Articles: general-anesthesia.
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Rev Esp Anestesiol Reanim · Nov 1992
Comparative Study[Chronotropic changes and cardiac arrhythmias during anesthetic induction and intubation in patients undergoing heart surgery. Study of 79 patients using Holter monitoring].
To assess changes in heart rate and cardiac arrhythmias during anaesthetic induction and tracheal intubation in patients undergoing cardiac surgery. ⋯ Changes in heart rate and ventricular arrhythmias occurring during anesthetic induction and tracheal intubation in patients undergoing valvular and coronary surgery were infrequent and not severe.
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(1) To prospectively observe and tabulate all perianesthetic complications in young infants undergoing herniorrhaphy with general anesthesia and (2) to identify all major postnatal complications and determine which, if any, might be significant risk factors for perianesthetic complications. ⋯ In a teaching hospital, prospectively observed perianesthetic complications can occur in more than 50% of infants 60 weeks PCA or younger undergoing herniorrhaphy with inhalation anesthesia. Infants younger than 49 weeks PCA with a significant preanesthetic risk factor should be monitored overnight for apnea and bradycardia.
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The case of a 3-day-old infant with Beckwith-Wiedemann syndrome who required anesthetic care during closure of an abdominal wall defect is presented. Beckwith-Wiedemann syndrome comprises a constellation of clinical features, including macroglossia, macrosomia, omphalocele, visceromegaly, mild microcephaly, facial nevus flammeus, horizontal earlobe creases, and renal medullary dysplasia. Due to the high rate of omphalocele in this syndrome, anesthetic care is frequently required during the neonatal period. ⋯ Additional anesthetic implications of this syndrome relate to the occurrence and management of hypoglycemia and polycythemia. Careful intraoperative management of glucose homeostasis is particularly important, since eventual neurologic outcome and intelligence will be normal provided prolonged neonatal hypoglycemia is avoided. Preoperative evaluation of the cardiac and genitourinary system, including echocardiography and renal ultrasound, are recommended because of the frequent occurrence of associated anomalies with omphalocele.
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Although plasma concentrations of propofol during anesthesia are well known, the free concentration remains unknown because of uncertainties regarding plasma protein binding, interaction with other protein-bound substances, the level of binding to its lipid carrier, and the use of adjuvants. At elevated surrounding pressure, all general anesthetics require higher concentrations to reach adequate levels of anesthesia. To determine the anesthetic potency of propofol at equilibrium conditions and to study the effects of pressure on propofol-induced anesthesia, Rana pipiens tadpoles were exposed to different concentrations of pure, not emulsified, propofol in aqueous solution. ⋯ For pressure greater than 121 atm abs, an increased excitability of the tadpoles made it difficult to distinguish the righting reflex from involuntary movements. The saturated solubility of propofol in aqueous solution was found to be 1.0 +/- 0.02 mM (mean +/- SD), and the octanol/water partition coefficient was 4,300 +/- 280. Propofol adhered to the correlation between anesthetic potency and octanol/water partition coefficient exhibited by other general anesthetics.(ABSTRACT TRUNCATED AT 250 WORDS)
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Minerva anestesiologica · Nov 1992
[Aspiration syndrome in cesarean section. Our experience from 1980 to 1990].
In the last twenty years maternal mortality attributed to anaesthesia has decreased. Inhalation of gastric contents is the commonest cause in patients undergoing cesarean section; in fact pregnant women are considered "high risk" because of gravidic modifications. In this retrospective study of 10017 caesarean sections performed under general anaesthesia in our institution between January 1980 and December 1990, we evaluated the frequency of this syndrome (7 cases = 1:1431). ⋯ All these seven patients were admitted at our recovery room for less than 5 days; aspiration pneumonitis occurred in only three patients. Our results suggested that induction of anaesthesia with high doses of thiopental reduces complications related to light anaesthesia, including vomiting. At a dose of 5-6 mg/kg thiopental didn't produce any significant neonatal depression as documented by Apgar scores.