Articles: general-anesthesia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1995
Review[Clinical potency of nitrous oxide--is MAC the gold standard?].
Nitrous oxide is delivered during most cases of general anaesthesia. Though it has a history of approx. 150 years there is no univocal understanding about its clinical potency. Research studies during the last 10 years support, however, the view that 1. the potency of nitrous oxide in the clinical settings is only 1/3 of the potency as estimated from the MAC value; 2. the potency of combinations of nitrous oxide and volatile anaesthetics is represented more appropriately by quantities which are derived from the EEG than by the addition of MAC fractions. The findings of the last 10 years do not support the hypothesis, that the addition of nitrous oxide to the breathing gas is more beneficial than waiving the use of nitrous oxide.
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Rev Esp Anestesiol Reanim · Oct 1995
[Application of the laryngeal mask in pediatric anesthesiology].
To analyze problems with inserting, maintaining and removing a laryngeal mask in children, as well as to assess the possible involvement of certain factors (experience with the laryngeal mask, type of anesthesia, duration of surgery, type of surgery, obesity, etc.) in favoring the development of complications. One hundred eighty-nine children undergoing a variety of surgical procedures under general anesthesia were studied; patients with full stomachs and/or a history of hiatus hernia were excluded. The agent used for anesthetic induction and the method of ventilation were chosen by the anesthesiologist responsible for each case. ⋯ Complications were more frequent when the laryngeal mask was placed by inexperienced personnel, when inhalational anesthetics were used for induction and maintenance, and when a No. 1 laryngeal mask was used. Adequate ventilation was provided for the patients who required it with an airways pressure between 8 and 18 cmH2O, arterial oxygen saturation over 98% and end-expiratory CO2 pressure under 35 mmHg. Cardiovascular repercussions were slight and hemodynamic stability was good.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
[Subdural catheterization uncovered by severe hypotension during epidural plus general anesthesia].
We experienced three cases of accidental subdural catheterization during epidural combined with general anesthesia. In each case, epidural catheterization was performed before induction of general anesthesia. Aspiration through the catheter and a response to a test dose were negative. ⋯ It is often difficult to identify subdural placement of an epidural catheter under general anesthesia since signs of massive sensory blockade are masked by general anesthesia. In each case, we suspected malpositioning of the catheter by severe hypotension due to sympatholysis which was difficult to treat. Subdural catheterization is a complication of epidural anesthesia that probably occurs more frequently than previously recognized and is usually unpredictable during general anesthesia.