Indian Journal of Anesthesia and Analgesia

Total Page:16

File Type:pdf, Size:1020Kb

Indian Journal of Anesthesia and Analgesia Indian Journal of Anesthesia and Analgesia Editor-in-Chief Dr. K.K. Mubarak Professor & Head, Dept. of Anaesthesiology Govt. Medical College, Kozhikode 673008, Kerala Associate Editors Lalit Gupta, Sandeep Sahu, SMH-Curie Cancer Center, Delhi Sanjay Gandhi Postgradaute Institute of Medical Mridu Paban Nath, Sciences, Lucknow Gauhati Medical College, Guwahati National Editorial Board Gaurav S. Tomar Satish G. Deshpande All India Institute of Medical Sciences, Government Medical College, New Delhi Latur Manjula Sudeep Sarkar Swarnalingam Thangavelu Seth G S MC and K E M Hospital, Tagore Medical College & Hospital, Chennai Mumbai Swati Bisht Mukesh Somvanshi Vydehi Institute of Medical Sciences, And Government Medical College & AG Hospitals, Research Centre, Bangalore Kota Uma Hariharan Naresh Ganpatrao Tirpude Dr Ram Manohar Lohia Hospital & PGIMER, Govt. Medical College, New Delhi Nagpur Vikas Chauhan Pramod Kumar All India Institute of Medical Sciences, PDU Medical College, New Delhi Rajkot Saramma P Abraham MOSC Medical College, Kolencherry International Editorial Board Amarjeet D. Patil, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom Managing Editor Publication Editor A Lal Manoj Kumar Singh Aims and Scope The Indian Journal of Anesthesia and Analgesia (IJAA) is of cial peer-reviewed scienti c journal addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. The Journal seeks a balance between outstanding basic scienti c reports and de nitive clinical and management investigations. The Journal welcomes manuscripts re ecting rigorous analysis, even if unusual in style and focus. Readership: Anesthesiologists, Critical Care Physicians and Surgeons. Of ce of Publication: Red Flower Publication Pvt. Ltd., 48/41-42, DSIDC, Pocket-II Mayur Vihar Phase-I, Delhi – 110 091(India), Phone: 91-11-22754205, 45796900, Fax: 91-11-22754205 E-mail: [email protected], Website: www.rfppl.co.in IJAA / Volume 6 Number 1 (Part - II) / January - February 2019 186 Indian Journal of Anesthesia and Analgesia Copyright Information Subscription Information For Authors The Indian Journal of Anesthesia and Analgesia is published four times a year. As soon as article is accepted for publication, authors will be requested to assign copyright of Volume 6 (6 issues) will be published in 2019 the article (or to grant exclusive publication and pISSN: 2349-8471, eISSN: 2455-6238 dissemination rights) to the publisher (respective the owner if other than Red Flower Publication For information on subscription rates please Pvt. Ltd.). This will ensure the widest possible contact protection and dissemination of information under copyright laws. Subscription and Marketing Manager Red Flower Publication Pvt. Ltd. More information about copyright regulations 48/41-42, DSIDC, Pocket-II for this journal is available at www.rfppl.co.in Mayur Vihar Phase-I Delhi - 110 091(India) For Readers Phone: 91-11-45796900, 22754205, 22756995 All the advice and information in this journal are [email protected] believed to be true and accurate at the date of its The journal is distributed free of cost to members publication. Neither the editors, nor the publisher of editorial board. Institutional subscription rates can accept any legal responsibility for any errors (India) INR 7500 and (other countries) USD586. or omissions that may have been made. The author is totaly resposible for any error or omission in All correspondence regarding individual and the article. The publisher makes no warranty, society subscriptions, subscription rates for 2019 express or implied, with respect to the material and advertisements should be addressed to: contained herein. [email protected]. All articles published in this journal are protected by copyright, which covers the Advertisement exclusive rights to reproduced and distribute the article (e.g. as offprints), as well as all translation E-mail: [email protected]. rights. No material published in this journal may be reproduced photographically or stored on micro lm, in electronic databases on video disks, Disclaimer etc, without obtaining written permission from the publisher (respective the copyright owner Red Flower Publication Pvt. Ltd. publishes if other than Red Flower Publication Pvt. Ltd.). advertisement in this journal reliance upon the The use of general descriptive names, trade responsibility of the advertiser to comply with names, trademarks, etc., in this publication, even all legal requirements relating to the marketing if not speci cally identi ed, does not imply that and sale of products or services advertised. Red these names are not protected by the relevant laws Flower Publication Pvt. Ltd. and the editors are not and regulations. responsible for claims make in the advertisement published in the journal. The appearance of © Red Flower Publication Pvt. Ltd. 2019 advertisements in Red Flower Publication Pvt. Ltd. publications does not constitute endorsement, implied or intended, of the product advertised or Red Flower Publication Pvt. Ltd. has partnered the claims make for it by the advertiser. for permission to reuse our content please locate the material that you with to use on link rfppl.co.in The views expressed in this publication do not and click on permission link and enter the title of necessarily re ect those of Red Flower Publication the publication that you wish to use. For assistance Pvt. Ltd. in placing a permission request. Red Flower Publication Pvt. Ltd. do not endorse the quality or the value of the advertised/sponsored products described therein. Journal Website http://rfppl.co.in/about_journal.php?jid=24 IJAA / Volume 6 Number 1 (Part - II) / January - February 2019 INDIAN JOURNAL OF ANESTHESIA AND ANALGESIA January - February 2019 Volume 6 Number 1 (Part - II) Contents Original Research Articles Comparison of Laryngeal Mask Airway Proseal and Supreme in Patients Posted for Elective Surgeries Under General Anaesthesia: A Randomised Clinical Trial 189 Chhaya Joshi, Preetham C, Archana E, SY Hulakund To Study and Compare Efficacy of Ropivacaine and Bupivacaine for Caudal Analgesia in Paediatric Patients 197 Aishwarya Bandewar, Alok Kumar, Manish Kokne Intrathecal Midazolam for Post Operative Pain Relief in Lower Segment Caesarean Section 207 Suman Gupta, Preeti Goyal Comparative Study of Nitroglycerin and Dexmedetomidine in Patients Undergoing Endoscopic Resection of Nasopharyngeal Fibroangioma 211 Syed Akram Moin, Thirukkovalluri Ravi Effect of Chronic Exposure to Trace Anaesthetic Gases on Plasma Homocysteine levels in Operating Room Personnel 219 Adam Amararapu, Nagaraj Gajagouni, Manasa Surampalli A Clinical Comparative Study between Caudal Levobupivacaine-Clonidine and Ropivacaine-Clonidine for Postoperative Analgesia in Paediatric Subumbilical Surgeries 227 Aiyappa DS, Janardhanan G, Pavitra Pushpa Study on Oral Nebivolol in Attenuating the Cardio Vascular Responses to Laryngoscopy and Endotracheal Intubation 235 Anil Kumar Akkenapalli A Randomised Prospective Double Blinded Study of Intrathecal Levobupivacaine with Fentanyl Verses Clonidine for Infraumblical Surgeries 241 Greeshma N Murdeshwar, HG Manjunath, Somashekara SP Comparison of Equipotent Doses of Hyperbaric Ropivacaine and Hyperbaric Levobupivacaine in Spinal Anaesthesia for Patients Undergoing Lower Abdominal and Lower Limb Surgeries 249 Gurpreet Singh, Niraj Mansukhlal Rathod, Kirti Patel Role of Intravenous Paracetamol for Peri-Operative Pain Management in Head and Neck Cancer Surgeries 255 Jayshree M Thakkar, Anupama Tomer, Priti M Patel Comparative Evaluation of Intravenous Granisetron Hydrochloride and Intravenous Lignocaine Hydrochloride to Alleviate the Pain on Propofol Injection 263 Jenish C Patel, Jayshree M Thakkar, Damini Makawana, Sanobar Khokhar, Saeed Vora, B C Shah Prediction of Difficult Intubation in Apparently Normal Patients by Combining Modified Mallampatti Test and Thyromental Distance 269 Kiran Nelamangala, Ravi Madhusudhana, Dinesh Krishnamurthy IJAA / Volume 6 Number 1 (Part - II) / January - February 2019 188 Indian Journal of Anesthesia and Analgesia Comparative Study of two doses of Magnesium Sulfate as an Adjuvant in Supraclavicular Brachial Plexus block for Post Operative Analgesia 277 Nanda S Nandyal, Gajendra Singh, KSR Murthy Intrathecal Fentanyl as an Adjuvant to Hyperbaric Bupivacaine in Lower Abdominal Surgeries - A Placebo Controlled Randomised Study 283 Naveen Kumar P, Umesh N P, Santhosh M C B Comparison of Midazolam and Propofol for Entropy - Guided Sedation During Regional Anesthesia 287 Nutan N M, Mubina Begum Bujapur, Nazeer Ahmed K, Sanjeev Birajdar To Study the N-Acetylcysteine and Vitamin C Effect on Oxidative Stress in Abdominal Sepsis and Control Patients with Different Weight Range 297 O Srinivas Kumar, M Madan Mohan Rao, G. Obulesu Comparision of Bupivacaine with and without Clonidine as for Supraclavicular Approach to Brachial Plexus Block 303 P.T. Rajya Lakshmi Devi, B. Sai Naveena Lakshmi Effect of Intrathecal Dexmedetomidine with Hyperbaric Bupivacaine Administered as Mixture and Sequentially in Lower Abdominal Procedures 311 Prithi Jain, Divya Vincent A Comparisoin of Fentanyl Citrate and Magnesium Sulphate as Adjuvants to 0.5% heavy Bupivacaine in Spinal Anaesthesia 323 Rajola Raghu, Pacharla Indira, Vanaja A Prospective Study of Thoracic Epidural
Recommended publications
  • Powering Your Performance
    POWERING YOUR PERFORMANCE B105M | B125M | B155M Modular Patient Monitors gehealthcare.com Advanced capabilities. Simple scalability. Dependable technology. B1x5M range of modular patient monitors deliver premium clinical performance across care areas. Scalable platform You can monitor essential vital signs (ECG, SpO2, Temp, NIBP, RR) and easily scale to advanced parameter modules like respiratory gases and Clinical precision anesthetic agents, NMT and Entropy™ – up to three advanced parameters simultaneously. These accurate, reliable, and easy-to-use monitors Intuitive design enable simple and intuitive workflow with a choice of 10-, 12- or 15-inch touch screen displays. B1x5M range of monitors come with Value Dependable technology Software Platform (VSP 3.0). Legacy of premium clinical performance. Excellence of advanced features. Timely clinical decisions. GE Healthcare’s more than 45 years of clinical excellence in The B1x5M range of modular patient monitors helps you quickly designing reliable patient monitoring systems provides you with take charge of patient conditions like arrhythmia and high/low advanced features, such as: blood pressure, and efficiently assess the level of consciousness. They seamlessly integrate with the CARESCAPE Ecosystem for centralized alarm management and efficient workflow. • DINAMAP™ SuperSTAT™ NIBP • EK-Pro v14 algorithm The solutions allow you to effectively monitor deteriorating • CO sidestream and cardiac output patient conditions and make timely interventions by tracking the 2 National Early Warning
    [Show full text]
  • Using Entropy in the General Anesthesia Managements
    Research Article Clinics in Surgery Published: 07 Jul, 2017 Using Entropy in the General Anesthesia Managements Elif Büyükerkmen, Remziye Gül Sivaci and Elif Doğan Baki* Departement of Anesthesiology and Reanimation, Afyon Kocatepe University, Afyonkarahisar, Turkey Abstract Purpose: We aimed to investigate the effects of three general anesthesic management on depth of anesthesia, anesthesic quality, agent consumption and postoperative recovery. Materials and Methods: 90 patients scheduled for elective tympanoplasty and septoplasty surgery with American Society of Anesthesiologist (ASA) pysical status between I-III were included in this study. Neuromuscular transmission (NMT), surgical pleth index (SPI) and entropy were monitorized in addition to standart monitoring. Entropy was recorded as state entropy (SE) and response entropy (RE). After standart anesthesia induction, patients were divided into three groups according to maintenance of anesthesia using a sealed envelope system. Propofol 3-5 mg/kg/h iv infusion was performed to Group 1 (Group P, n=30), Desflurane 1MAC was used to Group 2 (Group D, n=30) and Sevoflurane to Group 3 (Group S, n=30). Also, rocuronium and remifentanyl infusion were used in maintenance. While desflurane and sevoflurane consumption were recorded from the anesthesia directly, propofol consumption was calculated through the consumption of perfusors and recorded at the end of the surgery. Total cost of anesthetics that used were calculated by multiplying the unit price with their consumption. Apart from these, hemodynamic values of all patients, recovery time, alertness levels in the recovery room (according to Ramsey Scale) were recorded. Results: Significant differences were found between the three groups in terms of cost. While the cost of propofol was significantly lower, it was significantly higher in desfluane group.
    [Show full text]
  • The Effect of Spectral Entropy Monitoring on Propofol Use and Recovery in Children
    Anesth Pain Med 2014; 9: 138-143 ■Clinical Research■ The effect of spectral entropy monitoring on propofol use and recovery in children Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, *Myung Sung Pain Clinic, Busan, Korea Ji-yeon Lee, So Ron Choi, Chan Jong Chung, Ji Hyeon Lee, Ji-hye Park, and Chang-Yeoul Baik* Background: The evaluation of anesthetic depth using electro- use. Now, however, anesthesia depth can be measured using encephalography showed reduction in recovery time from anesthe- electroencephalography (EEG)-based devices, such as bispectral sia and decrease in the amount of anesthesia used. This research index (BIS), and spectral entropy; these monitors can indicate compared the dosage of propofol and the recovery characteristics when anesthesia was controlled using spectral entropy monitoring the level of consciousness during anesthesia [1-4]. One study and when it was controlled by hemodynamic changes. demonstrated that the control of anesthesia using BIS monitoring Methods: Seventy children of the American Society of Anesthes- decreased the anesthetic use and shortened recovery time [5]. iologists physical class I–II, ages 3–10, that were scheduled for general anesthesia were randomly distributed into two groups. The Entropy measurements reflect EEG signal irregularity. With children were sedated with midazolam (0.15 mg/kg), and anesthesia increasing anesthesia depth, EEG patterns change regularly while was induced with fentanyl (2.0 μg/kg), propofol (2.5 mg/kg), and entropy decreases. Because EEG-based monitoring systems cal- rocuronium (0.6 mg/kg). Anesthesia was maintained with propofol culate an index that reflects the hypnotic component of anest- continuous IV infusion under N2O in O2.
    [Show full text]
  • A Comparative Study Between Entropy and Clinical Response To
    Med. J. Cairo Univ., Vol. 87, No. 3, June: 2025-2031, 2019 www.medicaljournalofcairouniversity.net A Comparative Study between Entropy and Clinical Response to Determine the Requirement of Propofol for Induction of General Anesthesia in Geriatric Patients MAI A.K. NIDA, M.Sc.; WESAM F. MOUSA, M.D.; AHMED S. ELGEBALY, M.D. and HESHAM E. EL-ASHRY, M.D. The Department Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University Abstract Key Words: Entropy – Clinical response – Requirement of propofol – Geriatric patients. Background: Anesthesia under dosage causes awareness, while over dosage results in drug complications. Endotracheal intubation must be after an adequate level of anesthesia. Introduction Propofol is an IV short-acting anesthetic which causes hypo- tension in a dose dependent effect. With entropy, SE level 40- ANESTHESIA under dosage causes awareness, 60 and RE-SE difference <10 are the target during anesthesia. while over dosage results in drug complications Geriatrics are different in EEG spectral patterns than young [1] patients and are more vulnerable to complications of endotra- . Endotracheal intubation must be after an ade- cheal intubation and propofol. quate level of anesthesia as light anesthesia leads to sympathetic stimulation, laryngospasm, bron- Aim of Study: The aim of this study was to compare chospasm, and traumatization of airway and over between the conventional clinical end-point of hypnosis and entropy on the dosage requirement of propofol and hemody- dosage of anesthetics with delay in intubation leads namic during propofol induction of general anesthesia in to bradycardia, arrhythmia, hypotension and at geriatric patients. last, respiratory and cardiovascular arrest [2] .
    [Show full text]
  • Taylor V. Crawford
    Case 2:05-cv-04173-FJG Document 202-1 Filed 07/24/2006 Page 1 of 20 IN THE UNITED STATES DISTRICT COURT WESTERN DISTRICT OF MISSOURI CENTRAL DIVISION MICHAEL ANTHONY TAYLOR ) ) Plaintiff, ) ) v. ) No. 05-4173-CV-W-FJG ) LARRY CRAWFORD, et al., ) ) Defendants. ) ____________________________________) PLAINTIFF’S OPPOSITION TO DEFENDANTS’ PROPOSED PROTOCOL JOHN WILLIAM SIMON DONALD B. VERRILLI, JR. J.D., PH.D. MATTHEW S. HELLMAN GINGER D. ANDERS ERIC BERGER 2683 South Big Bend Blvd, # 12 JENNER & BLOCK LLP St. Louis, Missouri 63143 601 13th Street NW (314) 645-1776 Washington, DC 20005 FAX: (314) 645-2125 (202) 639-6000 FAX: (202) 661-4983 Counsel for Plaintiff Case 2:05-cv-04173-FJG Document 202-1 Filed 07/24/2006 Page 2 of 20 TABLE OF CONTENTS TABLE OF AUTHORITIES .......................................................................................................... ii INTRODUCTION ...........................................................................................................................1 I. THE STATE’S PROPOSED PROTOCOL MUST BE REJECTED. .................................2 A. Monitoring Anesthetic Depth. .................................................................................2 B. IV Access.................................................................................................................5 C. Mixing the Chemicals..............................................................................................7 D. Drug Administration. ...............................................................................................8
    [Show full text]
  • New Indications for Peripheral Pulse Wave Acta Universitatis Tamperensis 2408
    JARKKO HARJU New Indications for Peripheral Pulse Wave JARKKO HARJU New Indications for Peripheral Pulse Wave Acta Universitatis Tamperensis 2408 JARKKO HARJU New Indications for Peripheral Pulse Wave AUT 2408 AUT JARKKO HARJU New Indications for Peripheral Pulse Wave ACADEMIC DISSERTATION To be presented, with the permission of the Faculty Council of the Faculty of Medicine and Life Sciences of the University of Tampere, for public discussion in the auditorium of Finn-Medi 5, Biokatu 12, Tampere, on 14 September 2018, at 12 o’clock. UNIVERSITY OF TAMPERE JARKKO HARJU New Indications for Peripheral Pulse Wave Acta Universitatis Tamperensis 2408 Tampere University Press Tampere 2018 ACADEMIC DISSERTATION University of Tampere, Faculty of Medicine and Life Sciences Tampere University Hospital, Department of Anaesthesia Finland Supervised by Reviewed by Professor Arvi Yli-Hankala Docent Vesa Kontinen University of Tampere University of Turku Finland Finland Professor Niku Oksala Professor Tarmo Lipping University of Tampere Tampere University of Technology Finland Finland The originality of this thesis has been checked using the Turnitin OriginalityCheck service in accordance with the quality management system of the University of Tampere. Copyright ©2018 Tampere University Press and the author Cover design by Mikko Reinikka Acta Universitatis Tamperensis 2408 Acta Electronica Universitatis Tamperensis 1918 ISBN 978-952-03-0821-6 (print) ISBN 978-952-03-0822-3 (pdf) ISSN-L 1455-1616 ISSN 1456-954X ISSN 1455-1616 http://tampub.uta.fi Suomen Yliopistopaino Oy – Juvenes Print Tampere 2018 441 729 Painotuote To Eeva, Anna and Olli List of original publications This thesis is based on the following four original publications, referred to in the text by their Roman numerals (I-IV): I Matthias Gruenewald, M.*, Harju, J.*, Preckel, B., Molnár, Z., Yli- Hankala, A., Roßkopf, F., Koers, L., Orban, A., Bein, B.
    [Show full text]
  • Adequacy of Anaesthesia (Aoa) Clinical Brochure Adequacy of Anaesthesia (Aoa)
    GE Healthcare Adequacy of Anaesthesia (AoA) Clinical brochure Adequacy of Anaesthesia (AoA) AoA parameters provide continuous non-invasive measurement of: Adequacy of Anaesthesia (AoA) is a • Depth of anaesthesia with SPECTRAL ENTROPY™ concept made up of various parameters • Patient’s response to surgical stimuli and analgesic medications with SURGICAL PLETH INDEX (SPI)™ to help you assess patients’ individual • Muscle relaxation/recovery with NEUROMUSCULAR responses to the delivery of inhaled TRANSMISSION (NMT) and intravenous hypnotics, opioids, and The AoA split screen view incorporates values and trends obtained from the SPI, Entropy (State Entropy SE, Response Entropy RE and NMBAs during general anaesthesia. Burst Suppression Ratio BSR) and Neuromuscular Transmission (NMT) modules, providing a holistic view of the patient’s response to anaesthesia. When seconds counts in an intensive and multitasking enviroment, the BalanceView is guidance for prompt visualization of the patients’ responses to changes of anaesthesia conditions and may help save valuable time on responsiveness to analgesia/depth of anaesthesia optimization for each individual patient. The “white dot” that moves drastically away from the target zone may indicate inadequate hypnosis or analgesia level. Target Region Level of conciousness of Level Nociception-Antinociception Balance. Current data support SPI target range 20-50. Target at present reflects only the user preference. Spectral Entropy™ Control Entropy Entropy monitoring provides two indexes: parameters such as the EEG raw signal The GE Healthcare Entropy module, Figure 1 - Propofol consumption μg/kg/min • State Entropy (SE): Steady and robust which can help for in depth and more 120 E-ENTROPY, and accessories are -9% signal. The State Entropy value is always comprehensive analysis of state of brain.
    [Show full text]
  • Powering Your Performance
    POWERING YOUR PERFORMANCE B105M | B125M | B155M Modular Patient Monitors gehealthcare.com Advanced capabilities. Simple scalability. Integrated technology. B1x5M, B125M and B155M represent an additional solution to GE Healthcare’s monitoring platforms. Clinical precision It delivers a premium clinical performance across various care areas inherited from decades of research and innovation done with customer support. Scalable platform With B1x5M, you can monitor essential vital signs like ECG, SpO , Temperature, Non Invasive Blood Pressure, 2 Intuitive Respiration and you can also easily scale up your design monitoring capabilities using modules to monitor with precision respiratory gases and anesthetic agents, NMT and Entropy™ – with up to three advanced Integrated parameters simultaneously. technologies These precise, trustworthy, and easy-to-use monitors enable simple and Intuitive workflows with a choice of 10-, 12- or 15- inch touch screen displays to address your clinical and workflow related challenges. Legacy of premium clinical performance. Excellence of advanced features. Because every heartbeat counts… With decades of expertise designing The B1x5M range of modular patient monitors helps you quickly manage patient changing advanced and proven clinical algorithms conditions like arrhythmias and high/low blood pressure, and efficiently assess the level of and measurement technologies, this consciousness. range of monitors benefits parameter These monitors seamlessly integrate with your CARESCAPE Ecosystem to centralize patient innovations. It features: data, alarms, and to automatically capture and document vital signs. It decreases manual tasks, unnecessary movements, and as a result, improving workflows. • DINAMAP™ B1x5M range allows you to effectively monitor deteriorating patient conditions and make • SuperSTAT™ timely interventions by tracking the National Early Warning Score (NEWS).
    [Show full text]
  • INHALATIONAL ANAESTHETIC AGENTS (A) to Describe the Principles of Vaporisation of Inhalational Agents
    INHALATIONAL ANAESTHETIC AGENTS (a) To describe the principles of vaporisation of inhalational agents. Overview of inhaled anaesthetic agents: - Volatile anaesthetic agents (Eg. desflurane, isoflurane, sevoflurane, Etc.) are volatile liquids that require vaporisation into vapours to achieve GA - N2O and Xe are true gases (Ie. do not need vaporisation) to achieve GA Note – Gas and vapour are defined based upon a substance in gaseous state with respect to its “critical temperature” (temperature above which a gas cannot be liquefied by pressure alone): - Gas → defined as a substance in a gaseous state when ambient temperature is ABOVE its critical temperature - Vapour → defined as a substance in a gaseous state when ambient temperature is AT or BELOW its critical temperature Physical principles in process of vaporisation: - “Latent heat of vaporisation” o Defined as energy required to convert a substance from a liquid to gaseous phase o With liquid cooling (Ie. liquid evaporation in a vaporiser) → latent heat of vaporisation ↑↑↑ → this means more energy is needed to vapourise a liquid → this poses an issue with vaporisers o This is issue is circumvented by constructing vaporisers from metals with a high thermal conductivity (Ie. heat is able to flow through substance easily) → allows heat flow form atmosphere into liquid volatile agent to supply external energy for “latent heat of vaporisaiton” - “Saturated vapour pressure” (SVP) of a volatile anaesthetic: o Defined as the partial pressure exerted by the vapour phase when in equilibrium with the liquid phase (Ie. when equal # molecules is leaving and entering each phase per unit time) o It is dependent on: . (i) Temperature (usually measured at 20°C) → SVP ↑ with ↑ temperature (Ie.
    [Show full text]
  • Adequacy of Anesthesia Guidance for Colonoscopy Procedures
    pharmaceuticals Article Adequacy of Anesthesia Guidance for Colonoscopy Procedures Michał Jan Stasiowski 1,2,* , Małgorzata Starzewska 3, Ewa Niewiadomska 4, Seweryn Król 2,5 , Kaja Marczak 2, Jakub Zak˙ 1,2, Aleksandra Pluta 1,2, Jerzy Eszyk 6, Beniamin Oskar Grabarek 7,8 , Izabela Szumera 1,2, Michał Nycz 5 , Anna Missir 2, Lech Krawczyk 1 and Przemysław Jałowiecki 1 1 Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-555 Katowice, Poland; [email protected] (J.Z.);˙ [email protected] (A.P.); [email protected] (I.S.); [email protected] (L.K.); [email protected] (P.J.) 2 Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, Medykow Square 1, 41-200 Sosnowiec, Poland; [email protected] (S.K.); [email protected] (K.M.); [email protected] (A.M.) 3 Department of Cardiac Anaesthesia and Intensive Care, Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland; [email protected] 4 Department of Epidemiology and Biostatistics, School Health Sciences in Bytom, Medical University of Silesia, Piekarska 18 Street, 41-902 Bytom, Poland; [email protected] 5 Department of General, Colorectal and Polytrauma Surgery, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-555 Katowice, Poland; [email protected] 6 Unit of Endoscopy by the Department of Gastroenterology, 5th Regional Hospital, Medykow Square 1, 41-200 Sosnowiec, Poland; [email protected] 7 Department of Histology, Cytophysiology and Embryology, Faculty of Medicine
    [Show full text]
  • Monitoring of Depth of Anesthesia Using Entropy Monitor During Cardiopulmonary Bypass 1Pragya Sachan, 2Naina P Dalvi
    RIA Monitoring of Depth10.5005/jp-journals-10049-0032 of Anesthesia using Entropy Monitor ORIGINAL RESEARCH Monitoring of Depth of Anesthesia using Entropy Monitor during Cardiopulmonary Bypass 1Pragya Sachan, 2Naina P Dalvi ABSTRACT How to cite this article: Sachan P, Dalvi NP. Monitoring of Depth of Anesthesia using Entropy Monitor during Cardiopulmonary To monitor the depth of anesthesia using entropy monitor Aim: Bypass. Res Inno in Anesth 2017;2(2):45-50. during cardiopulmonary bypass (CPB) using (1) numerical indices provided by entropy monitor [response entropy (RE) Source of support: Nil and state entropy (SE), burst suppression ratio (BSR)] and (2) Conflict of interest: None modified version of Brice questionnaire used after 48 hours of surgery. Materials and methods: Design: Prospective observational INTRODUCTION study. Setting: Cardiovascular thoracic surgery (CVTS) opera- General anesthesia is defined as the condition of loss of tion theater (OT) of our hospital. Participants: 100 patients consciousness where patient is unresponsive to painful undergoing CPB surgery and willing to participate in the study. 1 Intervention: Brain and facial muscular activity recorded using surgical stimuli. However, patients do recall various disposable sensor with three electrodes attached to patient’s experiences during the surgery, known as “invisible scars forehead and a sensor cable that connects the sensor to entropy of the surgery.” The principle of entropy is that increas- module. Entropy indices were calculated and displayed in real ing depth of anesthesia causes increase in regularity of time. All patients were then interviewed 48 hours after surgery the electroencephalogram (EEG), which is then inferred about any recall of intraoperative awareness using the modified by entropy and used to estimate the depth of anesthesia.
    [Show full text]
  • Monitoring the Depth of Anaesthesia Using the New Modified Entropy Sensors During Supratentorial Craniotomy: Our Experience
    Original Article Monitoring the depth of anaesthesia using the new modified entropy sensors during supratentorial craniotomy: Our experience Richa Sharma, Pirjo Manninen, Lashmikumar Venkatraghavan Abstract Background: Monitoring the depth of anaesthesia can be a challenge in patients undergoing supratentorial craniotomy because the conventional sensors for both bispectral index and entropy monitors lose their contact with a brain after scalp elevation. The new sensors for the entropy monitor are more flexible and can be placed in different locations. The purpose of this study was to determine the feasibility on the use of new GE entropy sensors in monitoring depth of anaesthesia in patients undergoing supratentorial craniotomy. Materials and Methods: We retrospectively reviewed the data from 20 consecutive patients undergoing supratentorial craniotomy who had the monitoring of the depth of anaesthesia using modified entropy sensors. Prior to the induction of anaesthesia, the new GE entropy sensor (P/N M1038681) was applied in a modified fashion. We measured the state entropy (SE) and response entropy (RE) at 12 perioperative time points. Entropy values were compared with the clinical indices of depth of anaesthesia. Results: Data from 20 consecutive patients (orbitozygomatic craniotomy [10] and bifrontal craniotomy [10]) were analysed. Monitoring was possible in all the patients. The changes in entropy values correlated with clinical indices of depth of anaesthesia. However, some patients showed variations in absolute values (RE and SE) during the intraoperative period without any changes in the level of anaesthetic depth. Conclusions: Monitoring the depth of anaesthesia is feasible with the use of new entropy sensors in patients undergoing supratentorial craniotomy. In contrast to standard sensors, the new sensors offer flexibility with the placement.
    [Show full text]