Articles: general-anesthesia.
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Nihon Ishigaku Zasshi · Sep 1996
Biography Historical Article[Spread of Hanaoka's method of general anesthesia with Mafutsu-san: a discussion of surgical operations by Sanai Hashimoto].
It had been generally accepted that Hanoaka's secretiveness was the most contributory factor in preventing his method of general anesthesia with Mafutsusan from becoming wide spread in Japan. However, the author found several cases of the use of general anesthetic according to his method in various areas in Japan. For instance, Doryu Mikami, a surgeon of the Tsugaru feudal clan entered Hanaoka's school to study his medicine for several years and came back to Tsugaru to perform an amputation of the nose of a young lady with syphilis in about 1864. ⋯ These facts strongly suggest that the method had been transmitted and practised in many districts in Japan by many disciples of his school. However, such cases have not been reported in detail. Thus the widely rumoured evaluation of Hanaoka's secretiveness is incorrect.
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A case of severe accidental hypercapnia during anesthesia is presented. A 44-year-old woman underwent laparotomy under general anesthesia. Forty minutes after the start of the operation, BP rose slightly and HR increased from 110 to 140 x min-1. ⋯ Then, the pupils became promptly constricted and the response to painful stimuli appeared within 30 minutes. Her level of consciousness recovered completely after 4.5 hours of hyperventilation. She suffered from refractory hypotension (BP70-85 mmHg in systolic pressure) in spite of catecholamine administration, tachycardia (HR 140-160 x min-1) and ARDS in the ICU, but all the symptoms disappeared by the 16 hours after ICU admission.
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Review Comparative Study
Effects of regional anesthesia on perioperative outcome.
To provide an overview of current knowledge, this article reviews experimental and clinical data from investigations examining effects of regional anesthesia on perioperative morbidity in specific physiologic systems. The issues of morbidity and mortality following general and regional anesthesia are addressed, as are the development of perioperative thromboembolism and blood loss, which are known to be increased during general anesthesia. Finally, the effects of regional anesthesia on the vascular system, the perioperative stress response, and the pulmonary function are discussed.
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Anesthesia and analgesia · Sep 1996
Randomized Controlled Trial Comparative Study Clinical TrialA prospective randomized study comparing short- and intermediate-term perioperative outcome variables after spinal or general anesthesia for lumbar disk and laminectomy surgery.
General or regional anesthesia may be used for lumbar laminectomy. To determine whether one method is superior, 122 patients were randomly assigned to receive either a standard general anesthetic (GA) or spinal anesthesia (SA) supplemented with intravenous (IV) propofol sedation. Data from the intraoperative period through hospital discharge were collected and compared. ⋯ Severe nausea was more common in the GA group both in the PACU and during the 24 h after surgery. Analgesic requirements after discharge from the PACU, urinary retention, and days in the hospital did not differ between groups. This study suggests that SA may be superior to GA both intraoperatively and postoperatively for lumbar spine procedures lasting less than 2 h.
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General anesthesia is a state of reversible, descending depression of the central nervous system that is induced by inhalational or intravenous drugs. Components of general anesthesia include hypnosis, analgesia, amnesia, and muscle relaxation. Recognized anesthesia providers include CRNAs and anesthesiologists. Improvements in pharmacologic agents, technology, and education of providers have sharply reduced morbidity and mortality associated with anesthesia.