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Comparison of propofol consumption and recovery time in Caucasians from Italy, with Chinese, Malays and Indians from Malaysia

Ortolani O, Conti A, Chan YK, Sie MY, Ong GS

Anaesth Intensive Care, 2004 Apr;32(2):250-5.
PMID: 15957725

Differences in sensitivity to anaesthetic drugs may exist among different ethnic groups. Allelic variants for drug metabolizing isoenzymes and pharmacokinetic differences may account for a variable response to some anaesthetic drugs. This study was designed to compare propofol consumption and recovery characteristics in four ethnic groups: Chinese, Malays, and Indians in Malaysia and Caucasians in Italy. Patients undergoing total intravenous anaesthesia with propofol and fentanyl were evaluated for propofol consumption and recovery time. The Bispectral Index (BIS) was used to maintain the same anaesthesia depth in all patients. The BIS value, the response to verbal stimuli and eye-opening time were used to assess recovery. After propofol discontinuation the BIS values returned to baseline in 11+/-4.2 min for Caucasians, in 12.5+/-5.1 min for Chinese, 15.9+/-6.3 min for Malays and 22.1+/-8.1 for Indians. Time to eye-opening was 11.63+/-4.2 min in Caucasians, 13.23+/-4.9 min in Chinese, 16.97+/-5.2 min in Malays and 22.3+/-6.6 min in Indians. The propofol consumption was significantly lower in Indians compared to the other three groups (P<0.01). The recovery of Indians was much slower compared to Chinese, Malays and Caucasians. The recovery time of Malays is significantly slower compared to Chinese and Caucasians. Differences in propofol consumption and recovery time were not significant between Chinese and Caucasians, but the ratio recovery time/propofol consumption was significantly lower in Caucasians compared to all the other groups.

Matched MeSH terms: Anesthesia Recovery Period*
Fulltext Delayed recovery following lorazepam premedication

Inbasegaran K, Aun LT

Med J Malaysia, 1990 Sep;45(3):251-3.
PMID: 2152088

Oral lorazepam is a commonly used premedicant both locally and abroad. We studied its effect on recovery time after minor gynaecological procedures. The results showed a significant prolongation of recovery time.

Matched MeSH terms: Anesthesia Recovery Period*
Fulltext Prolonged paralysis with atracurium use in a patient with Rubinstein-Taybi syndrome

Dharmalingam TK, Liew Sat Lin C, Muniandy RK

BMJ Case Rep, 2018 Feb 22;2018.
PMID: 29472422 DOI: 10.1136/bcr-2017-222692

Rubinstein-Taybi syndrome (RTS) is a rare autosomal dominant disorder that occurs due to a microdeletion of chromosome 16p13. The craniofacial abnormalities in these patients may pose a challenge for anaesthetist performing tracheal intubation. However, there are no known reported cases of drug interaction with non-depolarising muscle relaxant in patients with RTS. This young patient with RTS presented with an unexpected prolonged atracurium effect during the course of anaesthesia. After ruling out other possible causes, we have come to a conclusion that RTS itself could have played a role in the prolonged effect of atracurium. However, further studies will be needed to confirm this hypothesis. In the meantime, care should be used when using muscle relaxants in patients with RTS.

Matched MeSH terms: Anesthesia Recovery Period*
Fulltext Anaesthetic complications in the recovery room

Norsidah AM, Puvaneswari A

Singapore Med J, 1997 May;38(5):200-4.
PMID: 9259599

The immediate post-operative period in the recovery room is a known period of high risk for anaesthetic complications to occur.

Matched MeSH terms: Anesthesia Recovery Period*
Fulltext A comparison of the maintenance and recovery charcateristic of sevoflurane-nitrous oxide against isoflurane-nitrous oxide anaesthesia

Chiu CL, Chan YK, Ong GS, Delilkan AE

Singapore Med J, 2000 Nov;41(11):530-3.
PMID: 11284610

To compare the maintenance and recovery characteristics of sevoflurane and isoflurane anaesthesia in Malaysian patients.

Matched MeSH terms: Anesthesia Recovery Period*
Sevoflurane for dental extraction in children with Tetralogy of Fallot

Chiu CL, Wang CY

Paediatr Anaesth, 1999;9(3):268-70.
PMID: 10320610

Two children with Tetralogy of Fallot presented for dental extraction. Anaesthesia was induced rapidly and smoothly by inhalation of sevoflurane. We discussed the advantages of sevoflurane as an induction agent as compared to halothane in these children.

Matched MeSH terms: Anesthesia Recovery Period
Fulltext The effect of ketamine on emergence agitation in children: A systematic review and meta-analysis

Ng KT, Sarode D, Lai YS, Teoh WY, Wang CY

Paediatr Anaesth, 2019 12;29(12):1163-1172.
PMID: 31587414 DOI: 10.1111/pan.13752

BACKGROUND: Ketamine is believed to reduce the incidence of emergence agitation in children undergoing surgery or procedure. However, recent randomized controlled trials reported conflicting findings.
AIMS: To investigate the effect of ketamine on emergence agitation in children.
METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were systematically searched from their start date until February 2019. Randomized controlled trials comparing intravenous ketamine and placebo in children were sought. The primary outcome was the incidence of emergence agitation. Secondary outcomes included postoperative pain score, duration of discharge time, and the adverse effects associated with the use of ketamine, namely postoperative nausea and vomiting, desaturation, and laryngospasm.
RESULTS: Thirteen studies (1125 patients) were included in the quantitative meta-analysis. The incidence of emergence agitation was 14.7% in the ketamine group and 33.3% in the placebo group. Children receiving ketamine had a lower incidence of emergence agitation, with an odds ratio being 0.23 (95% confidence interval: 0.11 to 0.46), certainty of evidence: low. In comparison with the placebo, ketamine group achieved a lower postoperative pain score (odds ratio: -2.42, 95% confidence interval: -4.23 to -0.62, certainty of evidence: very low) and lower pediatric anesthesia emergence delirium scale at 5 minutes after operation (odds ratio: -3.99, 95% confidence interval: -5.03 to -2.95; certainty of evidence: moderate). However, no evidence was observed in terms of incidence of postoperative nausea and vomiting, desaturation, and laryngospasm.
CONCLUSION: In this meta-analysis of 13 randomized controlled trials, high degree of heterogeneity and low certainty of evidence limit the recommendations of ketamine for the prevention of emergence agitation in children undergoing surgery or imaging procedures. However, the use of ketamine is well-tolerated without any notable adverse effects across all the included trials.
PROSPERO REGISTRATION: CRD42019131865.

Matched MeSH terms: Anesthesia Recovery Period
Reversible anesthesia of Southeast Asian primates with medetomidine, zolazepam, and tiletamine

Fahlman A, Bosi EJ, Nyman G

J. Zoo Wildl. Med., 2006 Dec;37(4):558-61.
PMID: 17315446

Medetomidine (0.02-0.06 mg/kg) in combination with zolazepam-tiletamine (0.8-2.3 mg/kg) were evaluated for reversible anesthesia in four species of Southeast Asian primates: Bornean orangutan (Pongo pygmaeus pygmaeus), Bornean gibbon (Hylobates muelleri), long-tailed macaque (Macaca fascicularis), and pig-tailed macaque (Macaca nemestrina). Twenty-three anesthetic procedures of captive-held and free-ranging primates were studied in Sabah, Malaysia. The induction was smooth and rapid. Respiratory and heart rates were stable throughout anesthesia, whereas body temperature and systolic arterial blood pressure decreased significantly. Atipamezole at five times the medetomidine dose effectively reversed anesthesia, with first signs of recovery within 3-27 min.

Matched MeSH terms: Anesthesia Recovery Period

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