Thoracic epidural analgesia is beneficial after major abdominal surgery, though side-effects and complications are rare but potentially devastating. The incidence of catheter-related infection approximately 5.5%. Several guidelines have been recommended to prevent during thoracic catheterization. Tunnelling often reduce the infections dislocations.A retrospective, single-centre analysis our acute pain service database was performed between 2010 2018. hygiene measures German Society...

Surgical smoke resulting from electrocauterization is a health risk for operating room personnel. The U.S. National Institute Occupational Safety and Health recommends the use of local exhaust ventilation such as portable evacuation system to reduce surgical smoke, but its efficiency has never been assessed under experimental conditions. In this study, particle filtration efficiencies five commercially available systems were investigated in model room. Two cutting angles, devices’ suction...

Although sevoflurane is one of the most commonly used volatile anesthetics in clinical practice, anesthesiologists are hardly aware their individual occupational chronic exposure. Therefore, we studied concentrations anesthesiologists' breathing zones, depending on kind induction for general anesthesia, airway device, and type airflow system operating room. Furthermore, baselines typical peaks during anesthesia were determined.Measurements performed with LumaSense Photoacoustic Gas Monitor....

The MIRUS™ (TIM, Koblenz, Germany) is an electronical gas delivery system, which offers automated MAC (minimal alveolar concentration)-driven application of isoflurane, sevoflurane, or desflurane, and can be used for sedation in the intensive care unit. We investigated its consumption volatile anesthetics at 0.5 (primary endpoint) corresponding costs. Secondary endpoints were technical feasibility to reach control automatically, depth MAC, awakening times. Mechanically ventilated sedated...

Use of anesthetic conserving devices (ACD) for inhalational isoflurane sedation in Intensive Care Units (ICU) has grown recent years, and healthcare professionals are concerned about pollution exposure-related health risks. Real-time measurements to determine exposure ICU personnel during short-term patient care procedures ACD handling have not yet been performed.Isoflurane concentrations the breathing zones staff (25 cm around nose mouth) were measured, by photoacoustic gas monitoring,...

Introduction: Severe acute global cerebral hypoxia can lead to significant disability in humans. Although different animal models have been described study hypoxia, there is no endogenous model that considers and its effect on the brain as an independent factor. Thus, we developed a minimally invasive rat model, which based non-depolarizing muscle blocking agent rocuronium anesthetized animals. This drug causes respiratory insufficiency by paralysis of striated muscles. Methods: In this...

Unidirectional displacement flow (UDF) ventilation systems in operating rooms are characterized by a uniformity of velocity ≥80% and protect patients room personnel against exposure to hazardous substances. However, the air below surgical lights surrounding zone is turbulent, which impairs system's effect.

To date, apart from moderate hypothermia, there are almost no adequate interventions available for neuroprotection in cases of brain damage due to cardiac arrest. Affected persons often have severe limitations their quality life. The aim this study was investigate protective properties the active compound dimethyl fumarate, monomethyl fumarate (MMF), on distinct regions central nervous system after ischemic events. Dimethyl is an already established drug neurology with known...

Background MIRUS™ is a device for target‐controlled inhalational sedation in the ICU combination with use of isoflurane, or sevoflurane, desflurane. The feasibility this has recently been proven; however, staff exposure may restrict its application. We investigated ambient room pollution during daily work to estimate personnel while using MIRUS ™. Methods This observational study assessed levels around 15 adult surgical patients who received volatile anaesthetics‐based median 11 hours....

The prevalence of patients with implanted cardioverter defibrillators (ICDs) and the frequency surgery on these are steadily rise. Guidelines recommend preoperative ICD reprogramming, although this is sometimes difficult in clinical practice. Placing a magnet practical alternative even no inactivation possible selected cases.In prospective observational study, we compared different perioperative management strategies depending location type electrocautery used. Patients undergoing above...

Although sevoflurane is commonly used in anaesthesia, a threshold value for maximum exposure to personnel does not exist and although anaesthetists are aware of the problem, surgeons rarely focus on it. We photo-acoustic infrared device measure during paediatric adenoidectomies. Sixty children were randomly allocated laryngeal mask, cuffed tracheal tube or uncuffed tube. The average mean (maximum) concentrations within surgeons' operating area 1.05 (10.05) ppm mask group, 0.33 (1.44) group...

Sevoflurane is commonly used for inhalational inductions in children, but the personnel's exposure to it potentially harmful. Guidance reduce gas pollution refers mainly technical aspects, impact of child's behavior has not yet been studied.The purpose this study was determine how child behavior, according Frankl Behavioral Scale, affects amount waste sevoflurane anesthesiologists' breathing zones.Sixty-eight children aged 36-96 months undergoing elective ENT surgery were recruited...

The new MIRUS™ system as well the established AnaConDa® uses a reflector to conserve volatile anaesthetics (VA) [1]. Both systems act with commercially available ICU ventilators. In contrast AnaConDa®, includes an automated control of end-tidal VA concentrations. this study we compared feasibility, costs and recovery times after anaesthesia isoflurane (ISO), sevoflurane (SEVO) or desflurane (DES) in ventilated spontaneously breathing patients.

Abstract Background Intensive care unit (ICU) physicians have extended the minimum alveolar concentration (MAC) to deliver and monitor long-term volatile sedation in critically ill patients. There is limited evidence of MAC’s reliability controlling depth this setting. We hypothesized that depth, measured by electroencephalography (EEG)-derived Narcotrend-Index (burst-suppression N_Index 0—awake 100), might drift downward over time despite constant MAC values. Methods This prospective...

Real-time photoacoustic gas monitoring is used for personnel exposure and environmental monitoring, but its accuracy varies when organic solvents such as alcohol contaminate measurements. This problematic anesthetic measurements in hospitals, because most disinfectants contain alcohol, which could lead to false-high concentrations. We investigated the cross-sensitivities of monitor Innova 1412 (AirTech Instruments, LumaSense, Denmark) against alcohols alcoholic while measuring sevoflurane,...

BACKGROUND Pre-operative risk assessment is important to quantify the patient's risks of morbidity and mortality, but its quality differs. We created a process-oriented score (PRO-score) for evaluation adults as three-stage warning checklist with concrete guidance. It contains contents current guidelines vital signs. OBJECTIVES investigated whether PRO-score suitable detect ‘red flag’ signs not only in American Society Anesthesiologists (ASA) physical status (PS) 3 or 4 patients also ASA-PS...

(Abstracted from Anesth Analg, 121:1519–1528, 2015) Occupational chronic sevoflurane exposure has been previously associated with increased formation of sister chromatid exchanges in animal studies and anesthetic personnel. To date, however, there is no current, defined worldwide uniform time-weighted mean threshold limit concentration.

Abstract Background The optimal pain therapy for children undergoing tonsillotomy remains unknown. Our aim was to evaluate a standard including the alternating application of ibuprofen and paracetamol. Methods Pain intensity 81 in‐patients after aged 2–12 years evaluated three times daily (mean observation 3.85 days) using Children's Infants’ Postoperative Scale (CHIPPS) in <5 years, or with Faces Scale‐Revised (FPS‐R) older children. Parents completed Parents’ Measure (PPPM‐D) addition....