Pub Date : 2022-12-31DOI: 10.23937/2377-4630/1410147
Neymark Dmitry
{"title":"Automation of Anesthesiology - Will Artificial Intelligence Replace Clinicians","authors":"Neymark Dmitry","doi":"10.23937/2377-4630/1410147","DOIUrl":"https://doi.org/10.23937/2377-4630/1410147","url":null,"abstract":"","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42283900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.23937/2377-4630/1410141
Ibekwe Stephanie Opusunju, Jeffrey Noel Shaheen, Schwenke Shannon Walter
{"title":"Intraoperative Transesophageal Echocardiography Leading to Changes in Surgical Management in the Setting of Infective Endocarditis","authors":"Ibekwe Stephanie Opusunju, Jeffrey Noel Shaheen, Schwenke Shannon Walter","doi":"10.23937/2377-4630/1410141","DOIUrl":"https://doi.org/10.23937/2377-4630/1410141","url":null,"abstract":"","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47315130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.23937/2377-4630/1410136
Ayres Marina D, Ferreira Luana A, Khouri Davi B, Ubaldo José L
Purpose of review: This is a short review describing recent data on the use of opioids in epidural anesthesia on abdominal surgery. It is known that postoperative pain has nociceptive, inflammatory and neuropathic components and must be prevented. The period following abdominal surgery is particularly challenging because it has other side effects related to the surgery, in addition to pain. Limiting these unwanted consequences requires a multidisciplinary team. Opioids remain the leading postoperative pain management drugs despite their known side effects, which are dose-dependent and may vary according to the route of administration. Sedation, dizziness, nausea, vomiting, and constipation are often related to opioid use. Since constipation or ileum are also directly related to abdominal surgery, temporary changes in gastrointestinal motility are inevitable after open surgeries. As such, there is concern that opioid-based anesthesia could make it worse and even increase postoperative morbidity and mortality. Recent findings: Several studies involving open colorectal surgery have shown that epidural analgesia, with or without opioid administration, is more effective in treating postoperative pain than intravenous analgesia, thus, this article intends to conduct a literature review to assess whether the association of opioids and local anesthetics in epidural analgesia for colorectal surgery increases the incidence and intensity of postoperative ileus. Summary: This review found no convincing evidence that the use of intrathecal opioids increases the incidence of postoperative ileus, in addition, it was shown to be an effective pain management tool, as expected.
{"title":"Epidural Anesthesia with Opioids in Open Colorectal Surgeries is not Related to Postoperative Ileum","authors":"Ayres Marina D, Ferreira Luana A, Khouri Davi B, Ubaldo José L","doi":"10.23937/2377-4630/1410136","DOIUrl":"https://doi.org/10.23937/2377-4630/1410136","url":null,"abstract":"Purpose of review: This is a short review describing recent data on the use of opioids in epidural anesthesia on abdominal surgery. It is known that postoperative pain has nociceptive, inflammatory and neuropathic components and must be prevented. The period following abdominal surgery is particularly challenging because it has other side effects related to the surgery, in addition to pain. Limiting these unwanted consequences requires a multidisciplinary team. Opioids remain the leading postoperative pain management drugs despite their known side effects, which are dose-dependent and may vary according to the route of administration. Sedation, dizziness, nausea, vomiting, and constipation are often related to opioid use. Since constipation or ileum are also directly related to abdominal surgery, temporary changes in gastrointestinal motility are inevitable after open surgeries. As such, there is concern that opioid-based anesthesia could make it worse and even increase postoperative morbidity and mortality. Recent findings: Several studies involving open colorectal surgery have shown that epidural analgesia, with or without opioid administration, is more effective in treating postoperative pain than intravenous analgesia, thus, this article intends to conduct a literature review to assess whether the association of opioids and local anesthetics in epidural analgesia for colorectal surgery increases the incidence and intensity of postoperative ileus. Summary: This review found no convincing evidence that the use of intrathecal opioids increases the incidence of postoperative ileus, in addition, it was shown to be an effective pain management tool, as expected.","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41870040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.23937/2377-4630/1410140
Marco Dornelles, Larissa P. Dornelles
This study aimed to report the use of a multimodal anesthetic (MA) regimen by combining a panoply of drugs without opioids for posterior spinal fusion surgery in a patient with Low-back incapacity and opioid intolerance. The surgery occurred without incidents nor do hemodynamic instabilities, except for a delay in waking up, reverse with extra doses of decurarizing. On the 13th day, she reported mild pain (VAS 2/10) and was satisfied with the result of the surgery. This case report highlights the new concept of using manifold drugs through the use a goal-direct strategies based on monitoring. Furthermore, we emphasize the use of good monitoring, such as ANI and IGP, for the success of this type of surgery. Scale; LIF: Lumbar Interbody Fusion; ALIF: Anterior Lumbar Interbody Fusion; PLIF: Posterior Lumbar Interbody Fusion; ERAS: Enhanced Recovery After Surgery; ANS: Autonomic Nervous System; OFA: Opioid-Free Anesthesia; BIS: Bispectral Index; TOF: Train-Of-Four; ANI: Analgesia Nociception Index; ICG: Impedance Cardiography; SV: Systolic Volume; HR: Heart Rate; CO: Cardiac Output; VET: Ventricular Ejection Time; MAC: Minimum Alveolar Concentration; PACU: Post-anesthesia Care Unit; AHT: Arterial Hypertension; CNS: Central Nervous System.
{"title":"Opioid Free Anesthesia with Goal-Directed Strategies Based On Monitoring For Spine Surgery in a Patient with Opioid Intolerance: A Case Report","authors":"Marco Dornelles, Larissa P. Dornelles","doi":"10.23937/2377-4630/1410140","DOIUrl":"https://doi.org/10.23937/2377-4630/1410140","url":null,"abstract":"This study aimed to report the use of a multimodal anesthetic (MA) regimen by combining a panoply of drugs without opioids for posterior spinal fusion surgery in a patient with Low-back incapacity and opioid intolerance. The surgery occurred without incidents nor do hemodynamic instabilities, except for a delay in waking up, reverse with extra doses of decurarizing. On the 13th day, she reported mild pain (VAS 2/10) and was satisfied with the result of the surgery. This case report highlights the new concept of using manifold drugs through the use a goal-direct strategies based on monitoring. Furthermore, we emphasize the use of good monitoring, such as ANI and IGP, for the success of this type of surgery. Scale; LIF: Lumbar Interbody Fusion; ALIF: Anterior Lumbar Interbody Fusion; PLIF: Posterior Lumbar Interbody Fusion; ERAS: Enhanced Recovery After Surgery; ANS: Autonomic Nervous System; OFA: Opioid-Free Anesthesia; BIS: Bispectral Index; TOF: Train-Of-Four; ANI: Analgesia Nociception Index; ICG: Impedance Cardiography; SV: Systolic Volume; HR: Heart Rate; CO: Cardiac Output; VET: Ventricular Ejection Time; MAC: Minimum Alveolar Concentration; PACU: Post-anesthesia Care Unit; AHT: Arterial Hypertension; CNS: Central Nervous System.","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43591971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.23937/2377-4630/1410135
Okeyemi Ajibade, Suleiman Zakari Aliyu, Oyedepo Olanrewaju Olubukola, Bolaji Benjamin Olusomi, Akere Abidemi David
Background: Propofol is used as an induction agent to facilitate laryngeal mask airway (LMA) insertion but unwanted responses such as drop in blood pressure, cough, laryngospasm, movement and apnoea may occur. Use of adjuvant with propofol or a combination of different synergistic pharmacologic agents that can maintain airway patency and hemodynamic parameters can be exploited to avoidance these undesirable responses and effects during LMA insertion. We compared the effects of ketaminefentanyl and propofol-fentanyl combinations on LMA insertion conditions and post-operative outcome in children undergoing herniotomy. Methods: The study was randomized double-blinded conducted on eighty ASA physical statuses I and II paediatric patients age ranged 1 to 15 years scheduled for herniotomy. The patients were grouped into two (A and B) of forty patients each and LMA was inserted following administrations of two different drug combinations. Group A received pre-mixed ketamine 2 mg/kg and fentanyl 2 μg/kg while group B received pre-mixed propofol 2.5 mg/kg and fentanyl 2 μg/kg. The quality of response to LMA placement (LMA insertion conditions) and post-operative outcome (patient recovery) was assessed. Results: The number of patients with acceptable LMA insertion conditions were comparable in both groups, p = 1.000, while incidence of apnoea was significantly greater in propofol-fentanyl group, p = 0.045 with no difference in the post-anaesthesia discharge scores between the groups, p = 0.241. Conclusion: Intravenous ketamine-fentanyl combination is a better induction agent for LMA insertion in children with acceptable LMA insertion conditions, good post-operative recovery scores and lower incidence of peri-insertion apnoea when compared with propofol-fentanyl combination.
{"title":"Effects of Ketamine-Fentanyl and Propofol-Fentanyl Combinations on LMA Insertion Conditions in African Children Undergoing Day-Case Herniotomy","authors":"Okeyemi Ajibade, Suleiman Zakari Aliyu, Oyedepo Olanrewaju Olubukola, Bolaji Benjamin Olusomi, Akere Abidemi David","doi":"10.23937/2377-4630/1410135","DOIUrl":"https://doi.org/10.23937/2377-4630/1410135","url":null,"abstract":"Background: Propofol is used as an induction agent to facilitate laryngeal mask airway (LMA) insertion but unwanted responses such as drop in blood pressure, cough, laryngospasm, movement and apnoea may occur. Use of adjuvant with propofol or a combination of different synergistic pharmacologic agents that can maintain airway patency and hemodynamic parameters can be exploited to avoidance these undesirable responses and effects during LMA insertion. We compared the effects of ketaminefentanyl and propofol-fentanyl combinations on LMA insertion conditions and post-operative outcome in children undergoing herniotomy. Methods: The study was randomized double-blinded conducted on eighty ASA physical statuses I and II paediatric patients age ranged 1 to 15 years scheduled for herniotomy. The patients were grouped into two (A and B) of forty patients each and LMA was inserted following administrations of two different drug combinations. Group A received pre-mixed ketamine 2 mg/kg and fentanyl 2 μg/kg while group B received pre-mixed propofol 2.5 mg/kg and fentanyl 2 μg/kg. The quality of response to LMA placement (LMA insertion conditions) and post-operative outcome (patient recovery) was assessed. Results: The number of patients with acceptable LMA insertion conditions were comparable in both groups, p = 1.000, while incidence of apnoea was significantly greater in propofol-fentanyl group, p = 0.045 with no difference in the post-anaesthesia discharge scores between the groups, p = 0.241. Conclusion: Intravenous ketamine-fentanyl combination is a better induction agent for LMA insertion in children with acceptable LMA insertion conditions, good post-operative recovery scores and lower incidence of peri-insertion apnoea when compared with propofol-fentanyl combination.","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46215862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
General anesthesia and regional anesthesia are the anesthetic techniques of choice for caesarian delivery. Anesthetic technique of choice is determined by several factors such as the safety of the parturient (evaluation of the airway and risk of aspiration), technical problems, the wellbeing of the fetus, and the experience of the anesthesiologist. Superiomposed preeclampsia is defined as chronic hypertension in pregnant women with gestational age > 20 weeks. When neurological manifestations arises, this condition becomes an emergency and requires immediate pregnancy termination by caesarian section. We report a case of a 42-year-old woman, 38-39 weeks pregnant, with a history of hypertension and ADHF Profile B, in an intubated state has undergone a green code caesarean section with general anesthesia using propofol 200 mg, fentanyl 100 mcg, rocuronium 50 mg. The operation lasted 50 minutes, and the patient maintained stable hemodynamics, with 300 ml blood loss. The baby was a male, born with APGAR score of 8/9, weighted 2410g. The patient was observed in the intensive care unit post-operatively. Pregnancy with superimposed preeclampsia carries a high risk of morbidity and mortality, for both the parturient and the fetus. Caesarean section with general anesthesia is preferred in superimposed preeclampsia with neurologic complications because it can achieve rapid induction, optimal airway control, and lower risk of hypotension and cardiovascular instability.
{"title":"General Anesthesia for the Gravid Patient in the Emergency Operating Room at Sanglah General Hospital","authors":"Munif Achmad, Jelita Kadek Intan, Wijaya I Nyoman Santa, Parami Pontisomaya","doi":"10.23937/2377-4630/1410134","DOIUrl":"https://doi.org/10.23937/2377-4630/1410134","url":null,"abstract":"General anesthesia and regional anesthesia are the anesthetic techniques of choice for caesarian delivery. Anesthetic technique of choice is determined by several factors such as the safety of the parturient (evaluation of the airway and risk of aspiration), technical problems, the wellbeing of the fetus, and the experience of the anesthesiologist. Superiomposed preeclampsia is defined as chronic hypertension in pregnant women with gestational age > 20 weeks. When neurological manifestations arises, this condition becomes an emergency and requires immediate pregnancy termination by caesarian section. We report a case of a 42-year-old woman, 38-39 weeks pregnant, with a history of hypertension and ADHF Profile B, in an intubated state has undergone a green code caesarean section with general anesthesia using propofol 200 mg, fentanyl 100 mcg, rocuronium 50 mg. The operation lasted 50 minutes, and the patient maintained stable hemodynamics, with 300 ml blood loss. The baby was a male, born with APGAR score of 8/9, weighted 2410g. The patient was observed in the intensive care unit post-operatively. Pregnancy with superimposed preeclampsia carries a high risk of morbidity and mortality, for both the parturient and the fetus. Caesarean section with general anesthesia is preferred in superimposed preeclampsia with neurologic complications because it can achieve rapid induction, optimal airway control, and lower risk of hypotension and cardiovascular instability.","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43443605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.23937/2377-4630/1410133
Lim Chaeseong, Pak Yujin, Park Hanmi, Lee Wonhyung, Yoon Seokhwa, Shin Yongsup
{"title":"Unexplained Intraoperative Hypertension and an Electrocautery Burn: A Case Report","authors":"Lim Chaeseong, Pak Yujin, Park Hanmi, Lee Wonhyung, Yoon Seokhwa, Shin Yongsup","doi":"10.23937/2377-4630/1410133","DOIUrl":"https://doi.org/10.23937/2377-4630/1410133","url":null,"abstract":"","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41652033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.23937/2377-4630/1410131
Gabriele F Silveira, Isadora AC Fraga, Larissa RM Castro, José Lucas UM Gomes, M. A. Delgado
{"title":"Anesthetic Immunomodulation and the Tumor Recurrence: A Narrative Literature Review","authors":"Gabriele F Silveira, Isadora AC Fraga, Larissa RM Castro, José Lucas UM Gomes, M. A. Delgado","doi":"10.23937/2377-4630/1410131","DOIUrl":"https://doi.org/10.23937/2377-4630/1410131","url":null,"abstract":"","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44264289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.23937/2377-4630/1410132
Petros K Yosief, G. G. Beraki, Susan R. Mayer, M. B. Mengistu, E. Tesfamariam
{"title":"Incidence and Risk factors of Postoperative Nausea and Vomiting after ENT Surgery","authors":"Petros K Yosief, G. G. Beraki, Susan R. Mayer, M. B. Mengistu, E. Tesfamariam","doi":"10.23937/2377-4630/1410132","DOIUrl":"https://doi.org/10.23937/2377-4630/1410132","url":null,"abstract":"","PeriodicalId":90855,"journal":{"name":"International journal of anesthetics and anesthesiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46338268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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