Acta anaesthesiologica Belgica
-
Acta Anaesthesiol Belg · Jan 1988
ReviewThe relevance of metabolic and endocrine responses to anesthesia and surgery.
The development of anesthesia has reached a stage where the evaluation of the usefulness of metabolic and endocrine responses is highly important. At present, these responses are commonly modulated in patients known to benefit most (e.g. patients with ischemic cardiovascular disease and patients undergoing major abdominal surgery), but no methods of totally response-free anesthesia and surgery are available, nor are there methods for the modulation of the responses on a wide clinical scale. Fortunately, in most patients undergoing conventional elective operations good anesthetic care is sufficient for blunting of the responses. Better methods of modulating the responses may be available in the future, which will greatly change anesthesia practice.
-
Acta Anaesthesiol Belg · Jan 1988
Review Comparative StudyThe relevance of immunologic responses to anesthesia and surgery.
Out of some three million general anesthetic (GA) procedures administered in the UK each year some 10,000 patients will suffer clinically a severe immediate hypersensitivity-type (anaphylactoid) response: some will suffer neurological deficit, a few will die. The problems are essentially those intrinsic to all intravenous administration and infrequently drug specific. ⋯ The relative incidence of severe LA to GA reactions reported nationwide to Sheffield lies between 5% and 10% of the total reports. In the post-operative period the dramatic changes in laboratory parameters of immunity refer largely to the stress response to surgery and probably have little relevance to post-operative infection and wound healing in elective surgery.
-
Acta Anaesthesiol Belg · Jan 1988
ReviewNo decisive break-through yet for general anesthesia combined with locoregional anesthesia!
Although on theoretical grounds locoregional anesthesia, because of the claimed suppression of stress response and the ease with which prolonged analgesia can be achieved, seems preferable to general anesthesia, the shortcomings and drawbacks are such that its use is restricted to well chosen indications. The hope that combination anesthesia can overcome the limitations of both techniques remain to be proven whereas the problems that can arise during the combined technique could pose a major threat to the patient.