scholarly journals Anesthetic Management by Total Intravenous Anesthesia with Continuous Infusion of Propofol, Ketamine, Pentazocine and Vecuronium

1999 ◽  
Vol 19 (7) ◽  
pp. 468-473
Author(s):  
Masahiko ONAKA ◽  
Hiromitsu YAMAMOTO ◽  
Masafumi AKATSUKA ◽  
Hidemaro MORI
Keyword(s):  
Continuous Infusion ◽  
Anesthetic Management ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia

scholarly journals BIS-Guided Total Intravenous Anesthesia for Orchiopexy and Circumcision in a Child with Severe Autism: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Selçuk Okur ◽  
Müge Arıkan ◽  
Gülşen Temel ◽  
Volkan Temel
Keyword(s):  
Bispectral Index ◽  
Index System ◽  
Anesthetic Management ◽  
Hospital Setting ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Anesthetic Agents ◽  
Postanesthetic Care Unit ◽  
Severe Autism

Autistic children are very difficult to manage in the hospital setting because they react badly to any change in routine. We describe a case of 10-year-old male patient with severe autism undergoing orchidopexy and circumcision. Following premedication, anesthesia was induced with remifentanil, propofol, atracurium, and maintained with total intravenous anesthesia (propofol and remifentanil). The Bispectral Index System was monitored for determination of the depth of anesthesia. After surgery, all infusions were discontinued. The patient was then transferred to the postanesthetic care unit. There were no adverse events observed during the anesthetic management. The patient was discharged from the hospital on the second postoperative day. Bispectral Index System-guided Total Intravenous Anesthesia can provide some advantages for patient with autism, such as hemodynamic stability, early and easy recovery, to facilitate faster discharge, to optimize the delivery of anesthetic agents, to minimize its adverse effects, and to maximize its safety.

scholarly journals Total Intravenous Anesthesia with Propofol Associated with Fentanyl, Lidocaine or Ketamine in Bitches Submitted to Elective Ovariohysterectomy

2017 ◽  
Vol 45 (1) ◽  
pp. 6
Author(s):  
Samuel Monzem ◽  
Paulo Roberto Spiller ◽  
Nathalie Bassil Moro Dower ◽  
Lianna Ghisi Gomes ◽  
Matias Bassinello Stocco ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Infusion Rate ◽  
Respiratory Function ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Inhalation Anesthesia ◽  
Analgesic Treatment ◽  
Physiological Limits ◽  
Extubation Time ◽  
Recovery Times

Background: Total intravenous anesthesia with propofol is an alternative to inhalation anesthesia because it offers smoother anesthetic recovery, however, since propofol does not have adequate analgesic action, it is necessary to associate it with some drug to avoid the pain process. In addition, the combination may minimize cardiovascular depression resulting from continuous infusion of propofol by reducing infusion rate. The aim of this study was to evaluate cardiorespiratory parameters and anesthetic recovery in bitches submitted to continuous infusion of fentanyl, lidocaine and ketamine associated with total intravenous anesthesia with propofol and submitted to elective ovariohisterectomy.Materials, Methods & Results: Twenty-four bitches were medicated intramuscularly with 0.03 mg/kg of acepromazine. After 30 min, they were divided into three groups with different analgesic treatments: group F (GF) received a loading dose (LD) of 0.0036 mg/kg fentanyl, followed by continuous infusion of 0.0036 mg/kg/h; group L (GL), LD of 3 mg/kg lidocaine, followed by 3 mg/kg/h and group K (GK), LD of 0.6 mg/kg ketamine, followed by 0.6 mg/kg/h. First a LD of analgesic treatment was administered, followed by induction (to the effect) and beginning of continuous infusion of the analgesic treatment and propofol. The animals were intubated with endotracheal tube of adequate size, and connected to 100% oxygen, being kept under spontaneous ventilation during the entire period of anesthetic maintenance. The infusion of propofol started at 0.34 mg/kg/min and was adjusted so as to maintain the surgical anesthesia plane of Guedel and the cardiovascular parameters within the physiological limits for the species. The cardiorespiratory parameters were measured at different moments: basal (before application of any drug) and 5, 15, 20, 30, 40, 50, 60, 70 and 80 min after induction. The surgery started 20 min after anesthetic induction and lasted 60 min. At the end of the surgery, infusions were terminated and anesthesia recovery was evaluated by measuring the extubation time, sternal decubitus, and quadrupedal position in min. A variance analysis was performed to compare means of cardiorespiratory parameters for the moments and groups followed by the Scott-knott test. Differences were considered significant when P < 0.05. The baseline parameters, age, weight and dose of propofol IC were not statistically different between groups. The infusion rate of propofol increased in all groups from M5 to M15. GF and GL presented lower values for heart rate and GK presented higher values for the same variable. Blood pressure decreased after induction and increased in M40, M50 and M60. The variables EtCo2, PaCo2 and HCO3 increased and pH decreased showing respiratory depression in all groups. The mean time, in min, for orotracheal extubation, sternal decubitus and quadrupedal position were respectively 5 ± 3, 20 ± 6 and 39 ± 13 for GF; 6 ± 2, 23 ± 7 and 51 ± 15 for GL; 4 ± 2, 18 ± 6 and 42 ± 22 for GK and did not present statistical difference between the groups.Discussion: The combination of continuous infusion of fentanyl, lidocaine or ketamine to total intravenous anesthesia with propofol provides cardiovascular stability, but does not prevent respiratory function depression. The dose of propofol IC was the same in all groups, thus demonstrating that analgesics have the same potency in the transoperative period and justifies similar anesthetic recovery times. Thus, it can be concluded that these associations are feasible for total intravenous anesthesia provided proper monitorins for respiratory function.

A Case of Total Intravenous Anesthesia Using a Propofol-Fentanyl Computer Asssisted Continuous Infusion: A case report

1999 ◽  
Vol 37 (3) ◽  
pp. 516
Author(s):  
Young Joo Park ◽  
Tae Hyung Han ◽  
Dae Woo Kim ◽  
Ho Yeong Kil ◽  
Seong Ik Lee ◽  
...  
Keyword(s):  
Case Report ◽  
Continuous Infusion ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia

Dexmedetomidine protects blood δ-aminolevulinate dehydratase from inactivation caused by hyperoxygenation in total intravenous anesthesia

2010 ◽  
Vol 30 (4) ◽  
pp. 289-295 ◽  
Author(s):  
João BT Rocha ◽  
Neusa M Heinzmann Bulow ◽  
Eduardo FM Correa ◽  
Cassiano Scholze ◽  
Cristina W Nogueira ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Molecular Oxygen ◽  
Human Blood ◽  
Thiobarbituric Acid ◽  
Total Intravenous Anesthesia ◽  
Thiobarbituric Acid Reactive Substances ◽  
Intravenous Anesthesia ◽  
Aminolevulinate Dehydratase ◽  
Remifentanil Group

Delta-aminolevulinate dehydratase (δ-ALA-D) enzyme is sensitive to pro-oxidant agents, including molecular oxygen. Here, we tested whether hyperoxygenation after total intravenous (i.v.) anesthesia could interact with the type of anesthesia (dexmedetomidine, continuous infusion; 0.5 μg/kg/h or remifentanil, continuous infusion; 0.3 μg/kg/min) plus propofol using blood δ-ALA-D activity and thiobarbituric acid reactive substances (TBARS) levels as ending points of toxicity. In absence or presence of dithiothreitol (DTT), δ-ALA-D activity was reduced after hyperoxygenation in the group treated with remifentanil and was not modified in dexmedetomidine group. TBARS increased considerably in the blood of both groups of patients after oxygenation. The results obtained here suggest that the hyperoxygenation was associated with a marked increase in TBARS production regardless of the type of anesthesia. δ-ALA-D activity was only inhibited in remifentanil group, which indicates a possible interaction between oxygenation and the type of anesthetic. This is the first demonstration that dexmedetomidine may protect blood δ-ALA-D from oxidation. However, further studies are necessary to establish a possible antioxidant role of dexmedetomidine against hyperoxygenation in human blood.

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