Articles: general-anesthesia.
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The pharmacokinetic and pharmacodynamic properties of propofol indicate that this may be an appropriate agent for induction and maintenance of anesthesia in obese patients. This study was designed to assess the rates of recovery and the pharmacokinetics of propofol infusions in morbidly obese patients. ⋯ Results from this study confirm the absence of propofol accumulation in morbidly obese patients when the current dosing scheme is used. Dosing schemes expressed in mg.kg-1 are the same as those in normal patients.
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We have studied the automatic administration of alfentanil during alfentanil-nitrous oxide anaesthesia in 11 patients using a closed-loop feedback control system based on EEG analysis. We chose a median EEG frequency of 2-4 Hz as the EEG set point. ⋯ The average effective therapeutic infusion of alfentanil was 0.140 (0.032) mg min-1. We conclude that EEG feedback control may be useful in assessing and defining the dose requirements of alfentanil.
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Comparative Study
[Utilization of laryngeal masks. Preliminary study. 21 cases. Department of Anesthesia-Resuscitation, Yaounde, Cameroon].
The authors present a preliminary and retrospective study about the utilization of laryngeal mask. 21 patients underwent surgery concerning short or mid term intervention. A positioning of a laryngeal mask was easy with 83 p.c. of success. ⋯ Not at all replacing endotracheal intubation, the laryngeal mask is in peculiar situations an other possibility of protection of respiratory tract, and of ventilation be spontaneous manual or mechanical. The advantages of laryngeal mask versus facial one are obvious.
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Case Reports
Anesthetic management of a patient with hereditary fructose intolerance and phenylketonuria.
This is a report of a five-year-old girl with phenylketonuria (PKU) and hereditary fructose intolerance (HFI) who underwent elective strabismus surgery. PKU and HFI are two inborn errors of metabolism which have an autosomal recessive mode of inheritance. This case report describes the anesthetic features of a patient with PKU and HFI, each defect requiring specific anesthetic management.
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Serum inorganic fluoride concentrations and their urinary excretion were examined during and after sevoflurane, isoflurane, or enflurane anesthesia in man. Duration of anesthesia was 3 hours in sevoflurane and enflurane groups (S3 group: n = 10, E3 group: n = 5), and 3 or 5 hours in isoflurane groups (I3 group: n = 5, I5 group: n = 5). Serum inorganic fluoride concentration of the S3 and E3 groups increased immediately following induction, and reached the maximum concentration of 21.8 +/- 9.3 (M +/- SD) mumol.l-1 (S3), 13.6 +/- 6.2 mumol.l-1 (E3) at 1 hour after anesthesia. ⋯ The change of serum inorganic fluoride sharply contrasted with urinary excretion. Our results suggest that fluoride excretion is largely carried out by the kidney. Therefore sevoflurane or enflurane anesthesia should be avoided in patients with renal dysfunction.