Articles: general-anesthesia.
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Review
Opioid analgesics in anesthesia: with special reference to their use in cardiovascular anesthesia.
In this article, an attempt has been made to review the use of receptor stimulating pure agonist opioids in anesthesia, especially in patients with cardiovascular disease. Particular emphasis has been placed on the use of opioids in high doses to produce anesthesia, techniques that recently have become popular in cardiovascular anesthesia. A major benefit of opioid anesthesia is the cardiovascular stability obtained during induction and throughout operation, even in patients with severely impaired cardiac function. ⋯ The use of very large doses of opioids also will prolong postoperative respiratory depression. High doses of opioids can reduce or prevent the hormonal and metabolic responses to the stress of surgery. However, even very large doses of fentanyl or its newer analogues do not prevent marked increases in plasma catecholamine concentrations in response to cardiopulmonary bypass.(ABSTRACT TRUNCATED AT 400 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Nausea and vomiting in day-case dental anaesthesia. The use of low-dose droperidol.
The anti-emetic effects of low-dose droperidol (1.25 mg), ultra-low-dose droperidol (0.25 mg) and a placebo were compared in patients admitted for day-case dental anaesthesia. Ultra-low-dose droperidol produced a significant decrease in the subjective feeling of nausea without delaying recovery or discharge from the hospital (p less than 0.05). Low-dose droperidol did not significantly reduce nausea (p greater than 0.05) and prolonged the recovery time (p less than 0.05).
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Klinische Wochenschrift · Nov 1984
Randomized Controlled Trial Comparative Study Clinical TrialAdrenocortical suppression by a single induction dose of etomidate.
In a prospective controlled trial we studied the effect of a single induction dose of etomidate or thiopentone on the adrenocortical function in 29 patients undergoing elective surgery. During anesthesia and in the recovery period serum cortisol rose significantly in the thiopentone group only. ⋯ Moreover, plasma ACTH increased significantly more after etomidate than after thiopentone (p less than 0.02) indicating relative unresponsiveness of the adrenal cortex to stimulation by endogenous ACTH. We conclude that a single i.v. bolus of etomidate (0.26 mg/kg) leads to significant adrenal insufficiency in patients without preexisting endocrine abnormalities.
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J Bone Joint Surg Br · Nov 1984
Case ReportsIntra-operative awakening to monitor spinal cord function during scoliosis surgery. Description of the technique and report of four cases.
We used a modification of the wake-up test to monitor spinal cord function in 102 consecutive scoliotic patients undergoing Harrington instrumentation. Four patients were found to have a neural deficit when they were awakened during the operation. ⋯ Using our method, we have encountered no problem in performing the wake-up test, although attention is drawn to the difficulty in repeating the test if the patient is re-anaesthetised with diazepam. There were no false negative results in this series.