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Yin L, Wang H, Yin X, Hu X. Impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery. BMC Anesthesiol 2024; 24:124. [PMID: 38561683 PMCID: PMC10983640 DOI: 10.1186/s12871-024-02509-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND This study aimed to investigate the impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery. METHODS A prospective observational study was conducted based on inclusion and exclusion criteria. A total of 384 elderly patients undergoing abdominal surgery under general anesthesia were enrolled in a grade A tertiary hospital in Chengdu, Sichuan Province from October 2021 and October 2022. After anesthesia induction, inflatable warming blankets were routinely used for active heat preservation, and nasopharyngeal temperature was monitored to observe the occurrence of intraoperative hypothermia. Patients were divided into hypothermia group and nonhypothermia group according to whether hypothermia occurred during the operation. Anesthesia recovery time and the incidence of adverse events or unwanted events during anesthesia recovery between the two groups were compared. RESULTS The numbers (percentage) of 384 patients who underwent abdominal surgery developed intraoperative hypothermia occurred in 240 (62.5%) patients, all of whom had mild hypothermia. There were statistically significant differences between mild hypothermia after active warming and nonhypothermia in the occurrence of shivering (χ2 = 5.197, P = 0.023) and anesthesia recovery time (Z = -2.269, P = 0.02) in elderly patients undergoing abdominal surgery during anesthesia recovery, and there were no statistically significant differences in hypoxemia, nausea or vomiting, hypertension, hypokalemia, hypocalcemia, analgesic drug use,postoperative wound infection or postoperative hospitalization days. CONCLUSIONS The incidence of intraoperative mild hypothermia after active warming was high in elderly patients who underwent abdominal surgery. Mild hypothermia increased the incidence of shivering and prolonged anesthesia recovery time in elderly patients undergoing abdominal surgery.
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Affiliation(s)
- Lu Yin
- Department of Anesthesiology, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Heng Wang
- Department of Anesthesiology, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xiaorong Yin
- Department of Anesthesiology, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xiuying Hu
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China.
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Roshan MBA, Jafarpoor H, Shamsalinia A, Fotokian Z, Hamidi SH. Effects of a forced-air warming system and warmed intravenous fluids on hemodynamic parameters, shivering, and time to awakening in elderly patients undergoing open cardiac surgery. Ann Card Anaesth 2023; 26:386-392. [PMID: 37861571 PMCID: PMC10691583 DOI: 10.4103/aca.aca_20_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 10/21/2023] Open
Abstract
Background As one of the most common postoperative complications, hypothermia is the main cause of numerous problems during treatment, especially in elderly patients with decreased cardiac reserves. Objectives The aim of the present study was to compare the effects of forced-air warming system (FAWS), warmed intravenous fluids (WIVFs) and routine method on hemodynamic parameters, arterial blood gases (ABGs), shivering, and time to awakening in elderly patients undergoing open cardiac surgery (OCS). Methods This clinical randomized controlled trial was conducted on 94 elderly patients who underwent OCS at Ayatollah Rouhani Hospital, Babol, Iran. They were divided into three groups, namely FAWS (n=31), WIVFs (n=31) and routine rewarming method (RRWM, with a blanket) (n=32). The data were then recorded in a checklist. Descriptive and inferential statistics were performed using SPSS 26 at a significance level of less than 0.05. Results The findings demonstrated that the degree of hypothermia had a significant decreasing trend in the groups receiving FAWS and WIVFs (P=0.002). Additionally, increased respiratory rate (P=0.013), higher bicarbonate (HCO3-) levels on arrival up to 4 hours after surgery (P=0.045), reduced lactate level (P=0.005), normal base excess (BE) and accelerated time to awakening (P=0.004) were observed in patients receiving FAWS. There was no significant difference in the study groups regarding shivering. Conclusion The results revealed that FAWS could mitigate the degree of hypothermia, increase body temperature and decrease the postoperative serum lactate levels. Moreover, BE as one of the most important parameters for ABGs, could remain at a normal level. Besides, the use of FAWS could lead to early awakening, and thus facilitate weaning and extubation of these patients.
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Affiliation(s)
- Mohammad Bagher Akbarpour Roshan
- Student Research Committee, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran
| | - Hasanali Jafarpoor
- Assistant Professor, Department of Anesthesiology and Operating Room, School of Allied Medical Sciences and Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran
| | - Abbas Shamsalinia
- Associate Professor, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran
| | - Zahra Fotokian
- Associate Professor, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran
| | - Seyed Hossein Hamidi
- Assistant Professor, Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, I.R.Iran
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Li XN, Zhou CC, Lin ZQ, Jia B, Li XY, Zhao GF, Ye F. High-flow nasal cannula oxygen therapy during anesthesia recovery for older orthopedic surgery patients: A prospective randomized controlled trial. World J Clin Cases 2022; 10:8615-8624. [PMID: 36157835 PMCID: PMC9453384 DOI: 10.12998/wjcc.v10.i24.8615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/11/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications. Therefore, reducing the incidence of postoperative hypoxemia is a clinical concern.
AIM To investigate the clinical efficacy of high-flow nasal cannula oxygen (HFNCO) in the resuscitation period of older orthopedic patients.
METHODS In this prospective randomized controlled trial, 60 older patients who underwent orthopedic surgery under general anesthesia were randomly divided into two groups: those who used conventional face mask and those who used HFNCO. All patients were treated with 60% oxygen for 1 h after extubation. Patients in the conventional face mask group were treated with a combination of air (2 L) and oxygen (2 L) using a traditional mask, whereas those in the HFNCO group were treated with HFNCO at a constant temperature of 34 °C and flow rate of 40 L/min. We assessed the effectiveness of oxygen therapy by monitoring the patients’ arterial blood gas, peripheral oxygen saturation, and postoperative complications.
RESULTS The characteristics of the patients were comparable between the groups. One hour after extubation, patients in HFNCO group had a significantly higher arterial partial pressure of oxygen (paO2) than that of patients in conventional face mask group (P < 0.001). At extubation and 1 h after extubation, patients in both groups showed a significantly higher arterial partial pressure of carbon dioxide (paCO2) than the baseline levels (P < 0.001). There were no differences in the saturation of peripheral oxygen, paO2, and paCO2 between the groups before anesthesia and before extubation (P > 0.05). There were statistically significant differences in paO2 between the two groups before anesthesia and 1 h after extubation and immediately after extubation and 1 h after extubation (P < 0.001). However, there were no significant differences in the oxygen tolerance score before leaving the room, airway humidification, and pulmonary complications 3 d after surgery between the two groups (P > 0.05).
CONCLUSION HFNCO can improve oxygen partial pressure and respiratory function in elderly patients undergoing orthopedic surgery under general endotracheal anesthesia. Thus, HFNCO can be used to prevent postoperative hypoxemia.
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Affiliation(s)
- Xiao-Na Li
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
| | - Cheng-Cheng Zhou
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
| | - Zi-Qiang Lin
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
| | - Bin Jia
- Department of Anaesthesiology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou 510000, Guangdong Province, China
| | - Xiang-Yu Li
- Department of Anaesthesiology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou 510000, Guangdong Province, China
| | - Gao-Feng Zhao
- Department of Anaesthesiology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou 510000, Guangdong Province, China
| | - Fei Ye
- Department of Anaesthesiology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou 510000, Guangdong Province, China
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Zhu R, Du T, Gao H. Effects of dezocine and ropivacaine infiltration anesthesia on cellular immune function indicators, anesthesia recovery time and pain factors in patients with open liver resection. Cell Mol Biol (Noisy-le-grand) 2020; 66:149-154. [PMID: 32538762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/17/2020] [Indexed: 06/11/2023]
Abstract
The current experiment was carried out to explore the effects of dezocine combined with ropivacaine infiltration anesthesia on the anesthesia recovery time and pain factors of patients with open hepatectomy. A prospective randomized controlled method was used to select 92 patients with open liver cancer resection in our hospital from August 2017 to November 2019. The patients were divided into a study group (n=46) and a control group (n=46) using a computer-generated random number table. Both groups underwent general anesthesia, based on this, the study group was treated with ropivacaine infiltration anesthesia 10 minutes before skin incision, and dezocine was given intravenously 0.5 h before surgery, the control group was anesthetized with ropivacaine 10 minutes before the incision, and was given a saline injection 0.5 h before the operation. Compared the recovery of anesthesia (recovery time of spontaneous breathing, time to open eyes, time to extubation), the incidence of adverse reactions, and cellular immune function indicators (peripheral blood CD4+, CD4+/CD8+, NK cell levels), stress response indicators [serum blood glucose (Glu), norepinephrine (NE), adrenaline (E)], pain factors [serum dopamine (DA), neuropeptide Y (NPY), substance P (SP)] before induction of anesthesia (T0), completion of surgery (T1), 12 hours after surgery (T2), and 24 hours after surgery (T3) between the two groups, and the degree of pain (VAS score) at T2 and T3 were compared between the two groups. The levels of CD4+, CD4+/CD8+, and NK cells in peripheral blood at T1, T2, and T3 in the study group were higher than those in the control group (P<0.05); serum Glu, NE, and E levels in the study group at T1, T2, and T3 were lower than those in the control group (P<0.05); serum DA, NPY, and SP levels in the study group at T1, T2, and T3 were lower than those in the control group (P<0.05); the VAS scores of the study group at T2 and T3 were lower than those of the control group (P<0.05); the time of spontaneous breathing recovery, eyes opening and extubation in the study group were shorter than those in the control group (P<0.05); the incidence of restlessness (4.35%), transient hypertension (6.52%), and cough (2.17%) in the study group were lower than those in the control group (P<0.05). Dezocine and ropivacaine infiltration anesthesia can significantly shorten the recovery time of anesthesia and inhibit pain factor secretion in patients with open hepatectomy and can reduce the body's stress response after surgery, reduce immune function fluctuations, and can reduce the incidence of adverse reactions to anesthesia, and help promote patients' postoperative recovery.
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Affiliation(s)
- Ronggang Zhu
- Department of Pharmacy, Jinan 2nd People's Hospital, Jinan, 250001, China
| | - Tingting Du
- Department of Pharmacy, Jinan 2nd People's Hospital, Jinan, 250001, China
| | - Hongzhu Gao
- Department of Pharmacy, The People's Hospital of Huaiyin Jinan, Jinan, 250021, China
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Usichenko TI, Städing D, Boesche M, Janner H, Hesse T, Lehmann R, Pavlovic D, Nowak A. Computerized 4-choice reaction time test for the measurement of psychomotor recovery after general anesthesia. J Clin Monit Comput 2019; 34:833-841. [PMID: 31342306 DOI: 10.1007/s10877-019-00355-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 07/16/2019] [Indexed: 11/30/2022]
Abstract
The recovery of patients after general anesthesia is usually estimated by using clinical scores. Since there is a lack of objective methods for assessing psychomotor recovery, the aim of this study was to evaluate three psychological tests for this purpose. Patients, scheduled for ambulatory gynecological surgery, underwent 3 standard psychological tests before (T1), 15 min after the surgery (T2) and on discharge from the recovery room (T3). The tests used were Wechsler memory scale (test 1, working memory capacity), d2-test (test 2, concentration endurance) and computer-based 4-choice-reaction time (4CRT, test 3, reaction time) as well as Postanesthesia Discharge Scoring System (PADSS). The same test battery was used in healthy female volunteers, all test results were compared at the different time points. In 109 patients, working memory capacity and concentration (tests 1 and 2) decreased, the reaction time (test 3) was prolonged at T2 in comparison with T1 and T3 (P < 0.01). PADSS increased from 8 (T2) to 10 (T3) (medians, P < 0.001). Fifty-seven healthy volunteers demonstrated a practice effect in all 3 tests through the course of the study (P <0.01). 4CRT test had shortest duration and enabled computerized data processing. All three tests objectively assess the recovery of psychomotor function in patients after general anesthesia, the computer-based 4CRT seems to be the most convenient for the clinical routine.
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Affiliation(s)
- Taras I Usichenko
- Department of Anesthesiology, University Medicine of Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany. .,Department of Anesthesia, McMaster University, Hamilton, Canada.
| | - Danika Städing
- Department of Anesthesiology, University Medicine of Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany
| | - Michael Boesche
- Department of Internal Medicine, University Medicine of Greifswald, Greifswald, Germany
| | - Henriette Janner
- Department of Anesthesiology, University Medicine of Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany
| | - Thomas Hesse
- Department of Anesthesiology, University Medicine of Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany
| | - Robert Lehmann
- Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Dragan Pavlovic
- Department of Anesthesia, Dalhousie University, Halifax, Canada
| | - Andreas Nowak
- Department of Anesthesiology and Intensive Care Medicine, Emergency Medicine and Pain Management, Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany
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Baftiu N, Krasniqi I, Haxhirexha K, Domi R. Survey about the Extubation Practice among Anaesthesiologists in Kosovo. Open Access Maced J Med Sci 2018; 6:350-354. [PMID: 29531602 PMCID: PMC5839446 DOI: 10.3889/oamjms.2018.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Tracheal extubations may be performed before or after awakening from anaesthesia. The advantage of extubation during anaesthesia may avoid all the unpleasant effects of fully awake extubation such as severe hypertension and tachycardia, malignant dysrhythmias, myocardial ischemia laryngospasm, and cough induced high intraocular and intracranial pressure. AIM To show the current practice of performing extubations in Kosovo, as well as the advantage and disadvantage in performing this procedure in an awake patient or inpatient in light anaesthesia. MATERIAL This study is conducted at the Regional Hospitals and the University Clinical Center of Kosovo during the year 2015. A questionnaire is given to the anesthesiologists to collect information about the techniques used for extubation, timing and management of extubation. RESULTS Based on this survey results that 86% of an anesthesiologist (71) extubate the patients when they are completely awake, while 14% of them (12) prefer to extubate the patients under light anaesthesia. From all anesthesiologists involved in this study, forty of them reported problems during extubation. Complications were related to airway, and they are treated by oxygenation and jaw support, but in rare cases, reintubation were performed. CONCLUSION Complications during extubation remain important risk factor while extubation during light anaesthesia can minimise some of them.
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Affiliation(s)
- Nehat Baftiu
- Clinic for Anaesthesiology and Intensive Care, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Islam Krasniqi
- Clinic for Anaesthesiology and Intensive Care, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Kastriot Haxhirexha
- Clinic for Anaesthesiology and Intensive Care, University Clinical Centre of Kosovo, Prishtina, Kosovo
| | - Rudin Domi
- Clinic for Anaesthesiology and Intensive Care, University Clinical Centre of Kosovo, Prishtina, Kosovo
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Yonehara S, Komasawa N, Watanabe N, Minami T. Application of laryngeal mask Protector™ Cuff Pilot™ for safe recovery from general anesthesia in a patient with difficult mask ventilation. J Clin Anesth 2018; 45:2-3. [PMID: 29216505 DOI: 10.1016/j.jclinane.2017.11.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 11/30/2017] [Indexed: 11/20/2022]
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Kapoor MC, Radhakrishnan M, Ramesh VJ, Murthy HS, Sharma D, Gundappa P, Das T, Wankhede R, Bhaskaran K, Sengupta S, Patil R, Dey S, Singh K, Moharana AK. A prospective observational study of the use of desflurane anesthesia in Indian adult inpatients undergoing surgery: The Registry in India on Suprane Emergence registry. J Anaesthesiol Clin Pharmacol 2017; 33:164-171. [PMID: 28781440 PMCID: PMC5520587 DOI: 10.4103/joacp.joacp_350_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background and Aims: Limited registry studies are available on the use of anesthetic agents. This registry was conducted to evaluate emergence outcomes in Indian adult patients undergoing surgery with desflurane anesthesia. Material and Methods: This multicenter, prospective, non-interventional, observational study (Registry in India on Suprane Emergence [RISE] registry) included adult inpatients who received desflurane as general anesthetic for surgical procedure of ≥2 h. Patients were stratified by age into three groups: ≥18–40 years, ≥41–65 years, and >65 years. Data on patients’ demographics, practice, and usage pattern of medications were collected. The primary efficacy outcomes were time to extubation, time to response to verbal command, and time to orientation. Results: Of 236 patients screened, 201 (≥18–40 years, n = 70; ≥41–65 years, n = 65; >65 years, n = 66) were enrolled in the study. Mean time to extubation observed in ≥18–40 years group was 7.2 ± 4.1 min, ≥41–65 years was 11.6 ± 8.99 min, and >65 years was 12.0 ± 10.5 min. Mean time to response to verbal command was 7.4 ± 4.3 min for ≥18–40 years, 10.9 ± 8.5 min for ≥41–65 years, and 10.0 ± 5.4 min for >65 years. Mean time to orientation was 13.0 ± 7.0 min for ≥18–40 years, 16.1 ± 12.0 min for ≥41–65 years, and 17.0 ± 8.6 min for >65 years. Incidence of nausea and retching/vomiting was observed in 8% of patients each in the postoperative period, and these complications were seen more in the >65 years age group. Overall, desflurane treatment maintained hemodynamic stability and no major airway events were reported. Conclusions: The RISE registry data suggest that desflurane-based anesthesia provides early recovery with stable hemodynamics without any airway adverse events, in a wide variety of surgical procedures.
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Affiliation(s)
- Mukul Chandra Kapoor
- Department of Anaesthesia, Max Smart Super Specialty Hospital, Saket, Delhi, India
| | - M Radhakrishnan
- Department of Anaesthesia, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - V J Ramesh
- Department of Anaesthesia, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - H S Murthy
- Department of Anaesthesia, Manipal Hospital, Bengaluru, Karnataka, India
| | - Dhirja Sharma
- Department of Anaesthesia, Max Super Speciality Hospital, Shalimar Bagh, Delhi, India
| | | | - Tanmoy Das
- Department of Anaesthesia, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India
| | - Ravi Wankhede
- Department of Anaesthesia, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India
| | - K Bhaskaran
- Department of Anaesthesia, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Saiket Sengupta
- Department of Anaesthesia, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India
| | | | - Sibasish Dey
- Medical Affairs, Baxter India Private Limited, Gurgaon, Haryana, India
| | - Kuljinder Singh
- Medical Affairs, Baxter India Private Limited, Gurgaon, Haryana, India
| | - Ashok K Moharana
- Medical Affairs, Baxter India Private Limited, Gurgaon, Haryana, India
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Rocha RG, Almeida EG, Carneiro LMM, Almeida NFD, Boas WWV, Gomez RS. [ Anesthesia recovery comparison between remifentanil-propofol and remifentanil-desflurane guided by Bispectral Index ® monitoring]. Rev Bras Anestesiol 2017; 67:500-507. [PMID: 28551058 DOI: 10.1016/j.bjan.2017.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 10/14/2016] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS®). METHODS Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES). After the discontinuation of the anesthetics, the times to extubation, to obey commands and to recover the airway protection reflex were recorted. In the post-anesthetic recovery room (PACU) it was recorded the occurrence of nausea and vomiting (PONV), scores of Ramsay sedation scale and of numeric pain scale (NPS), morphine dose and length of stay in the unit. RESULTS Data from 38 patients were analyzed: 18 from REM-PRO and 20 from REM-DES group. Anesthesia times were similar (REM-PRO=193min, SD 79.9 vs. 175.7min, SD 87.9 REM-DES; p=0.5). REM-DES had shorter times than REM-PRO group: time to follow command (8.5min; SD 3.0 vs. 5.6min; SD 2.5; p=0.0) and extubation time (6.2 minutes; 3.1-8.5 vs. 9.5 minutes; 4.9-14.4; p=0.0). Times to recover airway protective reflex were similar: 16 patients from REM-PRO (88.9%) restored the airway protective reflex 2min after extubation vs. 17 from REM-DES (89.5%); and 2 patients from REM-PRO (11.1%) vs. 2 from REM-DES (10.5%) 6min after extubation, p=1. Ramsay sedation score, NPS, PONV incidents, morphine dose and PACU stay of length PACU were also similar. CONCLUSION Remifentanil-desflurane-based anesthesia has a faster extubation time and to follow command than remifentanil-propofol-based anesthesia when both guided by BIS®.
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Affiliation(s)
- Raphael Grossi Rocha
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Centro de Pós-graduação, Belo Horizonte, MG, Brasil.
| | - Eduardo Giarola Almeida
- Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas, Departamento de Anestesia, Belo Horizonte, MG, Brasil
| | - Lara Moreira Mendes Carneiro
- Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas, Departamento de Anestesia, Belo Horizonte, MG, Brasil
| | - Natália Farias de Almeida
- Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas, Departamento de Anestesia, Belo Horizonte, MG, Brasil
| | - Walkíria Wingester Vilas Boas
- Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas, Departamento de Anestesia, Belo Horizonte, MG, Brasil
| | - Renato Santiago Gomez
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Centro de Pós-graduação, Belo Horizonte, MG, Brasil
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Jiang WN. Clinical nursing of agitation in anesthesia recovery period in elderly patients after hepalobectomy. Shijie Huaren Xiaohua Zazhi 2015; 23:1825-1828. [DOI: 10.11569/wcjd.v23.i11.1825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To develop effective nursing measures for agitation in anesthesia recovery period in elderly patients after hepalobectomy.
METHODS: Eighty-one elderly patients who underwent hepalobectomy at our hospital from May 2011 to 2012 were included in a control group, and 79 elderly patients who underwent hepalobectomy at our hospital from June 2012 to June 2013 were included in an observation group. The control group received routine care, and the observation group was given targeted nursing. The Riker sedation-agitation scale (SAS) was used to grade the agitation in the two groups, in order to evaluate the effect of targeted nursing.
RESULTS: The observation group had a total of 12 cases of agitation and 3 cases of SAS grade 6 agitation in anesthesia recovery period, significantly lower than the corresponding figures in the control group (28 cases and 15 cases) (P < 0.05).
CONCLUSION: Targeted nursing can effectively reduce the proportion of patients with agitation in anesthesia recovery period in elderly patients after hepalobectomy.
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