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1.

001-es BibID:BIBFORM096223
035-os BibID:(cikkazonosító)206 (scopus)85112712420 (wos)000686714500001
Első szerző:Fábián Ákos István (aneszteziológus)
Cím:Carboxymethyl-γ-cyclodextrin, a novel selective relaxant binding agent for the reversal of neuromuscular block induced by aminosteroid neuromuscular blockers : an ex vivo laboratory study / Ákos I. Fábián, Edömér Tassonyi, Vera Csernoch, Marianna Fedor, Tamás Sohajda, Lajos Szente, Béla Fülesdi1
Dátum:2021
ISSN:1471-2253
Megjegyzések:Background Residual neuromuscular block at the end of surgery may compromise the patient's safety. The risk of airway complications can be minimized through monitoring of neuromuscular function and reversal of neuromuscular block if needed. Effective reversal can be achieved with selective relaxant binding agents, however, sugammadex is the only clinically approved drug in this group. We investigated the concentration?response properties of a novel selective relaxant binding agent, carboxymethyl-?-cyclodextrin for the reversal of neuromuscular block. We evaluated the hypothesis that it is equally potent for reversing neuromuscular block as sugammadex. Methods Phrenic nerve ? hemidiaphragm tissue preparations were isolated from male Wistar rats and suspended in a tissue holder allowing electrical stimulation of the nerve and monitoring of muscle contraction force. Concentration?response relationships were constructed for the neuromuscular blocking agents rocuronium, pipecuronium, and vecuronium. The half-effective concentrations of sugammadex and carboxymethyl-?-cyclodextrin for reversal of neuromuscular block were determined. Results The half effective concentrations (95% confidence interval, CI) were 7.50 (6.93?8.12) ?M for rocuronium, 1.38 (1.33?1.42) ?M for pipecuronium, and 3.69 (3.59?3.80) ?M for vecuronium. The half effective concentrations (95% CI) of carboxymethyl-?-cyclodextrin and sugammadex were 35.89 (32.67?39.41) ?M and 3.67 (3.43?3.92) ?M, respectively, for the reversal of rocuronium-induced block; 10.14 (9.61?10.70) ?M and 0.67 (0.62?0.74) ?M, respectively, for the reversal of pipecuronium-induced block; and 376.1 (341.9?413.8) ?M and 1.45 (1.35?1.56) ?M, respectively, for the reversal of vecuronium-induced block. Conclusions Carboxymethyl-?-cyclodextrin is an effective, but less potent agent for reversal of neuromuscular block than sugammadex.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Neuromuscular blocking agent
Selective relaxant binding agent
Cyclodextrin
Sugammadex
Rocuronium
Pipecuronium
Vecuronium
Phrenic nerve
Hemidiaphragm
Megjelenés:BMC Anesthesiology. - 21 : 1 (2021), p. 1-9. -
További szerzők:Tassonyi Edömér (1940-2022) (aneszteziológus) Csernoch Vera (1987-) (orvos) Fedor Marianna Sohajda Tamás Szente Lajos (1951-) (vegyész) Fülesdi Béla (1961-) (aneszteziológus)
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2.

001-es BibID:BIBFORM078614
035-os BibID:(cikkazonosító)64 (scopus)85065222176 (wos)000466522400002
Első szerző:Fábián Ákos István (aneszteziológus)
Cím:The effect of magnesium on the reversal of rocuronium-induced neuromuscular block with sugammadex : an ex vivo laboratory study / Ákos I. Fábián, Vera Csernoch, Edömér Tassonyi, Marianna Fedor, Béla Fülesdi
Dátum:2019
ISSN:1471-2253
Megjegyzések: Background Magnesium dose-dependently potentiates the effect of non-depolarizing neuromuscular blocking agents. We investigated whether the potentiation of rocuronium-induced blockade by magnesium reduces the effect of sugammadex in an ex-vivo environment and how this influences the safety margin of reversal. Methods Phrenic nerve - hemidiaphragm tissue preparations were isolated from male Wistar rats. The specimens were suspended in a tissue holder that allowed registering muscle contraction amplitude following electrical stimulation of the nerve. Concentration-response relationships were elucidated for magnesium, as well as for rocuronium and sugammadex. Results The mean (95% confidence interval [CI]) half effective concentrations (EC50) of rocuronium in the presence of magnesium 1?mM or 1.5?mM were 7.50??M (6.97-8.07??M) and 4.25??M (4.09-4.41??M), respectively (p?<?0.0001). Increasing magnesium from 1?mM to 1.5?mM during reversal of rocuronium-induced block increased the mean (95% CI) EC50 of sugammadex from 3.67??M (3.43-3.92??M) to 5.36??M (5.18-5.53??M), whereas mean (95% CI) effective concentrations for 95% effect (EC95) were not significantly different at 7.22??M (6.09-8.54??M) and 7.61??M (7.05-8.20??M), respectively (p?=?0.542). When rocuronium-induced block was reversed to a train-of-four (TOF) ratio?>?0.9, but with still visible fade, increasing magnesium from 1?mM to 2?mM decreased the TOF ratio to below 0.9. If there was no visible fade after reversal, increasing magnesium concentration did not reduce the TOF ratio. Conclusions Magnesium potentiates the neuromuscular effect of rocuronium and shifts the concentration-response curve to the left. Magnesium decreases the safety margin of reversal of rocuronium-induced neuromuscular block with sugammadex.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Phrenic nerve-diaphragm preparation
Neuromuscular block
Rocuronium
Magnesium
Sugammadex
Megjelenés:BMC Anesthesiology. - 19 : 64 (2019), p. 1-8. -
További szerzők:Csernoch Vera (1987-) (orvos) Tassonyi Edömér (1940-2022) (aneszteziológus) Fedor Marianna Fülesdi Béla (1961-) (aneszteziológus)
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3.

001-es BibID:BIBFORM065510
Első szerző:Gyulaházi Judit (aneszteziológus, intenzív terápiás szakorvos)
Cím:Dreaming under anesthesia : is it a real possiblity? Investigation of the effect of preoperative imagination on the quality of postoperative dream recalls / Judit Gyulaházi, Pál Redl, Zsolt Karányi, Katalin Varga, Béla Fülesdi
Dátum:2016
ISSN:1471-2253
Megjegyzések:BackgroundImages evoked immediately before the induction of anesthesia by means of suggestions may influence dreaming during anesthesia. This study is a retrospective re-evaluation of the original prospective randomized trial.MethodsDream reports were studied in two groups. In group 1. dreams of patients who received suggestions, and in group 2, those of the control group of patients who did not. The incidence of dream reports and the characteristics and the theme of the reported dreams were compared among the groups.ResultsIn general, the control and the psychological intervention groups were different in terms of dreaming frequency, and non-recall dreaming. The incidence of dream reports was significantly higher in the suggestion group (82/190 at 10 min and 71/190 at 60 min respectively) than in the control group (16/80 at 10 min and 13/80 at 60 min, respectively; p10?=?0.001 and p60?=?0.002). There were no differences in the nature (thought- like or cinematic), quality (color or B&W) and the mood (positive vs. negative) of the recalled dreams. In general, the contents of the imaginary favorite place and the reported dream were identical in 73.2 %. Among the topics most successfully applied in the operating theater were loved ones (83.8 %), holiday (77.8 %) and sport (63.6 %).ConclusionThe results of the present study suggest that dreams during anesthesia are influenced by suggestions administered immediately preceding anesthesia.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:BMC Anesthesiology 16 : 53 (2016), p. 1-7. -
További szerzők:Redl Pál (1953-) (szájsebész) Karányi Zsolt (1961-) (biostatisztikus, bioinformatikus) Varga Katalin Fülesdi Béla (1961-) (aneszteziológus)
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Intézményi repozitóriumban (DEA) tárolt változat
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4.

001-es BibID:BIBFORM065512
Első szerző:Gyulaházi Judit (aneszteziológus, intenzív terápiás szakorvos)
Cím:The effect of preoperative suggestions on perioperative dreams and dream recalls after administration of different general anesthetic combinations : a randomized trial in maxillofacial surgery / Judit Gyulaházi, Katalin Varga, Endre Iglói, Pál Redl, János Kormos, Béla Fülesdi
Dátum:2015
ISSN:1471-2253
Megjegyzések:Images evoked immediately before the induction of anesthesia with the help of suggestions may influence dreaming during anesthesia.The aim of the study was to assess the incidence of evoked dreams and dream recalls by employing suggestions before induction of anesthesia while administering different general anesthetic combinations.MethodsThis is a single center, prospective randomized including 270 adult patients scheduled for maxillofacial surgical interventions. Patients were assigned to control, suggestion and dreamfilm groups according to the psychological method used. According to the anesthetic protocol there were also three subgroups: etomidate & sevoflurane, propofol & sevoflurane, propofol & propofol groups. Primary outcome measure was the incidence of postoperative dreams in the non-intervention group and in the three groups receiving different psychological interventions. Secondary endpoint was to test the effect of perioperative suggestions and dreamfilm-formation training on the occurrance of dreams and recallable dreams in different general anesthesiological techniques.ResultsDream incidence rates measured in the control group did not differ significantly (etomidate & sevoflurane: 40%, propofol & sevoflurane: 26%, propofol & propofol: 39%). A significant increase could be observed in the incidence rate of dreams between the control and suggestion groups in the propofol & sevoflurane (26%-52%) group (p = 0.023). There was a significant difference in the incidence of dreams between the control and dreamfilm subgroup in the propofol & sevoflurane (26% vs. 57%), and in the propofol & propofol group (39% vs.70%) (p = 0.010, and p = 0.009, respectively). Similar to this, there was a significant difference in dream incidence between the dreamfilm and the suggestion subgroups (44% vs. 70%) in the propofol & propofol group (p = 0.019). Propofol as an induction agent contributed most to dream formation and recalls (?2-test p value: 0.005). The content of images and dreams evoked using suggestions showed great agreement using all three anesthetic protocols.ConclusionThe psychological method influenced dreaming during anesthesia. The increase of the incidence rate of dreams was dependent on the anesthetic agent used, especially the induction agent.The study was registered in ClinicalTrials.gov. Identifier: NCT01839201.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:BMC Anesthesiology 15 : 11 (2015), p. 1-8. -
További szerzők:Varga Katalin Iglói Endre (1963-) (matematikus) Redl Pál (1953-) (szájsebész) Kormos János (1952-2015) (matematikus) Fülesdi Béla (1961-) (aneszteziológus)
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Intézményi repozitóriumban (DEA) tárolt változat
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5.

001-es BibID:BIBFORM079331
Első szerző:Juhász Marianna (aneszteziológus)
Cím:Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity / Juhász Marianna, Molnár Levente, Fülesdi Béla, Végh Tamás, Páll Dénes, Molnár Csilla
Dátum:2019
ISSN:1471-2253
Megjegyzések:Background Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods Twenty nine patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30?mmHg EtCO2 for 5?min respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation index as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Sevoflurane
CO2-reactivity
applanation tonometry
Megjelenés:BMC Anesthesiology. - 19 : 1 (2019), p. 109-116. -
További szerzők:Molnár Levente Fülesdi Béla (1961-) (aneszteziológus) Végh Tamás (1975-) (aneszteziológus, intenzív terápiás szakorvos) Páll Dénes (1967-) (belgyógyász, kardiológus) Molnár Csilla (1962-) (aneszteziológus)
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Intézményi repozitóriumban (DEA) tárolt változat
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6.

001-es BibID:BIBFORM070047
Első szerző:Molnár Levente
Cím:Assessment of cerebral circulation in a porcine model of intravenously given E. coli induced fulminant sepsis / Levente Molnár, Norbert Németh, Mariann Berhés, Endre Hajdú, Lóránd Papp, Ábel Molnár, Judit Szabó, Ádám Deák, Béla Fülesdi
Dátum:2017
ISSN:1471-2253
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:BMC Anesthesiology. - 17 : 98 (2017), p. 1-9. -
További szerzők:Németh Norbert (1975-) (kutatóorvos) Berhés Mariann (1975-) (orvos) Hajdu Endre Papp Lóránd Molnár Ábel Szabó Judit (1963-) (szakorvos, klinikai mikrobiológus) Deák Ádám (1974-) (állatorvos) Fülesdi Béla (1961-) (aneszteziológus)
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http://dx.doi.org/10.1186/s12871-017-0389-3DOI
Intézményi repozitóriumban (DEA) tárolt változat
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7.

001-es BibID:BIBFORM062454
Első szerző:Moore, Richard A.
Cím:Dexketoprofen/tramadol 25 mg/75 mg : randomised double-blind trial in moderate-to-severe acute pain after abdominal hysterectomy / R. A. Moore, H. J. McQuay, J. Tomaszewski, G. Raba, D. Tutunaru, N. Lietuviete, J. Galad, L. Hagymasy, D. Melka, J. Kotarski, T. Rechberger, B. Fülesdi, A. Nizzardo, C. Guerrero-Bayón, S. Cuadripani, B. Pizà-Vallespir, M. Bertolotti
Dátum:2016
ISSN:1471-2253
Megjegyzések:Background: Dexketoprofen trometamol plus tramadol hydrochloride is a new oral combination of two analgesics, which have different mechanisms of action for the treatment of moderate to severe acute pain. Methods: Randomised, double-blind, parallel, placebo and active-controlled, single and multiple-dose study to evaluate the analgesic efficacy and safety of dexketoprofen/tramadol 25 mg/75 mg in comparison with the single agents (dexketoprofen 25 mg and tramadol 100 mg) in moderate to severe acute pain after abdominal hysterectomy. Results: The efficacy analysis included 606 patients, with a mean age of 48 years (range 25-73). The study results confirmed the superiority of the combination over the single agents in terms of the primary endpoint (p <0.001). Secondary endpoints were generally supportive of the superiority of the combination for both single and multiple doses. Conclusions: The study results provided robust evidence of the superiority of dexketoprofen/tramadol 25 mg/75 mg over the single components in the management of moderate to severe acute pain, as confirmed by the single-dose efficacy, repeated-dose sustained effect and good safety profile observed. Trial registration: EU Clinical Trials Register (EudraCT number 2012-004545-32 , registered 04 October 2012); Clinicaltrials.gov ( NCT01904149 , registered 17 July 2013). ? 2016 Moore et al.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Analgesics
Dexketoprofen trometamol
Drug combinations
Hysterectomy
Pain
Postoperative
Tramadol
Megjelenés:BMC Anesthesiology 16 : 1 (2016), p. 1-14. -
További szerzők:McQuay, H. J. Tomaszewski, J. Raba, G. Tutunaru, D. Lietuviete, N. Galad, J. Hagymasy, L. Melka, D. Kotarski, J. Rechberger, Tomasz Fülesdi Béla (1961-) (aneszteziológus) Nizzardo, A. Guerrero-Bayón, C. Cuadripani, S. Pizà-Vallespir, B. Bertolotti, M.
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Intézményi repozitóriumban (DEA) tárolt változat
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8.

001-es BibID:BIBFORM068737
Első szerző:Sárkány Péter (aneszteziológus)
Cím:Does standing or sitting position of the anesthesiologist in the operating theatre influence sevoflurane exposure during craniotomies? / Péter Sárkány, Béla Tankó, Éva Simon, Judit Gál, Béla Fülesdi, Csilla Molnár
Dátum:2016
ISSN:1471-2253
Megjegyzések:BackgroundExposure of the OR staff to inhalational anesthetics has been proven by numerous investigators, but its potential adverse effect under the present technical circumstances is a debated issue. The aim of the present work was to test whether using a laminar flow air conditioning system exposure of the team to anesthetic gases is different if the anesthetist works in the sitting as compared to the standing position.MethodsSample collectors were placed at the side of the patient and were fixed at two different heights: at 100 cm (modelling sitting position) and 175 cm (modelling standing position), whereas the third collector was placed at the independent corner of the OR. Collected amount of sevoflurane was determined by an independent chemist using gas chromatography.ResultsAt the height of the sitting position the captured amount of sevoflurane was somewhat higher (median and IQR: 0.55; 0.29?1.73 ppm) than that at the height of standing (0.37; 0.15?0.79 ppm), but this difference did not reach the level of statistical significance. A significantly lower sevoflurane concentration was measured at the indifferent corner of the OR (0.14; 0.058?0.36 ppm, p?<?0.001).ConclusionsOpen isolation along with the air flow due to the laminar system does not result in higher anesthetic exposure for the sitting anesthetist positioned to the side of the patient. Evaporated amount of sevoflurane is below the accepted threshold limits in both positions.KeywordsOccupational exposure Sevoflurane
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Occupational exposure Sevoflurane
Megjelenés:BMC Anesthesiology. - 16 : 1 (2016), p. 120-125. -
További szerzők:Tankó Béla (1972-) (aneszteziológus) Simon Éva (1963-) (aneszteziológus) Gál Judit (1977-) (aneszteziológiai és ITO szakorvos) Fülesdi Béla (1961-) (aneszteziológus) Molnár Csilla (1962-) (aneszteziológus)
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Intézményi repozitóriumban (DEA) tárolt változat
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9.

001-es BibID:BIBFORM062339
Első szerző:Sárkány Péter (aneszteziológus)
Cím:Non-invasive pulse wave analysis for monitoring the cardiovascular effects of CO2 pneumoperitoneum during laparoscopic cholecystectomy- a prospective case-series study / Sárkány Péter, Lengyel Szabolcs, Nemes Réka, Orosz Lívia, Páll Dénes, Molnár Csilla, Fülesdi Béla
Dátum:2014
ISSN:1471-2253
Megjegyzések:AbstractBackground: Peritoneal insufflation results in hemodynamic changes during laparoscopic cholecystectomy.The aim of the present work is to test whether non-invasive applanation tonometry is suitable for reflectingthese hemodynamic alterations.Methods: 41 patients undergoing laparoscopic cholecystectomies were monitored using the SphygmoCor pulsewave analysing system. Peripheral blood pressures (PBP), central aortic blood pressures (CBP), augmentation index(ALX@HR75) and subendocardial viability ratio (SVR) were measured at rest (Phase 1), after anesthetic induction(Phase 2), after peritoneal inflation (Phase 3) and after peritoneal deflation (Phase 4).Results: Induction of anesthesia resulted in a statistically significant reduction in both the peripheral blood pressureand central aortic pressures, accompanied by a decrease in augmentation pressure and augmentation index.Peripheral blood pressures did not change along with the peritoneal cavity insufflation, except for a moderateincrease in systolic blood pressure. In contrast to this, an increase could be observed in central aortic pressure(106.77 ? 18.78 vs. 118.05 ? 19.85 mmHg, P < 0.01) which was accompanied by increased augementation pressure(18.97 ? 10.80 vs. 31.55 ? 12.01; P < 0.001) and augmentation index (7.31 ? 5.59 vs. 12.61 ? 7.56, P < 0.001), indicatinga rise in peripheral arterial stiffness.Conclusions: The Sphigmocor pulse wave analysis system can be reliably used for detecting and monitoringcardiovascular changes occurring during laparoscopic cholecystectomy.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Laparoscopic cholecystectomy
Hemodynamic changes
Applanation tonometry
Megjelenés:BMC Anesthesiology. - 14 : 98 (2014), p. 1-7. -
További szerzők:Lengyel Szabolcs (1981-) (belgyógyász) Nemes Réka (1985-) (aneszteziológus, intenzív terápiás szakorvos) Orosz Lívia Páll Dénes (1967-) (belgyógyász, kardiológus) Molnár Csilla (1962-) (aneszteziológus) Fülesdi Béla (1961-) (aneszteziológus)
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