Articles: general-anesthesia.
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Mesenteric traction syndrome consists of sudden tachycardia, hypotension, and cutaneous hyperemia, and frequently occurs during mesenteric traction in patients undergoing abdominal aortic aneurysm (AAA) reconstructive surgery. The etiology and clinical impact of this phenomenon are unknown, but the symptoms suggest a release of vasoactive materials from the mesenteric vascular bed. Thirty-one patients who underwent AAA surgery were studied. ⋯ Cutaneous hyperemia was observed in 58% of the patients. In an additional six patients, who had taken aspirin daily before AAA surgery, no significant changes were observed in the hemodynamic measurements or 6-K-PGF1 concentrations. These data suggest that mesenteric traction syndrome may be mediated at least in part by a selective release of prostacyclin.
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Anasth Intensivther Notfallmed · Feb 1989
Comparative Study[Mechanomyography and electromyography--2 competing methods of relaxometry using vecuronium].
The recording of the evoked twitch tension has been the established reference method to quantitate neuromuscular blockade. The evoked compound electromyogram has been introduced later as a clinically more convenient alternative. We compared both methods in 20 patients in whom cumulative dose response curves of vecuronium and the time constants of weaning neuromuscular blockade were determined. ⋯ No significant differences between the two methods were found in the cumulative 90% blocking dose, the duration of block and the recovery time (25%-75%). These results are in agreement with communications of previous authors using different nondepolarizing muscle relaxants. In the absence of abnormal conditions such as neuromuscular disorders and hypothermia, recording of evoked electromyography is a clinically satisfactory method to quantitate neuromuscular blockade.
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Anasth Intensivther Notfallmed · Feb 1989
[The use of pulse oximetry in detecting disorders of the arterial oxygen status in the immediate postoperative phase exemplified by combination anesthesia with isoflurane].
Adequate respiratory monitoring should immediately indicate deteriorations of arterial oxygen status, e.g. hypoxia (paO2-decrease [mmHg]), hypoxaemia (caO2-decrease [ml/dl]) and hypoxygenation (saO2-decrease [%]). These alterations have been detected in the early postanaesthetic period only by the classical clinical criterias cyanosis and tachycardia. Therefore, O2-application often is recommended for the first 10 min postoperatively. ⋯ With respect to the limitations of the method (measurement of arterial O2-saturation in peripheral circulation using pulse wave as an inflow indicator of arterial blood into the capillary bed; increased Hb-derivative concentrations, e.g. COHb), pulse oximetry for estimation of partial O2-saturation (psO2) seems to be the respiratory monitoring of choice in the early postoperative period. In that sense it is superior to pO2 but inferior to saO2 and caO2.