Articles: general-anesthesia.
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Anaesth Intensive Care · Oct 1994
Anaesthesia for three-stage thoracoscopic oesophagectomy: an initial experience.
We report our experience in the anaesthetic management of five patients undergoing three-stage thoracoscopic oesophagectomy. One patient required conversion to open thoracotomy because of extensive pleural adhesions. The other four patients, aged between 68 and 78, were all chronic smokers with mid-oesophageal squamous cell carcinoma. ⋯ Postoperative pulmonary complications were not decreased in our patients despite the avoidance of thoracotomy. The thoracoscopic technique might contribute to pulmonary complications because of prolonged thoracoscopic dissection and unintentional pulmonary injuries. The concept of minimally invasive surgery needs further evaluation when the technique is applied in extensive procedures such as oesophagectomy.
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Hare lip and cleft palate surgery team activities in Cambodia were launched in 1989 by a non-governmental Japanese organization, Operations Unies. The objectives of the project are to provide appropriate surgical treatment and safe general anesthesia for local patients and also to conduct technology transfer of general anesthesia and surgery to the local medical staffs. From June 1991 to January 1993, a surgery/anesthesia team was dispatched 4 times and a total of 130 patients received surgical treatments under general anesthesia. ⋯ The reasons why we chose intravenous agents are difficulty in obtaining inhaled agents in Cambodia and lack of scavenging system in a operating room. Although halothane anesthesia with spontaneous breathing has been recommended in developing countries, total intravenous anesthesia could be one of the applicable techniques in these countries. In Cambodia, shortage of medical doctors and the absence of anesthesiologist constitute a major barrier to technology transfer in clinical anesthesia.
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Acta Anaesthesiol. Sin. · Sep 1994
Randomized Controlled Trial Clinical TrialUse of esmolol to prevent hemodynamic changes during intubation in general anesthesia.
To assess the minimal effective dosage of esmolol to prevent hypertension and tachycardia during laryngoscopy and endotracheal intubation in fentanyl-pretreated anesthesia, a double-blinded, randomized study was conducted. Two hundred patients undergoing elective, noncardiac surgeries were randomly allocated into four groups: group A received saline, group B esmolol 20 mg, group C esmolol 40 mg and group D esmolol 60 mg intravenously. General anesthesia was induced with 0.1 mg/kg vecuronium, 5 micrograms/kg fentanyl and 0.3 mg/kg etomidate. ⋯ Hypertension (SBP > 180) was found in 18(36%) patients in group A, 19(38%) patients in group B, 9(18%) patients in group C, and 6(12%) patients in group D. When compared with group A, only group D had significantly lower incidence of these adverse events (p < 0.05). In conclusion, fentanyl 5 micrograms/kg could not completely prevent the hemodynamic changes associated with endotracheal intubation, and 60 mg esmolol was observed to have positive effect in helping to control these changes.