Articles: general-anesthesia.
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Arthroscopic shoulder surgery can be performed under regional or general anesthesia. The objective of this study was to demonstrate that regional anesthesia has several benefits over general anesthesia for this type of surgery, particularly in the ambulatory patient. ⋯ It provided excellent intraoperative analgesia and muscle relaxation. Postoperatively, regional anesthesia resulted in fewer side effects, fewer hospital admissions, and a shorter hospital stay than did general anesthesia.
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Minimal invasive, or more specifically laparoscopic surgery is now the standard procedure in an increasing number of surgical specialties. Inflating the abdomen with CO2 for long periods confronts the anesthesiologist with a number of problems that influence the choice of anesthetic and the monitoring deemed necessary. The increased intraabdominal pressure (IAP) and for some operations the extreme Trendelenburg position can disturb alveolar ventilation and compromise oxygenation. ⋯ Balanced anesthesia or total intravenous anesthesia is to be preferred, and the drugs employed should have rapid elimination kinetics with a short recovery time, since wound closure time is drastically reduced. Inhalational anesthesia alone may inhibit hypoxic pulmonary vasoconstriction thereby unduly increasing oxygen desaturation. The necessary degree of muscle relaxation still remains to be defined.
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Review Case Reports
[Definitive transient monocular blindness caused by ocular compression during general anesthesia].
We present a case of irreversible monocular blindness caused by obstruction of the central retinal artery detected in a young patient without any previous history, when waking up from a surgical procedure performed under general anesthesia. Clinical and complementary investigations were not conclusive. ⋯ The fact that the patient was simultaneously submitted to a controlled low blood pressure may have worsened the effects of the compression. Reviewing the medical literature on the subject reveals that, although rare, such accidents do occur; they must be prevented by a constant surveillance when performing surgical procedures.
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Journal of anesthesia · Jan 1993
Postoperative recovery of arterial oxygen saturation determined by pulse oximetry in pediatric patients.
Small children are physiologically subject to arterial oxygen desaturation. However, few reports have referred to the risk factors related to postanesthetic hypoxemia and the duration of hypoxemia. The purpose of this study was to clarify these two aspects. ⋯ Age, height, and weight of these 10 children were significantly different from the remaining 75, but there were no significant differences in anesthetic duration and postanesthetic awakefulness between the group with postanesthetic hypoxemia and the one without. The importance of monitoring the clinical condition of pediatric patients after general anesthesia is universally acknowledged. Monitoring with the pulse oximeter has proven very useful and shows that, unless oxygen saturation is monitored, all children should receive supplemental oxygen.