The purpose of this investigation was to describe the pharmacodynamic interaction between propofol and remifentanil for probability no response shaking shouting, laryngoscopy, Bispectral Index (BIS), electroencephalographic approximate entropy (AE).Twenty healthy volunteers received either or alone then concurrently with a fixed concentration propofol, respectively, via target-controlled infusion. Responses shouting laryngoscopy were assessed multiple times after allowing plasma effect site...

Background The authors hypothesized that the electroencephalogram (EEG) during higher anesthetic concentrations would show more "order" and less "randomness" than at lower concentrations. "Approximate entropy" is a new statistical parameter derived from Kolmogorov-Sinai entropy formula which quantifies amount of regularity in data. approximate predictability subsequent amplitude values EEG based on knowledge previous values. investigated dose-response relation desflurane anesthesia...

Background Several studies relating electroencephalogram parameter values to clinical endpoints using a single (mostly hypnotic) drug at relatively low levels of central nervous system depression (sedation) have been published. However, the usefulness derived from for anesthesia largely depends on its ability predict response stimuli different intensity or painfulness under combination hypnotic and an (opioid) analgesic. This study was designed evaluate predictive performance spectral edge...

Background Approximate entropy, a measure of signal complexity and regularity, quantifies electroencephalogram changes during anesthesia. With increasing doses anesthetics, burst-suppression patterns occur. Because the high-frequency bursts, spectrally based parameters such as median frequency spectral edge 95 do not decrease, incorrectly suggesting lightening The authors investigated whether approximate entropy algorithm correctly classifies occurrence burst suppression deepening Methods...

Recently, entropy algorithms have been proposed as electroencephalographic measures of anesthetic drug effects. Datex-Ohmeda (Helsinki, Finland) introduced the Entropy Module, a new monitor designed for measuring depth anesthesia. The calculates state (SE) computed over frequency range 0.8-32 Hz and response (RE) 0.8-47 Hz. authors investigated dose-response relation SE RE during sevoflurane anesthesia in comparison with Bispectral Index (BIS).Sixteen patients were studied without surgical...

The Shannon entropy is a standard measure for the order state of sequences. It quantifies degree skew distribution values. Increasing hypnotic drug concentrations increase electroencephalographic amplitude. probability density function amplitude values broadens and flattens, thereby changing from towards equal distribution. We investigated dose-response relation during desflurane monoanesthesia in comparison with previously used parameters.Electroencephalographic records obtained 12 female...

Thoracic paravertebral block (TPVB) can be used for unilateral surgical procedures. Modifications of the classic approach have been proposed to minimize risk pleural puncture. In this study, we evaluated feasibility and success rate a transverse in-plane ultrasound (US)-guided TPVB with radiologic confirmation catheter position.A total 36 patients scheduled surgery were included in prospective study. Ultrasonographically, process thoracic vertebra rib identified at appropriate level. The...

Patients with a proximal femur fracture are often difficult to evacuate from the accident scene. Prehospital pain management for this vulnerable group of patients may be challenging. Multiple co-morbidities, polypharmacy and increased age limit choice suitable analgesics. The fascia iliaca compartment (FIC) block an alternative intravenous However peripheral nerve is mainly applied by physicians.In Netherlands, prehospital emergency care mostly provided EMS-nurses. Therefore we examined...

Combining electrophysiological and hemodynamic features is a novel approach for improving current performance of brain switches based on sensorimotor rhythms (SMR). This study was conducted with dual purpose: to test the feasibility using combined electroencephalogram/functional near-infrared spectroscopy (EEG-fNIRS) SMR-based switch in patients tetraplegia, examine difference between motor imagery attempt this user group. A general improvement found when both EEG fNIRS classification as...

We read with great interest the report by Kolb et al. on remimazolam sedation for awake tracheal intubation [1]. In our experience, is a promising sedative agent such cases and we use it as routine when appropriate. The patient described weighed 76 kg, 5 mg bolus of was administered at start procedure, followed three boluses 2.5 2 min intervals (minutes 3, 7). total dose 12.5 which in keeping 15 (administered boluses) an earlier [2]. After initial experience only, changed practice to loading...

When a difficult airway is anticipated, awake tracheal intubation can be considered. Usually, low doses of sedatives are administered during this procedure for minimal sedation and anxiolysis, such as midazolam remifentanil. The newly developed ultra-short-acting benzodiazepine remimazolam has pharmacokinetic profile that more suitable titration than the long-acting midazolam. It titrated to effect while spontaneous breathing preserved. desired, cessation administration will result in...

The emergence from general anesthesia is currently difficult to predict and may be accompanied by respiratory complications. Switching all hypnotic drugs remimazolam at the end of operation antagonizing it with flumazenil might lead a rapid, smooth, safe patient awakening, potentially increasing operating theater efficiency reducing costs. In this case series five patients, combination remimazolam, propofol, sevoflurane was transitioned 0.9-1.0 mg/kg/h as sole agent near operation....

Introduction: Difficult airway management is a critical challenge in anesthesia, often necessitating advanced techniques to ensure patient safety. A presented with malignant lesion on the epiglottis, significantly altering anatomy. Flexible rhinolaryngoscopy revealed laryngeal carcinoma affecting entire causing thickening and displacement, which suggested potential for difficult intubation. Methods: Given expected feasibility of bag-mask ventilation front-of-neck access, an asleep intubation...

Rationale and patient concerns: Propofol is the most frequently used sedative for procedural sedation analgesia (PSA). However, side effects are cardiovascular respiratory depression pain on injection. Remimazolam equally effective as propofol with improved hemodynamic stability less not painful achieves a deeper level of sedation, suggesting that addition to remimazolam may combine best both worlds. Continuous administration PSA during colonoscopy has never been described. Here, we evaluate...

Background Anesthesiologists routinely increase the delivered anesthetic concentration before surgical stimulation in anticipation of increased requirement to achieve certain goals (e.g., amnesia, unconsciousness, and immobility). Electroencephalographic monitoring is one method determining indirectly effect on brain. The present study investigated stimuli concentration-response relation desflurane-induced electroencephalographic changes. Methods activity was recorded from 24 female patients...

The Narcotrend monitor (MonitorTechnik, Bad Bramstedt, Germany) has recently been introduced as an intraoperative of anesthetic state, based on a classification scheme originally developed for visual assessment the electroencephalogram. authors compared performance index (software version 4.0) to Bispectral Index (BIS, XP; Aspect Medical Systems, Natick, MA) electroencephalographic measures isoflurane drug effect during general anesthesia.The observed 15 adult patients scheduled undergo...