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Silvia Loggi, Nicoletta Mininno, Elisa Damiani, Benedetto Marini, Erica Adrario, Claudia Scorcella, Roberta Domizi, Andrea Carsetti, Simona Pantanetti, Gabriele Pagliariccio, Luciano Carbonari, Abele Donati
BACKGROUND: In vascular surgery with aortic cross-clamping, ischemia/reperfusion injury induces systemic haemodynamic and microcirculatory disturbances. Different anaesthetic regimens may have a varying impact on tissue perfusion. The aim of this study was to explore changes in microvascular perfusion in patients undergoing elective open abdominal aortic aneurysm repair under balanced or total intravenous anaesthesia. METHODS: Prospective observational study. Patients undergoing elective open infrarenal abdominal aortic aneurysm repair received balanced (desflurane + remifentanil, n = 20) or total intravenous anaesthesia (TIVA, propofol + remifentanil using target-controlled infusion, n = 20) according to the clinician's decision...
January 5, 2019: BMC Anesthesiology
M Weitzel, P Hammels, C Schorer, H Klingler, A Weyland
BACKGROUND: There is insufficient knowledge about the hemodynamic effects of cafedrine/theodrenaline (caf/theo), a commercially available drug combination, to treat hypotension. METHODS: This prospective observational study investigated the hemodynamic effects of caf/theo on anesthesia-induced hypotension in 20 patients scheduled for elective major abdominal surgery. After induction of total intravenous anesthesia (TIVA) with propofol and remifentanil, a decrease in mean arterial blood pressure (MAP) below 60 mm Hg (n = 12) was treated with 60 mg/3 mg caf/theo...
October 2018: Der Anaesthesist
David Miller, Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, Cliff L Shelton, Phil Alderson, Andrew F Smith
BACKGROUND: The use of anaesthetics in the elderly surgical population (more than 60 years of age) is increasing. Postoperative delirium, an acute condition characterized by reduced awareness of the environment and a disturbance in attention, typically occurs between 24 and 72 hours after surgery and can affect up to 60% of elderly surgical patients. Postoperative cognitive dysfunction (POCD) is a new-onset of cognitive impairment which may persist for weeks or months after surgery.Traditionally, surgical anaesthesia has been maintained with inhalational agents...
August 21, 2018: Cochrane Database of Systematic Reviews
Feng Chen, Guangyou Duan, Zhuoxi Wu, Zhiyi Zuo, Hong Li
OBJECTIVE: Neurological dysfunction remains a devastating postoperative complication in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), and previous studies have shown that inhalation anaesthesia and total intravenous anaesthesia (TIVA) may produce different degrees of cerebral protection in these patients. Therefore, we conducted a systematic literature review and meta-analysis to compare the neuroprotective effects of inhalation anaesthesia and TIVA. DESIGN: Searching in PubMed, EMBASE, Science Direct/Elsevier, China National Knowledge Infrastructure and Cochrane Library up to August 2016, we selected related randomised controlled trials for this meta-analysis...
October 11, 2017: BMJ Open
Sanda Stojanovic Stipic, Mladen Carev, Zarko Bajic, Daniela Supe Domic, Zeljka Roje, Anita Jukic, Tonci Stipic
S100B protein and neuron-specific enolase (NSE) can be considered the markers of cerebral injury. To our knowledge the association of general anesthesia for elective non-cardiac surgery in children with these markers has not been studied before. The goal of this study was to find out whether these markers change after adenotonsillectomy with general anesthesia. The secondary goal was to determine whether different types of anesthesia, gender, age and body mass index are associated with the change of S100B and NSE after adenotonsillectomy with general anesthesia...
October 2017: European Archives of Oto-rhino-laryngology
Valery V Likhvantsev, Giovanni Landoni, Dmitry I Levikov, Oleg A Grebenchikov, Yuri V Skripkin, Rostislav A Cherpakov
OBJECTIVE: Several studies have suggested that the cardioprotective effects of halogenated anesthetics in cardiac surgery result in reduced cardiac biomarker release compared with total intravenous anesthesia (TIVA). These findings came from relatively small randomized clinical trials and meta-analyses. The authors of this study hypothesized that the beneficial effects of volatile anesthetics translate into a reduced length of hospital stay after coronary artery bypass grafting surgery (CABG) with cardiopulmonary bypass...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Jeong Jin Min, Gahyun Kim, Jong-Hwan Lee, Kwan Young Hong, Wook Sung Kim, Young-Tak Lee
Despite numerous previous studies, there is little data on the effects of anesthetics on clinical outcome after off-pump coronary arterial bypass grafting (OPCAB). Therefore, we retrospectively compared the effects of anesthetic choice on in-hospital major adverse events (MAEs) and one-year major adverse cardiovascular and cerebral events (MACCEs) in patients undergoing OPCAB. Electronic medical records were reviewed in 192 patients who received propofol-remifenanil total intravenous anesthesia (TIVA) and propensity score-matched 662 patients who received isoflurane anesthesia...
2016: PloS One
N M H Bulow, E Colpo, R P Pereira, E F M Correa, E P Waczuk, M F Duarte, J B T Rocha
Cardiopulmonary bypass (CPB) with extracorporeal circulation produces changes in the immune system accompanied by an increase in proinflammatory cytokines and a decrease in anti-inflammatory cytokines. We hypothesize that dexmedetomidine (DEX) as an anesthetic adjuvant modulates the inflammatory response after coronary artery bypass graft surgery with mini-CPB. In a prospective, randomized, blind study, 12 patients (4 females and 8 males, age range 42-72) were assigned to DEX group and compared with a conventional total intravenous anesthesia (TIVA) group of 11 patients (4 females and 7 males)...
2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Poonam Malhotra Kapoor, Sameer Taneja, Usha Kiran, P Rajashekhar
OBJECTIVE (S): The aim of this study was to compare the effects of using inhalational anesthesia with desflurane with that of a total intravenous (iv) anesthetic technique using midazolam-fentanyl-propofol on the release of cardiac biomarkers after aortic valve replacement (AVR) for aortic stenosis (AS). The specific objectives included (a) determination of the levels of ischemia-modified albumin (IMA) and cardiac troponin I (cTnI) as markers of myocardial injury, (b) effect on mortality, morbidity, duration of mechanical ventilation, length of Intensive Care Unit (ICU) and hospital stay, incidence of arrhythmias, pacing, cardioversion, urine output, and serum creatinine...
October 2015: Annals of Cardiac Anaesthesia
Hong-Yan Xiong, Yang Liu, Duan-Chao Shu, Sheng-Li Zhang, Xinhong Qian, Wei-Xun Duan, Liang Cheng, Shi-Qiang Yu, Zhen-Xiao Jin
The effects of sevoflurane inhalation during cardiopulmonary bypass (CPB) on postoperative courses and serum cardiac troponin I (cTnI) concentrations in pediatric patients undergoing cardiac surgery have not been extensively investigated. In this single-center, prospective, randomized trial, an anesthetic regimen containing 2% sevoflurane used throughout the CPB process was compared with a total intravenous anesthesia (TIVA) regimen. One hundred and three patients undergoing congenital heart defect repair with CPB were included in this prospective randomized controlled study...
January 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Alberto Zangrillo, Mario Musu, Teresa Greco, Ambra Licia Di Prima, Andrea Matteazzi, Valentina Testa, Pasquale Nardelli, Daniela Febres, Fabrizio Monaco, Maria Grazia Calabrò, Jun Ma, Gabriele Finco, Giovanni Landoni
INTRODUCTION: Cardioprotective properties of volatile agents and of remote ischemic preconditioning have survival effects in patients undergoing cardiac surgery. We performed a Bayesian network meta-analysis to confirm the beneficial effects of these strategies on survival in cardiac surgery, to evaluate which is the best strategy and if these strategies have additive or competitive effects. METHODS: Pertinent studies were independently searched in BioMedCentral, MEDLINE/PubMed, Embase, and the Cochrane Central Register (updated November 2013)...
2015: PloS One
Jasminka Kopić
BACKGROUND: Clinical studies have shown that sevoflurane is cardio-protective in cardiac surgery patients, but this effect is doubtful in general surgery patients. This study has researched the influence of sevoflurane on the perioperative cardiac function and the incidence of cardiac ischaemic events in abdominal surgical patients. METHODS: Out of 80 patients scheduled for elective colorectal surgery, 42 received balanced sevoflurane-fentanyl anaesthesia, while 38 received intravenous midazolam-fentanyl anaesthesia...
July 2015: Wiener Klinische Wochenschrift
E E Lindholm, E Aune, I Seljeflot, J E Otterstad, K A Kirkebøen
BACKGROUND: Surgery induces inflammation and pro-inflammatory cytokines are associated with post-operative complications. In cardiac surgery, it has been shown that volatile anaesthetics have cardioprotective properties. We explored whether sevoflurane affects the pro-inflammatory response favourably compared with total intravenous anaesthesia (TIVA) after surgery. METHODS: We measured monocyte chemotactic protein 1 (MCP-1), matrix metalloproteinase 9 (MMP-9), C-reactive protein (CRP), vascular cell adhesion molecule 1 (VCAM-1), interleukin (IL)-6 and IL-8 perioperatively and evaluated if the anaesthetic regimen affected these mediators...
July 2015: Acta Anaesthesiologica Scandinavica
Çiğdem Y Güçlü, Süheyla Ünver, Bahar Aydınlı, Dilek Kazancı, Elif Dilber, Ayşegül Özgök
BACKGROUND: Neuropsychological and neurological deficits are still major causes of mortality and morbidity after cardiac surgery. These complications are thought to be caused by embolisms and cerebral hypoxia. Thus, continuous neuromonitoring is essential during cardiac surgery due to cerebral oxygen desaturation during different periods. Near-infrared spectrophotometry (NIRS), a non-invasive method, appears to offer many advantages for monitoring cerebral oxygenation and hemodynamics...
November 2014: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Mohammed Ahmed Umar, Sho Fukui, Kodai Kawase, Takaharu Itami, Kazuto Yamashita
Cardiovascular effects of total intravenous anesthesia using ketamine-medetomidine-propofol drug combination (KMP-TIVA) were determined in 5 Thoroughbred horses undergoing surgery. The horses were anesthetized with intravenous administration (IV) of ketamine (2.5 mg/kg) and midazolam (0.04 mg/kg) following premedication with medetomidne (5 µg/kg, IV) and artificially ventilated. Surgical anesthesia was maintained by controlling propofol infusion rate (initially 0.20 mg/kg/min following an IV loading dose of 0...
March 2015: Journal of Veterinary Medical Science
Dominique A Bettex, Patrick M Wanner, Marco Bosshart, Christian Balmer, Walter Knirsch, Hitendu Dave, Claudia Dillier, Christoph Bürki, Maja Hug, Burkhardt Seifert, Donat R Spahn, Beatrice Beck-Schimmer
OBJECTIVES: The protective effects of volatile anaesthetics against ischaemia-reperfusion injury have been shown in vitro, but clinical studies have yielded variable results. We hypothesized that, in children, sevoflurane provides superior cardioprotection after cardiac surgery on cardiopulmonary bypass (CPB) compared with totally intravenous anaesthesia (TIVA). METHODS: In this randomized controlled, single-centre study, 60 children with cyanotic and acyanotic heart defects undergoing elective cardiac surgery under CPB (RACHS-1 1-3) were randomized to sevoflurane or TIVA (midazolam <6 months of age, propofol >6 months of age)...
February 2015: Interactive Cardiovascular and Thoracic Surgery
G Landoni, T Greco, G Biondi-Zoccai, C Nigro Neto, D Febres, M Pintaudi, L Pasin, L Cabrini, G Finco, A Zangrillo
BACKGROUND: Many studies have compared desflurane, isoflurane, sevoflurane, total i.v. anaesthesia (TIVA), or all in cardiac surgery to assess their effects on patient survival. METHODS: We performed standard pairwise and Bayesian network meta-analyses; the latter allows indirect assessments if any of the anaesthetic agents were not compared in head-to-head trials. Pertinent studies were identified using BioMedCentral, MEDLINE/PubMed, Embase, and the Cochrane Library (last updated in June 2012)...
December 2013: British Journal of Anaesthesia
Patricia Hedenqvist, Anna Edner, Åsa Fahlman, Marianne Jensen-Waern
BACKGROUND: Anaesthesia in rabbits is associated with a high mortality rate, compared to that in cats and dogs. Total intravenous anaesthesia (TIVA) with drugs that provide cardiovascular stability and are rapidly metabolised could be of benefit for use in rabbits. The aim was to evaluate cardiorespiratory effects of TIVA with sufentanil-midazolam in eight New Zealand White rabbits. Subcutaneous premedication with medetomidine (0.1 mg/kg BW) was followed by IV administration of a mixture of 2...
2013: BMC Veterinary Research
Colin Failey, Jaime Aburto, Hector Garza de la Portilla, Jorge Francisco Romero, Leo Lapuerta, Alfonso Barrera
BACKGROUND: Office-based plastic surgery procedures continue to increase in popularity and a range of anesthetic techniques can be utilized, from light conscious sedation to general anesthesia requiring intubation. Total intravenous anesthesia (TIVA) is well suited for the office environment because it allows for moderate to deep sedation without the need for intubation. OBJECTIVE: The authors review plastic surgery procedures performed in an outpatient office-based operating room under TIVA to assess patient outcomes and complications...
February 2013: Aesthetic Surgery Journal
Sharadaprasad Suryaprakash, Murali Chakravarthy, Geetha Muniraju, Saurabh Pandey, Swapnil Pandey, Sona Mitra, Benak Shivalingappa, Stany Chittiappa, Jayaprakash Krishnamoorthy
AIMS AND OBJECTIVES: The objective of the study was to evaluate the myocardial protective effect of volatile agents-sevoflurane and desflurane versus total intravenous anesthesia (TIVA) with propofol in offpump coronary artery bypass surgery (OPCAB) by measuring cardiac troponin-T (cTnT) as a marker of myocardial cell death. MATERIALS AND METHODS: The study was conducted on 139 patients scheduled to undergo elective OPCAB surgery. The patients were randomly allocated to receive anesthesia with sevoflurane, desflurane or TIVA with propofol...
January 2013: Annals of Cardiac Anaesthesia
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