British journal of anaesthesia
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Day case surgery is becoming more acceptable, even for patients with complex medical conditions. Current recommendations suggest that patients who are graded as American Society of Anaesthesiologists physical status (ASA) III may be suitable for this approach. There is only a small amount of published data available to support this. We present a retrospective review of ASA III patients who had undergone day surgical procedures in our unit. ⋯ With good pre-assessment and adequate preparation ASA III patients can be treated safely in the day surgery setting.
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During EEG suppression with isoflurane or sevoflurane anaesthesia, median nerve stimulation causes cortical responses of two kinds: an N20 wave with a latency of 20 ms and an EEG burst with a latency of 200 ms. We tested the possibility that median nerve stimulation during EEG suppression with propofol would cause an EEG response that was consistent enough to be of use for neuromonitoring. ⋯ In addition to SSEP (somatosensory evoked potentials), three different evoked responses are noted that could be useful for clinical monitoring.
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The molecular basis of i.v. general anaesthetic activity was investigated using comparative molecular field analysis (CoMFA). ⋯ A single activity model can be formulated for i.v. general anaesthetics and preliminary pharmacophoric maps derived, which describe the molecular basis of their in vivo potency.
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Fluid depletion during the perioperative period is associated with poorer outcome. Non-invasive measurement of total body water by bioimpedance may enable preoperative fluid depletion and its influence on perioperative outcome to be assessed. ⋯ Further work is warranted to determine if bioimpedance changes may serve as a useful indicator of perioperative fluid depletion.
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Comparative Study
Comparison of the role of endothelin, vasopressin and angiotensin in arterial pressure regulation during sevoflurane anaesthesia in dogs.
In this study we aimed to clarify the role of endothelin in arterial pressure regulation during anaesthesia with increasing concentrations of sevoflurane (1-3 MAC) and compare it with those of vasopressin and angiotensin. ⋯ At 1 MAC, angiotensin attenuated the decrease in arterial pressure during sevoflurane anaesthesia more than endothelin and vasopressin. However, at higher MAC only vasopressin was specifically activated to partly compensate for the arterial pressure decrease.