General Anesthesia as a Multimodal Individualized Clinical Concept

Rogobete, Alexandru Florin; Săndesc, Dorel

doi:10.3390/medicina58070956

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…In recent decades, several new and modern techniques have been developed for continuous monitoring of vital signs in patients undergoing surgery under general anesthesia. These complex methods are intended to be an adjunct to the classical monitoring protocols used in general anesthesia to increase patient safety [27] . The main objectives of monitoring are to avoid overdosing or underdosing of anesthetic drugs, to adapt the concentration of substances in use, to reduce post-anaesthetic complications, and to increase patient comfort.…”

Section: Anesthesiamentioning

confidence: 99%

Trigeminal surgery: A review

Tavares¹,

Cepeda²,

Gómez³

et al. 2023

Int. J. Appl. Dent. Sci.

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Introduction:The study of trigeminal surgery is linked to trigeminal neuralgia and being a serious disorder can impair the patient's quality of life. Objective: To analyze the literature on relevant aspects of trigeminal surgery, such as decompression, sensitivity, anesthesia and schwannomas. Methodology: PubMed, SCOPUS and Google Scholar databases were reviewed to find recent articles published on trigeminal surgery with the following keywords: "trigeminal nerve", "trigeminal surgery", "decompression", "schwannomas", "anesthesia". Results: Microvascular decompression is the most effective procedure for the management of trigeminal neuralgia; highly favourable results have been achieved with this technique. Sensitivity is of great importance in the treatment of this condition, since it is the reason why patients will come for consultation with the aim of eliminating any discomfort related to a nerve condition. Anesthesia requires correct management for a good result in trigeminal surgery and to provide the best care and recovery to patients. Schwannomas are usually benign and rare intracranial tumours. There are several treatments that can help to treat them, the most used and that has achieved excellent results is gamma knife radiosurgery. Conclusions: Trigeminal neuralgia is a condition that usually appears in one or more branches of the trigeminal nerve, trigeminal surgery is usually a method to treat this condition by means of different techniques such as microvascular decompression and thus achieve disappearance of this disorder.

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Section: Anesthesiamentioning

confidence: 99%

Trigeminal surgery: A review

Tavares¹,

Cepeda²,

Gómez³

et al. 2023

Int. J. Appl. Dent. Sci.

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“…[1][2][3] The opioid side-effects (sedation, respiratory depression, constipation, cognitive and social dysfunctions) are well known and widely described. [4][5][6][7][8][9] Recently, many publications have highlighted new aspects of opioid therapyopioid-induced immunomodulation, as well as carcinogenesis processes and oxidative imbalance. [10][11][12][13][14][15] The principles of perioperative acute pain management have changed.…”

Section: Introductionmentioning

confidence: 99%

Are There Any Advantages of the Low Opioid Anaesthesia and Non-Opioid Postoperative Analgesia Protocol: A Clinical Observational Study

Kościuczuk,

Tarnowska,

Rynkiewicz-Szczepanska

2024

JPR

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The methods of perioperative analgesia and pain control have changed. The principle of opioid-based analgesia has been modified to multimodal analgesia, followed by LOA (low opioid anaesthesia) and OFA (opioid-free anaesthesia). The aim was to describe the effects of LOA on nausea, vomiting, and pain control during general anaesthesia and postoperative period after laparoscopic cholecystectomy. Patients and Methods:The protocol included the study group-40 patients received low-opioid anaesthesia (LOA), and the control group-40 patients received general anaesthesia with opioid analgesia (OA). The scheme of LOA was based on ketamine, lidocaine, magnesium sulfate, paracetamol, and metamizole. The OA was based on standard opioid (fentanyl) administration in induction and maintenance phase due to clinical observation. Postoperative analgesia included 1g of paracetamol and 1g of metamizol intravenously, with a 6-hour interval between doses. Results: Significant differences in the pain score in the periods of 2-6, 6-12, and 12-24 hours after anaesthesia between the groups were noticed (p < 0.001). Moreover, a significant difference in the frequency of nausea (p = 0.005) and vomiting (p = 0.04) between groups were presented. Nausea occurred in 54.05% of OA group, while in the LOA group, it occurred in a 23.08%. Vomiting occurred in 32.43% of control group, while in the study group, it occurred in 12.82% of patients. Conclusion:The LOA protocol was more beneficial in reducing nausea and vomiting than the opioid-based method of anaesthesia. The LOA protocol of general anaesthesia during laparoscopic cholecystectomy and non-opioid postoperative analgesia have better outcomes in pain control, as well as nausea and vomiting, and improve postoperative patient comfort. The LOA protocol during anaesthesia and non-opioid postoperative analgesia should be considered in routine practice.

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“…General anesthesia involves the administration of narcotic drugs to temporarily suppress the central nervous system, leading to reversible loss of consciousness, sensation, and reflexes[ 1 ]. Emergence agitation (EA) refers to a transient state of consciousness and behavior separation during the transition from anesthesia to full consciousness.…”

Section: Introductionmentioning

confidence: 99%

Influencing factors and risk prediction model for emergence agitation after general anesthesia for primary liver cancer

Song,

Lin,

et al. 2024

World J Gastrointest Surg

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BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors; however, it can lead to emergence agitation (EA). EA is a common complication associated with general anesthesia, often characterized by behaviors, such as crying, struggling, and involuntary limb movements in patients. If treatment is delayed, there is a risk of incision cracking and bleeding, which can significantly affect surgical outcomes. Therefore, having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia, which is beneficial for improving patient prognosis. AIM To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer. METHODS Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital (January 2020 to December 2023) was conducted. Post-surgery, the Richmond Agitation-Sedation Scale was used to evaluate EA presence, noting EA incidence after general anesthesia. Patients were categorized by EA presence postoperatively, and the influencing factors were analyzed using logistic regression. A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves. RESULTS EA occurred in 51 (25.5%) patients. Multivariate analysis identified advanced age, American Society of Anesthesiologists (ASA) grade III, indwelling catheter use, and postoperative pain as risk factors for EA (P < 0.05). Conversely, postoperative analgesia was a protective factor against EA (P < 0.05). The area under the curve of the nomogram was 0.972 [95% confidence interval (CI): 0.947-0.997] for the training set and 0.979 (95%CI: 0.951-1.000) for the test set. Hosmer-Lemeshow test showed a good fit (χ 2 = 5.483, P = 0.705), and calibration curves showed agreement between predicted and actual EA incidence. CONCLUSION Age, ASA grade, catheter use, postoperative pain, and analgesia significantly influence EA occurrence. A nomogram constructed using these factors demonstrates strong predictive accuracy.

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General Anesthesia as a Multimodal Individualized Clinical Concept

Cited by 4 publications

References 7 publications

Trigeminal surgery: A review

Trigeminal surgery: A review

Are There Any Advantages of the Low Opioid Anaesthesia and Non-Opioid Postoperative Analgesia Protocol: A Clinical Observational Study

Influencing factors and risk prediction model for emergence agitation after general anesthesia for primary liver cancer

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