Articles: general-anesthesia.
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General anesthesia induces hypothermia due to decreased metabolic rate and impaired thermoregulation. Adverse effects of hypothermia are common. Many warming devices are in use to prevent heat loss, but little attention has been paid to stimulating the body's own heat generation. ⋯ During anesthesia the thermogenic effect of i.v. amino acids was increased. The results support the existence of an inhibitory action normally exerted by central thermosensors in order to prevent hyperthermia. During anesthesia, central thermosensors are impaired, and hence amino acid thermogenesis is exaggerated, which may prevent hypothermia.
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Malignant hyperthermia (MH) is a pharmacogenetic disease which predisposes to the trigger of a life-threatening, hypermetabolic syndrome by potent inhaled anesthetics and by depolarizing skeletal muscle relaxants. Heat production in the anesthetized MH can be profound with 5-fold increases in oxygen consumption. ⋯ Possible mechanisms by which continuous release of calcium from skeletal muscle sarcoplasmic reticulum stores can produce the profound hyperthermia are discussed. Mutations in the gene coding the ryanodine receptor calcium release channel have been found in MH families and these mutant channels may be the functional basis for MH.
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Review Case Reports
Sudden sensorineural hearing loss after spinal surgery under general anesthesia.
Two patients, ages 72 and 71, who underwent lumbar decompressive surgery for spinal stenosis, were evaluated for postoperative sudden sensorineural hearing loss (SSHL). After two uncomplicated spinal procedures, both patients developed SSHL immediately after surgery. Hearing loss was moderate to profound in these two patients. ⋯ Further causes of postlumbar surgery SSHL may include microemboli or viral infections. SSHL is a rare but possible complication after nonotologic, noncardiac bypass surgery; only 26 cases of SSHL after this surgery have been reported. We encourage the continued reporting of sudden sensorineural hearing loss after spinal surgery.
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Ultra-rapid opioid detoxification (UROD) is an increasingly popular technique for detoxifying patients addicted to opiates. This technique aims at reducing not only the duration but also the intensity of withdrawal by using general anesthesia coupled with a naloxone or naltrexone medication. In this paper the authors attempt to review the history of UROD and the logic of its procedure and results whilst also demonstrating its advantages and limits. ⋯ Ultra-rapid opiate detoxification represents a potentially safe and effective treatment for opiate addicted patients but more rigorous research methods are needed to render this procedure entirely valid.