Sevoflurane provides faster recovery and postoperative neurological assessment than isoflurane in long-duration neurosurgical cases.

Abstract:

UNLABELLED:Sevoflurane (SEVO) provides faster emergence than isoflurane (ISO). This advantage is thought to magnify with increased duration of exposure. In addition, SEVO has several of the characteristics of an ideal neuroanesthetic. We designed a prospective, randomized, double-blinded study to compare the recovery profile of SEVO versus ISO in neurosurgery. Sixty patients undergoing intracranial surgery were enrolled. They were randomized to receive SEVO or ISO in 40% oxygen as part of a balanced anesthetic regimen. The anesthetic concentration (0.5 to 1.0 minimum alveolar anesthetic concentration [MAC]) was adjusted to maintain mean arterial blood pressure within 20% of the preinduction baseline. At the end of the surgery, neuromuscular blockade was reversed, anesthetics were discontinued without prior tapering, and fresh gas flow was increased to 10 L/min. Recovery end-points were measured as the time from closure of the anesthetic vaporizer. Mean MAC-hours were identical in both groups (4.7). Patients in the SEVO group demonstrated a shorter time to emergence (P = 0.02) and for response to command (squeeze hand, P = 0.03; move feet, P = 0.01). Patients in the SEVO group obtained a Glasgow coma scale score of >/=10 5 min before patients in the ISO group (P = 0.04). Obtaining an early neurological examination can be critical in neurosurgical patients. The observed difference in emergence between SEVO and ISO could therefore be of clinical importance. IMPLICATIONS:The low-solubility anesthetic, sevoflurane, provides faster recovery and postoperative neurological assessment than isoflurane after long-duration (4.7 MAC-h) intracranial surgery.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Gauthier A,Girard F,Boudreault D,Ruel M,Todorov A

doi

10.1097/00000539-200211000-00052

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

1384-8, table of contents

issue

5

eissn

0003-2999

issn

1526-7598

journal_volume

95

pub_type

临床试验,杂志文章,随机对照试验
  • Laparoscopic versus open myomectomy: a double-blind study to evaluate postoperative pain.

    abstract::The advantages of laparoscopic over open surgery have been documented in nonblinded settings. Our prospective, double-blind setting evaluated pain scores 72 h after surgery by comparing patients who underwent laparoscopic myomectomy or with laparotomy. Forty women referred for conservative myomectomy were included in ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000204321.85599.0d

    authors: Holzer A,Jirecek ST,Illievich UM,Huber J,Wenzl RJ

    更新日期:2006-05-01 00:00:00

  • The incidence of latex sensitivity in ambulatory surgical patients: a correlation of historical factors with positive serum immunoglobin E levels.

    abstract::Increasing reports of latex-induced anaphylaxis make preoperative identification of latex-sensitive individuals an important concern. The incidence of latex sensitivity and the efficacy of questionnaires in identifying this in ambulatory surgical populations have not been determined. To clarify these issues, 996 ambul...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199707000-00008

    authors: Lebenbom-Mansour MH,Oesterle JR,Ownby DR,Jennett MK,Post SK,Zaglaniczy K

    更新日期:1997-07-01 00:00:00

  • Incidence and Epidemiology of Perioperative Transfusion-Related Pulmonary Complications in Pediatric Noncardiac Surgical Patients: A Single-Center, 5-Year Experience.

    abstract:BACKGROUND:Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are the leading causes of transfusion-related fatalities. While these transfusion-related pulmonary complications (TRPCs) have been well detailed in adults, their burden in pediatric subsets remains poorly de...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003574

    authors: Thalji L,Thum D,Weister TJ,Weber WV,Stubbs JR,Kor DJ,Nemergut ME

    更新日期:2018-11-01 00:00:00

  • Dietary omega-3 fatty acids may be associated with increased neuropathic pain in nerve-injured rats.

    abstract:UNLABELLED:Certain dietary proteins and oils are capable of decreasing chronic neuropathic pain levels in rats after partial sciatic nerve ligation injury. We tested, for the first time, the role of dietary polyunsaturated fatty acids in suppressing pain in partial sciatic nerve ligation-injured rats. Six groups of mal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000158469.11775.52

    authors: Pérez J,Ware MA,Chevalier S,Gougeon R,Shir Y

    更新日期:2005-08-01 00:00:00

  • Within-patient variability of myogenic motor-evoked potentials to multipulse transcranial electrical stimulation during two levels of partial neuromuscular blockade in aortic surgery.

    abstract:UNLABELLED:Intraoperative recording of myogenic motor responses evoked by transcranial electrical stimulation (tcMEPs) is a method of assessing the integrity of the motor pathways during aortic surgery. To identify conditions for optimal spinal cord monitoring, we investigated the effects of manipulating the level of n...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199901000-00005

    authors: van Dongen EP,ter Beek HT,Schepens MA,Morshuis WJ,Langemeijer HJ,de Boer A,Boezeman EH

    更新日期:1999-01-01 00:00:00

  • Prehospital analgesia with acupressure in victims of minor trauma: a prospective, randomized, double-blinded trial.

    abstract:UNLABELLED:Untreated pain during the transportation of patients after minor trauma is a common problem in emergency medicine. Because paramedics usually are not allowed to perform invasive procedures or to give drugs for pain treatment, a noninvasive, nondrug-based method would be helpful. Acupressure is a traditional ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200209000-00035

    authors: Kober A,Scheck T,Greher M,Lieba F,Fleischhackl R,Fleischhackl S,Randunsky F,Hoerauf K

    更新日期:2002-09-01 00:00:00

  • A simple technique to reduce epistaxis and nasopharyngeal trauma during nasotracheal intubation in a child with factor IX deficiency having dental restoration.

    abstract::Epistaxis and airway trauma are often associated with nasotracheal intubation. We describe a patient with Factor IX deficiency who required nasotracheal intubation. An inexpensive, nonproprietary, rapid technique was used to reduce the trauma of intubation. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000133914.26066.99

    authors: Delgado AV,Sanders JC

    更新日期:2004-10-01 00:00:00

  • The effects of pentobarbital on blood-brain barrier disruption caused by intracarotid injection of hyperosmolar mannitol in rats.

    abstract:UNLABELLED:This study was performed to evaluate both the effects of pentobarbital on disruption of the blood-brain barrier (BBB) by hyperosmolar mannitol and the relationship between its effect on blood pressure and the integrity of the BBB. Under isoflurane anesthesia, rats in the control group were infused with 25% m...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199806000-00018

    authors: Chi OZ,Chun TW,Liu X,Weiss HR

    更新日期:1998-06-01 00:00:00

  • Continuous infraclavicular perineural infusion with clonidine and ropivacaine compared with ropivacaine alone: a randomized, double-blinded, controlled study.

    abstract::Although clonidine has been shown to increase the duration of local anesthetic action and prolong postoperative analgesia when included in single-injection nerve blocks, a controlled investigation of the efficacy of this practice to improve analgesia for continuous perineural local anesthetic infusion has not been rep...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ane.0000075840.52964.a7

    authors: Ilfeld BM,Morey TE,Enneking FK

    更新日期:2003-09-01 00:00:00

  • Postoperative ventilatory failure in an obese, myopathic woman with periodic somnolence: A case report.

    abstract::An obese woman with periodic sommolence developed postoperative ventilatory problems following an uncomplicated cholecystectomy. A severe myopathic process involving the respiratory muscles was found at necropsy. A brother, who died a week later, had myotonic dystrophy. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197507000-00026

    authors: Tsueda K,Shibutani K,Lefkowitz M

    更新日期:1975-07-01 00:00:00

  • The impact of oral premedication with midazolam on respiratory function in children.

    abstract:BACKGROUND:Premedication with midazolam is commonly used in children to reduce anxiety and improve cooperation before anesthesia. However, it has the potential to alter respiratory function because of its muscle relaxant properties. We assessed functional residual capacity (FRC), ventilation homogeneity, using a lung c...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181a324c3

    authors: von Ungern-Sternberg BS,Erb TO,Habre W,Sly PD,Hantos Z

    更新日期:2009-06-01 00:00:00

  • A Perioperative Evaluation of Respiratory Mechanics Using the Forced Oscillation Technique.

    abstract:BACKGROUND:The forced oscillation technique is a new approach for assessing perioperative respiratory function. METHODS:This study enrolled 40 patients undergoing general anesthesia: 20 for ≥2 hours and 20 for <2 hours. Respiratory parameters were measured the day before and after surgery using forced oscillation duri...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000720

    authors: Kuzukawa Y,Nakahira J,Sawai T,Minami T

    更新日期:2015-11-01 00:00:00

  • Patient characteristics and anesthetic technique are additive but not synergistic predictors of successful motor evoked potential monitoring.

    abstract:BACKGROUND:Spinal cord monitoring is associated with a significantly lower rate of neurologic deficits after deformity surgery, and has been shown to have predictive value in cervical, thoracic, and lumbar surgery. Lower extremity motor evoked potentials (MEPs) are particularly sensitive to anesthetics and physiologic ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181e41804

    authors: Deiner SG,Kwatra SG,Lin HM,Weisz DJ

    更新日期:2010-08-01 00:00:00

  • Cardiopulmonary bypass produces greater pulmonary than systemic proinflammatory cytokines.

    abstract::Cardiopulmonary bypass (CPB) impairs pulmonary endothelial injury in part by increasing expression of adhesion molecules that results in neutrophil influx. Although numerous proinflammatory cytokines up-regulate these responses, the extent to which systemic and pulmonary proinflammatory cytokines increase remains unkn...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200005000-00008

    authors: Kotani N,Hashimoto H,Sessler DI,Muraoka M,Wang JS,O'Connor MF,Matsuki A

    更新日期:2000-05-01 00:00:00

  • The Cognitive Science of Learning: Concepts and Strategies for the Educator and Learner.

    abstract::Education is the fundamental process used to develop and maintain the professional skills of physicians. Medical students, residents, and fellows are expected to learn considerable amounts of information as they progress toward board certification. Established practitioners must continue to learn in an effort to remai...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000000890

    authors: Weidman J,Baker K

    更新日期:2015-12-01 00:00:00

  • Anesthetic considerations for cerebral computer tomography.

    abstract::Cerebral computer tomography is a recently introduced neuroradiologic procedure involving tomographic x-rays of horizontal brain sections. Although most adults undergo the procedure without anesthesia, children and uncooperative adults must be given general anesthesia for absolute immobility. Of 84 procedures under ge...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197705000-00005

    authors: Ferrer-Brechner T,Winter J

    更新日期:1977-05-01 00:00:00

  • The hyperglycemic response to major noncardiac surgery and the added effect of steroid administration in patients with and without diabetes.

    abstract:BACKGROUND:The pattern and magnitude of the hyperglycemic response to surgical stress, the added effect of low-dose steroids, and whether these differ in diabetics and nondiabetics remain unclear. We therefore tested 2 hypotheses: (1) that diabetics show a greater increase from preoperative to intraoperative glucose co...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e318288416d

    authors: Abdelmalak BB,Bonilla AM,Yang D,Chowdary HT,Gottlieb A,Lyden SP,Sessler DI

    更新日期:2013-05-01 00:00:00

  • Preoperative Salivary Cortisol AM/PM Ratio Predicts Early Postoperative Cognitive Dysfunction After Noncardiac Surgery in Elderly Patients.

    abstract:BACKGROUND:The diagnosis of postoperative cognitive dysfunction (POCD) requires complicated neuropsychological testing and is often delayed. Possible biomarkers for early detection or prediction are essential for the prevention and treatment of POCD. Preoperative screening of salivary cortisol levels may help to identi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003740

    authors: Han Y,Han L,Dong MM,Sun QC,Zhang ZF,Ding K,Zhang YD,Mannan A,Xu YF,Ou-Yang CL,Li ZY,Gao C,Cao JL

    更新日期:2019-02-01 00:00:00

  • Hypnotic and analgesic effects of the alpha 2-adrenergic agonist dexmedetomidine in morphine-tolerant rats.

    abstract::Combinations of alpha 2 agonists and opiates are used in the clinical management of pain to harness their potential synergistic interaction for analgesia while limiting their side-effects. To better predict the clinical consequences of this combination, we studied the behavioral effects of dexmedetomidine, a highly se...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199609000-00030

    authors: Hayashi Y,Guo TZ,Maze M

    更新日期:1996-09-01 00:00:00

  • Hemodynamic dose-responses to halothane and isoflurane are different in swine with and without critical coronary artery stenosis.

    abstract::This study examined global hemodynamic responses to increasing concentrations of halothane and isoflurane in pigs with an acute critical coronary stenosis (CCS) on the left anterior descending coronary artery (LAD). The CCS was caused by graded inflation of an hydraulic occluder to the point where no hyperemic respons...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Gilbert M,Mori M,Myhre ES

    更新日期:1989-06-01 00:00:00

  • Supplemental intravenous crystalloid administration does not reduce the risk of surgical wound infection.

    abstract::Wound perfusion and oxygenation are important determinants of the development of postoperative wound infections. Supplemental fluid administration significantly increases tissue oxygenation in surrogate wounds in the subcutaneous tissue of the upper arm in perioperative surgical patients. We tested the hypothesis that...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000180217.57952.FE

    authors: Kabon B,Akça O,Taguchi A,Nagele A,Jebadurai R,Arkilic CF,Sharma N,Ahluwalia A,Galandiuk S,Fleshman J,Sessler DI,Kurz A

    更新日期:2005-11-01 00:00:00

  • A comparison of two epidural alpha 2-agonists, guanfacine and clonidine, in regard to duration of antinociception, and ventilatory and hemodynamic effects in goats.

    abstract::Epidural clonidine produces analgesia in humans with acute and chronic pain. Its use is limited because of short-lasting analgesia, hemodynamic depression, sedation, and respiratory depression. Intrathecal guanfacine has a longer duration of action than intrathecal clonidine. The present study compares these two drugs...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Smith BD,Baudendistel LJ,Gibbons JJ,Schweiss JF

    更新日期:1992-05-01 00:00:00

  • Postoperative hypoxemia after nonabdominal surgery: a frequent event not caused by nitrous oxide.

    abstract::We tested whether anesthesia that includes nitrous oxide (N2O) results in the development of intraoperative and postoperative pulmonary complications, including hypoxemia. We also tested whether aging contributes to the development of such complications, particularly when anesthesia includes N2O. We randomly allocated...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Lampe GH,Wauk LZ,Whitendale P,Way WL,Kozmary SV,Donegan JH,Eger EI 2nd

    更新日期:1990-12-01 00:00:00

  • Polymodal Mechanism for TWIK-Related K+ Channel Inhibition by Local Anesthetic.

    abstract:BACKGROUND:Local anesthetics cause reversible block of pain and robustly inhibit TWIK-related K channel (TREK-1) currents. Before local anesthesia onset, injection of local anesthetics can cause unwanted transient pain. TREK-1 is an anesthetic-sensitive potassium channel that when inhibited produces pain. A disordered ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004216

    authors: Pavel MA,Chung HW,Petersen EN,Hansen SB

    更新日期:2019-10-01 00:00:00

  • Inadvertent aortic cannulation with a pulmonary artery catheter detected by transesophageal echocardiography.

    abstract::Attempted pulmonary artery catheterization via the left internal jugular vein resulted in a misdiagnosis of pulmonary hypertension before transesophageal echocardiography revealed the catheter positioned in the ascending aorta. Inadvertent aortic cannulation through an unusual type of partial anomalous pulmonary venou...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000296459.51820.64

    authors: Siegmueller C,Bell A,Mittal T,George S

    更新日期:2008-01-01 00:00:00

  • Assessment of vaporizer performance in low-flow and closed-circuit anesthesia.

    abstract::The performance of five of the most commonly used halothane vaporizers and three enflurane vaporizers was tested under conditions encountered in low-flow and closed-circuit anesthesia. Anesthetic gas concentrations were measured continuously with a mass spectrometer connected to a circle system. The results indicated ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Lin CY

    更新日期:1980-05-01 00:00:00

  • Increased plasma concentrations of the mature form of adrenomedullin during cardiac surgery and hepatosplanchnic hypoperfusion.

    abstract::Adrenomedullin is a potent vasodilatory peptide. Plasma adrenomedullin (AM) concentrations increase during and after cardiopulmonary bypass (CPB). However, the cause of this increase and its site of production have not been identified. We investigated the role of the hepatosplanchnic and cerebral circulations in the i...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ane.0000072543.78106.aa

    authors: Yoshikawa D,Kawahara F,Okano N,Hiraoka H,Kadoi Y,Fujita N,Morita T,Goto F

    更新日期:2003-09-01 00:00:00

  • The effect of electroconvulsive treatment on thermal hyperalgesia and mechanical allodynia in a rat model of peripheral neuropathy.

    abstract:UNLABELLED:We tested the ability of electroconvulsive treatment (ECT) to block thermal hyperalgesia and mechanical allodynia in rats with peripheral neuropathy. Repeated ECT (six times daily) significantly reduced thermal hyperalgesia 48 h after the end of the final treatment but had no significant effects on mechanica...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199803000-00028

    authors: Shibata M,Wakisaka S,Inoue T,Shimizu T,Yoshiya I

    更新日期:1998-03-01 00:00:00

  • Using skin surface temperature to differentiate between complex regional pain syndrome type 1 patients after a fracture and control patients with various complaints after a fracture.

    abstract:OBJECTIVE:In this study, we assessed the validity of skin surface temperature recordings, based on various calculation methods applied to the thermographic data, to diagnose acute complex regional pain syndrome type 1 (CRPS1) fracture patients. METHODS:Thermographic recordings of the palmar/plantar side and dorsal sid...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/01.ane.0000289635.95869.70

    authors: Niehof SP,Beerthuizen A,Huygen FJ,Zijlstra FJ

    更新日期:2008-01-01 00:00:00

  • Recompression and adjunctive therapy for decompression illness: a systematic review of randomized controlled trials.

    abstract:INTRODUCTION:Decompression illness (DCI) is caused by bubble formation in the blood or tissues after a reduction in ambient pressure. Clinically, DCI may range from a trivial illness to paralysis, loss of consciousness, cardiovascular collapse, and death. Recompression is the universally accepted standard for the treat...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1213/ANE.0b013e3181cdb081

    authors: Bennett MH,Lehm JP,Mitchell SJ,Wasiak J

    更新日期:2010-09-01 00:00:00