Articles: general-anesthesia.
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Anasth Intensivther Notfallmed · Dec 1990
Review Comparative Study[Epidural conduction anesthesia versus general anesthesia. A critical evaluation of outcome studies using as examples cesarean section and patients with hip fractures].
In the field of anaesthesiology, outcome studies are undertaken to investigate the influence of different anaesthetic techniques on the intra- and postoperative course of patients in special clinical situations. The design of these studies should follow high methodological standards. ⋯ Up to now, results do not clearly indicate the use of certain techniques in concrete clinical situations. Decisions must be made in accordance with clinical aspects, individual experience and in cooperation with the patient and the surgeon.
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The three currently available paper radioallergosorbent tests ('suxamethonium', alcuronium and thiopentone) were evaluated. 'Suxamethonium' radioallergosorbent test (which employs choline conjugated to paper discs) proved to be reliable in the detection of allergy to neuromuscular blockers, which were confirmed as the most common cause of anaphylactic reaction during general anaesthesia. Thiopentone radioallergosorbent test may also be useful, and is recommended in conjunction with 'suxamethonium' radioallergosorbent test in the preliminary investigation of reactions. Patients with positive 'suxamethonium' radioallergosorbent test usually require further testing, including alcuronium radioallergosorbent test, skin testing with a wide range of drug concentrations or leucocyte histamine release test.
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Tidsskr. Nor. Laegeforen. · Nov 1990
Review[Conscious and unconscious awareness during anesthesia--how deep is the patient's sleep?].
A review is given over the aspects of awareness during general anaesthesia. Traditional clinical signs for evaluating depth of anaesthesia can be supplemented by objective methods such as EEG, cerebral function monitor and sensory evoked potentials. ⋯ Awareness can be graded from the obvious form, with recall of intraoperative events, to an unconscious form where the memory can be activated through special psychological techniques. We discuss the possibility of using unconscious perception of auditory signals for positive instructions to patients under anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
The laryngeal mask airway in paediatric anaesthesia.
Forty-eight children, aged between 2 and 10 years, admitted as day cases for otological surgery were allocated at random into two groups. The first group was anaesthetised using a standard facemask, and the second with a laryngeal mask airway. ⋯ Hypoxia was significantly less frequent in the laryngeal airway group (p less than 0.05), and there were significantly fewer interruptions to surgery than in the facemask group (p less than 0.001). Patient safety, operating and anaesthetic conditions were all considered superior in the laryngeal airway group.
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The 40-Hz auditory steady-state evoked response (ASSR) is a sinusoidal electrical response of the brain to periodically presented auditory stimuli. It was recorded during anesthesia in 10 elective surgical patients to evaluate its usefulness as a measure of the level of consciousness. The anesthetic agents used were thiopental, fentanyl, and isoflurane with or without nitrous oxide. ⋯ The changes of the ASSR paralleled those of the level of consciousness. The EEG measurements were distorted by the presence of muscle artifacts that were prominent during emergence and recovery. The amplitude of the ASSR appears to provide a more reliable indicator of the level of consciousness than the EEG.