Articles: general-anesthesia.
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Do patients form memories of intra-operative events when they are adequately anaesthetized? Studies of memory priming during anaesthesia with depth or awareness monitoring provide some evidence that they do, although only the most basic form of memory function, perceptual priming, persists when patients are unconscious. The probability of memory encoding increases as depth of anaesthesia decreases. There is a theoretical possibility that patients can be adversely affected, through memory priming, by comments made in the operating theatre, and some evidence that positive intra-operative suggestions can benefit patients.
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The cardiac catheterization lab has concerns for both patient care and for safety. As the cardiac catheterization lab continues to evolve, the demand for anesthesia services will certainly increase. The role of the anesthesiologist in the cardiac catheterization lab must be defined in this changing environment. ⋯ The anesthesiologist is becoming an integral part of the cardiac catheterization lab team, and an important element in maintaining a high level of patient care with minimal complications in the evolving modern day cardiac catheterization lab.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2007
Review[Airway pressure settings during general anaesthesia].
In volume-controlled mechanical ventilation with constant inspiratory gas flow, which is most often used during general anesthesia, only the end-expiratory airway pressure (PEEP) has to be set by the user. Inspiratory airway pressures result from the combination of tidal volume and respiratory compliance as well as instantaneous gas flow and respiratory resistance. Given a normal respiratory compliance of 50-60 ml/mbar in mechanically ventilated patients, a driving pressure of 7-10 mbar is necessary for a tidal volume of about 6 ml/kg predicted body weight. ⋯ Furthermore, PEEP increases the apnoea interval tolerated without desaturation and thereby increases the safety margin during induction of anesthesia. If atelectasis shall be completely recruited, an airway pressure of 40 cm H2O is needed for 40 seconds. In order to avoid a severe drop in arterial blood pressure which may be accompanied by cardiac arrhythmia, such a recruitment manoeuvre should only be performed in normovolemic patients.
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Review Comparative Study
[The value of regional and general anaesthesia in orthopaedic surgery].
Adequate postoperative pain management is of major importance for a short rehabilitation time after painful orthopaedic surgery. Multimodal pathways have been established to achieve a surgical patient free of pain and complications. Peripheral and central nerve blocks are a fundamental part of these interdisciplinary strategies and are already implemented in orthopaedic surgical care. This article summarises the value of special anaesthetic techniques, especially regional anaesthesia, in orthopaedic surgery and discusses their impact on several postoperative outcome goals.
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Introduction of the laryngeal mask airway (LMA) has been a revolutionary development in airway management over the last decades. It was first used clinically in 1981 by A. ⋯ Originally intended as a substitute for conventional mask respiration for short periods of general anaesthesia, the laryngeal mask is in the meantime used in many areas as an alternative to elective endotracheal intubation as well as an option for controlling difficult airways. This contribution provides an overview of the basics as well as practical aspects of LMA use, and discusses the possibilities and limitations of the laryngeal mask in daily practice.