Anaesthesia

Every hour of every day in hospital, different type and levels of anaesthesia are executed and lives are being saved in intensive care unit. The anaesthesiologist play an important role in this complex environment conducting the patient along the clinical pathway from admission to discharge.

Our exceptional portfolio provide reliable solutions to support the anaesthesiologist in the choice and combination of medication, dose, route and techniques, considering the risks and benefits for the individual patient to improve the clinical experience for patient and organization.

Quality And Predictability Of Recovery

An effective use of anaesthetic administration may allow faster recovery and can improve patient satisfaction. The combination of short-acting opioids and hypnotic given exclusively by the intravenous route, TIVA ‘total intravenous anaesthesia’, offers several potential advantages compare with inhalational anaesthesia. [1] [2] [5] [6]

These include reduced incidence of post-operative nausea and vomiting, greater hemodynamic more predictable and rapid recovery with a reduced atmospheric pollution. [1] [2]; Recent articles address the fact that TIVA ‘total intravenous anaesthesia’ can reduce the incidence of Post-Operative Delirium and the risk of recurrence in cancer surgery [3] [4]

Target Controlled infusion -TCI- is a user-friendly technique that helps to facilitate smooth and accurate TIVA ‘total intravenous anaesthesia’ while at the same time offering a faster and more comfortable patient recovery. [5] [6]

Pain Control And Enhanced Operational Efficiencies

Adequate pain management along with anaesthesia is crucial for medical and surgical procedures as well as during the post-operative phase.

TIVA ‘total intravenous anaesthesia’ can be used alone or combined with locoregional anaesthesia or even used in Post- Operative Care Unit or in Intensive Care Unit . [5] [8]

The infusion of intravenous anesthetics and analgesics can offer many advantages including rapid recovery of consciousness and psychomotor function. [7] [8]

General anaesthesia can be replaced by combinations of regional and local methods such as regional nerve blocks, neuraxial anaesthesia (spinal / epidural approach), or direct local infiltration. [9]

All these techniques can allow an early mobilization, help to improve outcomes and reduce length of hospital stay. [7] [8] [9]

Some anaesthesia solutions are also available in several topical formulation like cream, gel, spray or patch to help caregivers to improve the comfort of the patients and his family in everyday life.

Formulations Designed To Improve Patient Safety

All the Patient Safety organization have the mission to improve the safety of patients during anaesthesia care by encouraging safety research, education and distributing clear recommendations. [10] [11]

Medication errors and infections are two problems with a significant impact on patient’s morbidity and mortality in Operating Room -OR-and in Intensive Care Unit -ICU. [10] [11] [12]

ESA, APSF and EBA association recommended the use of standardized, premixed, ready-to- use formulation to reduce the risks of errors. They all recognized that the inclusion of pre-filled syringes for anaesthesiology medication delivery has the potential to improve medication safety . [12] [13] [14] [15]

Extrinsic contamination of anaesthetic agents has been identified as one of the risk factors for healthcare-associated infection and clinical articles suggested to use intravenous anaesthetics with EDTA formulation and the use of prefilled syringes to reduce the risk of contamination while drawing up the drug. [16] [17] [18]

Whether the anaesthesiologist will decide to conduct intravenous anaesthesia, sedation or local/regional anaesthesia Aspen can provide a comprehensive portfolio of drugs to support him along the whole clinical pathway.

* Group’s acquisition of the rights to commercialise anaesthesia product portfolio worldwide except in the USA.

References

  1. [1] British Journal of Anaesthesia 114 (4): 663–8 (2015)
    Type of anaesthesia and patient quality of recovery: a randomized trial comparing propofol–remifentanil tota i.v. anaesthesia with desflurane anaesthesia
    W.-K. Lee1, M.-S. Kim1, S.-W. Kang2, S. Kim1 and J.-R. Lee1*
  2. [2] Anaesthesist
    1999 · 48:807–812 © Springer-Verlag 1999S
    TIVA ‘total intravenous anaesthesia’ mit Propofol/Remifentanil oder balancierte AnästhesiE mit Sevofluran/Fentanyl bei laparoskopischen Operationen
    . Juckenhöfel1 · C. Feisel2 · H.J. Schmitt2 · A. Biedler1
  3. [3] Anesthesiology 2016; 124:69-79
    Long-term Survival for Patients Undergoing Volatile versus IV Anesthesia for Cancer Surgery A Retrospective Analysis
    Timothy J. Wigmore, M.A., F.R.C.A., F.F.I.C.M., F.C.I.C.M., Kabir Mohammed, M.Sc.,
    Shaman Jhanji, Ph.D., M.R.C.P., F.R.C.A., F.F.I.C.M.
  4. [5] Springer International Publishing AG 2017
    Advantages, Disadvantages, and Risks of TIVA ‘total intravenous anaesthesia’/TCI ;Ken B. Johnson
    A.R. Absalom, K.P. Mason (eds.), Total Intravenous Anesthesia and Target Controlled Infusions, DOI 10.1007/978-3-319-47609-4_32 621
  5. [6] Target-Controlled Infusion: A Mature Technology
    Anthony R. Absalom, MBChB, FRCA, MD,* John (Iain) B. Glen, BVMS, PhD, FRCA,† Gerrit J. C. Zwart, MD,*Thomas W.
  6. [7] Anesthesiology 2014; 120:703-13
    Ultrasound-guided Multilevel Paravertebral Blocks and Total Intravenous Anesthesia Improve the Quality of Recovery after Ambulatory Breast Tumor Resection
    Faraj W. Abdallah, M.D., Pamela J. Morgan, M.D., F.R.C.P.C., Tulin Cil, M.D., F.R.C.S.C.,
    Andrew McNaught, M.D., F.R.C.P.C., Jaime M. Escallon, M.D., F.R.C.S.C.,
    John L. Semple, M.D., F.R.C.S.C., Wei Wu, M.Sc., Vincent W. Chan, M.D., F.R.C.P.C.
  7. [8] Critical Care 2006, 10:R91 (doi:10.1186/cc4939
    Sedation in the intensive care unit with remifentanil/propofoL versus midazolam/fentanyl: a randomised, open- label,pharmacoeconomic trial
    Bernd Muellejans1, Thomas Matthey1, Joachim Scholpp2 and Markus Schil
  8. [9] British Journal of Anaesthesia 104 (5): 538–46 (2010
    REVIEWARTICLEFifteen years of ultrasound guidance in regional anaesthesia: Part 1
    P. Marhofer1*, W. Harrop-Griffiths2, S. C. Kettner1 and L. Kirchmair3
  9. [10] Eur J Anaesthesiol. 2010 Jul;27(7):592-7. doi: 10.1097/EJA.0b013e32833b1adf.
    The Helsinki Declaration on Patient Safety in Anaesthesiology.
    Mellin-Olsen J1, Staender S, Whitaker DK, Smith AF.
  10. [11] ESA newsletter 68 march 2017. http://newsletter.esahq.org/important-and-urgent-issues-in-perioperative- patient-safety-views-of-an-expert-panel/
  11. [12] Anesthesiology 2016; 124:1-3
    Perioperative Medication Errors Building Safer Systems
    Beverley A. Orser, M.D., Ph.D., David U, B.Sc.Phm., M.Sc.Phm.,Michael R. Cohen, M.S., Sc.D. (hon.), D.P.S. (hon.)
  12. [13] European Section and Board of Anaesthesiology UEMS
    1, October, 2011 EBA UEMS Recommendation for Safe Medication
  13. [14] APFS NEWSLETTER The Official Journal of the Anesthesia Patient Safety Foundation www.apsf.org Volume 25, No. 1, 1-20 Circulation 84,122 Spring 2010
  14. [15] Anesthesiology, V 124 • No 4 795 April 2016
    A Human Factors Engineering Study of the Medication Delivery Process during an Anesthetic
    Self-filled Syringes versus Prefilled Syringes
    Yushi Yang, Ph.D., Antonia Joy Rivera, Ph.D., Christopher R. Fortier, Pharm.D.,
  15. [16] PLOS ONE | DOI:10.1371/journal.pone.0138043 September 18, 2015
    RESEARCH ARTICLE Propofol Increases Host Susceptibility toMicrobial Infection by Reducing Subpopulations of Mature Immune Effector Cells at Sites of Infection
    Lavanya Visva
  16. [17] Anaesthesia 1993; 48: 30–2.
    Growth of microorganisms in solutions of intravenous anesthetic agents
    Berry CB, Gillespie T, Hood J, Scott NB.
  17. [18] Anaesthesia, 2007, 62, pages 575–580
    Microbial growth in propofol formulations with disodium edetate and the influence of venous access system dead space*
    T. Fukada1 and M. Ozaki2