China
Africa
Explore chapters and articles related to this topic
Sedation, analgesia and patient observation in interventional radiology
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
Jeffrey E. Quam, Michael A. Bettmann
Propofol (Diprivan®) is a fairly new sedative-hypnotic agent that was introduced as an anesthesia-induction agent. It is formulated as an aqueous emulsion in soybean oil, and is given intravenously in bolus form and/or as a maintenance infusion. The usual initial dose of propofol is 100 μg/kg body weight, over 3 to 5 min. Effectiveness is then maintained with a constant infusion dose of 25–75 μg/kg/min. The need for constant maintenance infusion makes the use of propofol impractical for many radiology suites. Like other sedatives, it may cause respiratory depression and decreased cardiac output. Neverthess, it has increased in popularity as a sedating agent for several reasons. It has a very rapid onset of action and an ultra-short half-life, giving fast emergence from sedation. It also has an anti-emetic effect.18,19 Direct comparisons have shown a more rapid return to baseline with propofol than with midazolam.20,21 A recent prospective study of conscious sedation during interventional neuroradiology procedures demonstrated the advantages of propofol, and also showed no subjective difference in patient satisfaction when using propofol in lieu of midazolam.22 Like benzodiazepines, propofol does not have any analgesic properties, and thus should be used in combination with an analgesic during interventional procedures. The aqueous-oil emulsion does cause some local pain on injection, but there is no risk of thrombophlebitis as is seen with diazepam. This infusion pain can be treated either by local lidocaine infiltration or with systemic analgesics.23 A final common, but harmless, side-effect of propofol is a temporary green discoloration of the patient’s urine.
A device to detect leakage at the patient end of total intravenous anaesthesia
Published in Journal of Medical Engineering & Technology, 2022
Rajkumar Chandran, Kalindi De Sousa, Seok Hwee Koo, Yin Yu Lim, Lei Shang, Fleming Paiputra, Joanne Huishan Tan, Terry Tsz Him Ching, Xiaojuan Khoo
The delivery of an incorrect dose of propofol has been reported to be a risk factor for awareness with recall [7]. Disconnections at the patient end during the usage of TIVA poses a risk of awareness due to the lower than intended dose of propofol entering the bloodstream arising from the leakage. While some of these complications may be avoided with using inhalation anaesthetic agents, there are situations that necessitate the use of TIVA as inhalation anaesthesia has its own drawbacks. The evidence in the literature suggests that TIVA is superior to inhalation anaesthesia for neuromonitoring in spinal surgeries. The effect on evoked potential signals used in neuromonitoring is more pronounced with inhalation anaesthesia than TIVA [8–10], hence making the latter a safer option in spinal surgeries. Propofol potentiates GABA-A receptor activity, has a rapid onset of action, and it is very short-acting. It also exhibits a neuroprotective effect during cerebral ischaemia [11–13]. TIVA is the preferred choice in high-risk patients with circulatory and neurological pathologies [13,14]
Optimization of propofol loaded niosomal gel for transdermal delivery
Published in Journal of Biomaterials Science, Polymer Edition, 2021
Wenjia Zhang, Xu Zhao, Guanling Yu, Meng Suo
Propofol (2,6-diisopropylphenol) is a highly lipophilic oily molecule (log p = 4.15) which is usually administered via intravenous route (continuous infusion or bolus injection) [1, 2]. The induction of anaesthesia is rapid, efficient and clinically safe [3, 4], however, the major limitations with intravenous route includes hypersensitivity, anaphylactic reactions and pain at the site of injection [5–7]. The modified lipid (soybean oil and egg yolk) based microemulsion injections shows side effects associated with high lipid intake (allergy, apnea, bradycardia and hypotension) and pain at the site of injection [8–11]. Thus, it is mandatory to design an alternative route (non-invasive) for propofol delivery to bypass the side effects associated with invasive intravenous route.
Outcomes and evaluation of endoscopic retrograde cholangiopancreatography via Gastro-Laryngeal Tube in adult patients: a prospective randomised control study
Published in Expert Review of Medical Devices, 2023
Anshika Dengre, Rudrashish Haldar, Ashish Kumar Kannaujia, Nidhi Singh, Samir Mohindra, Prabhaker Mishra
In Group S, propofol at 1.5-2 mg/kg was injected slowly followed by 0.5 mg/kg after 1 min till patient’s MOAA/S (Modified Observer’s Assessment of Alertness and Sedation Score) was 2–3 (moderate-to-deep sedation). After adequate loss of jaw tone, the bite block was inserted with the patient in supine position and it was secured with elastic bands provided with the bite block. Oxygen supplementation was done using nasal prongs. Spontaneous ventilation was confirmed by observing bilateral chest rise and adequate air entry on auscultation.