History of the Development of Anesthesia for the Dolphin A Quest to Study a Brain as Large as Man ’s
It is important for academic-minded human anesthesiologists to have an interdisciplinary perspective when engaging in cutting-edge research as well as the practice of human anesthesiology. This was a philosophy promoted by Dr. Robert Dripps, former pioneering Chairman of the Anesthesiology Department at the University of Pennsylvania (Philadelphia, Pennsylvania). Many human and veterinary anesthesiologists as well as biomedical engineers and neuroscientists benefited from Dr. Dripps ’s constructive outlook personified in the quest to develop dolphin anesthesiology. The motivation to anesthetize dolphins came from the fact that scientists and physicians wanted to study the brain of the dolphin, a brain as large as man’s. Also, investigators wanted to develop anesthesia for t he dolphin in order to study the electrophysiology of the dolphin’s highly sophisticated auditory system, which facilitates the dolphin’s amazing echolocation capability. Dolphin anesthesia involves a complex matter of unique neural control, airway anatomy, neuromuscular control of respiration, and sleep behavior.
This article details the pharmacological and nonpharmacological methods to minimise preoperative anxiety and the techniques of anaesthetic induction in infants and children undergoing surgery. The benefits and limitations of inhalational and intravenous induction and the current status of rapid sequence induction in children are discussed. MEDLINE database was searched for this narrative review using the keywords including preoperative anxiety, child, premedication, paediatric and anaesthetic induction. Search was restricted to articles in English, but without any publication date restrictions.
Agreement between surgical and anesthesia teams regarding appropriate perioperative management strategies is vital to delivering safe and effective patient care. Perioperative guidelines serve as a valuable reference in optimizing patients for surgery. The article provides a broad set of guidelines related to cardiovascular evaluation, medication reconciliation, and preoperative fasting and includes a framework for the care of patients with comorbidities, such as coronary artery disease and obstructive sleep apnea.
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Propofol is widely used for induction and maintenance of anaesthesia, which causes a rapid loss of consciousness. So far the mechanisms underlying the effect of propofol are still largely unknown. Here, we found that microinjection of propofol in the lateral hypothalamus caused a significant decrease in wakefulness and an increase in the amount of non-rapid eye movement sleep and rapid eye movement sleep. Application of propofol in the lateral hypothalamus affected the electroencephalogram power spectra with a decrease in theta oscillations and an increase in the delta oscillations. Additionally, using whole-cell patch cla...
CONCLUSIONS: The predictive model could enable screening for patients at higher risk of ION to provide more accurate risk assessment and surgical and anesthetic planning for perioperative ION in spine fusion. PMID: 31490255 [PubMed - as supplied by publisher]
Conclusions: Our experience suggests that intranasal dexmedetomidine is an advantageous sedation option for children and adults with intractable epilepsy who are undergoing MEG. Further research is needed to determine the best ways to apply these methods to younger children and those with developmental disabilities.
Oral and maxillofacial surgeons (OMSs) often treat patients with both diagnosed and undiagnosed obstructive sleep apnea (OSA). Patients with OSA are at substantial risk for peri- and postoperative complications after receiving intravenous sedation, general anesthesia, or postoperative opiate analgesia. The purpose of this study was to determine whether OMS providers are screening patients for peri- and postoperative risks related to OSA prior to office-based ambulatory anesthesia.
Purpose of review In several guidelines, regional anesthesia and analgesia have been suggested as safer alternatives for general anesthesia and systemic analgesia for their safety profile in patients suffering from obstructive sleep apnea (OSA). However, the underlying scientific basis is still evolving. The present review is intended to provide an up-to-date account on the question whether the use of regional anesthesia improves outcomes in patients with OSA. Recent findings A number of studies found favorable effects of regional anesthesia used in patients with OSA, including reduced incidence of major perioperative...
This study evaluated the validity of existing OSA screening tools in a cohort of extremely obese pregnant women [body mass index (BMI) ≥40 kg/m2] and determined what screening factors were most strongly associated with OSA in this cohort.
(Br J Anaesth. 2019;122:e64–e66) The authors of the present study previously reported that 20% of women experience obstructive sleep apnea episodes in the immediate postpartum period. They have also found that women sleeping in a 45-degree elevated upper body position, rather than supine, may have significantly reduced apnea-hypopnea indices. Subsequently, in this article, the authors reported on their continuing investigation, which evaluates the impact of delivery type on nocturnal oxygenation and the potential influence of elevated upper body position.