Articles: general-anesthesia.
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Anesthesia and analgesia · Dec 1995
Decreases in anesthesia-controlled time cannot permit one additional surgical operation to be reliably scheduled during the workday.
We tested whether anesthesiologists can decrease operating room (OR) costs by working more quickly. Anesthesia-controlled time (ACT) was defined as the sum of 1) the time starting when the patient enters an OR until preparation or surgical positioning can begin plus 2) the time starting when the dressing is finished and ending when the patient leaves the OR. Case time was defined as the time starting when one patient undergoing an operation leaves an OR and ending when the next patient undergoing the same operation leaves the OR. ⋯ Statistical analysis of measured OR times showed that ACt would have to be decreased by more than 100% to permit one additional scheduled, short (30-min) operation to be performed in an OR during an 8-h workday after a prior series of cases, each lasting more than 45 min. Anesthesiologists alone cannot reasonably decrease case times sufficiently to permit one extra case to be reliably scheduled during a workday. Methods to decrease ACT (e.g., using preoperative intravenous catheter teams, procedure rooms, and/or shorter acting drugs) may simply increase costs.
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Trends in neurosciences · Dec 1995
ReviewAnesthetic actions within the spinal cord: contributions to the state of general anesthesia.
The behavioral state known as general anesthesia is the result of actions of general anesthetic agents at multiple sites within the neuraxis. The most common end point used to measure the presence of anesthesia is absence of movement following the presentation of a noxious stimulus. ⋯ Studies in the spinal cord are likely to increase our understanding of the pharmacology by which general anesthetics alter the transmission of somatomotor information. It now appears that the pharmacology responsible for the production of anesthesia is agent- and site-selective, and not the result of a unitary mechanism of action.
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Randomized Controlled Trial Comparative Study Clinical Trial
Complications associated with removal of the laryngeal mask airway: a comparison of removal in deeply anaesthetised versus awake patients.
The purpose of the study was to compare the incidence of complications (coughing, biting, retching, vomiting, excessive salivation and airway obstruction) associated with removal of the laryngeal mask airway. The laryngeal mask airway was used in 100 adults undergoing urological procedures. The patients were randomly assigned to two groups. ⋯ No decrease in arterial oxygenation occurred in the anaesthetised patients in whom the laryngeal mask was removed by the anaesthetist. In 14 patients in the awake group the pH of secretions at the tip of the laryngeal mask was < or = 3 compared with only four patients in the anaesthetised group (P < 0.05). It is concluded that it may be safer to remove the laryngeal mask airway whilst the patients are deeply anaesthetised in the operating room than when they are awake in the recovery room.
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Journal of anesthesia · Dec 1995
Inhibitory effect of prostaglandin E1 on gastric secretion during general anesthesia in humans.
The present study was undertaken to clarify the effects of prostaglandin E1 (PGE1) on gastric secretion during general anesthesia. Thirty-three patients, 16 with (PGE1 group) and 17 without (control group) PGE1 administration, scheduled for selective surgery were studied during general anesthesia with nitrous oxide (67%) and enflurane (1%-2% inspired). PGE1 was administered at a rate of 50-200 ng·kg(-1)·min(-1) when hypotensive medication was required. ⋯ The pH of gastric juice increased significantly, and the acidity and pepsin activity decreased after the beginning of the administration of PGE1, and these changes were observed even 1h after discontinuation. There was significant differences in the pH, acidity, and pepsin activity between the two groups after administration of PGE1. The results indicate that PGE1 inhibits gastric secretion at doses that produce a sufficient hypotensive effect under general anesthesia.
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Journal of anesthesia · Dec 1995
Interactions of nicardipine to inhalation anesthetics sevoflurane and isoflurane.
The hemodynamic effects and pharmacokinetics of nicardipine under general anesthesia were compared between two different volatile anesthetics, sevoflurane and isoflurane. Sixteen adult neurosurgery patients were divided into sevoflurane and isoflurane groups. Anesthesia was maintained with either sevoflurane or isoflurane (0.5-1.5%) and nitrous oxide in oxygen. ⋯ The sevoflurane group had a significantly longer elimination half-life, a larger area under the plasma concentration curve, and smaller clearance of nicardipine compared to the isoflurane group. In summary, the effects of nicardipine on blood pressure and heart rate were significantly longer under isoflurane anesthesia than under sevoflurane anesthesia. However, the etabolism and excretion of nicardipine were significantly delayed under sevoflurane anesthesia.