Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It was the aim of this study to compare total intravenous anaesthesia (TIVA) with balanced anaesthesia using modern short-acting anaesthetics for ENT-surgery in children regarding the influence on haemodynamics, recovery, side-effects and costs. After approval of the Ethics Committee of the Medical Faculty of the University of Rostock, 80 children in the age of 3 to 12 years, rectally premedicated with midazolam (0.3 mg/kg) and atropine (0.01 mg/kg), were randomly assigned to TIVA (group 1, n = 41) and balanced anaesthesia (group 2, n = 39), respectively. TIVA was induced with propofol (2 mg/kg) and remifentanil (1 microgram/kg) and maintained with propofol (6 mg/kg/h) and remifentanil (0.2 microgram/kg/min). Controlled ventilation was performed with an air/oxygen mixture (1:1). Balanced anaesthesia was induced with the method of "single breath induction" using sevoflurane (8 Vol.%) in a mixture of nitrous oxide/oxygen (2:1). For maintaining balanced anaesthesia under low flow conditions, sevoflurane concentration was reduced to 1 Vol.% while the nitrous oxide/oxygen mixture was kept constant. Additionally 0.1 microgram/kg/min of remifentanil was given. For controlled ventilation, the patients of both groups were primarily relaxed for intubation with mivacurium (0.2 mg/kg) under continuous monitoring using TOF-stimulation (TOF-Guard). Further relaxation was performed with doses of 0.05 mg/kg of mivacurium after relaxometric control reached T1-level > 20% and T2-level > 0. Haemodynamic parameters (heart rate, mean arterial blood pressure), awakening time (time until the first spontaneous movements occurred), recovery time (according to Aldrete-Score > 8), side-effects (sevoflurane-induced excitation and propofol-induced pain due to the injection during induction of anaesthesia, postoperative vomiting) and costs for anaesthetic agents and relaxants were registered. The investigation showed significantly higher heart rate (p < 0.05) and significantly lower mean arterial pressure (p < 0.05) during balanced anaesthesia than during TIVA. Between the two groups there were no statistically significant differences regarding awakening time, recovery time and incidence of postoperative vomiting. In the TIVA-group, pain due to injection of propofol occurred in 10 patients (24.4%) and in group 2 sevoflurane-induced excitation during induction was registered in 22 patients (56.4%). Based on our presently existing purchase prices for the drugs used, there were no significant differences between the costs for TIVA and balanced anaesthesia. We conclude that both TIVA and balanced anaesthesia performed with short-acting anaesthetics, are suitable anaesthetic methods for ENT operations in children. Because balanced anaesthesia with sevoflurane led to higher heart rates, this kind of anaesthesia should be used with caution in children with heart diseases. The main advantage of both methods is their short recovery time.
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PMID:[Total intravenous anesthesia (TIVA) and balanced anesthesia with short-acting anesthetics for ENT surgery in children]. 1022 Sep 41

This prospective randomized study compares the effects of rocuronium (R) and vecuronium (V) on the early postoperative period in infants. Forty-eight infants between the ages of three and six, scheduled for elective ENT procedures, were studied after prior approval of local ethics committee and informed parental consent. All children were premedicated with chlorprotixene and belladonna. Anaesthesia was induced with 5 mg/kg thiopentone and 1 vol.-% halothane. Subsequently, 0.4 mg/kg rocuronium or 0.075 mg/kg vecuronium were administered, respectively. Anaesthesia and post-operative care were conducted by independent anaesthetists, who were unaware of the drug used and of the relaxometric data obtained. All children were monitored in the recovery room by pulse oximetry until they reached a Steward Score of 6. Demographic data did not differ between the groups. No differences were recorded between the non-depolarizing relaxants regarding intubation time (R: 24.1 +/- 4.2 min, V: 25.8 +/- 6.8 min) and the time interval from end extubation to leaving the operating theatre (R: 2.3 +/- 0.8 min, V: 2.6 +/- 1.2 min), respectively. Similarly, no differences in SaO2 were noted during the recovery period in the recovery room. Significant differences between the non-depolarizing relaxants were found in the TOF-ratios at extubation (R: 0.73 +/- 0.31 min, V: 0.48 +/- 0.34 min) and arrival in the recovery room (R: 0.88 +/- 0.21 min, V: 0.69 +/- 0.26 min). 0.4 mg/kg Rocuronium and 0.075 mg/kg vecuronium can be used for intubation during short operations on pre-school children. Rocuronium may be the better alternative, due to its faster neuromuscular recovery properties.
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PMID:[Rocuronium or vecuronium for intubation for short operations in the preschool age? Effects on time in the operating room and postoperative phase]. 1145 66