Sevoflurane for interventional neuroradiology procedures is associated with more rapid early recovery than propofol

Castagnini, Hugo E.; Eijs, Frank van; Salevsky, Fred C.; Nathanson, Michael H.

doi:10.1007/bf03018313

Cited by 31 publications

(16 citation statements)

References 13 publications

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“…All recovery times noted in this study were within the range of 5-9 min, which were consistent with those reported previously [5,6]. Previous studies comparing the recovery profiles after maintenance of anesthesia for neuroradiology with inhalation anesthetics or propofol [5,6] showed that sevoflurane was associated with a more rapid recovery profile than propofol, whereas isoflurane and propofol showed similar recovery profiles from anesthesia.…”

Section: Discussionsupporting

confidence: 90%

“…Anesthetic agents such as propofol, sevoflurane, isoflurane, and desflurane are commonly used to maintain anesthesia in patients undergoing general anesthesia for INR [4]. Previous studies have shown that sevoflurane is associated with more rapid recovery than that achieved using propofol, whereas isoflurane and propofol showed similar recovery profiles in patients emerging from anesthesia [5,6]. However, these studies used hemodynamic variables to titrate the depths of anesthesia, and neither movement nor intraoperative awareness can be assessed using hemodynamic indices [7].…”

Section: Introductionmentioning

confidence: 99%

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Sevoflurane versus propofol for interventional neuroradiology: a comparison of the maintenance and recovery profiles at comparable depths of anesthesia

Choi

Shin

et al. 2014

Korean J Anesthesiol

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BackgroundSevoflurane and propofol are used widely for interventional neuroradiology (INR). Using the bispectral index (BIS), we compared the clinical properties of sevoflurane and propofol anesthesia in patients undergoing INR at comparable depths of anesthesia.MethodsThe patients were allocated randomly into two groups. The sevoflurane group received propofol (1.5 mg/kg), alfentanil (5 µg/kg), and rocuronium (0.6 mg/kg) for induction, and the propofol group was induced with a target effect-site concentration of propofol (4 µg/ml), alfentanil (5 µg/kg), and rocuronium (0.6 mg/kg). After intubation, anesthesia was maintained with sevoflurane or propofol with 67% nitrous oxide in 33% oxygen. Sevoflurane and propofol concentrations were titrated to maintain the BIS at 50-60. Phenylephrine or opioid was used to maintain the mean arterial pressure within 20% of the baseline values. The amounts of phenylephrine or alfentanil used, the number of patients showing movement during the procedure, and the recovery times were recorded.Results Compared to the propofol group, the sevoflurane group showed faster recovery in spontaneous ventilation, eye opening, extubation, and orientation (4 vs. 7 min, 7 vs. 9 min, 8 vs. 10 min, 10 vs. 14 min, respectively; P < 0.01). In the propofol group, significantly greater amounts phenylephrine were used (P < 0.05), and more patients moved during the procedure (P < 0.05).ConclusionsThe use of sevoflurane in maintaining anesthesia during INR was associated with faster recovery, less patient movement during the procedure, and a more stable hemodynamic response when compared to propofol.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Sevoflurane versus propofol for interventional neuroradiology: a comparison of the maintenance and recovery profiles at comparable depths of anesthesia

Choi

Shin

et al. 2014

Korean J Anesthesiol

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“…1,3,8,14,18 Genelde nöroradyolojik girişimler hastalar için daha az uyarıcı ve daha az ağrılıdır. Endotrakeal entü-basyon için gereken anestezi miktarı dolayısıyla daha az olmaktadır.…”

Section: 21unclassified

“…Hem sevofluranın hem de propofolün girişimsel nöroradyolojide kullanılabi-leceğini ifade etmişlerdir. 18 Propofol ve izofluranın karşılaştırıldığı başka bir çalışmada da hastaların uyanma profillerinin benzer olduğu ve periferik damarlar üzerinde direkt vazodilatasyon yaparak mikrokateterlerin sebep olduğu vazospazmı önlemede kullanılabileceği ifade edilmiştir.…”

Section: 21unclassified

Evaluation of anesthesia applications in interventional neuroradiology cases

Kaya

Karaman²,

Süren³

et al. 2012

J Clin Exp Invest

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Objectives: In this study, we aimed to evaluate anesthesia applications of the patients underwent invasive interventional neuroradiology applications. Materials and methods:Between June 2004 and October 2004, 152 emergency or elective adult patients who were undergone general anesthesia were evaluated retrospectively. Information about the patients was taken from radiology, anesthesia notes and university's information system. Patients were evaluated in terms of age, gender, American Society of Anesthesiologists score, indication of application, the existence of concomitant diseases, anesthesia technique, anesthetic medications and the possibility of whether patient were in intensive care unit.Results: Of all, 55.3% of the patients (n=84) were female and 44,7% (n=68) were male. General anesthesia was applied in all cases and propofol was preferred mostly in induction and sevoflurane was preferred in maintenance. Surgically, 81,6% of the patients was elective and 18,4% was emergency patients. Diagnoses of patients were as follow: Cerebral aneurysm 63,8%, arteriovenous malformation 19,7%, thrombolytic therapy 8%, tumor embolization 5,3% and carotid stenting 3,2%. Totally 58 patients were taken into intensive care unit and 6 of these died. Conclusions:In order to provide a safe and efficient patient care, we think that permanent anesthesia equipment is necessary together with good physical conditions of the operation room, proficiency of neuroradiologist, the close relationship between the patient and anesthetist and a good knowledge of underlying neuropathology. Bulgular: Hastaların %55,3'ü (n=84) kadın ve %44,7'si de (n=68) erkeklerden oluşmaktaydı. Olguların tamamı-na genel anestezi uygulanmış olup indüksiyonda en fazla propofol, idamede ise sevofluran tercih edilmiştir. Hastaların %81,6'sı elektif, %18,4'ü acil alınmış olup olguların tanıları serebral anevrizma (%63,8), arteriovenöz malformasyon (%19,7), Trombolitik tedavi (%8), tümör embolizasyonu (5,3) ve karotis stenti (%3,2) şeklindeydi. Toplam 58 hasta yoğun bakım ünitesine yatırılmış olup altı tanesi kaybedilmiştir.Sonuç: Güvenli ve etkili hasta bakımının sağlanabilmesi için; altta yatan nöropatolojinin iyi bilinmesi, operasyon odasının fiziki şartları, nöroradyolog, hasta ve anestezist arasındaki yakın ilişki kadar kalıcı anestezi ekiplerinin de gerekli olduğunu düşünmekteyiz.Anahtar kelimeler: Girişimsel radyoloji, genel anestezi, serebral anevrizma, arteriovenöz malformasyonlar GİRİŞRadyoloji ünitesinde anestezi; bilgisayarlı tomografi, manyetik rezonans, girişimsel radyoloji ve ultrason eşliğinde biyopsi için son yıllarda yaygın olarak kullanılmaya başlanmıştır. Bununla paralel olarak girişimsel nöroradyolojik işlemler için anestezi ilgi çekici olmaya başlamıştır. Girişimsel nöroradyoloji, terapötik ilaç ve aygıtların endovasküler yol kullanılarak santral sinir sistemi hastalıklarında uygulanması olarak tanımlanmaktadır. Günümüzde ameliyathane dışında radyoloji ünitesinde başka sağlık sorunları da bulunan yaşlı populasyonda uzun ve giderek art...

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“…The anaesthesia literature is full of studies looking at early recoveryincluding in neuroanaesthesia. 9 Are differences in early recovery parameters helpful? It is certainly pragmatic, as neuroanaesthesiologists are still taught to waken the patient as quickly as possible so that a patent airway is established and to allow early assessment of neurological status.…”

mentioning

confidence: 98%

Research on neuroanaesthesia and real outcomes

Nathanson

Columb²

2012

European Journal of Anaesthesiology

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Sevoflurane for interventional neuroradiology procedures is associated with more rapid early recovery than propofol

Abstract: P Pu ur rp po os se e: : Sevoflurane and propofol are both suitable for neuroanesthesia but have not previously been compared as maintenance agents for long duration (one to five hours) procedures.

Cited by 31 publications

References 13 publications

Sevoflurane versus propofol for interventional neuroradiology: a comparison of the maintenance and recovery profiles at comparable depths of anesthesia

Sevoflurane versus propofol for interventional neuroradiology: a comparison of the maintenance and recovery profiles at comparable depths of anesthesia

Evaluation of anesthesia applications in interventional neuroradiology cases

Research on neuroanaesthesia and real outcomes

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