Articles: general-anesthesia.
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Am. J. Obstet. Gynecol. · Sep 1990
Comparative StudyA comparison of the effect of epidural, general, and no anesthesia on funic acid-base values by stage of labor and type of delivery.
The effect of epidural anesthesia on neonatal acid-base status, before, during, and after labor, was determined by review of funic blood-gas values from 142 women with normal term pregnancies and normal fetal heart rate patterns. Funic acid-base parameters were compared by type of anesthesia when stratified by mode of delivery (vaginal, cesarean section in the active phase of labor, or elective cesarean section). ⋯ Patients who had elective cesarean section with epidural anesthesia had funic acid-base values similar to women who had general anesthesia. Epidural analgesia-anesthesia offers no clear advantage to the uncompromised term fetus.
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Minerva anestesiologica · Sep 1990
Randomized Controlled Trial Comparative Study Clinical Trial[In vivo kinetics of the intratracheal tube cuff pressure during general anesthesia: a comparative evaluation of 3 models of endotracheal tubes with a new measuring system].
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It has been shown that a variable percentage of patients who receive a general anesthetic are significantly hypoxemic when they arrive at the recovery room. Pulse oximetry has proved to be a reliable method to determine arterial oxygen saturation when compared to arterial or mixed venous blood oxygen saturation measurements. The authors determined the incidence and severity of hypoxemia by pulse oximetry in 45 healthy adult patients, (non obese, non smokers) who underwent non thoracic surgery under general anesthesia. ⋯ The authors conclude that a significant number of healthy adult patients who are given a general anesthetic show severe hypoxemia when they arrive at the recovery room. The severe hypothermia found in these patients can aggravate the hypoxemia. They consider it is mandatory to control the temperature of and to administer oxygen in the recovery room to all patients who receive a general anesthetic.
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We have investigated the value of lower oesophageal contractility (LOC) in detecting awareness during anaesthesia in 20 human volunteer patients. LOC was measured either with subjects awake or after induction with propofol, during induction with propofol, and then as consciousness returned. Statistically significant changes were observed in the frequency of spontaneous contractions, peak and mean amplitude of spontaneous and provoked contractions, and the oesophageal contractility index as subjects lost consciousness and also as it was regained. The differences in LOC which occurred when subjects were conscious and unconscious support the view that LOC is related to the depth of anaesthesia, but its unreliability at the interface between consciousness and unconsciousness prevents selective detection of awareness, although the response in the presence of painful stimuli has not been tested.
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We experienced general anesthesia of two patients with cerebral palsy presupposed to have difficulties in tracheal intubation by reason of scoliosis. Case 1 is a 26-year-old woman. Chest X-ray photography and respiratory sounds in both pulmonary areas indicated neither airway stricture nor respiratory distress, but severe scoliosis presupposed difficult tracheal intubation. ⋯ While the intubation was being carried out by means of a stylet without developing larynx, severe bronchostriction was palpable at the point when the tube barely passed through the glottis, making the intubation impossible. However, the tube barely managed to be inserted while rotating with the stylet being extracted. Anesthesia was carried out by nitrous oxide.oxygen.halothane; peroperative hemodynamics underwent no remarkable change and arterial blood gas analysis presented no problems.