Articles: general-anesthesia.
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Comparative Study
The auditory evoked response as an indicator of awareness.
The latency of the early cortical wave Nb of the auditory evoked response (AER) was compared with responses to Tunstall's isolated forearm test, while the concentration of nitrous oxide was progressively reduced during light anaesthesia in seven patients. A threshold Nb latency of 44.5 ms was chosen to discriminate between an early cortical AER containing three waves and that with two waves of longer latency. ⋯ The addition of a volatile anaesthetic abolished any response, and increased Nb latency to more than 44.5 ms. The three wave AER pattern, therefore, is associated with a depth of anaesthesia at which awareness occurs.
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Randomized Controlled Trial Clinical Trial
Inspired oxygen concentration during general anaesthesia for caesarean section.
The effects on maternal oxygen saturation, foetal wellbeing and umbilical blood gases were compared when parturients received either 30 or 50% oxygen prior to delivery by Caesarean section under general anaesthesia. Maternal arterial oxygen saturation was significantly increased in the group receiving 50% oxygen. There was no difference between the two groups in terms of Apgar score minus colour, time to sustained respiration or umbilical cord blood gas estimations. The use of 30% inspired oxygen during uncomplicated Caesarean section is advocated.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
[A comparison of the course of anesthesia using a bolus application of propofol, methohexital or etomidate as hypnotics and alfentanil analgesia].
The suitability of the analgesic-hypnotic combination alfentanil-propofol in nitrous oxide-oxygen IPPB for short-term and outpatient anesthesia was studied in 50 patients of ASA risk groups I and II. This study appeared pertinent since the two substances have the shortest half-lives of their respective classes of medication. For comparison, two groups of similar size were treated with the well-established combinations alfentanil-methohexital and alfentanil-etomidate. ⋯ These patients also showed the most rapid recovery; consequently, the combination of alfentanil and propofol would appear to be especially suitable for outpatients. For the induction of anesthesia alfentanil was administered in a dosage of 30 micrograms/kg body weight in combination with propofol 1.5 mg/kg, methohexital 1.0 mg/kg or etomidate 0.2 mg/kg. For anesthesia maintenance the following mean dosages were found to be suitable: Alfentanil 1 microgram/kg/min, propofol 46 micrograms/kg/min, methohexital 24 micrograms/kg/min, and etomidate 4 micrograms/kg/min.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Complications during anaesthesia in patients with Duchenne's muscular dystrophy (a retrospective study)
The purpose of this retrospective study was to estimate the frequency and severity of anaesthetic complications in patients with Duchenne's muscular dystrophy (DMD). Forty-four boys with DMD were exposed to anaesthesia and surgery 84 times during a period of 22 years (1965-86). The procedures took place at 15 different hospitals. ⋯ Three out of the eight patients with severe complications occurred 1.5, 2.5 and 4 years before the neuromuscular disease was diagnosed. Thus an unusual course of anaesthesia in male children calls for further investigation. Although it has been stated before that succinylcholine is contraindicated in patients with Duchenne's muscular dystrophy, the drug continues to be used.