Articles: general-anesthesia.
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Cahiers d'anesthésiologie · Oct 1989
[Frequency of hypoxic episodes during general anesthesia in children].
We measured the frequency and extent of arterial hypoxemia during pediatric general anesthesia under routine clinical conditions. The subjects were 91 children (13 newborns, 27 infants, 37 children under 6 years, 14 children under 14 years) with normal heart and lungs scheduled for extrathoracic surgery. Mask anesthesia (spontaneous/assisted ventilation) was performed in 30 cases, endotracheal anesthesia (controlled ventilation) in 61 cases. ⋯ A body weight of 10 kg appeared to constitute a threshold: in children below this weight arterial oxygen desaturation occurred significantly more frequently (p less than 0.001), and the incidence of major episodes was significantly higher (p less than 0.005). Major episodes were almost evenly distributed between induction and awakening from anesthesia, only one episode occurred during maintenance. Desaturation was more likely to occur in intubated children than in those with a mask (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Biography Historical Article
[The tragic and marvelous history of anesthesia].
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Comparative Study
Epidural versus general anaesthesia for elective caesarean section. Effect on Apgar score and acid-base status of the newborn.
Elective Caesarean section deliveries over a 5-year period were studied to compare the effect of epidural block with general anaesthesia on the condition of the infant at birth. The Apgar score and umbilical arterial acid-base status were used as determinants of the latter. Epidural block was used in 139 (22.8%) mothers while 471 (77.2%) were performed under general anaesthesia. ⋯ The findings suggest that general anaesthesia, rather than asphyxia or aortocaval compression, is responsible for most of the depressed infants born by elective Caesarean section. This may involve over 20% of babies delivered in this manner, so greater use of epidural block for elective Caesarean section is recommended. Further investigations are required to improve results with general anaesthesia.
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The multiple occlusion technique was used to study the effects of paralysis on ventilatory mechanics during anaesthesia. Total respiratory compliance (Crs) was measured during spontaneous breathing and following neuromuscular block with controlled ventilation in 23 infants. ⋯ A possible cause of these differences may be the type of controlled ventilation given during paralysis, with tidal volume directly influencing values of Crs obtained. The results of this study suggest that values of Crs obtained during spontaneous breathing and paralysis should not be used interchangeably until further studies have been performed to assess factors influencing Crs during controlled ventilation.
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Regional-Anaesthesie · Sep 1989
Comparative Study[Mother and child stress parameters during cesarean section with general and peridural anesthesia].
This study compared maternal and fetal stress responses during cesarean section in either general anesthesia (GA) or epidural anesthesia (EA). Ten patients received GA with thiopental induction, intubation, and controlled ventilation with nitrous oxide and oxygen. After delivery, anesthesia was supplemented with fentanyl 0.2-0.3 mg. ⋯ Maternal epinephrine levels were lower under EA and below the normal range (EA 23 pg/ml, GA 77 pg/ml, P = 0.002); levels increased during GA and decreased during EA (P = 0.01). No statistical differences were seen in maternal norepinephrine (EA 206 pg/ml, GA 354 pg/ml). MAP was lower during EA (group levels EA 81 mmHg, GA 95 mmHg, P = 0.0002) and HR was higher during GA (group levels EA 89/min, GA 104/min, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)