Articles: general-anesthesia.
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Comparative Study
EEG Predicts movement response to surgical stimuli during general anesthesia with combinations of isoflurane, 70% N2O, and fentanyl.
Our objective was to evaluate the performance of the EEG as an indicator of anesthetic depth by measuring EEG prediction of movement response to surgical stimuli. ⋯ The EEG, expressed as F95, predicted movement response to surgical stimuli during combinations of isoflurane, 70% N2O, and fentanyl. The F95-response curves shifted upward on the frequency scale for the less intense stimuli and for anesthetic techniques using 70% N2O, fentanyl, or both. F95 prediction of movement response appeared to be related to anesthetic agent doses. Our F95-response curves may provide helpful guidelines for using F95 to titrate the administration of anesthetic agents and for assessing the depth of general anesthesia.
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Clinical Trial Controlled Clinical Trial
Laryngeal mask airway performance: effect of cuff deflation during anaesthesia.
We studied the effect of deflating the laryngeal mask airway (LMA) cuff in situ on recorded respiratory tidal ventilation in 30 spontaneously breathing anaesthetized patients. Another 26 patients were studied in whom the LMA cuff was undisturbed. ⋯ Complete cuff deflation, however, resulted in a 17% decrease in mean tidal ventilation (P < 0.05), with two patients (6%) demonstrating a substantial leak around the cuff and airway obstruction. The practice of complete cuff deflation during the recovery period from anaesthesia cannot be recommended.
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Case Reports
Unintentional intraoperative awareness during sufentanil anaesthesia for cardiac surgery.
The aim of this clinical report is to describe a case of unintentional intraoperative awareness during sufentanil anaesthesia in a patient undergoing elective aortocoronary bypass grafting. ⋯ Although awareness during opioid anaesthesia has been previously described with morphine and fentanyl, as far as we know this is the first clinical report of awareness with sufentanil. Given that recent efforts of early extubation in cardiac surgery patients may involve a reduction in the amount of opioid administered, this report serves as a reminder of the ever present potential for this disturbing complication.
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We have compared cardiorespiratory variables in anaesthetized piglets whose lungs were ventilated with oxygen in nitrous oxide (N2O group) or nitrogen (N group) after right ventricular carbon dioxide boluses (0.5 or 1 ml kg-1; n = 12) or slow graded injections (n = 6). Boluses affected all variables studied significantly (P < 0.05) except mean systolic arterial pressure. Significant changes in PE'CO2 (P = 0.012) and PaO2 (P = 0.048) values were observed in the N2O group. ⋯ Volumes and time required to induce a 50% increase in mean pulmonary arterial pressure differed significantly between groups (P < 0.05). We conclude that nitrous oxide worsened the effects of rapid and slow carbon dioxide emboli on cardiopulmonary variables. Rapid carbon dioxide embolism altered respiratory and haemodynamic variables, while slow carbon dioxide embolism changed only respiratory variables.