Articles: general-anesthesia.
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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.
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Randomized Controlled Trial Comparative Study Clinical Trial
Changes in intra-ocular pressure during general anaesthesia. A comparison of spontaneous breathing through a laryngeal mask with positive pressure ventilation through a tracheal tube.
Changes in-intra-ocular pressure during spontaneous ventilation with a laryngeal mask were compared with controlled ventilation using a tracheal tube in 40 patients undergoing intra-ocular surgery under general anaesthesia. Intra-ocular pressure was measured before induction, after establishing the airway, at the end of the operation and after removal of the airway device. Anaesthesia was induced with propofol and maintained with enflurane and nitrous oxide in oxygen. ⋯ At the end of surgery, intra-ocular pressure (mmHg) was 11.2 and 8.6 during spontaneous or controlled ventilation respectively. One min after removal of the device, mean intra-ocular pressure (mmHg) in the tracheal tube group (16.0) was slightly higher than baseline (15.3) and was significantly higher than the laryngeal mask group (10.9) (p < 0.01). Spontaneous ventilation with a laryngeal mask is an acceptable alternative to controlled ventilation with tracheal intubation in elective intra-ocular surgery.
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Review Case Reports
Tympanic membrane rupture following general anesthesia with nitrous oxide: a case report.
Although rare, tympanic membrane rupture during general anesthesia with nitrous oxide has been reported previously in the literature. Nitrous oxide administration and the effects on closed body cavities will be reviewed. Key factors in patient assessment which can determine safe use of nitrous oxide in the clinical setting will also be discussed.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 1995
Review[Inhalation anesthesia and intravenous anesthesia from the medical and economic viewpoint].
The unique pharmacokinetic properties of propofol gave rise to a widespread use of the technique of total intravenous anaesthesia. These properties of propofol are reviewed and compared to those of barbiturates and benzodiazepines. ⋯ The choice of an anaesthetic technique must not only be made with regard to medical implications; economical aspects have also to be taken into account without challenge to the quality of care. A consequent use of low-flow techniques and a market oriented purchase of drugs and disposables may allow cost savings in anesthesia.