Xenon: from stranger to guardian

Sanders, Robert D.; Maze, Mervyn

doi:10.1097/01.aco.0000174957.97759.f6

Cited by 34 publications

(20 citation statements)

References 60 publications

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“…Xenon exerts a potent analgesic action due to NMDA receptor inhibition [25] which may explain the lower overall remifentanil consumption during surgery; however, wash in and wash out of xenon are very fast [9, 13], and NMDA receptor blocking ability may not explain an effect on pain pathways up to 72 hours. Nowadays the evidence is that xenon is able to modulate long-term pathways [12, 14, 22] which are considered the end effectors producing the long-term organoprotective effects of the gas.…”

Section: Discussionmentioning

confidence: 99%

Xenon Anesthesia Improves Respiratory Gas Exchanges in Morbidly Obese Patients

et al. 2010

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Background. Xenon-in-oxygen is a high density gas mixture and may improve PaO2/FiO2 ratio in morbidly obese patients uniforming distribution of ventilation during anesthesia. Methods. We compared xenon versus sevoflurane anesthesia in twenty adult morbidly obese patients (BMI > 35) candidate for roux-en-Y laparoscopic gastric bypass and assessed PaO2/FiO2 ratio at baseline, at 15 min from induction of anaesthesia and every 60 min during surgery. Differences in intraoperative and postoperative data including heart rate, systolic and diastolic pressure, oxygen saturation, plateau pressure, eyes opening and extubation time, Aldrete score on arrival to the PACU were compared by the Mann-Whitney test and were considered as secondary aims. Moreover the occurrence of side effects and postoperative analgesic demand were assessed. Results. In xenon group PaO2-FiO2 ratio was significantly higher after 60 min and 120 min from induction of anesthesia; heart rate and overall remifentanil consumption were lower; the eyes opening time and the extubation time were shorter; morphine consumption at 72 hours was lower; postoperative nausea was more common. Conclusions. Xenon anesthesia improved PaO2/FiO2 ratio and maintained its distinctive rapid recovery times and cardiovascular stability. A reduction of opioid consumption during and after surgery and an increased incidence of PONV were also observed in xenon group.

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Section: Discussionmentioning

confidence: 99%

Xenon Anesthesia Improves Respiratory Gas Exchanges in Morbidly Obese Patients

et al. 2010

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“…In recent years several clinical trials have been published that characterize the anaesthetic properties as well as the other potential properties of Xenon [1-4]. Following the licensing of Xenon in 12 European countries in 2007 after Germany was first in 2005 there is increasing interest in gaining a better understanding of the underlying scientific opportunities that Xenon offers as well as the role that Xenon can play in anaesthesia in the future.…”

Section: Introductionmentioning

confidence: 99%

Recovery index, attentiveness and state of memory after xenon or isoflurane anaesthesia: a randomized controlled trial

et al. 2010

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BackgroundPerformance of patients immediately after anaesthesia is an area of special interest and so a clinical trial was conducted to compare Xenon with Isoflurane anaesthesia. In order to assess the early cognitive recovery the syndrome short test (SST) according to Erzigkeit (Geromed GmbH) was applied.MethodsASA I and II patients undergoing long and short surgical interventions were randomised to receive either general anaesthesia with Xenon or Isoflurane. The primary endpoint was the validated SST which covering memory disturbances and attentiveness. The test was used on the day prior to intervention, one and three hours post extubation. The secondary endpoint was the recovery index (RI) measured after the end of the inhalation of Xenon or Isoflurane. In addition the Aldrete score was evaluated up to 180 min. On the first post-operative day the patients rated the quality of the anaesthetic using a scoring system from 1-6.ResultsThe demographics of the groups were similar. The sum score of the SST delivered a clear trend one hour post extubation and a statistically significant superiority for Xenon three hours post extubation (p < 0.01). The RI likewise revealed a statistically significant superiority of Xenon 5 minutes post extubation (p < 0.01). The Aldrete score was significantly higher for 45 min. The scoring system results were also better after Xenon anaesthesia (p < 0.001).ConclusionsThe results show that recovery from anaesthesia and the early return of post-operative cognitive functions are significantly better after Xenon anaesthesia compared to Isoflurane. The results of the RI for Xenon are similar with the previously published results.Trial RegistrationThe trial was registered with the number ISRCTN01110844 http://www.controlled-trials.com/isrctn/pf/01110844.

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“…Cullen successfully performed general anaesthesia with xenon for the first time in 1951[7]. Xenon comes very close to being the ideal anaesthetic [8-12]. Its unique properties include a rapid onset and offset of action [13] and a recovery index with good arousal quality [14].…”

Section: Discussionmentioning

confidence: 99%

The breast feeding mother and xenon anaesthesia: four case reports. Breast feeding and xenon anaesthesia

et al. 2010

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BackgroundFour nursing mothers consented to anaesthesia for urgent surgery only on condition that their ability to breast feed would not be impaired.MethodsFollowing induction of general anaesthesia with propofol and remifentanil, 65-69% xenon supplemented with remifentanil was used as an inhalational anaesthetic for maintenance.ResultsAfter finishing surgery the women could be extubated between 2:52 and 7:22 minutes. The women were fully alert just minutes after extubation and spent about 45 minutes in the recovery room before discharge to a regular ward. They resumed regular breast feeding some time later. The propofol concentration in the blood was measured after 0, 30, 90, and 300 minutes and in the milk after 90 and 300 minutes. Just 90 minutes after extubation, the concentration of propofol in the milk was limited (> 3 mg/l) so that pharmacological effects on the babies were excluded after oral intake. Also, no traces of xenon gas were found in the maternal milk at any time. After propofol induction and maintenance of anaesthesia with xenon in combination with a water-soluble short-acting drug like remifentanil, the concentration of propofol in maternal milk is low (> 3 mg/l 90 min after anesthesia) and harmless after oral intake.ConclusionsThese results, as well as the rapid elimination and absence of metabolism of xenon, are of great interest to nursing mothers. General anaesthesia with propofol for induction only, combined with remifentanil and xenon for maintenance, has not yet been described in breast feeding mothers.

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Xenon: from stranger to guardian

Abstract: Further clinical trials are required to evaluate the role that xenon can play in the perioperative period.

Cited by 34 publications

References 60 publications

Xenon Anesthesia Improves Respiratory Gas Exchanges in Morbidly Obese Patients

Xenon Anesthesia Improves Respiratory Gas Exchanges in Morbidly Obese Patients

Recovery index, attentiveness and state of memory after xenon or isoflurane anaesthesia: a randomized controlled trial

The breast feeding mother and xenon anaesthesia: four case reports. Breast feeding and xenon anaesthesia

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