- |||||||||| ketamine / Generic mfg.
Preclinical, Journal: Return of the Righting Reflex Does Not Portend Recovery of Cognitive Function in Anesthetized Rats. (Pubmed Central) - Dec 7, 2021
Following ketamine, accuracy performance recovers within 2 h in most (63%) rats, but low omission performance recovers in only a minority (32%) of rats within 3 h. Finally, following either high or low doses of dexmedetomidine, few rats (25-32%) recover accuracy performance, and even fewer (0-13%) recover low omission performance within 3 h. Regardless of the anesthetic, RORR latency is not correlated with 5-CSRTT performance, which suggests that recovery of neurocognitive function cannot be inferred from changes in levels of consciousness. These results demonstrate how operant conditioning tasks can be used to assess real-time recovery of neurocognitive function following different anesthetic regimens.
- |||||||||| sevoflurane / Generic mfg.
Journal: Inhalational anesthetics (Pubmed Central) - Nov 29, 2021
The superiority of inhalational anesthetics over intravenous hypnotics with respect to intraoperative awareness is undisputed. The organ protective mechanism of preconditioning is an exclusive property of inhalational anesthetics among all the currently available hypnotics.
- |||||||||| sevoflurane / Generic mfg.
Preclinical, Journal: Effects of Maternal Abdominal Surgery on Fetal Brain Development in the Rabbit Model. (Pubmed Central) - Nov 29, 2021
Abdominal surgery in pregnant rabbits at a gestational age corresponding to the end of human second trimester results in limited neurohistological changes but not in neurobehavioral impairments. High intrauterine mortality limits translation to clinical scenario, where fetal mortality is close to zero.
- |||||||||| ketamine / Generic mfg., sevoflurane / Generic mfg.
Preclinical, Journal: Non-invasive visual evoked potentials under sevoflurane versus ketamine-xylazine in rats. (Pubmed Central) - Nov 25, 2021
Notably, sevoflurane and ketamine-xylazine revealed satisfying repeatability over time, which is critical to perform reliable follow-up studies. Ketamine-xylazine allowed to obtain more clearly discernible VEP components and less background noise, together with a quicker recording procedure and a consequently improved animal safety and welfare.
- |||||||||| ketamine / Generic mfg.
Opioid free anesthesia in elderly patients scheduled for laparoscopic cholecystectomy: Case series ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1223;
Before surgery 1 gr paracetamol and 4 mg dexamethason were administered intravenously.After premedication with 1 mg midazolam, anesthesia induction was performed using lidocaine 1 mg/kg, propofol 2 mg/kg, ketamine 0.5 mg/kg and rocuronium bromide 0.6 mg/kg.Following intubation, anesthesia was maintained with sevoflurane 0.6 MAC in airoxygen mixture and continuous intravenous infusion with lidocaine 2 mg/kg/h and magnesium sulphate 30 mg/kg.Before the end of surgery 1 gr metamisol was given intravenously.Postoperatively, pain was measured with numeric rating score (NRS) in all patients from 1 to 10 at rest and when coughing, appearance of nausea and vomiting and sleep disturbances, too.Ketoprofen 100 mg was given when NRS is 4-6/10 and 1 mg/kg tramadol when NRS is 7-10/10.One hour after surgery 2 patients have pain when coughing with NRS 6/10, and one have NRS 8/10.Four, eight, twelve and twenty four hours after surgery pain was 2-3/10 in all three patients.None of them have PONV and sleep disturbances after surgery. Inadequate analgesia for elderly surgical patients contributes to postoperative delirium, cardiorespiratory complications and failure to mobilize.1OFA has been shown that can give adequate analgesia in elderly patients, without respiratory depression, PONV, sleeping disturbances and early mobilization.Learning points: OFA achieve cardio-circulatory stability,avoid needs of opioids in the postoperative period, postoperative delirium, postoperative nausea and vomiting and sleep disturbances.
- |||||||||| midazolam hydrochloride / Generic mfg.
Mucopolysaccharidosis type IIIA - anesthesia approach, a case report ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1222;
The patient was sedated using 0,5 MAC of sevoflurane and 1 mcg/kg of fentanyl...After confirmation of a secure airway, induction of general anesthesia, guided by Bispectral index and neuromuscular blockade was performed using rocuronium...Preferably, a full diagnosis and comorbidities optimization should occur before an elective procedure. Early recognition of difficult airway allowing for timely planning and management is crucial for patient safety.Learning points: Difficult airway management has been reported so planning and preparation for all possible scenarios is important to assure the safety of our patients.
- |||||||||| fentanyl citrate / Generic mfg., sevoflurane / Generic mfg., rocuronium / Generic mfg.
Endotracheal tube obstruction during oesophageal atresia and tracheoesophageal fistula repair: a case Report ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1214;
OTT obstruction by a blood clot is an uncommon complication with reported incidence <2%.[2] Differential diagnoses include anaesthesia machine malfunction, extraluminal and other causes of OTT intraluminal obstruction, external lung compression and bronchospasm.[3] To our knowledge, there are no other reported cases of this kind of airway obstruction during TOF and OA repair surgery.Learning points: TOF/OA repair is a challenge for the Anesthesiologists. One should be aware of airway difficulties and ventilation critical incidents.
- |||||||||| sevoflurane / Generic mfg.
Perioperative stroke: A clinical case ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1211;
The rapid response provided did not change this patient’s poor prognosis, as the 30-day mortality rates in patients who experience a perioperative stroke range between 21% and 26%, but it highlighted the worth of opting for a sedation and analgesia technique rather than a general anesthesia in this particular case. It allowed a prompt identification of patient’s altered neurological status and ventilation pattern, therefore an immediate activation of the appropriate protocol.
- |||||||||| sevoflurane / Generic mfg.
Giant ovarian tumor (35 Kg) in the aftermath of a Pandemic: anesthetic challenge ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1203;
Balanced general anesthesia was conducted with a rapid sequence induction and maintenance with sevoflurane...Perioperative pulmonary complications were avoided.Learning points: We report the anesthesia of a patient with a giant ovarian tumor, which before pandemic was a very rare condition. Hybrid ventilatory mode prevented respiratory and hemodynamic failure and resulted in safe anesthetic management.
- |||||||||| ketamine / Generic mfg.
Congenital tongue malformation - a newborn airway management challenge ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1183;
We performed a balanced general anesthesia using ketamine (2 mg/kg) for induction to maintain spontaneous ventilation...Sevoflurane was used for maintenance...Maintenance of spontaneous ventilation during induction was a key factor. Also, the maneuver of pulling out the tongue as much as possible allowed laryngoscope introduction and helped in the visualization of glottis aperture.Learning points: Planification is essential when approaching a predictably difficult airway, particularly in neonates; Hemorrhagic risk associated with vascular malformations should prompt an adequate fluid therapy and transfusion strategy
- |||||||||| remifentanil / Generic mfg., sevoflurane / Generic mfg., rocuronium / Generic mfg.
Rupture risk: unexpected giant bullous emphysema ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1177;
Learning points:Bullous emphysema is associated with a risk of barotrauma. Ventilatory and anesthetic management is important in the prevention of these events.
- |||||||||| morphine sulphate / Generic mfg., sevoflurane / Generic mfg.
iPACK combined with adductor canal block as a safe adjunct to perioperative pain management in patients with severe hemophilia A undergoing total knee arthroplasty: a case report ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1174;
In the recovery room he was supplemented with 2,5mg of morphine hourly (total 7mg) for moderate knee pain in the recovery room...Perioperative management of hemophilic patients requires FVIII assays, blood products as well as a multidisciplinary team effort.1 The regional analgesia acts as an adjunct to pain management as it can avoid excessive opioid consumption, leading to keen recovery and shorter hospital stay.2 Learning points: A multidisciplinary team is necessary to manage the perioperative course of hemophiliac patients due to the high risk of hemorrhagic complications. The use of nerve blocks could be an adjunct to better manage perioperative pain, provide early ambulation, leading to better patient outcomes.
- |||||||||| ketorolac / Generic mfg., dexamethasone / Generic mfg.
Ehlers-Danlos Syndrome, what now? ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1170;
Currently, there are no guidelines for regional or general anesthesia in patients with EDS. Rare conditions such as EDS can present a clinical conundrum for the anesthetist, nevertheless knowledge of the basic implications of the condition can minimize patient morbidity and mortality without requiring in-depth knowledge of the disease.
- |||||||||| midazolam hydrochloride / Generic mfg., labetalol / Generic mfg.
Anaesthetic conserving device AnaConDa® used for hypertension control in critical care of burned Patient ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1164;
Initially, sedoanalgesia was maintained with propofol and fentanyl and changed to midazolam, dexmedetomidine and fentanyl because his hypertension...Adjuvant medication included perfusion of isosorbide dinitrate, remifentanil rather fentanyl and esmolol rather labetalol, were added progressively with relatively low efficacy...Its blood pressure-lowering effect is well known. Our case report reveals the potential of sevoflurane, through AnaConDa® device, as a sedative and hypotensive drug to treat resistant hypertension Learning points: AnaConDa device as a safety and simple form of inhalation sedation and effect of sevoflurane-induced hypotension.
- |||||||||| sevoflurane / Generic mfg.
Reducing the impact of desflurane on our environment ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1133;
Desflurane is a particularly impactful volatile agent due to its high atmospheric persistence and having a MAC 3x higher than sevoflurane... Our collective strategies resulted in a significant reduction in desflurane usage, reducing our carbon footprint by 52.7 tonnes of CO2 equivalence per month.
- |||||||||| fentanyl citrate / Generic mfg., sevoflurane / Generic mfg., paracetamol / Generic mfg.
Combination of Pectoral blocks type1 and type 2 as a part of a multimodal analgesia plan in obese women undergoing total mastectomy ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1114;
Patients in both groups had a inhaled low-flow anesthesia with sevoflurane combined with pre-emptive (i.v. paracetamol and dexketoprofen) and systemic analgesia with fentanyl...The combination of Pectoral blocks type 1 and type 2 has analgetic and opioid-sparing advantages in obese women undergoing total mastectomy and may become prerequisites for opioid-free anesthesia in this patient’s group.
- |||||||||| sevoflurane / Generic mfg.
Wolff-Parkinson-White pattern newly diagnosed inside the operative room ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1108;
WPW syndrome is a potential life-threatening condition and we should be aware of its anaesthetic implications. We emphasise the importance of preoperative evaluation, intraoperative monitoring and readiness to manage this disease potential complications.
- |||||||||| fentanyl citrate / Generic mfg., sevoflurane / Generic mfg., lidocaine topical / Generic mfg.
Anaesthetic management in Apert’s Syndrome ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1099;
C-MAC videolaryngoscopy showed partially closed vocal cords; lidocaine 30mg was administered topically, allowing for subsequent insertion of 6mm endotracheal tube...Regional anesthesia is recommended. General anesthesia is an option when difficult airway management equipment is available.
- |||||||||| ketamine / Generic mfg.
Emergent tracheostomy in a critical airway – which anesthesia to use? ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_1072;
Additionally, 20mg ketamine was administrated...Analgesia was achieved with 4mg of morphine and 1g of paracetamol...Our case offers a possible anesthetic approach for patients in which intubation or use of supraglottic devices are extremely difficult and maintaining a spontaneous ventilation is imperative until the definitive airway is established. Use of CPAP helps maintain airway patency during the procedure.Learning points: Sedoanalgesia may be a useful approach in a patient presenting with severe UAO undergoing emergent tracheostomy
- |||||||||| Anesthetic management of pulmonary transplantation due to COVID-19 irreversible lung Injury ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_996;
General balanced anesthesia was used, induction made with propofol, fentanyl and cisatracurium; maintenance with sevoflurane, propofol, dexmedetomidine, remifentanil and cisatracurium for 14 hours...Hemorrhagic risk reduced with the use of tranexamic acid...Hemodynamic was optimized using balanced solution, albumin and vasopressors (norepinephrine, vasopressin and milrinone)...With proper precautions, Epidural PCA can be an effective and safe option in the pain management. Learning points: Lung transplantation may be a viable therapy at COVID-19 with irreversible pulmonary injury
- |||||||||| sevoflurane / Generic mfg., levetiracetam / Generic mfg.
Anesthetic technique in a child with SchinzelGiedion Syndrome. A case report. ([VIRTUAL]) - Nov 25, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_993;
Case Report: We are dealing with a 4-year-old woman with SchinzelGiedion Syndrome, with a history of paroxysmal episodes mixed with regular treatment with Levetiracetam, microcephaly, facial alterations (midface retraction, wide mouth, protruding tongue, short neck), mild motor delay, cognitive delay...Once again we performed inhalational general anesthesia, performing induction with Sevoflurane...We must be familiar with the syndromes that affect the pediatric population, especially those that interfere with our daily clinical practice. Learning points: To date, there is no research about anesthesia in this syndrome; it is essential to remember the need to document procedures in rare syndromes to facilitate the work of our colleagues in the future.
- |||||||||| dexmedetomidine / Generic mfg.
Clinical, Journal: Effect of Dexmedetomidine on Perioperative Stress Response and Immune Function in Patients With Tumors. (Pubmed Central) - Nov 24, 2021
The heart rate significantly increased (P < 0.05) at T1 in group S, and both heart rate and mean arterial pressure significantly increased (P < 0.05) in group R when compared to group D. The heart rate significantly increased (P < 0.05) at T2 in group S and group R. Furthermore, the heart rate significantly increased (P < 0.05) at T3 and T4 in group S and group R. Intra-group comparison: The heart rate at T1-T4 and mean arterial pressure at T1-T4 significantly increased (P < 0.05) in group S, and the heart rate at T1 and T4, and mean arterial pressure at T2-T4 significantly increased (P < 0.05) in group R when compared to T0. The serum IL-6, IFN-γ, and β-EP significantly increased (P < 0.05) at T0' in group S and group R when compared to group D. Blood glucose, and serum IL-10, IFN-γ, and β-EP significantly increased (P < 0.05), while IL-18 significantly decreased (P < 0.05) at T1' in group S and group R. Continuous infusion of dexmedetomidine in combination with the inhalation of sevoflurane is superior to sevoflurane + remifentanil or sufentanil in patients undergoing tumor surgery.
- |||||||||| sevoflurane / Generic mfg.
Clinical, Journal: Effect of Permissive Mild Hypercapnia on Cerebral Vasoreactivity in Infants: A Randomized Controlled Crossover Trial. (Pubmed Central) - Nov 24, 2021
Allowing permissive mild hypercapnia during mechanical ventilation of infants led to lower driving pressure and comparable hemodynamic, respiratory, and cerebral oxygenation parameters than during normocapnia. Whereas a large scatter in NIRS-derived parameters was observed at all levels of Etco2, the correlation between TOI and MAP suggests that arterial pressure is an important component of cerebral oxygenation at mild hypercapnia.
- |||||||||| sevoflurane / Generic mfg.
Journal, HEOR: Evidence-Based Project: Cost Savings and Reduction in Environmental Release With Low-Flow Anesthesia. (Pubmed Central) - Nov 24, 2021
Sevoflurane was the most commonly used volatile agent...Simulated low-flow anesthesia demonstrated cost savings and environmental conservation. Project findings align with current literature showing that lowering FGFs represents an area of cost containment and an opportunity to lessen the environmental impact of anesthesia.
|
