Articles: general-anesthesia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1994
Review[Perioperative EEG monitoring: studies of the electrophysiological arousal mechanism].
Electroencephalogram recordings have been advocated for assessment of changes in cerebral function during anaesthesia. Controversy exists on the specificity of EEG parameters indicating depth of anaesthesia, because cortical electrical activity is modulated not only by drugs but also by a variety of exogenous and endogenous stimuli. In clinical practice, EEG measures often fail to accurately predict anaesthetic depth since the effects of nociceptive stimulation on the EEG are still not well defined. ⋯ The occurrence of slow EEG wave patterns may be related to functional blockade of the ascending activating system of the brain stem. In contrast, slowing of the EEG is comparable to EEG changes seen with increasing concentrations of anaesthetics. This indicates the difficulty to discriminate arousal phenomena from drug effects using EEG monitoring alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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Conscious awareness is an infrequent complication of general anesthesia. All methods of anesthesia have been implicated, and no method guarantees amnesia. This article examines implicit and explicit memory and discusses factors associated with awareness. ⋯ Strategies to block threatening auditory stimuli include use of earphones, music tapes, white noise, reassuring statements, or positive suggestion. Behavioral anesthesia decreases patient stress to enhance recovery. Evidence of patient benefit resulting from therapeutic suggestion is inconclusive.
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Twelve cases of post-anaesthetic pulmonary oedema (PO) secondary to upper airway obstruction (UAO) are reported. All were adult male patients undergoing uneventful elective surgical procedure under general anaesthesia. Post-anaesthetic laryngospasm was the single most important factor for the upper airway obstruction (UAO) in 5 (41.6%) patients. ⋯ Early recognition, maintenance of patent airway and adequate oxygenation via face mask or endotracheal tube with mechanical ventilation resolved the syndrome within 6-36 hours in all of these patients. Invasive haemodynamic monitoring or aggressive drug therapy were not applied in any of the patients. A heightened awareness among anaesthesiologists of the varied causes of post-anaesthetic UAO leading to PO may help reduce the occurrence and facilitate early management of the potential complications.
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialPrevention of endotracheal tube-induced coughing during emergence from general anesthesia.