Efficacy of Fentanyl or Alfentanil in Suppressing Reflex Sneezing After Propofol Sedation and Periocular Injection

Tao, Jeremiah; Nunery, William R.; Kresovsky, S.; Lister, Linda; Mote, Thomas

doi:10.1097/iop.0b013e31818ab3ca

Cited by 28 publications

(15 citation statements)

References 11 publications

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“…An opioid (fentanyl or alfentanil), given minutes before propofol, eliminated the sneeze reflex in patients with periocular injections. 86 Dexmedetomidine reliably produces conscious sedation where the patient remains responsive and cooperative to verbal commands. This is mediated through activation of a 2 -adrenoreceptors in the locus coeruleus which is a major site of noradrenergic innervation in the central nervous system.…”

Section: Patients With Increased Operative Risk or Risk Of Device Malmentioning

confidence: 99%

Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices

Poon

Irwin

2009

British Journal of Anaesthesia

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Deep brain stimulation has become an increasingly common treatment for Parkinson's disease and other movement disorders. Consequently, it is important to understand the concepts of appropriate patient selection, the implantation process, and the various drugs and techniques that can be used to facilitate this treatment. Currently, none of the anaesthetic techniques for neurostimulator implantation has proven to be superior to others, although awake or sedation techniques are popular as they facilitate intraoperative neurological testing. However, even with meticulous anaesthetic care, perioperative complications such as hypertension and seizures do occasionally occur and close monitoring is required. Anaesthesia in patients with an implanted neurostimulator requires special considerations because of possible interference between neurostimulators and other devices. We have reviewed the current knowledge of anaesthetic techniques and perioperative complications of neurostimulator insertion. Anaesthetic considerations in patients with an implanted neurostimulator are also discussed.

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Section: Patients With Increased Operative Risk or Risk Of Device Malmentioning

confidence: 99%

Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices

Poon

Irwin

2009

British Journal of Anaesthesia

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“…Tao et al administered fentanyl or alfentanil in an attempt to suppress the sneezing and noted 43.6 percent of patients who did not receive an opioid sneezed while none of the patients who received an opioid sneezed, thus preventing inadvertent needle injury during injection of local anesthetic with propofol sedation (Level II Evidence). 47 Ferraro et al found that sedation with remifentanil provided significant patient comfort, and they noted fewer incidents of bradycardia, hypertension, and respiratory problems than when patients were sedated with midazolam and propofol (Level III Evidence). 48 The well-known downside of opiates is nausea and vomiting, which can be avoided if pure local anesthesia is used.…”

Section: Evidence On Pain Managementmentioning

confidence: 97%

An Evidence-Based Approach to Blepharoplasty

Friedland

Lalonde

Rohrich

2010

Plastic and Reconstructive Surgery

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The Maintenance of Certification module series is designed to help the clinician structure his or her study in specific areas appropriate to his or her clinical practice. This article is prepared to accompany practice-based assessment of preoperative assessment, anesthesia, surgical treatment plan, perioperative management, and outcomes. In this format, the clinician is invited to compare his or her methods of patient assessment and treatment, outcomes, and complications, with authoritative, information-based references.This information base is then used for self-assessment and benchmarking in parts II and IV of the Maintenance of Certification process of the American Board of Plastic Surgery. This article is not intended to be an exhaustive treatise on the subject. Rather, it is designed to serve as a reference point for further in-depth study by review of the reference articles presented. (Plast. Reconstr. Surg. 126: 2222 CLINICAL SCENARIOA 56-year-old woman requests improvement in the appearance of her upper and lower eyelids. She had LASIK surgery 3 months earlier. She has ptosis of her left upper eyelid. What is the best evidence to guide you in the management of her condition? There is very little high level evidence in the blepharoplasty literature at this time. The age of evidence is just upon us, and objective measurement in aesthetic surgery is in its infancy. This article is a starting point where most of the evidence is level IV (case series) and level V (case reports or expert opinion). There is almost no level III evidence (retrospective comparative case series) and virtually no level II evidence (prospective comparative studies). It will be very difficult to create level I studies that are prospective randomized blinded controlled studies. Nevertheless, we have to start somewhere. One hundred years from now, there will be serious useful evidence-based studies in cosmetic plastic surgery, like looking from the top of a sky scraper. This is the first step at examining where we are in the basement of evidence based medicine in aesthetic blepharoplasty. METHODS FOR IDENTIFYING EVIDENCEA literature search of PubMed, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library was performed to obtain the best available evidence on blepharoplasty, with emphasis on preoperative assessment, treatment, and outcomes. The following search terms were combined as appropriate, and PubMed MeSH terms were used when available: blepharoplasty, eyelid surgery, diagnosis, preoperative assessment, risk factors, smoking, diabetes mellitus, pulmonary embolism, venous thrombosis, dry eye syndromes, anticoagulants, DVT prophylaxis, antibiotic prophylaxis, anesthetics, premedication, surgical treatment plan, treatment, surgery, outcome, complications, postoperative complications, pain management, and analgesia. The initial search was limited to human studies that were published from 1999 to 2009 and indexed as metaanalyses, randomized controlled trials, clinical trials, or comparative studies. Very fe...

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“…Fentanyl or remifentanil, given minutes before propofol, can avoid sneezing. [24] In patients with dystonia, propofol has been found to reduce firing rates of GPi nucleus. [25] Raz et al, in 2008, showed that propofol infusion at 50 µg/kg/min significantly reduced spontaneous firing rated of STN neurons interfering with lead placement, but neuronal activity returned to baseline in 9.4 ± 4.2 min after stopping propofol infusion.…”

Section: Microelectrode Recordingmentioning

confidence: 99%

Anaesthesia and deep brain stimulation

Bindu

Bithal

2016

Journal of Neuroanaesthesiology and Critical Care

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Deep brain stimulation (DBS) is becoming an increasingly popular minimally invasive surgical procedure for various movement disorders, especially Parkinson’s disease. Different nuclei have been identified depending on patients’ symptoms, but the success or failure of the procedure depends on various other factors such as proper patient selection and risk-benefit analysis. While various techniques of anaesthesia including monitored anaesthesia care, conscious sedation and general anaesthesia are being used routinely, no clear-cut evidence exists as to the best technique for this procedure. This review article discusses the surgical procedure of DBS, devices currently available, perioperative anaesthetic concerns and techniques, effect of anaesthetic drugs on microelectrode recordings and macro-stimulation and associated complications.

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Efficacy of Fentanyl or Alfentanil in Suppressing Reflex Sneezing After Propofol Sedation and Periocular Injection

Abstract: Fentanyl or alfentanil suppressed sneezing after propofol sedation and eyelid anesthetic injection. These medications may prevent needle injury.

Cited by 28 publications

References 11 publications

Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices

Anaesthesia for deep brain stimulation and in patients with implanted neurostimulator devices

An Evidence-Based Approach to Blepharoplasty

Anaesthesia and deep brain stimulation

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