Displaying publications 21 - 40 of 151 in total

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  1. Fulltext Sevoflurane induction in the elderly
    Cheong KF, Teh TS
    Med J Malaysia, 2001 Dec;56(4):446-50.
    PMID: 12014764
    The effects of 2% and 4% sevoflurane in oxygen and nitrous oxide for induction of anaesthesia in 60 unpremedicated elderly patients was compared to those obtained during an intravenous Thiopentone induction. Intravenous induction induced anaesthesia in 27 +/- 5 seconds, significantly faster than a 2% or 4% sevoflurane induction (109 +/- 36 and 71 +/- 24 seconds respectively). One patient in both the thiopentone and 2% sevoflurane groups, and 2 patients in the 4% sevoflurane group coughed during induction. The postinduction reduction in mean arterial pressure was greatest in the thiopentone group followed by the 4% and the 2% sevoflurane groups. Heart rate changes were minimal in all groups. We conclude that 2% or 4% sevoflurane offered suitable conditions for induction of anaesthesia in the elderly with minimal cardiovascular derangement.
    Matched MeSH terms: Anesthetics, Inhalation/pharmacology*; Anesthetics, Intravenous/pharmacology*
  2. The use of evipan sodium in obstetrics
    Goh TW
    Journal of the Malaya Branch of the British Medical Association, 1939;3:283-85.
    Matched MeSH terms: Anesthetics, Intravenous
  3. Inexpensive home-assembled human skull model for training and learning the peribulbar block technique
    Chua AW, Chua MJ, Harrisberg BP, Kumar CM
    Anaesth Intensive Care, 2022 09;50(5):400-402.
    PMID: 36076352 DOI: 10.1177/0310057X211063892
    Matched MeSH terms: Anesthetics, Local
  4. Fulltext Fentanyl pre-treatment alleviates pain during injection of propofol-lipuro premixed with lignocaine
    Ahmad N, Zanariah Y, Balan S
    Med J Malaysia, 2008 Dec;63(5):431-3.
    PMID: 19803312
    We studied the effect of fentanyl pretreatment on alleviating pain during the injection of Propofol-Lipuro. One hundred and seventy patients were randomly allocated to receive either 100 mcg of intravenous fentanyl or normal saline (placebo) followed by intravenous Propofol-Lipuro premixed with 20 mg lignocaine. The incidence of injection pain was 32% and 13% in the placebo and fentanyl groups, respectively. We found a statistically significant reduction in incidence of injection pain in the fentanyl group when compared with the placebo group (p<0.003). The number needed to treat was 6 (3.2< 95% CI <15.1). In conclusion, fentanyl pretreatment is effective in alleviating pain during injection of Propofol-Lipuro.
    Matched MeSH terms: Anesthetics, Local/administration & dosage*; Anesthetics, Local/adverse effects; Anesthetics, Intravenous/administration & dosage*; Anesthetics, Intravenous/adverse effects
  5. Preventing the withdrawal response associated with rocuronium injection: a comparison of fentanyl with lidocaine
    Ahmad N, Choy CY, Aris EA, Balan S
    Anesth Analg, 2005 Apr;100(4):987-990.
    PMID: 15781511 DOI: 10.1213/01.ANE.0000147790.76114.3A
    We compared the efficacy of IV fentanyl with IV lidocaine as pretreatment for the prevention of withdrawal response after rocuronium injection. For this prospective, randomized, placebo-controlled, double-blind study we recruited 90 patients aged between 18 and 65 yr, ASA physical status I or II, who had undergone elective surgery requiring general anesthesia and positive pressure ventilation. Patients were randomly allocated to 1 of 3 groups: group F received 2 mL IV fentanyl 50 microg/mL (100 microg), group L received 2 mL of preservative-free lidocaine 2% (40 mg), and group P (placebo) received 2 mL of normal saline. The incidence of withdrawal response after rocuronium was 57%, 30%, and 7% in the placebo, lidocaine, and fentanyl groups, respectively. We found a significant reduction in incidence of withdrawal response in both the fentanyl and lidocaine groups when compared with the placebo group (P < 0.05), with the fentanyl group being most effective (P < 0.05). In conclusion, both fentanyl and lidocaine are effective clinical treatments to alleviate the withdrawal response associated with rocuronium injection, with fentanyl being more effective.
    Matched MeSH terms: Anesthetics, Local/administration & dosage; Anesthetics, Local/therapeutic use*; Anesthetics, Intravenous/administration & dosage; Anesthetics, Intravenous/therapeutic use*
  6. Fulltext Evolution of electroencephalogram signal analysis techniques during anesthesia
    Al-Kadi MI, Reaz MB, Ali MA
    Sensors (Basel), 2013;13(5):6605-35.
    PMID: 23686141 DOI: 10.3390/s130506605
    Biosignal analysis is one of the most important topics that researchers have tried to develop during the last century to understand numerous human diseases. Electroencephalograms (EEGs) are one of the techniques which provides an electrical representation of biosignals that reflect changes in the activity of the human brain. Monitoring the levels of anesthesia is a very important subject, which has been proposed to avoid both patient awareness caused by inadequate dosage of anesthetic drugs and excessive use of anesthesia during surgery. This article reviews the bases of these techniques and their development within the last decades and provides a synopsis of the relevant methodologies and algorithms that are used to analyze EEG signals. In addition, it aims to present some of the physiological background of the EEG signal, developments in EEG signal processing, and the effective methods used to remove various types of noise. This review will hopefully increase efforts to develop methods that use EEG signals for determining and classifying the depth of anesthesia with a high data rate to produce a flexible and reliable detection device.
    Matched MeSH terms: Anesthetics/pharmacology
  7. Change in endotracheal tube cuff pressure during nitrous oxide anaesthesia: a comparison between air and distilled water cuff inflation
    Ahmad NL, Norsidah AM
    Anaesth Intensive Care, 2001 Oct;29(5):510-4.
    PMID: 11669433
    In this prospective, randomized controlled trial, changes in endotracheal tube cuff pressure were studied in 60 patients undergoing elective surgery under general anaesthesia with nitrous oxide and oxygen. The cuffs were inflated with either air or distilled water. The mean pressure in the air-filled cuffs increased steadily throughout the procedure, reaching 47.5 +/- 7.3 cmH2O at one hour compared with 31.6 +/- 2.4 cmH2O mean pressure in the water-filled cuffs. The pressure and the rate of rise in cuff pressure were significantly lower (P<0.05) in the water-filled cuffs throughout the hour of study. When an endotracheal tube cuff is distended with water, the rise in cuff pressure during nitrous oxide anaesthesia is lower than that of an air-filled cuff.
    Matched MeSH terms: Anesthetics, Inhalation*
  8. Breakthrough analysis of continuous fixed-bed adsorption of sevoflurane using activated carbons
    Ang TN, Young BR, Taylor M, Burrell R, Aroua MK, Baroutian S
    Chemosphere, 2020 Jan;239:124839.
    PMID: 31726519 DOI: 10.1016/j.chemosphere.2019.124839
    The inhalational anaesthetic agent - sevoflurane is widely employed for the induction and maintenance of surgical anaesthesia. Sevoflurane possesses a high global warming potential that imposes negative impact to the environment. The only way to resolve the issue is to remove sevoflurane from the medical waste gas before it reaches the atmosphere. A continuous adsorption study with a fixed-bed column was conducted using two commercial granular activated carbons (E-GAC and H-GAC), to selectively remove sevoflurane. The effect of bed depth (Z, 5-15 cm), gas flow rate (Q, 0.5-6.0 L/min) and inlet sevoflurane concentration (C0, ∼55-700 mg/L) was investigated. E-GAC demonstrated ∼60% higher adsorption capacity than H-GAC under the same operating conditions. Varying the levels of Z, Q and C0 showed significant differences in the adsorption capacities of E-GAC, whereas only changing the C0 level had significant differences for H-GAC. Three breakthrough models (Adams-Bohart, Thomas, and Yoon-Nelson) and Bed-depth/service time (BDST) analysis were applied to predict the breakthrough characteristics of the adsorption tests and determine the characteristic parameters of the column. The Yoon-Nelson and Thomas model-predicted breakthrough curves were in good agreement with the experimental values. In the case of the Adams-Bohart model, a low correlation was observed. The predicted breakthrough time (tb) based on kinetic constant (kBDST) in BDST analysis showed satisfactory agreement with the measured values. The results suggest the possibility of designing, scaling up and optimising an adsorption system for removing sevoflurane with the aid of the models and BDST analysis.
    Matched MeSH terms: Anesthetics, Inhalation/analysis*
  9. Anesthetic considerations in scoliosis patient with dopa-responsive dystonia or Segawa's syndrome
    Hasan MS, Leong KW, Chan CY, Kwan MK
    J Orthop Surg (Hong Kong), 2017 01;25(1):2309499016684743.
    PMID: 28166704 DOI: 10.1177/2309499016684743
    Segawa's syndrome or dopa-responsive dystonia is a rare hereditary disorder characterized by progressive dystonia of childhood onset, diurnal fluctuation of symptoms and complete or near complete alleviation of symptoms with administration of low-dose oral levodopa. From our literature search in PubMed, we found only three related publications: two on anesthesia for cesarean section and one on anesthesia for electroconvulsive therapy. We report our experience in providing anesthesia for corrective scoliosis surgery in two biological sisters with Segawa's syndrome. A review of the literature is also included.
    Matched MeSH terms: Anesthetics/therapeutic use
  10. Effects of MDR1 and OPRM1 genetic polymorphisms on the pharmacodynamics of propofol-remifentanil TIVA in pediatrics
    Liew Y, Capule FR, Rahman RA, Nor NM, Teo R, Makmor-Bakry M
    Pharmacogenomics, 2023 Apr;24(5):247-259.
    PMID: 36999508 DOI: 10.2217/pgs-2023-0006
    Aims: To investigate the roles of MDR1 (1236C>T, 2677G>T/A, and 3435C>T) and OPRM1 (118A>G) gene polymorphisms on the anesthetic and adverse effects of propofol-remifentanil total intravenous anesthesia in pediatric surgery. Materials & methods: The genotypes were identified through Sanger sequencing. The clinical data including hemodynamics on anesthesia, postanesthesia pain and sedation score and the occurrence of adverse effects were recorded and compared against the genetic data. Results: A total of 72 pediatric patients undergoing surgery were recruited. A weak to no association was found between the genetic polymorphisms of MDR1 and OPRM1 and the anesthetic and adverse effects of propofol-remifentanil. Conclusion: Genetic polymorphisms in OPRM1, but not in MDR1, gene polymorphism, demonstrated plausible association with the effects of propofol-remifentanil.
    Matched MeSH terms: Anesthetics, Intravenous/adverse effects
  11. Fulltext Awake Craniotomy: A Case Series of Anaesthetic Management using a Combination of Scalp Block, Dexmedetomidine and Remifentanil in Hospital Universiti Sains Malaysia
    Mohd Nazaruddin WH, Lukman MF, Abd Mukmin L, Zamzuri I, Izaini Ghani AR, Mohamad Zaini RH
    Med J Malaysia, 2013;68(1):64-6.
    PMID: 23466770 MyJurnal
    Awake craniotomy is a brain surgery in patients who are kept awake when it is indicated for certain intracranial pathologies. The anaesthetic management strategy is very important to achieve the goals of the surgery. We describe a series of our first four cases performed under a combination of scalp block and conscious sedation. Scalp block was performed using a mixture of ropivacaine 0.7% and adrenaline 5 5µg/ ml administered to the nerves that innervate the scalp. Conscious sedation was achieved with a combination of two recently available drugs in our country, dexmedetomidine (selective α 2-agonist) and remifentanil (ultra-short acting opioid). Remifentanil was delivered in a target controlled infusion (TCI) mode.
    Matched MeSH terms: Anesthetics
  12. Randomized double-blind comparison of ketamine-propofol, fentanyl-propofol and propofol-saline on haemodynamics and laryngeal mask airway insertion conditions
    Goh PK, Chiu CL, Wang CY, Chan YK, Loo PL
    Anaesth Intensive Care, 2005 Apr;33(2):223-8.
    PMID: 15960405
    The aim of this prospective, double-blind, randomized, placebo-controlled clinical trial was to investigate whether the administration of ketamine before induction with propofol improves its associated haemodynamic profile and laryngeal mask airway (LMA) insertion conditions. Ninety adult patients were randomly allocated to receive either ketamine 0.5 mg x kg(-1) (n = 30), fentanyl 1 microg x kg(-1) (n = 30) or normal saline (n = 30), before induction of anaesthesia with propofol 2.5 mg x kg(-1). Insertion of the LMA was performed 60s after injection of propofol. Arterial blood pressure and heart rate were measured before induction (baseline), immediately after induction, immediately before LMA insertion, immediately after LMA insertion and every minute for three minutes after LMA insertion. Following LMA insertion, the following six subjective endpoints were graded by a blinded anaesthestist using ordinal scales graded 1 to 3: mouth opening, gagging, swallowing, movement, laryngospasm and ease of insertion. Systolic blood pressure was significantly higher following ketamine than either fentanyl (P = 0.010) or saline (P = 0.0001). The median (interquartile range) summed score describing the overall insertion conditions were similar in the ketamine [median 7.0, interquartile range (6.0-8.0)] and fentanyl groups [median 7.0, interquartile range (6.0-8.0)]. Both appeared significantly better than the saline group [median 8.0, interquartile range (6.75-9.25); P = 0.024]. The incidence of prolonged apnoea (> 120s) was higher in the fentanyl group [23.1% (7/30)] compared with the ketamine [6.3% (2/30)] and saline groups [3.3% (1/30)]. We conclude that the addition of ketamine 0.5 mg x kg(-1) improves haemodynamics when compared to fentanyl 1 microg x kg(-1), with less prolonged apnoea, and is associated with better LMA insertion conditions than placebo (saline).
    Matched MeSH terms: Anesthetics, Dissociative/pharmacology*; Anesthetics, Intravenous/pharmacology*
  13. Fulltext Patients' desire for information about anaesthesia: a survey in a teaching hospital
    Hoe KS, Karis BM
    Med J Malaysia, 2002 Jun;57(2):145-53.
    PMID: 24326644
    The aim of this study was to investigate the attitudes and desire of Malaysian patients for information about anaesthesia and compare the result to that of other similar studies in other countries namely Scotland, Canada, Australia and denMark. Two hundred and forty patients undergoing elective surgery were asked to complete a preoperative quentionnaire examining their desire for information relating to anaesthesia. As in all countries compared, most Malaysian patients were interested to know the time they could start to mobilize from the bed and the time to commence normal oral intake postoperatively. Information related to postoperative pain and pain relief was also highly desired. However, patients showed less interest towards information about perioperative anaesthetic or surgical procedures and drug used. Unlike Australian patients, the Malaysian patients showed less interest about perioperative complications. As in other countries, patients under the age of 50 years had a greater desire for information than those who were older. However there was no difference in desire for information between male and female patients. Patients who have had previous anaesthesia would ask more information compared to those who had none.
    Matched MeSH terms: Anesthetics
  14. Assessment of tracheal intubating conditions in children using remifentanil and propofol without muscle relaxant
    Batra YK, Al Qattan AR, Ali SS, Qureshi MI, Kuriakose D, Migahed A
    Paediatr Anaesth, 2004 Jun;14(6):452-6.
    PMID: 15153205
    Tracheal intubation in children can be achieved by deep inhalational anaesthesia or an intravenous anaesthetic and a muscle relaxant, suxamethonium being widely used despite several side-effects. Studies have shown that oral intubation can be facilitated safely and effectively in children after induction of anaesthesia with propofol and alfentanil without a muscle relaxant. Remifentanil is a new, ultra-short acting, selective mu-receptor agonist that is 20-30 times more potent than alfentanil. This clinical study was designed to assess whether combination of propofol and remifentanil could be used without a muscle relaxant to facilitate tracheal intubation in children.
    Matched MeSH terms: Anesthetics, Intravenous/administration & dosage*; Anesthetics, Combined/administration & dosage*
  15. Is articaine more effective than lidocaine in patients with irreversible pulpitis? An umbrella review
    Nagendrababu V, Duncan HF, Whitworth J, Nekoofar MH, Pulikkotil SJ, Veettil SK, et al.
    Int Endod J, 2020 Feb;53(2):200-213.
    PMID: 31491042 DOI: 10.1111/iej.13215
    BACKGROUND: Pain management can be challenging during root canal treatment of teeth with irreversible pulpitis.

    AIM: To identify whether articaine or lidocaine is the most appropriate local anaesthetic solution for teeth with irreversible pulpitis undergoing root canal treatment.

    DATA SOURCE: The protocol of this umbrella review is registered in the PROSPERO database (CRD42019137624). PubMed, EBSCHO host and Scopus databases were searched until June 2019.

    STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: Systematic reviews published in English comparing the effectiveness of local anaesthesia following administration of articaine or lidocaine in patients undergoing root canal treatment of teeth diagnosed with irreversible pulpitis were included. Two independent reviewers selected the studies and carried out the data extraction and the appraisal of the included reviews. Disagreements were resolved in consultation with a third reviewer.

    STUDY APPRAISAL AND SYNTHESIS METHODS: The quality of the included reviews was appraised by two independent reviewers using the AMSTAR tool (a measurement tool to assess systematic reviews). Each of the 11 AMSTAR items was given a score of 1 if the specific criterion was met, or 0 if the criterion was not met or the information was unclear.

    RESULTS: Five systematic reviews with meta-analyses were included. The AMSTAR score for the reviews ranged from 8 to 11, out of a maximum score of 11, and all reviews were categorized as 'high' quality. Two reviews scored 0 for item 8 in AMSTAR because the scientific quality of the clinical trials included in these reviews was not used in the formulation of the conclusions.

    LIMITATIONS: Systematic reviews published only in the English language were included. Only a small number of studies were available to assess pain intensity during the injection phase, the time until the onset of anaesthesia and the occurrence of adverse events.

    CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Articaine is more effective than lidocaine for local anaesthesia of teeth with irreversible pulpitis undergoing root canal treatment. There is limited evidence that injection of articaine is less painful, has more rapid onset and has fewer adverse events compared with lidocaine.

    Matched MeSH terms: Anesthetics, Local
  16. Challenges Faced During the Ventilation of a Child With Bronchobiliary Fistula: A Case Report
    Zainal Abidin H, Mohd Lutfi N, Phang YY, Zarina FMI, Hamidah I, Saedah A, et al.
    A A Pract, 2020 Jul;14(9):e01281.
    PMID: 32909720 DOI: 10.1213/XAA.0000000000001281
    Hepatoblastoma is the most frequently occurring malignant tumor of the liver in children (ages ≤5 years). The formation of bronchobiliary fistula is a rare complication. We present a case report that describes the associated anesthetic challenges that we encountered for the treatment of this pathology.
    Matched MeSH terms: Anesthetics
  17. Pharmacokinetics of propofol infusion in Asian patients undergoing coronary artery bypass grafting
    Lee HS, Khoo YM, Chua BC, Ng AS, Tan SS, Chew SL
    Ther Drug Monit, 1995 Aug;17(4):336-41.
    PMID: 7482686
    The pharmacokinetics of propofol was studied in 11 Asian patients with fentanyl-isoflurane anaesthesia during cardiopulmonary bypass (CPB) and undergoing elective coronary artery bypass grafting (CABG). Instead of the usual increments of morphine and a benzodiazepine, propofol (4 mg/kg/h) was initiated at the start of CPB and ceased at CPB separation. Whole blood propofol concentrations were determined during and postinfusion using high-performance liquid chromatography with fluorescence detection. Data from four patients seemed to fit a two-compartment model, whereas those from seven patients were significantly (F test, p < 0.05) better fitted to a three-compartment model. The pharmacokinetic parameters were as follows: The mean (SD) of the initial distribution phase t1/2 pi, intermediate distribution phase t1/2 alpha, and elimination phase t1/2 beta were 2.22 (1.04) min, 42.9 (16.4) min, and 370 (138) min, respectively. The mean clearance of 1.31 (0.50) L/min was lower than those reported from other studies, whereas the mean blood concentration of 2.2 (1.0) mg/L at the 1-h infusion period was higher. The mean calculated apparent Css was 3.9 (1.5) mg/L. The low clearance is likely to be due to hemodynamic changes during CPB and CABG, thereby affecting drug distribution and blood flow to the liver.
    Matched MeSH terms: Anesthetics, Intravenous/administration & dosage; Anesthetics, Intravenous/blood; Anesthetics, Intravenous/pharmacokinetics*
  18. Fulltext Attitude of patients towards anaesthesia: comparing the use of a single consent for anaesthesia versus the combined surgical and anaesthetic consent
    Niew, Y.L., Chee, Magdalene M.X., Juanita, J., Nurul Ezzati, A.K., Mohd Sharol, A.W., Azarinah, I., et al.
    Journal of Surgical Academia, 2014;4(2):9-13.
    MyJurnal
    Anaesthesiology is a specialty which is less well known and the public usually have little knowledge regarding anaesthesia and the roles of Anaesthesiologist. Many hospitals now use a single dedicated consent for anaesthesia. This study was conducted to compare the effectiveness of a single consent for anaesthesia with the combined surgical and anaesthetic consent. A total of 109 patients, scheduled for elective surgery requiring anaesthesia were interviewed with a standardised questionnaire. Patients were divided into two groups, where one group used a single anaesthetic consent while the other used a combined surgical and anaesthetic consent. A single consent for anaesthesia was found to be more effective than the current combined surgical and anaesthetic consent (p
    Matched MeSH terms: Anesthetics
  19. Ultrasound-Guided Retroclavicular Block (aka Posterior Approach Infraclavicular Block): Anatomical Variation of the Clavicle Limits Block Feasibility
    Beh ZY, Hasan MS, Lai HY
    Reg Anesth Pain Med, 2016 8 23;41(5):658-9.
    PMID: 27547909 DOI: 10.1097/AAP.0000000000000456
    Matched MeSH terms: Anesthetics, Local
  20. Fulltext Ketamine-associated ulcerative cystitis: a case report and literature review
    Ho CC, Pezhman H, Praveen S, Goh EH, Lee BC, Zulkifli MZ, et al.
    Malays J Med Sci, 2010 Apr;17(2):61-5.
    PMID: 22135540 MyJurnal
    Ketamine can be abused as a recreational drug, and there has been a recent surge in its usage. The effects of ketamine on the urinary system were unknown until the recent publication of a few case reports. Many doctors are still unaware of this new clinical entity, termed ketamine-associated ulcerative cystitis. We report a case that we encountered and discuss the diagnosis and disease management in addition to a review of the literature.
    Matched MeSH terms: Anesthetics, Dissociative
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