Base de dados : MEDLINE
Pesquisa : E07.858.195 [Categoria DeCS]
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[PMID]:29444393
[Au] Autor:Hallet C; Venneman I; Hans G; Bonhomme V
[Ti] Título:Two different techniques of facial mask induction of anesthesia in children provide identical intubation conditions despite different anesthetic depth.
[So] Source:Acta Anaesthesiol Belg;67(2):81-85, 2016.
[Is] ISSN:0001-5164
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sevoflurane induction in chil- dren is performed using different techniques. Constricted, centered, and symmetrical pupils (CCSP) are classically the endpoint to be achieved before laryngoscopy is performed. OBJECTIVES: We investigated whether two different inhalation induction techniques with the same clinical end- point provided similar intubating conditions and comparable depth of anesthesia as assessed by the Bispectral Index (BIS). METHODS: Following IRB approval, and informed parental consent, 20 children were recruited. They were sched- uled for general anesthesia with tracheal intubation, and randomly assigned to Group 1, where the practitioner used 6% inspired sevoflurane in 50% 02/N20, and no manually assisted ventilation, or Group 2, where inspired sevoflurane was 8% in 50% 02/N20, and ventilation was manually supported upon loss of consciousness. BIS values were blinded. Laryngoscopy was performed after CCSP. Intubation conditions scoring was based on jaw relaxation (mobile = 1, partially mobile = 2, fixed = 3), position of vocal cords (open = 1, half-closed = 2, closed = 3), and cough (no cough = 1, 1 or 2 coughing efforts = 2, persistent coughing = 3). A total score > 3 corresponded to non-optimal conditions. RESULTS: Upon CCSP, BIS values were significantly lower in Group 1 [mean (SD) : 30 (8) - 48 (18), p <0.001], despite significantly higher end-tidal sevoflurane concentration in Group 2 [mean (SD) : 5.0 (0.7) - 6.2 (0.5) ; p <0.001]. Time to CCSP was slightly shorter in Group 2. Intubation conditions were always optimal except for one patient of Group 1. DISCUSSION: Both induction techniques achieve good intubating conditions. Possible explanations for the between-group BIS difference include variable appreciation of the CCSP endpoint, different induction lengths or sevoflurane equilibration times, or sevoflurane-induced increase in electroencephalogram power. A better indicator of the best time to intubate is needed to avoid too deep anesthesia in children.
[Mh] Termos MeSH primário: Anestesia por Inalação/métodos
Intubação Intratraqueal/métodos
Máscaras
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Monitores de Consciência
Método Duplo-Cego
Eletroencefalografia
Seres Humanos
Éteres Metílicos/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Methyl Ethers); 38LVP0K73A (sevoflurane)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE


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Registro de Ensaios Clínicos
[PMID]:27775995
[Au] Autor:McCormick PJ; Levin MA; Lin HM; Sessler DI; Reich DL
[Ad] Endereço:Departments of Anesthesiology (P.J.M., M.A.L., D.L.R.), Genetics and Genomic Sciences (M.A.L.), and Population Health Science and Policy (H.-M.L.), Icahn School of Medicine at Mount Sinai, New York, New York; and Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio (D.I.S.).
[Ti] Título:Effectiveness of an Electronic Alert for Hypotension and Low Bispectral Index on 90-day Postoperative Mortality: A Prospective, Randomized Trial.
[So] Source:Anesthesiology;125(6):1113-1120, 2016 12.
[Is] ISSN:1528-1175
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We tested the hypothesis that an electronic alert for a "double low" of mean arterial pressure less than 75 mmHg and a bispectral index less than 45 reduces the primary outcome of 90-day mortality. METHODS: Adults having noncardiac surgery were randomized to receive either intraoperative alerts for double-low events or no alerts. Anesthesiologists were not blinded and not required to alter care based upon the alerts. The primary outcome was all-cause 90-day mortality. RESULTS: Patients (20,239) were randomized over 33 months, and 19,092 were analyzed. After adjusting for age, comorbidities, and perioperative factors, patients with more than 60 min of cumulative double-low time were twice as likely to die (hazard ratio, 1.99; 95% CI, 1.2 to 3.2; P = 0.005). The median number of double-low minutes (quartiles) was only slightly lower in the alert arm: 10 (2 to 30) versus 12 (2 to 34) min. Ninety-day mortality was 135 (1.4%) in the alert arm and 123 (1.3%) in the control arm. The difference in percent mortality was 0.18% (99% CI, -0.25 to 0.61). CONCLUSIONS: Ninety-day mortality was not significantly lower in patients cared for by anesthesiologists who received automated alerts to double-low states. Prolonged cumulative double-low conditions were strongly associated with mortality.
[Mh] Termos MeSH primário: Alarmes Clínicos/estatística & dados numéricos
Monitores de Consciência/estatística & dados numéricos
Hipotensão/diagnóstico
Hipotensão/mortalidade
Monitorização Intraoperatória/instrumentação
Complicações Pós-Operatórias/mortalidade
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Monitorização Intraoperatória/métodos
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:28614132
[Au] Autor:Oh TK; Eom W; Yim J; Kim N; Kwon K; Kim SE; Kim DH
[Ad] Endereço:From the *Department of Anesthesiology and Pain Medicine, National Cancer Center, Gyeonggi-do, Republic of Korea; †Department of Anesthesiology and Pain Medicine, Moonsan Central General Hospital, Gyeonggi-do, Republic of Korea; and ‡Department of Biostatistics, Korea University College of Medicine, Seongbuk-gu, Republic of Korea.
[Ti] Título:The Effect of Chronic Opioid Use on End-Tidal Concentration of Sevoflurane Necessary to Maintain a Bispectral Index Below 50: A Prospective, Single-Blind Study.
[So] Source:Anesth Analg;125(1):156-161, 2017 Jul.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Opioid analgesics decrease the minimum alveolar concentration of inhalation agents during the acute phase response. However, the effect of chronic opioid exposure on minimum alveolar concentration of inhalation agents remains unknown. This study aimed to determine the concentration of sevoflurane necessary to maintain a bispectral index (BIS) <50 (SEVOBIS50) in patients with chronic opioid use compared with those naïve to opioid use. METHODS: We included chronic opioid users who received a stable dose of oral morphine of at least 60 mg/d according to the morphine equivalent daily dose for at least 4 weeks and opioid-naïve patients. General anesthesia that included thiopental, vecuronium, and sevoflurane in oxygen was administered to all patients. Anesthesia was maintained using predetermined end-tidal sevoflurane concentrations. Fifteen minutes after achieving the determined end-tidal sevoflurane concentration through closed circuit anesthesia, BIS was measured for 1 minute in both groups. SEVOBIS50 was determined using Dixon's up-down method and probit analysis. RESULTS: Nineteen and 18 patients from the chronic opioid and control groups, respectively, were included in the final analysis. SEVOBIS50values for the chronic opioid and control patients were 0.84 (95% confidence interval, 0.58-1.11) and 1.18 (95% confidence interval, 0.96-1.40), respectively (P = .0346). CONCLUSIONS: Our results suggest that the end-tidal concentration of sevoflurane necessary to maintain a BIS <50 is lower for chronic opioid users than for opioid-naïve patients.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Anestesia Geral/métodos
Anestésicos Inalatórios/administração & dosagem
Monitores de Consciência
Estado de Consciência/efeitos dos fármacos
Éteres Metílicos/administração & dosagem
Monitorização Intraoperatória/instrumentação
Morfina/administração & dosagem
[Mh] Termos MeSH secundário: Administração por Inalação
Administração Oral
Adulto
Idoso
Analgésicos Opioides/efeitos adversos
Esquema de Medicação
Interações Medicamentosas
Feminino
Seres Humanos
Masculino
Meia-Idade
Morfina/efeitos adversos
Estudos Prospectivos
República da Coreia
Método Simples-Cego
Fatores de Tempo
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Inhalation); 0 (Methyl Ethers); 38LVP0K73A (sevoflurane); 76I7G6D29C (Morphine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000001791


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[PMID]:28514284
[Au] Autor:Du Y; Shi H; Yu J
[Ad] Endereço:Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, Inner Mongolia Autonomous Region, PR China.
[Ti] Título:Comparison in anesthetic effects of propofol among patients with different ABO blood groups.
[So] Source:Medicine (Baltimore);96(20):e5616, 2017 May.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Our study was aimed to investigate anesthetic effects of propofol in patients with different blood groups.A total of 72 participants were enrolled from patients arranged for surgeries of cholecystectomy, tonsillectomy, and spinal operation. Each blood group (A, B, AB, and O) contained 18 participants. Mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) were assayed with Philips monitor. These indexes were observed before propofol anesthesia (T0), and then were recorded when concentration of propofol was 1 µg/mL (T1), 2 µg/mL (T2), 3 µg/mL (T3), and 4 µg/mL (T4). The differences in MAP, HR, and BIS at T0 among groups were compared with the χ test. Multiple comparisons were adopted to calculate the differences in MAP, HR, and BIS between groups at T1, T2, T3, and T4.No significant differences in age, sex, and weight of all groups were found (P > .05). Before propofol anesthesia (T0), all the participants exhibited no differences in MAP, HR, and BIS (P > .05). Subsequently, we found obvious differences in ΔMAP, ΔHR, and ΔBIS between groups. The patients in the B blood group showed highest ΔMAP and ΔHR at each time point (P < .05 for both). As for ΔBIS, patients in A blood group exhibited highest value at T3 and T4 (P < .05).The blood group remarkably affects the anesthetic effects of propofol.
[Mh] Termos MeSH primário: Sistema do Grupo Sanguíneo ABO
Anestésicos Intravenosos/uso terapêutico
Propofol/uso terapêutico
[Mh] Termos MeSH secundário: Pressão Arterial/efeitos dos fármacos
Biomarcadores Farmacológicos/sangue
Colecistectomia
Monitores de Consciência
Feminino
Frequência Cardíaca/efeitos dos fármacos
Seres Humanos
Masculino
Meia-Idade
Monitorização Intraoperatória
Procedimentos Ortopédicos
Coluna Vertebral/cirurgia
Tonsilectomia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (ABO Blood-Group System); 0 (Anesthetics, Intravenous); 0 (Biomarkers, Pharmacological); YI7VU623SF (Propofol)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000005616


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[PMID]:28422877
[Au] Autor:Choi JB; Na SH; Lee SY; Kim JY; Park SY; Kim JE; Hong S; An J; Park CH; Kim YC; Park WY
[Ad] Endereço:aDepartment of Anesthesiology and Pain Medicine, Ajou University, College of Medicine, Suwon bDepartment of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul cDepartment of Anesthesiology and Pain Medicine, Gwangmyeong Saeum Hospital, Gwangmyeong, Korea dDepartment of Anesthesia, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates eDepartment of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
[Ti] Título:Suxamethonium induces a prompt increase in the bispectral index.
[So] Source:Medicine (Baltimore);96(16):e6670, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Upon inducting general anesthesia in the operating room, we have observed a prompt increase in the bispectral index (BIS) after the intravenous injection of suxamethonium. We hypothesized that the cause of this BIS increase is muscle hyperactivity owing to fasciculation. However, no reports have been published regarding this abrupt increase in the BIS upon the induction of general anesthesia by suxamethonium. To investigate the degree of change in the BIS in patients receiving anesthesia with suxamethonium, we performed a prospective observational study of 63 participants who underwent closed reduction for nasal bone fracture. Anesthesia was induced by the total intravenous administration of anesthetics and 1.5 mg kg of suxamethonium was injected intravenously upon achieving BIS between 45 and 55. Intubation was performed after fasciculation. Electromyograms and BIS values were recorded from the induction of suxamethonium until 15 minutes after intubation. The mean BIS values were 95.4, 48.5, and 69.3 before induction, before the intravenous injection of suxamethonium, and immediately after fasciculation, respectively. The BIS value immediately after fasciculation (69.3 ±â€Š10.6) was significantly higher than the cutoff BIS value of 60 (P < .001). Although fasciculation after the intravenous injection of suxamethonium resulted in the prompt increase of the BIS to values over 60, none of the participants was awake during surgery. In conclusion, the administration of suxamethonium resulted in the postfasciculation increase of the BIS to an average value of 69.3 without affecting the patient's state of consciousness.
[Mh] Termos MeSH primário: Monitores de Consciência
Fasciculação/fisiopatologia
Succinilcolina/farmacologia
Inconsciência/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Anestesia Geral/métodos
Anestésicos Intravenosos
Eletroencefalografia
Eletromiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anesthetics, Intravenous); J2R869A8YF (Succinylcholine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006670


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[PMID]:28378573
[Au] Autor:He W; Huang RR; Shi QY; Liu XB; Wang JA; Yan M
[Ad] Endereço:Department of Anesthesia, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
[Ti] Título:Bispectral index-guided sedation in transfemoral transcatheter aortic valve implantation: a retrospective control study.
[So] Source:J Zhejiang Univ Sci B;18(4):353-359, 2017 Apr..
[Is] ISSN:1862-1783
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Transcatheter aortic valve implantation (TAVI) is a minimally invasive therapy for elderly patients with severe aortic valve stenosis who were refused surgical aortic valve replacement because of the high perioperative risk. Traditionally, this procedure has been done under general anesthesia, but more recently local anesthesia and sedation have become popular. This research assessed the effectiveness of transfemoral TAVI under bispectral index (BIS)-guided sedation. METHODS: In this single-center retrospective control analysis, clinical data, including demographic characteristics, echocardiography, periprocedural data, and main complications, were collected and assessed in 113 patients undergoing TAVI through the femoral artery under general anesthesia (GA group, n=36) and under BIS-guided sedation (SED group, n=77). RESULTS: The demographic characteristics and echocardiographic parameters between the two groups were similar (P>0.05). Two (2.6%) of patients were moved from BIS-guided sedation to general anesthesia for surgical reasons. Procedures were significantly shorter in the SED group than in the GA group ((127.10±44.43) min vs. (165.90±71.62) min, P=0.004). Patients in the SED group lost less blood and received significantly fewer red blood cells and catecholamines than those in the GA group (5.19% vs. 22.22%, P=0.017 and 67.53% vs. 97.22%, P<0.001). The length of hospital stay was significantly shorter and there were fewer pulmonary complications in the SED group than in the GA group. Thirty-day mortality was similar between the two groups. CONCLUSIONS: BIS-guided sedation is a feasible and safe approach for transfemoral TAVI. The anesthesiologist should choose the best anesthetic method according to the team's experience.
[Mh] Termos MeSH primário: Monitores de Consciência
Sedação Profunda/métodos
Substituição da Valva Aórtica Transcateter/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Anestesia Geral/métodos
Estenose da Valva Aórtica/cirurgia
Perda Sanguínea Cirúrgica
Feminino
Seres Humanos
Masculino
Monitorização Intraoperatória/métodos
Duração da Cirurgia
Estudos Retrospectivos
[Pt] Tipo de publicação:CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE
[do] DOI:10.1631/jzus.B1600522


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[PMID]:28315727
[Au] Autor:Ochiai K; Shiraishi A; Otomo Y; Koido Y; Kanemura T; Honma M
[Ad] Endereço:Department of Acute Critical Care and Disaster Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
[Ti] Título:Increasing or fluctuating bispectral index values during post-resuscitation targeted temperature management can predict clinical seizures after rewarming.
[So] Source:Resuscitation;114:106-112, 2017 May.
[Is] ISSN:1873-1570
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:AIM: To investigate whether an increasing bispectral index (BIS) value during targeted temperature management (TTM) correlates with increased clinical seizures after TTM or worse neurological prognoses after TTM. METHODS: We performed a retrospective prognostication study of patients who were treated with TTM after recovery of spontaneous circulation from cardiac arrest at a tertiary care hospital. We recorded the BIS regularly during TTM and calculated the correlations of the mean BIS values, standard deviations of the BIS values, and linear regression coefficient of the trend of the BIS values over time as index tests. Study outcomes included the occurrence of clinical seizures after TTM and unfavourable neurological outcomes (defined as a Cerebral Performance Scale score of 3-5). Receiver operating characteristics (ROC) analyses evaluated the predictability of the index tests for the study outcomes. RESULTS: Of 534 patients with post-cardiac arrest who were admitted to the intensive care unit, 103 were enrolled in this study. Thirty-one patients (30.1%) experienced sequelae in the form of clinical seizures, and 52 (50.5%) had unfavourable neurological outcomes at 30days post-resuscitation. The standard deviation (area under the ROC curve [AUC]=0.763) and the regression coefficient (AUC=0.763) had higher predictability of clinical seizures than the mean BIS value (AUC=0.657); in contrast, the low mean BIS value best predicted unfavourable neurological outcomes (AUC=0.861) compared to the standard deviation (AUC=0.532) and regression coefficient (AUC=0.501). CONCLUSION: An increase of, or greater fluctuation in, BIS during hypothermia may predict clinical seizures after TTM.
[Mh] Termos MeSH primário: Temperatura Corporal
Estado de Consciência
Hipotermia Induzida/métodos
Parada Cardíaca Extra-Hospitalar/terapia
Convulsões/etiologia
[Mh] Termos MeSH secundário: Idoso
Anestesia/métodos
Reanimação Cardiopulmonar
Monitores de Consciência
Eletroencefalografia
Feminino
Seres Humanos
Hipnóticos e Sedativos/uso terapêutico
Hipotermia Induzida/efeitos adversos
Unidades de Terapia Intensiva
Masculino
Meia-Idade
Relaxantes Musculares Centrais/uso terapêutico
Parada Cardíaca Extra-Hospitalar/complicações
Valor Preditivo dos Testes
Reaquecimento
Convulsões/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 0 (Muscle Relaxants, Central)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170320
[St] Status:MEDLINE


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[PMID]:28243855
[Au] Autor:Subramani Y; Riad W; Chung F; Wong J
[Ad] Endereço:Department of Anesthesia, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
[Ti] Título:Optimal propofol induction dose in morbidly obese patients: A randomized controlled trial comparing the bispectral index and lean body weight scalar.
[Ti] Título:Posologie optimale de propofol pour l'induction des patients obèses morbides: une étude randomisée contrôlée comparant l'indice bispectral et une échelle de poids idéal..
[So] Source:Can J Anaesth;64(5):471-479, 2017 May.
[Is] ISSN:1496-8975
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Propofol dosing based on total body weight (TBW) can lead to overdosing in morbidly obese (MO) patients. Our aim was to determine whether an induction dose of propofol based on a bispectral index (BIS) target is better for achieving loss of consciousness in MO patients than dosing based on lean body weight (LBW). METHODS: Sixty MO patients with a body mass index (BMI) of ≥ 40 kg·m were randomized to either BIS- or LBW-based propofol dosing groups. Anesthesia was induced with a propofol infusion of 100 mg·kg ·hr to an initial target endpoint of a BIS of 50 (BIS group) or until a precalculated dose of 2.6 mg·kg LBW based on the Janmahasatian equation was administered (LBW group). Induction was assessed using the observer's assessment alertness/sedation scale (OAA/S). If an OAA/S score of 0 was not achieved, infusions continued until it reached 0. The groups were compared for the primary outcome which was the difference in the propofol doses at the initial target endpoint. RESULTS: The median [interquartile range] OAA/S score at the initial target endpoint was lower in the BIS group than in the LBW group (0 [0-0] vs 1 [0-3], respectively; median difference 1, 95% confidence interval [CI] 0 to 3; P = 0.001). The number of patients requiring additional propofol doses was also higher for the LBW group [1 vs 18 patients, respectively; relative risk of requiring additional propofol 18; 95% CI 3 to 126; P = 0.001]. The mean (SD) propofol dose at the target endpoint was significantly lower in the LBW group than in the BIS group [164 (36) mg vs 225 (44) mg, respectively; mean difference 61 mg; 95% CI 41 to 83 mg; P = 0.002]. There was no difference between the two groups, however, regarding the total induction dose of propofol needed for the OAA/S to reach 0 (P = 0.07). CONCLUSION: The induction dose of propofol based on the BIS index was different from the induction dose based on LBW in MO patients. Patients in the LBW group required additional propofol to achieve an OAA/S of 0.
[Mh] Termos MeSH primário: Anestésicos Intravenosos/administração & dosagem
Peso Corporal
Monitores de Consciência
Obesidade Mórbida/complicações
Propofol/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Relação Dose-Resposta a Droga
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Intravenous); YI7VU623SF (Propofol)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.1007/s12630-017-0852-x


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[PMID]:28236863
[Au] Autor:Herrero S; Carrero E; Valero R; Rios J; Fábregas N
[Ad] Endereço:Universidad de Barcelona, Hospital Clínic, Sala de Recuperación Pós-Anestésicos, Villarroel, Barcelona, Spain. Electronic address: sherrern@clinic.ub.es.
[Ti] Título:Postoperative surveillance in neurosurgical patients - usefulness of neurological assessment scores and bispectral index.
[So] Source:Braz J Anesthesiol;67(2):153-165, 2017 Mar - Apr.
[Is] ISSN:0104-0014
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: We examined the additive effect of the Ramsay scale, Canadian Neurological Scale (CNS), Nursing Delirium Screening Scale (Nu-DESC), and Bispectral Index (BIS) to see whether along with the assessment of pupils and Glasgow Coma Scale (GCS) it improved early detection of postoperative neurological complications. METHODS: We designed a prospective observational study of two elective neurosurgery groups of patients: craniotomies (CG) and non-craniotomies (NCG). We analyze the concordance and the odds ratio (OR) of altered neurological scales and BIS in the Post-Anesthesia Care Unit (PACU) for postoperative neurological complications. We compared the isolated assessment of pupils and GCS (pupils-GCS) with all the neurologic assessment scales and BIS (scales-BIS). RESULTS: In the CG (n=70), 16 patients (22.9%) had neurological complications in PACU. The scales-BIS registered more alterations than the pupils-GCS (31.4% vs. 20%; p<0.001), were more sensitive (94% vs. 50%) and allowed a more precise estimate for neurological complications in PACU (p=0.002; OR=7.15, 95% CI=2.1-24.7 vs. p=0.002; OR=9.5, 95% CI=2.3-39.4). In the NCG (n=46), there were no neurological complications in PACU. The scales-BIS showed alterations in 18 cases (39.1%) versus 1 (2.2%) with the pupils-GCS (p<0.001). Altered CNS on PACU admission increased the risk of neurological complications in the ward (p=0.048; OR=7.28, 95% CI=1.021-52.006). CONCLUSIONS: Applied together, the assessment of pupils, GCS, Ramsay scale, CNS, Nu-DESC and BIS improved early detection of postoperative neurological complications in PACU after elective craniotomies.
[Mh] Termos MeSH primário: Craniotomia/efeitos adversos
Técnicas de Diagnóstico Neurológico
Procedimentos Neurocirúrgicos/efeitos adversos
Complicações Pós-Operatórias/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Monitores de Consciência
Delírio/diagnóstico
Diagnóstico Precoce
Feminino
Escala de Coma de Glasgow
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Período Pós-Operatório
Estudos Prospectivos
Pupila/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170227
[St] Status:MEDLINE


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[PMID]:28236859
[Au] Autor:Ilyas M; Khaqan A; Iqbal J; Riaz RA
[Ad] Endereço:COMSATS Institute of Information Technology, Department of Electrical Engineering, Chak Shahzad, Pakistan.
[Ti] Título:Regulation of hypnosis in Propofol anesthesia administration based on non-linear control strategy.
[So] Source:Braz J Anesthesiol;67(2):122-130, 2017 Mar - Apr.
[Is] ISSN:0104-0014
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Continuous adjustment of Propofol in manual delivery of anesthesia for conducting a surgical procedure overburdens the workload of an anesthetist who is working in a multi-tasking scenario. Going beyond manual administration and Target Controlled Infusion, closed-loop control of Propofol infusion has the potential to offer several benefits in terms of handling perturbations and reducing the effect of inter-patient variability. This paper proposes a closed-loop automated drug administration approach to control Depth Of Hypnosis in anesthesia. In contrast with most of the existing research on anesthesia control which makes use of linear control strategies or their improved variants, the novelty of the present research lies in applying robust control strategy i.e. Sliding Mode Control to accurately control drug infusion. Based on the derived patient's model, the designed controller uses measurements from EEG to regulate DOH on Bispectral Index by controlling infusion rate of Propofol. The performance of the controller is investigated and characterized with real dataset of 8 patients undergoing surgery. Results of this in silico study indicate that for all the patients, with 0% overshoot observed, the steady state error lies in between ±5. Clinically, this implies that in all the cases, without any overdose, the controller maintains the desired DOH level for smooth conduction of surgical procedures.
[Mh] Termos MeSH primário: Anestésicos Intravenosos/administração & dosagem
Simulação por Computador
Hipnóticos e Sedativos/administração & dosagem
Propofol/administração & dosagem
[Mh] Termos MeSH secundário: Automação
Monitores de Consciência
Eletroencefalografia
Seres Humanos
Infusões Intravenosas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Intravenous); 0 (Hypnotics and Sedatives); YI7VU623SF (Propofol)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170227
[St] Status:MEDLINE



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