Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of desflurane and isoflurane in anaesthesia for dental surgery.
We studied 50 ASA I-II patients, aged 18-65 yr, undergoing elective orofacial surgery. Anaesthesia was induced with fentanyl and propofol, and maintained with 66% nitrous oxide in oxygen and either desflurane or isoflurane to compare recovery characteristics and cardiovascular stability. Cardiovascular responses to induction, intubation and incision were similar with both agents, although the increase in heart rate in response to intubation was less marked in the desflurane group. ⋯ Mean duration of anaesthesia was 46 (SD 17.9) min (range 25-89 min) in the desflurane group and 41 (11.5) (23-60) min in the isoflurane group. Times to extubation were 6.7 (2.1) (3-10) min and 11.3 (4.1) (5-23) min, to eye opening 6.8 (2.2) (3-11) min and 12.7 (6.9) (7-37) min, to stating date of birth 9.0 (2.3) (4-12) min and 15.0 (6.9) (8-39) and to discharge from the recovery room 45 (11.6) (22-80) min and 64 (20.9) (28-134) min, for the desflurane and isoflurane groups, respectively (all P < 0.0001). No serious complications occurred in any patient.
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Randomized Controlled Trial Clinical Trial
Effect of intrathecal sufentanil on isoflurane requirements during lower abdominal surgery.
To determine the effect of intrathecal sufentanil on volatile anesthetic requirements during lower abdominal surgery. ⋯ Prior administration of intrathecal sufentanil significantly decreases the isoflurane requirement in surgical patients, in addition to its previously demonstrated rapid onset and receptor efficacy.
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A wartime embargo on casualty figures and an imprecise contemporary editorial contributed to the persisting belief that a grossly excessive mortality rate from barbiturate anaesthesia for surgery of the injured occurred after the Japanese attack on the American bases in Hawaii in December 1941. From accounts by surgical staff and official hospital records which have become available through US Freedom of Information legislation, it is clear that the rumoured death rate from this cause has been greatly exaggerated.
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Pulmonary Edema associated with negative airway pressure caused by upper airway obstruction is a most serious complications in anaesthetic practice (Tami et al, 1986). Laryngospasm associated with intubation and general anaesthesia is the most common cause of upper airway obstruction leading to negative pressure pulmonary edema (NPPE) in the anaesthetic adult (Tami et al, 1986). ⋯ NPPE appears to be related to markedly negative intrathoracic pressure due to forced inspiration against a closed upper airway resulting in transudation of fluid from pulmonary capillaries to the interstitium. The following is a presentation of a case of a healthy young male who developed NPPE secondary to airway obstruction caused by biting down on the endotracheal tube while awakening from general anaesthesia.