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Ian Shrier - One of the best experts on this subject based on the ideXlab platform.
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Desflurane does not accelerate recovery from operations of short duration: a practice audit.
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2004Co-Authors: Michael J. Tessler, Antoine Rochon, Ian ShrierAbstract:Purpose Desflurane, a newer Inhalation Anesthetic Agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon’s elective laparoscopic cholecystectomy patients.
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Desflurane does not accelerate recovery from operations of short duration: a practice audit
Canadian Journal of Anesthesia, 2004Co-Authors: Michael J. Tessler, Antoine Rochon, Ian ShrierAbstract:Purpose Desflurane, a newer Inhalation Anesthetic Agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon’s elective laparoscopic cholecystectomy patients. Methods With Institutional consent, we performed a retrospective comparison of the postoperative recovery of patients who received desflurane/air/oxygen to historical control patients who received isoflurane/N_2O/oxygen. Results Patient preoperative characteristics were similar in the two groups. Duration of surgery and the time from the end of surgery to patient leaving the operating room for the desflurane and isoflurane/N_2O groups were (in minutes) 42.7 ± 13.5 and 9.6 ±4.6 vs 47.2 ± 15.1 and 8.5 ± 4.1 respectively ( P = NS). Total Aldrete scores upon presentation to the postanesthesia care unit (PACU) were 8.1 ± 1.4 and 7.9 ± 1.8 for the two groups respectively ( P = NS). The percentage of patients who arrived in the PACU with consciousness scores of 2, 1, 0 for the desflurane and isoflurane/N_2O groups were 20.4, 75.5, and 4.1 vs 14.6, 73.2 and 12.2 respectively ( P = NS). Mean length of stay in the PACU for the two groups was 160 ± 111 and 156 ± 114 min ( P = NS). Conclusion: Our results show that in short procedures the use of desflurane does not necessarily result in faster patient recovery or discharge from the PACU. Objectif Le desflurane, nouvel anesthésique d’Inhalation, est reconnu comme un médicament supérieur parce qu’il permet un réveil postanesthésique plus rapide. Mais cela ne vaut que pour des opérations de longue durée, c’est-à-dire plus d’une heure. Nous avons évalué notre expérience de l’utilisation du desflurane pour des opérations de courte durée en procédant à l’analyse rétrospective des cas réglés de cholécystectomie laparoscopique d’un seul chirurgien. Méthode Une fois obtenu l’accord de l’institution, nous avons réalisé une comparaison rétrospective de la récupération postopératoire des patients ayant reçu desflurane/air/oxygène ou, dans le cas des patients témoins historiques, isoflurane/N_2O/oxygène. Résultats Les caractéristiques préopératoires des patients étaient comparables dans les deux groupes. La durée de l’opération et le temps écoulé entre la fin de l’opération et le départ du patient vers la salle de réveil (SDR) ont été, pour l’utilisation du desflurane et de l’isoflurane/N_2O respectivement, de (en minutes) 42,7 ± 13,5 et de 9,6 ± 4,6 vs 41,2 ± 15,1 et de 8,5 ± 4,1 (P = NS). Les scores totaux d’AIdrete à l’arrivée en SDR ont été de 8,1 ± 1,4 et de 7,9 ± 1,8 pour les deux groupes respectivement (P = NS). Le pourcentage de patients arrivés à la SDR avec des scores de conscience de 2, 1,0 pour le desflurane et l’isoflurane/N_2O ont été de 20,4, 75,5 et 4,1 vs 14,6, 73,2 et 12,2 respectivement (P = NS). Le séjour moyen en SDR a été de 160 ± 111 et de 156 ± 114 min (P = NS). Conclusion Nos résultats montrent que l’usage du desflurane pour des opérations de courte durée ne conduit pas nécessairement à une récupération plus rapide ou à un départ plus hâtif de la SDR.
Michael J. Tessler - One of the best experts on this subject based on the ideXlab platform.
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Desflurane does not accelerate recovery from operations of short duration: a practice audit.
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2004Co-Authors: Michael J. Tessler, Antoine Rochon, Ian ShrierAbstract:Purpose Desflurane, a newer Inhalation Anesthetic Agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon’s elective laparoscopic cholecystectomy patients.
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Desflurane does not accelerate recovery from operations of short duration: a practice audit
Canadian Journal of Anesthesia, 2004Co-Authors: Michael J. Tessler, Antoine Rochon, Ian ShrierAbstract:Purpose Desflurane, a newer Inhalation Anesthetic Agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon’s elective laparoscopic cholecystectomy patients. Methods With Institutional consent, we performed a retrospective comparison of the postoperative recovery of patients who received desflurane/air/oxygen to historical control patients who received isoflurane/N_2O/oxygen. Results Patient preoperative characteristics were similar in the two groups. Duration of surgery and the time from the end of surgery to patient leaving the operating room for the desflurane and isoflurane/N_2O groups were (in minutes) 42.7 ± 13.5 and 9.6 ±4.6 vs 47.2 ± 15.1 and 8.5 ± 4.1 respectively ( P = NS). Total Aldrete scores upon presentation to the postanesthesia care unit (PACU) were 8.1 ± 1.4 and 7.9 ± 1.8 for the two groups respectively ( P = NS). The percentage of patients who arrived in the PACU with consciousness scores of 2, 1, 0 for the desflurane and isoflurane/N_2O groups were 20.4, 75.5, and 4.1 vs 14.6, 73.2 and 12.2 respectively ( P = NS). Mean length of stay in the PACU for the two groups was 160 ± 111 and 156 ± 114 min ( P = NS). Conclusion: Our results show that in short procedures the use of desflurane does not necessarily result in faster patient recovery or discharge from the PACU. Objectif Le desflurane, nouvel anesthésique d’Inhalation, est reconnu comme un médicament supérieur parce qu’il permet un réveil postanesthésique plus rapide. Mais cela ne vaut que pour des opérations de longue durée, c’est-à-dire plus d’une heure. Nous avons évalué notre expérience de l’utilisation du desflurane pour des opérations de courte durée en procédant à l’analyse rétrospective des cas réglés de cholécystectomie laparoscopique d’un seul chirurgien. Méthode Une fois obtenu l’accord de l’institution, nous avons réalisé une comparaison rétrospective de la récupération postopératoire des patients ayant reçu desflurane/air/oxygène ou, dans le cas des patients témoins historiques, isoflurane/N_2O/oxygène. Résultats Les caractéristiques préopératoires des patients étaient comparables dans les deux groupes. La durée de l’opération et le temps écoulé entre la fin de l’opération et le départ du patient vers la salle de réveil (SDR) ont été, pour l’utilisation du desflurane et de l’isoflurane/N_2O respectivement, de (en minutes) 42,7 ± 13,5 et de 9,6 ± 4,6 vs 41,2 ± 15,1 et de 8,5 ± 4,1 (P = NS). Les scores totaux d’AIdrete à l’arrivée en SDR ont été de 8,1 ± 1,4 et de 7,9 ± 1,8 pour les deux groupes respectivement (P = NS). Le pourcentage de patients arrivés à la SDR avec des scores de conscience de 2, 1,0 pour le desflurane et l’isoflurane/N_2O ont été de 20,4, 75,5 et 4,1 vs 14,6, 73,2 et 12,2 respectivement (P = NS). Le séjour moyen en SDR a été de 160 ± 111 et de 156 ± 114 min (P = NS). Conclusion Nos résultats montrent que l’usage du desflurane pour des opérations de courte durée ne conduit pas nécessairement à une récupération plus rapide ou à un départ plus hâtif de la SDR.
Antoine Rochon - One of the best experts on this subject based on the ideXlab platform.
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Desflurane does not accelerate recovery from operations of short duration: a practice audit.
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2004Co-Authors: Michael J. Tessler, Antoine Rochon, Ian ShrierAbstract:Purpose Desflurane, a newer Inhalation Anesthetic Agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon’s elective laparoscopic cholecystectomy patients.
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Desflurane does not accelerate recovery from operations of short duration: a practice audit
Canadian Journal of Anesthesia, 2004Co-Authors: Michael J. Tessler, Antoine Rochon, Ian ShrierAbstract:Purpose Desflurane, a newer Inhalation Anesthetic Agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon’s elective laparoscopic cholecystectomy patients. Methods With Institutional consent, we performed a retrospective comparison of the postoperative recovery of patients who received desflurane/air/oxygen to historical control patients who received isoflurane/N_2O/oxygen. Results Patient preoperative characteristics were similar in the two groups. Duration of surgery and the time from the end of surgery to patient leaving the operating room for the desflurane and isoflurane/N_2O groups were (in minutes) 42.7 ± 13.5 and 9.6 ±4.6 vs 47.2 ± 15.1 and 8.5 ± 4.1 respectively ( P = NS). Total Aldrete scores upon presentation to the postanesthesia care unit (PACU) were 8.1 ± 1.4 and 7.9 ± 1.8 for the two groups respectively ( P = NS). The percentage of patients who arrived in the PACU with consciousness scores of 2, 1, 0 for the desflurane and isoflurane/N_2O groups were 20.4, 75.5, and 4.1 vs 14.6, 73.2 and 12.2 respectively ( P = NS). Mean length of stay in the PACU for the two groups was 160 ± 111 and 156 ± 114 min ( P = NS). Conclusion: Our results show that in short procedures the use of desflurane does not necessarily result in faster patient recovery or discharge from the PACU. Objectif Le desflurane, nouvel anesthésique d’Inhalation, est reconnu comme un médicament supérieur parce qu’il permet un réveil postanesthésique plus rapide. Mais cela ne vaut que pour des opérations de longue durée, c’est-à-dire plus d’une heure. Nous avons évalué notre expérience de l’utilisation du desflurane pour des opérations de courte durée en procédant à l’analyse rétrospective des cas réglés de cholécystectomie laparoscopique d’un seul chirurgien. Méthode Une fois obtenu l’accord de l’institution, nous avons réalisé une comparaison rétrospective de la récupération postopératoire des patients ayant reçu desflurane/air/oxygène ou, dans le cas des patients témoins historiques, isoflurane/N_2O/oxygène. Résultats Les caractéristiques préopératoires des patients étaient comparables dans les deux groupes. La durée de l’opération et le temps écoulé entre la fin de l’opération et le départ du patient vers la salle de réveil (SDR) ont été, pour l’utilisation du desflurane et de l’isoflurane/N_2O respectivement, de (en minutes) 42,7 ± 13,5 et de 9,6 ± 4,6 vs 41,2 ± 15,1 et de 8,5 ± 4,1 (P = NS). Les scores totaux d’AIdrete à l’arrivée en SDR ont été de 8,1 ± 1,4 et de 7,9 ± 1,8 pour les deux groupes respectivement (P = NS). Le pourcentage de patients arrivés à la SDR avec des scores de conscience de 2, 1,0 pour le desflurane et l’isoflurane/N_2O ont été de 20,4, 75,5 et 4,1 vs 14,6, 73,2 et 12,2 respectivement (P = NS). Le séjour moyen en SDR a été de 160 ± 111 et de 156 ± 114 min (P = NS). Conclusion Nos résultats montrent que l’usage du desflurane pour des opérations de courte durée ne conduit pas nécessairement à une récupération plus rapide ou à un départ plus hâtif de la SDR.
Hyoseok Na - One of the best experts on this subject based on the ideXlab platform.
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retrospective comparison between the effects of propofol and Inhalation Anesthetic Agent on postoperative recurrence rate of early and intermediate stage hepatocellular carcinoma
Medical Principles and Practice, 2020Co-Authors: Ahyoung Oh, Hyoseok NaAbstract:OBJECTIVE: Previous studies have reported that propofol has anti-tumor, anti-inflammatory, and anti-oxidative effects in addition to its Anesthetic properties. To confirm this, a retrospective investigation was conducted to determine whether different Anesthetic Agents-in particular, propofol and Inhalation Anesthetic Agent-have an effect on the recurrence of hepatocellular carcinoma (HCC) in patients who were diagnosed with primary HCC and underwent laparoscopic hepatectomy. SUBJECTS AND METHODS: Patients with Barcelona Clinic Liver Cancer stages 0, A, and B HCC, who underwent laparoscopic hepatic resection, were enrolled in this study. Postoperative HCC recurrence, which was determined from postoperative liver computed tomography, was evaluated for 24 months postoperatively according to the main Anesthetic Agents. The characteristics of HCC and other patient- or surgery-related variables were evaluated together. RESULTS AND CONCLUSION: During a 24-month period after hepatic resection, there was less recurrence of HCC in the propofol group than in the Inhalation group (P = 0.046). The mean time to recurrence was 20.8 months (95% CI, 19.7-22.0) and 19.1 months (95% CI, 17.8-20.4) in the propofol and the Inhalation group, respectively. In addition, multivariable Cox proportional regression analysis revealed that the propofol group showed significantly decreased recurrence rate than did the Inhalation group (hazard ratio, 0.57; 95% CI, 0.47-0.69; P = 0.029). When propofol had been used as the main general Anesthetic Agent for laparoscopic hepatic resection, the postoperative two-year recurrence rate had decreased in early- and intermediate-stage HCC.
Junke Wang - One of the best experts on this subject based on the ideXlab platform.
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Chronic exposure of gestation rat to sevoflurane impairs offspring brain development
Neurological Sciences, 2011Co-Authors: Yuheng Wang, Yongxia Cheng, Xiao-dan Tian, Xuefeng Tu, Junke WangAbstract:Recently it was demonstrated that the exposure of the developing brain during the period of synaptogenesis to drugs that block NMDA glutamate receptors can trigger widespread apoptotic neurodegeneration. Sevoflurane is a new Inhalation Anesthetic Agent commonly used in the clinic. Here we address whether sevoflurane could induce neurotoxicity in the developing brain. Sevoflurane was administered to rats before pregnancy and pregnant rats on embryonic days E6, E10, E14, and E18 1MAC for 6 h, and we employed histopathological, immunochemistry, semiquantitative RT-PCR, and Western blot to investigate the effect of the exposure of pregestation and gestation rats to sevoflurane on the offspring brain development. The results showed that the exposure of gestation but not pregestation rats to sevoflurane-induced extensive apoptotic neurodegeneration in the hippocampus of offspring at P0, P7, and P14, accompanied by altered expression of casepase-3, GAP-43, nNOS, NMDAR1, NMDAR2A, and NMDAR2B. Furthermore, upregulation of PKCα and p-JNK and downregulation of p-ERK and FOS protein levels were observed in the hippocampus of offspring at P0, P7, and P14 from rats exposed to sevoflurane at gestation, but not pregestation. In summary, our data suggest that sevoflurane induces developmental neurotoxicity in rats and this may be attributed to the upregulation of PKCα and p-JNK and downregulation of p-ERK and FOS protein in the hippocampus.