Articles: general-anesthesia.
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Paediatric anaesthesia · Feb 2004
ReviewConjoined twins--the anaesthetic management of 15 sets from 1991-2002.
The Red Cross War Memorial Children's Hospital, Cape Town, South Africa is the only dedicated children's hospital in sub-Saharan Africa and, as such, is the referral hospital for complex procedures from this region. Fifteen sets of conjoined twins have presented for separation from 1991 to 2002, and a total of 34 sets since 1964. Anaesthesia for procedures on conjoined twins is a demanding, exacting and meticulous exercise, whether prior to or during separation. ⋯ Planning for the postseparation period and the reconstruction and rehabilitation of the babies is essential from the time of their initial admission. Meticulous attention to detail, monitoring and vigilance are mandatory. Successful management of conjoined twins relies on close communication and cooperation of all members of the multidisciplinary team.
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Cochrane Db Syst Rev · Jan 2004
Review Meta AnalysisLocal versus general anaesthesia for carotid endarterectomy.
Carotid endarterectomy reduces the risk of stroke in people with recently symptomatic, severe carotid artery stenosis. However, there are significant perioperative risks which may be lessened by performing the operation under local rather than general anaesthetic. ⋯ There is insufficient evidence from randomised trials comparing carotid endarterectomy performed under local and general anaesthetic. Non-randomised studies suggest potential benefits with the use of local anaesthetic, but these studies may be biased. More randomised studies are needed.
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Anesthesia progress · Jan 2004
ReviewDental anesthesia management of methemoglobinemia-susceptible patients: a case report and review of literature.
A healthy but slightly pale 24-year-old female patient with a history of "turning blue" following dental procedures performed under local anesthesia claimed allergies to sulfa drugs, aspirin, Benadryl, and "all caines." The patient also acknowledged mild cyanosis after extreme exertion, Native American ancestry, and a 1996 diagnosis of methemoglobinemia following administration of a sulfa drug. Previous medical and dental records were reviewed. Restoration of several teeth and extraction of 2 third-molar teeth were completed under general anesthesia. ⋯ Vital signs, including pulse oximetry, remained stable, and the patient was dismissed after a 2-hour recovery/observation period. The patient experienced no postoperative complications. This case report provides a review of literature and clinical guidelines for management of methemoglobinemia-susceptible patients.
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Anaesthesiol Reanim · Jan 2004
Review[Regional anaesthesia versus general anaesthesia--pathophysiology and clinical implications].
Regional anaesthesia is well established in modern clinical practice. It provides a safe and reliable alternative to general anaesthesia, but is also of high clinical value in combination procedures. Our knowledge of perioperative pathophysiological characteristics increasingly indicates that regional blocks lead to excellent analgesia und profoundly modulate the postoperative stress response and thus, they can have therapeutic influence on postoperative convalescence, on the functional operation result and on the avoidance of frequent postoperative complications. ⋯ Optimised physiotherapy after total knee arthroplasty or improvements in pulmonary and gastrointestinal function demonstrate the capabilities of regional anaesthesia to facilitate postoperative rehabilitation. With regard to an improved organ function and a possibly shorter hospital stay, regional techniques appear cost-effective. It is important that regional anaesthesia is carried out on the basis of a clear individual indication, which considers the entire perioperative treatment process.