Articles: general-anesthesia.
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Comparative Study
Brief wakeful response to command indicates wakefulness with suppression of memory formation during surgical anesthesia.
In a previous study of patients emerging from anesthesia following surgery, we found that a brief wakeful response to command of an eye opening or single hand squeeze or count was not associated with memory formation, while the response of four hand squeezes or counts was associated with memory. We wanted to determine the anesthetic requirements for obtaining this brief wakeful response endpoint during surgery and to determine if memory occurred at this endpoint during surgical anesthesia. ⋯ A brief wakeful response to a command of opening the eyes or squeezing the hand was not associated with increased memory formation during surgery. A brief wakeful response to command was found during surgery when patients received fentanyl 4 micrograms/kg; but it was rarely found at fentanyl dosages of 2 micrograms/kg or less.
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Anaesthesiol Reanim · Jan 1995
Biography Historical Article[The "narcotization statistics" of Ernst Julius Gurlt of 1895--an early contribution to quality control in anesthesia].
The fifth compilation of anaesthetization statistics "Zur Narkotisirungsstatistik", presented by the surgeon Ernst Julius Gurlt in 1895 summarizes the answers to a questionnaire of the German Surgical Society given by 78 mainly large German surgical hospital departments. It comprises 55,395 anaesthetic procedures, most of them (34,412) performed under chloroform, although this substance was still associated with many more fatal complications than ether. ⋯ Details concerning premedication, the role of the anaesthetist, postoperative care, documentation and especially complications and how to prevent and deal with them are taken from 38 reprinted reports. Gurlt's activities initiated more than 100 years ago are to be seen as pioneer work in the field of anaesthesiological quality assessment.
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The Swiss Society of Anaesthesia and Resuscitation describes anesthesia as an activity of physicians, and a continuous presence of a medical anaesthesist is required. In small regional hospitals in the alpine region it is impossible to compete with big hospitals in the central area of Switzerland and there is no possibility to afford an anaesthesist for 365 days a year and 24 hours a day. ⋯ The education and the control of this person has to be performed by a medical anaesthesist. This is the only way in keeping the high quality of medical support in the peripheral region specially in the alpine part of our country.