Articles: general-anesthesia.
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The attitude of Joseph Lister (1827-1912) to chloroform is considered with particular reference to contemporary methods of administration and the effect of the agent on cardiac and respiratory function.
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In this review, an attempt has been made to select, evaluate, and interpret the pertinent literature relative to general anesthesia and the lung. Concepts of intrapulmonary gas exchange and respiratory system mechanics were synthesized, emphasizing the importance of changes in intrapulmonary gas distribution that are induced by general anesthesia and exploring the possible underlying mechanisms of these changes. ⋯ Numerous questions regarding the effect of anesthesia on the lung remain unanswered. The close relationship between advances in pulmonary physiology and the pulmonary effects of anesthetic actions is increasingly apparent, as is the importance of this knowledge in applying mechanical ventilation and end-expiratory pressure to patients with pulmonary disease.
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Anesthesia and analgesia · Sep 1975
The effects of ketamine on cardiovascular dynamics during halothane and enflurane anesthesia.
The cardiovascular effects of a single dose of ketamine administered during halothane or enflurane anesthesia were studied in 24 patients. During halothane anesthesia, ketamine caused a rapid and significant increase in arteriolar peripheral resistance (p less than 0.01) and a decrease in cardiac output, stroke volume, and systolic diastolic, and mean arterial blood pressures. ⋯ These results demonstrate that general anesthesia blocks the cardiovascular-stimulating properties of ketamine. They also indicate that ketamine has significant cardiovascular-depressant qualities when used during halothane or enflurane anesthesia.
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Arterial Po2 and Pco2 were measured at half-hourly intervals in eleven patients anaesthetized for lower limb vascular surgery with a combination of nitrous oxide 67% and halothane 0.3-0.5% in oxygen, and an extradural injection of bupivacaine. Values for the alveolar-arterial oxygen tension difference, physiological deadspace and deadspace-tidal volume ratio were calculated. Although both the alveolar-arterial oxygen tension difference and physiological deadspace were large, spontaneous ventilation was adequate to maintain both Po2 and Pco2 of arterial blood at acceptable values. Over the course of 2 hr following the extradural injection there were no significant changes in any measured value.