Articles: general-anesthesia.
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Acta Anaesthesiol Scand · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialThe influence of pancuronium and vecuronium combined with balanced anaesthesia on haemodynamics and myocardial oxygen balance.
The effects of the non-depolarizing muscle relaxants pancuronium (Pancuronium) and vecuronium (Norcuron) (0.1 mg/kg) on myocardial blood flow, myocardial oxygen consumption, myocardial lactate balance, cardiovascular dynamics and electrocardiogram were studied in two groups of eight patients undergoing coronary artery bypass surgery. After induction of anaesthesia with 0.015-0.02 mg/kg flunitrazepam, isoflurane (0.5 vol%) and N2O/O2 (l/l), neuromuscular blockade was induced with pancuronium or vecuronium (0.1 mg/kg) combined with a single dose of 0.005 mg/kg fentanyl. Haemodynamic measurements were performed and the electrocardiogram was recorded before anaesthesia, in steady-state anaesthesia, after relaxation with pancuronium or vecuronium combined with fentanyl, and after intubation. ⋯ None of the other haemodynamic parameters differed significantly in either patient group. We did not observe ST-segment depressions or elevations in the ECG, increases in PCWP or myocardial lactate production. Therefore extended myocardial ischaemia can be excluded in our patients who received pancuronium or vecuronium for neuromuscular blockade.
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Comparative Study
Combined epidural and general anesthesia in aortic surgery.
The perioperative course of 144 consecutive patients undergoing aortic reconstructive surgery was studied to assess the potential benefit of employing a combined epidural and light general anesthesia technique. A group of 67 patients had general anesthesia alone (GA), while in the group of 77 remaining patients, a combined epidural and general anesthesia (Epi-GA) was employed. The two groups were similar in regards to age, medical risk factors, preoperative assessment of cardiac and pulmonary function, and type of surgical reconstruction. ⋯ More patients in the GA group required a prolonged ventilatory support (P less than 0.05) and a high parenteral narcotic administration (P less than 0.025) during the first 48 hours. While the mortality rate was similar for the two groups (3.0% for GA group vs 5.2% for Epi-GA group), there was a higher percent of postoperative pulmonary complications observed in the GA group (7.6%) compared to the Epi-GA group (2.6%). By facilitating early extubation and a decreased need for systemic narcotics in the early postoperative period, Epi-GA may be beneficial in the high risk pulmonary patient undergoing aortic reconstruction.
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Psychother Psychosom Med Psychol · Jul 1990
[Preoperative anxiety--anxiety about the operation, anxiety about anesthesia, anxiety about pain?].
Questioning for the content of presurgical anxiety a situative examination of different contents of anxiety was performed combined with a correlational analysis of problem relevant personality traits (Freiburger Personality Inventory, FPI; Eigenschaftswörterliste, EWL). Preoperatively the anxiety in young patients is higher than it is in old ones, women anticipating thoracotomy name the highest anxiety scores. Generally the anxiety before important surgery is higher than before operations, which are calculated as being not so impressive; women show higher anxiety than men. ⋯ The informations about anxiety are related to content of anxiety, rarely to other variables, which were examined together with. The information is correlated to the personality traits, esp. to extraversion-introversion and emotional lability/stability, both are similarly correlated with pain, but not to postoperative complications. The idea that preoperative anxiety may reactively induce postoperative complications cannot be supported by the results.