Articles: general-anesthesia.
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Can learning occur during general anaesthesia? This paper reviews the studies which have addressed this issue and finds some evidence of implicit memory for intra-operative events, even with clinically adequate anaesthesia. This has implications both for clinical practice and for psychological theories of learning and awareness. ⋯ Methodological improvements are discussed, in particular the need for a reliable means of monitoring awareness during anaesthesia. These improvements would enable researchers to determine the conditions under which learning occurs and would provide information about the role of consciousness in learning.
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Care of patients with subarachnoid haemorrhage caused by ruptured cerebral artery aneurysm requires careful assessment of neurological function and prevention of rebleeding and ischaemia throughout the perioperative period. An understanding of the cerebral protection techniques used during periods of ischaemia or circulatory arrest will assist the provision of optimal conditions for successful surgical treatment of the aneurysm.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1995
Review[Do general anesthetics act on specific receptors?].
First of all, the meanings of the terms anaesthesia, anaesthetic and receptor are defined. Examples of anaesthetic actions in model systems are then described and compared with clinical actions of anaesthetics. When anaesthetics achieve a certain membrane concentration, they begin to influence membrane protein function in a nonspecific manner. ⋯ Rather, it is important that the drug does not show undesirable side effects when it achieves a critical membrane concentration at which lipophilic interactions occur. There are examples of specific interactions of general anaesthetics with receptors as well as examples of nonspecific effects on membranes. Whether these interactions are important for anaesthesia remains to be seen.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1995
Review[Clinical potency of nitrous oxide--is MAC the gold standard?].
Nitrous oxide is delivered during most cases of general anaesthesia. Though it has a history of approx. 150 years there is no univocal understanding about its clinical potency. Research studies during the last 10 years support, however, the view that 1. the potency of nitrous oxide in the clinical settings is only 1/3 of the potency as estimated from the MAC value; 2. the potency of combinations of nitrous oxide and volatile anaesthetics is represented more appropriately by quantities which are derived from the EEG than by the addition of MAC fractions. The findings of the last 10 years do not support the hypothesis, that the addition of nitrous oxide to the breathing gas is more beneficial than waiving the use of nitrous oxide.