Anesthesiology Research and Practice

Publisher: Hindawi Publishing Corporation

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ISSN 1687-6970
OCLC 220311955
Material type Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

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Hindawi Publishing Corporation

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Publications in this journal

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    ABSTRACT: Background. This study aimed to evaluate and compare total cost of sevoflurane and propofol for 1.0 MAC-hour of anaesthesia, employing three anaesthetic techniques. Methods. Adult patients scheduled for surgical procedures under general anaesthesia anticipated to last approximately an hour were randomized into three groups (n = 15 each), to receive anaesthesia using one of the following techniques: low flow technique involving induction with propofol, followed by sevoflurane delivered using initial fresh gas flows of 6 L/min till MAC reached 1.0 and then reduced to 0.5 L/min; alternate method of low flow entailing only a difference in fresh gas flow rates being maintained at 1 L/min throughout; the third technique involving use of sevoflurane for both induction and maintenance of anaesthesia. Results. Cost of sevoflurane to maintain 1 MAC-hour of anaesthesia was clinically least with low flow anaesthesia, though statistically similar amongst the three techniques. Once the cost of propofol used for induction in two of the three groups was added to that of sevoflurane, cost incurred was least with the technique using sevoflurane both for induction and maintenance of anaesthesia, as compared to low flow and alternative low flow techniques, a 26% and 32% cost saving, respectively (P < 0.05).
    Anesthesiology Research and Practice 10/2014; 2014:459432. DOI:10.1155/2014/459432
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    ABSTRACT: Introduction. Thoracic paravertebral block (TPVB) provides superior analgesia for breast surgery when used in conjunction with general anesthesia (GA). Although TPVB and GA are often combined, for some patients GA is either contraindicated or undesirable. We present a series of 28 patients who received a TPVB with sedation alone for breast cancer surgery. Methods. A target controlled infusion of propofol or remifentanil was used for conscious sedation. Ultrasound guided TPVB was performed at one, two, or three thoracic levels, using up to 30 mL of local anesthetic. If required, top-up local infiltration analgesia with prilocaine 0.5% was performed by the surgeon. Results. Most patients were elderly with significant comorbidities and had TPVB injections at just one level (54%). Patient choice and anxiety about GA were indications for TVPB in 9 patients (32%). Prilocaine top-up was required in four (14%) cases and rescue opiate analgesia in six (21%). Conclusions. Based on our technique and the outcome of the 28 patients studied, TPVB with sedation and ultrasound guidance appears to be an effective and reliable form of anesthesia for breast surgery. TPVB with sedation is a useful anesthetic technique for patients in which GA is undesirable or poses an unacceptable risk.
    Anesthesiology Research and Practice 08/2014; 2014:127467. DOI:10.1155/2014/127467
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    ABSTRACT: Background: This study was designed to assess and compare the effect of head and neck position on the oropharyngeal leak pressures,cuff position (employing fibreoptic view of the glottis)and ventilation scores between ProSeal LMA and the I-gel. Material and Methods: After induction of anesthesia, the supraglottic device was inserted and ventilation confirmed. The position of the head was randomly changed from neutral to flexion, extension and lateral rotation (left). The oropharyngeal leak pressures, fibreoptic view of glottis, ventilation scores, delivered tidal volumesand end tidal CO2 were noted in all positions. Results:In both the groups‟compared with neutral position;oropharyngeal leak pressures were significantly higher with flexion and lower with extension, but similar with rotation of head and neck.{ProSeal LMA (Neutral: 28 ± 4.19cm H2O, Flexion: 32 ± 4.11cm H2O, Extension: 24 ± 4.00 cm H2O and Lateral Rotation28 ± 3.15cm H2O). I-gel (Neutral: 22± 3.23cm H2O, Flexion: 25 ± 3. 64cm H2O, Extension: 19± 2. 61cm H2O, Rotation: 22± 2.74cm H2O)} However the oropharyngeal leak pressure was significantly higher for ProSeal LMA compared with the I-gel in all the position. Peak airway pressures were significantly higher with flexion in both the groups (however this did not affect ventilation),lower with extension in ProSeal group and comparable in I-gel group but did not change significantly with rotation of head and neck in both the group. Conclusion: Effective ventilation can be done with both ProSeal.Conclusion: Effective ventilation can be done with both ProSeal LMA and I-gel with head in all the above position. ProSeal LMA has a better margin of safety than I-gel due to better sealing pressures except in flexion where the increase in airway pressure is more with the former.Extreme precaution should be taken in flexion position in ProSeal LMA
    Anesthesiology Research and Practice 01/2014; 2014.