Comparative study of Intraoperative Haemodynamics and recovery characteristics of desflurane and sevoflurane in patients receiving General Anaesthesia

2021 ◽  
Vol 19 (3) ◽  
pp. 54-59
Author(s):  
Kavya M ◽  
Keyword(s):  
General Anaesthesia ◽  
Minute Ventilation ◽  
Muscle Relaxation ◽  
Randomized Study ◽  
Recovery Period ◽  
Rapid Onset ◽  
Early Recovery ◽  
Inhaled Anesthetics ◽  
Eye Opening ◽  
Group D

Background: Inhaled anesthetics used for general anaesthesia have a rapid onset and offset of action. The Induction and recovery depends on anaesthetic drug solubility, cardiac output and minute ventilation. Sevoflurane and desflurane have low blood gas partition coefficients, and therefore share the advantage of faster onset and recovery from anaesthesia when compared to other inhaled anesthetics. Hence, we designed this prospective randomized study to compare the intraoperative haemodynamic parameters and recovery characteristics of desflurane and sevoflurane. Methods: Sixty patients aged between 18-50 years belonging to ASA I and II scheduled for elective general anaesthesia were enrolled in the study and randomly divided into two groups to receive desflurane(group D) and sevoflurane(group S) for the maintenance of anaesthesia. Both groups were premedicated, pre oxygenated and induced with propofol. Muscle relaxation maintained with vecuronium. Desflurane and sevoflurane concentrations were adjusted according to entropy parameters and clinical variables like HR, NIBP, MAP and SPO2. Neuromuscular blockade reversed with neostigmine and glycopyrrolate. Recovery characteristics assessed using modified Aldrete scoring. Results: The intraoperative haemodynamics was similar with both desflurane and sevoflurane, and was maintained within 20% of baseline values. However, early recovery characteristics were significantly better in group D. Time to eye opening was 6.63 + 2.17 min in group S versus 4.77 + 1.41 min in group D (P< 0.001). Time to Extubation was 8.03 + 2.54 min in group S and 5.93 + 1.44 min in group D (P < 0.001). Response to verbal commands was 8.77 + 3.01 min in group S and 6.97 + 1.67 min in group D (P < 0.001). Modified Aldrete score were significantly better in group D than group S at 1st min, 2nd min and 3rd min. Thereafter, modified Aldrete score assessed at 5, 10, 15, 30 and 60 min were similar in both groups. Conclusion: Both desflurane and sevoflurane produce similar stable haemodynamic profile. Despite the faster early recovery with desflurane, no significant differences were found between the two volatile anaesthetics after 5 minutes during intermediate recovery period.

Comparative study of desflurane requirement and recovery characteristics in entropy guided general anaesthesia with or without dexmedetomidine infusion

2021 ◽  
Vol 19 (3) ◽  
pp. 71-76
Author(s):  
Rajesh R Nayak ◽  
Keyword(s):  
General Anaesthesia ◽  
Muscle Relaxation ◽  
Maintenance Infusion ◽  
Response Entropy ◽  
Desflurane Concentration ◽  
Adrenoceptor Agonists ◽  
Eye Opening ◽  
Induction Of Anaesthesia ◽  
Group D ◽  
Dexmedetomidine Infusion

Background: Newer anaesthetics such as desflurane have smaller blood-gas partition coefficient than older ones like halothane. Desflurane is preferred because it leads to faster onset of anaesthesia and faster emergence from anaesthesia. However, desflurane is considered to be more expensive than other volatile anaesthetics. Highly selective alpha two adrenoceptor agonists like Dexmedetomidine reduce anaesthetic requirements. Hence this study was designed to compare the effect of Dexmedetomidine infusion on desflurane consumption and recovery characteristics under entropy guided general anaesthesia. Materials and Methods: Fifty patients aged between 18-55 years belonging to ASA I and II scheduled for elective surgeries under general anaesthesia were randomly divided into two groups. Group D patients received a loading dose of inj Dexmedetomidine 1 µg/ kg, over 10 minutes before the induction of anaesthesia, and 0.5 µg/ kg/ hour infusion following induction of anaesthesia till the end of surgery. Group P patients received similar volumes of normal saline as bolus before the induction and maintenance infusion till the end of the surgery. Desflurane concentration was adjusted to maintain response entropy values between 40 to 60 and based on clinical variables like heart rate (HR), and mean arterial pressure (MAP). Muscle relaxation was guided by TOF count. HR, NIBP, MAP, SPO2, ENTROPY values were recorded. The total desflurane consumption was recorded from Anaesthesia gas module of GE Datex-Ohmeda S 5 Advance system. At end of surgery, desflurane was discontinued and patient extubated after adequate recovery and when TOF ratio was more than 0.9. Time to eye opening, extubation, response to verbal commands were recorded. Results: The mean consumption of desflurane at the end of one hour was significantly less in group D with p<0.001 (Group P 21.04±6.33 ml/hr and Group D 14.44±1.83 ml/hr). Eye opening time was significantly less in group D with p<0.001(Group P 297.60± 89.97sec and Group D 169.80±22.48 sec). Time for response to verbal commands was significantly less in group D with p<0.001 (Group P 423.60±113.02 sec and Group D 269.80±45.29 sec) Conclusion: Intraoperative Dexmedetomidine infusion reduces desflurane consumption, hastens recovery from desflurane during entropy guided general anaesthesia.

scholarly journals Comparison of postoperative recovery from desflurane and sevoflurane anaesthesia using laryngeal mask airway: a prospective randomized comparative study

2018 ◽  
Vol 6 (3) ◽  
pp. 853
Author(s):  
Supriya V. Jadhav ◽  
Prerna Gomes ◽  
Swati Daftary
Keyword(s):  
Statistical Significance ◽  
Postoperative Recovery ◽  
Research Centre ◽  
Early Recovery ◽  
Anaesthetic Agents ◽  
Recovery Profile ◽  
Inhalational Anaesthetic ◽  
Eye Opening ◽  
Group D ◽  
Mean Time

Background: Ambulatory surgeries necessitate safe anaesthesia and faster recovery. Sevoflurane and desflurane are proved as such effective inhalational anaesthetic agents. The aim of this study was to compare early postoperative recovery profile in patient undergoing elective ambulatory surgical operations and receiving anaesthesia with sevoflurane or desflurane using supreme LMA.Methods: This prospective study was conducted at Jaslok Hospital and Research Centre, Dr. G. Deshmukh Marg, Mumbai, from August 2014 to April 2015. Patients were randomized into two groups receiving desflurane (Group D- n=40) and sevoflurane (Group S- n=40) for maintenance of anaesthesia. Patients were monitored for recovery by using fast track criteria (FTC) score at different time intervals.Results: The demographic characteristics, hemodynamic parameters were comparable in both the groups and no statistical significance was seen among them (p>0.05). The mean time taken for postoperative recovery characteristics were significantly lower in in Group D than Group S (p=0.00). The FTC score was significantly higher in group D as compared to group S at all times (p<0.05) for thirty minutes. The prevalence of consuming additional analgesic was 12.5% in group D and 15% in group S (p=1.000). The additional antiemetic requirement was seen in 10% patients in both the groups (p=1.000).The incidence of coughing was seen in among 5% of Group D patients and in none among Group S (p=0.152).Conclusion: The study concludes that desflurane is superior to sevoflurane with respect to time of eye opening, response to verbal commands, orientation, ability to sit, early recovery profile and duration of stay in recovery room.

scholarly journals Clinical evaluation of general anaesthesia in pigeons using a combination of ketamine and diazepam

2012 ◽  
Vol 83 (1) ◽  
Author(s):  
Aidin Azizpour ◽  
Yashar Hassani
Keyword(s):  
General Anaesthesia ◽  
Normal Saline ◽  
Muscle Relaxation ◽  
Saline Group ◽  
Clinical Effects ◽  
Normal Saline Group ◽  
Rapid Induction ◽  
The Difference ◽  
Induction Of Anaesthesia ◽  
Group D

This study was undertaken to investigate the clinical effects of ketamine, diazepam and a ketamine and diazepam combination in the general anaesthesia of pigeons. Thirty-two pigeons of both sexes with body weights ranging from 280 g to 300 g were allocated randomly to four groups comprising eight birds each. Group D received a 0.5 mL mixture of diazepam (0.2 mg/kg) and normal saline, group K a 0.5 mL mixture of ketamine 5% (30 mg/kg) and normal saline, group D, group KD a 0.5 mL mixture of ketamine 5% (10 mg/kg), diazepam (0.2 mg/kg) and normal saline, whilst group C (control) received 0.5 mL of normal saline only. Each mixture was administered intramuscularly.Under standard operating room conditions, general anaesthesia was not observed in group C (normal saline alone). In group D, sedation and muscle relaxation without complete loss of consciousness was observed. Induction time of anaesthesia in group KD was significantly quicker than group K (p < 0.05). Duration of anaesthesia in group KD was significantly longer than group K (p < 0.05). Recovery took longer in group KD in comparison with group K, but the difference was not statistically significant (p > 0.05). The birds in group KD were calm and sedated, with good muscle relaxation, whilst in group K the birds were excited and showed a drop in body temperature.According to the results of this study, the combination of low dose ketamine hydrochloride (HCL) and diazepam overcame the adverse effects of ketamine alone. This combination produced a more rapid induction of anaesthesia, as well as an increase in anaesthesia duration, with good muscle relaxation and a smooth and slow recovery. Use of a combination of ketamine HCL given at 10 mg/kg and diazepam given at 0.2 mg/kg for anaesthesia in pigeons is therefore recommended.

scholarly journals The Effects of Dexmedetomidine and Fentanyl on Emergence Characteristics after Adenoidectomy in Children

2009 ◽  
Vol 37 (4) ◽  
pp. 571-576 ◽  
Author(s):  
F. Erdil ◽  
S. Demirbilek ◽  
Z. Begec ◽  
E. Ozturk ◽  
M. H. Ulger ◽  
...  
Keyword(s):  
Saline Solution ◽  
Controlled Study ◽  
Physical Status ◽  
Early Recovery ◽  
Anaesthetic Agents ◽  
Randomised Controlled Study ◽  
Eye Opening ◽  
Randomised Controlled ◽  
Study Intervention ◽  
Group D

This randomised controlled study evaluated the effects of fentanyl and dexmedetomidine on emergence characteristics of children having adenoidectomy and anaesthetised with sevoflurane. Ninety children, two to seven years of age and ASA physical status I, were studied. Children were randomly assigned to one of three groups of 30 children, with the study intervention injection given intravenously after intubation. Children in Group F received fentanyl 2.5 μg.kg−1 children in Group D received dexmedetomidine 0.5 μg.kg−1 and children in Group C received saline solution. Anaesthesia was induced with 50% N2O and 8% sevoflurane in O2 by mask and atracurium 0.6 mg.kg−1 was administered for tracheal intubation. All children received paracetamol 40 mg/kg rectally one hour preoperatively and dexamethasone 0.5 mg.kg−1 intravenously. The time to extubation was shorter in Group D than Group F. The eye-opening time was longer in Group F (16.1∓5.3 minutes) than in Groups C (12.0∓4.2 minutes) and D (12.7∓3.2 minutes). The proportion of pain-free children in early recovery was significantly higher in Groups D (47%) and F (43%) than Group C (13%) (P <0.05). The proportion of children with agitation scores >3 was lower in Groups D 17% (5/30) and F 13% (4130) than in Group C 47% (14/30) (P <0.05). Fentanyl 2.5 μg.kg−1 and dexmedetomidine 0.5 μg.kg−1 had similar haemodynamic effects and emergence characteristics. Fentanyl has been safely used in children for many years. Further studies of dexmedetomidine safety and its interaction with other anaesthetic agents are required before recommending its routine use during general anaesthesia in children.

scholarly journals A Prospective Randomized Study on Intraoperative Haemodynamic and Post-Operative Recovery Characteristics of Sevoflurane and Desflurane in Thyroid Surgeries under General Anaesthesia in Wayanad District

2021 ◽  
Vol 8 (24) ◽  
pp. 2045-2051
Author(s):  
Faias Karukappadath Siddique ◽  
Arun Aravind ◽  
Ashabi Mansoortheen
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
General Anaesthesia ◽  
Randomized Study ◽  
Significant Difference ◽  
Ethical Committee Approval ◽  
American Society ◽  
Operative Recovery ◽  
Group D

BACKGROUND Maintaining deep plane of anaesthesia to prevent haemodynamic fluctuation and absolute immobility at the same time ensuring early and smooth recovery to prevent bleeding and assessing vocal cord status are the challenges to the anaesthesiologists in thyroid surgeries. Use of volatile anaesthetics with low solubility and low blood gas partition coefficient are used for their haemodynamic stability and faster emergence from anaesthesia in various surgeries under general anaesthesia. we wanted to compare sevoflurane and desflurane in terms of intraoperative haemodynamics, postoperative emergence and recovery characteristics in thyroid surgeries of less than 2 hours duration. METHODS After getting institutional ethical committee approval, 70 patients belonging to American Society of Anaesthesiologists (ASA), physical status I or II undergoing elective thyroid surgery were randomly assigned to two groups to receive either 6 % Desflurane (group D ) or 2 % Sevoflurane (group S) for maintenance of general anaesthesia along with 33 % oxygen with 67 % nitrous oxide. The intraoperative heart rate, mean arterial pressure were recorded at 5 minute intervals and recovery characteristics including times to extubation, first spontaneous motion, response to painful pinch, recall of name, hand grip and PARS score ≥ 9 were recorded in both groups. RESULTS There was no statistically significant difference (P > 0.05) in mean heart rate and mean arterial pressure between group D and S and remained within 20 % of baseline. The time to achieve a PARS ≥ 9 was earlier in the desflurane group and it was statistically significant. CONCLUSIONS Desflurane and Sevoflurane based anaesthesia provides comparable intraoperative haemodynamics whereas post-operative recovery was quicker in patients who received Desflurane compared to Sevoflurane. KEYWORDS Desflurane, Haemodynamics, Recovery, Sevoflurane

Patterns of development of insomnia in patients with early recovery period of stroke

2019 ◽  
Vol 17 (7) ◽  
pp. 95-99
Author(s):  
O. V. Kurushina ◽  
◽  
E. A. Kurakova ◽  
Keyword(s):  
Recovery Period ◽  
Early Recovery ◽  
Early Recovery Period

Opportunities of ultrasound diagnostics of lung injury in SARS-CoV-2 infection (COVID-19): a clinical case

2020 ◽  
Vol 98 (11) ◽  
pp. 51-56
Author(s):  
G. V. Neklyudova ◽  
А. V. Chernyak ◽  
N. А. Tsareva ◽  
S. N. Аvdeev
Keyword(s):  
Lung Injury ◽  
Clinical Case ◽  
Ultrasound Examination ◽  
Recovery Period ◽  
Early Recovery ◽  
Acute Period ◽  
Ultrasound Diagnostics ◽  
Early Recovery Period

The article describes a clinical case demonstrating the results of the lungs ultrasound examination in the COVID-19 patient during the acute period of the disease and early recovery period.

scholarly journals Function of the nucleus accumbens in motor control during recovery after spinal cord injury

Science ◽  
2015 ◽  
Vol 350 (6256) ◽  
pp. 98-101 ◽  
Author(s):  
Masahiro Sawada ◽  
Kenji Kato ◽  
Takeharu Kunieda ◽  
Nobuhiro Mikuni ◽  
Susumu Miyamoto ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Nucleus Accumbens ◽  
High Frequency ◽  
Neuronal Damage ◽  
Recovery Period ◽  
Oscillatory Activity ◽  
Finger Movements ◽  
Early Recovery ◽  
Cord Injury

Motivation facilitates recovery after neuronal damage, but its mechanism is elusive. It is generally thought that the nucleus accumbens (NAc) regulates motivation-driven effort but is not involved in the direct control of movement. Using causality analysis, we identified the flow of activity from the NAc to the sensorimotor cortex (SMC) during the recovery of dexterous finger movements after spinal cord injury at the cervical level in macaque monkeys. Furthermore, reversible pharmacological inactivation of the NAc during the early recovery period diminished high-frequency oscillatory activity in the SMC, which was accompanied by a transient deficit of amelioration in finger dexterity obtained by rehabilitation. These results demonstrate that during recovery after spinal damage, the NAc up-regulates the high-frequency activity of the SMC and is directly involved in the control of finger movements.

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