Articles: general-anesthesia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2024
Review[Talking to Unconscious? - Therapeutic Communication During General Anaesthesia, Resuscitation and Therapy of Coma].
There are numerous reports from patients concerning perceptions during deep unconsciousness, be it general anaesthesia, cardiopulmonary resuscitation or intensive care and coma treatment. These experiences can cause considerable traumatisation. The most stressful experience is apparently not feeling pain, but the lack of communication, i.e. being recognised and being able to express oneself. Although there are already indications of positive effects of positive communication during general anaesthesia, these findings have not yet markedly changed the way we deal with the unconscious.
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Letter Comparative Study
One-year Outcomes of Spinal versus General Anesthesia: Comment.
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Minerva anestesiologica · Oct 2024
Meta Analysis Comparative StudyComparison between hemodynamic effects of remimazolam and propofol during general anesthesia: a systematic review and meta-analysis.
The need for safe anesthetic agents with minimal side effects has led to the development of remimazolam, a new benzodiazepine designed to be an alternative to the commonly used drug propofol, which has significant hemodynamic effects. This study aims to compare the hemodynamic effects of remimazolam with propofol during general anesthesia. ⋯ This study provides evidence that remimazolam induces fewer cardiorespiratory depressant effects and has a more favorable side effect profile compared to propofol during general anaesthesia.
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Meta Analysis Comparative Study
Remimazolam vs. propofol for general anaesthesia in elderly patients: a meta-analysis with trial sequential analysis.
Elderly patients comprise an increasing proportion of patients undergoing surgery, and they require special attention due to age-related physiological changes. Propofol is the traditional agent for anaesthesia, and recently, remimazolam, a novel ultra-short-acting benzodiazepine, has emerged as an alternative to propofol in general anaesthesia. ⋯ Remimazolam significantly reduced the risk of hypotension, bradycardia and injection pain, despite an increase in the time to loss of consciousness. Remimazolam appears to be an effective and well tolerated alternative to propofol in elderly patients undergoing general anaesthesia.
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Anesthesia and analgesia · Oct 2024
Changes in Intrinsic Connectivity Networks Topology Across Levels of Dexmedetomidine-Induced Alteration of Consciousness.
Human consciousness is generally thought to emerge from the activity of intrinsic connectivity networks (resting-state networks [RSNs]) of the brain, which have topological characteristics including, among others, graph strength and efficiency. So far, most functional brain imaging studies in anesthetized subjects have compared wakefulness and unresponsiveness, a state considered as corresponding to unconsciousness. Sedation and general anesthesia not only produce unconsciousness but also phenomenological states of preserved mental content and perception of the environment (connected consciousness), and preserved mental content but no perception of the environment (disconnected consciousness). Unresponsiveness may be seen during unconsciousness, but also during disconnectedness. Deep dexmedetomidine sedation is frequently a state of disconnected consciousness. In this study, we were interested in characterizing the RSN topology changes across 4 different and steady-state levels of dexmedetomidine-induced alteration of consciousness, namely baseline (Awake, drug-free state), Mild sedation (drowsy, still responding), Deep sedation (unresponsive), and Recovery, with a focus on changes occurring between a connected consciousness state and an unresponsiveness state. ⋯ The differential dexmedetomidine-induced RSN topological changes evidenced in this study may be the signature of inadequate processing of sensory information by lower-order RSNs, and of altered communication between lower-order and higher-order networks, while the latter remain functional. If replicated in an experimental paradigm distinguishing, in unresponsive subjects, disconnected consciousness from unconsciousness, such changes would sustain the hypothesis that disconnected consciousness arises from altered information handling by lower-order sensory networks and altered communication between lower-order and higher-order networks, while the preservation of higher-order networks functioning allows for an internally generated mental content (or dream).