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Congenital diaphragmatic hernia
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Erin E. Perrone, George B. Mychaliska
The airway should be controlled with orotracheal intubation. Single lung ventilation is unnecessary. Intravenous anesthesia is administered as needed and complemented by muscle paralysis and narcotics. Mechanical ventilation may be controlled throughout surgery with a pressure-cycled infant ventilator rather than the conventional anesthesia machine. Continuous oxygen saturation monitoring, both preductal and postductal, is critical. An arterial line should already be placed and accessible for intraoperative blood gases. A heating mattress is used, and the head and extremities are wrapped to minimize heat loss. Prophylactic antibiotics should be given preoperatively.
Neuroradiology in neurotrauma
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Anesthesia: Personal preferences will dictate the mode of anesthesia; both volatile and intravenous anesthesia or conscious sedation (if tolerable) are acceptable. The MR-compatible anesthetic machine may be located inside the inner controlled area or outside the controlled area with extended airway tubing. Consideration must be made for significant dead space in airway and intravenous tubing if located outside the inner controlled area. This will incur a delay in the delivery of intravenous drugs and inhaled volatile anesthesia, as well as a delay in capnography and gas sampling. It is good practice to prime and attach extra i.v. lumens with extended giving sets to allow the administration of vasopressors in the event of hemodynamic instability. Muscle relaxation is not usually necessary for the purpose of the scan.
Laparoscopic antireflux surgery
Published in Larry R. Kaiser, Sarah K. Thompson, Glyn G. Jamieson, Operative Thoracic Surgery, 2017
Sarah K. Thompson, Glyn G. Jamieson
The anesthetic is tailored to minimize postoperative nausea and/or vomiting. This involves avoidance of volatile agents (e.g., isoflurane, sevoflurane, nitrous oxide) and morphine. In our institution, the anesthetists prefer total intravenous anesthesia with propofol infusion. Dexamethasone 4 mg intravenous (IV) is administered, and a 5-HT3 antagonist (e.g., ondansetron) is commenced. All patients wear stockings in addition to pneumatic compression stockings, and receive appropriate antibiotic prophylaxis.
Study on the ameliorating effect of miR-221-3p on the nerve cells injury induced by sevoflurane
Published in International Journal of Neuroscience, 2021
Qirui Wang, Xin Tian, Qijuan Lu, Kun Liu, Jiekun Gong
In recent years, the continuous improvement of anesthesia technology has enabled more and more surgical operations and invasive examinations to be carried out smoothly [1, 2]. Anesthesia is divided into local anesthesia and general anesthesia, and the general anesthesia includes inhalation anesthesia or intravenous anesthesia [3, 4]. Sevoflurane is the most widely used inhalation anesthetics in clinical practice, which has the advantages of rapid effect, good controllability and low airway irritation [4, 5]. However, recent studies have proved that sevoflurane exposure has toxic effects on the central nervous system, which can lead to abnormal apoptosis of neurons and neurodegeneration [6, 7]. It is mainly manifested in the decline of cognitive functions such as learning and memory [8–10]. Therefore, it is important to study the therapeutic methods to reduce the neurocognitive impairment induced by sevoflurane.
Modified ‘sandwich’ injection with or without ligation for variceal bleeding in patients with both esophageal and gastric varices: a retrospective cohort study
Published in Scandinavian Journal of Gastroenterology, 2020
Tingting Hu, Simon Stock, Wandong Hong, Yongping Chen
Equipment: endoscope GIF-H260 (Olympus, Tokyo, Japan), the injection needle (Olympus NM-400L; Olympus, Tokyo, Japan), tissue adhesive (0.5 mL/ampoule; Braun-Melsungen, Germany), lauromacrogol (Tianyu Pharmaceutical, Zhejiang, China) and six multiband ligators (Cook Endoscopy, Winston-Salem, North Carolina, USA). Therapy was completed by endoscopic experts from our department. Patients were administered intravenous anesthesia. The ‘sandwich’ injection was performed as follows: after flushing the needles with an isotonic sodium chloride solution, lauromacrogol 3–5 mL, cyanoacrylate 0.5–2.0 mL and lauromacrogol 2–3 mL were injected into GV successively. The injection volume of tissue adhesive depended on the size of GV. The needle sheath was held in the puncture site to prevent leakage of the tissue adhesive. The injector catheter was not retracted until the varix had hardened. If the varix was soft or there was active bleeding, an additional 0.5 mL of tissue adhesive was supplemented [2,12]. The ligations were initiated 1 cm above the gastroesophageal junction and proceeded to the next proximal varix. No more than six or seven bands were positioned per session [15].
Local tumor progression after ultrasound-guided percutaneous microwave ablation of stage T1a renal cell carcinoma: risk factors analysis of 171 tumors
Published in International Journal of Hyperthermia, 2018
Guoliang Hao, Yanan Hao, Zhigang Cheng, Xu Zhang, Feng Cao, Xiaoling Yu, Zhiyu Han, Fangyi Liu, Mengjuan Mu, Jianping Dou, Xin Li, Damian Edward Dupuy, Jie Yu, Ping Liang
For a detailed procedure of US-guided percutaneous MWA for RCC, refer to our previous report [20]. MWA was performed by six interventional radiologists (MWA experience: P.L. and X.L.Y., 18 years each; Z.G.C. and Z.Y.H., 7 years each; J.Y. and F.Y.L., 6 years each) with the patient under moderate sedation and local anesthesia. The microwave unit (KY-2000; Kangyou Medical, Nanjing, China) used can produce 100 W of power at 2450 MHz. The cool-tip needle antenna had a diameter of 1.9 mm (15-G) and length of 18 cm. For tumors less than 2.0 cm in diameter, a single antenna was advanced, whereas 2 or more antennas were required for tumors with diameters of 2.0 cm or greater [21]. Intravenous anesthesia was administered by a combination of propofol (Diprivan; Zeneca Pharmaceuticals, Wilmington, DE, USA) and ketamine (Shuanghe Pharmaceuticals, Beijing, China) via the peripheral vein. The antenna was percutaneously inserted into the tumor and placed at the desired location under US guidance. Then, US-guided biopsy was performed by an automatic biopsy gun with an 18-G cutting needle, and 2–3 separate punctures were performed. A power output of 50 W for 10 min was routinely used during MWA. If the heat-generated hyperechoic water vapor did not completely encompass the entire tumor, prolonged microwave emission was applied until the desired temperature was reached.