Articles: general-anesthesia.
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British dental journal · May 1990
The use of nitrous oxide-oxygen inhalation sedation with local anaesthesia as an alternative to general anaesthesia for dental extractions in children.
The aim of this study was to determine whether children who were assessed to require the extraction of teeth under general anaesthetic could be treated using an alternative technique of nitrous oxide-oxygen inhalation sedation with local anaesthetic. Consent was obtained for 61 children to enter the study. Fifty-three children were treated successfully using inhalation sedation and local anaesthetic. It was evident that general anaesthetic facilities would still be required for a small proportion of children who could not cooperate adequately for treatment to be performed under sedation and local anaesthetic.
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Case Reports
Potential toxicity from prolonged anesthesia: a case report of a thirty-hour anesthetic.
Selection of anesthetics for prolonged administration must include consideration of potential toxicity resulting from extended exposure. This report deals with a patient undergoing a 30-hour anesthetic that included nitrous oxide (N2O) and isoflurane (9.7 MAC-hours). ⋯ In addition to outlining basic care guidelines for patients undergoing a prolonged anesthetic, this report discusses potential toxicity from prolonged exposure to both N2O and isoflurane. It concludes that isoflurane can be tolerated in doses up to 10 MAC-hours without fluoride toxicity but cautions against the use of N2O for periods longer than 24 hours.
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Expanded outpatient surgery for pediatric patients makes it difficult to provide an unhurried and thorough preoperative visit. A useful component could be a videotape to be seen by parents at the time of their initial hospital visit. For this study, a videotape was made that included an actual induction of anesthesia procedure, information about pediatric anesthesia, and a discussion of the risks of injury or death during anesthesia. ⋯ Most parents (65%) appeared to accept discussion of the risk of perioperative death, although some had strongly negative reactions. The results suggest that a supportive preoperative tape can acquaint parents with the basis for anesthesiologists' concerns and facilitate the preoperative visit. Seeing an actual anesthetic may help to reassure parents about the anesthetic care their children will receive.(ABSTRACT TRUNCATED AT 250 WORDS)
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Neuroleptic malignant syndrome is an uncommon, idiosyncratic, and sometimes life-threatening disorder associated with the use of neuroleptic drugs. The pathogenesis of neuroleptic malignant syndrome is uncertain, but it may be similar to that of malignant hyperthermia (MH). ⋯ We anesthetized a 17-year-old man with this syndrome multiple times for electroconvulsive therapy (ECT) using a variety of anesthetic techniques. In this patient, dantrolene pretreatment and the use of nondepolarizing muscle relaxants did not relieve symptoms of the syndrome, including fever and creatine phosphokinase (CPK) increases.