scholarly journals Comparing Postoperative Complications and Inflammatory Markers Using Total Intravenous Anesthesia Versus Volatile Gas Anesthesia for Pancreatic Cancer Surgery

2017 ◽  
Vol 7 (4) ◽  
Author(s):  
Jose M Soliz ◽  
Ifeyinwa C Ifeanyi ◽  
Mathew H Katz ◽  
Jonathan Wilks ◽  
Juan P Cata ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Postoperative Complications ◽  
Inflammatory Markers ◽  
Cancer Surgery ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Gas Anesthesia

scholarly journals Propofol-based intravenous anesthesia is associated with better survival than desflurane anesthesia in pancreatic cancer surgery

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0233598
Author(s):  
Hou-Chuan Lai ◽  
Meei-Shyuan Lee ◽  
Yin-Tzu Liu ◽  
Kuen-Tze Lin ◽  
Kuo-Chuan Hung ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Surgery ◽  
Intravenous Anesthesia

scholarly journals The Anesthesia in Abdominal Aortic Surgery (ABSENT) Study

2013 ◽  
Vol 119 (4) ◽  
pp. 802-812 ◽  
Author(s):  
Espen E. Lindholm ◽  
Erlend Aune ◽  
Camilla B. Norén ◽  
Ingebjørg Seljeflot ◽  
Thomas Hayes ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Aortic Surgery ◽  
Volatile Anesthetics ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic ◽  
Anesthesia Group ◽  
Coronary Events

Abstract Background: On the basis of data indicating that volatile anesthetics induce cardioprotection in cardiac surgery, current guidelines recommend volatile anesthetics for maintenance of general anesthesia during noncardiac surgery in hemodynamic stable patients at risk for perioperative myocardial ischemia. The aim of the current study was to compare increased troponin T (TnT) values in patients receiving sevoflurane-based anesthesia or total intravenous anesthesia in elective abdominal aortic surgery. Methods: A prospective, randomized, open, parallel-group trial comparing sevoflurane-based anesthesia (group S) and total intravenous anesthesia (group T) with regard to cardioprotection in 193 patients scheduled for elective abdominal aortic surgery. Increased TnT level on the first postoperative day was the primary endpoint. Secondary endpoints were postoperative complications, nonfatal coronary events and mortality. Results: On the first postoperative day increased TnT values (>13 ng/l) were found in 43 (44%) patients in group S versus 41 (43%) in group T (P = 0.999), with no significant differences in TnT levels between the groups at any time point. Although underpowered, the authors found no differences in postoperative complications, nonfatal coronary events or mortality between the groups. Conclusions: In elective abdominal aortic surgery sevoflurane-based anesthesia did not reduce myocardial injury, evaluated by TnT release, compared with total intravenous anesthesia. These data indicate that potential cardioprotective effects of volatile anesthetics found in cardiac surgery are less obvious in major vascular surgery.

scholarly journals Total Intravenous Anesthesia Including Ketamine versus  Volatile Gas Anesthesia for Combat-related Operative Traumatic Brain Injury

2008 ◽  
Vol 109 (1) ◽  
pp. 44-53 ◽  
Author(s):  
Kurt W. Grathwohl ◽  
Ian H. Black ◽  
Phillip C. Spinella ◽  
Jason Sweeney ◽  
Joffre Robalino ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Odds Ratio ◽  
Total Intravenous Anesthesia ◽  
Neurologic Outcome ◽  
Intravenous Anesthesia ◽  
Neurologic Outcomes ◽  
Good Neurologic Outcome ◽  
Gas Anesthesia

Background Traumatic brain injury is a leading cause of death and severe neurologic disability. The effect of anesthesia techniques on neurologic outcomes in traumatic brain injury and potential benefits of total intravenous anesthesia (TIVA) compared with volatile gas anesthesia (VGA), although proposed, has not been well evaluated. The purpose of this study was to compare TIVA versus VGA in patients with combat-related traumatic brain injury. Methods The authors retrospectively reviewed 252 patients who had traumatic brain injury and underwent operative neurosurgical intervention. Statistical analyses, including propensity score and matched analyses, were performed to assess differences between treatment groups (TIVA vs. VGA) and good neurologic outcome. Results Two hundred fourteen patients met inclusion criteria and were analyzed; 120 received VGA and 94 received TIVA. Good neurologic outcome (Glasgow Outcome Score 4-5) and decreased mortality were associated with TIVA compared with VGA (75% vs. 54%; P = 0.002 and 5% vs. 16%; P = 0.02, respectively). Multivariate logistic regression found admission Glasgow Coma Scale score of 8 or greater (odds ratio, 13.3; P < 0.001) and TIVA use (odds ratio, 2.3; P = 0.05) to be associated with good neurologic outcomes. After controlling for confounding factors using propensity analysis and repeated one-to-one matching of patients receiving TIVA with those receiving VGA with regard to Injury Severity Score, Glasgow Coma Scale score, base deficit, Head Abbreviated Injury Score, and craniectomy or craniotomy, the authors could not find an association between treatment and neurologic outcome. Conclusion Total intravenous anesthesia often including ketamine was not associated with improved neurologic outcome compared with VGA. Multiple confounders limit conclusions that can be drawn from this retrospective study.

scholarly journals Eye hydrodynamics in children subject to total intravenous anesthesia

2019 ◽  
Vol 12 (1) ◽  
pp. 70-74
Author(s):  
L. S. Khamraeva ◽  
L. Yu. Bobokha ◽  
N. Sh. Akhmedova
Keyword(s):  
Intraocular Pressure ◽  
Postoperative Complications ◽  
Antihypertensive Therapy ◽  
Aqueous Humor ◽  
Aqueous Humour ◽  
Objective Assessment ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Ophthalmic Drug ◽  
Endotracheal Anesthesia

Purpose: to study eye hydrodynamics in children subjected to total intravenous anesthesia during ophthalmic operations. Materials and methods. 50 children (100 eyes) aged 15 days to 14 years were examined. 21 children showed impaired hydrodynamics while the remaining 29 had no hydrodynamic disorders. All patients received combined endotracheal anesthesia for ophthalmic operations.Results. The patients with undisturbed hydrodynamics showed a significant increase in true intraocular pressure (Po) (by 3.8 ± 0.12 mm Hg) after an injection of anesthesia with ketamine, due to a significant increase in aqueous humor production. Children with disturbed hydrodynamics, who received an antihypertensive ophthalmic drug (arutimol 0.25–0.5 %), after an injection of anesthesia with fentanyl, showed a significant Po decrease (by 3.9 ± 0.12 mm Hg) due to a significant increase of outflow facility rate (C) and a decrease in aqueous humour volume (F). The patients who received no antihypertensive therapy showed a significant decrease in Po (by 2.08 ± 0.7 mm Hg) due to a significant increase in C. In contrast, the decrease in F proved to be insignificant.Conclusion. For an objective assessment of tonographic  parameters in children with impaired eye hydrodynamics who received antihypertensive therapy (arutimol 0.25–0.5 %) and anesthesized with fentanyl, we recommend that the Po indices be adjusted  upwards by 3.9 ± 0.12 mm Hg, without arutimol by 2.08 ± 0.7 mm Hg, which will help in choosing the type and volume of antiglaucomatous operations. It is also necessary to take into account the increase in Po under the action of ketamine (by 3.8 ± 0.12 mm Hg) in children with undisturbed eye hydrodynamics to prevent possible intra- and postoperative complications.

scholarly journals Volatile versus Total Intravenous Anesthesia for Cancer Prognosis in Patients Having Digestive Cancer Surgery

2020 ◽  
Vol 133 (4) ◽  
pp. 764-773 ◽  
Author(s):  
Kanako Makito ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi ◽  
Hideo Yasunaga
Keyword(s):  
Hazard Ratio ◽  
Cancer Surgery ◽  
Cancer Prognosis ◽  
Total Intravenous Anesthesia ◽  
Recurrence Free Survival ◽  
Intravenous Anesthesia ◽  
Free Survival ◽  
Anesthesia Group ◽  
Volatile Anesthesia ◽  
Type Of Surgery

Background Previous experimental and clinical studies have shown that anesthetic agents have varying effects on cancer prognosis; however, the results were inconsistent among these studies. The authors compared overall and recurrence-free survival in patients given volatile or intravenous anesthesia for digestive tract cancer surgery. Methods The authors selected patients who had elective esophagectomy, gastrectomy, hepatectomy, cholecystectomy, pancreatectomy, colectomy, and rectal cancer surgery from July 2010 to March 2018 using the Japanese Diagnosis Procedure Combination database. Patients were divided into a volatile anesthesia group (desflurane, sevoflurane, or isoflurane with/without nitrous oxide) and a propofol-based total intravenous anesthesia group. The authors hypothesized that total intravenous anesthesia is associated with greater overall and recurrence-free survival than volatile anesthesia. Subgroup analyses were performed for each type of surgery. Results The authors identified 196,303 eligible patients (166,966 patients in the volatile anesthesia group and 29,337 patients in the propofol-based total intravenous anesthesia group). The numbers (proportions) of death in the volatile anesthesia and total intravenous anesthesia groups were 17,319 (10.4%) and 3,339 (11.4%), respectively. There were no significant differences between the two groups in overall survival (hazard ratio, 1.02; 95% CI, 0.98 to 1.07; P = 0.28) or recurrence-free survival (hazard ratio, 0.99; 95% CI, 0.96 to 1.03; P = 0.59), whereas instrumental variable analyses showed a slight difference in recurrence-free survival (hazard ratio, 0.92; 95% CI, 0.87 to 0.98; P = 0.01). Subgroup analyses showed no significant difference in overall or recurrence-free survival between the groups in any type of surgery. Conclusions Overall and recurrence-free survival were similar between volatile and intravenous anesthesia in patients having digestive tract surgery. Selection of the anesthetic approach for these patients should be based on other factors. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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