Articles: general-anesthesia.
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The cellular and synaptic mechanisms that underpin the state of general anaesthesia are discussed. Anaesthetics act principally on synaptic processes and this provides a satisfactory basis for understanding their effects on neural networks. ⋯ Effects on action potential firing patterns also play a role in anaesthetic modulation of neuronal signalling. Many of these complex data can be explained in terms of altered ion channel function.
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Cahiers d'anesthésiologie · Jan 1995
Randomized Controlled Trial Clinical Trial[Effects of preoxygenation methods on the course of PaO2 and PaCO2 in anesthetic post-induction apnea].
This study compares two preoxygenation techniques by blood gases measurements during induction of anaesthesia. After hospital ethics committee approval, 17 adult surgical patients, ASA I, all free of cardiac or lung disease were randomly assigned to two groups. Before preoxygenation, venous and radial artery canulations were performed. ⋯ The group I had significantly higher PaO2 immediately after preoxygenation (397 +/- 49 vs 293 +/- 86 mmHg) and the time for SaO2 to decrease to 95% was significantly shorter in group II (3 +/- 1 vs 1.87 +/- 0.99 min). PaCO2 was not different after preoxygenation in group II. In summary, healthy and young patients receive better protection against hypoxia with normal breathing of 100% for 4 minutes.
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Regional anesthesia · Jan 1995
Comparative Study Clinical TrialA retrospective comparison of interscalene block and general anesthesia for ambulatory surgery shoulder arthroscopy.
An increasing percentage of all surgery is performed in an ambulatory surgery setting. Concurrently, arthroscopy of the shoulder joint has allowed definitive repair of shoulder pathology to occur in this environment. This study was designed to ascertain whether interscalene block is reliable and efficient for use in same-day surgery compared with general anesthesia for shoulder arthroscopy. ⋯ Interscalene block should be considered as a viable alternative to general anesthesia for shoulder arthroscopy in ambulatory surgery patients.
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New justification for the use of regional anaesthesia, either alone or in combination with general anaesthesia, has been provided with reports of some unexpected influences on outcome. A reduction in the incidence of postoperative thrombotic episodes and vascular graft occlusion is strongly suggested in patients with generalized vascular disease. Application of a variety of drugs, including local anaesthetics, opioids and adrenergic agonists, in the region of the spinal cord reduces afferent input during surgery and also the metabolic stress response. ⋯ Premedication with opioid and other analgesics may also enhance this pre-emptive effect. New general anaesthetic and analgesic drugs are available that are more suited to these combined techniques. They have shorter duration of action so that plasma concentration can be rapidly adjusted to match a variable surgical stimulus.