Articles: general-anesthesia.
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Anesthesia and analgesia · Mar 1995
Anesthesia with increasing doses of sufentanil and midlatency auditory evoked potentials in humans.
Our interest focused on the question whether sufentanil differs from alfentanil, fentanyl, and morphine with regard on its effects on midlatency auditory evoked potentials (MLAEP). Therefore, we studied MLAEP during general anesthesia with increasing doses of sufentanil in 16 patients scheduled for elective major urologic surgery. Anesthesia was induced with sufentanil (1 microgram/kg every 7 min to a total dose of 3 micrograms/kg). ⋯ For the amplitudes Na/Pa and Pa/Nb there was only a slight and statistically insignificant reduction. After the largest dose of sufentanil (3-5 micrograms/kg) Na and Pa showed a similar pattern as in awake patients. We conclude that sufentanil does not differ essentially from alfentanil, fentanyl, and morphine with regard on its effects on MLAEP.
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Acta Anaesthesiol. Sin. · Mar 1995
Case ReportsFoley catheter used as bronchial blocker for one lung ventilation in a patient with tracheostomy--a case report.
Anesthesia with one-lung ventilation is a good anesthetic technique for patients receiving thoracotomy in various underlying diseases. One lung ventilation can be achieved successfully by the application of a double-lumen endotracheal tube through the oral route. ⋯ Bronchial blocker with a Fogarty embolectomy catheter has been used successfully for such situations. Here, we reported the clinical experience in using the Foley catheter as the bronchial blocker in a patient with tracheostomy.
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Comparative Study
[Narcotic gas burden of personnel in pediatric anesthesia].
To assess the occupational exposure of the anaesthetist to anaesthetic gases, a total of 1 German and 25 Swiss hospitals were investigated. A Brüel & Kjaer Type 1302 multi-gas monitor was used to measure concentrations of nitrous oxide and halogenated anaesthetic agents in the anaesthetist's breathing zone. Measurements were performed during 114 general anaesthetic, 55 of which were in patients under 11 years of age. In these 55 patients, the influence of various factors on the exposure (time-weighted average concentrations) was estimated by comparing different data groups. The efficiency of the applied scavenging equipment was examined by surveying the exhalation valve with a leak detector (type TIF 5600, TIF Instruments, Miami). ⋯ The exposure levels of anaesthetic gases are generally higher during anaesthesia in children up to 10 years of age than in older patients. Nevertheless, the measurements showed that exposure during paediatric anaesthesia can be kept below the recommended limit (8-h TWA in Switzerland) of 100 ppm nitrous oxide and 5 ppm halothane or 10 ppm enflurane or isoflurane. Causes of high exposures were particularly high fresh gas flows often applied without scavenging or together with inefficient scavenging devices and the high part of mask anaesthesia and inhalation induction with a loosely held mask. To achieve an effective reduction of occupational exposure, well-adjusted and maintained scavenging systems and low-leakage work practices are of primary importance. As leakage can never be completely avoided, a ventilation rate of at least ten air changes per h should be maintained in operating rooms and rooms where anaesthesia is induced to keep down concentrations of waste anaesthetic gases. High exposure during mask anaesthesia and inhalation induction can be prevented by further measures. Using a LMA instead of a standard mask reduces the exposure to the same level as endotracheal intubation.
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Biography Historical Article
Charles Frederick Heywood. House surgeon at the ether demonstration.
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Case Reports
Clinical risk management. Building provider awareness in the administration of anaesthesia.
The area of anaesthesia has long been the focus of risk management concerns. This article will address a case study based on some of the high risk issues. Although the environment in which anaesthesia is administered is usually a carefully controlled area, the anaesthetic agents and the patient's response to them can be unpredictable. ⋯ Tables 1 and 2 highlight the Risk Management areas to address in anaesthesia and Tables 3 and 4 the risk issues which have occurred from over 20 years experience in the USA. (MMI Companies Inc. 1993). Many of these issues will be discussed in the case study scenario. Further reading around the risk issues will also be suggested.