OBJECTIVE: Remifentanil is being used increasingly during fast-track cardiac surgery. Postoperative hyperalgesia and opioid tolerance have been reported in volunteer studies and in patients after major abdominal surgery with remifentanil infusion. In the present study, the authors evaluated whether high-dose remifentanil infusion induces opioid tolerance in 90 patients undergoing coronary ...

We did a prospective, randomised, double-blind study to evaluate the efficacy and safety of a small dose of propofol alone, and propofol combined with dexamethasone, for the prevention of postoperative nausea and vomiting in adult Japanese patients listed for third molars extractions. One hundred and twenty patients, 55 men and ...

BACKGROUND: We studied whether a new model of nurse-provision of conscious sedation for cataract surgery maintained patient satisfaction and safety. METHODS: We prospectively and non-randomly studied 106 patients who had outpatient cataract surgery on a day when an anaesthetist was present at the UBC, Vancouver Hospital Eye Care Centre, and ...

OBJECTIVES: To determine if use of nurse practitioners (NPs) for procedural sedation and analgesia (PSA) compared with physicians (MDs) decreased overall length of stay (LOS) in the pediatric emergency department (PED). METHODS: Retrospective chart review was conducted on all children (age <21 years) undergoing procedural sedation and analgesia (PSA) for ...

This prospective study was performed to compare the incidence of complications occurring after neurosurgical procedures in patients anesthetized with either sevoflurane-fentanyl or propofol-remifentanil anesthesia. We enrolled 162 American Society of Anesthesiologists (ASA) I to III patients (82 females and 80 males, Glasgow 15) undergoing elective neurosurgical procedures. Anesthesia was conducted ...

OBJECTIVE: We conducted a study to assess the correlation of bispectral index (BIS) to 2 clinical sedation scales. METHODS: This was a prospective, observational study. The BIS number was recorded at baseline and every 30 seconds. One investigator separately monitored the patients for depth of sedation using the Observer's Assessment ...

OBJECTIVE: The contraceptive efficacy of hysteroscopic sterilization is well documented. The objective of this study was to compare procedure success, patient tolerance, and procedure time of Essure micro-insert hysteroscopic sterilization with or without anesthesia. STUDY DESIGN: Between February 2002 and May 2005, one operator performed 140 sterilization procedures in this ...

In a randomised double blind prospective study, we tested the hypothesis that postoperative pain is lower in patients who receive an ProSeal LMA laryngeal mask airway compared with a tracheal tube. One hundred consecutive female patients (ASA I-II, 18-75 years) undergoing laparoscopic gynaecological surgery were divided into two equal-sized groups ...

BACKGROUND AND AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) requires adequate patient sedation in order to carry out the procedure successfully. Propofol sedation is being increasingly used during ERCP. There are limited data to evaluate the efficacy of synergistic agents with propofol for sedation during ERCP. The aims of the current study ...

BACKGROUND: The aim of this review was to determine whether dexmedetomidine alone provided satisfactory conditions for children undergoing magnetice resonance imaging (MRI). METHODS: A retrospective review of 21 patients was undertaken, (age range: 1-8 years, weight 10-27 kg) who received dexmedetomidine to provide deep sedation for an MRI procedure. RESULTS: ...

BACKGROUND: Awareness under anesthesia can be a frightening experience for patients receiving electroconvulsive therapy (ECT). CASE REPORT: We present a 19-year-old, 62-kg, bipolar woman who was prescribed right unilateral ECT for a treatment-refractory major depressive episode. Her premedication comprised thiopentone sodium (200 mg) and succinylcholine (30 mg). She received 3 ...

BACKGROUND: Anesthesiologist-directed anesthetic preoperative evaluation clinic (APEC) is used to prepare patients to receive anesthesia for surgery. Studies have shown that APEC can reduce preoperative tests, consultations, surgery delays and cancellations. APEC with video-teaching has been purposed as a medium to provide comprehensive information about the process of anesthesia but ...

AIM: This study compared the effect of two different dosages of hydroxyzine supported by 50% nitrous oxide inhalation sedation in child patients. SUBJECTS AND METHODS: Thirty uncooperative healthy children with an age range of 31-120 months were included in this study. Patients were randomly assigned into two groups. The patients ...

OBJECTIVE: To compare the effects of esmolol and remifentanil, used as adjuncts for induced hypotension on surgical conditions and short-term cognitive functions, during tympanoplasty. METHODS: The study was conducted in Hacettepe University, School of Medicine, Ankara, Turkey between January 2005 and December 2006 following Institutional Ethical Committee approval, 40 ASA ...

OBJECTIVE: ENTROPY is a new anesthetic depth monitor based on the analysis of the EEG signal. Our aim has been to evaluate sedation of intubated surgical critically ill patients by means of the Ramsay sedation score, the Bispectral index and ENTROPY, and to analyse the correlation between these variables. METHODS: ...

BACKGROUND: Epinephrine infiltration of the nasal mucosa causes hypotension during functional endoscopic sinus surgery (FESS) under general anesthesia. A prospective randomized-controlled study was designed to determine whether relatively light general anesthesia is superior to fluid expansion in reducing epinephrine-induced hypotension during FESS. METHODS: Ninety patients undergoing elective FESS under general ...

BACKGROUND: Different fluid regimens are often adopted for elderly patients, but it is not known whether they handle infused fluids differently during the induction of anesthesia than young patients. METHODS: Mean arterial pressure (MAP), plasma dilution (based on hemoglobin) and volume kinetics were assessed during an intravenous (i.v.) infusion of ...

The gag reflex is a somatic natural response in which the body attempts to eliminate instruments or agents from the oral cavity by muscle contraction. Some patients suffered from such severe retching that behavioral techniques did not sufficiently reduce gagging in dentistry. In these patients, pharmacological management was thought to ...

BACKGROUND: The effects of total intravenous anaesthesia (TIVA) and balanced anaesthesia (BAL) on coughing during emergence from the general anaesthesia have not yet been compared. METHODS: Fifty patients, aged 18-60 yr, undergoing elective lumbar disk surgery were randomly allocated to undergo TIVA (propofol-remifentanil) or BAL (fentanyl-nitrous oxide-sevoflurane). Extubation was performed ...

BACKGROUND: The aim of this retrospective study was to compare the failure rates and the frequency of anaesthesia-related complications of two different methods of regional anaesthesia used for carotid endarterectomy--cervical epidural (CE) anaesthesia and cervical plexus block (CPB). METHODS: The study included 1828 carotid endarterectomies performed in 1455 patients between ...

BACKGROUND AND OBJECTIVE: The Laryngeal Tube Sonda (LTS) and the ProSeal Laryngeal Mask Airway (PLMA) are two new devices introduced for maintaining the airway during controlled ventilation under general anaesthesia. The present investigation compared their performance in a randomized controlled study. METHODS: One hundred ASA I-II patients, aged 18-60 yr ...

BACKGROUND: Choice of opioid may influence postoperative pain, recovery, and respiratory homeostasis in morbid obesity. The aim of this study was to compare the effects of target-controlled infusions (TCIs) of remifentanil or sufentanil on postoperative analgesia, recovery, and pulmonary function after laparoscopic gastric banding. METHODS: Forty morbidly obese patients undergoing ...

BACKGROUND: The study was part of the Thai Anesthesia Incidents Study (THAI Study), a multi-centered study conducted by the Royal College of Anesthesiologists of Thailand, aiming to survey anesthetic related complications in Thailand. OBJECTIVE: Identify the incidence and factors related to perioperative death in geriatric patients. Material and Method: During ...

OBJECTIVES: To observe procedural sedation practice within a district general hospital emergency department (ED) that uses propofol for procedural sedation. METHODS: Prospective observation of procedural sedation over an 11 month period. Patients over 16 years of age requiring procedural sedation and able to give informed consent were recruited. The choice ...

We tested the hypothesis that 5 cm H2O of positive end-expiratory pressure (PEEP) reduces the incidence of pneumocephalus in patients who undergo spinal intradural tumor surgery. Fifty-three ASA I to III patients who underwent thoracolumbar intradural tumor surgery between the years 2003 and 2006 were included in this study. All ...

BACKGROUND: Selective breeding produces animal strains with varying anesthetic sensitivity. It thus seems unlikely that various human ethnicities have identical anesthetic requirements. Therefore, the authors tested the hypothesis that the minimum alveolar concentration of sevoflurane differs significantly as a function of ethnicity. METHODS: The authors recruited 90 American Society of ...

BACKGROUND: Muscle relaxants facilitate tracheal intubation, but they are often not used for short peripheral surgical procedures. The consequences of this practice on the upper airway are still a matter of controversy. We therefore compared the incidence of post-intubation symptoms in a randomized study comparing patients intubated with or without ...

BACKGROUND: The oculocardiac reflex (OCR) is frequently observed during strabismus surgery. This study was designed to evaluate and compare the effect of sevoflurane and desflurane on the incidence of OCR. METHODS: After obtaining Institutional Review Board approval and informed consent from parents, we enrolled 237 paediatric patients, aged 2-10 yr, ...

BACKGROUND: Midazolam and propofol are sedative agents commonly administered to patients with brain injury. We compared plasma concentrations of glial cell S100beta protein and nitric oxide (NO) between patients who received midazolam and those who received propofol sedation after severe brain injury, and investigated the association between S100beta and NO ...

PURPOSE: The objective of our study was to compare the safety and efficacy of remifentanil during colonoscopy with those of the standard combination of midazolam and pethidine. METHODS: One-hundred and sixteen consecutive patients scheduled for colonoscopy were randomly assigned to groups A or B. Patients in group A (n = ...

BACKGROUND & AIMS: Propofol has been shown to be an effective method for endoscopic sedation but there are few studies of low-dose propofol protocols for gastrointestinal endoscopy. METHODS: One hundred patients (American Society of Anesthesiology classes I-III) undergoing outpatient colonoscopy were enrolled prospectively in a multidrug propofol regimen that consisted ...

Postoperative atrial fibrillation (AF) occurs in up to 50% of cardiac surgery patients and represents the most common postoperative arrhythmic complication. Elective cardioversion, a short but painful procedure, remains an option for patients who do not convert to sinus rhythm with medical therapy. Combinations of remifentanil (a potent analgesic with ...

Background: The quality of intraoperative analgesia with paracervical block (PCB) during egg collection in in-vitro fertilization (IVF) is still unclear. Objective: This study performed to compare the pain levels during egg collection and the subsequent intra and postoperative side effects in patients receiving a conscious sedation with and without paracervical ...

AIMS: To report the use of ketamine sedation as an alternative anaesthetic method for babies undergoing treatment for retinopathy of prematurity (ROP). METHODS: All babies who underwent treatment for ROP over a 2-year period were included in this study. The babies preoperative weight, medical condition, and ventilation status was recorded. ...

PURPOSE: The purpose was to evaluate two sedation protocols during dental sessions in anxious children. MATERIALS AND METHODS: It was a randomized and double-blind study, with each individual being his/her own control within each protocol. Furthermore, the two protocols were compared. Twenty children (36 to 84 months old) who exhibited ...

OBJECTIVE: To determine whether sevoflurane, because of its lower blood/gas partition coefficient, compared with isoflurane as the primary anesthetic agent, allows earlier tracheal extubation and assessment of cognitive function after off-pump coronary artery bypass (OPCAB) surgery. DESIGN: Prospectively, patients were randomly assigned to receive sevoflurane or isoflurane as their primary ...

Endoscopic submucosal dissection (ESD) is accepted as one of the treatments for en bloc resection of large superficial colorectal lesions. This procedure is performed by using air insufflation, is time consuming, and is associated with severe abdominal discomfort. The safety and efficacy of carbon dioxide (CO(2)) insufflation during colonoscopy already ...

OBJECTIVE: To compare hemodynamics, recovery profiles, postoperative side effects and costs of desflurane-remifentanil and propofol-remifentanil anesthesia for septorhinoplasty operations. METHODS: A prospective and randomized study was carried out at the Gazi University Hospital, Ankara, Turkey from April to September 2003. Forty patients undergoing septorhinoplasty operations were randomly allocated to receive ...

BACKGROUND: The current study was designed to assess the effect of magnesium sulphate infusion on hemodynamic parameters, neuromuscular blocking, propofol consumption, serum concentration of magnesium ions, and recovery from anesthesia during total intravenous anesthesia. METHODS: For this study, 60 patients undergoing septorhinoplasty operations were randomly allocated to receive magnesium sulphate ...

OBJECTIVE: The aim of this study was to evaluate the 8-h time-weighted average (8-h TWA) exposure to nitrous oxide of dentists working in a paediatric dental unit, and to relate this to various operator, patient and environmental factors. METHODS: This prospective, open-label study monitored nitrous oxide levels using either a ...

BACKGROUND: Inadequate analgesia during general anaesthesia may present as undesirable haemodynamic responses. No objective measures of the adequacy of analgesia exist. We aimed at developing a simple numerical measure of the level of surgical stress in an anaesthetized patient. METHODS: Sixty and 12 female patients were included in the development ...

OBJECTIVES: Complete removal of a brain tumor without inflicting neurological deficits is a desirable end result in neurosurgical practice. Currently no prospective randomized surgical series in the literature exists comparing tumor resection under general versus local anesthesia awake surgery may achieve more aggressive tumor resection and minimize postoperative neurological morbidity. ...

BACKGROUND: Intraoperative awareness in patients undergoing general anesthesia is an infrequent but well-described adverse outcome. The reported incidence of this phenomenon is between 0.1% and 0.9%. METHODS: With institutional review board approval, the authors reviewed continuous quality improvement data from 3 yr (2002-2004) at the locations where the physician group ...

STUDY OBJECTIVE: To compare operating conditions, intraoperative adverse events, recovery profiles, postoperative adverse effects, patient satisfaction, and costs of small-dose lidocaine spinal anesthesia with those of general anesthesia using fentanyl and propofol for elderly outpatient prostate biopsy. DESIGN: Prospective, randomized, blind study. SETTING: Outpatient anesthesia unit at a municipal hospital. ...

BACKGROUND: The aim of this prospective study was to determine the risk factors of epileptiform discharge during induction with sevoflurane in healthy adult patients. METHODS: Forty adult patients with American Society of Anesthesiologists physical status I were randomly allocated to one of four groups. Group A: Patients breathed 8% sevoflurane ...

BACKGROUND AND AIMS: Tracheal intubation for general anesthesia often leads to traumatization of the airway mucosa resulting in postoperative sore throat, hoarseness and cough. This study was undertaken to determine the effects of betamethasone gel in reducing these complications. MATERIALS AND METHODS: One hundred patients (ASA I-II) to undergo endotracheal ...

BACKGROUND AND OBJECTIVE: This study was conducted to compare bispectral index, state entropy and response entropy in patients undergoing coronary artery bypass grafting. METHODS: In 66 patients, anaesthesia was maintained at two different levels using bispectral index. Doses of sufentanil and midazolam were adjusted to achieve a bispectral index in ...

BACKGROUND: Delayed recovery of cognitive function is a well-recognized phenomenon in older patients. The potential for the volatile anaesthetic used to contribute to alterations in postoperative cognitive function in older patients following minor surgical procedures has not been determined. We compared emergence from isoflurane and sevoflurane anaesthesia in older surgical ...

Maintenance of anaesthesia with volatile anaesthetic agents affects the perioperative course of patients undergoing off-pump coronary artery bypass (OPCAB) surgery. This facilitates adequate depth of anaesthesia, reduction in need of analgesic dosage, early extubation and transfer from Intensive Care Unit. We compared two volatile anaesthetic agents sevoflurane and isoflurane in ...

The purpose of the present study was to determine the effects of magnesium sulfate (MgSO(4)) on the neuromuscular function and spontaneous breathing of patients under sevoflurane and spinal anesthesia. Twenty-two patients with a history of arrhythmia undergoing elective knee surgery were randomly assigned to two groups: group M (n = ...