Articles: general-anesthesia.
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Br J Obstet Gynaecol · Sep 1986
Maternal stress response associated with caesarean delivery under general and epidural anaesthesia.
The maternal stress response to caesarean delivery with either general or epidural anaesthesia was investigated. Patients given a general anaesthetic showed statistically significant increases in blood pressure, heart rate, and levels of plasma catecholamines, cortisol and glucose. Epidural anaesthesia, to at least the T6 dermatome, obtunded these responses. The significance of these findings to the choice of method of anaesthesia is discussed.
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Randomized Controlled Trial Clinical Trial
The cricoid yoke--a device for providing consistent and reproducible cricoid pressure.
An instrument is described which, when used during the accelerated induction technique, ensures that consistent and adequate cricoid pressure can be applied. Mothers undergoing general anaesthesia for elective Caesarean section were studied in order to illustrate the clinical application of the instrument. The consequences to intubating conditions of applying adequate cricoid pressure, and an assessment of the instrument's control over the incidence of regurgitation during operation were investigated.
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Acta Anaesthesiol Scand · Aug 1986
Pulmonary ventilation, CO2 response and inspiratory drive in spontaneously breathing young infants during halothane anaesthesia.
Pulmonary ventilation, CO2 response and inspiratory drive were studied during halothane anaesthesia prior to surgery in 13 spontaneously breathing infants less than 6 months of age. Pneumotachography and capnography were used. Airway and oesophageal pressures were measured and occlusion tests were performed at functional residual capacity. ⋯ It is concluded that young spontaneously breathing infants anaesthetized with halothane (MAC 1.3) have an increased respiratory drive with greater tidal volumes during CO2 stimulations. Respiratory timing, dynamic compliance and total pulmonary resistance were, however, uninfluenced by 4% CO2 stimulation. Increased monitoring of CO2 output in anaesthetized infants is suggested.
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Anasth Intensivther Notfallmed · Aug 1986
[Course of central body temperature in the laminar airflow operating room in various anesthesia procedures].
The oesophageal body temperature of 130 patients was measured pre- and intraoperatively. 92% (n = 116) of the operations (implantation or replacement of hip prostheses) were performed in an operating room having a laminar air flow system with horizontal air flow. 9% (n = 14) of the operations (laparotomies) were performed in a room of identical design without an air circulation system. Three different forms of anesthesia were investigated with regard to their influence on interior body temperature: 1) general anesthesia with a volatile anesthetic (INH); 2) peridural anesthesia with additional general anesthesia (KPDA+ITN); and 3) neuroleptic anesthesia (NLA). A drop in temperature during the operation was found in all patients. ⋯ In the operating room with laminar air flow the INH-patients sustained the greatest decrease in temperature; the mean value in the first hour was 1.1 degrees C/h, and up to 4.6 degrees C/3 h toward the end of the operation. There was a comparable drop in temperature in the first hour in patients anesthetized with KPDA+ITN, but the rate slowed down toward the end of the investigation (2.2 degrees C/3 h). NLA caused a characteristic temperature behavior, with an initial fall in temperature, plateau phase, and subsequent rise (total: -1.0 degrees C/3 h) Temperature regulation was influenced least by NLA in the operating room with laminar air flow; thus, in this context, NLA proved to be a favourable form of anesthesia.
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Children with neurological and neuromuscular diseases often present anesthetic problems in the perioperative period. The anesthetic technique can play a significant role in altering the state of the brain during neurosurgical procedures through effects on the cerebral circulation and metabolism. Pre-existing neuromuscular disease may also have specific anesthetic implications such as cardiorespiratory involvement (eg, myotonia dystrophica), the potential for drug interactions (eg, myasthenia gravis) or abnormal responses to commonly used drugs (eg, malignant hyperthermia). In this review, the perioperative anesthetic considerations in a number of common neurological and neuromuscular conditions in the pediatric patient are discussed.