Anesthetics, Intravenous

Publication Title: 
British Journal of Anaesthesia

BACKGROUND: Possible utility of high-dose i.v. melatonin as an anaesthetic adjuvant has not been studied. This study compared its effects with thiopental and propofol. METHODS: Sprague Dawley rats were assigned to receive bolus or cumulative i.v. doses of melatonin, thiopental or propofol. Righting reflex, hindpaw withdrawal to a noxious stimulus, response to tail clamping and haemodynamic effects were assessed. RESULTS: Melatonin caused a dose-dependent increase in paw withdrawal threshold and the percent of rats displaying loss of the righting reflex.

Author(s): 
Naguib, M.
Hammond, D. L.
Schmid, P. G.
Baker, M. T.
Cutkomp, J.
Queral, L.
Smith, T.
Publication Title: 
British Journal of Anaesthesia

BACKGROUND: General anaesthesia is a balance between hypnosis and analgesia. We investigated whether an increase in remifentanil blood concentration would reduce the amount of propofol required to maintain a comparable level of anaesthesia in 60 patients undergoing ambulatory surgery. METHODS: Patients were allocated randomly to receive remifentanil to a target blood concentration of 2 ng ml(-1) (low), 4 ng ml(-1) (medium), or 8 ng ml(-1) (high), administered by target-controlled infusion (TCI).

Author(s): 
Milne, S. E.
Kenny, G. N. C.
Schraag, S.
Publication Title: 
Journal of Clinical Pharmacology

This study was undertaken to assess the bioequivalence between a new formulation of propofol 2% and the commercially available product Diprivan. Secondary objectives were to compare the times to onset of and emergence from hypnosis, the hemodynamic effects, and the safety profiles. Twelve healthy male volunteers were included in a randomized crossover study. Subjects were administered a 2-mg/kg single bolus injection of each formulation separated by a 7- to 10-day washout period. Plasma propofol was determined by reversed-phase liquid chromatography with fluorescence detection.

Author(s): 
Abad-Santos, Francisco
Gálvez-Múgica, M. Angeles
Santos, M. Angeles
Novalbos, Jesús
Gallego-Sandín, Sonia
Méndez, Paloma
Casimiro, Cesar
Gilsanz, Fernando
Publication Title: 
Minerva Anestesiologica

AIM: The purpose of this study was to test the safety and efficacy of small doses of remifentanil and alfentanil in a continuous total intravenous anesthesia technique for patients undergoing major abdominal surgery. METHODS: Sixty patients were enrolled in the study, and received in a double blind fashion either remifentanil (0.1 microg/kg/min) or alfentanil (alfentanil 0.75 microg/kg/min) in association with propofol (12 mg/kg/h at induction; 6-9 mg/kg/h for maintenance) and cisatracurium.

Author(s): 
Iannuzzi, E.
Iannuzzi, M.
Cirillo, V.
Viola, G.
Parisi, R.
Chiefari, M.
Publication Title: 
Anesthesia and Analgesia

Previous studies have observed a correlation of implicit memory with certain electroencephalogram (EEG) measures during anesthesia. Here, we tested the relationship between hypnotic depth determined by computer system (Narcotrend(TM)) and implicit memory in anesthetized patients, assessed by a postoperative reading speed test. Thirty-two patients undergoing laparoscopic herniotomy and 30 age-matched volunteer controls were included the study. All patients received IV midazolam 2-3 mg followed by an induction dose of propofol and remifentanil.

Author(s): 
Münte, Sinikka
Münte, Thomas F.
Grotkamp, Jörg
Haeseler, Gertrud
Raymondos, Konstantinos
Piepenbrock, Siegfried
Kraus, Gabriele
Publication Title: 
Journal of Clinical Monitoring and Computing

OBJECTIVE: To determine the degree of linearity and correlation between the anaesthetic depth indices BIS and AAI over a wide range of hypnotic depth using propofol. METHODS: 20 ASA I patients were studied during propofol induction. Co-induction with 0.05 mg fentanyl and 30 mg propofol iv before initiation of the study. Thereafter repeated doses of propofol 0.5 mg/kg iv. every minute until BIS < 30. Loss of responsiveness to verbal command was determined by repeated loud commands to the patient. BIS (Aspect 2000 XP, BIS algorithm 4.0, system rev.

Author(s): 
Anderson, Russell E.
Barr, Gunilla
Jakobsson, Jan G.
Publication Title: 
British Journal of Anaesthesia

BACKGROUND: Etomidate-associated hypnosis has only been studied using standard clinical criteria and raw EEG variables. We conducted a BIS-based investigation of etomidate induction of general anaesthesia. METHODS: Thirty hydroxyzine-premedicated ASA I patients were randomly allocated to receive etomidate 0.2, 0.3, or 0.4 mg kg(-1) intravenously over 30 s. The BIS was continuously recorded. A tourniquet was placed on a lower limb to record purposeful movements and myoclonia. Tracheal intubation was facilitated using rocuronium 0.6 mg kg(-1) when the BIS value was 50.

Author(s): 
Lallemand, M.-A.
Lentschener, C.
Mazoit, J.-X.
Bonnichon, P.
Manceau, I.
Ozier, Y.
Publication Title: 
British Journal of Anaesthesia

BACKGROUND: Target-controlled infusions (TCI) are used to simplify administration and increase precision of i.v. drugs during general anaesthesia. However, there is a limited relationship between preset targets and measured concentrations of drugs and between measured concentrations and measures of brain function, such as the bispectral index (BIS). METHODS: We set out to evaluate the performance of TCI devices for propofol (Diprifusor) and remifentanil (Remifusor, prototype), during laparoscopic cholecystectomy in 21 patients.

Author(s): 
Hoymork, S. C.
Raeder, J.
Grimsmo, B.
Steen, P. A.
Publication Title: 
British Journal of Anaesthesia

BACKGROUND: The effect of cardiopulmonary bypass (CPB) on the level of anaesthetic depth has not been studied previously in a randomized way. METHODS: We assessed the effect of CPB on the propofol needed to maintain a fixed bispectral index score, and on the recovery from anaesthesia in 22 patients undergoing coronary artery bypass graft surgery with CPB (on-pump) compared with 18 patients operated on without CPB (off-pump). Anaesthesia was induced and maintained with propofol and alfentanil.

Author(s): 
Ahonen, J.
Sahlman, A.
Yli-Hankala, A.
Eriksson, H.
Nemlander, A.
Rämö, J.
Salmenperä, M.
Publication Title: 
Acta Anaesthesiologica Scandinavica

BACKGROUND: Age-related differences in the spectral composition of the EEG in induction and emergence times, and in drug consumption during propofol anaesthesia were investigated. METHODS: The EEGs of 60 female patients between 22 and 85 years of age were monitored continuously during standardized induction of anaesthesia with 2 mg of propofol kg(-1)60 s(-1). The EEGs were visually assessed in 20-s epochs according to a scale from A (awake) to F (very deep hypnosis). Visual EEG classifications, spectral parameters, and induction times were compared between different age groups.

Author(s): 
Schultz, A.
Grouven, U.
Zander, I.
Beger, F. A.
Siedenberg, M.
Schultz, B.

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