Articles: general-anesthesia.
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A review of the literature and of our recent data (obtained by computer-based analysis of multiple inert gas elimination) re-emphasizes the significant gas exchange disturbances found to occur during general anesthesia which develop for probably several reasons. In this report we suggest firstly that the reduction in functional residual capacity (FRC) may well be an effect of anesthesia just as is abnormal gas exchange. In other words, the reduction in FRC is not per se the cause of gas exchange disturbances, but rather occurs alongside them. ⋯ Such factors include altered hypoxic vasoconstriction, a change in airway secretions and clearance of those secretions, changes in bronchomotor tone, changes in surfactant activity, and alveolar volume loss due to rapid uptake of soluble anesthetic gases like nitrous oxide. To qualitatively and quantitatively distinguish amongst these various potential factors will require experimental protocols and techniques of a highly controlled and accurate nature. That in 1983 we still do not understand the basic mechanisms behind abnormal gas exchange during anesthesia attests to the difficulty of mounting such an experiment.
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Regional-Anaesthesie · Jan 1984
Comparative Study[Comparative studies on general anesthesia versus peridural anesthesia in primary cesarean section].
In a prospective interdisciplinary study involving the departments of gynaecology, anaesthetics and paediatrics, the influence on both the mother and neonate of general as opposed to epidural anaesthesia was compared in 47 planned caesarean sections. Neither maternal or foetal risk factors were present in these cases, and the cardiotocogram was always normal before the anaesthetic was applied. Methods. ⋯ Acid-base and PCO2 values were not markedly influenced by either of the techniques used, but the maternal capillary PO2 levels were very much higher in the general anaesthetic group. The neonates born under general anaesthetic had a lower 1 min Apgar score, as a result of the relatively long induction-delivery time, of on average 17 min. The 5 and 10 min Apgar scores and the neurophysiological development of the babies revealed no differences between the two groups.
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Ann Fr Anesth Reanim · Jan 1984
[Anesthesia and intensive care in cardiac surgery. Activity at the French centers in 1982].
A national survey was carried out to inquire about the practice of anaesthesia and surgical intensive care in cardiac surgery in French hospitals. In 1982, 15,797 surgical procedures with cardiopulmonary bypass were collected; 1,360 and 555 were performed in children and infants respectively. Coronary surgery accounted for 46% of the total. ⋯ With the exception of arterial blood pressure monitoring, there was no consensus on the method or the extent of monitoring of patients undergoing cardiac surgery. A Swan-Ganz catheter was only used in 18% of cases. Neuroleptanalgesia was the anaesthetic technique most often used.