Medical mistakes have been identified as resulting from a breakdown in one or more of five major areas: equipment performance, communication, staffing levels, complex environments and workloads. Because many of these areas relate directly to the practice of anesthesiology, they can contribute significantly to the safety and quality of the ...

BACKGROUND: Sedation of patients for deep small bowel enteroscopy presents unique challenges and is traditionally provided by anesthesiologists. No study has directly evaluated gastroenterologist-guided, nurse-administered sedation for deep enteroscopy. Further, no comparison exists between gastroenterologist-guided versus anesthesiologist-guided sedation during deep enteroscopy. AIMS: To evaluate safety and efficacy of performing deep ...

AIM: To assess the tolerability and safety of same-day tandem procedures, endoscopic ultrasound (EUS) followed by endoscopic retrograde cholangiopancreatography (ERCP) under conscious sedation. METHODS: A retrospective review was conducted at Loma Linda University Medical Center, a tertiary-care center. All 54 patients who underwent EUS followed by ERCP (group A) from ...

BACKGROUND: None of the currently available hypnosis monitoring systems have evaluated balanced xenon anaesthesia. We investigated the performance of the bispectral index (BIS) and the composite A-line autoregressive index (cAAI) while comparing balanced xenon with sevoflurane anaesthesia. METHODS: Sixty patients undergoing elective abdominal surgery participated in this registered double-blinded, controlled ...

BACKGROUND: General anesthesia influences the thermoregulatory process. The aim of this study was to compare the efficacy of low-dose prophylactic ketamine with that of placebo in preventing postoperative shivering. METHODS: A prospective randomized double-blind study involved 76 ASA I and II patients undergoing general anesthesia that was expected to last ...

For laparoscopic cholecystectomy (LC), the use of spinal anesthesia may offer several advantages over general anesthesia. The aim of this prospective, randomized study was to compare the surgical outcome of LC performed under general anesthesia to that of LC performed under spinal anesthesia. Sixty patients were randomly assigned to either ...

BACKGROUND: Propofol is a popular agent for providing procedural sedation in pediatric population during lumbar puncture and spinal anesthesia. Adjuvants like clonidine and fentanyl are administered intrathecally to prolong the duration of spinal anesthesia and to provide postoperative analgesia. We studied the propofol requirement after intrathecal administration of clonidine or ...

BACKGROUND AND OBJECTIVE: The I-gel is a new single-use supraglottic airway device without an inflatable cuff. This study was designed to investigate the usefulness of the I-gel compared with the classic laryngeal mask airway (cLMA) and ProSeal laryngeal mask airway (pLMA) in anaesthetized, paralysed patients. METHODS: The American Society of ...

Preload with crystalloid or colloid solution is widely recommended for the prevention of maternal hypotension during spinal anaesthesia. A combination of simultaneous rapid crystalloid infusion with vasopressor has also been suggested. This study tested the hypothesis that ephedrine infusion with crystalloid loading at spinal anaesthesia would reduce hypotension and alter ...

To evaluate the efficacy of the combined infusion of dexmedetomidine and fentanyl on the hemodynamic response during cardiac surgery with cardiopulmonary bypass (CPB) in children. Thirty-two children, ages 1 month to 10 years, scheduled for cardiac surgery with cardiopulmonary bypass were randomly divided in two groups: the MDZ Group received ...

This study evaluated the effect of pentazocine pretreatment on fentanyl-induced cough. With ethics committee approval, 277 ASA I-II patients, aged between 19 and 63 years, undergoing various elective surgeries during general anesthesia, were enrolled in this prospective, randomized, double-blind, placebo-controlled clinical trial. All patients were randomly assigned to one of ...

investigator either placed or did not place earplugs into the patients' ears (PLUG or noPLUG groups, respectively). Propofol requirements for stable sedation guided by the bispectral index and incidence of postoperative recall of intraoperative events were assessed in a double-blinded fashion. We found high but comparable propofol requirements in both ...

This study was designed to compare the intra-operative and post-operative analgesic requirements and side effects of using fentanyl infusion versus remifentanil infusion during short-duration surgical procedures in children. The study comprised of 40 children randomly allocated into two equal groups: fentanyl (F-group) or remifentanil (R-group). Both were administered a continuous ...

The regional cerebral oxygen saturation (rSO(2)) decreases significantly during ordinary anesthetic recovery in pediatric patients anesthetized with sevoflurane or desflurane. The present study examined the relationship between rSO(2) and the clinical parameters associated with the degree of anesthetic recovery. Twelve pediatric patients with American Society of Anesthesiologists physical status 1 ...

Macintosh laryngoscopic intubation is a lifesaving procedure, but a difficult skill to learn. The Airtraq optical laryngoscope (AOL) is a novel intubation device with advantages over the direct laryngoscope for untrained personnel in a manikin study. We compared the effectiveness of AOL with Macintosh laryngoscope for tracheal intubation by novice ...

This study was performed to evaluate the effectiveness of intravenous low dose ketamine for reducing the incidence and severity of postoperative sore throat (POST). This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 70 years old who were classified as American ...

BACKGROUND: The patient state index (PSI) and the bispectral index (BIS) quantify anaesthetic depth based on the EEG using different algorithms. We compared both indices with regard to the prediction of the depth of propofol anaesthesia. METHODS: In 17 patients, propofol was infused until burst suppression occurred and stopped thereafter ...

To analyze the hemodynamic effects and myocardial injury using troponin-T and creatine phosphokinase (CPK-MB) with isoflurane and compare it with a control group in patients undergoing off-pump coronary artery bypass (OPCAB) surgery. This prospective, randomized study was performed in patients scheduled for elective OPCAB surgery during February 2007 to February ...

BACKGROUND: In experimental and clinical studies, volatile anaesthesia has proven to possess cardioprotective properties. However, no randomized controlled trials on the use of isoflurane during the entire cardiac surgical procedure are available. We therefore compared isoflurane-sufentanil vs propofol-sufentanil anaesthesia in patients undergoing coronary artery bypass grafting. METHODS: One hundred patients ...

Outpatient inguinal herniorrhaphy (IH) can be successfully performed under general, regional, or local anesthesia. In this study recovery profile, postoperative pain scores, incidence of adverse effects, and patient and surgeon satisfaction were compared between paravertebral block (PVB) and fast-track general anesthesia (GA) via laryngeal mask airway (LMA) for outpatient IH. ...

Summary We compared the performance of the Intersurgical Solus laryngeal mask airway (LMA) with that of the i-gel in 120 patients of ASA physical status during general anaesthesia with respect to oropharyngeal leak pressure, peak airway pressure, airway manipulation, insertion time, fibreoptic view, ventilatory parameters, and peri-operative complications. After receiving ...

STUDY OBJECTIVE: To compare the topical and the pulpal anesthesia efficacy of liposomal and plain benzocaine formulations. DESIGN: Double-blinded, randomized crossover study. SETTING: University ambulatory dental center. PATIENTS: 30 ASA physical status I volunteers. INTERVENTIONS: Volunteers received, in three different sessions, topical application of liposome-encapsulated 10% benzocaine (LB10), 10% benzocaine ...

PURPOSE: The purpose of this randomized control trial was to determine the performance of a novel rule-based adaptive closed-loop system for propofol administration using the bispectral index (BIS(R)) and to compare the system's performance with manual administration. The effectiveness of the closed-loop system to maintain BIS close to a target ...

This study was conducted to determine the optimal pillow height for the best laryngoscopic view. Fifty patients were enrolled and preanesthetic airway evaluations were recorded. After induction of anesthesia, the Macintosh 3 blade was used for direct laryngoscopy without a pillow or with a pillow 3, 6, or 9 cm ...

The aim of this study is to describe the effect of sedation and analgesia on postoperative amplitude-integrated EEG (aEEG) in newborns with congenital heart disease (CHD) undergoing heart surgery. This is a consecutive series of 26 newborns with CHD of which 16 patients underwent cardiopulmonary bypass (CPB) surgery and 10 ...

AIM: Inadequate emergence after anesthesia in the adult patient may be distinguished by the patients' activity level into two subtypes: emergence delirium and hypoactive emergence. The aim of this study was to determine the incidence of inadequate emergence in its different forms, to identify causative factors and to examine the ...

OBJECTIVES: The objective was to compare the occurrence of respiratory depression, adverse events, and recovery duration of propofol versus ketamine for use in procedural sedation in the emergency department (ED). METHODS: This was a randomized nonblinded prospective clinical trial of adult patients undergoing procedural sedation for painful procedures in the ...

The purpose of this investigation was to evaluate the effects of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures. Forty-four adults scheduled for head and neck procedures were randomly assigned into 2 groups for this single-blind investigation. Anxiety and baseline pain levels were documented preoperatively. Both groups ...

BACKGROUND: The present study was a part of the multi-centered study of model of Anesthesia related adverse events in Thailand by incident report. (The Thai Anesthesia Incident Monitoring Study or Thai AIMS). The objective of the present study was to identify and analyze anesthesia incident in geriatric patients in order ...

To describe outcome of treatment with propofol and phenobarbital for status epilepticus (SE) after portosystemic shunt (PSS) attenuation. CASE OR SERIES SUMMARY: Three dogs without preceding seizure activity, were diagnosed with a single extrahepatic PSS. Following standard preoperative medical therapy, an ameroid constrictor was placed surgically. Recovery was uneventful until ...

The effects of sevoflurane general anesthesia and bupivacaine selective spinal anesthesia on QT dispersion (QTd) and corrected QT (QTc) interval were investigated. This prospective, randomized, double-blind study was conducted between July and September 2009 in the Urology and General Surgery operating rooms. Forty ASA I-II patients undergoing noncardiac surgery were ...

We introduce a new, simple portable inhalational induction device (PD) that provides co-operative inhalational induction of anaesthesia using N(2)O and subsequent sevoflurane in the preanaesthetic induction area in children. Forty-five children (30 to 94 months old age, <35 kg) who were scheduled to undergo simple operations were assigned randomly to ...

We evaluated the effect and safety of the immediate postoperative continuous infusion of remifentanil at two doses in patients undergoing laparoscopic-assisted vaginal hysterectomy (LAVH) with alfentanil-based patient-controlled analgesia (PCA). The study enrolled 50 ASA physical status 1 or 2 patients scheduled to undergo LAVH. Anesthesia was maintained with sevoflurane-remifentanil-air. At ...

In most extracorporeal membrane oxygenation (ECMO) centers patients are heavily sedated to prevent accidental decannulation and bleeding complications. In ventilated adults not on ECMO, daily sedation interruption protocols improve short- and long-term outcome. This study aims to evaluate safety and feasibility of sedation interruption following cannulation in neonates on ECMO. ...

To assess the difficulty in both laryngoscopy and tracheal intubation related to goitre and to identify factors predictive of difficult intubation due to this condition. Prospective observational. We used the Intubation Difficulty Scale (IDS) in 80 consecutive patients with large goitre (defined by the inability to palpate the cricoid cartilage, ...

BACKGROUND: We conducted a prospective controlled clinical trial of the effect of isocapnic hyperpnoea (IH) on the times-to-recovery milestones in the operating room (OR) and postanesthetic care unit (PACU) after 1.5 to 3 hours of isoflurane anesthesia. METHODS: Thirty ASA grade I-III patients undergoing elective gynecological surgery were randomized at ...

The Airtraq laryngoscope is a new tracheal intubation device that has been developed for the management of normal and difficult airways. As with the lightwand, the Airtraq can be used without placing the patient in the 'sniffing position' for direct laryngoscopy. The purpose of this study was to compare the ...

In this study we investigated the effects of intravenously administered dexmedetomidine on the duration of hyperbaric ropivacaine in spinal anesthesia, and the side effects. In a prospective, double-blind study, sixty ASA I-II patients were randomized to two groups of 30 individuals. All patients were administered hyperbaric ropivacaine (22.5 mg) for ...

We investigated effects of vitamin C and E (VCE) administration on desflurane-induced oxidative toxicity and element changes in the blood of operative patients under desflurane general anesthesia. Forty American Society of Anesthesiologists I or II Physical Status adult patients were scheduled for elective surgery. The patients were randomly divided into ...

BACKGROUND AND OBJECTIVE: Analogue disposable devices of the laryngeal tube S II (LTS II) and the Fastrach laryngeal intubation mask (ILMA, Fastrach), namely the laryngeal tube disposable (LTS-D) and the Fastrach laryngeal intubation mask disposable (Fastrach-D), have recently been introduced. The purpose of this study was to compare each reusable ...

STUDY OBJECTIVE: To assess the feasibility of propofol-fentanyl sedation protocol with ketamine for gynecologic diagnostic laparoscopy. DESIGN: Prospective, double-blind, randomized study (Canadian Task Force classification I). SETTING: Outpatient operating unit in a university hospital specializing in obstetrics and gynecology. PATIENTS: Eighty women who underwent outpatient gynecologic diagnostic laparoscopy. INTERVENTIONS: Patients ...

BACKGROUND: Surgical stress index (SSI), a novel multivariate index, has recently been proven to react well to surgical nociceptive stimuli and analgesic drug concentration changes during general anesthesia. We investigated the feasibility of application of SSI for guidance of remifentanil administration during propofol-remifentanil anesthesia. METHODS: Eighty patients scheduled for elective ...

To test the hypothesis that sedation in elderly patients is often electrophysiologically equivalent to general anesthesia (GA). Prospective, observational study. Operating room of a university medical center. 40 elderly patients (>or=65 yrs of age) undergoing hip fracture repair with spinal anesthesia and propofol-based sedation. In the routine practice group (RP; ...

The purpose of this study was to examine the influence of recovery time following a dynamic warm-up (DY) and a static stretch warm-up (SS) on power performance in adolescent athletes. Following baseline measures, 19 males (16.5 +/- 1.1 yrs) performed the vertical jump (VJ) and seated medicine ball toss (MB) ...

BACKGROUND: Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to investigate the effect ...

The aim of this study was to compare the streamlined liner of the pharynx airway (SLIPA), a new supraglottic airway device (SGA), with the laryngeal mask airway ProSeal (PLMA) during general anesthesia. Sixty patients were randomly allocated to two groups; a PLMA group (n = 30) or a SLIPA group ...

The rapid emergence and recovery from general anesthesia afforded by sevoflurane is associated with a high incidence of emergence agitation in children. Small doses of ketamine reduce the incidence of emergence agitation. This study compared the effects of ketamine 0.25 mg/kg and 0.5 mg/kg on emergence agitation and postoperative pain. ...

Keeping in consideration the merits of total intravenous anesthesia (TIVA), a genuine attempt was made to find the ideal drug combinations which can be used in general anesthesia. This study was conducted to evaluate and compare two drug combinations of TIVA using propofol-ketamine and propofol-fentanyl and to study the induction, ...

To describe the method that seeks to improve the administration of regional anesthesia for vitroretinal surgery avoiding the risk of potential complications associated with other techniques through comparison of safety and efficacy of classic peribulbar anesthesia versus single percutaneous technique using a prospective, randomized clinical trial. One hundred patients were ...

BACKGROUND: In this prospective, randomized, double-blind study, we evaluated and compared the incidence of postoperative nausea and vomiting (PONV) after paediatric strabismus surgery with two different anaesthetic methods, sevoflurane or remifentanil-sevoflurane. METHODS: In total, 78 paediatric patients (aged 6-11 yr) undergoing strabismus surgery were enrolled and randomly assigned to two ...