Abstract:
UNLABELLED: BACKGROUND:Hyperventilation may be used to hasten recovery from general anesthesia with potent inhaled anesthetics. However, its effect may be less pronounced with the newer, less soluble agents, and it may result in rehypnotization if subsequent hypoventilation occurs because more residual anesthetic will be available in the body for redistribution to the central nervous system. We used GasMan® simulations to examine these issues. METHODS:One MAC of isoflurane, sevoflurane, or desflurane was administered to a fictitious 70 kg patient for 8 h with normoventilation (alveolar minute ventilation [VA] 5 L.min-1), resulting in full saturation of the vessel rich group (VRG) and >95% saturation of the muscle group. After 8 h, agent administration was stopped, and fresh gas flow was increased to 10 L.min-1 to avoid rebreathing. At that same time, we continued with one simulation where normoventilation was maintained, while in a second simulation hyperventilation was instituted (10 L.min-1). We determined the time needed for the partial pressure in the VRG (FVRG; representing the central nervous system) to reach 0.3 MAC (MACawake). After reaching MACawake in the VRG, several degrees of hypoventilation were instituted (VA of 2.5, 1.5, 1, and 0.5 L.min-1) to determine whether FVRG would increase above 0.3 MAC(= rehypnotization). RESULTS:Time to reach 0.3 MAC in the VRG with normoventilation was 14 min 42 s with isoflurane, 9 min 12 s with sevoflurane, and 6 min 12 s with desflurane. Hyperventilation reduced these recovery times by 30, 18, and 13% for isoflurane, sevoflurane, and desflurane, respectively. Rehypnotization was observed with VA of 0.5 L.min-1 with desflurane, 0.5 and 1 L.min-1 with sevoflurane, and 0.5, 1, 1.5, and 2.5 L.min-1 with isoflurane. Only with isoflurane did initial hyperventilation slightly increase the risk of rehypnotization. CONCLUSIONS:These GasMan® simulations confirm that the use of hyperventilation to hasten recovery is marginally beneficial with the newer, less soluble agents. In addition, subsequent hypoventilation results in rehypnotization only with more soluble agents, unless hypoventilation is severe. Also, initial hyperventilation does not increase the risk of rehypnotization with less soluble agents when subsequent hypoventilation occurs. Well-controlled clinical studies are required to validate these simulations.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
De Wolf AM,Van Zundert TC,De Cooman S,Hendrickx JFdoi
10.1186/1471-2253-12-22subject
Has Abstractpub_date
2012-09-18 00:00:00pages
22issn
1471-2253pii
1471-2253-12-22journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Neuropathic pain is evasive to treat once developed, however evidence suggests that local administration of anesthetics near the time of injury reduces the development of neuropathic pain. As abnormal electrical signaling in the damaged nerve contributes to the initiation and maintenance of neuropathic pain,...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-015-0113-x
更新日期:2015-10-06 00:00:00
abstract:BACKGROUND:Data on the best norepinephrine bolus dose for management of hypotension are limited. The aim of this study was to compare the efficacy and safety of two norepinephrine bolus doses in the rescue management of maternal hypotension during cesarean delivery. METHODS:This randomized, controlled trial included m...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01004-y
更新日期:2020-04-17 00:00:00
abstract:BACKGROUND:The timing of laryngeal mask airway (LMA) removal remains undefined. This study aimed to assess the optimal timing for LMA removal and whether topical anesthesia with lidocaine could reduce airway adverse events. METHODS:This randomized controlled trial assessed one-to-six-year-old children with ASA I-II sc...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-021-01235-7
更新日期:2021-01-08 00:00:00
abstract:BACKGROUND:Transpulmonary thermodilution (TPTD) derived parameters are used to direct fluid management in ICU-patients. Extravascular lung water EVLW and its ratio to pulmonary blood volume (pulmonary vascular permeability index PVPI) have been associated with mortality. In single indicator TPTD pulmonary blood volume ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-81
更新日期:2014-09-24 00:00:00
abstract:BACKGROUND:Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between patients who received...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01212-6
更新日期:2020-11-30 00:00:00
abstract:BACKGROUND:Sugammadex, a γ-cyclodextrin derivative, belongs to a new class of selective relaxant binding agents. Sugammadex was approved 10-years ago by the European medicines agency and today is used in clinical anesthesia and emergency medicine globally. In this review, indications for neuromuscular block, the challe...
journal_title:BMC anesthesiology
pub_type: 杂志文章,评审
doi:10.1186/s12871-018-0605-6
更新日期:2018-11-06 00:00:00
abstract:BACKGROUND:Hyperthermic isolated limb perfusion (HILP) is used for patients with intractable or extensive in-transit metastatic melanoma of the limb to deliver high concentrations of cytotoxic agents to the affected limb and offers a treatment option in a disease stage with a poor prognosis when no treatment is given. ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-15
更新日期:2013-07-17 00:00:00
abstract:BACKGROUND:Bone cement implantation syndrome is a known complication causing mortality during perioperative period particularly in patients with malignancy. With rise in aging population with malignancy in low income country, the syndrome is more likely to be encountered. CASE PRESENTATION:We present a case of 66 year...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0492-x
更新日期:2018-03-02 00:00:00
abstract:BACKGROUND:Renal dysfunction following intraoperative arterial hypotension is mainly caused by an insufficient renal blood flow. It is associated with higher mortality and morbidity rates. We hypothesised that the intraoperative haemodynamics are more stable during xenon anaesthesia than during isoflurane anaesthesia i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0799-2
更新日期:2019-07-09 00:00:00
abstract:BACKGROUND:It has been hypothesized that dexamethasone can inhibit persistent postoperative pain, but data on humans is lacking and results from animal studies are conflicting. We explored the effect of 16 mg dexamethasone IV administered preoperatively on persistent pain 1 year after lumbar discectomy. METHODS:This i...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0277-z
更新日期:2016-11-16 00:00:00
abstract:BACKGROUND:Mortality from anaesthesia and surgery in many countries in Sub-Saharan Africa remain at levels last seen in high-income countries 70 years ago. With many factors contributing to these poor outcomes, the World Health Organization (WHO) launched the "Safe Surgery Saves Lives" campaign in 2007. This program in...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0228-8
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:Most trauma patients admitted to the hospital alive and die later on, decease during the initial care in the emergency department or the intensive care unit (ICU). However, a number of patients pass away after having been discharged from the ICU during the initial hospital stay. On first sight these cases co...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01159-8
更新日期:2020-09-23 00:00:00
abstract:BACKGROUND:Conventionally, ultrasonographic assessment of diaphragm contractility has involved measuring respiratory changes in diaphragm thickness (thickening fraction) using B-mode or caudal displacement with M-mode. Two-dimensional speckle-tracking has been increasingly used to assess muscle deformation ('strain') i...
journal_title:BMC anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1186/s12871-016-0201-6
更新日期:2016-07-25 00:00:00
abstract:BACKGROUND:Desflurane during early reperfusion has been shown to postcondition human myocardium, in vitro. We investigated the role of adenosine and bradykinin receptors, and generation of radical oxygen species in desflurane-induced postconditioning in human myocardium. METHODS:We recorded isometric contraction of hu...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-10-12
更新日期:2010-07-29 00:00:00
abstract:BACKGROUND:The volatile anesthetic isoflurane protects the heart from hypoxia/reperfusion (H/R) injury. However, it is still incompletely understood whether isoflurane exerts its protective role through preventing mitochondrial permeability transition pore (MPTP) opening. METHODS:Primary cultured cardiocytes were expo...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-17
更新日期:2014-03-10 00:00:00
abstract:BACKGROUND:The calcium sensitizer levosimendan is increasingly used to improve hemodynamics in patients with acutely decompensated heart failure. By binding to cardiac troponin C the conformation of the calcium-troponin C complex is stabilized, which leads to acceleration of actin-myosin crossbrigde formation and incre...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0644-z
更新日期:2018-12-03 00:00:00
abstract:BACKGROUND:The sensory innervation of the shoulder is complex and there are variations in the branching patterns of the sensory fibres. Articular branches from the axillary nerve to the subacromial bursa are described in more than 50% of investigated shoulders but the isolated contribution of sensory input from the axi...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-020-0952-y
更新日期:2020-01-31 00:00:00
abstract:BACKGROUND:The α2-adrenergic agonist dexmedetomidine (DEX) is a sedative and can be used as an adjunct to hypnotics. The study sought to evaluate the effects of different doses of DEX on the requirements for propofol for loss of consciousness (LOC) in patients monitored via the bispectral index (BIS). METHODS:In this ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01013-x
更新日期:2020-04-25 00:00:00
abstract:BACKGROUND:Rotational elastometry (ROTEM) has been shown useful to monitor coagulation in trauma patients and in major elective surgery. In this study, we aimed to evaluate the utility of ROTEM to identify hemostatic disturbances and to predict the need for transfusion, compared with standard coagulation tests (SCTs) i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0440-1
更新日期:2017-10-24 00:00:00
abstract:BACKGROUND:Embolic stroke is a common complication of atrial myxoma, whereas multiple cerebral aneurysms associated with atrial myxoma is rare. The pathogenesis of the cerebral vascular disease related to an atrial myxoma is still not well known, and there are no guidelines to guide treatment and anesthesia management ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01055-1
更新日期:2020-07-04 00:00:00
abstract:BACKGROUND:Pierre Robin Sequence (PRS) patients are known for their triad of micrognathia, glossoptosis, and airway obstruction. Their airway can be a challenge even for the most experienced pediatric anesthesiologist. CASE PRESENTATION:We report the case of a 9 day old 3.5 kg boy diagnosed with PRS, cleft palate, and...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0754-2
更新日期:2019-05-22 00:00:00
abstract:BACKGROUND:In patients with subarachnoid hemorrhage (SAH), vasospasm remains one of the major complications. The application of intravenous magnesium sulfate (MgSO4) has been under discussion to prevent cerebral ischemia. Our aim was to examine the impact of early MgSO4 administration on local cerebral microcirculation...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0435-y
更新日期:2017-10-17 00:00:00
abstract:BACKGROUND:Despite international data indicating that Enhanced Recovery After Surgery (ERAS) programs, which combine evidence-based perioperative strategies, expedite recovery after surgery, few centers have successfully adopted this approach within the U.S. We describe the implementation and efficacy of an ERAS progra...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0223-0
更新日期:2016-08-03 00:00:00
abstract:BACKGROUND:Sugammadex reverses neuromuscular block (NMB) through binding aminosteroid neuromuscular blocking agents. Although sugammadex appears to be highly selective, it can interact with other drugs, like corticosteroids. A prospective single-blinded randomized clinical trial was designed to explore the significance...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0254-6
更新日期:2016-10-21 00:00:00
abstract:BACKGROUND:McGrath MAC video laryngoscope offers excellent laryngosopic views and increases the success rate of orotracheal intubation in some cases. The aim of this study was to determine the usefulness of McGrath MAC for routine nasotracheal intubation by comparing McGrath MAC with Airway scope and Macintosh laryngos...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0451-y
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to verify whether propofol impaired learning and memory through the interplay of N-methyl-D-aspartate (NMDA) receptor with brain-derived neurotrophic factor (BDNF)-tyrosine kinase B (TrkB) signaling pathway. METHODS:120 Sprague-Dawley (SD) rats were randomly assigned into ei...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0491-y
更新日期:2018-04-05 00:00:00
abstract:BACKGROUND:Older age is associated with chronic illnesses and disability, which contribute to increased admission to the intensive care unit (ICU). Our primary objective was to compare the characteristics, ICU management and outcomes of critically ill patients ≥ 80 year-old with those of younger patients. METHODS:This...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-126
更新日期:2014-12-20 00:00:00
abstract:BACKGROUND:Many cases of coronary artery spasm (CAS) during general plus epidural anesthesia have been reported. But transversus abdominis plane(TAP) block in combination with general anesthesia has not been reported to be a cause of CAS, let alone a life-threatening CAS. CASE PRESENTATION:In this case report, we pres...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0616-3
更新日期:2018-10-20 00:00:00
abstract:BACKGROUND:Intracranial-pressure (ICP) monitoring is useful for patients with increased ICP following hemorrhagic stroke. In this study, the changes in pressure gradients between the two cerebral hemispheres were investigated after hemorrhagic stroke of one side, and after a craniotomy. METHODS:Twenty-four patients wi...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-112
更新日期:2014-12-03 00:00:00
abstract:BACKGROUND:The role of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) as a prognostic factor in patients admitted to the intensive care unit (ICU) is not yet fully established. We aimed to determine whether NT-pro-BNP is predictive of ICU mortality in a multicenter cohort of critically ill patients. METHODS:A ...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2253-14-16
更新日期:2014-03-10 00:00:00