Track topics on Twitter Track topics that are important to you
We hypothesized that pre-treatment with methylene blue could potentiate the effects of general anaesthetic agents in patients undergoing parathyroidectomy
Sample and study design The local ethics committee granted approval for this study and informed written consent will be obtained from all participants. We will study ASA grade I or II patients, aged between 45 and 73 years who were free from cardiovascular and pulmonary diseases. Patients with psychiatric disorders or drug abuse as well as those weighing 20% more or less than their ideal body weight will all be excluded.
The interventional group will consist of 11 patients scheduled for elective parathyroidectomy who will receive MB infusion (5mg.kg-1 in 250 ml 5% glucose-saline) approximately 60 min before anaesthesia induction. A further 11 patients scheduled for unilateral thyroid lobectomy without MB pre-treatment will be recruited as controls. They will present with normal thyroid tests and will carefully be selected in an attempt to match the intervention group on the basis of age, weight and sex. Both types of surgical procedures will be performed by the same surgical team.
Anaesthesia and surgery All patients will be premedicated with oral midazolam 7.5 mg and they will receive a loading dose of lactate-ringer solution (5 ml.kg-1) intravenously after arrival in the operating theatre. The standard anaesthetic monitoring will comprise non-invasive blood pressure, ECG, pulsed oxygen saturation and end-tidal carbon dioxide. Processed EEG parameters will be acquired with a BIS monitor, using surface electrodes, with impedance maintained at less than 5kΩ to ensure adequate signal quality. Raw EEG data from two channels (F7-CZ and F8-CZ) will be processed by company proprietary software and the BIS values (calculated for each 4-sec epoch) will be continuously displayed along with the trend line.
Propofol will be infused using a commercially available TCI system loaded with Schneider's 3-compartment pharmacokinetic model wherein the individual patient's age, height and weight will be programmed. The target effect-site concentration of propofol will be computed to yield a time to peak effect of 1.6 min, which has been confirmed clinically.
During anaesthesia induction, the patients will breath an air-oxygen mixture through a face mask. The target effect-site concentration of propofol will first be set at 0.5 ng.ml-1 and it will be increased by 0.2 ng.ml-1 every 2 min until the clinical endpoint will be achieved (loss of consciousness and unresponsiveness). Then, ventilation will be assisted manually and the trachea will be intubated after the intravenous administration of fentanyl (100 mcg) and rocuronium (0.7 mg.kg-1).
During anaesthesia maintenance, the effect-site concentration of propofol will be targeted to achieve BIS values between 30 and 60. Additional fentanyl, rocuronium or vasopressor agents (ephedrine) will be given at the discretion of the attending anaesthetist.
Measurements When each patient will be comfortable on the operating table, baseline measurements of BIS, mean arterial pressure (MAP), heart rate (HR) and pulsed oxygen saturation (SpO2) will be taken.
During propofol induction, BIS values, MAP, HR and SpO2 will be recorded every 1-min and the Observer's Assessment of Alertness/Sedation (OAAS) rating scale will be recorded after each equilibration period (score 5=awake and responds readily to name spoken in normal tone; 4= lethargic response to name in normal tone; 3=response only after name is called loudly and/or repeatedly; 2= response only after name is called loudly and after mild shaking; 1= dose not respond when name is called and after mild shaking).
During surgery and anaesthesia maintenance, BIS values and the effect-site concentration of propofol will be recorded each 5-min.
Other recorded data will include the doses of propofol required for anaesthesia induction and maintenance, the total amount of vasopressor and the time until anaesthesia emergence and readiness for tracheal extubation.
Statistics Assuming that MB pre-treatment would reduce the requirement of propofol by 25%, power analysis with alpha = 0.05, beta = 0.8, shows that we would need to study at least 10 patients in each group. The computer program SAS 8.0 for Windows will be used for all data analyses. Parametric data will be analysed by two-way ANOVA. Unpaired Student t-tests, Chi-squared tests and Fisher's exact probability tests will be used as appropriate for comparison between groups. All values are expressed as mean (M), standard deviation (SD) and statistical significance will be accepted at p < 0.05.
Observational Model: Case Control, Observational Model: Natural History, Time Perspective: Longitudinal, Time Perspective: Prospective
Service d'Anesthésiologie, Hôpitaux Universitaires de Genève, Rue Micheli-du-Crest
University Hospital, Geneva
Published on BioPortfolio: 2014-08-27T03:36:52-0400
The goal of this clinical research study is to compare methylene blue (an oral rinse) to standard therapy to learn if one is better, the same, or worse than the other in controlling mucosi...
Open label prospective, non-randomised proof of principle study assessing the use of methylene blue fluorescence cholangiography.
A Phase 1 trial to assess the single-dose safety, tolerability, and pharmacokinetic (PK) of Methylene Blue Injection, USP 1 mg/kg in healthy adult voluneetrs.
This is a pilot study to determine the hemodynamic effects when hydroxocobalamin vs methylene blue is administered during cardiopulmonary bypass in patients at risk of vasoplegia by measur...
To explore the effects of pre-treatment with methylene blue on reduced perioperative vascular resistance in patients with obstructive jaundice.
An oral formulation of methylene blue with colonic delivery (MB-MMX) has been developed to increase detection of colorectal polys during colonoscopy. Traditionally, there have been safety concerns ...
Curcumin and salicylic acid are both phenolic compounds and they can both affect cancer treatment efficacy. In this study, the effects of methylene blue-curcumin (CU-MB) and methylene blue-salicylic a...
Methylene blue dye is easy to obtain in developing countries and can be used in sentinel lymph node mapping for breast cancer. However, the accuracy of methylene blue alone for sentinel lymph node map...
Anionic surfactant as sodium dodecyl sulfate (SDS) can be assayed by using methylene blue (MB). The ion-association of SDS-MB can be extracted solventless but sorbed on a specified polyurethane foam (...
To evaluate whether methylene blue (MB) could minimize the effects of ischemia-reperfusion injury in the nonischemic lung on a lung transplantation rodent model.
A compound consisting of dark green crystals or crystalline powder, having a bronze-like luster. Solutions in water or alcohol have a deep blue color. Methylene blue is used as a bacteriologic stain and as an indicator. It inhibits GUANYLATE CYCLASE, and has been used to treat cyanide poisoning and to lower levels of METHEMOGLOBIN.
A condition of abnormally elevated output of PARATHYROID HORMONE (or PTH) triggering responses that increase blood CALCIUM. It is characterized by HYPERCALCEMIA and BONE RESORPTION, eventually leading to bone diseases. PRIMARY HYPERPARATHYROIDISM is caused by parathyroid HYPERPLASIA or PARATHYROID NEOPLASMS. SECONDARY HYPERPARATHYROIDISM is increased PTH secretion in response to HYPOCALCEMIA, usually caused by chronic KIDNEY DISEASES.
Usually a benign tumor, that commonly presents as a solitary blue nodule with spindled MELANOCYTES covered by smooth SKIN. Several variants have been identified, one variant being malignant. The blue color is caused by large, densely packed melanocytes deep in the DERMIS of the nevus. In CHILDREN, they usually occur on the BUTTOCKS and LUMBOSACRAL REGION and are referred to as cellular blue nevi. Malignant blue nevi are more commonly found on the SCALP.
The metal-free blue phycobilin pigment in a conjugated chromoprotein of blue-green algae. It functions as light-absorbing substance together with chlorophylls.
Prepaid health and hospital insurance plan.
Alternative Medicine Cleft Palate Complementary & Alternative Medicine Congenital Diseases Dentistry Ear Nose & Throat Food Safety Geriatrics Healthcare Hearing Medical Devices MRSA Muscular Dyst...
Cardiology is a specialty of internal medicine. Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...
Pulmonary relating to or associated with the lungs eg Asthma, chronic bronchitis, emphysema, COPD, Cystic Fibrosis, Influenza, Lung Cancer, Pneumonia, Pulmonary Arterial Hypertension, Sleep Disorders etc Follow and track Lung Cancer News ...