Articles: general-anesthesia.
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Anesthesia and analgesia · Feb 1994
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of lumbar epidural and general anesthesia on plasma catecholamines and hemodynamics during abdominal aortic aneurysm repair.
Twenty-four patients undergoing abdominal aortic aneurysm (AAA) repair were studied to compare the effects of lumbar epidural anesthesia (LEA) and general anesthesia (GA) on plasma catecholamine levels and hemodynamics before and during infrarenal aortic cross-clamping. Patients received either a high dose of opioid anesthetic (GA group, n = 12), or lumbar epidural anesthesia to T4 sensory level with a light general anesthetic (LEA group, n = 12). Systemic vascular resistance (SVR) and norepinephrine (NE) and epinephrine (E) levels were measured before anesthetic induction (before epidural activation in the LEA group, and before general anesthesia induction in the GA group), 15 min before cross-clamping, and 1,5, and 10 min after cross-clamping. ⋯ After clamping, SVR increased in both groups, but the increase occurred after 1 min in the GA group and took 5 min to become significant in the LEA group. There was no significant correlation between changes in NE or E and changes in SVR in either group. This study shows that epidural anesthesia to T4 prevents NE and E increases in response to abdominal surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
The effect of positive end-expiratory pressure on respiratory resistive properties in anaesthetized paralysed humans.
The respiratory resistive properties of the normal human respiratory system are volume-dependent. The overall flow resistance (Rmax,rs) can be partitioned into airway resistance (Raw) and the additional resistance (delta Rrs) which may result from the viscoelastic properties of the respiratory system, from inequality of time constants (pendelluft), or from both. Because positive end-expiratory pressure (PEEP) increases end-expiratory lung volume and may equalize ventilation within the lungs, the effect of PEEP on Raw, delta Rrs, and their sum (Rmax,rs) was assessed in anaesthetized surgical patients without evidence of lung disease. ⋯ We conclude that the overall flow resistance was not affected by PEEP. In contrast, PEEP clearly modified the contribution of its two components. The decrease in Raw with PEEP could have resulted, at least in part, from modification in the basal vagal tone.
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To evaluate the presence and the relationship between postoperative nystagmus and nausea. ⋯ The presence of nystagmus in the early part of recovery from general anesthesia is associated with a higher incidence of nausea and vomiting during the first postoperative day.
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The ability of opioids to produce complete general anesthesia is controversial. Nitrous oxide (N2O) is often added to fentanyl-based anesthetics to produce unconsciousness and amnesia. The addition of N2O may adversely affects fentanyl's hemodynamic stability and safety. The purpose of this study was to determine the physiologic consequences of combining N2O with fentanyl in newborn animals. ⋯ Fentanyl (3,000 micrograms/kg) when combined with 50% N2O in O2 produced a plane of general anesthesia in newborn lambs in which the behavioral responses to painful stimuli were abolished. The response to sound was never eliminated, nor was cerebral oxygen consumption decreased. The combination of 50% N2O in O2, 3,000 micrograms/kg fentanyl, tracheal intubation, and mechanical ventilation did not depress heart rate, blood pressure, or blood flow to any of the major organs, except the kidneys.
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The Journal of urology · Feb 1994
Case ReportsDorsal nerve block for management of intraoperative penile erection.
Intraoperative penile erection during general anesthesia can delay or prevent the completion of cystoscopic or penile surgical procedures. The dorsal penile nerve block is offered as a treatment for intraoperative erection. Advantages of this technique include less potential for cardiovascular complications and improved postoperative analgesia.