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Pauchard JC, Hafiani EM, Bonnet L, Cabelguenne D, Carenco P, Cassier P, Garnier J, Lallemant F, Pons S, Sautou V, De Jong A, Caillard A. Guidelines for reducing the environmental impact of general anaesthesia. Anaesth Crit Care Pain Med 2023; 42:101291. [PMID: 37562688 DOI: 10.1016/j.accpm.2023.101291] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To provide guidelines for reducing the environmental impact of general anaesthesia. DESIGN A committee of ten experts from SFAR and SF2H and SFPC learned societies was set up. A policy of declaration of competing interests was applied and observed throughout the guideline-writing process. Likewise, it did not benefit from any funding from a company marketing a health product (drug or medical device). The committee followed the GRADE® method (Grading of Recommendations Assessment, Development and Evaluation) to assess the quality of the evidence on which the recommendations were based. METHODS We aimed to formulate recommendations according to the GRADE® methodology for three different fields: anaesthesia vapours and gases; intravenous drugs; medical devices and the working environment. Each question was formulated according to the PICO format (Population, Intervention, Comparator, Outcome). The literature review and recommendations were formulated according to the GRADE® methodology. RESULTS The experts' work on the synthesis and application of the GRADE® method led to the formulation of 17 recommendations. Since the GRADE® method could not be entirely applied to all of the questions, some of the recommendations were formulated as expert opinions. CONCLUSION Based on strong agreement between experts, we produced 17 recommendations designed to guide reducing the environmental impact of general anaesthesia.
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Affiliation(s)
- Jean-Claude Pauchard
- Ramsay Santé, Member of Société Française d'Anesthésie Réanimation (SFAR) Substainable Development Committee, Clinique Aguiléra, Biarritz, France.
| | - El-Madhi Hafiani
- Department of Anaesthesia, Resuscitation and Perioperative Medicine, DMU DREAM - Tenon Hospital, AP-HP Sorbonne University, Paris, France.
| | - Laure Bonnet
- Department of Anesthesia and Intensive Care, Centre Hospitalier Princess Grace, Monaco
| | | | - Philipe Carenco
- Hygiene Department CHU de Nice, Nice, France; CPias PACA, Marseille, France; AFNOR, La Plaine Saint-Denis, France; Comité Européen de Normalisation, Brussels, Belgium; Bureau de Normalisation de l'Industrie Textile et de l'Habillement (BNITH), domaine des textiles en santé, Paris, France
| | - Pierre Cassier
- Institute of Infectious Agents, Hospices Civils de Lyon, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Jérémie Garnier
- Department of Anesthesia and Intensive Care Unit, CHU Amiens-Picardie, 1 Rond-Point du Pr Christian Cabrol, 80054 Amiens Cedex 1, France
| | - Florence Lallemant
- Department of Anesthesia and Intensive Care Unit, CHU Lille, F-59000 Lille, France; CHU Lille, Pôle des Urgences, F-59000 Lille, France
| | - Stéphanie Pons
- DMU DREAM, Department of Anesthesiology and Critical Care, Sorbonne University, GRC 29, AP-HP, Pitié-Salpêtrière, Paris, France
| | - Valérie Sautou
- Clermont Auvergne University, Clermont Auvergne INP, CNRS, CHU Clermont Ferrand, ICCF, F-63000 Clermont-Ferrand, France
| | - Audrey De Jong
- PhyMedExp, Montpellier University, INSERM, CNRS, CHU Montpellier, France; Department of Anesthesia and Intensive Care Unit, St-Eloi Hospital, France
| | - Anaïs Caillard
- Department of Anesthesia and Intensive Care Unit, CHU Brest, Cavale Blanche Hospital, France; ORPHY, EA 4324, France
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Liu M, Yuan Y, Wang X, Wang T, Bian N, Zhao L, Cui G, Liu W, Ma Z, Yang X, Liang S, Liu Z. Low-intensity transcranial ultrasound stimulation modulates neural activities in mice under propofol anaesthesia. BMC Neurosci 2023; 24:48. [PMID: 37648991 PMCID: PMC10466774 DOI: 10.1186/s12868-023-00817-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Previous studies have reported that transcranial focused ultrasound stimulation can significantly decrease the time to emergence from intraperitoneal ketamine-xylazine anaesthesia in rats. However, how transcranial focused ultrasound stimulation modulates neural activity in anaesthetized rats is unclear. METHODS In this study, to answer this question, we used low-intensity transcranial ultrasound stimulation (TUS) to stimulate the brain tissue of propofol-anaesthetized mice, recorded local field potentials (LFPs) in the mouse motor cortex and electromyography (EMG) signals from the mouse neck, and analysed the emergence and recovery time, mean absolute power, relative power and entropy of local field potentials. RESULTS We found that the time to emergence from anaesthesia in the TUS group (20.3 ± 1.7 min) was significantly less than that in the Sham group (32 ± 2.6 min). We also found that compared with the Sham group, 20 min after low-intensity TUS during recovery from anaesthesia, (1) the absolute power of local field potentials in mice was significantly reduced in the [1-4 Hz] and [13-30 Hz] frequency bands and significantly increased in the [55-100 Hz], [100-140 Hz] and [140-200 Hz] frequency bands; (2) the relative power of local field potentials in mice was enhanced at [30-45 Hz], [100-140 Hz] and [140-200 Hz] frequency bands; (3) the entropy of local field potentials ([1-200 Hz]) was increased. CONCLUSION These results demonstrate that low-intensity TUS can effectively modulate neural activities in both awake and anaesthetized mice and has a positive effect on recovery from propofol anaesthesia in mice.
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Affiliation(s)
- Meiqi Liu
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Yi Yuan
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Xingran Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Teng Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Nannan Bian
- School of Electrical Engineering, Yanshan University, Qinhuangdao, 066004, China
| | - Li Zhao
- Department of Thoracic Surgery, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Guangying Cui
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Wenchao Liu
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Zhongfeng Ma
- Department of General Surgery, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Xiaochun Yang
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Shujuan Liang
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China
| | - Zhuo Liu
- Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China.
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Tan H, Lou AF, Wu JE, Chen XZ, Qian XW. Determination of the 50% and 95% Effective Dose of Remimazolam Combined with Propofol for Intravenous Sedation During Day-Surgery Hysteroscopy. Drug Des Devel Ther 2023; 17:1753-1761. [PMID: 37333966 PMCID: PMC10276603 DOI: 10.2147/dddt.s406514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose Remimazolam has demonstrated the potential as a valuable medication for procedural sedation. However, there were some shortcomings for higher doses of remimazolam during hysteroscopy in spite of less frequent adverse events. The aim of this study was to find the 50% and 95% effective dose (ED50 and ED95) of remimazolam when combined with propofol for intravenous sedation during day-surgery hysteroscopy. Patients and Methods Patients were randomly assigned evenly (20 per group) to one of five different dosage of remimazolam: group A (0.05mg/kg), group B (0.075mg/kg), group C (0.1mg/kg), group D (0.125mg/kg) or group E (0.15mg/kg). Intravenous injection of sufentanil 0.1µg/kg was administered before sedative medication. Intravenous anesthesia was commenced with remimazolam. Subsequently, propofol was administered at 1mg/kg and maintained at 6mg/kg/h. Success was defined when the patient did not move during cervical dilation, had sufficient sedation as judged by SE <60 and no requirement for rescue doses. The success rate, induce and average dosage of propofol, the induction time, total surgery time, recovery time, and adverse events were recorded. Estimate of ED50 and ED95 with 95% confidence interval (CI) was performed by probit regression. Results The mean (95% CI) values for ED50 and ED95 of remimazolam in patients were 0.09 (0.08-0.11) mg/kg and 0.21 (0.16-0.35) mg/kg, respectively. There was no difference in the induction time, total surgery time, and recovery time among groups. No serious adverse events occurred in all patients. Conclusion The dose-response effects of remimazolam were evaluated for intravenous sedation during hysteroscopy. A combination of remimazolam and propofol was recommended to produce stabler sedation, reduce the total dosage and have less effect on cardiovascular and respiratory depression.
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Affiliation(s)
- Hua Tan
- Department of Anesthesiology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Ai-Fei Lou
- Department of Anesthesiology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Jian-Er Wu
- Department of Anesthesiology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Xin-Zhong Chen
- Department of Anesthesiology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Xiao-Wei Qian
- Department of Anesthesiology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
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Zhao N, Zeng J, Fan L, Wang J, Zhang C, Zou S, Zhang B, Li K, Yu C. Moderate sedation by total intravenous remimazolam-alfentanil vs. propofol-alfentanil for third molar extraction: A prospective randomized controlled trial. Front Med (Lausanne) 2022; 9:950564. [PMID: 36117971 PMCID: PMC9479102 DOI: 10.3389/fmed.2022.950564] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundOral dental treatment cause anxiety, fear, and physical stress. This study aimed to investigate the efficacy and safety of moderate sedation by remimazolam with alfentanil vs. propofol with alfentanil in third molar extraction.MethodsThis single-center, randomized, single-blind clinical trial included 100 adults who underwent third molar ambulatory extraction. All patients had continuous infusion of Alfentanil 0.2 μg/kg/min. Group remimazolam with alfentanil (group RA) had an induction dose of 80 μg/kg and maintenance dosage of 5 μg/kg/min. In group propofol with alfentanil (PA group), propofol was infused at an initial concentration of 1.8 μg/mL under target controlled infusion (TCI) mode and a maintenance concentration of 1.5 μg/mL. The incidence rates of adverse effects were recorded and compared. Depth of sedation was assessed using the modified observer alertness/sedation assessment (MOAA/S) and entropy index. Recovery characteristics were recorded and complications observed for next 24 h.ResultsThe incident of adverse events 6 (12%) in the group RA was lower than the group PA 25 (50%) [Mean difference 0.136 (95%CI, 0.049–0.377); P < 0.05], with no serious adverse events during the sedation procedure. The incidence of injection pain in group RA was significantly lower than that in group PA [4 vs. 26%, mean difference 0.119 (95%CI, 0.025–0.558); P = 0.004]. Before starting local anesthesia, the mean arterial pressure, heart rate, and respiratory rate of the PA group were lower than those of the RA group. None of the patients required further treatments for a decreased heart rate, blood pressure, or low SpO2. The rate of moderate sedation success was 100% in both groups. The MOAA/S score was similar between the groups indicating that the depth of sedation was effective. Group RA had significantly shorter recovery and discharge times than those of group PA.ConclusionsRemimazolam with alfentanil is a safer and more effective alternative for ambulatory sedation and can reduce recovery and discharge time and the incidence of perioperative adverse events compare with propofol.Clinical trial registrationhttp://www.chictr.org.cn/index.aspx, identifier: ChiCTR2200058106.
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Affiliation(s)
- Nan Zhao
- Department of Anesthesiology, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Zeng
- Department of Anesthesiology, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lin Fan
- Department of Anesthesiology, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jing Wang
- Department of Anesthesiology, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Zhang
- Department of Anesthesiology, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - SiHai Zou
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Department of Oral Surgery, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
| | - Bi Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- Department of Oral Surgery, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
| | - Kai Li
- Department of Anesthesiology, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Cong Yu
- Department of Anesthesiology, Stomatology Hospital Affiliated Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
- *Correspondence: Cong Yu
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5
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Chen JT, Wu YM, Tiong TY, Cata JP, Kuo KT, Li CC, Liu HY, Cherng YG, Wu HL, Tai YH. Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11061631. [PMID: 35329957 PMCID: PMC8948899 DOI: 10.3390/jcm11061631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 01/25/2023] Open
Abstract
The clinical efficacy of spectral entropy monitoring in improving postoperative recovery remains unclear. This trial aimed to investigate the impact of M-Entropy (GE Healthcare, Helsinki, Finland) guidance on emergence from anesthesia and postoperative delirium in thoracic surgery. Adult patients undergoing video-assisted thoracoscopic surgery for lung resection at a medical center were randomly allocated into the M-Entropy guidance group (n = 39) and the control group (n = 37). In the M-Entropy guidance group, sevoflurane anesthesia was titrated to maintain response and state entropy values between 40 and 60 intraoperatively. In the control group, the dosing of sevoflurane was adjusted based on clinical judgment and vital signs. The primary outcome was time to spontaneous eye opening. M-Entropy guidance significantly reduced the time proportion of deep anesthesia (entropy value <40) during surgery, mean difference: −21.5% (95% confidence interval (CI): −32.7 to −10.3) for response entropy and −24.2% (−36.3 to −12.2) for state entropy. M-Entropy guidance significantly shortened time to spontaneous eye opening compared to clinical signs, mean difference: −154 s (95% CI: −259 to −49). In addition, patients of the M-Entropy group had a lower rate of emergence agitation (absolute risk reduction: 0.166, 95% CI: 0.005−0.328) and delirium (0.245, 0.093−0.396) at the postanesthesia care unit. M-Entropy-guided anesthesia hastened awakening and potentially prevented emergence agitation and delirium after thoracic surgery. These results may provide an implication for facilitating postoperative recovery and reducing the complications associated with delayed emergence and delirium.
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Affiliation(s)
- Jui-Tai Chen
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (J.-T.C.); (Y.-M.W.); (C.-C.L.); (H.-Y.L.); (Y.-G.C.)
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Ming Wu
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (J.-T.C.); (Y.-M.W.); (C.-C.L.); (H.-Y.L.); (Y.-G.C.)
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Tung-Yu Tiong
- Division of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (T.-Y.T.); (K.-T.K.)
- Division of Thoracic Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Juan P. Cata
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 409, Houston, TX 77030, USA;
| | - Kuang-Tai Kuo
- Division of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (T.-Y.T.); (K.-T.K.)
- Division of Thoracic Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chun-Cheng Li
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (J.-T.C.); (Y.-M.W.); (C.-C.L.); (H.-Y.L.); (Y.-G.C.)
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hsin-Yi Liu
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (J.-T.C.); (Y.-M.W.); (C.-C.L.); (H.-Y.L.); (Y.-G.C.)
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yih-Giun Cherng
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (J.-T.C.); (Y.-M.W.); (C.-C.L.); (H.-Y.L.); (Y.-G.C.)
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hsiang-Ling Wu
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Ying-Hsuan Tai
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (J.-T.C.); (Y.-M.W.); (C.-C.L.); (H.-Y.L.); (Y.-G.C.)
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-2-2736-1661 (ext. 3229); Fax: +886-2-2739-0500
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6
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Rogobete AF, Bedreag OH, Papurica M, Popovici SE, Bratu LM, Rata A, Barsac CR, Maghiar A, Garofil DN, Negrea M, Petcu LB, Toma D, Dumbuleu CM, Rimawi S, Sandesc D. Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance during General Anesthesia-A New Era in Patient Safety Standards and Healthcare Management. ACTA ACUST UNITED AC 2021; 57:medicina57020132. [PMID: 33540844 PMCID: PMC7913052 DOI: 10.3390/medicina57020132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/16/2022]
Abstract
The development of general anesthesia techniques and anesthetic substances has opened new horizons for the expansion and improvement of surgical techniques. Nevertheless, more complex surgical procedures have brought a higher complexity and longer duration for general anesthesia, which has led to a series of adverse events such as hemodynamic instability, under- or overdosage of anesthetic drugs, and an increased number of post-anesthetic events. In order to adapt the anesthesia according to the particularities of each patient, the multimodal monitoring of these patients is highly recommended. Classically, general anesthesia monitoring consists of the analysis of vital functions and gas exchange. Multimodal monitoring refers to the concomitant monitoring of the degree of hypnosis and the nociceptive-antinociceptive balance. By titrating anesthetic drugs according to these parameters, clinical benefits can be obtained, such as hemodynamic stabilization, the reduction of awakening times, and the reduction of postoperative complications. Another important aspect is the impact on the status of inflammation and the redox balance. By minimizing inflammatory and oxidative impact, a faster recovery can be achieved that increases patient safety. The purpose of this literature review is to present the most modern multimodal monitoring techniques to discuss the particularities of each technique.
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Affiliation(s)
- Alexandru Florin Rogobete
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
| | - Ovidiu Horea Bedreag
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
| | - Marius Papurica
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
| | - Sonia Elena Popovici
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
- Correspondence: (S.E.P.); (L.M.B.); Tel.: +40-728-001-971
| | - Lavinia Melania Bratu
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Correspondence: (S.E.P.); (L.M.B.); Tel.: +40-728-001-971
| | - Andreea Rata
- Department of Vascular Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Clinic of Vascular Surgery, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania
| | - Claudiu Rafael Barsac
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
| | - Andra Maghiar
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
| | - Dragos Nicolae Garofil
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Mihai Negrea
- Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, 400376 Cluj Napoca, Romania;
| | - Laura Bostangiu Petcu
- Faculty of Management, The Bucharest University of Economic Studies, 020021 Bucharest, Romania;
| | - Daiana Toma
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
| | - Corina Maria Dumbuleu
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
| | - Samir Rimawi
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
| | - Dorel Sandesc
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.F.R.); (O.H.B.); (M.P.); (C.R.B.); (A.M.); (D.S.)
- Anaesthesia and Intensive Care Research Center, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.T.); (C.M.D.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 300723 Timisoara, Romania;
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Chen W, Feng Y, Chen X, Jiang F, Miao J, Chen S, Chen H. Effect of Laryngeal Mask Airway Insertion on Parameters Derived From Catacrotic Phase of Photoplethysmography Under Different Concentrations of Remifentanil. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2020; 8:2700609. [PMID: 33178499 PMCID: PMC7647452 DOI: 10.1109/jtehm.2020.3017368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/25/2020] [Accepted: 07/29/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Some parameters have been extracted from photoplethysmography (PPG) with a good relativity with nociception, but without encouraging results in qualifying the balance of nociception-anti-nociception (NAN). The features of PPG have not been thoroughly depicted and more prospective univariate parameters deserve to be explored. The aim of this study was to investigate the ability of parameters derived from catacrotic phase of PPG to grade the level of analgesia. METHODS 45 patients with ASA I or II were randomized to receive a remifentanil effect-compartment target controlled infusion (Ceremi) of 0, 1, or 3 ng/ml, and a propofol effect-compartment target controlled infusion to maintain an acceptable level of hypnosis with state entropy (SE) at 40~60. Laryngeal mask airway (LMA) insertion was applied as a noxious stimulus. Five diastole-related parameters, namely diastolic interval (DI), diastolic slope (DS), the minimum slope during catacrotic phase (DSmin), the interval between DSmin and its nearest trough (DTI), and area difference ratio (ADR), were extracted. Pulse beat interval (PBI) was calculated as a reference parameter. RESULTS LMA insertion elicited a significant variation in all parameters except ADR during Ceremi of 0 and 1 ng/ml. Compared to PBI (prediction probability ([Formula: see text]) = 0.796), the parameters of DI, DS, and DTI presented a better consistence with the level of anti-nociceptive medication, with [Formula: see text] of 0.825, 0.822, and 0.822 respectively. CONCLUSION The features extracted from catacrotic phase of PPG, including DI, DS, and DTI, could provide a promising potential to qualify the balance of NAN.
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Affiliation(s)
- Wanlin Chen
- College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhou310027China
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness AppraisalHangzhou310027China
| | - Ying Feng
- Department of AnesthesiaWomen’s Hospital, School of MedicineZhejiang UniversityHangzhou310006China
| | - Xinzhong Chen
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness AppraisalHangzhou310027China
- Department of AnesthesiaWomen’s Hospital, School of MedicineZhejiang UniversityHangzhou310006China
| | - Feng Jiang
- College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhou310027China
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness AppraisalHangzhou310027China
| | - Jiajun Miao
- College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhou310027China
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness AppraisalHangzhou310027China
| | - Shali Chen
- College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhou310027China
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness AppraisalHangzhou310027China
| | - Hang Chen
- College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhou310027China
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness AppraisalHangzhou310027China
- Zhejiang LaboratoryConnected Healthcare Big Data Research CenterHangzhou311121China
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