Articles: general-anesthesia.
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Comparative Study
Evaluation of the Pneupac Ventipac portable ventilator: comparison of performance in a mechanical lung and anaesthetized patients.
The performance of the Pneupac Ventipac portable gas-powered ventilator was evaluated in two stages. The accuracy of delivery of the ventilator was assessed using a mechanical lung model at different combinations of compliance and airway resistance to simulate normal and diseased lungs. The performance of the ventilator was then assessed in 20 anaesthetized patients. ⋯ Delivered tidal volume was between -19 and +12% of the present tidal volume in the group of anaesthetized patients using the ventilator in airmix mode. The ventilator was reliable and simple to use, and performance was within acceptable limits in the anaesthetized patients. However, we recommend that a means of verifying the adequacy of ventilation should always be used when transporting critically ill or anaesthetized patients with any portable ventilator, particularly when lung compliance or airway resistance may be abnormal.
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Comparative Study
Thoracic epidural anesthesia improves outcome after breast surgery.
The authors' objective was to compare the outcomes, including the incidence of nausea and vomiting and the time until discharge to home, of patients undergoing general anesthesia and thoracic epidural anesthesia for oncologic breast procedures. ⋯ Thoracic epidural anesthesia is a safe technique not associated with neurologic or respiratory complications. The use of thoracic epidural anesthesia for breast surgery could improve patients recovery and reduce the cost of these procedures.
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Randomized Controlled Trial Clinical Trial
Effects of magnesium sulphate on suxamethonium-induced complications during rapid-sequence induction of anaesthesia.
Twenty patients were studied in a double-blind manner to investigate whether magnesium sulphate, when given during a rapid-sequence induction of anaesthesia, lessens the side effects caused by suxamethonium. Patients were randomly allocated to two groups; equal volumes of either magnesium sulphate (40 mg.kg-1) or saline were given during rapid-sequence induction of anaesthesia, after thiopentone but before the administration of suxamethonium (1.5 mg.kg-1). The changes in the serum potassium concentration, the degree of muscle fasciculations and the presence of postoperative myalgia were recorded. ⋯ Magnesium did not clinically prolong muscle relaxation. There was no difference between the groups in the incidence of myalgia after surgery (one patient in each group). Since no significant increase in the serum potassium concentration was demonstrated, no assessment could be made of the effect of magnesium sulphate on the serum potassium concentration after administration of suxamethonium.
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Comparative Study Clinical Trial Controlled Clinical Trial
Combined thoracic epidural with light general anesthesia for thymectomy in myasthenia gravis.
Forty-seven myasthenia gravis patients undergoing transsternal thymectomy were allocated into 2 groups. Group 1 which consisted of 27 patients was anesthetized using the balanced technique, while 20 patients in group 2 received the combination of thoracic and balanced anethesia. The ventilation was controlled through the endotracheal tube in both groups. ⋯ Adequacy of respiration was observed postoperatively in the intensive care unit (ICU). Group 1 patients required 76.9 per cent of further ventilatory support for the period of 37.11 +/- 39.54 hours and duration of the ICU stay was 65.52 +/- 85.84 hours, whereas, the patients in group 2 showed significantly different results, which were 15.8 per cent of ventilatory support (P = 0.002) for 10.33 +/- 6.03 hours (P = 0.014) and 22.8 +/- 8.06 hours for staying in ICU (P = 0.021). This study demonstrated that the combined thoracic epidural with light general anesthesia provides excellent intraoperative anesthesia together with postoperative analgesia, which reduces the need for postoperative respiratory support, as well as decreases the hospital cost.
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Randomized Controlled Trial Clinical Trial
[Changes in dementia rating scale scores of elderly patients with femoral neck fracture during perioperative period].
We evaluated changes in dementia rating scale scores in the revised version of Hasegawa's dementia scale (HDS-R), and rated dementia, 2 days before and 7 days after surgery in the elderly patients with femoral neck fracture. The 50 patients examined ranged in age from 70 years to 101 years. A perfect score in the HDS-R is 30 points, and a score below 20 points strongly suggests dementia. ⋯ In octogenarian patients, there was a negative correlation between "postoperative score minus preoperative score" and "the number of the days from suffering fracture to surgery". These results showed that general anesthesia is more advantageous than epidural anesthesia from the viewpoint of the intellectual faculty in septuagenarian and octogenarian patients with femoral neck fracture, and it is within the bounds of possibility that the intellectual faculty may decline if an octogenarian patient is operated after a long delay from the occurrence of fracture. To prevent this decline, patients must be operated on as soon as possible.