Articles: general-anesthesia.
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J. Am. Vet. Med. Assoc. · Nov 1993
Case ReportsSuspected malignant hyperthermia syndrome in a miniature pot-bellied pig anesthetized with isoflurane.
Hyperthermia developed in a 7-week-old Vietnamese pot-bellied pig after isoflurane anesthesia for routine ovariohysterectomy. Shivering and a sudden increase in heart rate were noticed 90 minutes after anesthetic induction, both of which persisted throughout the remaining anesthetic period. ⋯ Malignant hyperthermia was suspected to be the cause of the clinical signs in this pig, but specific tests to support this diagnosis were not performed. This report illustrates that hyperthermia may develop in this breed of swine during isoflurane anesthesia, and rectal temperature should be monitored during and after the anesthetic period.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the cardiovascular effects of intravenous, epidural and intrathecal sufentanil analgesia as a supplement to general anaesthesia for abdominal aortic aneurysm surgery.
Sixty ASA Grade II-III patients, without clinical symptoms of ventricular dysfunction and scheduled for elective bifemoral grafting for abdominal aneurysms, were allocated randomly to three equal groups to receive 150 micrograms sufentanil intravenously, epidurally or intrathecally. All patients received midazolam, vecuronium and nitrous oxide. Except for right ventricular stroke work index and pulmonary vascular resistance, all haemodynamic measurements decreased after sufentanil injection, but to the greatest extent after intravenous injection. ⋯ Despite the changes in systemic vascular resistance and the concordant alterations in cardiac index after aortic cross-clamping and revascularization, intrathecal sufentanil provided more stability in heart rate than intravenous or epidural sufentanil. In conclusion, intrathecal sufentanil produced the most stable heart rate. Two patients in the intrathecal group developed spinal headaches post-operatively.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative effectiveness and tolerance study of a new galenic etomidate formula].
One of the major disadvantages of etomidate is the high frequency of pain on injection. A new galenic formulation based on a lipid emulsion for etomidate (Etomidat-Lipuro) was compared with the commercial standard (etomidate in propylene glycol, Hypnomidate) in a prospective, randomised, double-blind clinical evaluation in 232 patients undergoing elective surgery in general anaesthesia. The patients were premedicated with flunitrazepam 2 hours before the investigation. Two intravenous cannulas were inserted in veins of forearm or back of the hand. One cannula was only used for the application of etomidate and removed immediately after injection. General anaesthesia was induced with 0.3 mg/kg etomidate at an injection rate of 20 mg/30 s. If the patient did not complain of pain or other sensations during injection spontaneously, he was questioned for 15 s after beginning of injection. The arm used for application of etomidate was kept free of any manipulation during the operation and the following five postoperative days. ⋯ There were marked differences between the two etomidate preparations concerning venous irritation. About 20% of the patients receiving the hypnotic in propylene glycol complained spontaneously of pain on injection, whereas none with the lipid emulsion. No difference was found in the incidence of myoclonic movements. The time interval between the beginning of injection and loss of eyelid closure reflex was about 50 s and not different for the two galenic formulations. Blood pressure during and after induction of anaesthesia did not differ. The heart rate in the group of patients with etomidate in lipid emulsion was slightly increased before and immediately after intubation compared to the propylene glycol group. 4% of the patients in the propylene glycol group suffered from postoperative venous complications as reddening, swelling, induration or pain. These complications could not be seen in the lipid emulsion group.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind comparison between doxapram and pethidine in the treatment of postanaesthetic shivering.
Sixty patients who shivered after routine surgery under general anaesthesia were allocated randomly to receive normal saline (n = 20), doxapram 1.5 mg kg-1 (n = 20) or pethidine 0.33 mg kg-1 (n = 20). Both doxapram and pethidine were effective in treating postoperative shivering 2-3 min after i.v. administration. ⋯ In the pethidine group, all patients had stopped shivering by 7 min after treatment. We conclude that both doxapram and pethidine were effective in the treatment of postoperative shivering.