Journal of anesthesia
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Journal of anesthesia · Dec 1994
Preoperative hypoxemia in conscious patients after subarachnoid hemorrhage.
We retrospectively examined partial arterial pressure of oxygen (Pao2) afer subarachnoid hemorrhage (SAH), adjusted for patient-related risk factors for hypoxemia in 51 adult patients with no disturbance of consciousness undergoing surgery for clipping of intracranial aneurysms. A control group of 174 patients undergoing other operations were used for comparison. ⋯ In three patients in the SAH group, Pao2 was less than 60 mmHg. Close monitoring of arterial oxygenation with pulse oximetry is desirable, and supplemental oxygen should be considered during transfer from the patients' room to the operating suite, even for conscious patients of SAH without cardiopulmonary disease.
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Journal of anesthesia · Dec 1994
Depression of sighing in the first three postoperative days with epidural morphine analgesia.
We have studied the effect of spontaneous sighs on maintaining arterial oxygenation in patients receiving epidural morphine for analgesia after upper abdominal surgery. Sixteen patients scheduled for elective gastrectomy were monitored continuously with pulse oximetry and respiratory inductive plethysmography (RIP) during one night preoperatively and for 60 h postoperatively with repeate arterial blood gas analysis. ⋯ Although postoperative Pao2 values were significantly lower than preoperative values, there was no correlation between the decreases in Pao2 values and number of sighs. Thus, it is unlikely that the long-term absence of spontaneous sighs observed may serve as a contributing factor for the long-lasting hypoxemia in the postoperative period.
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Journal of anesthesia · Dec 1994
Influence of tumor size on anesthetic management for pheochromocytoma resection.
The relationship between tumor size and the complexity of anesthetic management was studied using several values: plasma catecholamine concentrations, requirement of vasoactive agents, surgical time, blood loss, plasma glucose concentrations, and hemodynamic variables. Ten patients with clinical and laboratory diagnosis of pheochromocytoma were prospectively studied. Each anesthesia was maintained using inhalational anesthetic agents. ⋯ However, the tumor weight was not correlated with hemodynamic variables. Patients who required propranolol generally had a significantly larger tumor than those who did not. In conclusion, surgical removal of large pheochromocytoma required more complicated anesthetic management than that of small pheochromocytoma.