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Prevention of Sevoflurane Delirium and Agitation With Propofol
Zakaria Messieha DDS
Article Category: Other
Volume/Issue: Volume 60: Issue 2
Online Publication Date: Jan 01, 2013
DOI: 10.2344/0003-3006-60.3.67
Page Range: 67 – 71

Inhalation anesthesia has been known to cause emergence delirium and agitation, particularly in young children. Halothane was the induction agent of choice for children for 4 decades until the advent of sevoflurane, which offered better clinical outcomes in the pediatric patient. Sevoflurane is advantageous because it does not cause significant cardiac depression and dysrhythmias compared to halothane. Inhalation induction and maintenance are often necessary in children who are uncooperative and combative. There are numerous other advantages

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Keita Ohkushi DDS, PHD,
 Ken-ichi Fukuda DDS, PHD,
 Yoshihiko Koukita DDS, PHD,
 Yuzuru Kaneko DDS, PHD, and
 Tatsuya Ichinohe DDS, PHD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 4
Online Publication Date: Jan 01, 2016
Page Range: 175 – 180

Anesthetics used for ambulatory anesthesia should have the following characteristics: smooth and rapid induction, easily controllable depth of anesthesia in the maintenance phase, rapid emergence and recovery from anesthesia, and few adverse reactions after general anesthesia. 1 Two anesthetics currently used for ambulatory anesthesia are propofol and sevoflurane. Emergence from propofol anesthesia is rapid because the context-sensitive half-time is less than 30 minutes 2 even after 5-hour continuous infusion. Emergence from sevoflurane

Figure 2.; General anesthesia was induced with 5% sevoflurane in 67% nitrous oxide and 33% oxygen, and then maintained with a continuous infusion of 6–12 mg/kg propofol per hour and 0.5–1.5% sevoflurane in 67% nitrous oxide and 33% oxygen.
Hiroyoshi Kawaai,
 Kazuho Tanaka, and
 Shinya Yamazaki
Figure 2.
Figure 2.

General anesthesia was induced with 5% sevoflurane in 67% nitrous oxide and 33% oxygen, and then maintained with a continuous infusion of 6–12 mg/kg propofol per hour and 0.5–1.5% sevoflurane in 67% nitrous oxide and 33% oxygen.


Hiroyoshi Kawaai DDS, PhD,
 Kazuho Tanaka DDS, PhD, and
 Shinya Yamazaki DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 52: Issue 1
Online Publication Date: Mar 01, 2005
Page Range: 12 – 16

, there are no reports of patients with FCMD being anesthetized with an inhalational anesthetic. We had the opportunity to provide general anesthesia for patients with BMD and FCMD in our hospital. This report describes 2 patients with progressive muscular dystrophy who were successfully anesthetized with a continuous infusion of propofol and inhalation of sevoflurane for dental treatment. CASE REPORTS Case 1 A 19-year-old, 59-kg man with BMD and mental retardation was admitted for dental treatment under general anesthesia. He

Preet Mohinder Singh MD, DNB, MNAMS,
 S. Rajeshwari MD,
 Anuradha Borle MD, DNB, MNAMS, and
 Valluvan Rangasamy MD
Article Category: Research Article
Volume/Issue: Volume 62: Issue 3
Online Publication Date: Jan 01, 2015
Page Range: 118 – 121

the nasopharynx till a good trace of end-tidal carbon dioxide could be obtained via a sampling line connected to the ETT using a standard sampling angle connector. This angle connector was further connected a Jackson Rees breathing circuit (modified Mapleson F circuit). The Jackson Rees circuit was connected to a fresh gas outlet of an anesthesia workstation, which simultaneously allowed inflow of both high-flow oxygen and sevoflurane. (The connection assembly is seen in Figure 2 .) As the nasally inserted ETT ostensibly bypassed the obstruction at the oropharynx

Nayuka Usami DDS, PhD,
 Midori Tooyama DDS, PhD,
 Wakana Oda DDS, PhD,
 Yuu Kawamoto DDS,
 Saki Kishimoto DDS,
 Ayano Minamide DDS, and
 Hitoshi Niwa DDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
Page Range: 38 – 40

was observed on the patient's electrocardiogram (ECG). In the operating room, the patient's initial arterial blood pressure (ABP) via noninvasive blood pressure cuff and heart rate (HR) were 141/56 mm Hg and 81 bpm, respectively. General anesthesia was induced using fentanyl 50 μg, propofol 60 mg, and rocuronium 40 mg. The patient was nasally intubated, and an invasive arterial catheter was placed in the right radial artery. Anesthesia was maintained using sevoflurane 1.2% with oxygen 1 L/min and air 5 L/min plus a continuous infusion of remifentanil (0

Eri Tanaka,
 Kenji Yoshida,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
Figure 1. 
Figure 1. 

Method of general anesthesia. General anesthesia was induced by oxygen 5 L/min and 5% sevoflurane, and then a tracheotomy was performed, after which general anesthesia was maintained at oxygen 3 L/min and 3% sevoflurane. A cannula was inserted into the femoral artery, and arterial pressure was continuously recorded throughout the experiment using a polygraph and a pressure transducer.


Kenji Yoshida,
 Eri Tanaka,
 Hiroyoshi Kawaai, and
 Shinya Yamazaki
<bold>Figure 1</bold>
Figure 1

Method of general anesthesia. General anesthesia was induced by oxygen 5 L/min and 5% sevoflurane, and then a tracheotomy was performed, after which general anesthesia was maintained at oxygen 3 L/min and 3% sevoflurane. A cannula was inserted into the femoral artery, and arterial pressure was continuously recorded throughout the experiment using a polygraph and a pressure transducer.


Mary Satuito DDS and
 James Tom DDS, MS
Article Category: Other
Volume/Issue: Volume 63: Issue 1
Online Publication Date: Jan 01, 2016
Page Range: 42 – 49

being partly or entirely halogenated, making them more stable and less toxic. 8 Fluroxene was introduced in 1951, the same year halothane was first synthesized. Halothane, an ethane, was then introduced for clinical use in 1956, followed by methoxyflurane, the first of the methyl-ethyl ethers, in 1960. Enflurane was introduced in 1972 and isoflurane in 1980, and both of these agents limited the nephrotoxicity and hepatotoxicity of methoxyflurane. Desflurane and sevoflurane were synthesized in the 1960s and 1970s but did not become commercially available for clinical

Shu Tomita,
 Shinya Yamazaki,
 Kohei Togami,
 Hitoshi Tada, and
 Hiroyoshi Kawaai
<bold>Figure 2.</bold>
Figure 2.

Time course of experiment 1. Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), end-tidal CO2 (ETCO2), and palatal mucosal blood flow (PMBF) were measured in both groups at 12, 17, 22, 27, 32, and 42 minutes after administration of 0.2 mg/kg midazolam, 0.05 mg/kg butorphanol, and 2 mg/kg rocuronium (time 0). The SMB group was maintained with sevoflurane in oxygen. The DMB group was maintained with dexmedetomidine. SMB indicates sevoflurane, midazolam, and butorphanol; DMB, dexmedetomidine, midazolam, and butorphanol.