Articles: general-anesthesia.
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We report the anesthetic management of Cesarean section in a pregnant (31 weeks) woman with dilated cardiomyopathy. She had dyspnea and chest pain which were signs of congestive heart failure. The left ventricular ejection fraction was 38%. ⋯ There was no significant cardiovascular changes in the mother during the operation. The baby was apneic and showed no movement at birth, but he was immediately intubated and his condition became almost normal on the following day. In the anesthesiological management of Cesarean sections with cardiac disease, general anesthesia with fentanyl can be used to minimize cardiovascular changes in the mother as long as the baby is immediately resuscitated after delivery.
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Obstet. Gynecol. Clin. North Am. · Mar 1995
Management of anesthetic complications and emergencies in the obstetric patient.
The importance of cooperation and understanding between the obstetrician and anesthesiologist in the management of obstetric emergencies cannot be overemphasized. Indications for cesarean section and choice of anesthetic are significant considerations. Algorithms for the management of special treatment problems such as malignant hyperthermia, postdural headache, and epidural abscess and hematoma are presented. Posting of protocols for the management of particular crises in both delivery and postanesthesia care units is strongly recommended.
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Journal of anesthesia · Mar 1995
The patency of the airway via each upper airway orifice during general anesthesia.
The patency of the airway via each orifice was examined during general anesthesia in 112 patients by occluding other orifices in order to develop a method in which fiberoptic endotracheal intubation (FEI) and ventilation could be performed via different orifices. Ventilation was well maintained via the mouth in 61 (54.5%), via bilateral nostrils in 87 (77.7%), and via the unilateral right and left nostril in 67 (59.8%) and 73 (65.2%) patients, respectively. With the aid of an artificial airway, ventilation was well maintained via the mouth in 112 (100.0%), via bilateral nostrils in 111 (99.1%), and via the unilateral right and left nostril in 106 (94.6%) and 105 (93.8%) patients, respectively. Based on these findings, we developed a method in which FEI is performed via the nostril, while ventilation is performed with a mask applied over only the mouth.
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Randomized Controlled Trial Clinical Trial
The effect of midazolam premedication on implicit memory activation during alfentanil-nitrous oxide anaesthesia.
Eighty-three patients were given midazolam 0.1 mg.kg-1 by intramuscular injection as premedication before general anaesthesia with alfentanil-nitrous oxide. During anaesthesia patients were presented (through headphones) with either statements about common facts of some years ago (group A) (n = 43) or new verbal associations, e.g. names of fictitious, nonfamous people (group B) (n = 40). ⋯ In this study we found no explicit or implicit memory for the auditory information presented during anaesthesia. Midazolam premedication can prevent implicit memory activation during alfentanil-nitrous oxide anaesthesia.