Articles: general-anesthesia.
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Comparative Study
Comparison of the Finapres and direct arterial pressure monitoring during profound hypotensive anaesthesia.
The Finapres was compared with direct intraarterial pressure monitoring in 10 patients undergoing local resection of choroidal melanoma, an operation that requires a period of profound hypotension. Good agreement was recorded for systolic arterial pressure and heart rate over a range of pressures. However, agreement of mean and diastolic pressures was poor, with the Finapres tending to overestimate these values. In cases requiring profound hypotension, direct arterial pressure monitoring remains the method of choice.
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Randomized Controlled Trial Clinical Trial
Optimum concentration of bupivacaine for combined caudal--general anesthesia in children.
Caudal epidural anesthesia has become widely accepted as a means of providing postoperative pain relief and intraoperative supplementation to general anesthesia for children. To determine the best concentration of bupivacaine for combined general-caudal anesthesia in children, 122 children aged 1-8 yr scheduled for outpatient inguinal herniorrhaphy were randomized to receive, in a double-blind fashion, caudal anesthesia with bupivacaine in one of six concentrations (0.125, 0.15, 0.175, 0.2, 0.225, or 0.25%). After incision, a programmed reduction in inspired halothane resulted, if tolerated by the subject, in an inspired halothane concentration of 0.5% 10 min after incision. ⋯ Children receiving greater than or equal to 0.2% bupivacaine tended to complain more of leg weakness after surgery; however, the difference did not reach statistical significance (39 of 67 vs. 16 of 47; P = 0.057). The incidence of complaints of leg weakness and paresthesia was positively correlated with bupivacaine concentration (r = 0.706; P = 0.05). Subjects receiving 0.125% bupivacaine had higher pain scores on arrival to the PACU than did those receiving 0.2% bupivacaine (P = 0.05); there were no other differences in pain scores.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
[Effects of clonidine premedication upon hemodynamic changes associated with laryngoscopy and tracheal intubation].
The authors studied 30 patients undergoing general anesthesia in order to evaluate whether oral clonidine premedication could attenuate the hemodynamic changes associated with laryngoscopy and tracheal intubation. Patients were randomly assigned to one of two groups; clonidine group (n = 15) who received oral clonidine of approximately 5 micrograms.kg-1, or control group (n = 15) who received no clonidine. ⋯ However, no significant difference was noted between the two groups in the heart rate responses to laryngoscopy and tracheal intubation. It is concluded that oral clonidine of 5 micrograms.kg-1 as a preanesthetic medication could attenuate the pressor responses associated with laryngoscopy and tracheal intubation.
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Comparative Study
[Regional or general anesthesia in patients with pulmonary risks?].
Such partial functions of the respiratory system as ventilation, gas exchange, bronchomotor tone, respiratory regulation, secretion within the airways, mucociliary clearance, etc., are less impaired by such procedures as peridural or spinal anaesthesia than by general anaesthesia. As a result, it is often concluded that regional anaesthesia should always be used preferentially in the case of patients with a pulmonary risk. ⋯ These are factors that cannot readily be influenced by anaesthesiological measures. For this reason, the pre-operative diagnostic evaluation and preparation, post-operative prophylaxis and treatment, including the components pain elimination, physiotherapy, respiratory therapy, broncholysis and secretolysis, are more important than the anaesthetic procedure itself.