Articles: anesthesia.
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Randomized Controlled Trial Clinical Trial
Transcranial Doppler: response of cerebral blood-flow velocity to carbon dioxide in anaesthetized children.
To determine the effect of carbon dioxide on the cerebral circulation in anaesthetized infants and children, 13 healthy children, ASA physical status I or II, between three months and seven years of age and scheduled for urologic surgery, were studied. Anaesthesia was induced with thiopentone and vecuronium. After tracheal intubation, anaesthesia was maintained with 70 per cent nitrous oxide in oxygen, fentanyl 2 micrograms.kg-1, vecuronium 0.05 mg.kg-1 and 0.8-1.0 per cent end-tidal isoflurane. ⋯ Cerebral blood flow velocity increased logarithmically and directly with the PETCO2 (r2 = 0.56). There were no complications associated with the use of transcranial Doppler sonography. These data indicate that CO2 has a direct effect on the velocity of blood in the middle cerebral artery in infants and children anaesthetized with isoflurane.
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Gynäkologische Rundschau · Jan 1991
Randomized Controlled Trial Comparative Study Clinical Trial[Patient-controlled lumbar catheter peridural anesthesia versus continuous perfusor catheter peridural anesthesia--initial results].
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Randomized Controlled Trial Clinical Trial
Prevention of hypotension following spinal anaesthesia for elective caesarean section by wrapping of the legs.
Twenty-four parturients undergoing elective Caesarean section were allocated randomly to have the legs wrapped with elasticated Esmarch bandages immediately following spinal anaesthesia or to serve as controls. Significant hypotension (systolic arterial pressure less than 100 mm Hg and less than 80% of baseline value) was treated with i.v. ephedrine in 5-mg boluses. ⋯ Systolic arterial pressure was significantly (P less than 0.05) less in control subjects at 4, 5 and 6 min following spinal injection. No patient in the leg wrapped group became hypotensive following removal of the elasticated bandages.
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Randomized Controlled Trial Comparative Study Clinical Trial
Long-term cognitive and social sequelae of general versus regional anesthesia during arthroplasty in the elderly.
This study compared the effects of general and regional anesthesia on cognitive and psychosocial functioning in elderly persons. Sixty-four patients between 60 and 86 yr of age undergoing knee arthroplasty were randomly assigned to receive either general or regional anesthesia. ⋯ The results indicated that there were no cognitive or psychosocial effects of general or regional anesthesia after 3 months in elderly persons undergoing knee arthroplasty. In this patient population, general anesthesia poses no more risk to long-term mental function than regional anesthesia.
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Anesthesia and analgesia · Dec 1990
Randomized Controlled Trial Clinical TrialEffect on outcome of prolonged exposure of patients to nitrous oxide.
Prolonged (several days or repeated) exposure to nitrous oxide (N2O) can cause injury or death. To assess whether relatively prolonged anesthesia with N2O in normal patients might similarly cause untoward effects, we investigated whether the addition of N2O to isoflurane anesthesia caused injury to patients having surgical resection of acoustic neuroma lasting approximately 10 h. Twenty-six patients undergoing surgical resection of acoustic neuroma were randomly assigned to a regimen that included or excluded N2O (50%-60%) during isoflurane anesthesia plus intravenous adjuvants. ⋯ We measured standard clinical variables (blood pressure, heart rate), oxygen saturation, neurologic status, pain, and the incidence and type of morbid outcomes. Exposure to N2O did not increase the incidence of morbid outcomes (including hepatic injury, infection, or hypoxemia), prolong hospitalization, or increase common postoperative complaints such as nausea, vomiting, coughing, or headache. Patients anesthetized with either regimen were equally satisfied with their anesthetic.