Articles: general-anesthesia.
-
Mental status changes were assessed and compared in 172 general surgical and orthopedic patients and 190 nonsurgical patients, all aged 55 and over, during a 10-month period. Assessments included a structured psychosocial questionnaire and standardized tests of cognition, affect, and function. The relationship of surgery, type of surgery, age, gender, and postoperative delirium to long-term postoperative decline was evaluated. ⋯ Hierarchical multiple regression analyses assessed the unique contributions of demographic and surgical variables to cognitive, affective, and functional change. None of the independent variables tested made a significant contribution to changes from baseline to long-term follow-up. The findings may be due to the physical and psychological health of this sample, and replication of this work in more impaired populations may be productive.
-
Animal studies show that airway receptors responsible for eliciting respiratory protective reflexes are not uniformly distributed in the airways. Based on this information, it is possible that the protective reflex responses to airway irritation in humans may vary, depending on the site of stimulation. The purpose of this study is to examine whether the protective reflex responses evoked from the larynx are different from those evoked from the lower airways and to see how change in depth of anesthesia modifies the protective reflex responses evoked from individual sites. ⋯ The respiratory reflex responses evoked by injection of water vary, depending on the site of stimulation. The incidence of various reflex responses was not affected by the changing depth of anesthesia. The sensitivity to airway irritation seems to be greater at the larynx and trachea than at the more peripheral airways.
-
Mivacurium is a potent, short-acting, nondepolarizing relaxant of the benzylisoquinoline series. In adults endotracheal intubation can be performed after a 2 x ED95 dose of 0.15-0.2 mg/kg within 2-2.5 minutes. In infants onset time and clinical duration of mivacurium are significantly shorter than in adults. ⋯ The properties of mivacurium described above are related to patients with normal pseudocholinesterase activity. Particularly patients with atypical pseudocholinesterase show a marked increase in clinical duration. Side-effects due to significant histamine release with flush, tachycardia and hypotension are seldom observed if mivacurium is injected slowly over a period of more than 30 seconds and bolus injections of more than 2 x ED95 or 3 x ED95 are avoided.
-
Anaesthesiol Reanim · Jan 1996
Biography Historical Article[The 16th October 1846 and its outcome].
Morton's first successful public demonstration of ether anaesthesia for a surgical operation, performed on October 16, 1846 in Boston/Massachusetts, had far-reaching consequences. The first effect was the surprisingly fast propagation of the new way of preventing pain to nearly all parts of the globe. Anaesthesia made it possible to perform operations previously considered impossible under conditions now acceptable for the patient. ⋯ Much later, the special field of anaesthesiology emerged. Today, 150 years after Morton's pioneer work, anaesthesiology comprises not only pain relief for operative procedures but also responsibilities in Emergency and Critical Care Medicine and in the treatment of patients with chronic pain. Accordingly, without the least disparagement of daily interdisciplinary cooperation, one can wholeheartedly support Mayrhofer's view that the "Century of Surgeons" has given way to the "Century of Anaesthesiologists".