Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Local versus general anaesthesia in carotid surgery. A prospective, randomised study.
A randomised, prospective study was performed to compare local (LA) and general anaesthesia (GA) in carotid surgery with special emphasis on complications and the need for intra-operative shunting. Fifty-six patients were randomised to LA and 55 to GA. Eight patients in the LA group required a GA for various reasons. ⋯ During surgery the highest recorded systolic pressure was significantly higher in the LA group (210 mmHg versus 173 mmHg, P less than 0.001). LA for carotid endarterectomy is comparable with general anaesthesia regarding peroperative complications but produces significantly higher blood pressures than general anaesthesia. On the other hand it allows the possibility of neurologic monitoring of the patient and leads to significantly less use of an intra-operative shunt.
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Experimental evidence from various neuropsychological and neurophysiological fields indicates that an oscillatory brain mechanism in a frequency range of 30-40 Hz is necessary for adequate sensory information processing. An oscillatory component of that particular frequency range can also be observed in the mid-latency auditory evoked potentials. Thus general anesthesia can be defined as a suppression of sensory information processing, and the effect of the i.v. anesthetics, Propofol and ketamine, on auditory perception and auditory-evoked potentials was therefore studied. ⋯ In contrast to Propofol, ketamine does not alter auditory perception. Suppression of sensory information processing must take place at a higher cortical level in a dissociative manner. The persistence of a 30-40 Hz oscillation must be seen in connection with dreams and hallucinations as reported for the drug and may be interpreted as insufficient suppression of sensory information processing under ketamine anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiovascular effects of fibrescope-guided nasotracheal intubation.
The cardiovascular effects of fibrescope-guided nasotracheal intubation were compared to those of a control group of patients who were intubated using the Macintosh laryngoscope. The 60 patients studied received a standard anaesthetic technique which included a muscle relaxant and were allocated randomly to one of two groups immediately before tracheal intubation. Systolic and diastolic arterial pressures in the fibreoptic group were significantly lower than in the control group during the first minute after intubation. ⋯ The heart rate in the fibreoptic group was significantly higher than in the control group during all five minutes after intubation. The maximum increase in heart rate was significantly higher in the fibreoptic group. The cardiovascular responses to fibreoptic nasotracheal intubation under general anaesthesia should not cause undue concern in fit patients, but appropriate measures should be taken to prevent excessive tachycardia in compromised patients.
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Anaesth Intensive Care · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialPost-cholecystectomy pulmonary function following interpleural bupivacaine and intramuscular pethidine.
Twenty-four patients who were to undergo cholecystectomy were randomised into two groups, one to receive postoperative analgesia with interpleural bupivacaine, 20 ml of a 0.5% solution with adrenaline 5 micrograms/ml, and the other to receive intramuscular pethidine, 1 mg/kg. Preoperative and postoperative pulmonary function, postoperative pain scores, and days from operation to hospital discharge were recorded and statistically compared. There was no significant difference in pain scores, nor in days to discharge; however, postoperative pulmonary mechanics were significantly poorer in the interpleural group. A hypothesis to explain the differences is offered.
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Rev Esp Anestesiol Reanim · Nov 1989
Letter Case Reports[Postoperative stridor caused by residual relaxation].