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Intravenous Anaesthesia (intravenous + anaesthesia)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Intravenous Anaesthesia

  • total intravenous anaesthesia
    		•

    Selected Abstracts

    Annual Scientific Meeting of the UK Society for Intravenous Anaesthesia in York, November 2009

    ANAESTHESIA, Issue 5 2010
    Article first published online: 24 MAR 2010
    No abstract is available for this article. [source]

    Anaesthesia for endoscopic sinus surgery

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2010
    A. R. BAKER
    Endoscopic sinus surgery is commonly performed and has a low risk of major complications. Intraoperative bleeding impairs surgical conditions and increases the risk of complications. Remifentanil appears to produce better surgical conditions than other opioid analgesics, and total intravenous anaesthesia with propofol may provide superior conditions to a volatile-based technique. Moderate hypotension with intraoperative , blockade is associated with better operating conditions than when vasodilating agents are used. Tight control of CO2 does not affect the surgical view. The use of a laryngeal mask may be associated with improved surgical conditions and a smoother emergence. It provides airway protection equivalent to that provided by an endotracheal tube in well-selected patients, but offers less protection from gastric regurgitation. Post-operatively, multimodal oral analgesia provides good pain relief, while long-acting local anaesthetics have been shown not to improve analgesia. [source]

    Endotracheal tube size and sore throat following surgery: a randomized-controlled study

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010
    M. JAENSSON
    Background: Sore throat following endotracheal intubation is a common problem following surgery and one of the factors that affects the quality of recovery. This study was carried out with the primary aim of assessing whether the size of the endotracheal tube (ETT) affects the risk of sore throat in women following anaesthesia. Methods: One hundred healthy adult women undergoing elective surgery were randomly allocated to oral intubation with either ETT size 6.0 or 7.0. Anaesthesia was based on either inhalation or total intravenous anaesthesia according to standardized routines. Pre- and post-operatively, sore throat and discomfort were assessed on a four-graded scale and for hoarseness on a binary scale (yes or no). Post-operatively, the assessments were performed after 1,2 and 24 h, and if there was discomfort at 24 h, a follow-up call was made at 72 and 96 h. Results: After 1,2 h post-operatively, there were a higher proportion of patients with sore throat in ETT 7.0 vs. ETT 6.0 (51.1% vs. 27.1%), P=0.006. This difference between the groups was also evident, P=0.002, when comparing changes between the pre- and the post-operative values. The severity of discomfort from sore throat was also higher in ETT 7.0 (38.8%) compared with ETT 6.0 (18.8%), P=0.02. No differences were found in the incidence of hoarseness between the groups. The remaining symptoms lasted up to 96 h post-operatively in 11%, irrespective of the tube size. Conclusion: Use of a smaller-sized ETT can alleviate sore throat and discomfort in women at the post-anaesthesia care unit. [source]

    The three-way stopcock may be a weak component of total intravenous anaesthesia

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009
    A. ZECHA-STALLINGER
    Background: An intravenous line is needed to administer anaesthesia, particularly when total intravenous anaesthesia (TIVA) is performed. A disadvantage of TIVA is that the intravenous concentration of anaesthetics cannot be easily measured compared with volatile anaesthetics. If a three-way stopcock is accidentally unscrewed, TIVA drugs cannot reach the patient's veins, thus resulting in inadequate anaesthesia levels, possibly resulting in awareness. We therefore measured the required torque to open five different brands of three-way stopcocks in an attempt to make an intravenous-line including all elements safer. Methods: The torque required to open one, two or three three-way stopcocks being connected in a perpendicular manner was measured with a biaxial servo hydraulic material testing machine. Results: The force required to open three-way stopcocks connected with an intravenous catheter ranged in five different stopcock models from 5.03±0.75 to 2.21±0.51 N respectively; with two three-way stopcocks from 2.68±0.42 to 1.31±0.59 N, respectively, and with three three-way stopcocks from 1.29±0.27 to 0.82±0.05 N, respectively. Conclusion: Turning a three-way stopcock to become loose with possibly leaking drugs requires minimal amounts of force and decreases significantly if not connected in-line. [source]

    Myopexy (Faden) results in more postoperative vomiting after strabismus surgery in children

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2001
    M. Saiah
    Background: Strabismus correction in children is associated with a high incidence of postoperative nausea and vomiting. The purpose of this prospective, double-blind study was to examine the influence of the surgical method for correction of squint on the incidence of postoperative vomiting. Methods: One hundred and twenty consecutive children aged 2,12 years, scheduled for elective strabismus surgery, were enrolled in this prospective, double-blind study. A standardised total intravenous anaesthesia was given to all children. The development of perioperative oculocardiac reflex was noted and the number of episodes of vomiting during the first 48 h postoperatively was recorded. At the completion of the study, the children who were operated with myopexy according to Faden, were allocated to a Faden group, those without a myopexy to the non-Faden group. All the patients included in this study were operated on by the same surgeon with standardised techniques. Results: The Faden group was younger, lighter and the operation time was longer (P<0.05). The incidence of vomiting was greater in the Faden group; 53% versus 12% (P<0.05). The incidence of oculocardiac reflex was similar in both groups; 40% in the Faden versus 28% in the non-Faden group, respectively. The total dose of propofol and alfentanil was similar between the groups. Requirement of analgesics for postoperative pain was similar in both groups. The only independent risk factor for postoperative vomiting was the Faden operation. Conclusion: The surgical method used for strabismus correction in children has a great influence on the incidence of postoperative vomiting. The Faden operation is associated with a very high incidence of postoperative vomiting; this particular group of patients has to be considered as a high risk group for postoperative vomiting and deserves an antiemetic prophylaxis. [source]

    Anaesthetic management of a patient with myotonic dystrophy

    PEDIATRIC ANESTHESIA, Issue 4 2001
    DRCOG, R.J. White MBBS
    A 13-year-old boy with myotonic dystrophy underwent insertion of a percutaneous gastrostomy feeding tube under general anaesthesia. We used a laryngeal mask airway and a spontaneously breathing technique with propofol total intravenous anaesthesia. Postoperative vomiting and aspiration, 12 h after the procedure, subsequently required intubation and ventilation. We discuss the anaesthetic management of this case and review the features of the disease to be considered when contemplating anaesthesia in such patients. [source]

    Combination propofol,ketamine anaesthesia in sick neonates

    PEDIATRIC ANESTHESIA, Issue 1 2001
    Samuel Golden MD
    Two critically ill, opioid-tolerant neonates were anaesthetized using pancuronium and a mixture of propofol (PROP) and ketamine (KET). Three mg of KET were added per ml (10 mg) of PROP in a single syringe and infused at a rate of 100,150 ,g·kg,1·min,1 of the PROP component (30,45 ,g·kg,1·min,1 KET). Total doses of 12,15 and 3.6,4.5 mg·kg,1 of PROP and KET, respectively, were administered. Both patients remained haemodynamically stable throughout their surgical procedures. PROP-KET is a rational and effective combination for intravenous anaesthesia in critically ill neonates who are likely to be opioid-tolerant when an anaesthesia vaporizer is not readily available. [source]

    A comparison of volatile and non volatile agents for cardioprotection during on-pump coronary surgery

    ANAESTHESIA, Issue 9 2009
    S. De Hert
    Summary A randomised study of 414 patients undergoing coronary artery surgery with cardiopulmonary bypass was conducted to compare the effects of a volatile anaesthetic regimen with either deesflurane or sevoflurane, and a total intravenous anaesthesia (TIVA) regimen on postoperative troponin T release. The primary outcome variable was postoperative troponin T release, secondary outcome variables were hospital length of stay and 1-year mortality. Maximal postoperative troponin T values did not differ between groups (TIVA: 0.30 [0.00,4.79] ng.ml,1 (median [range]), sevoflurane: 0.33 [0.02,3.68] ng.ml,1, and desflurane: 0.39 [0.08,3.74] ng.ml,1). The independent predictors of hospital length of stay were the EuroSCORE (p < 0.001), female gender (p = 0.042) and the group assignment (p < 0.001). The one-year mortality was 12.3% in the TIVA group, 3.3% in the sevoflurane group, and 6.7% in the desflurane group. The EuroSCORE (p = 0.003) was the only significant independent predictor of 1-year mortality. [source]

    Effects of moderate acute isovolaemic haemodilution on myocardial function in patients undergoing coronary surgery under volatile inhalational anaesthesia

    ANAESTHESIA, Issue 3 2009
    S. G. De Hert
    Summary When myocardial oxygen demand is increased by elevated heart rate in patients undergoing coronary artery surgery under total intravenous anaesthesia, acute isovolaemic haemodilution may be associated with a deterioration of cardiac function. We investigated the effects of acute isovolaemic haemodilution during volatile inhalational anaesthesia. Forty patients undergoing coronary surgery were randomly assigned to two groups according to the rate of atrioventricular pacing (Group 70 at 70.min,1 and Group 90 at 90.min,1). While paced at the fixed heart rate, acute isovolaemic haemodilution was performed before the start of cardiopulmonary bypass. In both groups mean (SD) stroke volume increased with haemodilution (from 65 (9) to 83 (10) ml.min,1 (p < 0.01) in Group 70 and from 65 (9) to 81 (9) ml.min,1 (p < 0.01) in Group 90) as a result of a decrease in systemic vascular resistance (from 1175 (231) to 869 (164) dynes.s.cm,5 (p < 0.01) and from 1060 (185) to 849 (146) dynes.s.cm,5 (p < 0.01), respectively) and an increase in end-diastolic volume (from 1049 (234) to 1405 (211) ml (p < 0.01) and from 1078 (106) to 1438 (246) ml (p < 0.01), respectively). Left ventricular pressure-derived data remained unchanged with acute isovolaemic haemodilution in both groups. [source]

    Caesarean section in a complicated case of central core disease

    ANAESTHESIA, Issue 5 2008
    R. N. Foster
    Summary We describe the anaesthetic management of a 21-year-old lady with central core disease for elective Caesarean section. Central core disease is characterised by muscle weakness, skeletal deformities and susceptibility to malignant hyperthermia. Total intravenous anaesthesia was used because of the combination of potential malignant hyperthermia, severe kyphoscoliosis and extensive spinal scarring. The authors believe there is no previous report of propofol and remifentanil being used in these circumstances. A short review of central core disease and its anaesthetic implications is provided. [source]

    Total intravenous anaesthesia for oculoplastic surgery in a patient with myasthenia gravis without high-dependency care

    ANAESTHESIA, Issue 7 2003
    S. Lam
    No abstract is available for this article. [source]

    Re-use of equipment between patients receiving total intravenous anaesthesia: a postal survey of current practice,

    ANAESTHESIA, Issue 6 2003
    M. J. Halkes
    Summary In order to establish current practice with regard to the reuse of infusion equipment between patients receiving total intravenous anaesthesia (TIVA), a postal survey of 393 consultants was carried out. Additionally, consultants' awareness of relevant guidelines was assessed. Overall, 46% of consultants change all equipment between cases, 37% change one-way valves and 17% change distal lengths of the infusion tubing. Only 13% of consultants reported knowledge of any guidelines. In the absence of any data relevant to the current techniques of administering TIVA, the level of risk associated with the reuse of infusion components is impossible to quantify. Disposal of all equipment between cases incurs a 26% greater cost when compared to changing one-way valves alone. Variation in practice between consultants creates the potential for system errors. Practice should be standardised and, to comply with the published guidelines, should involve disposal of all equipment between cases. [source]