Articles: general-anesthesia.
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Laboratory animal science · Dec 1994
Acute toxicosis in two dogs associated with etomidate-propylene glycol infusion.
Etomidate, formulated in propylene glycol, was used as the primary anesthetic agent in two dogs (No. 1 and 2) and etomidate, formulated in saline, was used as the primary anesthetic agent in an additional 20 dogs, while developing a canine model for baroreceptor sensitivity testing. Dogs 1 and 2 had signs of acute toxicosis after infusion of etomidate in propylene glycol. Dog 1 received less total etomidate than did dog 2, 5.9 mg/kg vs 15.8 mg/kg, respectively. ⋯ After supportive treatment, dog 2 regained consciousness and hemodynamic variables improved within 12 h. None of the additional 20 dogs that received infusion of etomidate in saline had any clinical adverse effects, suggesting a causal relationship between the etomidate-propylene glycol formulation and the adverse effects in dogs 1 and 2. Although etomidate may be useful in designing cardiovascular models under general anesthesia, such complications may warrant use of a different etomidate formulation in the dog when the agent is administered at these infusion rates.
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Case Reports
[Fiberscopic intubation under general anesthesia for children with Goldenhar syndrome].
Goldenhar syndrome is characterised by an eye abnormality such as epibulbar dermoid and lipoma, associated with ear, mandibular, and/or vertebral anomalies. It is well documented that difficult intubation in patient with this syndrome may be expected because of mandibular hypoplasia and limitation of neck movement resulting from vertebral anomalies. We report anesthetic management of two children with Goldenhar syndrome, 9 and 14-year-old. ⋯ By using this adapter, under sevoflurane/nitrous oxide anesthesia with vecuronium, we could successfully intubate with a 6 mm spiral tube through the nostril without any major problems. Anesthesia and surgery went uneventfully, and no postoperative complications were noted. We confirmed that our newly developed mask adapter for fiberoptic bronchoscopy is as useful for children with difficult intubation as for adults.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Use of EEG spectral edge as index of equipotency in a comparison of propofol and isoflurane for maintenance of general anaesthesia.
Propofol and isoflurane were compared for haemodynamic stability and recovery time as main anaesthetic agents for maintenance in a total of 43 ASA I and II patients in uncomplicated operations lasting at least 30 min. The premedication (oral diazepam), induction (thiopentone-fentanyl-suxamethonium) and maintenance protocol (N2O-O2 2:1 litre min-1, fentanyl and vecuronium in incremental doses) were identical for all patients. In one group of 20 patients, propofol was used in continuous intravenous (i.v.) infusion (starting dose 3 mg kg-1 h-1), while in the second group of 23 patients, isoflurane was administered in a starting concentration of 1%. ⋯ The incidence of mean blood pressure deviations/case in the propofol group was less than half of those occurring in the isoflurane group (0.45 vs. 0.96 P = 0.04). The mean duration of blood pressure deviation from baseline value was 5.5 min in the propofol group vs. 16.8 min in the isoflurane group (P = 0.01). The recovery intervals were significantly shorter in the propofol group (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)