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Journal articles on the topic 'Anaesthesia'
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Hofer, Christoph Karl, Pedro David Wendel Garcia, Christof Heim, and Michael Thomas Ganter. "Analysis of anaesthesia services to calculate national need and supply of anaesthetics in Switzerland during the COVID-19 pandemic." PLOS ONE 16, no. 3 (March 19, 2021): e0248997. http://dx.doi.org/10.1371/journal.pone.0248997.
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Background In Switzerland, details of current anaesthesia practice are unknown. However, they are urgently needed to manage anaesthesia drug supply in times of drug shortages due to the pandemic. Methods We surveyed all Swiss anaesthesia institutions in April 2020 to determine their annual anaesthesia activity. Together with a detailed analysis on anaesthetic drug use of a large, representative Swiss anaesthesia index institution, calculations and projections for the annual need of anaesthetics in Switzerland were made. Only those drugs have been analysed that are either being used very frequently or that have been classified critical with regard to their supply by the pharmacy of the index institution or the Swiss Federal Office of Public Health. Results The response rate to our questionnaire was 98%. Out of the present 188 Swiss anaesthesia institutions, 185 responded. In Switzerland, the annual number of anaesthesias was 1’071’054 (12’445 per 100’000 inhabitants) with a mean anaesthesia time of 2.03 hours. Teaching hospitals (n = 54) performed more than half (n = 572’231) and non-teaching hospitals (n = 103) provided almost half of all anaesthesias (n = 412’531). Thereby, private hospitals conducted a total of 290’690 anaesthesias. Finally, office-based anaesthesia institutions with mainly outpatients (n = 31) administered 86’292 anaesthesias. Regarding type of anaesthesia provided, two thirds were general anaesthesias (42% total intravenous, 17% inhalation, 8% combined), 20% regional and 12% monitored anaesthesia care. Projecting for example the annual need for propofol in anaesthesia, Switzerland requires 48’573 L of propofol 1% which corresponds to 5’644 L propofol 1% per 100’000 inhabitants every year. Conclusions To actively manage anaesthesia drug supply in the context of the current pandemic, it is mandatory to have a detailed understanding of the number and types of anaesthesias provided. On this basis, the Swiss annual consumption of anaesthetics could be projected and the replenishment organized.
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Chadha, N. K., C. Repanos, and A. J. Carswell. "Local anaesthesia for manipulation of nasal fractures: systematic review." Journal of Laryngology & Otology 123, no. 8 (August 2009): 830–36. http://dx.doi.org/10.1017/s002221510900560x.
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AbstractObjective:To determine the most effective local anaesthetic method for manipulation of nasal fractures, and to compare the efficacy of local anaesthesia with that of general anaesthesia.Method:Systematic review and meta-analysis.Databases:Medline, Embase, Cochrane Library, National Research Register and metaRegister of Controlled Trials.Included studies:We included randomised, controlled trials comparing general anaesthesia with local anaesthesia or comparing different local anaesthetic techniques. Non-randomised studies were also systematically reviewed and appraised. No language restrictions were applied.Results:Five randomised, controlled trials were included, three comparing general anaesthesia versus local anaesthesia and two comparing different local anaesthetic methods. No significant differences were found between local anaesthesia and general anaesthesia as regards pain, cosmesis or nasal patency. The least painful local anaesthetic method was topical tetracaine gel applied to the nasal dorsum together with topical intranasal cocaine solution. Minimal adverse events were reported with local anaesthesia.Conclusions:Local anaesthesia appears to be a safe and effective alternative to general anaesthesia for pain relief during nasal fracture manipulation, with no evidence of inferior outcomes. The least uncomfortable local anaesthetic method included topical tetracaine gel.
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Bashir, Aamir, Muhammad Naveed Azhar, and Muhammad Azam. "Anaesthetic Management of Patients for Brachytherapy in Radiation Suite." Pakistan Journal of Medical and Health Sciences 16, no. 9 (September 30, 2022): 205–6. http://dx.doi.org/10.53350/pjmhs22169205.
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Background: Cervical cancer is one of the leading sites for cancer in female patients and brachytherapy remains one of the treatment modality for it. Anaesthetic services are required in certain cases. Anaesthesia services outside operating room pose challenges for anaesthesiologists due to remote access need for slave monitors etc. Aim: To evaluate the outcome of different anaesthetic techniques in female patients undergoing cervical brachytherapy procedures in radiotherapy department. Methods: This retrospective cross-sectional analysis conducted at a tertiary care cancer centre of Shaukat Khanum Memorial Trust Lahore. Anaesthetic details of all female patients planned for brachytherapy over a time period of three years from 2016 to 2018 was recorded. The subjects were female patients for the given procedure. Their mean age in years, ASA status, anaesthetic technique either General anaesthesia or Spinal anaesthesia in terms of patient number and percentage of total patients for either, any complication related to anaesthetics was recorded. Chi square test was applied to see any correlation between anaesthetic technique and complications. Results: There were 87 female patients in this research having mean age of 51±15 years. Regarding ASA physical status, 27(31%) of ASA status II while 60(69%) patients of ASA status III. General anaesthesia was given to 33(38%) patients, while 54(62%) patients received spinal anaesthesia. Overall, complications rate remained 7% and it was less in spinal anaesthesia (2%) as compared to general anaesthesia (8%) with statistically significant p-value of 0.001 Conclusions: We concluded that cervical brachytherapy can be safely conducted under spinal anaesthesia in radiation suite. Keywords: Brachytherapy, spinal anaesthesia, general anaesthesia, anaesthesia outside OR.
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Van Den Berg, A. A., D. Savva, N. M. Honjol, and N. V. Rama Prabhu. "Comparison of Total Intravenous, Balanced Inhalational and Combined Intravenous-Inhalational Anaesthesia for Tympanoplasty, Septorhinoplasty and Adenotonsillectomy." Anaesthesia and Intensive Care 23, no. 5 (October 1995): 574–82. http://dx.doi.org/10.1177/0310057x9502300508.
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Two hundred and thirty-five consecutive Saudi patients aged between two and fifty-three years undergoing elective tympanoplasty (n = 32), septorhinoplasty (n = 68) or adenotonsillectomy (n=135) were studied. They were randomized to receive either a total intravenous anaesthetic (10 ears, 23 noses, 44 throats) consisting of propofol for induction of anaesthesia followed by a propofol infusion, a combined intravenous-inhalational anaesthetic (11 ears, 22 noses, 46 throats) consisting of the above with isoflurane in oxygen-enriched air, or a balanced inhalational anaesthetic (11 ears, 23 noses, 45 throats) consisting of thiopentone for induction of anaesthesia and oxygen in nitrous oxide with isoflurane for maintenance. During tympanoplasty, all three anaesthetic techniques produced stable heart rates and arterial pressures. During septorhinoplasty, blood pressure rose in patients who received total intravenous anaesthesia, while combined and balanced techniques produced haemodynamic stability. During adenotonsillectomy, total intravenous anaesthesia produced a rise in both heart rate and blood pressure, the combined technique produced a rise in heart rate alone while balanced anaesthesia produced haemodynamic stability. Postoperatively, vomiting, pain scores and analgesic requirements were similar following all three types of anaesthetic within each surgical site subgroup. Our findings support the choice of balanced inhalational anaesthesia for all three types of ENT surgery and, where cost and facilities permit, total intravenous anaesthesia for tympanoplasty and combined intravenous-inhalational anaesthesia for septorhinoplasty.
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Muloshi, Carol. "Neonatal Apgar Score Outcomes in Spinal Versus General Anaesthesia at the University Teaching Hospital (UTH), Lusaka." University of Zambia Journal of Agricultural and Biomedical Sciences 4, no. 4 (October 1, 2020): 18–24. http://dx.doi.org/10.53974/unza.jabs.4.4.339.
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Background: The knowledge gap was from the fact that the type of anaesthetic drug administered during caesarean section can have effects on neonatal outcome like low Apgar score with most hospitals in developed countries now using more modern inhalational anaesthetic agents with fewer or no cardio-respiratory depressant effects e.g. Isoflurane or Sevoflurane. However at UTH, halothane is still being used for maintenance of general anaesthesia despite well documented cardio-respiratory depressant effects with very limited research done on its effects on neonatal Apgar score. The Apgar score is a means of rapid evaluation of the physical condition of infants shortly after birth. Thus this study investigated the effects of general anaesthesia with halothane versus spinal anaesthesia on neonatal Apgar score. Objective and study design: With the view of determining the type of anaesthesia administered during caesarean section with the least effects on neonatal wellbeing shortly after birth, a prospective observational cohort study was conducted at the University Teaching Hospital between May 2015 and January 2016.The scientific objective was to determine the effects of general anaesthesia with halothane versus spinal anaesthesia on neonatal Apgar score. This study involved 70 neonates, 54 were born from mothers that had undergone caesarean section under spinal anaesthesia and 16 from mothers that had undergone general anaesthesia. The data was analysed using SPSS version 16.0. Inferential analysis was conducted using logistic regression. Results: 20 neonates out of 54 (37%) in the spinal anaesthetic group had an Apgar score less than 8 at 1 minute[Fig 1]. Out of the 16 neonates in the general anaesthesia group, 14 (87.5%) had Apgar score less than 8 at 1 minute[Fig 1]. One (1.9%) neonate had an Apgar score less than 8 at 5 minutes in the spinal anaesthesia group. While 4 (25%) neonates had Apgar score less than 8 in the GA group[Fig2] The logistic regression at 1 minute Showed that it is over 11 times more likely to get a low Apgar with a general anaesthetic as compared to a spinal anaesthetic (OR 11.9), [Table 3]. The Apgar score at 1 minute in the Spinal anaesthesia group was statistically significantly higher than the general anaesthesia group (p=0.002). The logistic regression at 5 minutes Showed that it is over 17 times more likely to get a low Apgar with a general anaesthetic as compared to a spinal anaesthetic (OR 17.7), [Table 4]. Further, the 5 minutes Apgar score in the spinal anaesthesia group was statistically significantly higher than the general anaesthesia group (p=0.014),[Table 4]. Conclusion: With the results pointing to the fact that there is significant difference in neonatal Apgar score outcomes in spinal versus general anaesthesia, the researcher therefore rejected the null hypothesis. It is therefore inferred that spinal anaesthesia method has better neonatal outcomes by Apgar score measure than general anaesthesia method.
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Abbadi, Abdel Karim Al Oweidi Al, Iulian Constantin, Aurelia Romila, Alina Mihaela Calin, Laurian Lucian Frincu, Ciprian Dinu, and Alina Mihaela Elisei. "The Morphological Substrate of the Sensory Pathways - Anatomy, Neurotransmission, Neurochemistry in Intraosseous Anaesthesia." Revista de Chimie 70, no. 6 (July 15, 2019): 2218–21. http://dx.doi.org/10.37358/rc.19.6.7308.
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In order to apply the most accurate and efficient locoregional techniques, the knowledge of the anatomical characteristics of the oro-maxilo-facial territory becomes imperatively necessary, without which the installation and the effect of the locoregional anaesthetics may be poor. Due to the many advantages it presents, locoregional anaesthesia is considered as a current use method during routine dental care. A good local or locoregional anaesthetic must be harmless to the tissues, must have no local or general toxicity, must lead to a high quality and durable anaesthetic, must not cause lesions to nerve endings, to be subject to dental surgery or of oral surgery, can be satisfactorily solved by using locoregional anaesthesia techniques, which are used successfully in patients with balanced psychic, who are calm and cooperative. A good anaesthesia suppresses pain, prevents pain-induced shock, and allows the dentist to work in optimal conditions. Although modern anaesthesia techniques have greatly changed the working environment in dental surgeries or outpatient facilities of oral and maxillo-facial surgery, emotion and anxiety, fears continue to exist in patients who will have to undergo care treatments. In order to apply the most accurate and effective locoregional anaesthetic techniques, the knowledge of the anatomical characteristics of oro-maxilo-facial territory becomes imperatively necessary, without which the location and effect of locoregional anaesthetics may be poor. The study includes 114 patients studied in the period 2015-2017 on which we used Stabident system intraosseous anaesthesia of company Fairfax under two available systems: Stabident Regular and Stabident Alternative. Intraosseous anaesthesia reduces the amount of injected anaesthesia, thus reducing the toxicity of anaesthetic procedures; this technique allows the use of vasoconstrictors for the immediate delivery of anaesthesia to the teeth affected by pulpitis without the risk of necrosis. Intraosseous anaesthesia is an anaesthesia technique similar to the ideal anaesthesia technique.
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Jain, Meenu, Namrata Dogra, Manish Gupta, and Seema Grover. "Articaine VS Lignocaine in Orthodontic Extraction of Maxillary Premolars - A Randomized, Double-Blinded Study." Journal of Evolution of Medical and Dental Sciences 10, no. 35 (August 30, 2021): 2969–74. http://dx.doi.org/10.14260/jemds/2021/607.
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BACKGROUND Local anaesthetics helps in preventing pain during surgical and dental procedures by blocking the peripheral nerves. The primary objective of this investigation was to compare and evaluate 4 % articaine hydrochloride (with 1 : 100000 adrenaline) and 2 % lignocaine hydrochloride (with 1 : 80000 adrenaline) in terms of pulpal anaesthesia, volume of anaesthetic solution administered, need of re-anaesthesia and difficulty of extraction during orthodontic extraction of maxillary first premolars. METHODS This prospective randomized, double-blinded study was conducted on 43 patients of less than 40 years of age requiring bilateral maxillary first premolar extractions for orthodontic purposes. Each patient was randomly assigned to receive either 2 % lignocaine hydrochloride or 4 % articaine hydrochloride for premolar extraction of one side and other solution was administered for premolar extraction of contralateral side spaced 1 to 3 weeks apart. In each patient, the difference in pulpal anaesthesia, volume of anaesthetic solution administered, need of re-anaesthesia, difficulty of extraction and duration of anaesthesia was assessed on administration of lignocaine hydrochloride and articaine hydrochloride. RESULTS Statistically significant difference in pulpal anaesthesia levels was found when the articaine and lignocaine groups (P > 0.05) were compared, with a higher mean pulpal anaesthesia among the articaine group. There was no difference in volume of anaesthetic solution administered on buccal and palatal side among the articaine and lignocaine groups. Only 2.3 % of patients in both the groups required re-anaesthesia on the buccal side. There was no significant difference in difficulty of extraction in both the groups. The articaine group had a longer mean duration of anaesthesia as compared to the lignocaine group which was highly significant. CONCLUSIONS Articaine may be used to replace lignocaine in orthodontic extraction of maxillary premolars with clinical advantages like higher pulpal anaesthesia and longer duration of anaesthesia. KEY WORDS Local Anaesthetic, Lignocaine Hydrochloride, Articaine Hydrochloride, Orthodontic Extraction, Prospective Study, Double-Blinded Study.
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Raj, Dipti, Kumari Priti, and Hasina Quari. "Anaesthetic management of emergency caesarean section in a patient with peripartum cardiomyopathy under general anaesthesia - a case report." Journal of Society of Anesthesiologists of Nepal 3, no. 1 (March 20, 2016): 32–34. http://dx.doi.org/10.3126/jsan.v3i1.14580.
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Peripartum cardiomyopathy is a unique and rare kind of cardiomyopathy of unknown cause that occurs during pregnancy or the postpartum period. Regional anaesthesia for anaesthetic management of this condition has been extensively described. There are limited reports of anaesthetic management of caesarean section of this case under general anaesthesia. We report a case of 32 years old lady diagnosed to have peripartum cardiomyopathy requiring emergency caesarean section that was successfully managed under general anaesthesia. Anaesthetic management was directed towards optimization of myocardial contractility, preload and after load.
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Rana, MS, MM Rahman, UK Rima, and NS Juyena. "General anaesthesia of indigenous pigs in Bangladesh." Bangladesh Veterinarian 30, no. 2 (March 6, 2014): 46–53. http://dx.doi.org/10.3329/bvet.v30i2.18254.
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Anaesthetic trials were conducted with propofol (P), xylazine-propofol (XP), xylazine-ketamine (XK), xylazine-thiopentone (XT) in 16 healthy indigenous pigs. Respiration rate decreased significantly (P < 0.01) five minutes after induction, and during maximum depth of anaesthesia, and had not returned to control value after recovery from anaesthesia with all anaesthetic combinations. Heart rate with P increased significantly (P<0.01) five minutes after induction, whereas it decreased significantly (P < 0.01) with XP, XK and XT during anaesthesia and remained below the normal range after recovery from anaesthesia except after XP. In all anaesthetic sessions, rectal temperature decreased significantly (P < 0.01) in all stages of anaesthesia: after recovery the rectal temperature almost returned to control value in P and XP. Slight to moderate salivation was observed in all pigs with P and XP. It is suggested that P and XP combination seems to be suitable for general anaesthesia in pigs, but XP is more suitable. DOI: http://dx.doi.org/10.3329/bvet.v30i2.18254 Bangl. vet. 2013. Vol. 30, No. 2, 46-53
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Williams, N., A. Strunin, and W. Heriot. "Pain and Vomiting after Vitreoretinal Surgery: A Potential Role for Local Anaesthesia." Anaesthesia and Intensive Care 23, no. 4 (August 1995): 444–48. http://dx.doi.org/10.1177/0310057x9502300405.
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Periconal local anaesthesia with subtenon supplementation was used to provide anaesthesia for 94 patients having vitreoretinal surgery. Of these, 44 patients also received general anaesthesia with neuromuscular block. None of these patients received opioid or antiemetic before or during surgery. In comparison with a retrospective control group, patients who had received local anaesthesia as part of their anaesthetic technique were less likely to be given a parenteral opioid (P< 0.001) or to vomit (P<0.001) within six hours of the completion of surgery. They also experienced significantly fewer bradycardic episodes during surgery (P=0 001). For patients having general anaesthesia, administration of an intraoperative antiemetic reduced the incidence of vomiting within six hours of the completion of surgery (P=0.008). For patients who did not receive local anaesthetic, shorter operating time was a factor associated with both reduced postoperative vomiting (P=0.0015) and administration of parenteral opioid (P=0.0014). It is suggested that the use of local anaesthesia as part of the anaesthetic technique for vitreoretinal surgery is associated with improved patient comfort.
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Stanley, T. H. "Opiate Anaesthesia." Anaesthesia and Intensive Care 15, no. 1 (February 1987): 38–59. http://dx.doi.org/10.1177/0310057x8701500107.
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Current use of opioids in anaesthesia is reviewed with particular emphasis on the use of opioids in anaesthetic doses, techniques that recently have become popular in cardiovascular anaesthesia. A major benefit of opioid anaesthesia (particularly fentanyl) is the cardiovascular stability which obtains during induction and throughout operation, even in patients with severely impaired cardiac function. Anaesthetic doses of morphine are associated with a higher incidence of cardiovascular disturbances and other problems. Pethidine is unsuitable for cardiovascular surgery because of severe haemodynamic disturbances when high doses are given. Sufentanil and alfentanil may prove more suitable alternatives. High doses of opioids can reduce or prevent hormonal and metabolic responses to the stress of surgery. Even very large doses of fentanyl or its new analogues do not prevent marked increases in plasma catecholamine concentrations in response to cardiopulmonary bypass. The reduction in hormonal and metabolic stress response does not appear to continue postoperatively.
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Gaut, N., R. Neiger, and B. Glanemann. "Effects of anaesthesia on thyroxine and thyroid-stimulating hormone levels in dogs." Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere 36, no. 06 (2008): 427–31. http://dx.doi.org/10.1055/s-0038-1622706.
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Summary Objective: Although hypothyroidism is a common endocrinopathy in dogs, the diagnosis is not always straightforward. Several factors, including systemic disease or administration of drugs, can affect thyroid function and may lead to erroneous test results. The aim of this study was to evaluate if anaesthesia has an effect on total thyroxin (TT4) or thyroid-stimulating hormone (cTSH) levels in dogs. Material and methods: Twenty-four dogs presented for various primary problems underwent anaesthesia for endoscopy. Four different anaesthetic protocols using a combination of propofol and isoflurane, propofol and halothane, thiopental and isoflurane or thiopental and halothane (each n = 6) were randomly chosen for each dog. TT4 and cTSH levels were measured before and 24 hours after anaesthesia. Results: Post-anaesthetic TT4 levels were significantly lower than pre-anaesthetic levels (p = 0.0002). There was no significant difference between the four anaesthetic groups (p = 0.17). The post-anaesthetic cTSH values were not significantly (p = 0.73) different compared to the pre-anaesthetic values. Conclusions: Results indicate that TT4 values may significantly decrease for at least 24 hours post recovery from anaesthesia irrelevant of the anaesthetic agent used. Clinical relevance: The study has highlighted that thyroid testing in dogs should always be viewed in light of the clinical situation. General anaesthesia can lower TT4 levels to a point where hypothyroidism may be wrongly diagnosed.
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Trembach, N. V. "Impact of bispectral index monitoring on critical incidents rate in high-risk patients: a randomised controlled trial." Kuban Scientific Medical Bulletin 29, no. 1 (January 25, 2022): 48–61. http://dx.doi.org/10.25207/1608-6228-2022-29-1-48-61.
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Background. The likelihood of intraoperative critical incidents depends largely on reflex control of the cardiorespiratory system that is often susceptible to chronic pathology. The reflex suppression may link to the depth of anaesthesia, making the latter monitoring particularly important at higher hypotension risks and their patient predisposition.Objectives. A study of the effect of bispectral index anaesthesia monitoring on critical incidents (CIs) rate in high-risk abdominal surgery patients.Methods. A randomised controlled trial enrolled 80 high-risk and 80 low-risk patients. Each cohort randomly allocated patients between subcohorts (by 40 people): 1 — anaesthesia rendered to maintain a 40–60 bispectral index (treatment cohort), 2 — by clinical values and anaesthetic level control in exhaled gas (control cohort), intraoperative control of anaesthetic requirement, bispectral index and critical incidents.Results. A critical incidents rate analysis in high-risk patients showed a lower rate in the bispectral index anaesthesia control cohort. Total 127 critical incidents were registered in 53 patients. The analysis revealed fewer CIs for objective sedation depth monitoring, 45% patients of treatment cohort vs. 87.5% in control. Significantly fewer (by half) patients exhibited hypotension in the treatment cohort, with lower (4-fold) rates of arrhythmia, bradycardia and general respiratory CIs. Anaesthetic doses and bispectral indices at anaesthesia stages were significantly lower in the treatment cohort as well.Conclusion. Objective anaesthesia depth monitoring in high-risk patients reduces the rates of haemodynamic incidents during anaesthesia maintenance and respiratory incidents at arousal due to prevention of excessive anaesthetic depth.
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Lavin, Michael. "Anaesthetic Techniques in Cataract Surgery: General Anaesthesia, Local Infiltrative Anaesthesia, or Topical Anaesthesia?" European journal of Implant and Refractive Surgery 6, no. 2 (April 1994): 113–16. http://dx.doi.org/10.1016/s0955-3681(13)80193-1.
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Savaj, Dr Priyank, Dr Shaila S. Kamath, and Dr Sunil B V. "Factors associated with patient Satisfaction with Anaesthetic care at A Tertiary Care Hospital." YMER Digital 21, no. 02 (February 25, 2022): 605–12. http://dx.doi.org/10.37896/ymer21.02/58.
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Background: Patient satisfaction with Anaesthesia care is an important variable which reflects health care service provided and is quality indicator for Anaesthesia care. Postoperative anaesthesia visits are important in reducing the dissatisfaction during perioperative period. Method: This was a prospective observational Study, conducted in a tertiary care hospital. 150 patients who underwent general anaesthesia for elective surgeries were interviewed with Standardized questionnaires. Questions were related to pre-operative, intraoperative, postoperative anaesthetic care and anaesthetic related complications. Data was entered in Microsoft excel and analysed using SPSS software version 25 (IBM). Chi square test was used to assess the association between each factor & the overall dissatisfaction of patient. Result: From total of 150 patients, 145(96.7%) were satisfied and 5(3.3%) were dissatisfied with overall anaesthetic care. Factors that associated with patient dissatisfaction were pain during swallowing/sore throat (42.9% p=<0.0001), nausea/vomiting (33.3% p=<0.001) and shivering (15.4% p=0.011). 17.3% of the patients expressed their dissatisfaction during perioperative visits, which was finally reduced to 3.3% by additional anaesthesia visits. Conclusion: overall Patient satisfaction was 96.7% which is high and acceptable. Patients dissatisfaction rate can be improved with post-operative anaesthesia visits.
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Teja, Srinivas, N. V. Rama Rao, P. Sharmila Nirojini, Venkateswara rao, and Ramarao Nadendla. "Paediatric regional anaesthesia: Comparing caudal Anaesthesia and Ilioinguinal block for Paediatric Inguinal Herniotomy." Research in Pharmacy and Health Sciences 2, no. 1 (February 15, 2016): 45–50. http://dx.doi.org/10.32463/rphs.2016.v02i01.09.
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Caudal anaesthesia and ilioinguinal block are effective, safe anaesthetic techniques for paediatric inguinal herniotomy. This review article aims to educate medical students about these techniques by examining their safety and efficacy in paediatric surgery, as well as discussing the relevant anatomy and pharmacology. The roles of general anaesthesia in combination with regional anaesthesia, and that of awake regional anaesthesia, are discussed, as is the administration of caudal adjuvants and concomitant intravenous opioid analgesia.
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Kantia, Rajwanti G., Shivrajsinh K. Jhala, Deepakkumar N. Suthar, and Vijander Singh Dabas. "Propofol/Etomidate Induced and Isoflurane Maintained Anaesthesia in Dogs." Indian Journal of Veterinary Sciences & Biotechnology 18, no. 5 (November 7, 2022): 19–23. http://dx.doi.org/10.48165/ijvsbt.18.5.04.
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Twenty-four clinical cases of dogs presented for surgical interventions requiring general anaesthesia were randomly divided into four groups (n=6) irrespective of age, breed, sex, body weight and surgical procedure. The animals of group I and II were first premedicated with atropine sulphate @ 0.02 mg/kg BW and butorphanol @ 0.2 mg/kg BW intramuscularly; whereas, atropine sulphate @ 0.02 mg/kg BW and buprenorphine @ 0.02 mg/kg BW was administered intramuscularly in animals of group III and IV, followed by diazepam @ 0.5 mg/kg BW intravenously in all the dogs. Induction of anaesthesia was achieved by intravenous administration of 1% propofol in group I and III and 0.2 % etomidate in group II and IV till effect. Dose sparing effect of pre-anaesthetic drugs, anaesthetic duration, viz., duration of surgery, duration of maintenance of anaesthesia, total duration of anaesthesia, recovery time and quality parameters, viz., quality of sedation, induction, maintenance anaesthesia and recovery were recorded. There was significant reduction in the induction dose of etomidate as well as recovery time as compared to propofol with both the pre-anaesthetic agents. The induction dose of propofol was also significantly reduced particularly with butorphanol than with buprenorphine. Duration of surgery, duration of maintenance of anaesthesia and total duration of anaesthesia were apparently lower in group IV than other three groups, but the duration of surgery only differed significantly due to variety of surgical procedures. Quality of sedation, induction, maintenance anaesthesia and recovery were found good to excellent in all the groups.
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Jildenstål, Pether, Amanda Bäckström, Klara Hedman, and Margareta Warrén-Stomberg. "Spectral edge frequency during general anaesthesia: A narrative literature review." Journal of International Medical Research 50, no. 8 (August 2022): 030006052211186. http://dx.doi.org/10.1177/03000605221118682.
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Previous studies have attempted to determine the depth of anaesthesia with different anaesthetic agents using electroencephalogram (EEG) measurements with variable success. Measuring depth of anaesthesia is confounded by the complexity of the EEG and the fact that different agents create different pattens. A narrative review was undertaken to examine the available research evidence on the effect and reliability of spectral edge frequency (SEF) for assessing the depth of anaesthesia in adult patients under general anaesthesia. A systematic search of the PubMed®, Scopus®, CINAHL and Cochrane databases identified six randomized controlled trials and five observational studies. The findings of these studies suggest that SEF varies according to the anaesthetic drugs used. Remifentanil and age are two factors that can affect SEF, while other opioids and benzodiazepine (administered separately) seem to have no effect. No patients experienced intraoperative awareness. However, this does not indicate that SEF can provide full protection against it and the number of articles in which intraoperative awareness was studied was too small to afford any certainty. None of the studies demonstrated a reliable SEF interval associated with adequate general anaesthesia. SEF must be adapted to the anaesthetic drug used, the patient’s age and state while under general anaesthesia.
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Elliott, Lucy, Karen Coulman, Natalie S. Blencowe, Mahim Qureshi, Sethina Watson, Ronelle Mouton, and Robert J. Hinchliffe. "Protocol for a systematic review of reporting standards of anaesthetic interventions in randomised controlled trials." BMJ Open 10, no. 1 (January 2020): e034372. http://dx.doi.org/10.1136/bmjopen-2019-034372.
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IntroductionThere is significant variation in how anaesthesia is defined and reported in clinical research. This lack of standardisation complicates the interpretation of published evidence and planning of future clinical trials. This systematic review will assess the reporting of anaesthesia as an intervention in randomised controlled trials (RCT) against the Consolidated Standards of Reporting Trials for Non-Pharmacological Treatments (CONSORT-NPT) framework.Methods and analysisOnline archives of the top six journals ranked by impact factor for anaesthesia and the top three general medicine and general surgery journals will be systematically hand searched over a 42-month time period to identify RCTs describing the use of anaesthetic interventions for any invasive procedure. All modes of anaesthesia and anaesthesia techniques will be included. All study data, including the type of anaesthetic intervention described, will be extracted in keeping with the CONSORT-NPT checklist. Descriptive statistics will be used to summarise general study details including types/modes of anaesthetic interventions, and reporting standards of the trials.Ethics and disseminationNo ethical approval is required. The results will be used to inform a funding application to formally standardise general, local, regional anaesthesia and sedation for use in clinical research. The systematic review will be disseminated via peer-reviewed manuscript and conferences.PROSPERO registration numberCRD42019141670.
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Grace, R. F., and V. J. Roach. "Caesarean Section in a Patient with Paramyotonia Congenita." Anaesthesia and Intensive Care 26, no. 5 (October 1998): 534–37. http://dx.doi.org/10.1177/0310057x9802600511.
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This case report details spinal anaesthesia for an elective caesarean section in a patient with the rare condition of paramyotonia congenita. There are few case reports of anaesthesia in this condition and none in the Australian anaesthetic literature. This case highlights the need for the avoidance of hypothermia and depolarizing muscle relaxants, the safety of spinal anaesthesia and a conservative approach to the management of plasma potassium concentration. The subsequent review outlines the current literature and discusses other issues involved in the anaesthetic management of this disorder.
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Bindu, Barkha, and Parmod Bithal. "Anaesthesia and deep brain stimulation." Journal of Neuroanaesthesiology and Critical Care 03, no. 03 (August 2016): 197–204. http://dx.doi.org/10.4103/2348-0548.190064.
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AbstractDeep brain stimulation (DBS) is becoming an increasingly popular minimally invasive surgical procedure for various movement disorders, especially Parkinson’s disease. Different nuclei have been identified depending on patients’ symptoms, but the success or failure of the procedure depends on various other factors such as proper patient selection and risk-benefit analysis. While various techniques of anaesthesia including monitored anaesthesia care, conscious sedation and general anaesthesia are being used routinely, no clear-cut evidence exists as to the best technique for this procedure. This review article discusses the surgical procedure of DBS, devices currently available, perioperative anaesthetic concerns and techniques, effect of anaesthetic drugs on microelectrode recordings and macro-stimulation and associated complications.
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Valimungighe, Moise Muhindo, Larrey Kasereka Kamabu, Rodriguez Mbusa Baraka, Kambale Mayalunga, Gloire à. Dieu Byabene Kaduku, Oboth Ronald, Okiror Paul, and Albert Ahuka ona Longombe. "Anaesthetic practices in the gynaecology and obstetric department in the principal health facilities of Butembo city, Eastern of the Democratic Republic of the Congo." Journal of Medical Research 6, no. 5 (October 28, 2020): 233–42. http://dx.doi.org/10.31254/jmr.2020.6513.
Full textAbstract:
Background: The practice of anaesthesia should be team work involving Obstetrician and Anesthesiologist to determine the anaesthetic and surgical needs of the patient in order to have a successful plan for the baby and mother. The aim of this survey was to evaluate the practice of anesthesia in obstetric and gynaecology department in the principal health facilities of Butembo city. Methods: A prospective and observational descriptive study was done in four health facilities of Butembo city, from January 1st, 2015 to December 31st, 2019. Results: 64.86% of obstetrical and gynaecological procedures were done under spinal anaesthesia. General anaesthesia with an endotracheal tube was performed in 2.97% of the cases, the laryngeal mask in 0.10% and intra venous anaesthesia without any airway support in 96.93% of the cases. 100% of the cases had benefited from a pre-anaesthetic consultation; 77.75% anaesthesia was administered by anaesthetic officers. 53,27% of the patients were classified as ASA I and 77.25% of cases were electives. Caesareans accounted for 87.83% of emergency cases and 70.73% of elective cases. The pre-medication consisted of atropine and diazepam in 31,02%. Bupivacaine was used for spine anaesthesia in 66.87%. Maintenance during general anaesthesia with ketamine was done in 98.72%. Pethidine was the analgesic used in intraoperative in 48.00%. Tramadol was the most used drugs for pain management in post operative period. Adverse events were recorded in 2.94% of the patients; hypotension was noted in 39,27%. 24 maternal deaths were recorded. Fifteen among them died due to complication related to anaesthesia. There is a dependency between the accidents and complications and qualification of anaesthetists. Conclusion: Anaesthesia is commonly used in the gynaecology and obstetric department. It is important to promote continuous training of Non Physician Anaesthetists as well as Consultants Anaesthesiologists in order to practice safe anaesthesia for the well being of our patients. Spinal anaesthesia was the common used predominantly with few adverse events to the mother and foetus.
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Alabi, Adeyinka Abiodun, Oladele Vincent Adeniyi, Olukayode Ademola Adeleke, Pamela Pilla, and Mohamed Rashid Haffajee. "Factors associated with failed spinal anaesthesia for Caesarean sections in Mthatha general hospital, Eastern Cape, South Africa." South African Family Practice 59, no. 4 (August 28, 2017): 39. http://dx.doi.org/10.4102/safp.v59i4.4737.
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Background: The use of spinal anaesthesia has increased in the last three decades, given that it is the recommended anaesthetic of choice for better foetal and maternal outcomes in Caesarean section. Failed spinal anaesthesia (FSA) exposes patients to unfavourable experience of pain and the potential complications of general anaesthesia that are being avoided in the first instance. This study determines the incidence and the predictors of failed spinal anaesthesia in pregnant women presenting for Caesarean section at Mthatha General Hospital, Eastern Cape.
Methods: This descriptive cross-sectional study included 197 pregnant women scheduled for Caesarean section under spinal anaesthesia at Mthatha General Hospital from May 1 to August 30, 2013. A standard proforma was utilised for data collection on items of demographic, surgical and anaesthetic records of each parturient. The main outcome measure was the incidence of failed spinal anaesthesia (defined as partial or incomplete spinal block requiring conversion to general anaesthesia).
Results: The incidence of failed spinal anaesthesia was 11.7%, which was slightly higher in emergency Caesarean sections. In univariate analysis, previous anaesthesia, obesity, dry tap of cerebrospinal fluid (CSF), bloody CSF and duration of work experience less than one year were significantly associated with FSA in the cohort.
Conclusion: The study found a high incidence of failed spinal anaesthesia during Caesarean section in this setting. Upskilling of doctors in spinal anaesthesia is urgently needed in the study setting.
(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)
S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1292696
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RANA, MD SOHEL, MD MIZANUR RAHMAN, and NASRIN SULTANA JUYENA. "Anaesthetic responses and reflexes to propofol and its combination in swine." Indian Journal of Animal Sciences 88, no. 10 (October 22, 2018): 1133–37. http://dx.doi.org/10.56093/ijans.v88i10.84078.
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To determine the effectiveness of propofol alone (P), and the combination of xylazine-propofol (XP), xylazineketamine (XK), xylazine-thiopentone (XT), anaesthetic protocols were studied in randomly selected 16 healthy indigenous pigs of either sexes, age 12 to 15 months and weight ranging from 12 to 16 kg. The responses of propofol and the combinations in different stages of anaesthesia were closely monitored. Various reflex responses and muscle tenacity were also observed concurrently during the period of anaesthesia. The study found the shortest (0.29±0.02 min) induction period with XT anaesthesia and the longest (2.95±0.21 min) by XK; whereas, induction of anaesthesia with P and XP was 0.4±0.08 and 0.41±0.08 min respectively. The time required for maximum depth of anaesthesia was the shortest in P (7.50±0.65 min) than the combinations. However, the anaesthetic protocol with XP produced the highest (65.25±3.30 min) duration of anaesthesia than the shortest (10.75±1.75 min) extent with P. Moreover, time to recovery from anaesthesia was higher (83.25±2.14 min) in XT and shorter (18.50±1.32 min) in P protocol. Good muscle relaxation was observed in XP, XK and XT combinations. Palpebral, conjunctival, jaw, tail and digital reflexes were almost absent in XP and XT combinations. The study concluded that propofol itself is a safe anaesthetic for short surgical interventions and its combination with xylazine is to be recommended for prolonged surgical procedures in swine.
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G. Ali, Mohamed, Abeer A. Mohammed, Mohammed A. Soliman, Rehab S. Mamoon, Mohammed A. Sarhan, Amel M. Youssef, and Fahima M. Okeel. "Do Different Types of Anaesthesia for Cesarean Delivery cause Subacute Low Back Pain ?" Pakistan Journal of Medical and Health Sciences 15, no. 9 (September 30, 2021): 2699–702. http://dx.doi.org/10.53350/pjmhs211592699.
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Background: Low back pain is a common complaint after cesarean delivery, different causes may be involved however they are poorly understood due to many confounders. Methodology: We performed this retrospective cohort study to assess the intensity of low back pain among 38 women (26 of them underwent cesarean delivery, assessed after 6 to 12 weeks from delivery date, they were classified into: epidural anaesthetic group (Group A) n.=6, spinal anaesthetic group (Group B) n.=13, general anaesthetic group (Group C) n.=7 and they were either primiparous or multiparous who did not receive any type of anaesthesia for at least one year prior to the last obstetric anaesthesia while the other 12 women were the control group (Group D) who didn’t experience any pregnancy or anaesthesia. Results: The mean values of visual analogue scale (VAS) in Group A, Group B, Group C, and Group D were 5.00 ±1.67, 4.62 ±1.12, 5.14 ±1.21, and 2.17 ±0.71, respectively. The ANOVA test revealed a significant difference in VAS among groups A, B, C, and D. Despite, the post-hoc test revealed a significant difference in VAS between group A versus group D, group B versus group D, and group C versus group D, but there were no significant differences between group A versus group B, group A versus group C, and group B versus group C. Conclusion: Cesarean delivery with different anaesthetic types as: epidural, spinal and general anaesthesia was associated with subacute low back pain without significant differences in pain intensity between these anaesthetic types. Key words: Neuraxial Anaesthesia, General Anaesthesia,Cesarean Delivery, Subacute Period, Low Back Pain.
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Chua, Alfred WY, Chandra M. Kumar, Matthew J. Chua, and Brian P. Harrisberg. "Anaesthesia for ophthalmic procedures in patients with thyroid eye disease." Anaesthesia and Intensive Care 48, no. 6 (November 2020): 430–38. http://dx.doi.org/10.1177/0310057x20957018.
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Thyroid eye disease is an autoimmune inflammatory disorder of the orbit in adults. It causes inflammation, expansion and fibrosis of orbital fat, muscles and the lacrimal gland, leading to facial disfigurement, functional disability and, in severe cases, blindness. Overall, approximately 20% of affected patients need some form of surgical intervention requiring anaesthesia. This narrative review explores the background of thyroid eye disease, surgical procedures performed and their implications for anaesthesia. General anaesthesia is used for orbital decompression procedures, strabismus correction surgery and complex oculoplastic procedures. Local anaesthetic infiltration or regional anaesthesia under monitored anaesthesia care are the techniques most commonly employed for eyelid retraction surgery. It is important to limit the volume of local anaesthetic agent used during infiltration and continuously monitor the orbital volume and ocular pressure with a ballottement technique. In addition, the contralateral eye should be checked and, if necessary, protected against corneal exposure. Retrobulbar, peribulbar and sub-Tenon’s blocks are best avoided. Topical anaesthesia has been used for some strabismus correction surgery but its use is limited to motivated and cooperative patients only.
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Strub, B., J. Sonderegger, A. Von Campe, J. Grünert, and J. J. Osterwalder. "What benefits does ultrasound-guided axillary block for brachial plexus anaesthesia offer over the conventional blind approach in hand surgery?" Journal of Hand Surgery (European Volume) 36, no. 9 (July 12, 2011): 778–86. http://dx.doi.org/10.1177/1753193411413664.
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Axillary block for brachial plexus anaesthesia is a popular anaesthetic technique for hand surgery with different approaches. We investigated the efficacy of the blind and ultrasound-guided approaches administered by a hand surgeon. A total of 141 patients were prospectively randomized to Group A without and Group B with ultrasound guidance. The principal variables evaluated were number of failures, duration of surgery, time to onset of anaesthesia, volume of anaesthetic injected, and complications. The success rate and the mean time to onset of anaesthesia were significantly better under ultrasound guidance. The duration of surgery and the rate of complications did not differ. Ultrasound-guided plexus anaesthesia is markedly more effective than the blind technique when performed by a hand surgeon.
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O, Fagbohun,, Towobola, O, and Akintimeyin, O. "Anaesthetic Considerations for Laminectomy and Spinal Decompression in a Patient with Cervical Myelopathy: A Case Report." Scholars International Journal of Traditional and Complementary Medicine . 5, no. 6 (July 5, 2022): 109–13. http://dx.doi.org/10.36348/sijtcm.2022.v05i06.001.
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The principal focus of the anaesthetist during surgical intervention in a patient with cervical myelopathy is to prevent further deterioration of the neurological system while delivering anaesthetic care. Successful surgical outcome of these patients requires a detailed preoperative review, careful and knowledge based peri-operative anaesthesia care plan and a robust collaboration between the anaesthetic and neuro-surgical teams. We report the case of a 76year old male medical doctor who presented with progressively worsening symptoms of cervical myelopathy and subsequently had laminectomy and decompression under general anaesthesia relaxant technique. We aim to highlight the place of detailed anaesthetic care plan in the successful management of this patient who was assessed as high risk for both a difficult airway and peri-operative anaesthetic complications associated with anaesthesia for cervical laminectomy and decompression.
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Dmitrović, Petra, Jana Vanaga, Julien Dupont, Thierry Franck, Alexandra Gougnard, Johann Detilleux, Liga Kovalcuka, Alexandra Salciccia, Didier Serteyn, and Charlotte Sandersen. "Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses." Animals 11, no. 10 (October 9, 2021): 2922. http://dx.doi.org/10.3390/ani11102922.
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Controversy continues to surround the use of opioids in equine anaesthesia, with variable effects reported. This blinded clinical study aimed to investigate the influence of a low-dose fentanyl continuous rate infusion (CRI) on isoflurane requirements, parasympathetic tone activity (PTA), and anaesthetic parameters in horses during general anaesthesia. All of the twenty-two horses included in the research underwent a standard anaesthetic protocol. Eleven horses in the fentanyl group (Group F) received a loading dose of fentanyl at 6 µg/kg, followed by a CRI of 0.1 µg/kg/min during anaesthesia. A further 11 horses in the control group (Group C) received equivalent volumes of normal saline. Anaesthetic parameters and PTA index were recorded during anaesthesia. The achieved mean fentanyl plasma concentration was 6.2 ± 0.83 ng/mL. No statistically significant differences between groups were found in isoflurane requirements, MAP values, and mean dobutamine requirements. However, horses in Group F required a significantly lower dose of additional ketamine to maintain a sufficient depth of anaesthesia. Significantly higher PTA values were found in the fentanyl group. Further research is warranted to determine the limitations of PTA monitoring, and the influence of various anaesthetics on its values.
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Gurney, Jason K., Melissa A. McLeod, Douglas Campbell, Elizabeth Dennett, Sarah Jackson, Jonathan Koea, Nicholas Lash, and Dick Ongley. "Anaesthetic choice for hip or knee arthroplasty in New Zealand: Risk of postoperative death and variations in use." Anaesthesia and Intensive Care 50, no. 3 (December 6, 2021): 178–88. http://dx.doi.org/10.1177/0310057x211050934.
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Anaesthetic choice for large joint surgery can impact postoperative outcomes, including mortality. The extent to which the impact of anaesthetic choice on postoperative mortality varies within patient populations and the extent to which anaesthetic choice is changing over time remain under-explored both internationally and in the diverse New Zealand context. In a national study of 199,211 hip and knee replacement procedures conducted between 2005 and 2017, we compared postoperative mortality among those receiving general, regional or general plus regional anaesthesia. Focusing on unilateral ( n=86,467) and partial ( n=13,889) hip replacements, we assessed whether some groups within the population are more likely to receive general, regional or general plus regional anaesthesia than others, and whether mortality risk varies depending on anaesthetic choice. We also examined temporal changes in anaesthetic choice over time. Those receiving regional alone or general plus regional for unilateral hip replacement appeared at increased risk of 30-day mortality compared to general anaesthesia alone, even after adjusting for differences in terms of age, ethnicity, deprivation, rurality, comorbidity, American Society of Anesthesiologists physical status score and admission type (e.g. general plus regional: adjusted hazard ratio (adj. HR)=1.94, 95% confidence intervals (CI) 1.32 to 2.84). By contrast, we observed lower 30-day mortality among those receiving regional anaesthesia alone compared to general alone for partial hip replacement (adj. HR=0.86, 95% CI 0.75 to 0.97). The latter observation contrasts with declining temporal trends in the use of regional anaesthesia alone for partial hip replacement procedures. However, we recognise that postoperative mortality is one perioperative factor that drives anaesthetic choice.
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Khakurel, Sharad, and Rupesh Kumar Yadav. "Continuous Spinal Anaesthesia for Intertrochanteric Femur Fracture in a Patient with Skeletal Dysplasia." Case Reports in Anesthesiology 2021 (April 9, 2021): 1–5. http://dx.doi.org/10.1155/2021/6644894.
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The practice of continuous spinal anaesthesia is not common. Though underutilised, it offers significant advantage when compared to the single-shot technique nonetheless. Time and again, it has proven its worth in patients with advanced cardiac illness, spinal deformities, and obesity. We here successfully employed this neuraxial anaesthetic technique in a sixty-two-year-old male patient with skeletal dysplasia, who presented for surgical fixation of intertrochanteric fracture of the femur. With short stature, anticipated difficult airway, and poor pulmonary status complicating the anaesthetic plan, we opted for continuous spinal anaesthesia. The procedure was carried out uneventfully with 8 mg of hyperbaric bupivacaine used in titration to anaesthetic needs. Patients with skeletal dysplasia present with wide array of clinical conditions that pose a formidable challenge to anaesthesiologists. Continuous spinal anaesthesia can be safely practiced in such patients as it provides a titratable form of neuraxial blockade with reduced dose of local anaesthesia. This, in turn, ensures a predictable block and, thus, hemodynamic stability.
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Khudr, Jamal, Luke Hughes, and Fizan Younis. "The what, why and when of wide awake local anaesthesia no tourniquet surgery." British Journal of Hospital Medicine 83, no. 1 (January 2, 2022): 1–10. http://dx.doi.org/10.12968/hmed.2021.0383.
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Wide awake local anaesthesia no tourniquet, also known as WALANT, is the practice of performing surgery under local anaesthetic in the absence of a tourniquet. This technique uses the vasoconstrictive effects of adrenaline and the local anaesthetic effects of lignocaine to establish a Bier block with haemostatic control. Permitting active patient participation intraoperatively, wide awake local anaesthesia no tourniquet surgery improves patient compliance with rehabilitation and yields higher patient satisfaction. With reduced cost and equipment requirements, this method improves accessibility for patients and productivity for healthcare institutions. This is of particular benefit within the current COVID-19 climate, as wide awake local anaesthesia no tourniquet technique provides a means of overcoming restrictions to theatre access and anaesthetic support. This review delves into the current uses of wide awake local anaesthesia no tourniquet surgery, outlining the initial conception of the practice by Canadian surgeons. The advantages and disadvantages are considered, and potential future applications of this technique are discussed.
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Landry, Jami, and Paul Maza. "Effectiveness of the anaesthetic combination of tiletamine, zolazepam, ketamine and xylazine for the sterilisation of street dogs in field clinics." Veterinary Record Case Reports 8, no. 2 (April 2020): e000953. http://dx.doi.org/10.1136/vetreccr-2019-000953.
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15 dogs presented to a sterilisation clinic in March 2017 for ovariohysterectomy or castration surgeries. All patients were initially injected with an anaesthetic combination of Telazol (tiletamine/zolazepam), ketamine and xylazine (TKX) intramuscularly, followed by venous catheterisation and a number of follow-up intravenous boluses of TKX when appropriate to maintain a surgical anaesthesia. 6 dogs required redosing of the TKX drug combination. Data of monitoring anaesthesia via heart rate, respiratory rate, jaw tone, limb and muscle movement were collected. These data were used to determine timing for additional intravenous half doses of TKX for the maintenance of anaesthesia. All surgeries were successful without complications, and the anaesthetic protocol was effective at maintaining surgical anaesthesia. This case report describes a group of patients in which TKX was used as the anaesthetic protocol, with details on this previously unreported protocol such that others may be able to consider using TKX in future dog sterilisation clinics.
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Grasso, Chiara, Vanessa Marchesini, and Nicola Disma. "Applications and Limitations of Neuro-Monitoring in Paediatric Anaesthesia and Intravenous Anaesthesia: A Narrative Review." Journal of Clinical Medicine 10, no. 12 (June 15, 2021): 2639. http://dx.doi.org/10.3390/jcm10122639.
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Safe management of anaesthesia in children has been one of the top areas of research over the last decade. After the large volume of articles which focused on the putative neurotoxic effect of anaesthetic agents on the developing brain, the attention and research efforts shifted toward prevention and treatment of critical events and the importance of peri-anaesthetic haemodynamic stability to prevent negative neurological outcomes. Safetots.org is an international initiative aiming at raising the attention on the relevance of a high-quality anaesthesia in children undergoing surgical and non-surgical procedures to guarantee a favourable outcome. Children might experience hemodynamic instability for many reasons, and how the range of normality within brain autoregulation is maintained is still unknown. Neuro-monitoring can guide anaesthesia providers in delivering optimal anaesthetic drugs dosages and also correcting underling conditions that can negatively affect the neurological outcome. In particular, it is referred to EEG-based monitoring and monitoring for brain oxygenation.
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P, Prathyusha, Amith Adyanthaya, Marium Raheema, Swetha S. Nair, Aparna Sivaraman, Risana K, Nazreen Ayub K, and Reshma Aloysius. "Assessment of Pain Perception in Paediatric Patients on Application of Cooled and Uncooled Topical Anaesthetic Gel before Infiltration Anaesthesia - A Pilot Study." Journal of Evolution of Medical and Dental Sciences 10, no. 23 (June 7, 2021): 1751–55. http://dx.doi.org/10.14260/jemds/2021/362.
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BACKGROUND Topical anaesthesia is fundamental in enhancing pain control during the process of dental injections. The study compared the effect of cooled and uncooled topical anaesthetic gel before infiltration anaesthesia in assessing pain perception in paediatric patients undergoing dental treatment procedures. METHODS This is a split-mouth study where 16 children aged between 8 and 10 years who required bilateral local anaesthesia administration for various dental procedures were selected. Before infiltration anaesthesia, topical anaesthetic gel cooled to 40 C was applied on one side in the first visit followed by application of uncooled gel on the contralateral side in the subsequent visit. The patients were asked to individually rate their pain experience on each side using the Wong-Baker Faces Pain Rating Scale (WB-FPRS). Anxiety was assessed using pulse oximeter and FLACC scale (face, legs, activity, cry, and consolability). Data was analysed statistically using the paired ‘t’-test and a P value less than or equal to 0.05 was considered as statistically significant. RESULTS Patients reported less pain on Wong-Baker Faces Pain Rating Scale by using cooled topical anaesthetic gel. Discomfort and anxiety levels were also seen to be low when assessed using pulse oximeter and FLACC Scale for the same group (P < 0.05). CONCLUSIONS Cooling the soft tissue site with anaesthetic gel helped reduce pain perception during infiltration in children and was seen to be a more feasible technique. Hence this technique can be used as a successful adjunct to the local anaesthesia administration prior to dental procedures. KEY WORDS Anaesthesia, Cooling, Topical Gel, Injection, Pain
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Owen, Jennifer P., and Robert N. Kelsh. "A suitable anaesthetic protocol for metamorphic zebrafish." PLOS ONE 16, no. 3 (March 5, 2021): e0246504. http://dx.doi.org/10.1371/journal.pone.0246504.
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Zebrafish are frequently used as a means to investigate development. These studies increasingly require repeated anaesthesia of zebrafish during juvenile (i.e. metamorphic) stages. The effects of anaesthesia during this time remain poorly studied. The aim of this study was to develop a reliable method that can be used for frequently repeated anaesthesia during juvenile stages. Initially, we assessed different concentrations of MS-222, the most commonly used fish anaesthetic, for 30 minute anaesthesia with recovery. We showed that suitable MS-222 doses could be identified for the smallest (7mm) and largest (20mm) fish. However, we found that juvenile fish within a specific metamorphic window (sized between 8–16 mm) were vulnerable to MS-222 and no standard concentration of MS-222 provided reliable anaesthesia under these conditions. Hence we focussed our efforts on identifying a protocol for these stages. We tested six different published anaesthesia protocols P1—P6 where P1, P2 corresponds to 0.01% MS-222, P3, P4: 0.085% 2-phenoxyethanol and P5, P6: 0.00025%/0.0050% Propofol/Lidocaine. In protocols P1, P3, P5 fish were maintained by immersion, whilst in P2, P4 and P6: fish were maintained on an anaesthetic-doused cotton-pad. We assessed reliable anaesthesia using 10 fish for 10 minutes, with full recovery. Our data allowed us to eliminate two of these protocols as unsuitable for short term anaesthesia with recovery of juvenile fish. Extending these studies to explore repeated anaesthesia at 4 day intervals for 20 days under the remaining four protocols, we showed that P1 and P4 were both suitable for repeated anaesthesia, and that P4 was most suitable for imaging. We confirmed that P4 remained suitable when the frequency of anaesthesia was increased to every 2 days. We conclude that this protocol provides a refinement to the current protocol for repeated anaesthesia with recovery of juvenile zebrafish in the vulnerable metamorphic window.
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Qureshi, Irfan Parvez, Saima Qureshi, and Vimal Modi. "Study of early post-operative complications in relation to nature of anaesthesia and type of surgery." International Surgery Journal 5, no. 8 (July 24, 2018): 2827. http://dx.doi.org/10.18203/2349-2902.isj20183199.
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Background: Many people have complications after surgery; some transient, others serious, but all are important to patients. The likelihood of postoperative complications is influenced by the type of surgery, the patients pre-existing comorbid state and perioperative management. Anaesthesia result in a variety of metabolic and endocrine responses, but conventional wisdom maintains that anaesthetic technique has little long-term effect on patient outcomes. There is accumulating evidence that, on contrary, anaesthetic management may in fact exert a number of longer-term effects in postoperative outcome.Methods: A prospective study of early post-operative complication in 100 patients’, who underwent major surgery, was done in the Department of Surgery in a tertiary care teaching hospital, Indore. Therefore, the present study was carried out prospectively to study the incidence of postoperative complications in relation to age, sex and other factors which influence them and correlation of post-operative complications with the nature of anaesthesia, duration of operation, type of surgery and in surgery above diaphragm or below diaphragm.Results: The incidence of post-operative complications was more in patients operated with general anaesthesia (48.38% and 12.9% respectively) the morbidity and mortality in patients who were operated under spinal anaesthesia was lower than general anaesthesia, but morbidity was higher in patients who were operated under epidural anaesthesia, but mortality was lower than epidural.Conclusions: There is accumulating evidence that anaesthetic management may indeed exert a number of influences on longer term postoperative outcomes. Further prospective, randomized, large scale, human trials with long- term follow-up are required to clarify the association between anaesthesia technique and postoperative outcome.
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Patey, R., and RP Alston. "Anaesthesia and cardiopulmonary bypass: a UK and Ireland survey." Perfusion 8, no. 4 (July 1993): 313–19. http://dx.doi.org/10.1177/026765919300800406.
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A postal survey of consultant anaesthetists in the UK and Ireland was undertaken in the summer of 1989 to determine anaesthetic practice during cardiopulmonary bypass (CPB). A questionnaire requiring details of anaesthetic agents used for induction of anaesthesia, maintenance of anaesthesia before CPB and during CPB was sent to 198 consultants. There was a 52% response rate. Intravenous anaesthetics were used during induction of anaesthesia, maintenance of anaes thesia and during CPB by 100%, 64% and 81 % of respondents respectively. Opioids were used by 96%, 96% and 80%, volatile anaesthetics by 73%, 95% and 36%, and neuromuscular blockers by 100%, 97% and 90%. It is concluded that a balanced anaesthetic technique using neuromuscular blockers, opioids and intravenous anaesthetics is that which is most commonly used during CPB.
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Sørensen, A. M., J. Dalsgaard, and T. B. Hansen. "Local anaesthesia versus intravenous regional anaesthesia in endoscopic carpal tunnel release: a randomized controlled trial." Journal of Hand Surgery (European Volume) 38, no. 5 (July 3, 2012): 481–84. http://dx.doi.org/10.1177/1753193412453664.
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We carried out a prospective randomized trial in 38 patients to compare intravenous regional anaesthesia with local anaesthesia in endoscopic carpal tunnel release using the Agee single-portal technique. There was no significant difference in reported pain during surgery. Immediately after surgery, patients in the local anaesthesia group reported significantly less pain in the hand and at the tourniquet. Two hours after surgery, patients in the local anaesthesia group reported significantly less hand pain. Moreover, significantly fewer patients in the local anaesthetic group required additional analgesics during the first 2 hours after operation. We conclude that local anaesthesia reduces post-operative pain in endoscopic carpal tunnel release compared with intravenous regional anaesthesia.
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Lavy, JA, and HRF Powell. "Stapes surgery under local anaesthesia." Annals of The Royal College of Surgeons of England 95, no. 1 (January 2013): 37–39. http://dx.doi.org/10.1308/003588413x13511609954932.
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In the UK, stapes surgery is performed almost universally under general anaesthesia. In 1984 there was consensus that local anaesthesia should be the technique of choice in stapes surgery. Despite reports of successful use of local anaesthesia for middle ear surgery, this is still not widely accepted practice in the UK. We describe the senior author’s technique for local anaesthetic stapes surgery and present the hearing results for a series of 100 consecutive cases.
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Smith, W. D. A. "Surgery without Pain — Part 1: Background." Anaesthesia and Intensive Care 14, no. 1 (February 1986): 70–78. http://dx.doi.org/10.1177/0310057x8601400115.
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This paper was commissioned to cover the beginnings of anaesthesia: the transition from surgical operations with pain to those without. It reviews some previous pre-anaesthetic histories (Part I): it focuses upon attitudes to pain; and it seeks evidence from the one hundred years before the discovery of anaesthesia. Finally (Part II) it outlines the introduction of nitrous oxide and of ether anaesthesia.
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Smith, W. D. A. "Surgery without Pain — Part II: 1800–1847." Anaesthesia and Intensive Care 14, no. 2 (May 1986): 186–92. http://dx.doi.org/10.1177/0310057x8601400214.
Full textAbstract:
This paper was commissioned to cover the beginning of anaesthesia: the transition from surgical operations with pain to those without. It reviews some previous pre-anaesthetic histories (Part I): it focuses upon attitudes to pain; and it seeks evidence from the one hundred years before the discovery of anaesthesia. Finally (Part II) it outlines the introduction of nitrous oxide and of ether anaesthesia.
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Milton, Sherran. "Circulation and Invasive Monitoring: Back to Basics." Journal of Perioperative Practice 19, no. 7 (July 2009): 213–20. http://dx.doi.org/10.1177/175045890901900702.
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Introduction The monitoring of patients within the perioperative environment has become increasingly sophisticated as technological advances are made within anaesthesia and anaesthetic technique. The contemporary anaesthetic practitioner (AP) is required to prepare an ever mounting array of complex monitoring equipment within their daily routine. For clarification, in this article the abbreviation AP will refer to a nurse or operating department practitioner who is performing the anaesthetic assistant role, not to a physicians' assistant (anaesthesia) (AAGBI 2008).
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Fisher, M. McD, and C. J. Bowey. "Alleged Allergy to Local Anaesthetics." Anaesthesia and Intensive Care 25, no. 6 (December 1997): 611–14. http://dx.doi.org/10.1177/0310057x9702500602.
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The aim of this study was to determine the incidence of true local anaesthetic allergy in patients with an alleged history of local anaesthetic allergy and whether subsequent exposure to local anaesthetics is safe. Two hundred and eight patients with a history of allergy to local anaesthesia were referred over a twenty-year period to our Anaesthetic Allergy Clinic. In this open study, intradermal testing was performed in three patients and progressive challenge in 202 patients. Four patients had immediate allergy and four patients delayed allergic reactions. One hundred and ninety-seven patients were not allergic to local anaesthetics. In 39 patients an adverse response to additives in local anaesthetic solutions could not be excluded. In all but one patient local anaesthesia has been given uneventfully subsequently. A history of allergy to local anaesthesia is unlikely to be genuine and local anaesthetic allergy is rare. In most instances LA allergy can be excluded from the history and the safety of LA verified by progressive challenge.
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Ayodeji, Emmanuel E., Fatungase O. Motunrayo, Nwokoro C. Chigbundu, and Shoyemi R. Oluwatoyin. "Pattern of anaesthesia techniques for herniotomy at a southwestern tertiary health institution: a 5-year review." Nigerian Journal of Paediatrics 48, no. 1 (February 4, 2021): 1–7. http://dx.doi.org/10.4314/njp.v48i1.1.
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Background: Anaesthesia for herniotomy may be challenging because the margin of error in managing such a young patient can be extremely small since the body reserves are limited and the organ systems may not be fully developed. Also, the psychological, physiological and pharmacological responses to anaesthesia are quite different from adult. Safe and effective care of children under anaesthesia is therefore crucial. This study aims to audit the pattern of anaesthetisia techniques used and their associated complications during herniotomy procedure in our health facility. Material and methods: This is a retrospective review of patients’ files, theatre records and anaesthetic-record charts of herniotomy cases performed in a tertiary health Institution from January 2011 to December 2015. Relevant clinical information were entered into proforma designed for the study. Data was analysed with descriptive statistics using the Statistical Package for Social Sciences (SPSS) version 20 Chicago IL (U.S.A). Inferential statistics of Chi-Square, Mann-Whitney and Kruskal-Wallis Test were alsoperformed. Results: One hundred and fortyfour in-patient children who belonged to American Society of Anesthesiologists Physical Health Status (ASA) grade I and II had herniotomies during the study period. The mean age is 4.21±3.72years (range, 6months – 16years) with male to female ratio of 47:1 (i.e 141 to 3). General anaesthesia (135, 94%) of various techniques was the most common technique while regional anaesthesia was only employed in nine (6%) children. The regional anaesthesia techniques were caudal block 1 (0.7%) and subarachnoid block 8 (5.5%) and were sedated to allow for cooperation in some of the cases. One hundred and twenty-four (86%) children presented as simple, elective cases while twenty (14%) children as complicated or emergency cases. Conclusion: This study showed that herniotomy can be safely performed under various options of anaesthesia techniques depending on the expertise of the anaesthetists involved. The simple, electives inguinal hernia and hydroceles could have been performed as day cases.
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Kim, Ha-Jung, Priodarshi Roychoudhury, Stuti Lohia, Jin-Sun Kim, Hyung-Tae Kim, Young-Jin Ro, and Won-Uk Koh. "Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis." Medicina 57, no. 11 (November 15, 2021): 1250. http://dx.doi.org/10.3390/medicina57111250.
Full textAbstract:
Background and Objectives: Some of the postoperative complications following orthopaedic surgeries are associated with a systemic inflammatory response (SIR), which varies depending on the anaesthetic technique. We aimed to compare the effects of general and spinal anaesthesia on the SIR after total knee arthroplasty (TKA), based on C-reactive protein (CRP) levels, the platelet-lymphocyte ratio (PLR), and the neutrophil-lymphocyte ratio (NLR). Materials and Methods: Patients who underwent TKA between January 2014 and December 2018 were included. Electronic medical records of the patients were retrospectively reviewed and analysed. To reduce the impact of potential confounding factors, we performed propensity score matching according to the anaesthetic technique. Results: A total of 1311 TKA cases were analysed. After propensity score matching, the maximal CRP value and changes in CRP levels in the general anaesthesia group were higher than those in the spinal anaesthesia group. However, the maximal NLR and PLR and the changes in NLR and PLR were not different between the two groups. There were no differences in postoperative clinical outcomes. Conclusion: Spinal anaesthesia tended to induce a lower inflammatory response than general anaesthesia when considering CRP levels in patients undergoing TKA. However, the effects of anaesthetic techniques on the overall outcomes were not significant.
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Jenkins, J. G. "Unilateral Block and Spinal Anaesthesia." Journal of the Royal Society of Medicine 79, no. 2 (February 1986): 110–11. http://dx.doi.org/10.1177/014107688607900214.
Full textAbstract:
Unilateral block is a rare complication of spinal anaesthesia. A case where a unilateral block occurred following the administration of a spinal anaesthetic, and where a second spinal anaesthetic to complete the block was successfully administered, is reported. The possible causes of unilateral block are discussed.
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Hedenqvist, P., J. V. Roughan, and P. A. Flecknell. "Effects of repeated anaesthesia with ketamine/medetomidine and of pre-anaesthetic administration of buprenorphine in rats." Laboratory Animals 34, no. 2 (April 1, 2000): 207–11. http://dx.doi.org/10.1258/002367700780457536.
Full textAbstract:
Two groups of rats were anaesthetized at weekly intervals for 6 weeks with either ketamine/medetomidine alone (60 mg/0.4 mg/kg i.p.) or ketamine/medetomidine (45 mg/0.3 mg/kg i.p.) one hour following buprenorphine (0.05 mg/kg s.c.). Animals that received buprenorphine had longer periods of surgical anaesthesia ( P = 0.04) and a greater depression of both mean pedal withdrawal score ( P < 0.01) and mean respiratory rate ( P = 0.014). Mean total duration of anaesthesia was also greater in the buprenorphine group on day 1. Sleep times reduced with successive doses of anaesthetic in the buprenorphine group ( P = 0.024). Two animals in the buprenorphine group died. Repeated anaesthesia with ketamine/medetomidine alone was not associated with anaesthetic mortality. These results indicate that although buprenorphine has a clear anaesthetic-sparing effect, its use with ketamine/medetomidine may be associated with an increased risk of anaesthetic-related mortality.
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Field, Karl J., William J. White, and C. Max Lang. "Anaesthetic effects of chloral hydrate, pentobarbitone and urethane in adult male rats." Laboratory Animals 27, no. 3 (July 1, 1993): 258–69. http://dx.doi.org/10.1258/002367793780745471.
Full textAbstract:
Chloral hydrate, pentobarbitone and urethane were evaluated and compared for onset, duration and depth of anaesthesia, cardiovascular and respiratory effects, nociception and mortality in adult male rats. Chloral hydrate (300 and 400 mg/kg) severely depressed the cardiovascular and respiratory systems. Duration of anaesthesia was linearly related to dose, and anaesthetic depth and analgesia were excellent. Pentobarbital (40 mg/kg) produced a short period of light surgical anaesthesia. Moderate to severe respiratory and cardiovascular depression occurred. Duration of anaesthesia was not related to dose. Urethane (1·2 and 1·5 g/kg) caused moderate cardiovascular depression. In addition, mortality was high at the 1·5 g/kg dose. Duration of anaesthesia was greater than 24 h for most animals. Anaesthesia depth and analgesia were excellent.
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Keller, L. S. F., C. K. Drozdowicz, L. Rice, T. A. Bowman, and C. M. Lang. "An evaluation of three anaesthetic regimes in the gray short-tailed opossum (Monodelphis domestica)." Laboratory Animals 22, no. 3 (July 1, 1988): 269–75. http://dx.doi.org/10.1258/002367788780746449.
Full textAbstract:
The effect of several anaesthetic agents on the gray short-tailed opossum ( Monodelphis domestica) was investigated. Pentobarbitone sodium at a dose of 50 mg/kg sedated the animals but did not produce analgesia or anaesthesia. A combination of ketamine hydrochloride and xylazine at 40 mg/kg and 5 mg/kg, respectively, sedated the animals, but anaesthetic lerels were not attained. Halothane was most effective in producing anaesthesia in Monodelphis domestica. Hypothermia was a major side effect with all three anaesthetic regimes.