What anesthesia technique is used in your center for kidney transplantation and why was it chosen?

8 kg, 10 month old baby with a type I Chiari malformation.

This is a new procedure for our anesthesia department to be managing and I am looking for any advice/direction that would be helpful. Thank you.

Suggestions for links to articles?

We have been using Ketamine + Xylazine as a standard anaesthetic for mice in our lab. However, due to some policy problems, ketamine is no longer produced here in China. I wonder if there is any other anaesthetic that have similar anaesthetic effect on mice? Please help me. Thanks a million!

Tooth extraction under sedation, minor oral surgery, sedation, general anesthesia

When the BIS was first marketed in 1996, only the BIS values were trended horizontally on the screen. Sadly, this left users with the option of trying to drive their 'car' (titrate anesthetic) with the 'rear view mirror' (information delayed from real time ). The net effect was that when things were going along steadily, all of a sudden the patient would wake up.

The electrical signal of the frontalis muscle (EMG) was not originally trended for fear it would 'contaminate' the BIS signal. When Aspect sent their people to observe my use of trending EMG as the secondary signal, they invariably commented 'I've never seen anyone use the device this way.' To which I replied, 'No one uses a tool that is not useful.'

The EMG of the frontalis muscle is like the EKG of the heart muscle, a real time, useful signal. The 'contamination' of the EMG spike is telling you, 'Hey dude, I am about to wake up unless you intervene!' There is no all of a sudden when EMG provides an early warning signal.

The EMG on the VISTA model is in red. When the red (EMG) goes up, the white (propofol) goes in... until RMG is returned to baseline, preferably not so high a dose(s) that spontaneous ventilation is eliminated in my paradigm. I typically use 200-400 mcg/kg propofol doses repeated to effect.

FWIW, the current factory default has the EMG pre-set as the secondary trend to BIS. The plug in modules do not have this option, only the free standing ones. It also works for the monchrome A-2000.

I used to think that as Pcrit is the same during sedation and natural sleep, this means that the properties of the UA muscles remain intact under sedation, but then I read an old article that explained that because of the methodology to get the Pcrit, where the CPAP is on, the muscles don't have activity, and so you shouldn't expect to have a different Pcrit as, even if the drug would cause muscle relaxation, it would not make a difference in an already relaxed muscle....(Morrison DL, Launois SH, Isono S, Feroah TR, Whitelaw WA, Remmers JE. Pharyngeal narrowing and closing pressures in patients with obstructive sleep apnea.pdf. Am Rev Respir Dis. 1993;148:606–11.)

Now I'm reading an article by Eastwood about increasing dose of propofol and Pcrit and says that it increased Pcrit, so now I don't know what to think (Eastwood PR, Platt PR, Shepherd K, Maddison K, Hillman DR. Collapsibility of the upper airway at different concentrations of propofol anesthesia. Anesthesiology  2005;103(3):470–7.)

Can anyone explain me where's the problem? 

Thanks

I am looking for software (free or paid) that allows monitoring data to be extracted from the GE Carescape B850 anesthetic monitor. Ideally the data should be downloadable in a CSV or Excel file.

iv dexamethasone has been shown to decrease pain after laproscopic surgery.Can any other drug by intraperitoneal route be sufficient?

Dexmedetomidine is used as an adjuvant to intrathecal  local anesthetic                     (Bupivacaine/ Ropivacaine ). Does it help in prolonging duration of spinal anesthesia? How would you rate it on comparison to fentanyl/ morphine?