Articles: general-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.
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Monaldi Arch Chest Dis · Sep 1994
ReviewAtelectasis formation and gas exchange impairment during anaesthesia.
Anaesthesia is accompanied by impaired oxygenation of the blood, and sometimes hypoxaemia may develop despite an increased oxygen fraction of the inspired gas. The major cause of this derangement is shunt, an effect of prompt atelectasis formation in dependent lung regions. An additional cause is ventilation/perfusion (V/Q) mismatch, possibly produced by intermittent airway closure. The magnitude of shunt and size of atelectasis are independent of the age of the patient, whereas V/Q mismatch increases with age, explaining the age dependent impairment of oxygenation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of electroconvulsive therapy after propofol and methohexital anesthesia.
Fifty-eight patients with major depression were randomly assigned to receive a hypnotic dose of either propofol or methohexital for their complete treatment series of electroconvulsive therapy (ECT). As expected, seizure duration was significantly shorter with propofol than with methohexital anesthesia. ⋯ However, this was independent of the choice of propofol or methohexital as the anesthetic. This study supports previous reports that seizure duration does not influence recovery from depression.
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Randomized Controlled Trial Clinical Trial
A simple method for the maintenance of oxygen saturation following intravenous induction of anaesthesia with propofol.
One hundred unpremedicated fit adult patients having elective minor day-stay surgery and general anaesthesia were randomly allocated to one of two groups. During 30 s of intravenous propofol administration (2.5 mg.kg-1), study group patients (n = 50) were instructed to take three vital capacity breaths of room air, whilst control group patients (n = 50) were given no specific instructions. Pulse oximetry was continuously recorded over the next 5 min and the lowest oxygen saturation was noted. ⋯ Oxygen saturation returned to the pre-induction value significantly earlier in the study group patients compared with controls (97 s vs 135 s, p < 0.01). These results demonstrate that significant desaturation occurs in patients following intravenous induction of anaesthesia with propofol. This desaturation may be attenuated by asking patients to take three vital capacity breaths of room air during induction of anaesthesia.