Articles: general-anesthesia.
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Anesthesia and analgesia · May 1993
Fentanyl plasma concentrations maintained by a simple infusion scheme in patients undergoing cardiac surgery.
The ability of a simple infusion scheme for fentanyl to achieve and maintain one of two target concentrations of fentanyl in plasma was studied in 17 patients having cardiac surgery that required the use of moderate hypothermic cardiopulmonary bypass (CPB). All patients received preanesthetic medication including morphine, a benzodiazepine, and/or scopolamine. Anesthesia was induced and maintained by one of two fentanyl infusion regimens: HIGH-FEN (n = 6), a priming infusion of 2.4 micrograms.kg-1 x min-1 for 20 min in combination with a continuous infusion of 0.3 microgram.kg-1.min-1 for the duration of the operation to produce a plasma fentanyl concentration of 20-25 ng/mL; or LOW-FEN (n = 11), priming and maintenance infusions of 2.4 and 0.15 micrograms.kg-1 x min-1 designed to produce a fentanyl concentration of 12-15 ng/mL of plasma. ⋯ The 11 patients receiving LOW-FEN had a plasma fentanyl concentration maintained below 20 ng/mL (range 13-17 ng/mL). Eight patients before and 10 patients after CPB required anesthetic supplementation for adverse hemodynamic or somatic responses. For comparison purposes, another eight patients received a single 75 micrograms/kg dose of fentanyl during 20 min for induction of anesthesia, and 7 of the 8 required supplemental anesthetic agents before and after CPB.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anasthesiol Intensivmed Notfallmed Schmerzther · May 1993
[The laryngeal mask with > 1900 general anesthesias--report of experiences].
Since November 1990 until January 1993, the laryngeal mask airway was employed for 1925 general anaesthesias, i.e. 19.6% of all general anaesthesias in our hospital. On the basis of the protocols the age distribution of the patients, the practice of anaesthesia (premedication with oral benzodiazepines, induction with thiopental, anaesthesia sustained with enflurane/nitrous oxide/oxygen) and the complications are reported. ⋯ One aspiration was recorded, but could not be attributed to the laryngeal mask. Complications with major influence on the postoperative course and hospital stay were not seen.
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Comparative Study
Neonatal wellbeing after elective caesarean delivery with general, spinal, and epidural anaesthesia.
A comparison was made of the acid-base and Apgar status of neonates following general (n = 34), spinal (n = 28) and epidural (n = 23) anaesthesia for elective caesarean section. Neonates delivered following spinal anaesthesia were more acidaemic (pH = 7.249) (P < 0.05) than those delivered following epidural (pH = 7.291) or general anaesthesia (pH = 7.296) despite measures taken to minimize hypotension. ⋯ The difference between epidural and general anaesthesia was significant (P < 0.05). Using these two measures of neonatal wellbeing, epidural anaesthesia provided the most favourable outcome.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective randomised study of local versus general anaesthesia for cataract surgery.
One hundred and sixty-nine patients (aged 65-98 years) were randomised to receive either local or general anaesthesia for cataract surgery. Cognitive function was assessed using a battery of psychometric tests performed pre-operatively, and at 24 h, 2 weeks and 3 months postoperatively. ⋯ Pulse rate and blood pressure were stable in the local anaesthetic group compared with the general anaesthetic group where marked fluctuations were noted; 61% of patients in the general anaesthetic group experienced falls in systolic blood pressure greater than 30% of the pre-induction value. No evidence of long-term postoperative cognitive dysfunction was detected and there was no significant difference between the performances of the two groups.
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Klinische Pädiatrie · May 1993
Comparative Study[Sedation versus general anesthesia in pediatric endoscopy].
Upper endoscopy was performed in 567 patients: 237 under general anesthesia, 261 in intravenous sedation with midazolam and etomidat (mean dosage 0.26 mg/kg bodyweight), 69 without any premedication. In these many patients defended strongly and some investigations have to been interrupted. ⋯ In our experience sedation with midazolam and etomidat is most comfortable for patient and endoscopist and the time needed is shorter than in general anaesthesia. Therefore we recommend this method even in therapeutic endoscopy, except only in sclerotherapy of esophageal varices.