The effect of bispectral index monitoring on end-tidal gas concentration and recovery duration after outpatient anesthesia.

We performed this study to determine whether instituting monitoring of bispectral index (BIS) throughout an entire operating room would affect end-tidal gas concentration (as a surrogate for anesthetic use) or speed of recovery after outpatient surgery. Primary caregivers (n = 69) were randomly assigned to a BIS or non-BIS Control group with cross-over at 1-mo intervals for 7 mo. Data were obtained in all outpatients except for those having head-and-neck surgery.

Optimal propofol-alfentanil combinations for supplementing nitrous oxide for outpatient surgery.

Background: The combination of propofol and alfentanil with nitrous oxide provides balanced anesthesia with rapid recovery and minimal emetic side effects. The object of this study was to compare recovery parameters at varying proportions of propofol and alfentanil, and to determine the dosing rate and plasma concentration of propofol necessary to supplement nitrous oxide in the presence of varying concentrations of alfentanil

Methods: Forty-eight patients were anesthetized with nitrous oxide, targeted manual infusions of alfentanil (target plasma concentrations of 0, 50, 100, and 150 ng/ml), and propofol at rates that were varied up or down by 25% depending on the response (movement/no movement) of the preceding patient (at the same alfentanil target concentrations) to ulnar-nerve stimulation. The minimum concentrations of propofol and alfentanil required to prevent movement in 50% of patients (EC50) was determined by logistic regression.

Management of bladder function after outpatient surgery.

Background: This study was designed to test a treatment algorithm for management of bladder function after outpatient general or local anesthesia.

Methods: Three hundred twenty-four outpatients, stratified into risk categories for urinary retention, were studied. Patients in category 1 were low-risk patients (n = 227) having non-pelvic surgery and randomly assigned to receive 10 ml/kg or 2 ml/kg of intravenous fluid intraoperatively.

Voiding in patients managed with or without ultrasound monitoring of bladder volume after outpatient surgery.

Unlabelled: The goal of this study was to determine whether recovery room monitoring of bladder volume would affect patient outcome after ambulatory surgery. Incidence of urinary retention and times to void and to discharge were compared in 161 patients managed with ultrasound bladder monitoring versus 173 controls without bladder monitoring. Urinary retention was diagnosed by clinical means or by ultrasound, confirmed by bladder catheterization.

Propofol versus isoflurane for endoscopic sinus surgery.

Purpose: A previous retrospective study reported that propofol anesthesia decreased bleeding during endoscopic sinus surgery compared with isoflurane. We performed a prospective study to compare the effects of propofol versus isoflurane on measured blood loss and the surgeon's subjective assessment of operating conditions during endoscopic sinus surgery.

Patients And Methods: After receiving institutional review board approval and written informed consent, 56 patients undergoing endoscopic sinus surgery were randomly assigned to receive propofol (n = 30) or isoflurane (n = 26) supplemented with nitrous oxide-oxygen and alfentanil.