Articles: general-anesthesia.
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Anaesthesia alters normal thermoregulatory control of the body, usually leading to perioperative hypothermia. Hypothermia is associated with a large number of serious complications. To assess perianaesthetic hypothermia, core temperature should be monitored vigorously. ⋯ Intravenous fluid warming is also helpful when large volumes are required. In some patients, induction of mild therapeutic hypothermia may become an issue for the future. Recent studies indicate that patients suffering from neurological disease may profit from rapid core cooling.
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The spectrum of spinal surgery in adult life is considerable. Anaesthesia for major spinal surgery, such as spinal stabilization following trauma or neoplastic disease, or for correction of scoliosis, presents a number of challenges. The type of patients who would have been declined surgery 20 yr ago for medical reasons, are now being offered extensive procedures. ⋯ The perioperative management of these patients is discussed. The advent of techniques to monitor spinal cord function has reduced postoperative neurological morbidity in these patients. The anaesthetist has an important role in facilitating these methods of monitoring.
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Fever occurs when pyrogenic stimulation activates thermal control centres. Fever is common during the perioperative period, but rare during anaesthesia. Although only a limited number of studies are available to explain how anaesthesia affects fever, general anaesthesia seems to inhibit fever by decreasing the thermoregulatory-response thresholds to cold. ⋯ Accordingly, this fever might be diminished in patients who receive opioids for pain treatment. Post-operative fever is a normal thermoregulatory response usually of non-infectious aetiology. Fever may be important in the host defence mechanisms and should not be routinely treated lest the associated risks exceed the benefits.
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Review Comparative Study
A systematic review of the safety and effectiveness of fast-track cardiac anesthesia.