Medical Gas Research最新文献

{"title":"Prospective randomized double-blind study to evaluate propofol and combination of propofol and sevoflurane as maintenance agents in reducing postoperative nausea and vomiting in female patients undergoing laparoscopic surgery","authors":"T. Bansal, S. Singhal, Khushboo Kundu","doi":"10.4103/2045-9912.337994","DOIUrl":"https://doi.org/10.4103/2045-9912.337994","url":null,"abstract":"Prevention and management of postoperative nausea and vomiting (PONV) is a fundamental part of anesthesia. Using sevoflurane and propofol in combination for maintenance of anesthesia has been found to reduce PONV compared to sevoflurane alone. However, there are limited studies comparing propofol with a combination of propofol and sevoflurane for the incidence of PONV after laparoscopic surgery. The prospective, randomized, double-blind study was planned to compare propofol and combination of propofol and sevoflurane as maintenance agents for the incidence of PONV. Seventy female patients of 18–60 years, of American Society of Anesthesiologists I or II, undergoing laparoscopic surgery were included. Propofol group (n = 35) included induction with propofol and maintenance with propofol infusion, and propofol + sevoflurane group (n = 35) included induction with propofol and maintenance with a combination of propofol infusion and sevoflurane inhalation. The objectives were to find the incidence of PONV and requirement of rescue antiemetic. In the propofol group, 11 patients (33%) experienced PONV and in the propofol + sevoflurane group, PONV was experienced by 12 patients (38.7%) [0.65]. In the propofol group, 11 patients required ondansetron and out of these 11 patients, 2 patients required metoclopramide. In the propofol + sevoflurane group, Ondansetron was required by 12 patients and 3 patients out of these 12 patients required metoclopramide. In the present study, the incidence of PONV was found to be similar in both groups. So, it can be suggested to add sevoflurane in smaller doses to infusion of propofol for maintenance of anesthesia.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"137 - 140"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43333180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of retrograde intubation as rescue procedure in unanticipated difficult airway: an old technique still relevant in low resource settings","authors":"Tanmay Tiwari, B. Sharma, Sachin Rajput","doi":"10.4103/2045-9912.337998","DOIUrl":"https://doi.org/10.4103/2045-9912.337998","url":null,"abstract":"In cases with an unanticipated difficult airway, retrograde intubation can be used as an alternative procedure for airway management when a fiber optic bronchoscope is unavailable. We here report a case of successful management of an unanticipated difficult airway following a failed intubation in a 34-year-old 54 kg male patient with carcinoma lateral border of tongue using retrograde intubation guided technique. Maintaining oxygenation and minimizing airway trauma should be the priority following a failed intubation. Decisions seeking alternative techniques following failed intubation are easy, if valid and applicable techniques (as per anesthesiologist's skills and available resources) are discussed before induction of anesthesia.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"158 - 160"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42809743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preemptive low-dose intravenous ketamine in the management of acute and chronic postoperative pain following laparoscopic cholecystectomy: a prospective randomized control study","authors":"Shruti Jain, N. Nazir, Saurav M Mustafi","doi":"10.4103/2045-9912.337995","DOIUrl":"https://doi.org/10.4103/2045-9912.337995","url":null,"abstract":"Preemptive analgesia with intravenous ketamine has been utilized as a part of multi-modal analgesia for acute postoperative pain following laparoscopic cholecystectomy with mixed outcomes. We tested the effectiveness of low-dose ketamine for acute and chronic postoperative pain after laparoscopic cholecystectomy in a randomized controlled experiment. The study involved 50 individuals who had a laparoscopic cholecystectomy under general anesthesia. All the patients were separated into two equal groups. The ketamine and control groups were given 0.5 mg/kg ketamine and 2 mL of normal saline, respectively, at 15 minutes before incision. Patients in the ketamine group had a significantly lower numeric pain rating scale score at 0 minutes than those in the control group. The numeric pain rating scale score of the ketamine group was considerably greater than the control group after a half-hour interval. At other time periods, there was no significant difference in numeric pain rating scale scores between the two groups. The ketamine group had a greater duration of analgesia and sedation score than the control group. The cumulative tramadol demand at 24 hours and the incidence of chronic pain did not differ significantly across the groups. Substantial analgesic effect of intravenous ketamine lasted only up to 30 min postoperatively. There was no discernible effect in terms of chronic pain prevention.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"141 - 145"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48610961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of dexmedetomidine and remifentanil infusion in geriatric patients undergoing outpatient cataract surgery: a prospective, randomized, and blinded study","authors":"C. Kaya, N. Çelebi, S. Debbağ, O. Canbay, O. Onal","doi":"10.4103/2045-9912.337996","DOIUrl":"https://doi.org/10.4103/2045-9912.337996","url":null,"abstract":"Dexmedetomidine is an α2 agonist and remifentanil is a short-acting μ opioid agonist. We aimed to compare the dexmedetomidine and remifentanil infusions used for conscious sedation in geriatric patients undergoing outpatient cataract surgery in terms of sedation quality, side effects, and surgeon satisfaction. Eighty patients were allocated into two groups as per the administration of dexmedetomidine (dexmedetomidine group) and remifentanil (remifentanil group) infusion in this randomized, prospective, double-blinded study. In dexmedetomidine group (n = 40), after a loading of 1 μg/kg dexmedetomidine in 10 minutes, 0.4 μg/kg/h infusion was administered. In the remifentanil group (n = 40), remifentanil at a dose of 0.05 μg/kg was administered for 10 minutes, and then 0.05 μg/kg/min infusion was continued. Observer Assessment Warning/Sedation Scale values evaluating sedation quality were lower in the dexmedetomidine group than in the remifentanil group, although it was not statistically significant (P > 0.05). Bispectral Index values evaluating sedation quality were lower in the dexmedetomidine group according to the remifentanil group (P < 0.05). The dexmedetomidine group had lower Verbal Rating Scale and Visual Analogue Scale scores evaluating pain intensity compared with the remifentanil group (P < 0.05). The nausea Visual Analogue Scale values evaluating the severity of postoperative nausea in the dexmedetomidine group were lower than those in the remifentanil group (P < 0.05). The surgeon satisfaction was found to be greater in the dexmedetomidine group compared with the remifentanil group (P = 0.015). In geriatric patients, the targeted sedation and analgesia levels were achieved more easily with dexmedetomidine infusion, without hemodynamic and respiratory side effects, compared to remifentanil infusion.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"146 - 152"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46247700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperoxia and the cardiovascular system: experiences with hyperbaric oxygen therapy","authors":"J. Schipke, Thomas E. Muth, Clark Pepper, J. Schneppendahl, Martin A. Hoffmanns, Sven Dreyer","doi":"10.4103/2045-9912.337997","DOIUrl":"https://doi.org/10.4103/2045-9912.337997","url":null,"abstract":"Hyperoxia has been described to induce bradycardia by direct stimulation of the parasympathetic nervous system. Also, hyperoxia has been found to increase blood pressure by an elevation of vascular resistance. However, the latter effect itself would induce bradycardia by baroreceptor stimulation. This single-arm monocentric retrospective study aims to evaluate the correlation between these effects by investigating the relation between oxygen (O2) administration and heart rate over time. Data were collected from 23 patients without cardiovascular problems undergoing hyperbaric oxygen therapy (2.4 bar) retrospectively. During single oxygen bouts, transcutaneously measured partial pressure of O2 was increased. During this surge of oxygen pressure, the arterial blood pressure was increased while the heart rate was decreased. Respiration rate was maintained independently from breathing 100% O2 or air. During single oxygen bouts, the half-life of transcutaneously measured partial pressure of O2 was 5.4 ± 2.1 mmHg/s, and the half-life of heart rate was 0.45 ± 0.19 beats/min. It has been shown that hyperbaric oxygen therapy increases the transcutaneously measured partial pressure of O2. This increase was rather fast, followed by a rather slow decrease in HR. This finding does not support direct vagal activation. Heart rate is not decreased due to a direct vagal activation during hyperbaric oxygen therapy. Our single-arm, retrospective study has additionally confirmed that oxidative stress injures the endothelium, and the reduced endothelial-derived vasodilators cause vasoconstriction. As a consequence, blood pressure increases, and heart rate is then further decreased via the baroreceptor reflex.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"153 - 157"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic gas consumption with target-controlled administration versus a semi-closed circle system with automatic end-tidal concentration control in an artificial lung model","authors":"M. Bellgardt, V. Vinnikov, A. Georgevici, Livia Procopiuc, T. Weber, A. Meiser, J. Herzog-Niescery, D. Drees","doi":"10.4103/2045-9912.337991","DOIUrl":"https://doi.org/10.4103/2045-9912.337991","url":null,"abstract":"The use of volatile anesthetics as sedatives in the intensive care unit is relevant to the patient's outcome. We compared anesthetic gas consumption of the conventional semi-closed Aisys CS™ with the MIRUS™ system, which is the first anesthetic gas reflector system that can administer desflurane in addition to isoflurane and sevoflurane. We connected an artificial lung model to either a MIRUS™ system and a Puritan Bennett™ 840 ventilator or an Aisys CS™ anesthesia machine. We found that consumption of 0.5% isoflurane, which corresponds to the target concentration 0.5 MAC, was averaged to 2 mL/h in the MIRUS™ system, which is identical to the Aisys CS™ at a fresh gas flow (FGF) of 1.0 L/min. MIRUS™ consumption of 1% sevoflurane was averaged to 10 mL/h, which corresponds to 8.4 mL/h at FGF 2.5 L/min. The MIRUS™ system consumed 3% or 4% desflurane at an average of 13.0 mL/h or 21.3 mL/h, which is between the consumption at 1.0 L/min and 2.5 L/min FGF. Thus, the MIRUS™ system can effectively deliver volatile anesthetics in clinically relevant concentrations in a similar rate as a conventional circular breathing system at FGFs between 1.0 L/min and 2.5 L/min.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"131 - 136"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46610360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking for more than hot air: how experimental design can enhance clinical evidence for hyperbaric oxygen therapy","authors":"Adam T. Biggs, Lanny F. Littlejohn","doi":"10.4103/2045-9912.337992","DOIUrl":"https://doi.org/10.4103/2045-9912.337992","url":null,"abstract":"Hyperbaric oxygen therapy is emerging as a potential treatment for critical medical and psychological issues, including mild traumatic brain injury, traumatic brain injury, and post-traumatic stress disorder. Based on the promising results from numerous case studies, randomized clinical trials generated conflicting interpretations despite frequent improvements in patient symptoms. The primary debate concerns whether the therapeutic benefits could be attributed to placebo effects or sham conditions that actually induce a therapeutic state. In part, the contention has been exacerbated by experimental designs which could not properly account for extraneous variables, such as the potential for differing patient expectations to influence the outcome. The current discussion addresses five methodological challenges that complicate any determination of clinical significance due to experimental design. These challenges include: 1) not properly addressing or controlling patient expectations prior to the experimental sessions; 2) the challenge of experimental masking in clinical designs that require pressurized environments; 3) patient subjectivity in the primary dependent variables; 4) potential fluidity in patient symptoms or data, such as regression to the mean; and 5) the potential for nocebo effects to exaggerate treatment benefits by lowering performance expectations during pre-treatment assessments. Each factor provides an influential means by which placebo effects could complicate results and prevent the combined data from reaching a threshold of clinical significance. The discussion concludes with methodological best practices with which future research could minimize placebo effects and produce more conclusive results.","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 1","pages":"116 - 124"},"PeriodicalIF":2.9,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42649456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative melatonin in COVID-19 patients: benefits beyond sedation and analgesia.","authors":"Abhijit S Nair","doi":"10.4103/2045-9912.325990","DOIUrl":"https://doi.org/10.4103/2045-9912.325990","url":null,"abstract":"<p><p>Cytokine storm in coronavirus disease 2019 (COVID-19) patients leads to acute lung injury, acute respiratory distress syndrome, multiorgan dysfunction, shock, and thrombosis thus contributing to significant morbidity and mortality. Several agents like steroids, ascorbic acid, vitamins (C, D, E), glutathione, N-acetylcysteine have been used and several studies are underway to identify its efficacy in addressing undesirable effects due to COVID-19 illness. Among several experimental modalities based on expert opinion and anecdotal data, melatonin is one molecule that appears promising. Owing to its anti-inflammatory, anti-oxidant, and immunomodulatory properties, melatonin can be an important agent used as a component of multimodal analgesia in COVID-19 patients, suspected patients, and patients with exposure to positive patients undergoing emergency or urgent surgeries. Further research is required to know the optimal time of initiation, dose, and duration of melatonin as an adjunct.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 2","pages":"41-43"},"PeriodicalIF":2.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/98/MGR-12-41.PMC8562396.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39565734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of diagnosis and prognosis of COVID-19 disease by blood gas parameters using decision trees machine learning model: a retrospective observational study.","authors":"Mehmet Tahir Huyut,&nbsp;Hilal Üstündağ","doi":"10.4103/2045-9912.326002","DOIUrl":"https://doi.org/10.4103/2045-9912.326002","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) epidemic went down in history as a pandemic caused by corona-viruses that emerged in 2019 and spread rapidly around the world. The different symptoms of COVID-19 made it difficult to understand which variables were more influential on the diagnosis, course and mortality of the disease. Machine learning models can accurately assess hidden patterns among risk factors by analyzing large-datasets to quickly predict diagnosis, prognosis and mortality of diseases. Because of this advantage, the use of machine learning models as decision support systems in health services is increasing. The aim of this study is to determine the diagnosis and prognosis of COVID-19 disease with blood-gas data using the Chi-squared Automatic Interaction Detector (CHAID) decision-tree-model, one of the machine learning methods, which is a subfield of artificial intelligence. This study was carried out on a total of 686 patients with COVID-19 (n = 343) and non-COVID-19 (n = 343) treated at Erzincan-Mengücek-Gazi-Training and Research-Hospital between April 1, 2020 and March 1, 2021. Arterial blood gas values of all patients were obtained from the hospital registry system. While the total-accuracyratio of the decision-tree-model was 65.0% in predicting the prognosis of the disease, it was 68.2% in the diagnosis of the disease. According to the results obtained, the low ionized-calcium value (< 1.10 mM) significantly predicted the need for intensive care of COVID-19 patients. At admission, low-carboxyhemoglobin (< 1.00%), high-pH (> 7.43), low-sodium (< 135.0 mM), hematocrit (< 40.0%), and methemoglobin (< 1.30%) values are important biomarkers in the diagnosis of COVID-19 and the results were promising. The findings in the study may aid in the early-diagnosis of the disease and the intensive-care treatment of patients who are severe. The study was approved by the Ministry of Health and Erzincan University Faculty of Medicine Clinical Research Ethics Committee.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 2","pages":"60-66"},"PeriodicalIF":2.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/cd/MGR-12-60.PMC8562394.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39542732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential therapeutic effect of oxygen-ozone in controlling of COVID-19 disease.","authors":"Bahman Yousefi,&nbsp;Seyedeh Zahra Banihashemian,&nbsp;Zahra Khatibiyan Feyzabadi,&nbsp;Sahar Hasanpour,&nbsp;Parviz Kokhaei,&nbsp;Anna Abdolshahi,&nbsp;Alireza Emadi,&nbsp;Majid Eslami","doi":"10.4103/2045-9912.325989","DOIUrl":"10.4103/2045-9912.325989","url":null,"abstract":"<p><p>Atmospheric ozone is produced when nitrogen oxides react with volatile organic compounds. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome contains a unique N-terminal fragment in the Spike protein, which allows it to bind to air pollutants in the environment. 'Our approach in this review is to study ozone and its effect on the SARS-CoV-2 virus and patients with coronavirus disease 2019 (COVID-19). Article data were collected from PubMed, Scopus, and Google Scholar databases. Ozone therapy has antiviral properties, improves blood flow, facilitates the transfer of oxygen in hypoxemic tissues, and reduces blood coagulation phenomena in COVID-19 patients. Ozone has immunomodulatory effects by modulating cytokines (reduction of interleukin-1, interleukin-6, tumor necrosis factor-α, and interleukin-10), induction of interferon-γ, anti-inflammatory properties by modulating NOD-, LRR- and pyrin domain-containing protein 3, inhibition of cytokine storm (blocking nuclear factor-κB and stimulating nuclear factor erythroid 2-related factor 2 pathway), stimulates cellular/humoral immunity/phagocytic function and blocks angiotensin-converting enzyme 2. In direct oxygen-ozone injection, oxygen reacts with several biological molecules such as thiol groups in albumin to form ozonoids. Intravenous injection of ozonated saline significantly increases the length of time a person can remain hypoxic. The rectal ozone protocol is rectal ozone insufflation, resulting in clinical improvement in oxygen saturation and biochemical improvement (fibrinogen, D-dimer, urea, ferritin, LDH, interleukin-6, and C-reactive protein). In general, many studies have shown the positive effect of ozone therapy as a complementary therapy in the recovery of COVID-19 patients. All the findings indicate that systemic ozone therapy is nontoxic and has no side effects in these patients.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"12 2","pages":"33-40"},"PeriodicalIF":2.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/63/MGR-12-33.PMC8562402.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39565733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}