Articles: general-anesthesia.
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Acta Anaesthesiol Scand · Oct 1984
Randomized Controlled Trial Clinical TrialHypotensive anesthesia, thromboprophylaxis and postoperative thromboembolism in total hip arthroplasty.
A prospective study was performed in 120 patients undergoing total hip arthroplasty. The patients were randomly allocated to four groups. The first two groups had nitroprusside-induced hypotensive anesthesia with either a fixed combination of sodium heparin and dihydroergotamine mesylate (HDHE) or dextran 70. ⋯ There was a lower incidence of pulmonary embolism in patients with HDHE and normotensive anesthesia. Major wound hematomas were noted postoperatively in 12% of the patients receiving HDHE, whereas no major hematomas developed following dextran prophylaxis. No anaphylactic reaction was noted from dextran 70, using hapten-dextran prophylaxis.
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Randomized Controlled Trial Comparative Study Clinical Trial
General anaesthesia for caesarean section in severe pre-eclampsia. Comparison of the renal and hepatic effects of enflurane and halothane.
In a randomized study of patients undergoing Caesarean section, either enflurane (mean 0.24 MAC-h) or halothane (mean 0.23 MAC-h) and 50% nitrous oxide in oxygen were administered to women (n = 12) with severe pre-eclampsia-eclampsia and to 16 healthy pregnant patients with normal renal and hepatic function. No evidence of nephrotoxicity was found in any pre-eclamptic or normal patient. ⋯ Postoperative liver function tests showed no important changes from preoperative values, although reductive metabolites of halothane were not measured. In patients with severe pre-eclampsia there appears no contraindication to enflurane or, probably, halothane as volatile supplements during general anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of fentanyl and halothane supplementation to general anaesthesia on the stress response to upper abdominal surgery.
The stress response to surgery and anaesthesia was studied in 20 patients undergoing cholecystectomy or vagotomy and pyloroplasty. Patients were anaesthetized with thiopentone and nitrous oxide; 10 patients received supplements of 0.5-1.5% halothane and the others fentanyl (mean 17 micrograms kg-1). ⋯ The hyperglycaemic response in the halothane group was greater than in the fentanyl group. Plasma noradrenaline concentrations increased in the group receiving halothane, but did not increase significantly in the group receiving fentanyl.
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Br Med J (Clin Res Ed) · May 1983
Randomized Controlled Trial Comparative Study Clinical TrialProfile of recovery after general anaesthesia.
The duration of impairment of mental functioning after anaesthesia was studied in 55 patients undergoing hernia repair who were divided into three groups in which the method of induction of anaesthesia (intravenous or inhalational) and ventilation (spontaneous or controlled) was varied. Performance in a five minute serial reaction time test and subjective estimates of coordination were assessed four times a day for two complete postoperative days and were compared with those in a control group of orthopaedic patients in hospital. ⋯ These results suggest that such patients should be advised not to undertake hazardous tasks such as driving a car for at least 48 hours after a general anaesthetic. Discrepancies between subjective and objective assessments of impairment also suggest that patients should not rely on their own assessments of fitness to drive.
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Anesthesia and analgesia · Feb 1983
Randomized Controlled Trial Comparative Study Clinical TrialThromboembolism after total hip replacement: role of epidural and general anesthesia.
The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied. Sixty patients were randomly allotted to one of two groups receiving either epidural or general anesthesia. Epidural anesthesia (N = 30) consisted of 0.5% bupivacaine with epinephrine intraoperatively; for pain relief in the postoperative period (24 h), 0.25% bupivacaine with epinephrine was given every 3 h. ⋯ Possible explanations for these differences include increased circulation in the lower extremities, less tendency for intravascular clotting to occur, and more efficient fibrinolysis in association with continuous epidural anesthesia. The decrease in blood loss associated with epidural anesthesia with lower transfusion requirements also might play a role. Epidural analgesia prolonged into the postoperative period, in addition to other appropriate thromboprophylactic measures, should be of value in patients undergoing operations associated with a high risk of thromboembolic complications.