scholarly journals AB111. 5. An observational study on the effects of propofol-based total intravenous anaesthesia versus vapour-based inhalational anaesthesia on blood pressure and heart rate in women undergoing elective breast cancer surgery

2019 ◽  
Vol 3 ◽  
pp. AB111-AB111
Author(s):  
Iarlaith Kennedy ◽  
Brian O’Donnell
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Heart Rate ◽  
Observational Study ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Total Intravenous Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Inhalational Anaesthesia

Comparison of Total Intravenous, Balanced Inhalational and Combined Intravenous-Inhalational Anaesthesia for Tympanoplasty, Septorhinoplasty and Adenotonsillectomy

1995 ◽  
Vol 23 (5) ◽  
pp. 574-582 ◽  
Author(s):  
A. A. Van Den Berg ◽  
D. Savva ◽  
N. M. Honjol ◽  
N. V. Rama Prabhu
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Anaesthetic Techniques ◽  
Total Intravenous Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Haemodynamic Stability ◽  
Inhalational Anaesthetic ◽  
Inhalational Anaesthesia ◽  
Intravenous Anaesthetic ◽  
Induction Of Anaesthesia

Two hundred and thirty-five consecutive Saudi patients aged between two and fifty-three years undergoing elective tympanoplasty (n = 32), septorhinoplasty (n = 68) or adenotonsillectomy (n=135) were studied. They were randomized to receive either a total intravenous anaesthetic (10 ears, 23 noses, 44 throats) consisting of propofol for induction of anaesthesia followed by a propofol infusion, a combined intravenous-inhalational anaesthetic (11 ears, 22 noses, 46 throats) consisting of the above with isoflurane in oxygen-enriched air, or a balanced inhalational anaesthetic (11 ears, 23 noses, 45 throats) consisting of thiopentone for induction of anaesthesia and oxygen in nitrous oxide with isoflurane for maintenance. During tympanoplasty, all three anaesthetic techniques produced stable heart rates and arterial pressures. During septorhinoplasty, blood pressure rose in patients who received total intravenous anaesthesia, while combined and balanced techniques produced haemodynamic stability. During adenotonsillectomy, total intravenous anaesthesia produced a rise in both heart rate and blood pressure, the combined technique produced a rise in heart rate alone while balanced anaesthesia produced haemodynamic stability. Postoperatively, vomiting, pain scores and analgesic requirements were similar following all three types of anaesthetic within each surgical site subgroup. Our findings support the choice of balanced inhalational anaesthesia for all three types of ENT surgery and, where cost and facilities permit, total intravenous anaesthesia for tympanoplasty and combined intravenous-inhalational anaesthesia for septorhinoplasty.

scholarly journals Inhalational versus Propofol-Based Total Intravenous Anaesthesia: Practice Patterns and Perspectives among Australasian Anaesthetists

2018 ◽  
Vol 46 (5) ◽  
pp. 480-487 ◽  
Author(s):  
A. Lim ◽  
S. Braat ◽  
J. Hiller ◽  
B. Riedel
Keyword(s):  
Practice Patterns ◽  
Controlled Trial ◽  
Significant Proportion ◽  
Cancer Surgery ◽  
Sufficient Evidence ◽  
Perioperative Outcomes ◽  
Total Intravenous Anaesthesia ◽  
Cancer Outcomes ◽  
Intravenous Anaesthesia ◽  
Inhalational Anaesthesia

Increasing evidence suggests that total intravenous anaesthesia (TIVA) may be the preferred anaesthetic for cancer resection surgery. To assist the preparation of a randomised controlled trial (RCT) examining Volatile (versus TIVA) Anaesthesia and Perioperative Outcomes Related to Cancer (VAPOR-C) we developed an 18-question electronic survey to investigate practice patterns and perspectives (emphasising indications, barriers, and impact on cancer outcomes) of TIVA versus inhalational general anaesthesia in Australasia. The survey was emailed to 1,000 (of 5,300 active Fellows) randomly selected Australian and New Zealand College of Anaesthetists (ANZCA) Fellows. The response rate was 27.5% (n=275). Of the respondents, 18% use TIVA for the majority of cases. In contrast, 46% use TIVA 20% of the time or less. Respondents described indications for TIVA as high risk of nausea, neurosurgery, and susceptibility to malignant hyperthermia. Lack of equipment, lack of education and cost were not considered barriers to TIVA use, and a significant proportion (41%) of respondents would use TIVA more often if setup were easier. Of the respondents, 43% thought that TIVA was associated with less cancer recurrence than inhalational anaesthesia, while 46% thought that there was no difference. Yet, only 29% of respondents reported that they use TIVA often or very often for cancer surgery. In Australasia, there is generally a low frequency of TIVA use despite a perception of benefit when compared with inhalational anaesthesia. Anaesthetists are willing to use TIVA for indications where sufficient evidence supports a meaningful level of improvement in clinical outcome. The survey explores attitudes towards use of TIVA for cancer surgery and demonstrates equipoise in anaesthetists’ opinions regarding this indication. The inconsistent use of TIVA in Australasia, minimal barriers to its use, and the equipoise in anaesthetists’ opinions regarding the effect of TIVA versus inhalational anaesthesia on cancer outcomes support the need for a large prospective RCT.

scholarly journals Dexmedetomidine as an Adjunctive Analgesic with Bupivacaine in Paravertebral Analgesia for Breast Cancer Surgery

2014 ◽  
Vol 5;17 (5;9) ◽  
pp. E589-E598 ◽  
Author(s):  
Sahar A. Mohamed
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Side Effects ◽  
Pulse Rate ◽  
Radical Mastectomy ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Postanesthesia Care Unit ◽  
Modified Radical Mastectomy ◽  
Group B

Background: There is little systematic research on the efficacy and tolerability of the addition of adjunctive analgesic agents in paravertebral analgesia. The addition of adjunctive analgesics, such as fentanyl and clonidine, to local anesthetics has been shown to enhance the quality and duration of sensory neural blockades, and decrease the dose of local anesthetic and supplemental analgesia. Objectives: Investigation of the safety and the analgesic efficacy of adding 1 µg/kg dexmedetomidine to bupivacaine 0.25% in thoracic paravertebral blocks (PVB) in patients undergoing modified radical mastectomy. Study Design: A randomized, double-blind trial. Setting: Academic medical center. Methods: Sixty American Society of Anesthesiologists physical status –I – III patients were randomly assigned to receive thoracicPVB with either 20 mL of bupivacaine 0.25% (Group B, n = 30), or 20 mL of bupivacaine 0.25% + 1 µg/kg dexmedetomidine (Group BD, n= 30). Assessment parameters included hemodynamics, sedation score, pain severity, time of first analgesics request, total analgesic consumption, and side effects in the first 48 hours. Results: There was a significant reduction in pulse rate and diastolic blood pressure starting at 30 minutes in both groups, but more evidenced in group BD (P < 0.001). Intraoperative Systolic blood pressure showed a significant reduction at 30 minutes in both groups (P < 0.001) then returned to baseline level at 120 minutes in both groups. There was a significant increase in pulse rate starting 2 hours postoperative until 48 hours postoperatively in group B but only after 12 hours until 48 hours in group BD (P < 0.001). The time of the first rescue analgesic requirement was significantly prolonged in the group BD (8.16 ± 42 hours) in comparison to group B (6.48 ± 5.24 hours) (P = 0.04). The mean total consumption of intravenous tramadol rescue analgesia in the postanesthesia care unit in the firtst 48 hours postoperatively was significantly decreased in group BD (150.19 ± 76.98 mg) compared to group B (194.44 ± 63.91 mg) (P = 0.03). No significant serious adverse effects were recorded during the study. Limitations: This study is limited by its sample size. Conclusion: The addition of dexmedetomidine 1 µg/kg to bupivacaine 0.25% in thoracic PVB in patients undergoing modified radical mastectomy improves the quality and the duration of analgesia and also provides an analgesic sparing effect with no serious side effects. Key words: Dexmedetomidine, paravertebral block, postoperative analgesia, breast cancer surgery

Comparison of two injectable anaesthetic techniques on induction and subsequent anaesthesia in pigs

2021 ◽  
pp. 002367722110298
Author(s):  
Anneli Ryden ◽  
Sheila Fisichella ◽  
Gaetano Perchiazzi ◽  
Görel Nyman
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Anaesthetic Techniques ◽  
Total Intravenous Anaesthesia ◽  
Depth Of Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Physiological Variables ◽  
Arterial Blood ◽  
Nociceptive Stimulus ◽  
Free Induction

Pig experiments often require anaesthesia, and a rapid stress-free induction is desired. Induction drugs may alter the subsequent anaesthesia. Therefore, the aim of the present study was to compare, in pigs, the effects of two different injectable anaesthetic techniques on the induction and on the physiological variables in a subsequent eight hours of total intravenous anaesthesia (TIVA). Twelve domestic castrates (Swedish Landrace/Yorkshire) 27‒31 kg were used. The pigs were randomly assigned to different induction drug combinations of zolazepam–tiletamine and medetomidine intramuscularly (ZTMe) or midazolam, ketamine intramuscularly and fentanyl intravenously (MiKF). Time from injection to unconsciousness was recorded and the ease of endotracheal intubation assessed. The TIVA infusion rate was adjusted according to the response exhibited from the nociceptive stimulus delivered by mechanically clamping the dewclaw. The time from injection to unconsciousness was briefer and intubation was easier in the ZTMe group. Results from the recorded heart rate, cardiac index and arterial blood pressure variables were satisfactorily preserved and cardiovascular function was maintained in both groups. Shivering was not observed in the ZTMe group, but was observed in four of the pigs in the MiKF group. The requirement of TIVA was lower in the ZTMe group. In conclusion, ZTMe had better results than MiKF in areas such as shorter induction time, better intubation scoring results and less adjustment and amount of TIVA required up to six hours of anaesthesia. The results may have been due to a greater depth of anaesthesia achieved with the ZTMe combination at the dose used.

scholarly journals THE COMBINATION OF ULTRASOUND-GUIDED PECTORAL NERVES II AND PARASTERNAL BLOCKS AS A VALID ALTERNATIVE FOR ANESTHESIA IN BREAST SURGERY: AN OBSERVATIONAL STUDY

2017 ◽  
pp. 175-179
Author(s):  
Erika Basso Ricci
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Observational Study ◽  
Breast Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Thoracic Wall ◽  
Lateral Part ◽  
Ultrasound Guided ◽  
Mastectomy Group

Background: Breast cancer surgery is often associated with severe postoperative pain that may compromise systemic homeostasis, which increases perioperative morbidity, the length of stay in the hospital, and costs. Scientifi c evidence has also shown that an inadequate analgesia could promote the risk of persistent pain development after breast surgery. Objective: Recent literature suggested that the pectoral nerves II (PECS II) block may represent a valid alternative to general anesthesia (GA) and conventional, regional techniques for analgesia in breast surgery. This technique may provide complete anesthesia of the lateral part of the thorax but cannot block, by itself, the anterior cutaneous branches of the intercostal nerves. The combination of a parasternal block (PSB) and a PECS II block has been performed as a single anesthetic technique. Study Design: This is an observational, monocenter, prospective, and cohort study. We obtained the approval of our scientifi c ethic committee and clinical trials registration. Setting: This study enrolled patients undergoing an elective breast surgery. In particular, we enrolled patients who were scheduled for a mastectomy or quadrantectomy of the medial part of the breast. Methods: We recruited 40 patients who were scheduled for breast surgery. A PECS II block was performed with an injection of ropivacaine 0.5% 20 mL + 10 mL. Then, a PSB was performed by 2 separate injections of 3 mL of 0.5% ropivacaine, for each one, at the level of the second and fourth intercostal space. All of the patients received intraoperative sedation and multimodal analgesia. During the intraoperative period, the accessory need of a local anesthetic infi ltration, conversion to GA, and the total amount of propofol required to maintain good comfort of the patients were recorded. In the fi rst 24 postoperative hours, every 6 hours, postoperative pain was assessed by an investigator using a numerical rating scale (NRS). The consumption of analgesic and antiemetic drugs and the incidence of postoperative nausea and vomiting (PONV) were also recorded. Results: Our observational analysis yielded 40 patients in a period of 6 months. The population was subdivided into 2 groups: a mastectomy group or a quadrantectomy group. All of the population reported their pain scores at rest (rNRS < 3) and during activity (iNRS < 5) in the postoperative period. None of the patients required GA. Six patients (27.3%) in the mastectomy group required a supplemental anesthetic infi ltration. Eleven (27.5%) patients required a rescue analgesic drug: 9 (40.9%) in the mastectomy group and 2 (11.1%) in the quadrantectomy group. Two patients reported events of PONV, one for each group (4.54% for the mastectomy group and 5.55% for the quadrantectomy group). No complications occurred. Conclusion: This study indicates the safety and feasibility of the novel ultrasound-guided thoracic wall blocks during inpatient and outpatient breast surgery for the management of intraoperative anesthesia and postoperative analgesia. Limitations: This is an observational study; a randomized control trial is mandatory to confi rm the results. Key words: Breast cancer surgery, pectoralis nerve block, parasternal block, ultrasound-guided anesthesia, regional anesthesia, pain control

scholarly journals YOUTUBE VIDEOS QUALITY AS EDUCATIONAL SOURCES OF INFORMATION ABOUT EXERCISES AFTER BREAST CANCER SURGERY: Observational Study (Preprint)

10.2196/22451 ◽  
2020 ◽  
Author(s):  
Alvaro Manuel Rodriguez Rodriguez ◽  
Maria Blanco ◽  
Pedro Lopez Diaz ◽  
Marta de la Fuente Costa ◽  
Yasmin Ezzatvar de Llago ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Observational Study ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Sources Of Information ◽  
Youtube Videos ◽  
Educational Sources
Sign in / Sign up

Export Citation Format

Share Document