Articles: general-anesthesia.
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J. Endocrinol. Invest. · Oct 1989
Randomized Controlled Trial Clinical TrialEffects of surgery and general or epidural anesthesia on plasma levels of cortisol, growth hormone and prolactin in infants under one year of age.
Twenty infants under one yr of age undergoing minor surgery were divided in two groups according to the type of anesthesia (epidural, Group 1, n = 10; general, Group 2, n = 10) which was randomly performed. Blood samples for cortisol (F), growth hormone (GH), and prolactin (PRL) determination were taken from each infant in baseline conditions, before surgery, and at the end of surgery. Mean plasma F levels in infants of group 2 rose significantly (p less than 0.01) before surgery to attend a maximum at the end of surgery (p less than 0.005). ⋯ Mean plasma PRL levels showed a significant increase before surgery (p less than 0.05 and p less than 0.01 in group 1 and 2, respectively) and a further increase at the end of surgery in both groups of infants (p less than 0.005). These results suggest that in infants under one yr of age both types of anesthetic procedures preceding surgery have no significant effect on plasma GH, but produce a significant increase of cortisol and prolactin mean plasma levels. The cortisol response to surgery and general or epidural anesthesia was similar to that reported in adults and prepubertal boys.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Oct 1989
ReviewLung function during anesthesia and respiratory insufficiency in the postoperative period: physiological and clinical implications.
This review covers the physiological and clinical implications of lung function during anesthesia and respiratory insufficiency in the postoperative period. We have divided it into 3 main sections: 1) lung function changes induced by anesthesia and surgery, in which the impact on pulmonary mechanics, ventilation/perfusion changes and gas exchange are examined; 2) physiological implications of postoperative respiratory function secondary to decreased alveolar ventilation, development of atelectasis, and interstitial lung edema; and 3) clinical implications of postoperative respiratory failure. In this last section we analyze the current therapeutic modalities available to reduce the incidence of postoperative respiratory failure, as well as related morbidity and mortality.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of the neuromuscular block induced by mivacurium, suxamethonium or atracurium during nitrous oxide-fentanyl anaesthesia.
We compared the neuromuscular and cardiovascular changes following administration of mivacurium 0.15, 0.20 and 0.25 mg kg-1, suxamethonium 1.0 mg kg-1 or atracurium 0.5 mg kg-1 i.v. in 41 (ASA physical status I or II) patients during nitrous oxide-fentanyl anaesthesia. Mean onset times for total ablation of twitch response for mivacurium 0.15, 0.20 and 0.25 mg kg-1, were 2.5, 2.4 and 2.7 min, respectively, similar to that for atracurium (2.5 min), but longer than for suxamethonium (1.1 min) (P less than 0.05). ⋯ Following neostigmine 0.045 mg kg-1, mean times for twitch tension to recover from 10% to 90% of control were similar for mivacurium (9.7 min) and atracurium (10.5 min). Transient decreases in mean arterial pressure (greater than 20%) were observed in seven of 15 patients who received the two higher doses of mivacurium.