Articles: general-anesthesia.
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Case Reports
EEG-controlled "overdosage" of anesthetics in a patient with a history of intra-anesthetic awareness.
In spite of the ever-growing pharmacologic arsenal available for induction and maintenance of anesthesia, to our knowledge no treatment regimen exists that will provide full protection against intraoperative awareness. To date, no single monitoring technique is able to detect awareness or predict recall. Although the frequency of these complications is rare, the occurrence of any such event can be very distressful for the patient. Based on our clinical experience with a patient with a history of recall and a marked resistance to benzodiazepines, we present electroencephalogram-based anesthetic management as a technique to address this difficult problem.
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Acta Anaesthesiol Scand · Nov 1994
Randomized Controlled Trial Clinical TrialPlatelet activation in major surgical stress: influence of combined epidural and general anaesthesia.
Platelets are activated in surgery releasing vasoactive substances such as serotonin and thromboxane. Platelets become temporarily hypoaggregable during surgery followed by a postoperative hyperaggregability. Local anaesthetics are known to inhibit platelet function but earlier reports are conflicting. ⋯ Postoperatively both groups showed significant hyperaggregability. The release products were not significantly influenced by regional anaesthesia. In conclusion epidural as combined with general anaesthesia affects platelet responses to major abdominal surgery only to a minor extent, although it may attenuate the haemodynamic response.
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Anesthesia and analgesia · Nov 1994
Plasma inorganic fluoride and intracircuit degradation product concentrations in long-duration, low-flow sevoflurane anesthesia.
Plasma inorganic fluoride (F-) concentrations in long-duration, low-flow sevoflurane anesthesia were studied to assess effects on renal and hepatic function. The intracircuit concentration of degradation product generated by reaction between sevoflurane and CO2 absorbant was also determined. Ten patients undergoing prolonged surgery of 10 h or longer received sevoflurane anesthesia at 1 L/min. ⋯ Its individual maximum concentrations were 13.6-35.1 ppm (24.3 +/- 2.4 ppm). Postanesthesia clinical laboratory tests showed no renal impairment and only mild hepatic dysfunction that was not associated with anesthesia. Hyperfluorinemia and minute quantities of compound A were detected following long-duration, low-flow sevoflurane anesthesia.
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Case Reports
Hypoplastic left heart syndrome: anesthetic care prior to transplantation or surgical palliation.
Hypoplastic left heart syndrome is the most common lethal cardiac defect in neonates. Options for treatment include cardiac transplantation and surgical palliation. ⋯ During this time, anesthetic care may be required for various surgical procedures. Associated anomalies seen in these infants and the anesthetic implications imposed by the abnormal cardiac anatomy are discussed.