isoflurane. General anesthesia was maintained with isoflurane in 100% oxygen for various procedures, including proventriculotomy (6 birds), tibial (1 bird) or mandibular (1 bird) fracture repair, and drainage of an iatrogenic hematoma (1 bird). Heart rate and respiratory rate varied greatly among birds. The arterial blood pressure values recorded from 6 of the birds during maintenance of general anesthesia were higher than values recorded for most mammalian species, but were comparable to values reported for awake chickens and turkeys.