Articles: general-anesthesia.
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Ambulatory surgical procedures are a large and increasing fraction of all surgery in the United States. A specialized health care team must be assembled to care for these patients and meet their special needs. Ambulatory surgery patients should be selected according to medical and psychosocial criteria. ⋯ Premedication should be supportive, and verbal as well as medicinal; drugs include ataractics and analgesics. All forms of general or regional anesthesia may be used. Recovery goals must be well defined, aiming for "home readiness." Ambulatory anesthesia care is concluded with postdischarge follow-up, for quality assurance and risk management.
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Critical care clinics · Jan 1990
ReviewGeneral anesthesia: management considerations in the trauma patient.
Endotracheal intubation and mechanical ventilation are vital components of the resuscitation of the most seriously injured patients and those suffering from multisystem trauma. Therefore, general anesthesia administered both intravenously and endotracheally becomes the anesthetic of choice for most of this patient population. ⋯ Monitoring techniques include the basic noninvasive monitoring set forth in the American Society of Anesthesiologist's standards, as well as invasive cardiac monitoring via arterial catheters and pulmonary artery catheters. Attention to detail in the recovery room will continue the success of a well-conducted general anesthetic for the trauma patient.
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A state exists after the induction of anaesthesia in which patients may be aware of their surroundings yet unable to communicate. This problem of awareness and recall during general anaesthesia is a recent one in the relatively short history of anaesthesia. Prior to the introduction of muscle relaxants in 1942 by Griffith and Johnson, it was felt that "light anaesthesia" would be signified by violent movements. ⋯ None has yet been found to be totally reliable and numerous reports of awareness can be found in the literature. Light inhalation and total intravenous anaesthesia have been blamed for the majority of these case reports. However, awareness during total intravenous anaesthesia is avoidable with the proper use of a combination of a hypnotic and an analgesic such as midazolam and alfentanil for general anaesthesia.
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J Conn State Dent Assoc · Jan 1990
Biography Historical Article"Vignettes" or a portrayal of Horace Wells.