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Background: Monitoring depth of anesthesia via the processed electroencephalogram (EEG) has been found useful in reducing the amount of anesthetic drugs, optimizing wake-up times, and, in some studies, reducing awareness. Our goal was to determine if titrating sevoflurane as the maintenance anesthetic to a depth of anesthesia monitor (SEDLine™, Masimo, CA) would shorten time to extubation in elderly patients undergoing non-cardiac surgery while on beta-adrenergic blockade. This patient population was selected because the usual cardiovascular signs of inadequate general anesthesia may be masked by beta-blocker therapy.Methods: Surgical patients older than 65 years of age receiving beta-adrenergic blockers for a minimum of 24 h preoperatively were randomized to two groups: a group whose titration of sevoflurane was based on SEDLine™ data (SEDLine™ group) and a group whose titration was based on usual clinical criteria (control group) where SEDLine™ data were concealed. The primary endpoint was time from skin closure to time to extubation. Aldrete score, White Fast Track score and QoR-40 were also assessed.Results: There was no significant difference in time to extubation [12.5 (SD 7.4) min in the control group versus 13.0 (SD 5.9) min for the treatment group]. The control group used more fentanyl [339 mcg (SD 205)] than did the treatment group [238 mcg (SD 123)] (P<0.02). There was no difference in sevoflurane utilization, Aldrete, White Fast Track scores, time to PACU discharge, or QoR-40 assessments between the groups.Conclusion: Use of the SEDLine™ monitor's data to titrate sevoflurane did not improve the time to extubation or change short-term outcome of geriatric surgical patients receiving beta-adrenergic blockers. (ClinicalTrials.gov number, NCT00938782). [ABSTRACT FROM AUTHOR]

Laypersons, researchers and clinicians alike speak of the biotechnology revolution with excitement. Media coverage of new breakthroughs in medicine often have the public and the investment community on the edge of their seats, eager for the next blockbuster drug to cure everything from high cholesterol levels to cancer. In this perspective, we examine some of the more popularized and influential new technologies in drug discovery and assess their relative impact on the actual attainment of new therapeutics. [ABSTRACT FROM AUTHOR]

Laypersons, researchers and clinicians alike speak of the biotechnology revolution with excitement. Media coverage of new breakthroughs in medicine often have the public and the investment community on the edge of their seats, eager for the next blockbuster drug to cure everything from high cholesterol levels to cancer. In this perspective, we examine some of the more popularized and influential new technologies in drug discovery and assess their relative impact on the actual attainment of new therapeutics. [ABSTRACT FROM AUTHOR]

Discusses the discovery of anticancer drugs in the U.S. DNA synthesis and cell division; Targeted specificity and side effects of anticancer drugs; Use of Glivec for treating chronic myelogenous leukemia; Incidence and mortality of cancers.