Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
Delayed ACTH response to human corticotropin releasing hormone during cardiopulmonary bypass under diazepam-high dose fentanyl anaesthesia.
The inhibitory effect of high dose fentanyl (0.1 mg.kg-1) and diazepam (0.5 mg.kg-1) anaesthesia on the pituitary-adrenal response to coronary artery surgery during cardiopulmonary bypass was assessed by comparison of the adrenocorticotropic hormone and cortisol responses to intravenous boluses of either 0.1 mg (n = 14) or 0.2 mg (n = 14) human corticotropin releasing hormone administered 5 min after starting cardiopulmonary bypass, with the responses obtained in a control group (n = 14). Blood samples were taken before inducing anaesthesia, just before cardiopulmonary bypass and at 5, 20, 35, 50, 65 and 80 min thereafter. ⋯ Plasma cortisol concentrations did not vary between the three groups at any sampling time. During cardiopulmonary bypass the early adrenocorticotropic responses to human corticotropin releasing hormone are blunted but later there is a good response, suggesting that the inhibitory effect of high dose fentanyl and diazepam anaesthesia takes place in the hypothalamus.
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We sought to determine the effectiveness of a magnet placed over the thyroid cartilage in the neck to guide an endotracheal tube into the trachea. Forty patients aged 18 to 60 yr with normal airway anatomy (ASA grade I) who required general anesthesia with an endotracheal tube and paralysis for their surgery were chosen and informed consents were obtained. The tip of the epiglottis was exposed with a No. 3 MacIntosh laryngoscope, and a magnet was held over the thyroid cartilage. ⋯ This magnet-guided technique can be used when it is difficult to expose a patient's larynx. It is noninvasive, simple, and can be used without any delay when expensive flexible fiberoptic endoscopes are not readily available. The procedure takes an average of 1 to 2 min.
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Comparative Study
Mortality after spinal and general anaesthesia for surgical fixation of hip fractures.
One thousand, three hundred and thirty three patients who underwent anaesthesia for surgical fixation of a hip fracture were studied prospectively to assess the effects on outcome of general and spinal anaesthesia. There were no significant differences between the groups in risk factors, length of hospital stay or mortality rates after 30 days or one year. The data presented may be useful for those wishing to audit anaesthetic services provided to patients with hip fracture.
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Randomized Controlled Trial Comparative Study Clinical Trial
Midlatency auditory evoked potentials and explicit and implicit memory in patients undergoing cardiac surgery.
A high incidence of intraoperative awareness during cardiac surgery has been reported. Midlatency auditory evoked potentials (MLAEP) have been used recently as an indicator of awareness. In the current study, memory for information presented during anesthesia was investigated using MLAEP as one experimental indicator in 45 patients scheduled for elective cardiac surgery. ⋯ When the early cortical potentials of MLAEP are preserved during general anesthesia, auditory information may be processed and remembered postoperatively by an implicit memory task.