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A El M Btarny - One of the best experts on this subject based on the ideXlab platform.
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the effect on outcome of peribulbar anaesthesia in conjunction with general Anesthesia for vitreoretinal surgery
Anaesthesia, 2010Co-Authors: Ashraf M Ghali, A El M BtarnyAbstract:Summary The purpose of this study was to evaluate peri-operative outcome after vitreoretinal surgery when peribulbar anaesthesia is combined with general anaesthesia. Sixty adult patients undergoing elective primary retinal detachment surgery with scleral buckling or an encircling procedure received either peribulbar anaesthesia in conjunction with general anaesthesia or general anaesthesia alone. For peribulbar anaesthesia a single percutaneous injection of 5–7 ml of local anaesthetic solution (0.75% ropivacaine with hyaluronidase 15 iu.ml−1) was used. The incidence of intra-operative oculocardiac reflex and surgical bleeding interfering with the surgical field, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In the block group there was a lower incidence of oculocardiac reflex and surgical bleeding intra-operatively. Patients in the block group also had better postoperative analgesia and a lower incidence of postoperative nausea and vomiting compared with the group without a block. The use of peribulbar anaesthesia in conjunction with general Anesthesia was superior to general anaesthesia alone for vitreoretinal surgery with scleral buckling.
Jiang Hua-hu - One of the best experts on this subject based on the ideXlab platform.
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EPIDURAL COMBINED INTRAVENOUS Anesthesia AND TOTAL INTRAVENOUS Anesthesia IN UPPER ABDOMINAL SURGERY
Modern Preventive Medicine, 2011Co-Authors: Jiang Hua-huAbstract:[Objective]To compare the epidural combined intravenous Anesthesia and total intravenous Anesthesia on hemodynamics,drug dosage,intravenous Anesthesia postoperative effects of waking up,restlessness and postoperative pain of patients with upper abdominal surgery.[Methods]80 patients with elective abdominal operation on a row totally were randomly divided into epidural combined with General Anesthesia Group(group A)and total intravenous anaesthesia group(Group B). We recorded the blood flow dynamics in patients with two groups at various points the dosage,intravenous Anesthesia,postoperative recovery time,number of restlessness and postoperative VAS pain score.[Results]We compared the hemodynamic changes in patients of the two groups before surgery,and there was significant difference between the two groups. MAP and HR in Group B after extubation significantly increased than the group A(P﹤0.05). The propofol,fentanyl and CIS-Atracurium dosage of benzene in Group A were significantly lower than in the B group(P﹤0.01). If patients waked early,the time of extubation was significantly reduced,number of restlessness and postoperative analgesia of good.[Conclusion]The thoracic epidural combined intravenous Anesthesia for abdominal surgery is a safe,economic,effective and conducive to fast-track Anesthesia postoperative recovery in patients with preferred methods of Anesthesia.
Ashraf M Ghali - One of the best experts on this subject based on the ideXlab platform.
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the effect on outcome of peribulbar anaesthesia in conjunction with general Anesthesia for vitreoretinal surgery
Anaesthesia, 2010Co-Authors: Ashraf M Ghali, A El M BtarnyAbstract:Summary The purpose of this study was to evaluate peri-operative outcome after vitreoretinal surgery when peribulbar anaesthesia is combined with general anaesthesia. Sixty adult patients undergoing elective primary retinal detachment surgery with scleral buckling or an encircling procedure received either peribulbar anaesthesia in conjunction with general anaesthesia or general anaesthesia alone. For peribulbar anaesthesia a single percutaneous injection of 5–7 ml of local anaesthetic solution (0.75% ropivacaine with hyaluronidase 15 iu.ml−1) was used. The incidence of intra-operative oculocardiac reflex and surgical bleeding interfering with the surgical field, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In the block group there was a lower incidence of oculocardiac reflex and surgical bleeding intra-operatively. Patients in the block group also had better postoperative analgesia and a lower incidence of postoperative nausea and vomiting compared with the group without a block. The use of peribulbar anaesthesia in conjunction with general Anesthesia was superior to general anaesthesia alone for vitreoretinal surgery with scleral buckling.
Jin Yousong - One of the best experts on this subject based on the ideXlab platform.
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Clinical Study on Inhalation Anesthesia with Sevoflurane in Infant Cleft Lip Repair Surgery
Journal of Fujian Medical University, 2009Co-Authors: Jin YousongAbstract:Objective To make a comparison between the effect of inhalation Anesthesia with sevoflurane and that of intravenous anaesthesia induced with ketamine in infant cleft lip repair surgery,and to assess the clinical value of inhalation Anesthesia with sevoflurane in the surgery. Methods Eighty patients with cleft lip and palate,American Society Anesthesiologists(ASA)Ⅰ～Ⅱ,aged 3～10 months,were randomized into two groups(n=40 each) : sevoflurane group and ketamine group.In sevoflurane group,Anesthesia was induced with sevoflurane(7%) and oxygen(3 L/min),while in ketamine group,ketamine(2.5 mg/kg) was intravenously injected.After induction,Anesthesia of the two groups was maintained by fentanyl(2 μg/kg) and vecuronium(0.1 mg/kg),and their respiration was controlled via Anesthesia machine after endotracheal intubation.Sevoflurane group was continuously exposed to 1% ～3% sevoflurane,and ketamine group was administered additional ketamine(1 mg/kg) each time.The two groups were respectively given additional fentanyl(1 μg/kg) for another time during the operation.The induction time and analepsia time were recorded.The mean arterial blood press(MAP),heart rate(HR),oxygen saturation(SpO2) and end-tidal carbon dioxide tension(PetCO2) were measured immediately before and after induction,during operation,before and after endotracheal intubation.The side effects during Anesthesia such as irritating cough,holding breathlessness,laryngeal spasm,increased secretion,restlessness or somnolence were noted.Results There were not significant differences in the induction time between the two groups(P0.05),but the analepsia time in sevoflurane group was obviously shorter than that in ketamine group(P0.01).The heart rate and MAP were lower than those in ketamine group(P0.01 respectively),while side effects in sevoflurane group were more severe compared with those in ketamine group(P0.01). Conclusion Inhalation Anesthesia with sevoflurane has great advantages over intravenous anaesthesia induced with ketamine in infant cleft lip repair surgery with its rapid induction,shorter analepsia time after operation,and less hemodynamic effects,and with no postoperative restlessness and somnolence observed,and in that it is more safe and controllable in the surgery.
Simon Courtman - One of the best experts on this subject based on the ideXlab platform.
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A follow-up survey of total intravenous Anesthesia usage in children in the U.K. and Ireland.
Paediatric anaesthesia, 2019Co-Authors: Au-chyun Nicole Goh, Oliver Bagshaw, Simon CourtmanAbstract:BACKGROUND Total intravenous Anesthesia usage in children remains relatively unpopular in the UK and Ireland. A postal survey by Hill et al in 2008 indicated that only 26% of Consultants used a propofol infusion at least once a month. AIMS Following an increase in teaching and training opportunities in pediatric total intravenous Anesthesia in the UK, we repeated the survey among Consultant members of Association of Paediatric Anaesthetists of Great Britain and Ireland and Society for Intravenous Anaesthesia, to see if this had affected total intravenous Anesthesia usage in children and how practice may have changed. METHODS We used an anonymous online survey sent to Association of Paediatric Anaesthetists of Great Britain and Ireland and Society for Intravenous Anaesthesia members. RESULTS A total of 291 responses were analyzed. Total intravenous Anesthesia was the default method of Anesthesia in 8% of respondents and a further 46% used total intravenous Anesthesia at least monthly. Overall total intravenous Anesthesia usage had increased in the past year in 53%. The main indications were malignant hyperthermia susceptibility, and postoperative nausea and vomiting. Ear/nose/throat surgery was the most popular surgical specialty. The main reasons for not using total intravenous Anesthesia were that it was too "fiddly" and lack of confidence in the user. Most respondents used propofol in combination with remifentanil. Over 80% used propofol target-controlled infusion. The potential for propofol-related infusion syndrome concerned many, with 74% limiting infusion duration as a result. Bispectral Index was not used routinely by the majority of anesthetists. Even though most anesthetists did not use total intravenous Anesthesia routinely, 98% felt they would be confident to anesthetize an malignant hyperpyrexia-positive patient using the technique. CONCLUSION This survey has shown that although total intravenous Anesthesia is not the default anesthetic technique for most anesthetists, overall usage in children has more than doubled in the past 10 years, with many happy to use it in a wide variety of patients and procedures.
