Articles: general-anesthesia.
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Am. J. Obstet. Gynecol. · May 1989
Comparative StudyCardiac output in women undergoing cesarean section with epidural or general anesthesia.
Cardiac output during cesarean section and for 24 hours after delivery was estimated by using a noninvasive ultrasonic Doppler technique and was compared between term pregnant patients who underwent either epidural or general anesthesia. Cardiac output peaked by 36.7% and 26.3% of baseline values at 15 and 30 minutes after delivery, respectively, with epidural anesthesia and by 28% and 17.2%, respectively, with general anesthesia. ⋯ This study demonstrates a similar pattern of increase in cardiac output with epidural and general anesthesia and a return by 60 minutes to preoperative levels, which persisted for up to 24 hours after delivery. The applicability of this noninvasive technique can be extended in various circumstances during pregnancy, labor, delivery, and the postpartum period to further define cardiac output in pregnancy.
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Review Case Reports
Massive intraoperative atelectasis secondary to untreated mediastinal Hodgkin's disease: report of the hazard and review of the literature.
Mediastinal adenopathy in Hodgkin's disease has been known to cause relative airway compromise, particularly in the more vulnerable left mainstem bronchus. This has been infrequently reported to occur during general anesthesia and to cause respiratory embarrassment, representing a significant hazard. The possibility of its occurrence should be recognized. Preoperative evaluation of the airway by chest films and tomography, followed by radiation therapy in those patients at risk, is recommended to minimize the chances of respiratory complications during general anesthesia.
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Case Reports
Anaesthetic management for caesarean section in a patient with uncorrected truncus arteriosus.
We describe the successful management of a 25-yr-old primigravida with uncorrected truncus arteriosus, requiring an urgent Caesarean section for delivery of a live infant and we discuss the rationale of using the chosen drug combination and the importance of adequate monitoring in selecting an anaesthetic technique based on the pathophysiology of the congenital cardiac lesion.
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Critical care medicine · Apr 1989
Randomized Controlled Trial Clinical TrialTrendelenburg position and passive leg raising do not significantly improve cardiopulmonary performance in the anesthetized patient with coronary artery disease.
The effects of the Trendelenburg (TREND) position and passive straight leg raising (PLR) on cardiopulmonary performance in 18 anesthetized patients undergoing myocardial revascularization were studied with a two-dimensional transesophageal echocardiography probe and a thermodilution right ventricular ejection fraction (RVEF) pulmonary artery catheter. The TREND position (at 20 degrees) and PLR (at 60 degrees) were studied in relation to the level-supine position in random order. ⋯ PLR had similar effects as the TREND position, except CI did not change significantly. Thus, the TREND and PLR resulted in minor hemodynamic improvement with right ventricular dilation, decreased RVEF, and impaired oxygenation in the anesthetized cardiac surgical patient.