Articles: general-anesthesia.
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Acta Anaesthesiol Belg · Jan 2004
Review Comparative StudyPerioperative management for one day hospital admission: regional anesthesia is better than general anesthesia.
The past ten years have showed real and considerable growth in the number and complexity of ambulatory surgeries. The remaining real problems are the postoperative pain and the adverse effects due to parenteral opioids promoting hospital readmissions and increasing costs. ⋯ Regional anesthesia techniques such as spinal anesthesia and peripheral nerve blocks are ideal techniques for one day hospital admissions surgical procedures. It is now fully demonstrated that these techniques allowed rapid and complete anesthetic blocks, a limitation of adeverses events and unplanned hospital admissions and increased the quality of prolonged optimal postoperative pain relief if continuous peripheral nerve blocks are used.
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Review Case Reports
[Intraoperative coronary spasm in patients without a history of anginal chest pain].
We report three cases of intraoperative coronary spasm that developed during non-cardiac surgical procedures. None of the patients had a history of anginal chest pain. The presumed contributing factors were: 1) suction of the trachea during general anesthesia, 2) hyperventilation and hypotension during induction of general anesthesia, and 3) hyperventilation during neuroanesthesia. ⋯ Some of common intraoperative conditions such as hyperventilation, hypotension, and inadequate depth of anesthesia, were reported to be potent precipitating factors for coronary spasm. In recent years, a larger proportion of surgical patients have coronary risk factors. Careful anesthetic management is required to prevent intraoperative coronary spasm even in patients without a history of coronary artery disease.
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Hypothermia occurs due to body heat redistribution between core and peripheral tissues as well as imbalance between heat loss and production. Perioperative hypothermia not only induces offensive shivering and prolongation of anesthetic recovery but also increases blood loss and incidence of surgical wound infection, increasing postoperative morbidity. ⋯ Anesthesiologists should have knowledge of the characteristics of the various kinds of fluid warmer currently available and use them appropriately according to surgical procedures and the patient's position. It was reported recently that administration of amino acid can prevent intraoperative hypothermia, possibly by increasing the heat production in the body.