Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Arterial oxygen saturation during induction of anaesthesia and laryngeal mask insertion: prospective evaluation of four techniques.
In a prospective, randomized study of 87 patients, we have compared the incidence of hypoxaemia during induction of anaesthesia with subsequent Laryngeal Mask Airway (LMA) insertion in healthy adults when four different techniques were used: one without supplementary oxygen, and three with supplementary oxygen. Twelve patients did not receive supplementary oxygen before LMA placement, 25 underwent partial denitrogenation by breathing oxygen from the start of injection of the induction agent, 25 underwent formal denitrogenation by breathing oxygen for 3 min, and 25 received five tidal volume breaths of oxygen by face mask using positive pressure immediately after induction of anaesthesia. Anaesthesia was induced with propofol 2.0 mg kg-1 and fentanyl 1 microgram kg-1. ⋯ Desaturation occurred in 11 of 12 patients who did not receive supplementary oxygen, and in 19 of 25 patients who received manual ventilation with 100% oxygen after induction of anaesthesia before LMA insertion. Full denitrogenation and partial denitrogenation were equally successful in preventing desaturation. Failure to position the LMA successfully occurred in 3% of patients, and some difficulty was encountered in another 18%.
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Randomized Controlled Trial Comparative Study Clinical Trial
Esmolol hydrochloride for management of the cardiovascular stress responses to laryngoscopy and tracheal intubation.
In a double-blind, randomized, controlled prospective study, 30 grade ASA I/II patients received a continuous i.v. infusion of normal saline or esmolol hydrochloride before induction of anaesthesia and tracheal intubation. Arterial pressure and heart rate were measured to assess the pressor response to laryngoscopy and intubation. The heart rate decreased in the esmolol group before induction of anaesthesia. The pressor response to laryngoscopy was significantly less marked in the esmolol group.
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Randomized Controlled Trial Clinical Trial
Electroconvulsive therapy-induced cardiac arrhythmias during anesthesia with methohexital, thiamylal, or thiopental sodium.
To determine the frequency of electroconvulsive therapy (ECT)-induced arrhythmias under methohexital, thiamylal, or thiopental sodium anesthesia with and without atropine premedication. ⋯ These data suggest that anesthesia for ECT therapy should be induced with methohexital to minimize the possibility of potentially life-threatening cardiac arrhythmias. Atropine premedication may further decrease the frequency of premature atrial contractions and bradycardia, while increasing the frequency of tachycardia.
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J. Oral Maxillofac. Surg. · May 1992
Biography Historical ArticleDr Horace Wells: the discoverer of general anesthesia.
The discovery of anesthesia in the second quarter of the 19th century was one of the greatest advances in the history of medicine. This discovery has been variously attributed to Long, Wells, Morton, Jackson, and others. In this article, the authors place in perspective the role each of these men has played. The conclusion is that to Wells belongs the singular honor and title of discoverer.
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Comparative Study
Somatosensory and auditory evoked responses recorded simultaneously: differential effects of nitrous oxide and isoflurane.
Auditory (AER) and somatosensory evoked responses (SSER) were recorded simultaneously in eight patients under anaesthesia before surgery. We studied the effects of equi-MAC end-expiratory concentrations of isoflurane (0.65-0.75%) and nitrous oxide (60-65%). The anaesthetics were changed at random in three consecutive 10-min periods so that each patient received both drugs. ⋯ We were unable to demonstrate significant differences in Pa and Nb amplitude between isoflurane and nitrous oxide that we had seen previously. However, the amplitude of the SSER wave N20 was reduced significantly by nitrous oxide compared with isoflurane (P = 0.0004). This wave (N20) is thought to emanate from the thalamo-cortical radiations, and our findings may be explained by an analgesic effect of nitrous oxide mediated by endogenous opioids.