Comparing the relaxing effects of desflurane and sevoflurane on oxytocin-induced contractions of isolated myometrium in both pregnant and nonpregnant rats

In this study, the effects of 2 volatile anesthetics, desflurane and sevoflurane, on oxytocin-induced contractions of isolated myometrium in pregnant and nonpregnant rats were compared. Twenty pregnant and 20 nonpregnant Wistar albino rats were studied at 19 to 20 days' gestation (term, 22 days). A total of 40 myometrial strips were obtained from pregnant and nonpregnant rats, and each of these was randomly assigned to 1 of 4 groups (n=10, each group). After spontaneous myometrial contractions were induced in the De Jalon solution, the effects of 0.5, 1, and 2 minimum alveolar anesthetic concentrations (MAC) of desflurane or sevoflurane, in the absence and presence of oxytocin (2 x 10(-9) M), were investigated. Oxytocin significantly increased the amplitude and duration of spontaneous contractions in longitudinal myometrial strips (P < .05), but not the frequency. Both agents (except for 0.5 MAC in the nonpregnant group) inhibited the duration, amplitude, and frequency of induced contractions in a dose-dependent manner. The inhibitory potencies of desflurane and sevoflurane were similar. It was found that isolated strips of pregnant rat myometrium were more sensitive to the inhibitory effects of both agents than were the nonpregnant rat myometrial strips

Sedation for outpatient endometrial biopsy: Comparison of remifentanil-propofol and Alfentanil-propofol

The purpose of the study was to compare the clinical activity of remifentanil or alfentanil. under propofol sedation with regard to respiratory rate, sedation and recovery rate when used for outpatient endometrial. biopsy. Patients were randomized to receive intravenously either bolus remifentanil 0.4 mug/kg and propofol 1 mg/kg in the remifentanil group (n = 30), or bolus alfentanil 20 mug/kg and propofol 1 mg/kg in the alfentanil group (n = 30). Patients were monitored for heart rate, systolic and diastolic arterial pressure, peripheral O-2 saturation (SpO(2)), respiration rate, and Aldrete sedation score. Pulse oximetry was used to monitor heart rate and SpO(2) during endometrial biopsy. Apnoea was observed in five patients from the remifentanil group, and in three patients from the alfentanil group. The groups did not differ with regard to apnoea incidences. Times were recorded for orientation and Aldrete score > 8, and were similar between the two groups (13.20 +/- 3.64 min and 14.0 +/- 3.87 min in the remifentanil. group, 14.7 +/- 3.64 min and 15.9 +/- 3.15 min in the alfentanil group, respectively). The sedative and analgesic combination of remifentanil-propofol does not offer any advantages compared with a combination of alfentanil-propofol with regards to respiration and recovery during sedation for outpatient endometrial biopsy

Early recovery properties of sevoflurane and desflurane in patients undergoing total hip replacement surgery

Background. The pharmacokinetic properties of sevoflurane and desflurane differ from those of other volatile anesthetics. For example, both agents allow more rapid emergence than traditional volatile anesthetics. However, few direct comparisons of the 2 agents have been made

Efficacy of different doses of lidocaine in the prevention of pain due to propofol injection: A randomized, open-label trial in 120 patients

Background. The incidence of pain due to propofol injection is high, but the most efficacious method of preventing this pain has not been identified

Comparison of patient-controlled analgesia with and without a background infusion after appendicectomy in children

Background: There have been many studies using patient-controlled analgesia (PCA) and opioids for postoperative analgesia in children. In this study, we investigated the efficacy, usefulness and analgesic consumption of two different PCA programmes [bolus dose alone (BD) or bolus dose with background infusion (BD+BI)] to evaluate postoperative analgesia for children after emergency appendicectomy

The direct depressant effects of desflurane and sevoflurane on spontaneous contractions of isolated gravid rat myometrium

Our purpose was to investigate the direct depressant effects of desflurane and sevoflurane at 0.5, 1 and 2 minimum alveolar concentrations (MAC) on spontaneous contractions of isolated gravid rat myometrium. Ten gravid, albino Wistar rats, weighing 240-310 g and at 19-20 days' gestation were used. Sixty myometrial strips were obtained from 10 rats, and randomly assigned into six groups of 10. After obtaining spontaneous myometrial contractions in de Jalon solution for 45 min, 0.5, 1 or 2 MAC of desflurane or sevoflurane were continuously bubbled in the bath for 15 min and myometrial contractions evaluated during the last 10 min. Desflurane 0.5 MAC did not affect duration or amplitude of spontaneous contractions, but frequency was significantly decreased (P < 0.05). Duration, amplitude and frequency were all significantly decreased by desflurane I and 2 MAC (P < 0.05). Sevoflurane did not affect duration, amplitude or frequency at 0.5 MAC, but amplitude and frequency were significantly decreased at I MAC and all were significantly decreased at 2 MAC (P < 0.05). The frequency of contractions was decreased 21.2% with 1 MAC desflurane versus 17.1% with I MAC sevoflurane. The amplitude and frequency of contractions were decreased 48.2% and 48.7% with 2 MAC desflurane versus 58.9% and 49.3% with 2 MAC sevoflurane, respectively. We suggest that due to tocolytic activity, desflurane and sevoflurane can be useful in non-obstetric surgery during pregnancy. (C) 2003 Elsevier Science Ltd. All rights reserved

Comparison of recovery properties of desflurane and sevoflurane according to gender differences

Background: The aim of this study was to investigate the recovery properties of desflurane and sevoflurane in patients undergoing elective surgery, according to the gender differences

A Comparison of 1 Minimum Alveolar Concentration Desflurane and 1 Minimum Alveolar Concentration Isoflurane Anesthesia in Patients Undergoing Craniotomy for Supratentorial Lesions

AbstractBackgroundA critical point in craniotomy is during opening of the dura and the subsequent potential for cerebral edema. Use of desflurane in neurosurgery may be beneficial because it facilitates early postoperative neurologic evaluation; however, data on the effect of desflurane on intracranial pressure in humans are limited. Isoflurane has been used extensively in neurosurgical patients.ObjectiveThis study compared 1 minimum alveolar concentration (MAC) desflurane with 1 MAC isoflurane in facilitating hemodynamic stability, brain relaxation, and postoperative recovery characteristics in patients who underwent craniotomy for supratentorial lesions.MethodsA total of 70 patients (aged 18–65 years), with American Society of Anesthesiologists (ASA) 1 or 2 physical status, who underwent craniotomy for supratentorial lesions, were enrolled in the study. For induction of anesthesia, fentanyl (2 μg/kg IV) and propofol (2 mg/kg IV) were administered. Endotracheal intubation was performed after administration of vecuronium (0.1 mg/kg IV) for total muscle relaxation. Before insertion of the skull pins, additional fentanyl (2 μg/kg IV) was administered. Patients were randomly allocated to 1 of 2 anesthetic regimens. For maintenance of anesthesia, 35 patients received 1 MAC of desflurane (group 1) and 35 patients received 1 MAC of isoflurane (group 2) within 50% oxygen in nitrous oxide. Intraoperatively, heart rate (HR) and mean arterial pressure (MAP) were measured and recorded before induction and 1 minute after induction, after endotracheal intubation, before skull pin insertion and 1 minute after skull pin insertion, before incision and 1 minute after incision, and before extubation and 1 minute after extubation. Also, HR and MAP were recorded at 30-minute intervals. Postoperatively, extubation time, eye opening time to verbal stimuli, orientation time, and time to reach an Aldrete postanesthetic recovery score of ≥8 were recorded. In addition, opioid consumption was calculated and recorded. Brain relaxation was evaluated according to a 4-step brain relaxation scoring scale. All outcomes of the study were assessed and recorded by an anesthesiologist blinded to the volatile anesthetic gases studied.ResultsNo significant difference in HR was observed between the 2 groups. Intraoperative MAP values in group 1 were higher than in group 2 (P < 0.05). No significant difference was found between these groups in brain relaxation and opioid consumption. Extubation time, eye opening time to verbal stimuli, and time to reach an Aldrete score of ≥8 were found to be significantly shorter in patients in group 1 compared with patients in group 2 (P < 0.05).ConclusionsIn patients who underwent craniotomy for supratentorial lesions, patients who received 1 MAC desflurane–based anesthesia had earlier postoperative cognitive recovery and postoperative neurologic examination compared with patients who received 1 MAC isoflurane–based anesthesia. The observed benefits of early recovery from anesthesia, however, should be considered with risks such as higher MAP in patients administered 1 MAC desflurane

Randomized, double-blinded comparison of tropisetron and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy

This prospective, randomized, placebo-controlled, double-blinded study was designed to evaluate the efficacy of tropisetron in preventing postoperative nausea and vomiting after elective supratentorial craniotomy in adult patients. We studied 65 ASA physical status I-III patients aged 18 to 76 years who were undergoing elective craniotomy for resection of various supratentorial tumors. Patients were divided into two groups and received either 2 mg of tropisetron (group T) or saline placebo (group P) intravenously at the time of dural closure. A standard general anesthetic technique was used. Episodes of nausea and vomiting and the need for rescue antiemetic medication were recorded during 24 hours postoperatively. Demographic data, duration of surgery and anesthesia, and sedation scores were comparable in both groups. Nausea occurred in 30% of group T patients and in 46.7% of group P patients (P > .05). The incidence of emetic episodes was 26.7% and 56.7% in the two groups (P < .05). Rescue antiemetic medication was needed in 26.7% and 60% of the patients (P < .05). Administration of a single dose of tropisetron (2 mg intravenously) given at the time of dural closure was effective in reducing postoperative nausea and vomiting after elective craniotomy for supratentorial tumor resection in adult patients

The effectiveness of intramuscular Dexmedetomidine on hemodynamic responses during tracheal intubation and Anesthesia induction of hypertensive patients: A randomized, double-blind, placebo-controlled study

Background: Hypertensive patients are at risk for increased hemodynamic response to tracheal intubation. Sympatholytic drugs administered during the preinduction period may prevent adverse events