Articles: general-anesthesia.
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Respiratory oxygen, carbon dioxide, and nitrous oxide concentrations were recorded in 20 patients breath-by-breath during general anesthesia and early recovery, using the Cardiocap multiparameter monitor. Several approved maneuvers were performed to demonstrate the usefulness of endtidal oxygen measurement. "Oxygrams" provided by the fast paramagnetic oxygen sensor confirmed the capnometric information in the diagnosis of hypoventilation, apnea, and disconnections. In one patient, the alarm for inspiratory oxygen concentration, set at 18%, appeared to prevent alveolar hypoxia and low arterial saturation from occurring when oxygen instead of nitrous oxide was turned off. ⋯ Changes in nitrous oxide concentration often complemented oxygen-related information obtained in our observations. In the recovery room, a decrease in end-tidal oxygen concentration preceded low pulse oximetry readings. Therefore, it is suggested that all three gases should be monitored continuously to prevent mishaps related to insufficient ventilation and inappropriate gas concentrations during anesthesia and immediate recovery.
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Randomized Controlled Trial Clinical Trial
Awareness following different techniques of general anaesthesia for caesarean section.
Using the isolated arm technique, the frequency of awareness was evaluated in 50 full-term patients undergoing elective Caesarean section under general anaesthesia. In 20 patients, anaesthesia was induced with thiopentone 4 mg kg-1, and in the other 30 patients, induction was with ketamine 1.5 mg kg-1. ⋯ Awareness was significantly greater after induction with thiopentone (14/20) than after ketamine (4/30). There were no significant differences in Apgar scores or umbilical vein blood-gas values in the newborns.
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Randomized Controlled Trial Clinical Trial
Neurobehavioural effects of propofol on the neonate following elective caesarean section.
Forty mothers undergoing elective Caesarean section under general anaesthesia were allocated randomly to receive either propofol 2.8 mg kg-1 (n = 20) or thiopentone 5 mg kg-1 (n = 20) for induction of anaesthesia. Twenty neonates delivered by uncomplicated vaginal delivery were evaluated also as unmedicated controls. Neurobehavioural examinations were carried out at 1, 4 and 24 h after delivery. ⋯ Newborn children examined 1 h after birth, after maternal anaesthesia with propofol, showed a depression in alert state, pinprick and placing reflexes, and mean decremental count in Moro and light. There was a generalized irritability in 25% of them. This depression was not observed at 4 h.
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A case of opisthotonus following the use of the anaesthetic induction agent propofol is described. The patient was a woman with a known history of epilepsy. It is recommended that propofol should not be used in such patients.