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At least 19 recordsLinked to original sources
PubMed1990

Equipment for inhalation anesthesia.

Inhalation anesthesia has three requirements: delivery of oxygen, delivery of an appropriate concentration of a volatile anesthetic agent, and removal of carbon dioxide. Halothane and isoflurane are the most commonly used anesthetic agents. They are usually delivered with a semiclosed circle system using an out-of-the-circuit vaporizer. Carbon dioxide is eliminated by chemical absorption and by flow of excess oxygen and waste anesthetic agent through the pop-off valve. These gases should be scavenged to prevent room contamination. A variety of ancillary equipment is available to assist the anesthetist during the procedure.

Anesthesia, Inhalation↗
PubMed2000

[Comparison between total intravenous anesthesia and inhalation anesthesia in the surgery of acute cholecystitis].

We investigated retrospectively the influence of anesthetic methods on the intraoperative managements and postoperative outcomes in 26 patients receiving emergency or early surgery for acute cholecystitis. Fourteen of the 26 patients received total intravenous anesthesia with propofol, fentanyl, and ketamine (PFK group), while the remainder received nitrous oxide and isoflurane or sevoflurane anesthesia (GO group). There were no significant differences between the groups with respect to demographic data. We found no significant differences between the groups in duration of operation and anesthesia, the incidence of intraoperative hypotension, and the use of ephedrine and dopamine during induction and maintenance of anesthesia. After surgery, the PFK group had significantly earlier bowel function than the GO group, with earlier starting of oral intake (54.0 +/- 25.1 vs 89.3 +/- 31.9 hours after surgery; P = 0.026). These data suggest that total intravenous anesthesia by propofol, fentanyl, and ketamine may provide the earlier recovery of bowel function than inhaled anesthesia after emergency or early surgery for acute cholecystitis.

Acute Disease↗
PubMed1989

Early extubation after coronary artery surgery in efficiently rewarmed patients: a postoperative comparison of opioid anesthesia versus inhalational anesthesia and thoracic epidural analgesia.

Twenty-eight patients were studied after uncomplicated aortocoronary bypass surgery with hypothermic cardiopulmonary bypass (CPB). In all patients residual hypothermia was effectively treated by the use of extended rewarming during CPB and postoperatively by an external heat source. This treatment almost eliminated postoperative shivering, and it resulted in the lowering of oxygen uptake, carbon dioxide production, and required ventilatory volumes to stable levels where spontaneous breathing could be used safely. The patients were divided into two groups. In group I (n = 12), intraoperative anesthesia was based on an intravenous (IV) opioid (phenoperidine), which caused persistent respiratory depression and made mechanical ventilation necessary for a mean postoperative time period of 10.7 +/- 3.8 hours even with the rewarming. In group II (n = 16), thoracic epidural analgesia and intraoperative general anesthesia with enflurane were used. In this group, postoperative metabolic and ventilatory requirements were stable and low, finger skin temperature was normalized earlier, systemic vascular resistance was lower, and stroke index was higher. Emergence from anesthesia was uneventful and was achieved early postoperatively in Group II. The patients had good pain relief and were mentally alert. Adequate spontaneous breathing was resumed quickly and endotracheal extubation was performed within the first two postoperative hours (1.6 +/- 0.5 hours). No complications or increased morbidity occurred, and no patient needed to be reintubated in Group II.

Analgesia, Epidural↗
PubMed1993

[N2O-supplemented intravenous anesthesia versus inhalation anesthesia. A comparative study of the sympathoadrenergic reaction and postoperative vigilance].

The aim of the present study was a comparison of the intraoperative sympathoadrenergic response and the postoperative vigilance of a propofol/alfentanil anaesthesia to a conventional isoflurane anaesthesia. 25 patients were admitted to the study undergoing septorhino surgery. Patients with continuous intravenous anaesthesia with propofol/alfentanil combined with nitrous oxide showed better haemodynamic conditions without an increase of blood pressure and catecholamines under laryngoscopy, intubation and surgical stimulation. In contrast to that the patients with isoflurane anesthesia showed a significant increase in haemodynamic parameters and capillary bloodflow. The measured plasma adrenalin levels showed wide intraindividual fluctuation but no significant difference between the groups. The suppression of plasma noradrenaline was more pronounced under intravenous anaesthesia. Recovery was significantly faster and vigilance significantly better in the patients undergoing intravenous anaesthesia. After 30 min patients with i.v. anaesthesia fulfilled all the conditions to be transferred to the regular ward; the other group needed more than one hour. It can be concluded that continuous i.v. anaesthesia with propofol/alfentanil is superior in suppressing the stress response to invasive stimuli and provides faster recovery and better postoperative analgesia.

Adult↗
PubMed2000

[Exposure of anesthetists to sevoflurane and nitrous oxide during inhalation anesthesia induction in pediatric anesthesia].

Inhalational mask induction with nitrous oxide and sevoflurane in young children is an appropriate alternative to intravenous induction and is considered safe and of rapid onset. Disadvantages of this technique are environmental pollution and occupational exposure to the inhalation agents used. Moreover, the potential health hazards are not yet completely clear. The purpose of the present study was to examine the anaesthesiologist's occupational exposure to nitrous oxide and sevoflurane in paediatric anaesthesia and mask induction. Twenty children underwent inhalational induction with nitrous oxide and sevoflurane in the operating theatre (air exchange rate 20.2/h, anaesthetic waste gas scavenger 40 l/min). Anaesthesia was maintained with the same agents. Air samples were taken from the edge of the anaesthesiologist's mouth continuously every 90 seconds, and trace concentrations of nitrous oxide and sevoflurane were analyzed with a direct reading infrared spectrometer (Brüel & Kjaer 1302, Denmark). Measurements taken during anaesthesia showed an increase in the concentrations of the anaesthetics used, but these were low. The highest mean concentrations occurred during induction (3.35 +/- 4.23 ppm for sevoflurane and 37.09 +/- 11.65 ppm for nitrous oxide). The overall peak levels measured were 6.31 +/- 4.23 ppm for sevoflurane and 68.78 +/- 40.79 ppm for nitrous oxide. Though the induction period was short compared to the whole length of anaesthesia, its impact on the overall waste gas exposure was 46.3% for sevoflurane (nitrous oxide 40.6%). Nonetheless, applicable German health law regulations were never infringed. The trace concentrations measured during inhalational mask induction and maintenance of anaesthesia were very low. With regard to modern workplace laws and health care regulations, gaseous induction in paediatric anaesthesia does not threaten the personnel's health.

Air Pollutants, Occupational↗
PubMed1995

[Anesthetics: total intravenous anesthesia or inhalation anesthesia in neurosurgery].

In this review article the pro's and contra's of the use of either inhalational or intravenous anaesthetics for neurosurgical procedures are discussed. The objective is to stimulate thoughts concerning controversial subjects, rather than to resolve issues. It is much less complicated to approach the practice of neuroanaesthesia with a few straight forward "rules" based on laboratory measurements (such as intravenous drugs are good because they reduce CBF and ICP, whereas inhalational agents are bad because they increase CBF and ICP). It should also be noted that whereas statements about potential detrimental or beneficial effects of different anaesthetic agents are relatively common, there is a dearth of well-designed prospective studies of sufficient power to substantiate the outcome advantages or disadvantages. The choice of an anaesthetic should include more than just a consideration of the potential intracranial effects of a drug: it should also include experience with a drug and, more important a consideration of the patient as a whole.

Anesthesia, Inhalation↗
PubMed1988

[Endocrine reaction pattern: midazolam-fentanyl anesthesia versus inhalation anesthesia].

In a randomised controlled study in 16 orthopaedic patients, the influence of midazolam-fentanyl-N2O/O2 anesthesia (group A) resp. halothane-N2O/O2 anesthesia (group B) on the plasma concentrations of the endocrine parameters ACTH, aldosterone, cortisol, 17-DHEA, insulin, prolactin, T3, T4, TBG (thyroxine bounded globuline) as well as adrenaline, noradrenaline, and dopamine was investigated. Additionally the metabolites glucose, lactate, free glycerin, and acetacetate were measured. Beside prolactin values, only the values for ACTH, aldosterone, cortisol, and 17-DHEA differed with respect to both anesthesia methods. Under halothane-N2O/O2 anesthesia free T4 rose initially also, here represented by T4/TBG-ratio (= FTI). However, the fall of T3 concentration showed no phase - resp. anesthesia-specific changes. Catecholamine levels reached highest values towards the end of operation resp. one hour after extubation in both groups. The insulin secretion, however, was not significantly raised in either group during acute stress phases. As an expression of modified metabolic regulation comparable rises of plasma levels of glucose, lactate, free glycerin, and acetacetate were observed under midazolam-fentanyl-N2O/O2 anesthesia as well as under halothane-N2O/O2. According to presented data, both methods of anesthesia modulated the endocrine metabolic response of the organism to surgical stress, without showing any clinically relevant advantages or disadvantages attributable to either method.

Adult↗
PubMed1997

Reduced postoperative analgesic demand after inhaled anesthesia in comparison to combined epidural-inhaled anesthesia in patients undergoing abdominal surgery.

We studied the effect of epidural/general combination anesthesia, in comparison to inhaled anesthesia, on postoperative pain and analgesic consumption in patients undergoing upper abdominal surgery. Anesthesia was induced with propofol and maintained with enflurane in 70% N2O as necessary to maintain arterial blood pressure within 20% of baseline. Group I received bupivacaine 0.25% 0.2 mL/kg and sufentanil 1 microgram/kg 65 +/- 3 min before dermal incision and 0.1 mL/kg bupivacaine 0.25% + sufentanil 2 micrograms/mL (BS) every hour thereafter. Group II received 0.2 mL/kg of BS 316 +/- 15 min after dermal incision in the recovery room. Postoperative patient-controlled epidural analgesia (PCEA) with BS was provided. Pain intensities and consumption of PCEA BS were recorded on postoperative days (PODs) 1 to 5. Inspiratory fraction of enflurane was lower (0.5% +/- 0.01% vs 1.6% +/- 0.04%; P < 0.001) in Group I compared with Group II. Cumulative postoperative consumption of PCEA BS was higher in Group I compared with Group II from the evening of POD 2 until the end of the study (301 +/- 19 mL vs 249 +/- 17 mL; P < 0.001), while pain intensities were comparable at all times. The intraoperative effects of combined BS and enflurane/N2O (inspiratory fraction [Fi] approximately 1 minimum alveolar anesthetic concentration [MAC]) did not preempt postoperative pain in contrast to enflurane/N2O anesthesia (Fi approximately 2.8 MAC).

Abdomen↗
PubMed2003

Intraocular pressure changes during laparoscopy in patients anesthetized with propofol total intravenous anesthesia versus isoflurane inhaled anesthesia.

UNLABELLED: We examined intraocular pressure (IOP) changes during gynecologic laparoscopy performed under either thiopental-isoflurane anesthesia or total IV propofol anesthesia. Forty adult women with no preexisting eye disease scheduled for gynecologic CO(2) insufflation laparoscopy were included in the study. Heart rate, mean arterial blood pressure, peak and plateau airway pressure, ETCO(2), and IOP (using a Schioetz tonometer) were measured at defined intervals during the procedure. IOP decreased significantly after the induction of anesthesia in both groups, and remained so throughout the procedure in the propofol group. In the isoflurane group, however, IOP was increased significantly above the preinduction level after pneumoperitoneum with head-down position. There was no correlation between IOP and blood pressure or airway pressure. In conclusion, propofol total IV anesthesia may be a better choice for laparoscopic surgery should control of IOP be a concern. IMPLICATIONS: In this study, we examined the effect of two anesthetic techniques on the intraocular pressure changes during laparoscopic surgery in healthy subjects. Propofol IV anesthesia protected against increases in intraocular pressure with pneumoperitoneum and head-down position.

Adult↗
PubMed2001

Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane-nitrous oxide: postoperative nausea with vomiting and economic analysis.

BACKGROUND: To assess the incidence of postoperative nausea and vomiting after total intravenous anesthesia (TIVA) with propofol versus inhalational anesthesia with isoflurane-nitrous oxide, the authors performed a randomized trial in 2,010 unselected surgical patients in a Dutch academic institution. An economic evaluation was also performed. METHODS: Elective inpatients (1,447) and outpatients (563) were randomly assigned to inhalational anesthesia with isoflurane-nitrous oxide or TIVA with propofol-air. Cumulative incidence of postoperative nausea and vomiting was recorded for 72 h by blinded observers. Cost data of anesthetics, antiemetics, disposables, and equipment were collected. Cost differences caused by duration of postanesthesia care unit stay and hospitalization were analyzed. RESULTS: Total intravenous anesthesia reduced the absolute risk of postoperative nausea and vomiting up to 72 h by 15% among inpatients (from 61% to 46%, P < 0.001) and by 18% among outpatients (from 46% to 28%, P < 0.001). This effect was most pronounced in the early postoperative period. The cost of anesthesia was more than three times greater for propofol TIVA. Median duration of stay in the postanesthesia care unit was 135 min after isoflurane versus 115 min after TIVA for inpatients (P < 0.001) and 160 min after isoflurane versus 150 min after TIVA for outpatients (P = 0.039). Duration of hospitalization was equal in both arms. CONCLUSION: Propofol TIVA results in a clinically relevant reduction of postoperative nausea and vomiting compared with isoflurane-nitrous oxide anesthesia (number needed to treat = 6). Both anesthetic techniques were otherwise similar. Anesthesia costs were more than three times greater for propofol TIVA, without economic gains from shorter stay in the postanesthesia care unit

Adult↗
PubMed2026

Post-operative pain, nausea, vomiting and optic nerve sheath diameter following total intravenous versus inhalational anesthesia for adults undergoing robotic transabdominal surgery - a systematic review and meta- analysis.

BACKGROUND: The introduction of robotic-assisted abdominal surgery is aimed at reducing the primary and secondary adverse outcomes. Anesthesia in robotic surgery varies from anesthesia for open or laparoscopic surgical procedures. The choice of anesthesia influences the perioperative control of pain, nausea, vomiting, and Optic nerve sheath diameter (ONSD). The purpose of this systematic review was to assess outcome variation in patients undergoing transabdominal robot-assisted surgery done under total intravenous anesthesia or inhalational anesthesia. METHODOLOGY: We searched the Cochrane Central Register of Controlled Trials, PubMed, and Google Scholar (January, 2017 to June, 2024). Search terms included "Anesthesia", "Robotics", "prostatectomy", hysterectomy", "nephrectomy", "cholecystectomy" and "cystectomy" with the Boolean operators "AND" and "OR". We searched for randomized controlled trials (RCTs) including adults of both genders aged 18 years and above, who underwent transabdominal robotic-assisted laparoscopic surgery and targeting the consequences related to TIVA or inhalational anesthesia. We reviewed titles and abstracts and proceeded to full-text articles of the eligible studies relevant to inclusion criteria. Mean and standard deviations with 95% CI were calculated. Forest plots were used to present data visually. RESULTS: Six studies (340 patients) were included. We found only one study in which post-operative pain was assessed and results favored intravenous anesthesia in robotic transabdominal surgery. Only two studies reported post-operative nausea and vomiting (PONV). Both studies stated that PONV is reported in few patients in the inhalation anesthesia group. We found evidence suggesting that change in ONSD measurements at 10&#xa0;min after induction (MD 0.04,95% CI -0.02 to 0.11 p&#x2009;=&#x2009;0.19) and 40-60&#xa0;min after Trendelenburg position (MD -0.26, 95% CI -0.34 to 0.17, p&#x2009;=&#x2009;0.16) are much less in intravenous anesthesia group than in inhalation anesthesia group. Total intravenous anesthesia maintains the ONSD and hence the ICP better than inhalational anesthesia in robotic transabdominal surgery with CO2 pneumoperitoneum in Trendelenburg positioning requirements. It would be a safer choice than inhalational anesthesia due to fewer adverse events. CONCLUSION: This review concludes that TIVA is a better choice than inhalational anesthesia for transabdominal robotic-assisted surgery in urology, gynecology, and gastroenterology in both male and female patients.

Humans↗
PubMed2001

Delivery and scavenging system for small animal inhalational anesthesia.

BACKGROUND: Inhalational agents have been widely used for anesthesia in laboratory animals. However, the safe use of inhalational agents in small laboratory animals has been limited by the lack of a suitable and effective scavenging system for the removal of waste anesthetic gases. The aim of the present study is to develop an anesthetic system that can be manufactured using common household and laboratory items. MATERIALS AND METHODS: An anesthetic system was designed for rats weighing from 300 to 350 g. A face mask for the rat was made by cutting off the distal part of a 50-ml centrifuge tube. A scavenging hood was made from a transparent plastic food storage box. Exhaust of anesthetic gases from the scavenger hood was facilitated by fitting an outlet connected to a pump. Four experienced researchers or technicians tested the scavenger hood. RESULTS: In 79.2% of the trials the participants could smell halothane when the pump from the scavenger system was not operational. However, when the pump was switched on, halothane was detected only 16.7% of the time (P < 0.001). CONCLUSION: We have developed a simple and effective method of delivering inhalational anesthesia to small laboratory animals and of removing waste anesthetic gases.

Anesthesia, Inhalation↗
PubMed1990

[Repetitive inhalation anesthesia in rats].

Inhalational anesthesia in the rat seems a good process, by a rapid induction and awakening if a steady state ventilation-perfusion ratio and no pollution are obtained. Animals are cooped up in an "induction-box" which is joined to a scavenger system. Anesthesia maintenance is assumed with a Bain circuit and allows short and frequent anesthesia. Isoflurane does not markedly decrease circulatory and respiratory factors at low concentration (2%). So any anaesthetist can do himself such a practical system.

Anesthesia, Inhalation↗
PubMed1999

Recovery after total intravenous anesthesia (TIVA) using propofol and inhalation anesthesia (IA) using halothane in day case surgery.

The aims of this study were to compare recovery by clinical tests, the Perceptual Speed Test (PST) and the Ball Bearing Test (BBT), home recovery, side effects and satisfaction of anesthesia between total intravenous anesthesia using propofol and inhalation anesthesia using halothane in day case surgery and to determine average cost per case of each technique from the provider's the perspective. Forty patients were randomly allocated into TIVA and IA groups. The anesthetic times were 42.1 +/- 26.47 minutes and 37.6 +/- 14.75 minutes respectively. Recovery was assessed by the time to orientation, sitting up, standing up and to success in obtaining baseline values of the PST & BBT. The observer was blinded to the anesthetic technique that the patient received. Recovery tests showed no difference between the two groups. The recovery times of TIVA and IA as assessed by the PST and BBT were 1.2 +/- 0.41 and 1.1 +/- 0.31 hour respectively. From a home questionnaire, both groups showed no difference in the first 2-3 hours of home recovery, incidence of side effects and satisfaction of anesthesia. When asked about the difficulty in getting home, no TIVA patients complained of sleepiness whereas 6/16 IA patient did (p = 0.018). The average cost per case of TIVA and IA was 642.15 and 363.15 bahts respectively.

Administration, Inhalation↗
PubMed2002

Complications of inhaled anesthesia delivery systems.

Inhaled anesthesia delivery systems (ADS) have evolved in the past 20 years from simple pneumatic machines to complex computer-controlled devices. For the purposes of this discussion, we will outline some of the potential complications that may result from the use of these systems. Because of the complexity of modern ADS, it is incumbent on the anesthesiologist to be cognizant of potential problems that may arise with their use. Even though it is now more difficult than ever for the practitioner to develop a comprehensive understanding of these machines, it remains essential for the safe practice of anesthesia. When the anesthesiologist understands the basic design differences between products from different manufacturers, it is more likely that the appropriate preoperative checks will be performed and that delivery of a safe anesthetic can be ensured. Although malpractice claims associated with anesthesia delivery systems are rare, when they do occur they may be severe, and they continue to occur. These complications may range in severity from mild hypercapnia to awareness and even death.

Air Pressure↗
PubMed1995

Implicit memory for stimuli presented during inhalation anesthesia in children.

During general inhalation anesthesia, neutral phrases including either the color blue or yellow combined with one of two objects, ball or kite, were repeatedly presented to 36 children undergoing eye surgery. Postoperative testing with a coloring and two-choice task was performed to detect preferences for the colors and objects presented under anesthesia. No preference attributable to implicit memory could be demonstrated, and there was no explicit recollection of intraoperative events. Memory of intraoperative events occurring during inhalation anesthesia was not demonstrated with the present methodology in young children.

Anesthesia, Inhalation↗