Articles: general-anesthesia.
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Patients who present for abdominal aortic surgery often have significant atherosclerotic disease which may involve the coronary arteries. Haemodynamic responses occurring during fentanyl (100 micrograms X kg-1) oxygen anaesthesia for abdominal aortic surgery were studied in 16 patients. Anaesthesia was induced with fentanyl 100 micrograms X kg-1 with no supplemental doses and metocurine-pancuronium mixture (4:1). ⋯ Eleven of the 16 patients required treatment for postoperative hypertension. Five of the 16 patients developed myocardial ischaemia, defined as ST segment depression greater than 0.1 mV, at some time during the operative procedure. Unsupplemented fentanyl anaesthesia (100 micrograms X kg-1) was unable to maintain a hypodynamic circulation in patients having abdominal aortic operations.
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Obstetrics and gynecology · Nov 1986
Effect of anesthesia for primary cesarean section on postoperative infectious morbidity.
It has been stated that general anesthesia is a risk factor for postcesarean infectious morbidity. A retrospective review of 252 women who had undergone primary cesarean section at the University of Iowa Hospital was conducted. Regional anesthesia was successfully administered to 170 patients, and general anesthesia was administered to 82 patients. ⋯ There were no statistically significant differences between the two groups with regard to multiple indexes of postoperative fever or infection, including febrile morbidity, diagnosis of infection, use of therapeutic antibiotics, fever index, and postoperative hospital stay. General anesthesia, as administered to patients in the present series, did not increase the risk of infectious morbidity after primary cesarean section. However, our surgeons apparently were influenced by the choice of anesthetic technique when selecting a skin incision.
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To compare postoperative well-being after general and epidural anaesthesia, 58 women undergoing Caesarean section were divided into a general anaesthetic group receiving intramuscular opioid postoperatively (26), and an epidural group receiving morphine via the epidural route (32). The epidural group required less analgesia (p less than 0.01 at 0.5 and 8 hours, p less than 0.001 at 4 hours). There was no difference in the use of oral analgesics. ⋯ More in the epidural group had a very good night's sleep during each night studied. Patients in the epidural group were slower to use the ward toilet (p less than 0.01) and had more itching (p less than 0.001). Our conclusion is that patients progressed well in both groups.