29 research outputs found
Remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy: comparison of adjuvant propofol and ketamine
OBJECTIVE: Laryngoscopy and stimuli inside the trachea cause an intense sympatho-adrenal response. Remifentanil seems to be the optimal opioid for rigid bronchoscopy due to its potent and short-acting properties. The purpose of this study was to compare bolus propofol and ketamine as an adjuvant to remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy. MATERIALS AND METHODS: Forty children under 12 years of age who had been scheduled for a rigid bronchoscopy were included in this study. After midazolam premedication, a 1 µg/kg/min remifentanil infusion was started, and patients were randomly allocated to receive either propofol (Group P) or ketamine (Group K) as well as mivacurium for muscle relaxation. Anesthesia was maintained with a 1 µg/kg/min remifentanil infusion and bolus doses of propofol or ketamine. After the rigid bronchoscopy, 0.05 µg/kg/min of remifentanil was maintained until extubation. Hemodynamic parameters, emergence characteristics, and adverse events were evaluated. RESULTS: The demographic variables were comparable between the two groups. The decrease in mean arterial pressure from baseline values to the lowest values during rigid bronchoscopy was greater in Group P (p = 0.049), while the reduction in the other parameters and the incidence of adverse events were comparable between the two groups. The need for assisted or controlled mask ventilation after extubation was higher in Group K. CONCLUSION: Remifentanil-based total intravenous anesthesia with propofol or ketamine as an adjuvant drug along with controlled ventilation is a viable technique for pediatric rigid bronchoscopy. Ketamine does not provide a definite advantage over propofol with respect to hemodynamic stability during rigid bronchoscopy, while propofol seems more suitable during the recovery period
Use of a Ketamine-Propofol Combination During Sedation and Analgesia
Aim: The aim of this study was to evaluate 1:1 mixture of ketamine
and propofol for sedative/analgesic efficacy, patient comfort and
postoperative complications.
Methods: The anesthesia and nursing records of patients
who received ketamine-propofol mixture in Bezmialem Vakıf
University Hospital between 2009 and 2010 were retrospectively
documented.
Results: Of the 51 adult patients who received ketamine-propofol
sedation, 39 patients had ASA 1-2 score while 12 patients had
ASA 3-4 score. No patient had apnea, desaturation, hypotension or
vomiting. Two patients who had postoperative agitation received
midazolam. All patients were transferred to the surgical ward
when Aldrete scores were >8. Surgeon and patient satisfaction
were high except in 2 patients.
Conclusion: Ketamine and propofol mixture for the purpose
of sedation and analgesia is a practical method with minimal
negative effects on respiration and hemodynamic variables,
however, hallucination associated with ketamine may be observed.
We conclude that due to the lack of hypnotic activity, 1/2 or 1/3
instead of 1/1 ketamine and propofol mixture would be more
appropriate. (The Medical Bulletin of Haseki 2015; 53:41-6
Effectiveness of morphine via thoracic epidural vs intravenous infusion on postthoracotomy pain and stress response in children Author(s): Bozkurt, P; Kaya, G; Yeker, Y; et al. Source: PEDIATRIC ANESTHESIA Volume: 14 Issue: 9 Pages: 748-754 DOI: 10.1111/j.1460-9592.2004.01278.x Published: SEP 2004
Effects of systemic and epidural morphine on antidiuretic hormone levels in children Author(s): Bozkurt, P; Kaya, G; Yeker, Y; et al. Source: PAEDIATRIC ANAESTHESIA Volume: 13 Issue: 6 Pages: 508-514 DOI: 10.1046/j.1460-9592.2003.01096.x Published: JUL 2003
Embolia gasosa venosa inadvertida durante cesariana: bolsas retráteis para líquidos intravenosos sem saídas autovedantes oferecem riscos. Relato de caso
O anestesiologista deve estar ciente das causas, do diagnóstico e do tratamento de embolia venosa e adotar padrões de prática para prevenir sua ocorrência. Embora a embolia gasosa seja uma complicação conhecida da cesariana, descrevemos um caso raro de desatenção que causou embolia gasosa iatrogênica quase fatal durante uma cesariana sob raquianestesia. uma das razões para o uso de bolsas autorretráteis para infusão em vez dos frascos convencionais de vidro ou plástico é a precaução contra embolia gasosa. Também demonstramos o risco de embolia venosa com o uso de dois tipos de bolsas plásticas retráteis (à base de cloreto de polivinil [PVC] e de polipropileno) para líquidos intravenosos. As bolsas para líquidos sem saídas autovedantes apresentam risco de embolia gasosa se o sistema de fechamento estiver quebrado, enquanto a flexibilidade da bolsa limita a quantidade de entrada de ar. bolsas à base de pvc, que têm mais flexibilidade, apresentam risco significativamente menor de entrada de ar quando o equipo de administração intravenosa (IV) é desconectado da saída. usar uma bolsa pressurizada para infusão rápida sem verificar e esvaziar todo o ar da bolsa IV pode ser perigoso