Articles: general-anesthesia.
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Can learning occur during general anaesthesia? This paper reviews the studies which have addressed this issue and finds some evidence of implicit memory for intra-operative events, even with clinically adequate anaesthesia. This has implications both for clinical practice and for psychological theories of learning and awareness. ⋯ Methodological improvements are discussed, in particular the need for a reliable means of monitoring awareness during anaesthesia. These improvements would enable researchers to determine the conditions under which learning occurs and would provide information about the role of consciousness in learning.
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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.
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We aimed to describe the frequency of atelectasis occurring during anaesthesia, to describe the size and pattern of the atelectasis, and to standardise the method of identifying the atelectasis and calculate its area. ⋯ On the basis of the present findings, we defined atelectasis as pulmonary dependent densities with attenuation values of -100 to +100 HU.
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Preschool children depend on their parents for support and guidance in dealing with new or stressful situations. When requested, the parents should be allowed to support their children during ambulatory surgical procedures, especially during the induction of anesthesia. With proper understanding on our part, and with proper preparation and counseling, the parents can become our allies and help to smooth the experience for the child, for the staff, and for themselves. Future efforts should be directed at studying the effects of different methods of preoperative preparation and counselling on the parents' attitude and cooperation during induction.