Articles: general-anesthesia.
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Oculocardiac reflex is one of the trigemino-vagal reflexes, and is frequently observed during anesthesia for pediatric strabismus surgery. The reflex is greatly exaggerated in the presence of hypoventilation, hypoxemia and acidosis. ⋯ Several related reflexes are known, such as blepharocardiac reflex, oculorespiratory reflex, and the sudden infant death syndrome. Although the reflex can be prevented by a retrobulbar block or the administration of parasympatholytic drugs, well conducted anesthesia and cooperation with the surgeon is much more important.
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Awareness and recall under anesthesia is a complication that appears to be related to the use of muscle relaxants. While little is known about unconscious awareness and its physical and psychological consequences, it is well known that recall can result in traumatic psychological sequelae under certain circumstances. ⋯ In the event of unexpected awareness, the anesthesiologist must deal with the patient in an honest and forthright manner. Failure to do so may lead to dire psychological consequences for the patient and legal consequences for the anesthesiologist.
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This chapter reviewed the mechanisms and manifestations of transient and irreversible cerebral ischemia and the current experimental approaches to attenuate ischemic neuronal injury. Patients with signs or symptoms of cerebral ischemia are likely to have abnormal cerebrovascular dynamics, with areas of cerebrum at risk, and may be at an increased risk of stroke after general or vascular surgery. ⋯ Nonetheless, the available data indicate that most perioperative strokes occur in the postoperative period and appear to be thromboembolic in nature. The existence of neither asymptomatic carotid bruits nor intraoperative hypotension appears to be associated with the occurrence of perioperative stroke.