scholarly journals Effects of Intravenous Anesthetics vs Inhaled Anesthetics on Early Postoperative Sleep Quality and Complications of Patients After Laparoscopic Surgery Under General Anesthesia

2021 ◽  
Vol Volume 13 ◽  
pp. 375-382
Author(s):  
Shiyi Li ◽  
Bijia Song ◽  
Yang Li ◽  
Junchao Zhu
Keyword(s):  
Laparoscopic Surgery ◽  
Sleep Quality ◽  
General Anesthesia ◽  
Intravenous Anesthetics ◽  
Inhaled Anesthetics

scholarly journals Spinal block and delirium in oncologic patients after laparoscopic surgery in the Trendelenburg position: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0249808
Author(s):  
Jorge Kiyoshi Mitsunaga ◽  
Vinicius Fernando Calsavara ◽  
Elton Shinji Onari ◽  
Vinicius Monteiro Arantes ◽  
Carolina Paiva Akamine ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Spinal Block ◽  
Trendelenburg Position ◽  
General Anesthesia Group ◽  
Randomized Controlled ◽  
Anesthesia Group ◽  
Oncologic Patients

Delirium is the most common postsurgical neurological complication and has a variable incidence rate. Laparoscopic surgery, when associated with the Trendelenburg position, can cause innumerable physiological changes and increase the risk of neurocognitive changes. The association of general anesthesia with a spinal block allows the use of lower doses of anesthetic agents for anesthesia maintenance and facilitates better control over postoperative pain. Our primary outcome was to assess whether a spinal block influences the incidence of delirium in oncologic patients following laparoscopic surgery in the Trendelenburg position. Our secondary outcome was to analyze whether there were other associated factors. A total of 150 oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position were included in this randomized controlled trial. The patients were randomized into 2 groups: the general anesthesia group and the general anesthesia plus spinal block group. Patients were immediately evaluated during the postoperative period and monitored until they were discharged, to rule out the presence of delirium. Delirium occurred in 29 patients in total (22.3%) (general anesthesia group: 30.8%; general anesthesia plus spinal block: 13.8% p = 0.035). Patients who received general anesthesia had a higher risk of delirium than patients who received general anesthesia associated with a spinal block (odds ratio = 3.4; 95% confidence interval: 1.2–9.6; p = 0.020). Spinal block was associated with reduced delirium incidence in oncologic patients who underwent elective laparoscopic surgeries in the Trendelenburg position.

scholarly journals Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery

2020 ◽  
Vol 3 (2) ◽  
pp. 46-49
Author(s):  
Hunsehalli Revanasiddappa Narendra ◽  
Aparna Nerurkar ◽  
Shibu Sasidharan
Keyword(s):  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Cuff Pressure ◽  
Pressure Gauge ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Observational Analysis ◽  
Endotracheal Tube Cuff Pressure

ABSTRACT Background Laparoscopic surgery is performed under general anesthesia with mechanical ventilation, and a high-volume, low-pressure endotracheal tube (ETT) with a sealing cuff pressure about 20–30 cm of H2O is commonly used for a proper seal and avoidance of overinflation. Nitrous oxide (N2O) is an inhalational anesthetic that is used with oxygen in the ratio 50:50 for the maintenance of anesthesia if there is no facility of medical air. However, N2O increases the intracuff pressure of the tracheal tube due to diffusion of N2O in to cuff during general anesthesia. The present research was done to study the cuff pressure changes during laparoscopic surgeries with N2O anesthesia and to assess its variation during the various stages of surgery and also its correlation with position of the patient. Materials and methods A study was done in a tertiary-level hospital over a period of 1 year in 70 patients undergoing laparoscopic surgery. Endotracheal tube was inflated with incremental doses of 0.5 mL of air to a point where no leak on auscultation on the suprasternal area was noted. Cuff pressure measurement using cuff pressure monitor (Hand pressure gauge) was done at the time of first inflation of cuff up to 20–30 cm of H2O and airway pressure, along with total amount of air inflated was noted as “zero” reading. Thereafter, cuff pressure was measured at regular interval of 5 minutes. Cuff pressures and airway pressures were taken just prior to insufflation, 2 minutes after abdominal insufflation, thereafter every 15 minutes throughout surgery, and 2 minutes after desufflation and prior to extubation. Results Out of 70 patients, maximum patients were of the age-group of 20–50 years (78.5%). There was no statistically significant difference between the groups. Cuff pressure at the induction was kept in range of 20–30 cm of H2O. In this study, mean tracheal cuff pressure at baseline was 21.10 + 6.16 (p value of 0.207) and prior to insufflation was 21 + 7.13 (p value of 0.733). The cuff pressures at 2 minutes post insufflation (P2), P15, P30, P45, and P60 were 31.40 ± 12.54 cm of H2O, 25.79 ± 8.68 cm of H2O, 24.61 ± 7.37 cm of H2O, 23.83 ± 9.43 cm of H2O, and 24.63 ± 4.77 cm of H2O, respectively. p value was strongly significant showing a positive correlation between pneumo-peritoneum and cuff pressures. We could see the cuff pressure continuously increasing in successive readings. Post desufflation and prior to extubation, there was a fall in cuff pressure with mean cuff pressure being 17.24 + 5.32 cm of H2O and 15.27 + 4.00 cm of H2O, respectively, which also suggests that cuff pressures increased with pneumoperitoneum. Conclusion Use of N2O increases the cuff pressure (31.4 + 12.54 cm of H2O), especially immediately post-insufflation (35.54 + 12.06 cm of H2O), more so in head low position (36.28 + 12.13 cm of H2O). Mean airway pressure (Ppeak) also increased with pneumoperitoneum (22.60 + 4.38 cm of H2O). The regular monitoring of endotracheal tube cuff pressure should be a part of regular safe practice of anesthesia, and use of handy device like hand pressure gauge should be implemented in regular practice where N2O is used. How to cite this article Narendra HR, Nerurkar A, Sasidharan S. Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery. J Med Acad 2020;3(2):46–49.

The Effects of Different Oxygen Concentrations on Recruitment Maneuver During General Anesthesia for Laparoscopic Surgery

2014 ◽  
Vol 24 (5) ◽  
pp. 410-413 ◽  
Author(s):  
Ufuk Topuz ◽  
Ziya Salihoglu ◽  
Banu V. Gokay ◽  
Tarik Umutoglu ◽  
Mefkur Bakan ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Recruitment Maneuver ◽  
Oxygen Concentrations

scholarly journals A COMPARATIVE STUDY OF HAEMODYNAMIC AND RECOVERY CHARACTERISTICS OF DESFLURANE VERSUS SEVOFLURANE IN PATIENTS UNDER GOING LAPAROSCOPIC SURGERY

2019 ◽  
pp. 1-2
Author(s):  
Ankita Bhensdadia
Keyword(s):  
Laparoscopic Surgery ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Early Mobilization ◽  
Hemodynamic Instability ◽  
Minimal Invasive ◽  
Blood Gas ◽  
Hemodynamic Stability ◽  
Inhaled Anesthetics ◽  
Care Surgery

Laparoscopic surgeries are minimal invasive surgery very popular now a days as a day care surgery as it provide early mobilization, shorter hospital stay. The main drawback is intra-operative hemodynamic instability due to pneumoperitoneum. Therefore, anesthesiologist must choose anesthetic agent which provide hemodynamic stability and rapid recovery. Inhaled anesthetics with low blood: gas partition contributes to faster induction and emergence from anesthesia. Both Desurane and Sevourane have low blood: gas partition coefcient 0.42 and 0.65 respectively .We conducted the study to know which of these two agents contributes to faster recovery and hemodynamics. CONCLUSION- Desurane and Sevourane provide stable intraoperative hemodynamic, however early and intermediate recovery is signicantly faster in Desurane group than Sevourane grou

The difference between induction and maintenance dosages of propofol for general anesthesia in patients with and without sleep quality disorder

2020 ◽  
Vol 21 ◽  
pp. 100125
Author(s):  
Alireza Mirkheshti ◽  
Mina Vishteh ◽  
Ardeshir Tajbakhsh ◽  
Dariush Abtahi ◽  
Rofeideh Falahinejadghajari ◽  
...  
Keyword(s):  
Sleep Quality ◽  
General Anesthesia ◽  
The Difference

Spinal anesthesia vs general anesthesia in gynecological laparoscopic surgery: a systematic review and meta-analysis.

2021 ◽  
Author(s):  
Luigi Della Corte ◽  
Antonio Mercorio ◽  
Ilaria Morra ◽  
Gaetano Riemma ◽  
Pasquale De Franciscis ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Meta Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Current Evidence ◽  
Cochrane Library ◽  
Laparoscopic Treatment ◽  
Gynecological Diseases

Introduction: In the last years, spinal anesthesia (SA) has emerging as alternative to general anesthesia (GA) for the laparoscopic treatment of gynecological diseases, for better control of postoperative pain. The aim of the review is to compare the advantages of SA compared to GA. Methods: MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Cochrane Library, and CINAHL were searched from inception until March 2021. Randomized controlled trials (RCTs) and non-randomized studies (NRSs) about women who underwent SA and GA for gynecological laparoscopic surgery. Relevant data were extracted and tabulated. Results: The primary outcomes included the evaluation of postoperative pain (described as shoulder pain), postoperative nausea and vomiting, and operative times. One hundred and eight patients were included in RCTs, 58 in NRSs. The qualitative analysis had conflicting results and for the most of parameters (hemodynamic variables, nausea and postoperative analgesic administration) no statistically significant differences were observed: in the NRSs studies, contradictory results regarding the postoperative pain in SA and GA groups were reported. Regarding the quantitative analysis, in the RCT studies, women who received SA had not significantly lower operative times (RR -4.40, 95% CI -9.32 to 0.53) and a lower incidence of vomiting (RR 0.51, 95% CI 0.17 to 1.55); on the other hand, in the NRS studies, women who received SA had longer operative times (RR 5.05, 95% CI -0.03 to 10.14) and more episodes of vomiting (RR 0.56, 95% CI 0.10 to 2.97) compared to those with GA: anyway, the outcomes proved to be insignificant. Conclusions: Current evidence suggests no significant advantages to using SA over GA for laparoscopic treatment of gynecological diseases.

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