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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)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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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)
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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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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