Opioids

Fukuda, Kazuhiko

doi:10.1016/b978-0-443-06959-8.00027-3

Cited by 36 publications

(29 citation statements)

References 486 publications

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“…Remifentanil is metabolized rapidly by nonspecific cholinesterase in plasma and leads to quick recovery in patients with any condition. 6,7 Besides, because its context-sensitive half-life is 5-10 minutes, 22,23 interaction with other drugs in the recovery state is unlikely. Rocuronium, a nondepolarizing neuromuscular blocking agent, can be reversed by sugammadex, a specific reversal agent for rocuronium neuromuscular blockade.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Because controlling the recovery state is important in managing ambulatory general anesthesia, we perform total intravenous anesthesia consisting mainly of propofol and remifentanil, which allows a quick and comfortable recovery. [4][5][6][7] Midazolam, a short-acting benzodiazepine injection, was shown to be a clear determinant of delayed recovery from general anesthesia in our previous study, 8 so we ceased using midazolam injection in ambulatory general anesthesia in our facility. Nevertheless, some patients still spent longer than others in emergence and/or recovery from general anesthesia.…”

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confidence: 99%

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Independent Predictors of Delay in Emergence From General Anesthesia

Miyagawa¹,

Higuchi²,

Ishii-Maruhama³

et al. 2015

Anesthesia Progress

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Some patients with intellectual disabilities spend longer than others in emergence from ambulatory general anesthesia for dental treatment. Although antiepileptic drugs and anesthetics might be involved, an independent predictor for delay of the emergence remains unclear. Thus, a purpose of this study is to identify independent factors affecting the delay of emergence from general anesthesia. This was a retrospective cohort study in dental patients with intellectual disabilities. Patients in need of sedative premedication were removed from participants. The outcome was time until emergence from general anesthesia. Stepwise multivariate regression analysis was used to extract independent factors affecting the outcome. Antiepileptic drugs and anesthetic parameters were included as predictor variables. The study included 102 cases. Clobazam, clonazepam, and phenobarbital were shown to be independent determinants of emergence time. Parameters relating to anesthetics, patients' backgrounds, and dental treatment were not independent factors. Delay in emergence time in ambulatory general anesthesia is likely to be related to the antiepileptic drugs of benzodiazepine or barbiturates in patients with intellectual disability.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Independent Predictors of Delay in Emergence From General Anesthesia

Miyagawa¹,

Higuchi²,

Ishii-Maruhama³

et al. 2015

Anesthesia Progress

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“…During last decade, some studies have reported the positive effects of different doses of intrathecal meperidine during spinal anesthesia on reducing the severity and incidence of perioperative shivering [12-14]. Intravenous meperidine is widely used for the treatment of shivering intra-operatively (during the cesarean section) and post-operatively (in the recovery room) but it could be associated with side effects.…”

Section: Introductionmentioning

confidence: 99%

Intrathecal Meperidine Plus Lidocaine for Prevention of Shivering during Cesarean Section

et al. 2013

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BackgroundShivering related to spinal anesthesia may interfere with monitoring and is uncomfortable. The aim of the present study was to investigate low-dose intrathecal meperidine for the prevention of shivering after induction of spinal anesthesia in parturients with cesarean section.MethodsThis was a prospective randomized, double-blind, placebo-controlled trial including 100 parturients, of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for elective cesarean section under spinal anesthesia who were randomly assigned to a meperidine (0.2 mg/kg) plus hyperbaric lidocaine (5%, 75 mg, n = 50; group M) group or a placebo plus hyperbaric lidocaine (5%, 75 mg, n = 50; group L) group. Demographic and surgical data, adverse events, and the mean intensity for each parturient were assessed during the entire study period by a blinded observer.ResultsThere were no significant differences between the two study groups regarding the demographic and surgical data (P > 0.05). The incidence of shivering during the entire study period significantly decreased in the group of parturients who received intrathecal meperidine (P = 0.04). There were no significant differences in nausea and vomiting between the two groups.ConclusionsLow-dose intrathecal meperidine (10 mg) is safe and effective in reducing the incidence and severity of shivering associated with spinal anesthesia in parturients with cesarean section.

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“…Data are conflicting regarding the effect of caudal analgesia on voiding, 19,20 while morphine is well known to cause urinary retention and urodynamic problems. 21 However, our study was not designed or powered enough to detect the effect of the block on voiding.…”

Section: Discussionmentioning

confidence: 96%