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 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.

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.

scholarly journals Dexmedetomidine versus propofol as a sedative agent in the intensive care unit: a randomized single blinded prospective study

2018 ◽  
Vol 6 (6) ◽  
pp. 2127
Author(s):  
Pollov Borah ◽  
Rishav Kakati ◽  
Rajib K. Bhattacharyya
Keyword(s):  
Patient Comfort ◽  
Loading Dose ◽  
Maintenance Infusion ◽  
Mechanically Ventilated ◽  
Icu Discharge ◽  
Surgical Icu ◽  
Icu Sedation ◽  
Group D ◽  
Essential Prerequisite ◽  
Dexmedetomidine Infusion

Background: Sedation is an essential prerequisite for every ICU patient. It promotes patient comfort, helps in alleviation of anxiety, stabilizes vitals and reduces the time to extubation and ICU discharge. This study aims at comparing dexmedetomidine versus propofol in ICU sedation with respect to maintenance of vitals, time to extubation, incidence of adverse effects and cost effectiveness.Methods: 60 intubated and mechanically ventilated post-surgical ICU patients were randomly allocated to two groups of 30 each. Group D received dexmedetomidine infusion as a loading dose of 0.1mcg/kg/min IV over 10 minutes followed by maintenance infusion of 0.2-0.7mcg/kg/h IV. Group P received propofol infusion as a loading dose of 5mcg/kg/min IV over 5 minutes followed by a maintenance infusion of 0.3-3mg/kg/h IV. Patients in both groups were maintained at Richmond agitation sedation score of -1 to -2. Measurements of HR, NIBP, SpO2 were taken at regular intervals till cessation of sedation and extubation. Data thus collected was subjected to statistical analysis.Results: Dexmedetomidine was seen to be comparable to propofol as far as maintaining vitals was concerned. Group D (dexmedetomidine) had a statistically significant shorter mean duration to sedation cessation and extubation than group P (propofol). Dexmedetomidine also had the added advantages of minimal respiratory depression, decreased opioid requirements as well as greater cost effectiveness.Conclusions: Dexmedetomidine was found to be a better choice for sedation in the ICU compared to propofol.

scholarly journals Intravenous anaesthesia in goats: A review

2013 ◽  
Vol 84 (1) ◽  
Author(s):  
T. Brighton Dzikiti
Keyword(s):  
General Anaesthesia ◽  
Muscle Relaxation ◽  
Scientific Information ◽  
Working Environment ◽  
Total Intravenous Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Anaesthetic Agents ◽  
Inhalation Anaesthetic ◽  
Intravenous Anaesthetic ◽  
Balanced Anaesthesia

Intravenous anaesthesia is gradually becoming popular in veterinary practice. Traditionally, general anaesthesia is induced with intravenous drugs and then maintained with inhalation agents. Inhalation anaesthetic agents cause more significant dose-dependent cardiorespiratory depression than intravenous anaesthetic drugs, creating a need to use less of the inhalation anaesthetic agents for maintenance of general anaesthesia by supplementing with intravenous anaesthesia drugs. Better still, if anaesthesia is maintained completely with intravenous anaesthetic drugs, autonomic functions remain more stable intra-operatively. Patient recovery from anaesthesia is smoother and there is less pollution of the working environment than happens with inhalation anaesthetic agents. Recently, a number of drugs with profiles (pharmacokinetic and pharmacodynamic) suitable for prolonged intravenous anaesthesia have been studied, mostly in humans and, to a certain extent, in dogs and horses. There is currently very little scientific information on total intravenous anaesthesia in goats, although, in the past few years, some scholarly scientific articles on drugs suitable for partial intravenous anaesthesia in goats have been published. This review article explored the information available on drugs that have been assessed for partial intravenous anaesthesia in goats, with the aim of promoting incorporation of these drugs into total intravenous anaesthesia protocols in clinical practice. That way, balanced anaesthesia, a technique in which drugs are included in anaesthetic protocols for specific desired effects (hypnosis, analgesia, muscle relaxation, autonomic stabilisation) may be utilised in improving the welfare of goats undergoing general anaesthesia.

scholarly journals Preoperative management and features of induction of anaesthesia in acute bowel obstruction (clinical lecture)

2021 ◽  
Vol 16 (7-8) ◽  
pp. 18-32
Author(s):  
M.М. Pylypenko ◽  
M.V. Bondar
Keyword(s):  
General Anaesthesia ◽  
Bowel Obstruction ◽  
Rapid Sequence Induction ◽  
Arterial Hypotension ◽  
Infusion Therapy ◽  
Electrolyte Disturbances ◽  
Vital Functions ◽  
Rapid Sequence ◽  
Abdominal Hypertension ◽  
Induction Of Anaesthesia

This article presents the main approaches to the pre-operative preparation of patients with severe acute bowel obstruction and emphasizes that this preparation should be limited in time and don’t delay the surgery. In severe bowel obstruction, in addition to a thorough assessment of vital functions and determination of leading physiologic disorders, it is extremely important to examine patients using specific scales which allow determining the risks of major complications. General anaesthesia usually is the method of choice for acute bowel obstruction; however, it could be supplemented by regional anaesthesia to improve intra- and postoperative pain relief. While preparing for general anaesthesia, first of all, it is necessary to determine the risks of difficult airway and complicated intubation, as well as regurgitation and aspiration of gastric contents, which allows you to purposefully approach the choice of intubation techniques and prevent the occurrence of these formidable complications. Sellick’s manoeuvre is no longer required in these patients, and instead of it during intubation, bimanual laryngoscopy can be used. Arterial hypotension is a common complication during induction of anaesthesia in severe bowel obstruction, and such patients should always be treated with infusion therapy, and their fluid and electrolyte disturbances should be corrected. At the same time, to prevent intestinal oedema and the development of intra-abdominal hypertension, infusion therapy should be limited both in time and in volume. If hypovolemia cannot be completely corrected, vasopressors should be given prophylactically to reduce the risk of significant arterial hypotension during rapid sequence induction.

scholarly journals Comparison of Intravenous Lidocaine and Dexmedetomidine Infusion for Prevention of Postoperative Catheter-Related Bladder Discomfort: A Randomized Controlled Trial

2018 ◽  
Author(s):  
Shuying Li ◽  
Hui Li ◽  
Juan Ni ◽  
Yushan Ma
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Abdominal Hysterectomy ◽  
Urinary Catheterization ◽  
Intravenous Lidocaine ◽  
Time Points ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Group D ◽  
Dexmedetomidine Infusion

Abstract Background: Catheter-related bladder discomfort (CRBD) frequently occurs during recovery in patients who undergo intra-operative urinary catheterization distress. We conducted this study to compare the effect of intravenous lidocaine and dexmedetomidine infusion for preventing CRBD. Methods: 120 patients undergoing elective open abdominal hysterectomy and hysteromyoma requiring urinary bladder catheterization were randomly allocated into three groups of 40 each. Group L received a 2 mg/kg lidocaine bolus followed by infusion of 1.5 mg/kg/h; Group D received a 0.5 mg/kg dexmedetomidine bolus followed by infusion of 0.4 mg/kg/h; Group C received a bolus and infusion of normal saline of equivalent volume. The incidence and different severity (mild, moderate, and severe) of CRBD were assessed on arrival in the postanaesthesia care unit at 0, 1, 2, and 6 h postoperatively. Results: The incidence of CRBD was significantly lower in Group L and Group D compared with Group C at 0, 1, and 2 h. However, there was no significant difference among the three groups regarding the different severity of CRBD at all time points. The requirement of rescue tramadol for CRBD was lower in group L and group D than in group C. The incidence of sedation was significantly higher in Group D compared to Group L and Group C, though no difference in other adverse effects was observed. Conclusions: Intravenous lidocaine and dexmedetomidine infusion reduced the incidence of CRBD as well as the additional tramadol requirement for CRBD, but had no effect on the different severity of CRBD.

Agents used for intravenous induction of anaesthesia

1966 ◽  
Vol 4 (25) ◽  
pp. 97-99 ◽  
Keyword(s):  
Nitrous Oxide ◽  
General Anaesthesia ◽  
Intravenous Injection ◽  
Intravenous Anaesthesia ◽  
Nitrous Oxide Oxygen ◽  
Induction Of Anaesthesia ◽  
Combined Technique

The term ‘intravenous anaesthesia’ has become ambiguous, because except for short outpatient or surgery procedures, it is unusual nowadays for general anaesthesia to be produced by means of either a gas or an intravenous injection alone. Because other drugs are also used as adjuncts, difficulties of terminology may arise. For instance, should the nitrous oxide/oxygen/curare technique be described as an inhalation, intravenous or combined technique? An attempt is made to avoid such difficulties in the title of this article.

Analgesia, anaesthesia, and sedation

2020 ◽  
pp. 623-645
Keyword(s):  
Drug Interactions ◽  
General Anaesthesia ◽  
Muscle Relaxation ◽  
Hospital Setting ◽  
Intravenous Sedation ◽  
Local Analgesia ◽  
Reversal Agents

This chapter summarizes the different techniques available for analgesia, anaesthesia, and sedation in dentistry. This includes the use of benzodiazepines while highlighting the indications and contraindications for each technique and approach. The varying methods of administration of local analgesia are outlined, with information on the commonly used preparations and techniques. The use of both oral and intravenous sedation is discussed, including important points on drug interactions and reversal agents. This chapter considers the triad of unconsciousness, muscle relaxation, and analgesia that makes up general anaesthesia and details the drugs used to achieve this in a hospital setting.

scholarly journals The Contrasting Effects of Enflurane on Transplacental Exchange after Methohexitone and Ketamine Induction of Anaesthesia for Caesarean Section

1978 ◽  
Vol 6 (3) ◽  
pp. 239-242 ◽  
Author(s):  
J. W. Downing ◽  
P. J. C. Houlton ◽  
J. G. Brock-Utne ◽  
R. J. R. Buley
Keyword(s):  
Caesarean Section ◽  
Beneficial Effect ◽  
General Anaesthesia ◽  
Elective Caesarean Section ◽  
Volatile Agent ◽  
Inhalational Agent ◽  
Induction Of Anaesthesia ◽  
Uterine Relaxation

Supplementation of general anaesthesia with enflurane 0.6% before delivery of the foetus by elective Caesarean section, produced contrasting effects after methohexitone and ketamine administration. Enflurane, an inhalational agent causing vasodilation and uterine relaxation, enhanced maternal to foetal transplacental exchange following methohexitone induction of narcosis. This beneficial effect of the volatile agent was not seen after ketamine, a vasoconstrictor drug which stimulates myometrial contraction.

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