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Sample records for anesthesia general

  1. [General anesthesia].

    Science.gov (United States)

    Feiss, P

    2001-04-30

    General anaesthesia is a reversible loss of consciousness induced and maintained with a hypnotic drug given either by venous injection and infusion, or by inhalation. A potent opioid is usually associated to inhibit the transmission of pain and thus to lessen sympathetic and endocrine reactions to nociceptive stimuli. Myorelaxation is used to facilitate tracheal intubation and surgery. Whatever the anaesthetic protocol use, the patient and anaesthesia machine require close monitoring. In addition to vital signs, the depth of anaesthesia may be monitored using automated electroencephalographic analysis and myorelaxation should always be monitored using a nerve stimulator, but pain or analgesia evaluation is only based on clinical signs of sympathetic stimulation. Because anaesthesia-related death and morbidity have decreased considerably, future improvements in outcome should concern perioperative comfort, i.e. prevention of cognitive disturbances, nausea, vomiting and pain.

  2. Acute Paraplegia After General Anesthesia

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    Gholam Hossein Ghaedi

    2011-08-01

    Full Text Available Acute paraplegia is a rare but catastrophic complication of surgeries performed on aorta and corrective operations of vertebral column. Trauma to spinal cord after spinal anesthesia and ischemia of spinal cord also may lead to acute paraplegia. Acute paraplegia as a complication of general anesthesia in surgeries performed on sites other than aorta and vertebral column is very rare. Here we present a 56 year old woman with acute paraplegia due to spinal cord infarction after laparoscopic cholecystectomy under general anesthesia probably caused by atherosclerosis of feeding spinal arteries and ischemia of spinal cord after reduction of blood flow possibly due to hypotension during general anesthesia.

  3. Adenotomy under general anesthesia.

    Science.gov (United States)

    Vokurka, J; Jakoubková, S; Vít, Z; Drahokoupilová, M

    1989-01-01

    Experience obtained from adenotomy (AT) under general anesthesia using Ketamin hydrochloride (Ketalar, Narkamon) in children are presented in this paper. The authors had used intramuscular premedication with Prothazin, Dolsin and Atropin at the first stage, then they shifted to oral administration of a combination of Diazepam, Theadryl and Atropin. Ketamin may be applied intravenously in the dosage of 1.0 to 1.5 mg/kg of body weight in most children. Where it is not possible, a triple dose into the muscle is used. A total of 2,266 AT were performed. About 70% of patients were calm during the operation, once a suspected aspiration was considered but it was not confirmed. The main contribution of the method is 100% amnesia of the surgery made. The procedure is a compromise between a requirement for minimal traumatization of the child's psyche by the intervention and the resources available, particularly the need of personnel at the majority of otorhinolaryngo-logical departments nowadays.

  4. The thermodynamics of general anesthesia

    CERN Document Server

    Heimburg, T; Heimburg, Thomas; Jackson, Andrew D.

    2006-01-01

    It is known that the action of general anesthetics is proportional to their partition coefficient in lipid membranes (Meyer-Overton rule). This solubility is, however, directly related to the depression of the temperature of the melting transition found close to body temperature in biomembranes. We propose a thermodynamic extension of the Meyer-Overton rule which is based on free energy changes in the system and thus automatically incorporates the effects of melting point depression. This model provides a quantitative explanation of the pressure reversal of anesthesia. Further, it explains why inflammation and the addition of divalent cations reduce the effectiveness of anesthesia.

  5. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

    Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th......, the administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

  6. Double balloon enteroscopy examinations in general anesthesia

    Institute of Scientific and Technical Information of China (English)

    Laszlo; Zubek; Lena; Szabo; Peter; Laszlo; Lakatos; Janos; Papp; Janos; Gal; Gabor; Elo

    2010-01-01

    AIM:To demonstrate that the double balloon enteroscopy(DBE) can be safely performed in general anesthesia with intubation.METHODS:We performed a retrospective examination between August 2005 and November 2008 amongpatients receiving intubation narcosis due to DBE examination.The patients were grouped based on sex,age and physical status.Anesthesia records includedduration of anesthesia,quantity of medication usedand anesthesia-related complications.We determinedthe frequency of complications in the differen...

  7. Apnea after Awake Regional and General Anesthesia in Infants : The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial

    NARCIS (Netherlands)

    Davidson, Andrew J.; Morton, Neil S.; Arnup, Sarah J.; De Graaff, Jurgen C.; Disma, Nicola; Withington, Davinia E.; Frawley, Geoff; Hunt, Rodney W.; Hardy, Pollyanna; Khotcholava, Magda; Von Ungern Sternberg, Britta S.; Wilton, Niall; Tuo, Pietro; Salvo, Ida; Ormond, Gillian; Stargatt, Robyn; Locatelli, Bruno Guido; McCann, Mary Ellen; Lee, Katherine; Sheppard, Suzette; Hartmann, Penelope; Ragg, Philip; Backstrom, Marie; Costi, David; Von Ungern-Sternberg, Britta S.; Knottenbelt, Graham; Montobbio, Giovanni; Mameli, Leila; Giribaldi, Gaia; Prato, Alessio Pini; Mattioli, Girolamo; Wolfler, Andrea; Izzo, Francesca; Sonzogni, Valter; Van Gool, Jose T D G; Numan, Sandra C.; Kalkman, Cor J.; Hagenaars, J. H M; Absalom, Anthony R.; Hoekstra, Frouckje M.; Volkers, Martin J.; Furue, Koto; Gaudreault, Josee; Berde, Charles; Soriano, Sulpicio; Young, Vanessa; Sethna, Navil; Kovatsis, Pete; Cravero, Joseph P.; Bellinger, David; Marmor, Jacki; Lynn, Anne; Ivanova, Iskra; Hunyady, Agnes; Verma, Shilpa; Polaner, David; Thomas, Joss; Meuller, Martin; Haret, Denisa; Szmuk, Peter; Steiner, Jeffery; Kravitz, Brian; Suresh, Santhanam; Hays, Stephen R.; Taenzer, Andreas H.; Maxwell, Lynne G.; Williams, Robert K.; Bell, Graham T.; Dorris, Liam; Adey, Claire; Bagshaw, Oliver; Chisakuta, Anthony; Eissa, Ayman; Stoddart, Peter; Davis, Annette; Myles, Paul; Wolf, Andy; McIntosh, Neil; Carlin, John; Leslie, Kate; De Lima, Jonathan; Hammer, Greg; Field, David; Gebski, Val; Tibboel, Dick

    2015-01-01

    Background: Postoperative apnea is a complication in young infants. Awake regional anesthesia (RA) may reduce the risk; however, the evidence is weak. The General Anesthesia compared to Spinal anesthesia study is a randomized, controlled trial designed to assess the influence of general anesthesia (

  8. Apnea after Awake Regional and General Anesthesia in Infants : The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial

    NARCIS (Netherlands)

    Davidson, Andrew J; Morton, Neil S; Arnup, Sarah J; de Graaff, Jurgen C; Disma, Nicola; Withington, Davinia E; Frawley, Geoff; Hunt, Rodney W; Hardy, Pollyanna; Khotcholava, Magda; von Ungern Sternberg, Britta S; Wilton, Niall; Tuo, Pietro; Salvo, Ida; Ormond, Gillian; Stargatt, Robyn; Locatelli, Bruno Guido; McCann, Mary Ellen; Absalom, Anthony

    2015-01-01

    BACKGROUND: Postoperative apnea is a complication in young infants. Awake regional anesthesia (RA) may reduce the risk; however, the evidence is weak. The General Anesthesia compared to Spinal anesthesia study is a randomized, controlled trial designed to assess the influence of general anesthesia (

  9. The elderly and general anesthesia

    DEFF Research Database (Denmark)

    Steinmetz, J; Rasmussen, L S

    2010-01-01

    Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th...

  10. Local Anesthesia Combined With Sedation Compared With General Anesthesia for Ambulatory Operative Hysteroscopy

    DEFF Research Database (Denmark)

    Brix, Lone Dragnes; Thillemann, Theis Muncholm; Nikolajsen, Lone

    2016-01-01

    anesthesia combined with sedation (group LA + S; n = 76) or general anesthesia (group GA; n = 77). Primary outcome was the worst pain intensity score in the postanesthesia care unit (PACU) rated by the patients on a numerical rating scale. FINDING: Data from 144 patients were available for analysis (LA + S...... was shorter (P anesthesia with sedation can be recommended as a first choice anesthetic technique for operative ambulatory hysteroscopy....

  11. [General anesthesia for two patients taking methylphenidate (Ritalin)].

    Science.gov (United States)

    Kasuga, Takaho; Meno, Aki; Honda, Masahiro; Momoeda, Kanako; Nagase, Masaki; Hanaoka, Kazuo

    2008-06-01

    We experienced anesthesia care for two patients taking methylphenidate (Ritalin), which is a central nervous system stimulant of amphetamine analogues, usually administered for narcolepsy or refractory depression. The proper dose of methylphenidate is 20-60 mg per day. General anesthesia with epidural anesthesia was administered to both cases for total hip replacement. One patient could discontinue taking methylphenidate five days before the operation, but the other patient could not. Both cases needed more anesthetics than usual on induction, but very stable condition could be maintained during and after the operations. We consider that it is possible to perform general anesthesia safely for patients taking a usual dose of methylphenidate.

  12. Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia

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    LaQuia A. Vinson

    2016-08-01

    Full Text Available The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA or office-based general anesthesia (OBGA in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029. Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

  13. General anesthesia suppresses normal heart rate variability in humans

    Science.gov (United States)

    Matchett, Gerald; Wood, Philip

    2014-06-01

    The human heart normally exhibits robust beat-to-beat heart rate variability (HRV). The loss of this variability is associated with pathology, including disease states such as congestive heart failure (CHF). The effect of general anesthesia on intrinsic HRV is unknown. In this prospective, observational study we enrolled 100 human subjects having elective major surgical procedures under general anesthesia. We recorded continuous heart rate data via continuous electrocardiogram before, during, and after anesthesia, and we assessed HRV of the R-R intervals. We assessed HRV using several common metrics including Detrended Fluctuation Analysis (DFA), Multifractal Analysis, and Multiscale Entropy Analysis. Each of these analyses was done in each of the four clinical phases for each study subject over the course of 24 h: Before anesthesia, during anesthesia, early recovery, and late recovery. On average, we observed a loss of variability on the aforementioned metrics that appeared to correspond to the state of general anesthesia. Following the conclusion of anesthesia, most study subjects appeared to regain their normal HRV, although this did not occur immediately. The resumption of normal HRV was especially delayed on DFA. Qualitatively, the reduction in HRV under anesthesia appears similar to the reduction in HRV observed in CHF. These observations will need to be validated in future studies, and the broader clinical implications of these observations, if any, are unknown.

  14. General Anesthesia with Preserved Spontaneous Breathing through an Intubation Tube

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    V. V. Moroz

    2010-01-01

    Full Text Available Objective: to study whether spontaneous patient breathing may be preserved during elective operations under general anesthesia with tracheal intubation. Subjects and methods. One hundred and twelve patients undergoing elective surgeries under general endotracheal anesthesia were randomized into 2 groups: 1 patients who had forced mechanical ventilation in the volume-controlled mode and 2 those who received assisted ventilation as spontaneous breathing with mechanical support. Conclusion. The study shows that spontaneous breathing with mechanical support may be safely used during some surgical interventions in patients with baseline healthy lungs. Key words: Pressure Support, assisted ventilation, spontaneous breathing, general anesthesia, lung function.

  15. PNEUMOTHORAX AFTER MODIFIED RADICAL MASTECTOMY UNDER GENERAL ANESTHESIA

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    Amminikutty

    2014-11-01

    Full Text Available A 67 yrs old lady who underwent modified Radical mastectomy under General Anesthesia developed pneumothorax in the immediate post-operative period. She was treated with chest tube insertion and was discharged from hospital 8 days later

  16. General Anesthesia for a Patient With Pelizaeus-Merzbacher Disease

    OpenAIRE

    Kamekura, Nobuhito; Nitta, Yukie; Takuma, Shigeru; Fujisawa, Toshiaki

    2016-01-01

    We report the successful management of general anesthesia for a patient with Pelizaeus-Merzbacher disease (PMD). PMD is one of a group of progressive, degenerative disorders of the cerebral white matter. The typical clinical manifestations of PMD include psychomotor retardation, nystagmus, abnormal muscle tone, seizures, and cognitive impairment. General anesthesia for a patient with PMD may be difficult mainly because of seizures and airway complications related to poor pharyngeal muscle con...

  17. Correlation of bupivacaine 0.5% dose and conversion from spinal anesthesia to general anesthesia in cesarean sections

    NARCIS (Netherlands)

    Seljogi, D; Wolff, A P; Scheffer, G J; van Geffen, G J; Bruhn, J

    2016-01-01

    BACKGROUND: Failed spinal anesthesia for cesarean sections may require conversion to general anesthesia. The aim of this study was to determine whether the administered spinal bupivacaine dose for performing a cesarean section under spinal anesthesia was related to the conversion rate to general ane

  18. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair : Data from the General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes

    NARCIS (Netherlands)

    Frawley, Geoff; Bell, Graham; Disma, Nicola; Withington, Davinia E; de Graaff, Jurgen C; Morton, Neil S; McCann, Mary Ellen; Arnup, Sarah J; Bagshaw, Oliver; Wolfler, Andrea; Bellinger, David; Davidson, Andrew J; Absalom, Anthony

    2015-01-01

    BACKGROUND: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes

  19. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair : Data from the General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes

    NARCIS (Netherlands)

    Frawley, Geoff; Bell, Graham; Disma, Nicola; Withington, Davinia E; de Graaff, Jurgen C; Morton, Neil S; McCann, Mary Ellen; Arnup, Sarah J; Bagshaw, Oliver; Wolfler, Andrea; Bellinger, David; Davidson, Andrew J

    2015-01-01

    BACKGROUND: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes

  20. Awareness during general anesthesia: An Indian viewpoint

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    Reshma P Ambulkar

    2016-01-01

    Conclusion: Awareness under anesthesia is a distressing complication with a potential for long-term psychological consequences, and every effort should be undertaken to prevent it. It is reassuring though that our data in Indian cancer patients at high risk for intra-operative awareness suggests that it is an uncommon occurrence.

  1. A Wavelet Transform Based Method to Determine Depth of Anesthesia to Prevent Awareness during General Anesthesia

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    Seyed Mortaza Mousavi

    2014-01-01

    Full Text Available Awareness during general anesthesia for its serious psychological effects on patients and some juristically problems for anesthetists has been an important challenge during past decades. Monitoring depth of anesthesia is a fundamental solution to this problem. The induction of anesthesia alters frequency and mean of amplitudes of the electroencephalogram (EEG, and its phase couplings. We analyzed EEG changes for phase coupling between delta and alpha subbands using a new algorithm for depth of general anesthesia measurement based on complex wavelet transform (CWT in patients anesthetized by Propofol. Entropy and histogram of modulated signals were calculated by taking bispectral index (BIS values as reference. Entropies corresponding to different BIS intervals using Mann-Whitney U test showed that they had different continuous distributions. The results demonstrated that there is a phase coupling between 3 and 4 Hz in delta and 8-9 Hz in alpha subbands and these changes are shown better at the channel T7 of EEG. Moreover, when BIS values increase, the entropy value of modulated signal also increases and vice versa. In addition, measuring phase coupling between delta and alpha subbands of EEG signals through continuous CWT analysis reveals the depth of anesthesia level. As a result, awareness during anesthesia can be prevented.

  2. Cardiac Dysrhythmias with General Anesthesia during Dental Surgery

    OpenAIRE

    Rodrigo, Chandra R.

    1988-01-01

    Dysrhythmias with general anesthesia during dental surgery have been frequently reported. The incidence appears higher in spontaneously breathing patients lightly anesthetized with halothane. Anxiety, sitting posture, hypoxia, Chinese race, and heart disease appear to aggravate the condition. Use of beta blockers or lidocaine prior to anesthesia, intravenous induction, controlled ventilation with muscle relaxants, and use of isoflurane or enflurane in spontaneously breathing patients appear t...

  3. CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoud, Mohamed [Cincinnati Children' s Hospital Medical Center, Department of Anesthesiology, Cincinnati, OH (United States); Towe, Christopher [Cincinnati Children' s Hospital Medical Center, Department of Pulmonary Medicine, Cincinnati, OH (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2015-07-15

    Today's practice of medicine involves ever more complex patients whose care is coordinated with multidisciplinary teams. Caring for these patients can challenge all members of the health care team. Sedation/anesthesia in infants/toddlers as well as uncooperative or intellectually or emotionally impaired children who require imaging studies of the chest are ongoing challenges. High-quality computed tomography (CT) chest imaging studies in children under general anesthesia are extremely important for accurate interpretation and subsequent medical decision-making. Anesthesia-induced atelectasis may obscure or mimic true pathology creating a significant quality issue. Obtaining a high-quality, motion-free chest imaging study in infants and children under general anesthesia remains a difficult task in many institutions. Meticulous attention to anesthesia and imaging techniques and specialized knowledge are required to properly perform and interpret chest imaging studies. In this commentary, we discuss the continuous struggle to obtain high-quality CT chest imaging under general anesthesia. We will also discuss the major concerns of the anesthesiologist, radiologist and pulmonologist and why cooperation and coordination among these providers are critical for an optimal quality study.

  4. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

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    Donmez T

    2016-10-01

    Full Text Available Turgut Donmez,1 Vuslat Muslu Erdem,2 Oguzhan Sunamak,3 Duygu Ayfer Erdem,2 Huseyin Imam Avaroglu1 1Department of General Surgery, 2Department of Anesthesiology and Reanimation, Lutfiye Nuri Burat State Hospital, 3Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Background: Laparoscopic total extraperitoneal (TEP inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA. To date, no reports compare the efficacy of spinal anesthesia (SA with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. Materials and methods: Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I or the SA TEP group (Group II. Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg and fentanyl (10 µg were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation. Results: All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (P<0.0001 and 4 h (P=0.002 after the procedure for the SA and GA groups, respectively. There was no difference between the two groups regarding complications, hospital stay, recovery, or surgery time. Generally, patients were more satisfied with SA than GA (P<0.020. Conclusion: TEP inguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better

  5. General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

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    Lucía Vizcaíno-Martínez

    2014-01-01

    Full Text Available Objective: The aim was to evaluate general anesthesia (GA plus ilioinguinal nerve block (IIB versus spinal anesthesia (SA in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications. Materials and Methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, maintenance with sevoflurane, airway management with laryngeal mask allowing spontaneous ventilation and ultrasound-guided IIB; SA group, patients who underwent spinal block with 2% mepivacaine. The study variables were pain intensity, assessed by visual analog scale, analgesic requirements until hospital discharge, time to ambulation and discharge, postoperative complications-related to both techniques and satisfaction experienced. Results: Thirty-two patients were enrolled; 16 patients in each group. The differences regarding pain were statistically significant at 2 h of admission (P < 0.001 and at discharge (P < 0.001 in favor of the GA plus ilioinguinal block group. In addition in this group, analgesic requirements were lower than SA group (P < 0.001, with times of ambulation and discharge significantly shorter. The SA group had a higher tendency to develop complications and less satisfaction. Conclusion: General anesthesia plus IIB is better than SA regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients.

  6. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    OpenAIRE

    2016-01-01

    Turgut Donmez,1 Vuslat Muslu Erdem,2 Oguzhan Sunamak,3 Duygu Ayfer Erdem,2 Huseyin Imam Avaroglu1 1Department of General Surgery, 2Department of Anesthesiology and Reanimation, Lutfiye Nuri Burat State Hospital, 3Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Background: Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). ...

  7. Remifentanil consumption in septoplasty surgery under general anesthesia

    Science.gov (United States)

    Al-Mustafa, Mahmoud M.; Al Oweidi, Abdelkarim S.; Al-Zaben, Khaled R.; Qudaisat, Ibraheem Y.; Abu-Halaweh, Sami A.; Al-Ghanem, Subhi M.; Massad, Islam M.; Samarah, Walid K.; Al-Shaer, Reem A.; Ismail, Said I.

    2017-01-01

    Objectives: To evaluate the influence of the ORM1 variants in codon 118 on the intra-operative remifentanil consumption under general anesthesia. Methods: A prospective gene association study, performed at the Jordan University Jordan, Amman, Jordan from September 2013 to August 2014. It includes patients who underwent septoplasty surgery under general anesthesia. All patients received standard intravenous anesthesia. Anesthesia maintained with fixed dose of Sevoflurane and variable dose of Remifentanil to keep the systolic blood pressure between 90-100 mm Hg. The Remifentanil dose was calculated and correlated with ORM1 genotype variance. Results: Genotype and clinical data were available for 123 cases. The A118A genotype was seen in 96 patients (78%), the A118G genotype was seen in 25 patients (20.3%), and only 2 patients had genotype G118G (1.6%). The G118G variant was removed from the statistical analysis due to small sample size. There was a significant effect of ORM1 genotype variant and the amount of remifentanil consumed. The A118A genotype received 0.173 ± 0.063 µg kg-1 min-1 and the A118G genotype received 0.316 ± 0.100 µg kg-1 min-1 (p<0.0001). Conclusion: The ORM1 gene has a role in intra-operative remifentanil consumption in patients who underwent septoplasty surgery under general anesthesia. The A118G gene required higher dose of remifentanil compared with the A118A genotype. PMID:28133690

  8. SURVEILLANCE OF BACTERIAL CONTAMINATION OF ANESTHESIA MACHINE AND PERIPHERAL INTRAVENOUS CANNULA DURING GENERAL ANESTHESIA

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    Ch. Srinivas

    2015-01-01

    Full Text Available BACKGROUND: Given the expanding role of the anesthesiologist as the “total perioperative physician,” the increasing number of invasive procedures performed by anesthesiologists, and the increase in the prevalence of emerging diseases, stringent attention to infection control practices is paramount. AIM : To find out the bacterial contamination of anesthesia machine and internal lumen of the injection port of peri pheral intravenous cannula, and evaluation of its risk factors during general anesthesia procedures. MATERIALS AND METHODS: 50 general anaesthesia procedures were selected randomly after the approval of ethics committee and informed consent from the patien t. Samples were taken for bacterial culture on 2 sites in anesthesia machine (Adjustable pressure limiting valve {APL} and agent concentration dial of inhaled anesthetics{AD} and internal lumen of the injection port of peripheral intravenous cannula befor e starting and after completion of procedures. Bacteria and colony count were identified according to standard laboratory methods . RESULTS : Adjustable pressure limiting valve area was contaminated with bacteria in 12% (6/50 before starting procedure and 34% (17/50 after completion of procedures. Agent concentration dial of inhaled anesthetic site was contaminated with bacteria in 10% (5/50 before starting procedure and 28% (14/50 after completion of procedures. Bacterial contamination occurred in the i nternal lumen of the injection port of peripheral intravenous cannula in 16% (8/50 during general anesthesia. Isolated bacteria in anesthesia machine and peripheral intra venous cannula sites are STAPHYLO COCCI, STREPTOCOCCI, MICRO COCCI, ENTERO COCCI, E. COLI, and PSEUDOMONAS . CONCLUSION: Bacterial contamination is significantly associated with procedure order in a day (bacterial contamination rate is increased from first procedure to fifth procedure in a day. It is significantly associated with surgical s pecialty highest in

  9. Combined spinal and general anesthesia is better than general anesthesia alone for laparoscopic hysterectomy

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    Poonam S Ghodki

    2014-01-01

    Full Text Available Context: Spinal anesthesia (SA was combined with general anesthesia (GA for achieving hemodynamic stability in laparoscopic hysterectomy. Aims: The aim of our study was to evaluate the impact of SA combined with GA in maintaining hemodynamic stability in laparoscopic hysterectomy. The secondary outcomes studied were requirement of inhaled anesthetics, vasodilators, and recovery profile. Settings and Design: We conducted a prospective, randomized study in ASAI/II patients posted for laparoscopic hysterectomy, who were willing to participate in the study. Materials and Methods: Patients were randomly assigned to receive SA with GA (group SGA or plain GA (group GA. Group SGA received 10 mg bupivacaine (heavy for SA. GA was administered using conventional balanced technique. Maintenance was carried out with nitrous oxide, oxygen, and isoflurane. Comparison of hemodynamic parameters was carried out during creation of pneumoperitoneum and thereafter. Total isoflurane requirement, need of vasodilators, recovery profile, and regression of SA were studied. Statistical analysis used: Descriptive statistics in the form of mean, standard deviation, frequency, and percentages were calculated for interval and categorical variables, respectively. One-way analysis of variance (ANOVA was applied for noting significant difference between the two groups, with chi-square tests for categorical variables and post-hoc Bonferroni test for interval variables. Comparison of heart rate (HR, mean arterial pressure (MAP, SPO2, and etCO2 was done with Student′s t-test or Mann-Whitney test, wherever applicable. Results: Patients in group SGA maintained stable and acceptable MAP values throughout pneumoperitoneum. The difference as compared to group GA was statistically significant (P < 0.01. Group GA showed additional requirement of metoprolol (53.33% and higher concentration of isoflurane (P < 0.001 to combat the increased MAP. Recovery was early and quick in group SGA as

  10. COMPARATIVE STUDY OF SPINAL ANESTHESIA AND GENERAL ANESTHESIA IN CHILDREN UNDERGOING SURGERIES BELOW UMBILICUS

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    Ashish

    2014-09-01

    Full Text Available AIM: Aim of our study to compare the spinal anaesthesia and general anaesthesia in children undergoing surgeries below umbilicus. OBJECTIVE: to assess the patient comfort in pt. with GA and pt. with spinal anaesthesia, the adequate surgical condition, assess the hemodynamic change, assess the post op analgesia and to assess the post op complication. MATERIAL AND METHOD: 60 ASA grade I & II children of either sex, aged 5-12 yrs undergoing elective surgeries for the lower abdominal, perineal and lower limb surgeries were taken. After taking a detailed history, thorough general physical examination, all pertinent investigation were carried out to exclude any systemic disease. Patients were classified randomly into 2 groups (30 patients in each group. Group A: General anesthesia was given. Group P: subarachnoid block was given. Intraoperative monitoring consisted of SPO2, PR, NIBP, RR and assessment of duration of post-operative analgesia. P-value <0.05 consider significant. RESULT: Analysis revealed that there were no significant differences between the patients with respect to age, sex, duration and type of surgery In SAB since less general anaesthetic drug including parental opioid are used the risk and postoperative respiratory depression is minimal. The stress response to surgery is also limited and recovery is fast. Postoperatively complications like sore throat, laryngeal irritation, cough etc. was also less associated with it. CONCLUSION pediatric spinal anesthesia is not only a safe alternative to general anesthesia but often the anesthesia technique of choice in many lower abdominal and lower limb surgeries in children. The misconception regarding its safety and flexibility is broken and is now found to be even more cost effective. It is much preferred technique special for common day case surgeries generally performed in the pediatric age group.

  11. Fetal heart rate changes associated with general anesthesia.

    Science.gov (United States)

    Fedorkow, D M; Stewart, T J; Parboosingh, J

    1989-07-01

    Decreased fetal heart rate variability was noted 90 seconds after the induction of general anesthesia with sodium thiopentone and fentanyl in a patient undergoing basket extraction of a renal calculus at 30 weeks' gestation. The fetal sleep pattern lasted for 105 minutes after the anesthetic was discontinued, 45 minutes after the mother was fully awake.

  12. [General anesthesia for a pregnant patient with PAPA syndrome].

    Science.gov (United States)

    Ohno, Seika; Ariyama, Jun; Tsujita, Miki; Ueshima, Hironobu; Imanishi, Hirokazu; Terao, Kazuhisa; Mieda, Tsutomu; Kitamura, Akira

    2014-08-01

    A 31-year-old female, with 22 weeks of pregnancy, presented with sudden onset of severe headache. CT scan showed diffuse subarachnoid hemorrhage. A cerebral angiogram showed dissecting aneurysm of right cerebral artery. To obliterate the aneurysm and prevent rupture, the patient underwent coil embolization via an endovascular approach under general anesthesia because the procedure under sedation with local anesthesia was too risky for re-bleeding. The patient has been diagnosed as PAPA syndrome. Although the arthritis was now stable and she was taking no drug, remarkable osteoarthritis was observed. The cervical spine X ray demonstrated no cervical ankylosis. As patient was sedated with propofol, airway examination could not be done except noticing thyromental distance of seven centimeters. Patient's trachea was intubated using Macintosh size #3 laryngoscope blade and a 7.0 non-styletted tracheal tube at the first attempt without any problems (Cormack grade I). Anesthesia was maintained with sevoflurane, fentanyl and remifentanil. After the end of endovascular surgery, the patient was transferred to the intensive care unit under mechanical ventilation. She was weaned from mechanical ventilation 2 days later but consciousness was unclear. Right incomplete paralysis was also observed. MRI revealed vasospasm on the bilateral internal carotid artery. The patient underwent percutaneous tansluminalangioplasty coil and intraarterial injection of fasudil hydrochloride under local anesthesia. The consciousness recovered fully and the paralysis was improved. The patient delivered the baby by Caesarean sections under combined spinal and epidural anesthesia at 36 weeks without any problems with both the mother and baby.

  13. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    Science.gov (United States)

    Donmez, Turgut; Erdem, Vuslat Muslu; Sunamak, Oguzhan; Erdem, Duygu Ayfer; Avaroglu, Huseyin Imam

    2016-01-01

    Background Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). To date, no reports compare the efficacy of spinal anesthesia (SA) with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. Materials and methods Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I) or the SA TEP group (Group II). Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg) and fentanyl (10 µg) were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation. Results All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (Pinguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better patient satisfaction than GA. PMID:27822053

  14. Influence of local mucosal anesthesia combined with non tracheal intubation general anesthesia on EMR patients' intra-operative serum indexes

    Institute of Scientific and Technical Information of China (English)

    Sheng-Yong Liang

    2015-01-01

    Objective:To analyze the influence of local mucosal anesthesia combined with non tracheal intubation general anesthesia on EMR patients’ intra-operative serum indexes.Methods: 162 patients who received EMR from September 2013 to September 2014 in our hospital were enrolled and randomly divided into the observation group, including 81 cases, who received local mucosal anesthesia combined with non tracheal intubation general anesthesia, and the control group, including 81 cases, who received local mucosal anesthesia combined with routine tracheal intubation general anesthesia. Then inflammation index, stress index and immune index, etc were compared.Results:1) after general anesthesia, serum cytokine levels of IL-23, IL-32, PCT,β-EP and TNF-α, etc of the observation group were all significantly lower than those of the control group(P<0.05); 2) after general anesthesia, serum cytokine levels of COR, ET, TH and Ins, etc of the observation group were significantly lower than those of the control group(P<0.05); 3) after general anesthesia, serum levels of sICAM 1, CD11b, CD18 and CD20 of the observation group were lower than those of the control group; CD56 level was higher than that of the control group(P<0.05).Conclusion:Local mucosal anesthesia combined with non tracheal intubation general anesthesia provides sufficient anesthetic depth for EMR patients, and at the same time, can effectively reduce intra-operative systemic inflammatory response and stress response and contribute to the protection of body's immune function.

  15. The thermodynamics of general and local anesthesia

    CERN Document Server

    Graesboll, Kaare; Heimburg, Thomas

    2014-01-01

    General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. This analysis is able to describe experimentally observed calorimetric profiles and permits prediction of the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff-effect of long-chain alcohols and the additivity of the effect of general and local anesthetics.

  16. [Epidural analgesia in combination with general anesthesia].

    Science.gov (United States)

    Gottschalk, Antje; Poepping, Daniel M

    2015-07-01

    Epidural anaesthesia is a widely used and accepted technique for perioperative analgesia in different kinds of surgery. Apart from analgetic effect and due to wide positve effects on patients outcome epidural analgesia is often used with general anaesthesia. It represents a reliable and reversible neural deafferentation technique that effectively contributes to a reduction of the surgical stress response with subsequent positive effects on cardiopulmonary, gastrointestinal, and immune function. Animal studies suggest that the use of epidural anaesthesia may be beneficial for cancer surgery because of less tumour recurrence. Further, a benefit is expected in patient's mortality. This article summarizes and critically discusses the current knowledge on the effects of epidural anaesthesia on pain management, cardiopulmonary as well as gastrointestinal functions and patient's outcome.

  17. Postoperative rhabdomyolysis following pars-plana vitrectomy under general anesthesia

    OpenAIRE

    Campbell JP; Soelberg C; Lauer AK

    2013-01-01

    John P Campbell,1 Cobin Soelberg,2 Andreas K Lauer11Retina Division, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA; 2Division of Anesthesiology, Oregon Health and Science University, Portland, OR, USAImportance: Rhabdomyolysis is a known, but rare, complication of general anesthesia. To the authors' knowledge, it has never before been reported following an ocular surgery, and we could find no similar cases in the surgical literature following any brief s...

  18. Postoperative rhabdomyolysis following pars-plana vitrectomy under general anesthesia

    Directory of Open Access Journals (Sweden)

    Campbell JP

    2013-08-01

    Full Text Available John P Campbell,1 Cobin Soelberg,2 Andreas K Lauer11Retina Division, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA; 2Division of Anesthesiology, Oregon Health and Science University, Portland, OR, USAImportance: Rhabdomyolysis is a known, but rare, complication of general anesthesia. To the authors' knowledge, it has never before been reported following an ocular surgery, and we could find no similar cases in the surgical literature following any brief surgical procedure. We believe this case to be unique in those regards and aim to raise awareness among ophthalmologists of this postoperative complication, as timely intervention can prevent renal failure and death.Observations: We report the case of a 58-year-old male who developed rhabdomyolysis following vitrectomy for retinal detachment repair under general anesthesia. The patient had several risk factors for this complication including morbid obesity, type II diabetes mellitus, and American Society of Anesthesia class III risk profile. His postoperative course was notable for significant myalgias in the postoperative recovery area, followed several hours later by oliguria, "root beer" colored urine, and a markedly elevated creatinine kinase level. He was hospitalized for two days for intravenous hydration and monitoring of his renal function and has fully recovered.Relevance: As the prevalence of obesity and type II diabetes mellitus increase worldwide, ophthalmologists need to be aware of the signs and symptoms of postoperative rhabdomyolysis. Treatment often requires inpatient hospitalization to prevent the associated morbidity and mortality.Keywords: rhabdomyolysis, general anesthesia, vitrectomy, retinal detachment, obesity, diabetes

  19. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study...... was to investigate the effect of anesthesia and surgery on serum tryptase in the absence of anaphylaxis....

  20. Breast augmentation under general anesthesia versus monitored anesthesia care: a retrospective comparative study.

    Science.gov (United States)

    Eldor, Liron; Weissman, Avi; Fodor, Lucian; Carmi, Nurit; Ullmann, Yehuda

    2008-09-01

    Breast augmentation is one of the leading esthetic surgeries, enjoying high satisfaction rates. Pain, nausea, and vomiting are frequent shortcomings of the immediate postoperative period. The aim of this study was to compare breast augmentation from the anesthetic point of view: general anesthesia (GA) versus monitored anesthesia care (MAC). The charts of 115 patients were reviewed in this retrospective study performed over a period of 2 years. Sixty-nine women chose to have the surgery done under MAC, and 46 under GA. Statistically significant differences were noted in both postoperative hospital stay (16.1 +/- 6.78 hours vs. 11.7 +/- 6.10 hours) and frequency of vomiting (mean, 0.5 vs. 0.22 times per patient) after GA and MAC, respectively (Mann-Whitney, P < 0.01). Postoperative pain, assessed using the visual analog scale, was significantly higher (mean visual analog scale, 5 vs. 3.27) when the prosthesis was placed in the submuscular plane compared with the subglandular plane (Mann-Whitney, P = 0.043). When offered a choice, more women preferred MAC over GA for their breast augmentation procedure. Less vomiting and shorter postoperative hospitalization were prominent in the MAC group.

  1. [Use of general anesthesia during fiber colonoscopy in cancer patients].

    Science.gov (United States)

    Zamiralova, O Ia; Shcherbakov, A M; Evtiukhin, A I

    2002-01-01

    The evidence on the attitude of 60 cancer out-patients to fibrocolonoscopy carried out under general anesthesia was evaluated versus different procedures of intravenous injection. Most patients were scared prior to examination; 83.3% felt sleepy during the procedure while 85% of those anesthetized wouldn't mind receiving narcosis for repeat examination. Propofol (diprivan) alone showed an advantage over midazolam (dormicum) in being more tolerable and cutting stay at hospital by a third. Ketamin proved undesirable due to psychomimetic effects and delayed regaining of consciousness.

  2. General anesthesia for the heaviest man in the world

    Directory of Open Access Journals (Sweden)

    Abdullah S Terkawi

    2014-01-01

    Full Text Available The prevalence of obesity has increased greatly over the last 20 years, resulting in an increase in the number of bariatric and nonbariatric surgeries in this population. We present the case of a 20-year-old male, weighing 610 kg (1345 lb, and believed to be the heaviest living man in the world. After 4 months of rigorous in-hospital weight reduction, now weighing 510 kg (1125 lb, he underwent a laparoscopic gastric sleeve procedure under general anesthesia. This report describes the management of his anesthetic and exemplifies the challenges associated with this patient population.

  3. Effect of general anesthesia and orthopedic surgery on serum tryptase

    DEFF Research Database (Denmark)

    Garvey, Lene H; Bech, Birgitte Louise; Mosbech, Holger;

    2010-01-01

    Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to inve...

  4. Subarachnoid versus General Anesthesia in Penile Prosthetic Implantation: Outcomes Analyses

    Directory of Open Access Journals (Sweden)

    Gerard D. Henry

    2012-01-01

    Full Text Available The leading patient complaint during the perioperative period for penile prosthesis implantation is postoperative pain, while emesis and urticaria also affect the procedure’s perceived success. In analyzing surgical outcomes, assessment of the anesthetic for postoperative pain and side effects should be included. This paper retrospectively reviews 90 consecutive, primary inflatable penile prosthetic operations performed by a single surgeon at one private medical center. Fifty-seven patients were included in final analysis. Patients who had more than one procedure that day or who used chronic pain medication were excluded. The type and amount of each drug used for each respective side effect (within the first 24 hours after procedure were compared to determine relative benefit. Twenty patients received general anesthesia (denoted herein as “GA” and 37 received spinal (or also known as subarachnoid anesthesia (denoted herein as “SA”. Patients receiving GA had significantly greater (P<0.0001 occurrence and amount of intravenous pain treatment than those receiving SA. Patients with SA required less intravenous pain medication and less treatment for nausea/emesis.

  5. Postoperative Submandibular Gland Swelling following Craniotomy under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Haruka Nakanishi

    2015-01-01

    Full Text Available Objective. Reporting of a rare case of postoperative submandibular gland swelling following craniotomy. Case Report. A 33-year-old male underwent resection for a brain tumor under general anesthesia. The tumor was resected via a retrosigmoid suboccipital approach and the patient was placed in a lateral position with his face down and turned to the right. Slight swelling of the right submandibular gland was observed just after the surgery. Seven hours after surgery, edematous change around the submandibular gland worsened and he required emergent reintubation due to airway compromise. The cause of submandibular gland swelling seemed to be an obstruction of the salivary duct due to surgical positioning. Conclusion. Once submandibular swelling and edematous change around the submandibular gland occur, they can worsen and compromise the air way within several hours after operation. Adequate precaution must be taken for any predisposing skull-base surgery that requires strong cervical rotation and flexion.

  6. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial

    DEFF Research Database (Denmark)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels

    2016-01-01

    RATIONALE: Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes...... compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. AIM AND HYPOTHESIS: The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether....... Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. STUDY OUTCOMES: The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary...

  7. Prolonged analgesia following preoperative bupivacaine neural blockade for oral surgery performed under general anesthesia.

    Science.gov (United States)

    Chapman, P J; Ganendran, A

    1987-03-01

    The effectiveness of prolonged neural blockade following removal of impacted third molars under general anesthesia was evaluated in a controlled clinical study. There was a significant reduction in the amount of postoperative pain experienced, and no complications, either local or systemic, occurred. The technique has advantages, especially when general anesthesia is administered to outpatients.

  8. Effect of general anesthesia and major versus minor surgery on late postoperative episodic and constant hypoxemia

    DEFF Research Database (Denmark)

    Rosenberg, J; Oturai, P; Erichsen, C J;

    1994-01-01

    STUDY OBJECTIVE: To evaluate the relative contribution of general anesthesia alone and in combination with the surgical procedure to the pathogenesis of late postoperative hypoxemia. DESIGN: Open, controlled study. SETTING: University hospital. PATIENTS: 60 patients undergoing major abdominal...... surgery and 16 patients undergoing middle ear surgery, both with comparable general anesthesia. MEASUREMENTS AND MAIN RESULTS: Patients were monitored with continuous pulse oximetry on one preoperative night and the second postoperative night. Significant episodic or constant hypoxemia did not occur...... on the second postoperative night following middle ear surgery and general anesthesia, but severe episodic and constant hypoxemia did occur on the second postoperative after major abdominal surgery and general anesthesia. CONCLUSIONS: General anesthesia in itself is not an important factor in the development...

  9. Effect of general anesthesia in infancy on long-term recognition memory in humans and rats.

    Science.gov (United States)

    Stratmann, Greg; Lee, Joshua; Sall, Jeffrey W; Lee, Bradley H; Alvi, Rehan S; Shih, Jennifer; Rowe, Allison M; Ramage, Tatiana M; Chang, Flora L; Alexander, Terri G; Lempert, David K; Lin, Nan; Siu, Kasey H; Elphick, Sophie A; Wong, Alice; Schnair, Caitlin I; Vu, Alexander F; Chan, John T; Zai, Huizhen; Wong, Michelle K; Anthony, Amanda M; Barbour, Kyle C; Ben-Tzur, Dana; Kazarian, Natalie E; Lee, Joyce Y Y; Shen, Jay R; Liu, Eric; Behniwal, Gurbir S; Lammers, Cathy R; Quinones, Zoel; Aggarwal, Anuj; Cedars, Elizabeth; Yonelinas, Andrew P; Ghetti, Simona

    2014-09-01

    Anesthesia in infancy impairs performance in recognition memory tasks in mammalian animals, but it is unknown if this occurs in humans. Successful recognition can be based on stimulus familiarity or recollection of event details. Several brain structures involved in recollection are affected by anesthesia-induced neurodegeneration in animals. Therefore, we hypothesized that anesthesia in infancy impairs recollection later in life in humans and rats. Twenty eight children ages 6-11 who had undergone a procedure requiring general anesthesia before age 1 were compared with 28 age- and gender-matched children who had not undergone anesthesia. Recollection and familiarity were assessed in an object recognition memory test using receiver operator characteristic analysis. In addition, IQ and Child Behavior Checklist scores were assessed. In parallel, thirty three 7-day-old rats were randomized to receive anesthesia or sham anesthesia. Over 10 months, recollection and familiarity were assessed using an odor recognition test. We found that anesthetized children had significantly lower recollection scores and were impaired at recollecting associative information compared with controls. Familiarity, IQ, and Child Behavior Checklist scores were not different between groups. In rats, anesthetized subjects had significantly lower recollection scores than controls while familiarity was unaffected. Rats that had undergone tissue injury during anesthesia had similar recollection indices as rats that had been anesthetized without tissue injury. These findings suggest that general anesthesia in infancy impairs recollection later in life in humans and rats. In rats, this effect is independent of underlying disease or tissue injury.

  10. [Characteristic features of systemic hemodynamics during cesarean section under general anesthesia with ketamine].

    Science.gov (United States)

    Moiseev, V N

    1983-02-01

    On the basis of a comparative investigation of the central hemodynamics by the method of integrative rheography of the body in two groups of women during the operation of cesarean section under general anesthesia with ether or ketamin the author makes a conclusion that ketamin is a good drug for anesthesia in urgent surgical situations.

  11. GENERAL ANESTHESIA: IS IT SAFE FOR NEWBORNS, INFANTS AND YOUNG CHILDREN ?

    Directory of Open Access Journals (Sweden)

    Nancheva Jasminka

    2016-07-01

    Full Text Available The exposure of neonates, infants and small children to general anesthesia is becoming a common occurrence. Accumulating preclinical data indicate that exposure to commonly used general anesthetic agents during key periods of brain development in this population(between late gestation and 3 to 4 years of age, can lead to apoptotic neurodegeneration, synapse loss, and cognitive and neurobehavioral deficits that persist as the organism matures. New work suggests that infants and small children undergoing some types of surgery could have better recovery if they receive regional anesthesia rather than general anesthesia. In response to this concerns, the Food and drug administration (FDA and the International Research Society in anesthesia (IARS started an initiative called Smart Tots (Strategies for Mitigating Anesthesia- related neuro Toxicity in Tots which examine the effects of anesthesia on brain development. Also another two major prospective studies are ongoing in children : PANDA (Pediatric Anesthesia Neurodevelopment assessment Study project is a large, multi-center study based at the Morgan Stanley Children’s Hospital of New York at Columbia University, and another one is GAS study which is a multisite randomized controlled trial comparing neurodevelopment outcomes in infant receiving general anesthesia compared to spinal and other regional anesthetics to the stress response to surgery. The findings from these studies will help researches to design the safest anesthetic regimens and to develop the new and safer anesthetic drugs for use in pediatric medicine.

  12. Postoperative Pain in Children After Dentistry Under General Anesthesia.

    Science.gov (United States)

    Wong, Michelle; Copp, Peter E; Haas, Daniel A

    2015-01-01

    The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R ≥ 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P < .001, Wilcoxon matched pairs signed rank test). Moderately good correlation between the 2 pain measures existed 2 and 12 hours from discharge (Spearman rhos correlation coefficients of 0.604 and 0.603, P < .005). In conclusion, children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics.

  13. Severe Anisocoria after Oral Surgery under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Francesco Inchingolo, Marco Tatullo, Fabio M. Abenavoli, Massimo Marrelli, Alessio D. Inchingolo, Bruno Villabruna, Angelo M. Inchingolo, Gianna Dipalma

    2010-01-01

    Full Text Available Introduction. Anisocoria indicates a difference in pupil diameter. Etiologies of this clinical manifestation usually include systemic causes as neurological or vascular disorders, and local causes as congenital iris disorders and pharmacological effects.Case Report. We present a case of a 47-year-old man, suffering from spastic tetraparesis. After the oral surgery under general anesthesia, the patient developed severe anisocoria: in particular, a ~4mm diameter increase of the left pupil compared to the right pupil.We performed Computed Tomography (CT in the emergency setting, Nuclear magnetic resonance (NMR of the brain and Magnetic Resonance Angiography of intracranial vessels. These instrumental examinations did not show vascular or neurological diseases. The pupils returned to their physiological condition (isocoria after about 180 minutes.Discussion and Conclusions. Literature shows that the cases of anisocoria reported during or after oral surgery are rare occurrences, especially in cases of simple tooth extraction. Anisocoria can manifest in more or less evident forms: therefore, it is clear that knowing this clinical condition is of crucial importance for a correct and timely resolution.

  14. A comparative study of pain following endodontic treatment under general anesthesia

    Directory of Open Access Journals (Sweden)

    Feizi Ghader

    2015-01-01

    Full Text Available   Background and Aims: Postoperativee endodontic pain is an outstanding problem for dental patients. Therefore, a successful management of endodontic pain has become as one of the main dental objectives. The aim of the present study was to compare the postoperative endodontic pain in patients under general anesthesia versus local anesthesia.   Materials and Methods: For conducting this clinical trial study, 50 patients having mandibular molars candidate for root canal therapy were selected. Twenty-five patients treated under general anesthesia because of their fear, anxiety or gag reflex. Other 25 patients treated under local anesthesia. All teeth were prepared using engine-driven rotary system in a crown-down technique and filled using lateral condensation technique. Heft- parker visual analog scale was used to measure the degree of pain at 6, 12, 24, and 48 hours after the treatment. Mann-Whitney, Chi-square, and T-tests were used to compare the intensity of postoperative pain between the groups.   Results: The mean intensity of postoperative pain in local and general anesthesia groups at 6, 12 and 24 hours had statistically significant difference (P<0.05.   Conclusion: Postoperative pain in patients who treated under general anesthesia was significantly less than the patients who treated under local anesthesia.

  15. The Comparison Of Total Intravenous Anesthesia (Propofol, Alfentanyl Plus Midazolam, Alfentanyl With General Anesthesia In D&C Patients

    Directory of Open Access Journals (Sweden)

    Shoeibi G

    2004-07-01

    Full Text Available Background: Total Intravenous Anesthesia (TIVA compared to general anesthesia has some pits and falls. Many drugs have been employed for this anesthesia. Propofol is accounted as the last advent anesthetic drug. It belongs to alkyl phenol families and has been accounted one of the best choices for the continuous infusion. Invention of midazolam as the first water soluble benzodiazepine was also an important event in anesthesia and it can be used as continuous infusion for the anesthesia. Materials and Methods: In this randomized controlled clinical trial, alfentanyl plus propofol or midazolam were used for TIVA anesthesia in 60 female patients undergoing Dilatation and Curettage (D&C in Dr.Shariati hospital in March 2002 till March 2003. They were allocated reandomly in two group of alfentanyl plus propofol (propofol group or alfentanyl plus midazolam (midazolam group Results: There was no significant difference in mean of age between propofol group and midazolam group (P>0.05, also There was no significant difference in preanesthesia condition such as blood pressure and heart rate between propofol group and midazolam group (p>0.05. After induction of anesthesia there was a gross blood pressure decrease in both group that it was greater in midazolam group (85 mmHg versus 73 mmHg, P0.05 also there was just one naloxane injection in midazolam group that have no significant difference between groups (P>0.05. Recovery room stay was significantly lower in propofol group (25 minutes versus 39 minutes, P<0.05. Conclusion: The results of this study was similar to Vuyk et.al.In their study there was a significant lower recovery time estimated by psychomotor reflexes and there was significant lower drowsiness, place and time orientation time compared to midazolam group. Finally according to the results of this study it can be resulted that TIVA with propofol is more suitable than midazolam and it can lower hospitalization time and cost. In future studies

  16. Prevalence and specifications of postoperative sore throat following general endotracheal anesthesia in patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Zeynab Maghsood-Taleghani

    2007-01-01

    Full Text Available Introduction: Tracheal intubation is a standard technique for the performance of general anesthesia which might lead to stress in patient. This study has been done to evaluate prevalence and specifications of postoperative sore throat following general endotracheal anesthesia in patients undergoing open reduction surgery of extremity limbs fractures.Methods and Materials: In this cross-sectional study a number of 78 patients with 15-65 year old undergoing open reduction surgery of extremity limbs fractures were selected upon to researcher characteristics and in un-randomized sampling. Sensory, affective, intensity and general condition of pain were assessed in 1 and 24 hour after general anesthesia and extubation by using McGill Pain Questionnaire-Short Form (MPQ-SF questionnaire. Results: Upon to result, average age was 29 year and base on McGill Pain Questionnaire-Short Form (MPQ-SF questionnaire results, average score of sensory components of sore throat, 1 and 24 hour after general anesthesia was 3.42 and 1.2 respectively, and average score of affective components of sore throat 1 and 24 hour after general anesthesia was 1.14 and.46 respectively, and average score of sore throat intensity, 1 and 24 hour after general anesthesia was 3.51 and 1.18, respectively. 75.6% of patients had sore throat 1 hour after general anesthesia and 24 hour after decrease to 29.5%. In general, the majority of patients (33.3% said that their sore throat intensity is discomforting. Pair t test revealed a significant difference between sensory and affective components and also intensity of sore throat in 1 and 24 hour after general anesthesia. Average score of sore throat intensity in females was greater than males. Pearson correlation test revealed a significant difference between age and sore throat intensity in 24 hour after general anesthesia.Conclusion: According to results of this study, awareness to complication following general endotracheal anesthesia and

  17. Inflammatory Profile of Awake Function-Controlled Craniotomy and Craniotomy under General Anesthesia

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    Markus Klimek

    2009-01-01

    Results. Plasma IL-6 level significantly increased with time similarly in both groups. No significant plasma IL-8 and IL-10 change was observed in both experimental groups. The VAS pain score was significantly lower in the awake group compared to the anesthesia group at 12 hours postoperative. Postoperative anxiety and stress declined similarly in both groups. Conclusion. This study suggests that awake function-controlled craniotomy does not cause a significantly different inflammatory response than craniotomy performed under general anesthesia. It is also likely that function-controlled craniotomy does not cause a greater emotional challenge than tumor resection under general anesthesia.

  18. General anesthesia-associatedDNA damage in peripheral blood mononuclear cells of surgical patients

    Institute of Scientific and Technical Information of China (English)

    Wang Haiyan; Zhou Qi; Fu Huo

    2011-01-01

    Objective:To evaluate retrospectively the effect of general anesthesia onDNA damage in the blood mononuclear cells (PBMCs) of surgical patients in order to provide evidence for a better nursing care during the procedure.Methods: Clinical charts of76 patients who underwent operation under general anesthesia and76 healthy control subjects with documented results of DNA damage extent inPBMCs from the single-cell gel electrophoresis(SCGE) or comet assay and serum contents of superoxide dismutase(SOD) and malondialdehyde(MDA)from biochemical analyses were reviewed. The percentage of comet PBMCs and tailDNAand serum contents of SOD and MAD were analyzed by student t-test.Results: Compared with healthy control subjects, generally anesthetized surgical patients had significantly higher % cometPBMCs and % tail DNA(P<0.05) and significantly lower serum concentrations ofSOD (P<0.05) and significantly higher serum concentrations ofMAD (P<0.05). Compared with levels before general anesthesia in surgical patients, % cometPBMCs, % tailDNA, and serum levels ofMADwere significantly higher (P<0.05 or0.01), and serum levels ofSOD were significantly lower (P<0.05), after general anesthesia.Conclusions: General anesthesia during surgery causes a certain degree of hypoxia and PBMC damage. Particular attention should be paid to monitoring and maintenance of blood oxygen saturation in patients undergoing surgery under general anesthesia.

  19. Effect of remifentanil on consumption of sevoflurane in entropy monitored general anesthesia

    OpenAIRE

    Kim, Hyung Tae; Heo, Hyeon Eon; Kwon, Young Eun; Lee, Myeong Jong

    2010-01-01

    Background Monitoring of anesthetic depth is important for successful general anesthesia. It is well known that entropy or BIS monitoring assisted titration of anesthetic drugs decreases their consumption. This study evaluated the effect of remifentanil on consumption of sevoflurane during entropy monitored general anesthesia. Methods Patients were randomly assigned to two groups. The R group was administered 0.1 µg/kg/min of remifentanil and inhaled sevoflurane, while the S group was adminis...

  20. Regional or general anesthesia for fast-track hip and knee replacement - what is the evidence?

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Aasvang, Eske Kvanner

    2015-01-01

    Regional anesthesia for knee and hip arthroplasty may have favorable outcome effects compared with general anesthesia by effectively blocking afferent input, providing initial postoperative analgesia, reducing endocrine metabolic responses, and providing sympathetic blockade with reduced bleeding...... and less risk of thromboembolic complications but with undesirable effects on lower limb motor and urinary bladder function. Old randomized studies supported the use of regional anesthesia with fewer postoperative pulmonary and thromboembolic complications, and this has been supported by recent large non......-randomized epidemiological database cohort studies. In contrast, the data from newer randomized trials are conflicting, and recent studies using modern general anesthetic techniques may potentially support the use of general versus spinal anesthesia. In summary, the lack of properly designed large randomized controlled...

  1. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia

    Directory of Open Access Journals (Sweden)

    Aysun Postaci

    2012-01-01

    Full Text Available Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  2. Acute unilateral parotid gland swelling after lateral decubitus position under general anesthesia.

    Science.gov (United States)

    Postaci, Aysun; Aytac, Ismail; Oztekin, Cetin Volkan; Dikmen, Bayazit

    2012-07-01

    Acute swelling of the parotid gland after general anesthesia (commonly known as anesthesia mumps or acute postoperative sialadenitis) is a rare but declared complication of anesthesia. The etiology is not clear, but some possible causes such as obstruction of glandular excretory ducts caused by patient position and increase in the viscosity of the saliva because of acute dehydratation and/or medications like atropin have been proposed. We report a swelling in the left preauricular and postauricular region extending to the angle of the mandibule in a 35-year-old patient after left lateral decubitus position for laparoscopic nephrectomy.

  3. Memory Loss, Alzheimer’s Disease and General Anesthesia: A Preoperative Concern

    Science.gov (United States)

    Thaler, Adam; Siry, Read; Cai, Lufan; García, Paul S.; Chen, Linda; Liu, RenYu

    2012-01-01

    Background The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient’s or the patient family member has made a request to address their concern on memory loss, Alzheimer’s disease and general anesthesia before surgery. Methods Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer’s disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using “anesthesia memory loss” as a search phrase. Results Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer’s disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer’s disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2nd, 2011, searching “anesthesia memory loss” in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer’s disease without conclusive scientific literature support. Conclusion The potential link between memory loss and Alzheimer’s disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can

  4. Comparison between general anesthesia and spinal anesthesia in attenuation of stress response in laparoscopic cholecystectomy: A randomized prospective trial

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    Writuparna Das

    2015-01-01

    Full Text Available Background: Laparoscopy though minimally invasive produces significant hemodynamic surge and neuroendocrine stress response. Though general anesthesia (GA is the conventional technique, now-a-days, regional anesthesia has been accepted for laparoscopic diagnostic procedures, and its use is also being extended to laparoscopic surgeries. Objective: The aim was to compare the hemodynamic surge and neuroendocrine stress response during laparoscopic cholecystectomy (LC under GA and spinal anesthesia (SA in American Society of Anesthesiologists (ASA PS 1 patients. Materials and Methods: Thirty ASA physical status I patients, aged 18-65 years were randomly allocated into two equal groups of 15 each. Group A received GA with controlled ventilation. Patients were preoxygenated for 5 min with 100/5 oxygen, premedicated with midazolam 0.03 mg/kg intravenous (i.v, fentanyl 2 mcg/kg i.v; induction was done with thiopentone 3-5 mg/kg i.v; intubation was achieved after muscle relaxation with 0.5 mg/kg atracurium besylate i.v. Anesthesia was maintained with 1-2% sevoflurane and N2O:O2 (60:40 and intermittent i.v injection of atracurium besylate. Group B SA with 0.5% hyperbaric bupivacaine and 25 μg fentanyl along with local anesthetic instillation in the subdiaphragmatic space. Mean arterial pressure, heart rate (HR, oxygen saturation, end tidal carbon-dioxide were recorded. Venous blood was collected for cortisol assay before induction and 30 min after pneumoperitoneum. All data were collected in Microsoft excel sheet and statistically analyzed using SPSS software version 16 (SPSS Inc., Chicago, IL, USA. All numerical data were analyzed using Student′s t-test and paired t-test. Any value <0.05 was taken as significant. Results: Mean arterial pressure and mean HR and postpneumoperitoneum cortisol level were lower in group B than group A though the difference was not statistically significant in hemodynamic parameters but significant in case of cortisol

  5. Fetomaternal Outcome in Severe Preeclamptic Women Undergoing Emergency Cesarean Section under Either General Or Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Suman Chattopadhyay

    2014-01-01

    Full Text Available This prospective observational study compared the effects of general and spinal anesthesia in 173 severe preeclamptic women undergoing emergency cesarean section. 146 (84.5% patients underwent spinal anesthesia (SA and 27 (15.5% patients had general anesthesia (GA. Most of the patients were primigravid and nulliparous. Intraoperatively SA group required more intravenous fluid and vasopressor support, while GA group required more preoperative labetalol injection for blood pressure control. Overall 13.3% of patients required critical care, particularly GA group (44.4% versus 7.5%; P<0.001. Patients receiving GA had a higher mortality (25.9% versus 1.4%; P<0.001. The length of hospital stay was comparable. Significantly more neonates of patients receiving GA were found to be preterm (77.8% versus 44.5%; P<0.01 and required advanced resuscitation. GA group also had higher neonatal mortality (29.6% versus 11%; P<0.05. To conclude, severe preeclamptic mothers receiving general anesthesia and their babies required more critical care support. Maternal as well as neonatal mortality was significantly higher with general anesthesia.

  6. Tourniquet-induced cardiovascular responses in anterior cruciate ligament reconstruction surgery under general anesthesia: Effect of preoperative oral amantadine

    Directory of Open Access Journals (Sweden)

    Ashraf Abd Elmawgood

    2015-01-01

    Conclusion: Preoperative oral amantadine reduced tourniquet induced hypertension and postoperative analgesic requirements in anterior cruciate ligament reconstruction surgery under general anesthesia.

  7. Ocular risk management in patients undergoing general anesthesia: an analysis of 39,431 surgeries

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    Newton Kara-Junior

    2015-08-01

    Full Text Available OBJECTIVE:This study sought to describe and analyze ocular findings associated with nonocular surgery in patients who underwent general anesthesia.METHODS:The authors retrospectively collected a series of 39,431 surgeries using standardized data forms.RESULTS:Ocular findings were reported in 9 cases (2.3:10,000, which involved patients with a mean age of 58.9±19.5 years. These cases involved patients classified as ASA I (33%, ASA II (55% or ASA III (11%. General anesthesia with propofol and remifentanil was used in 4 cases, balanced general anesthesia was used in 4 cases, and regional block was used in combination with balanced general anesthesia in one case. Five patients (55% underwent surgery in the supine position, one patient (11% underwent surgery in the lithotomy position, two patients (22% underwent surgery in the prone position, and one patient (11% underwent surgery in the lateral position. Ocular hyperemia was detected in most (77% of the 9 cases with ocular findings; pain/burning of the eyes, visual impairment, eye discharge and photophobia were observed in 55%, 11%, 11% and 11%, respectively, of these 9 cases. No cases involved permanent ocular injury or vision loss.CONCLUSION:Ophthalmological findings after surgeries were uncommon, and most of the included patients were relatively healthy. Minor complications, such as dehydration or superficial ocular trauma, should be prevented by following systematic protocols that provide appropriate ocular occlusion with a lubricating ointment and protect the eye with an acrylic occluder. These procedures will refine the quality of anesthesia services and avoid discomfort among patients, surgeons and anesthesia staff.

  8. Effect of cisatracurium versus atracurium on intraocular pressure in patients undergoing tracheal intubation for general anesthesia

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2011-01-01

    Conclusions: Compared with atracurium, administration of cisatracurium can better prevent the increase of IOP following tracheal intubation in general anesthesia. The observed difference might be related to different effects on hemodynamic variables. Application of these results in patients under ophthalmic surgery is warranted.

  9. Postoperative urinary retention after general and spinal anesthesia in orthopedic surgical patients

    Directory of Open Access Journals (Sweden)

    Alaa Abdel aziz Niazi

    2015-01-01

    Conclusion: Urinary retention is more common after spinal than general anesthesia in orthopedic patients. Adding narcotics to the local anesthetics intrathecally causes more incidence of postoperative urinary retention, which may delay patients discharge and transabdominal ultrasonography is a reliable, noninvasive, inexpensive and simple method to measure bladder volume postoperatively.

  10. Chronic alcoholism and general anesthesia%慢性酗酒与全身麻醉

    Institute of Scientific and Technical Information of China (English)

    王维维; 王常松; 李恩有

    2015-01-01

    Background With the increasing proportion of chronic alcoholism in surgical patients, anesthesiologists should pay attention to the treatment of alcoholism with general anesthesia.Objective To investigate the effects of chronic alcoholism on general anesthesia and provide theories for clinical application.Content Review the impacts of chronic alcoholism on the body systems and general anesthesia treatment of alcoholism.Trend A more secure and reliable general anesthesia method for chronic alcoholism should be searched.%背景 随着外科手术中慢性酗酒患者比例的增加,酗酒患者的全身麻醉管理受到麻醉医师的关注. 目的 探讨慢性酗酒对全身麻醉的影响,为临床工作提供依据. 内容 综述慢性酗酒对全身系统的影响和酗酒患者的全身麻醉管理. 趋向 寻找安全、可靠的慢性酗酒者的全身麻醉方法.

  11. Paraplegia after thoracotomy under combined general and epidural anesthesia in a child.

    NARCIS (Netherlands)

    Allison, C.E.; Aronson, D.C.; Geukers, V.G.; Berg, R. van den; Schlack, W.S.; Hollmann, M.W.

    2008-01-01

    A 9-year-old boy underwent a thoracotomy for excision of his right third rib under combined general and epidural anesthesia for a Ewings sarcoma. Postoperatively, he was found to have a complete T2-3 paraplegia. Permanent paraplegia was described as a rare complication of thoracotomy in adults, and

  12. Treatment Needs and Adverse Events Related to Dental Treatment under General Anesthesia for Individuals with Autism

    Science.gov (United States)

    Rada, Robert E.

    2013-01-01

    Individuals with autism can be quite challenging to treat in a routine dental-office setting, especially when extensive dental treatment and disruptive behavioral issues exist. Individuals with autism may also be at higher risk for oral disease. Frequently, general anesthesia is the only method to facilitate completion of the needed dental…

  13. Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

    Directory of Open Access Journals (Sweden)

    H. L. Yang

    2016-01-01

    Full Text Available Background. Postoperative sore throat is one of the major complaints of general anesthesia in the postanesthesia care unit. This prospective study investigated the preventive effect of ketorolac tromethamine spray in postendotracheal-intubation-induced sore throat after general anesthesia. Methods. Surgical patients undergoing general anesthesia with endotracheal intubation were recruited from a medical center. Patients were randomly assigned to group K (treated with 5% ketorolac tromethamine spray or group D (treated with distilled water spray. Before intubation, each endotracheal tube was sprayed with the appropriate solution by physicians over the 20 cm length of the cuff. Each group comprised 95 patients fitting the inclusion and exclusion criteria for whom complete data sets were collected. The intensity of the sore throat was measured at 1, 3, 6, and 24 h after surgery, and data were compared. Results. The two groups had similar characteristics. Postoperative sore throat was significantly less frequent in group K than in group D (p<0.001 and the pain intensity was significantly lower in group K than in group D at each time point (all p<0.001. Conclusions. This study demonstrated that preanesthesia 5% ketorolac tromethamine spray could effectively decrease postendotracheal-intubation-induced sore throat in patients undergoing general anesthesia.

  14. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal

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    Mercês Lobo

    2015-08-01

    Full Text Available BACKGROUND: Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results.OBJECTIVES: Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality in a tertiary center in Portugal and review the literature.METHODS: Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation.RESULTS: A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregional anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding per operative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference.CONCLUSIONS: We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers.

  15. Remifentanil at induction of general anesthesia for cesarean section: Double blind, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Shokoufeh Behdad

    2013-05-01

    Full Text Available Introduction: Remifentanil, with its rapid activity onset and short duration of action, may be more effective than other opioids for providing hemodynamic stability during obstetric anesthesia. However, there is some evidence of adverse effects on neonatal respiratory function. We investigated maternal and fetal effects of remifentanil during cesarean section surgery. Methods: Eighteen women with singleton term pregnancies, and physical class status of I or II as defined by the American Society of Anesthesia (ASA, who were undergoing general anesthesia for semi-elective cesarean section were randomized into two groups (40 in each group that received either and intravenous bolus of 0.5 µg/kg remifentanil or the same dose of saline as a placebo. Maternal hemodynamic variables and neonatal umbilical artery pH and Apgar score at first and fifth min were evaluated in both groups. Results: Systolic and diastolic blood pressure were significantly lower after tracheal intubation and skin incision in the remifentanil group as compared with the control group (p<0.05. There were no significant differences regarding heart rate between groups at any time (p>0.05. Apgar scores at first and fifth min were not significantly different among groups (p>0.05. No neonate required assisted ventilation or naloxan administration. Conclusion: Remifentanil may be a safe and effective drug for the induction of general anesthesia and surgical stimulation without subsequent neonatal depression. 

  16. One-week postoperative patency of lower extremity in situ bypass graft comparing epidural and general anesthesia

    DEFF Research Database (Denmark)

    Wiis, Julie Therese; Jensen-Gadegaard, Peter; Altintas, Ümit

    2014-01-01

    BACKGROUND: The purpose of this study was to determine whether anesthesia affects graft patency after lower extremity arterial in situ bypass surgery. METHODS: This investigation was a retrospective study using a national database on vascular surgical patients at a single medical institution. We...... under epidural (n = 386) or general (n = 499) anesthesia. Thirty-day mortality (3.4% for epidural anesthesia versus 4.4% general anesthesia; P = 0.414) and comorbidity were comparable in the 2 groups. Graft occlusion within 7 days after surgery was reported in 93 patients, with a similar incidence...... in the epidural (10.1%) and general (10.8%) anesthesia groups (P = 0.730). When examining a subgroup of patients (n = 242) exposed to surgery on smaller vessels (femorodistal in situ bypass procedures, n = 253), the incidence of graft occlusion was also similar in the 2 groups at 14.0% and 9.4%, respectively (P...

  17. Risk of Autism Associated with General Anesthesia during Cesarean Delivery: A Population-Based Birth-Cohort Analysis

    Science.gov (United States)

    Chien, Li-Nien; Lin, Hsiu-Chen; Shao, Yu-Hsuan Joni; Chiou, Shu-Ti; Chiou, Hung-Yi

    2015-01-01

    The rates of Cesarean delivery (C-section) have risen to >30 % in numerous countries. Increased risk of autism has been shown in neonates delivered by C-section. This study examined the incidence of autism in neonates delivered vaginally, by C-section with regional anesthesia (RA), and by C-section with general anesthesia (GA) to evaluate the…

  18. Direct Modulation of Microtubule Stability Contributes to Anthracene General Anesthesia

    Science.gov (United States)

    Emerson, Daniel J.; Weiser, Brian P.; Psonis, John; Liao, Zhengzheng; Taratula, Olena; Fiamengo, Ashley; Wang, Xiaozhao; Sugasawa, Keizo; Smith, Amos B.; Eckenhoff, Roderic G; Dmochowski, Ivan J.

    2013-01-01

    Recently, we identified 1-aminoanthracene as a fluorescent general anesthetic. To investigate the mechanism of action, a photoactive analogue, 1-azidoanthracene, was synthesized. Administration of 1-azidoanthracene to albino stage 40–47 tadpoles was found to immobilize animals upon near-UV irradiation of the forebrain region. The immobilization was often reversible, but it was characterized by a longer duration consistent with covalent attachment of the ligand to functionally important targets. IEF/SDS-PAGE examination of irradiated tadpole brain homogenate revealed labeled protein, identified by mass spectrometry as β-tubulin. In vitro assays with aminoanthracene-cross-linked tubulin indicated inhibition of microtubule polymerization, similar to colchicine. Tandem mass spectrometry confirmed anthracene binding near the colchicine site. Stage 40–47 tadpoles were also incubated 1 h with microtubule stabilizing agents, epothilone D or discodermolide, followed by dosing with 1-aminoanthracene. The effective concentration of 1-aminoanthracene required to immobilize the tadpoles was significantly increased in the presence of either microtubule stabilizing agent. Epothilone D similarly mitigated the effects of a clinical neurosteroid general anesthetic, allopregnanolone, believed to occupy the colchicine site in tubulin. We conclude that neuronal microtubules are “on-pathway” targets for anthracene general anesthetics and may also represent functional targets for some neurosteroid general anesthetics. PMID:23484901

  19. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report

    Directory of Open Access Journals (Sweden)

    Márcio Luiz Benevides

    Full Text Available Abstract Background and objectives: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50 kg/m2, who underwent cesarean section under general anesthesia. Case report: Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m2. Cesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 min, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1st minute (received positive pressure ventilation by mask for about 2 min and 8 in the 5th minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4th postoperative day.

  20. Effect of different dose of lidocaine on etomidate-induced myoclonus during general anesthesia induction

    Institute of Scientific and Technical Information of China (English)

    Xiao-Li Yang

    2016-01-01

    Objective:To study the effect of different dose of lidocaine on etomidate-induced myoclonus during general anesthesia induction. Methods:A total of 105 cases who received surgery under general anesthesia were selected for study and randomly divided into A, B and C group who received intravenous injection of 20 mg, 40 mg and 0 mg lidocaine during anesthesia induction respectively, then number of cases and degree of myoclonus were compared among three groups, and hemodynamic indexes, inflammation indexes and stress indexes during induction process were evaluated. Results:The number of cases of myoclonus 0 grade of A group and B group was significantly more than that of C group, the number of cases of myoclonus 1 grade, 2 grade and 3 grade was significantly less than that of C group, and the number of cases of myoclonus 0 grade, 1 grade, 2 grade and 3 grade of A group was not sinificantly different from that of B group. There was no difference in HR and MBP at T1-T4 points in time within A group, HR and MBP at T2-T4 points in time within B group were significantly lower than those at T1 point in time, and HR and MBP at T2-T4 points in time within C group were significantly higher than those at T1 point in time. During anesthesia induction, serum hs-CRP, HMGB-1, NE and E contents all showed increasing trend, and the increasing trend of hs-CRP, HMGB-1, NE and E contents of A group and B group was weaker than that of C group. Conclusions:Both 20 mg and 40 mg lidocaine can effectively reduce the incidence of etomidate-induced myoclonus and also alleviate inflammatory and stress response during anesthesia induction;20 mg lidocaine has less influence on hemodynamics and is a more ideal dose for prevention of etomidate-induced myoclonus.

  1. Use of triazolam and alprazolam as premedication for general anesthesia

    OpenAIRE

    Kim, Doyun; Lee, Seongheon; Pyeon, Taehee; Jeong, Seongwook

    2015-01-01

    Background Triazolam has similar pharmacological properties as other benzodiazepines and is generally used as a sedative to treat insomnia. Alprazolam represents a possible alternative to midazolam for the premedication of surgical patients. The purpose of this study was to evaluate the anxiolytic, sedative, and amnestic properties of triazolam and alprazolam as pre-anesthetic medications. Methods Sixty adult patients were randomly allocated to receive oral triazolam 0.25 mg or alprazolam 0.5...

  2. Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

    Directory of Open Access Journals (Sweden)

    Robert A. Goldberg

    2014-01-01

    Full Text Available To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia. Methods. In this retrospective case series, 30 patients (13 males and 17 females underwent tumor removal through eyelid crease (17 eyes, conjunctival (nine eyes, lateral canthal (two eyes, and transcaruncular (two eyes approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia. Results. The median (range age and follow-up duration were 48.5 (31–87 years old and 24.5 (4–375 weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases, pleomorphic adenoma (5 cases, solitary fibrous tumor (4 cases, neurofibroma (2 cases, schwannoma (2 cases, and orbital varix (1 case. None of the patients experienced recurrence. Conclusions. Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia.

  3. Local Anesthesia in Open Inguinal Hernia Repair Improves Postoperative Quality of Life Compared to General Anesthesia: A Prospective, International Study.

    Science.gov (United States)

    Huntington, Ciara R; Wormer, Blair A; Cox, Tiffany C; Blair, Laurel J; Lincourt, Amy E; Augenstein, Vedra A; Heniford, B Todd

    2015-07-01

    The choice of general (GA) versus local anesthesia (LA) in open inguinal hernia repair (OIHR) has a substantial financial impact and may influence clinical outcomes. Our study compares postoperative quality of life (QOL) in patients undergoing OIHR under LA versus GA. A cooperative prospective study from centers in 10 countries was performed through the International Hernia Mesh Registry from 2007 to 2012. QOL was compared at one, six, 12, and 24 months for LA versus GA with univariate and multivariate analysis controlling for known confounding variables. Of 1128 patients who underwent OIHR, 585(52%) used GA and 533(48%) used LA. Most were male (92%) with unilateral (94%), primary (91%) repairs with a mean age 57 ± 16 years. There was no difference (P > 0.05) in age, gender, operative time, mesh size, length of stay, infection, recurrence, reoperation, or death. Multivariate analysis demonstrated significant QOL differences between groups: GA had higher odds of discomfort at one and six months [odds ratio (OR) 3.3, 2.0], movement limitation at one and six months (OR 3.5, 2.8), and mesh sensation at one and 12 months (OR 2.9, 1.8). Overall, patients undergoing OIHR under LA had improved postoperative QOL in the short and long term compared with GA.

  4. Redox Changes Induced by General Anesthesia in Critically Ill Patients with Multiple Traumas

    Science.gov (United States)

    Papurica, Marius; Rogobete, Alexandru Florin; Sandesc, Dorel; Dumache, Raluca; Nartita, Radu; Sarandan, Mirela; Cradigati, Alina Carmen; Luca, Loredana; Vernic, Corina; Bedreag, Ovidiu Horea

    2015-01-01

    The critically ill polytrauma patient is a constant challenge for the trauma team due to the complexity of the complications presented. Intense inflammatory response and infections, as well as multiple organ dysfunctions, significantly increase the rate of morbidity and mortality in these patients. Moreover, due to the physiological and biochemical imbalances present in this type of patients, the bioproduction of free radicals is significantly accelerated, thus installing the oxidative stress. In the therapeutic management of such patients, multiple surgical interventions are required and therefore they are being subjected to repeated general anesthesia. In this paper, we want to present the pathophysiological implications of oxidative stress in critically ill patients with multiple traumas and the implications of general anesthesia on the redox mechanisms of the cell. We also want to summarize the antioxidant treatments able to reduce the intensity of oxidative stress by modulating the biochemical activity of some cellular mechanisms. PMID:26693352

  5. Anesthesia for major general surgery in neonates with complex cardiac defects.

    Science.gov (United States)

    Walker, Amy; Stokes, Monica; Moriarty, Anthony

    2009-02-01

    Centers with large cardiac workloads may be presented with neonates who need major general surgery before correction or palliation of a serious cardiac defect. This is still a rare situation with only three short case reports available in the medical literature (1-3). We have reviewed the anesthetic and analgesic regimens of 18 such neonates who presented to the Birmingham Children's Hospital in the 4-year period 2004-2007. These children require meticulous preoperative evaluation and although it might be anticipated that they would pose a serious challenge to anesthetists, in reality with thorough investigation, preparation, and careful management, they tolerate general anesthesia well. These children may be transferred to centers of specialist pediatric cardiac anesthesia to be benefited from experience obtained there.

  6. Redox Changes Induced by General Anesthesia in Critically Ill Patients with Multiple Traumas

    Directory of Open Access Journals (Sweden)

    Marius Papurica

    2015-01-01

    Full Text Available The critically ill polytrauma patient is a constant challenge for the trauma team due to the complexity of the complications presented. Intense inflammatory response and infections, as well as multiple organ dysfunctions, significantly increase the rate of morbidity and mortality in these patients. Moreover, due to the physiological and biochemical imbalances present in this type of patients, the bioproduction of free radicals is significantly accelerated, thus installing the oxidative stress. In the therapeutic management of such patients, multiple surgical interventions are required and therefore they are being subjected to repeated general anesthesia. In this paper, we want to present the pathophysiological implications of oxidative stress in critically ill patients with multiple traumas and the implications of general anesthesia on the redox mechanisms of the cell. We also want to summarize the antioxidant treatments able to reduce the intensity of oxidative stress by modulating the biochemical activity of some cellular mechanisms.

  7. General anesthesia: as a challenge and treatment need option in pediatric dentistry

    OpenAIRE

    2005-01-01

    Objetive. The purpose of this study was to determine the type and characteristics of the interventions, indications of dental treatment and procedures performed to patients treated under general anesthesia (GA) by pediatric dentistry residents, during the 1997-1999 period. Method. a sample of 57 hospital records of patientes treated as part of the Special Pediatric course at the Puerto rico Pediatric hostpial were reviewed. statistical analysis was done using the chi-square test for infere...

  8. Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index

    Directory of Open Access Journals (Sweden)

    Sayed Mohammad Reza Hadavi

    2013-09-01

    Full Text Available Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS, end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S. Methods: This study was carried out on 60 parturient patients undergoing elective C/S. A standardized anesthetic technique was applied: induction with Thiopental (4-5 mg/kg and Succinylcholine (1.5-2 mg/kg as well as maintenance with O2, N2O, and isoflurane. Electrocardiogram, heart rate, blood pressure, Spo2, end-tidal isoflurane concentration, BIS, and any clinical signs of inadequate depth of anesthesia such as movement, sweating, lacrimation, coughing, and jerking were continuously monitored and recorded at 16 fixed time points during anesthesia. Results: A median BIS of less than 70 (range: 42-68 was obtained on all occasions during surgery; however, at each milestone, at least 20% of the patients had BIS values above 60. Hemodynamic parameters increased significantly in some patients, especially during laryngoscopy and intubation. No patient experienced recall or awareness. Conclusion: The currently used general anesthetic technique in our center appears inadequate in some milestones to reliably produce BIS values less than 60, which are associated with lower risk of awareness. Therefore, with respect to such desirable outcomes as good Apgar and clinical status in neonates, we would recommend the application of this method (if confirmed by further studies through larger dosages of anesthetic agents.

  9. CLINICAL APPLICATION OF ACUPUNCTURE ON ALLEVIATION OF STRESS REACTION INDUCED BY TRACHEAL INTUBATION IN GENERAL ANESTHESIA

    Institute of Scientific and Technical Information of China (English)

    SHI Jin-hua

    2006-01-01

    By summarizing the formation of stress reaction induced by tracheal intubation and method of medicinal control, the recognition of Chinese medicine in treatment of cardiac arrhythmia and hypertension with acupuncture and the clinical application of acupuncture on stress reaction induced by tracheal intubation,it is concluded that the side effects of tracheal intubation are inevitable, even though there are many methods presented for the prevention and treatment for it. In recent years, the functions of acupuncture in anesthesia,especially in regulation of circulatory properties have been developed gradually and have been applied by many physicians in controlling the stress reaction induced by tracheal intubation in general anesthesia. Being a kind of dual-directional and positive regulation and stimulation, acupuncture provides definite and safe effects on controlling the stress reaction induced by tracheal intubation.

  10. HEMODYNAMIC STATUS IN AIRWAY MANAGEMENT DURING GENERAL ANESTHESIA: COMPARISON OF THREE METHODS

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    K MONTAZERI

    2000-03-01

    Full Text Available Introduction. The laryngeal mask airway (LMA was recently introduced in general anesthesia as an alternative to the face mask or tracheal intubation for airway maintenance. Methods. The effects of LMA insertion, face mask or tracheal intubation on homodynamic status were studied in 195 normotensive patients who underwent elective transurethral lithotripsy (TUL. The patients were monitored with blood pressure measurement and pulse oximetry. Anesthesia was induced with sodium thiopental, succynilcholine and fentanyl and maintained with halothane, nitrous oxide and oxygen. Findings. The heart rate (HR and mean arterial pressure increased after LMA insertion. face mask or tracheal intubation, compared with baseline (P<0.05. The hemodynamic changes were significantly greater after tracheal intubation and face mask than after LMA insertion (P<0.05. Conclusion. We conclude that insertion of LMA is associated with less hemodynamic disturbances than face mask or tracheal intubation in normotensive patients undergoing elective operations.

  11. Percolation Model of Sensory Transmission and Loss of Consciousness under General Anesthesia

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    Zhou, David W.; Mowrey, David D.; Tang, Pei; Xu, Yan

    2015-01-01

    Neurons communicate with each other dynamically. How such communications lead to consciousness remains unclear. Here, we present a theoretical model to understand the dynamic nature of sensory activity and information integration in a hierarchical network, in which edges are stochastically defined by a single parameter, p, representing percolation probability of information transmission. We validate the model by comparing the transmitted and original signal distributions and show that a basic version of this model can reproduce key spectral features clinically observed in electroencephalographic recordings of transitions from conscious to unconscious brain activities during general anesthesia. As p decreases, a steep divergence of the transmitted signal from the original was observed, along with a loss of signal synchrony and a sharp increase in information entropy in a critical manner, resembling the precipitous loss of consciousness during anesthesia. The model offers mechanistic insights into the emergence of information integration from a stochastic process, laying the foundation to understand the origin of cognition. PMID:26382705

  12. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca

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    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Introduction Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. Methods A retrospective cohort study was carried out in pediatric dentistry unit of the Univ...

  13. Effects of music therapy under general anesthesia in patients undergoing abdominal surgery

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    Kahloul, Mohamed; Mhamdi, Salah; Nakhli, Mohamed Said; Sfeyhi, Ahmed Nadhir; Azzaza, Mohamed; Chaouch, Ajmi; Naija, Walid

    2017-01-01

    ABSTRACT Background: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. Methods: This is a prospective, randomized, double-blind study conducted in the operating theatre of visceral surgery at Sahloul Teaching Hospital over a period of 4 months. Patients aged more than 18 undergoing a scheduled surgery under general anesthesia were included. Patients undergoing urgent surgery or presenting hearing or cognitive disorders were excluded. Before induction, patients wore headphones linked to an MP3 player. They were randomly allocated into 2 groups: Group M (with music during surgery) and group C (without music). Hemodynamic parameters, quality of arousal, pain experienced, patient’s satisfaction, and awareness incidence during anesthesia were recorded. Results: One hundred and forty patients were included and allocated into 2 groups that were comparable in demographic characteristics, surgical intervention type and anesthesia duration. Comparison of these two groups regarding the hemodynamic profile found more stability in group M for systolic arterial blood pressure. A calm recovery was more often noted in group M (77.1% versus 44%, p < 10–3). The average Visual Analog Scale (VAS) score was lower in the intervention group (33.8 ± 13.63 versus 45.1 ± 16.2; p < 10–3). The satisfaction rate was significantly higher among the experimental group (81.4% versus 51.4%; p < 10–3). The incidence of intraoperative awareness was higher in group C (8 cases versus 3 cases) but the difference was not statistically significant. Conclusion: Music therapy is a non-pharmacological, inexpensive, and non-invasive technique that can significantly enhance patient satisfaction and decrease patients’ embarrassing experiences related

  14. Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial

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    Anıl İçel Saygı

    Full Text Available CONTEXT AND OBJECTIVE: As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section.DESIGN AND SETTING: Prospective randomized controlled clinical trial in a tertiary-level public hospital.METHODS: Our study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50 and spinal anesthesia (n = 50 groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups.RESULTS: Mean bowel sounds (P = 0.036 and gas discharge time (P = 0.049 were significantly greater and 24th hour hemoglobin difference values (P = 0.001 were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively, urine volume at the first postoperative hour (P < 0.001 and median Apgar score at the first minute (P < 0.0005 were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042, in the spinal anesthesia group.CONCLUSION: In elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

  15. Dextroamphetamine (but Not Atomoxetine Induces Reanimation from General Anesthesia: Implications for the Roles of Dopamine and Norepinephrine in Active Emergence.

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    Jonathan D Kenny

    Full Text Available Methylphenidate induces reanimation (active emergence from general anesthesia in rodents, and recent evidence suggests that dopaminergic neurotransmission is important in producing this effect. Dextroamphetamine causes the direct release of dopamine and norepinephrine, whereas atomoxetine is a selective reuptake inhibitor for norepinephrine. Like methylphenidate, both drugs are prescribed to treat Attention Deficit Hyperactivity Disorder. In this study, we tested the efficacy of dextroamphetamine and atomoxetine for inducing reanimation from general anesthesia in rats. Emergence from general anesthesia was defined by return of righting. During continuous sevoflurane anesthesia, dextroamphetamine dose-dependently induced behavioral arousal and restored righting, but atomoxetine did not (n = 6 each. When the D1 dopamine receptor antagonist SCH-23390 was administered prior to dextroamphetamine under the same conditions, righting was not restored (n = 6. After a single dose of propofol (8 mg/kg i.v., the mean emergence times for rats that received normal saline (vehicle and dextroamphetamine (1 mg/kg i.v. were 641 sec and 404 sec, respectively (n = 8 each. The difference was statistically significant. Although atomoxetine reduced mean emergence time to 566 sec (n = 8, this decrease was not statistically significant. Spectral analysis of electroencephalogram recordings revealed that dextroamphetamine and atomoxetine both induced a shift in peak power from δ (0.1-4 Hz to θ (4-8 Hz during continuous sevoflurane general anesthesia, which was not observed when animals were pre-treated with SCH-23390. In summary, dextroamphetamine induces reanimation from general anesthesia in rodents, but atomoxetine does not induce an arousal response under the same experimental conditions. This supports the hypothesis that dopaminergic stimulation during general anesthesia produces a robust behavioral arousal response. In contrast, selective noradrenergic stimulation

  16. Influence of Ringer’s lactated solution in continuous infusion and general anesthesia on hematocrit in dogs

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    Rogério Luizari Guedes

    2015-08-01

    Full Text Available The measurement of serum parameters during general anesthesia procedures are subject to variations due to differences in protocol, splenic storage, and by the instituted fluid therapy. The aim of this study was to assess the hematocrit changes promoted by controlled fluid therapy and general anesthesia. Six mongrel female dogs underwent an anesthetic protocol with acepromazine (0.03 mg kg-1 and tramadol (5 mg kg-1 for premedication, induction with propofol (3 mg kg-1, and maintained with isoflurane and mechanical ventilation for 120 minutes. After induction, they were infused with 10 ml kg hr-1 of Ringer’s lactate solution. Hematocrit measurements were performed from the start until 72 hours from anesthesia and evaluated statistically to check if there were significant changes over time. The fluid therapy, the acepromazine and propofol in the anesthetic protocol promotes a significant reduction of hematocrit up to four hours after general anesthesia.

  17. Antidepressant treatment with MAO-inhibitors during general and regional anesthesia: a review and case report of spinal anesthesia for lower extremity surgery without discontinuation of tranylcypromine.

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    Krings-Ernst, Ilana; Ulrich, Sven; Adli, Mazda

    2013-10-01

    Monoamine oxidase-(MAO)-inhibitors are a treatment of last resort in treatment resistant depression, which is regarded as a condition of increased psychiatric risk. General and regional anesthesia for elective surgery during use of long-term MAO-inhibitors remains a matter of debate because of an increased risk of drug interactions and decreased sympathetic stability. A series of case reports and new comparative studies reveal the safety of anesthesia/analgesia in non-cardiac surgery without discontinuation of the MAO-inhibitor if best effort is made for maintenance of sympathetic homeostasis and if known drug interactions are avoided. Very few reports with severe adverse incidents have been noted. Severe cardiovascular morbidity, a contraindication of MAO-inhibitors, probably contributed to peri- and postoperative complications. According to new studies, the risk of pharmacokinetic drug interactions is lower for tranylcypromine than for phenelzine. In the present case, a 66-year-old psychiatric patient on permanent treatment with 20 mg/day tranylcypromine was admitted for forefoot surgery. Anesthetic premedication consisted of 7.5 mg oral midazolam. Intravenous midazolam (0.5 mg) was dispensed for intraoperative sedation. After local anesthesia of the puncture site with 30 mg isobar prilocaine, spinal anesthesia was achieved by a single shot of 13.5 mg hyperbar bupivacaine (0.5%) intrathecally. Postoperative regional and general analgesia were accomplished by a peripheral nerve block with 50 mg isobar bupivacaine as well as oral etoricoxib and oxycodone. No peri- or postoperative complications were encountered. It is concluded that general or regional anesthesia for noncardiac surgery without discontinuation of MAO-inhibitor treatment may be a safe intervention after careful evaluation of an individual's perioperative and psychiatric risk. The increased psychiatric risk in patients treated with MAO-inhibitors outweighs the increased, however manageable

  18. Is there any benefit in associating neuraxial anesthesia to general anesthesia for coronary artery bypass graft surgery?

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    Fabiano Timbó Barbosa

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: The use of neuraxial anesthesia in cardiac surgery is recent, but the hemodynamic effects of local anesthetics and anticoagulation can result in risk to patients. OBJECTIVE: To review the benefits of neuraxial anesthesia in cardiac surgery for CABG through a systematic review of systematic reviews. CONTENT: The search was performed in Pubmed (January 1966 to December 2012, Embase (1974 to December 2012, The Cochrane Library (volume 10, 2012 and Lilacs (1982 to December 2012 databases, in search of articles of systematic reviews. The following variables: mortality, myocardial infarction, stroke, in-hospital length of stay, arrhythmias and epidural hematoma were analyzed. CONCLUSIONS: The use of neuraxial anesthesia in cardiac surgery remains controversial. The greatest benefit found by this review was the possibility of reducing postoperative arrhythmias, but this result was contradictory among the identified findings. The results of findings regarding mortality, myocardial infarction, stroke and in-hospital length of stay did not show greater efficacy of neuraxial anesthesia.

  19. Comparison of 1.5% lidocaine and 0.5% ropivacaine epidural anesthesia combined with propofol general anesthesia guided by bispectral index

    Institute of Scientific and Technical Information of China (English)

    XIANG Yan; LI Yu-hong

    2007-01-01

    Objective:To compare the effects of epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine on propofol requirements,the time to loss of consciousness (LOC),effect-site propofol concentrations,and the hemodynamic variables during induction of general anesthesia guided by bispectral index (BIS) were studied.Methods:Forty-five patients were divided into three groups to receive epidurally administered saline (Group S),1.5% (w/w) lidocaine (Group L),or 0.5% (w/w) ropivacaine (Group R).Propofol infusion was started to produce blood concentration of 4 μg/ml.Once the BIS value reached 40~50,endotracheal intubation was facilitated by 0.1 mg/kg vecuronium.Measurements included the time to LOC,effect-site propofol concentrations,total propofol dose,mean arterial blood pressure (MABP),and heart rate (HR) at different study time points.Results:During induction of anesthesia,both Groups L and R were similar for the time to LOC,effect-site propofol concentrations,total propofol dose,MABP,HR,and BIS.The total doses of propofol administered until 1 min post-intubation were significantly less in patients of Groups R and L compared with Group S.MABP and HR were significantly lower following propofol induction compared with baseline values in the three groups,or MABP was significantly increased following intubation as compared with that prior to intubation in Group S but not in Groups R and L while HR was significantly increased following intubation in the three groups.Conclusion:Epidural anesthesia with 1.5% lidocaine and 0.5% ropivacaine has similar effects on the time to LOC,effect-site propofol concentrations,total propofol dose,and the hemodynamic variables during induction of general anesthesia.

  20. Adult patient with pulmonary agenesis: focusing on one-lung ventilation during general anesthesia.

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    Yu, Yuetian; Zhu, Cheng; Qian, Xiaozhe; Gao, Yuan; Zhang, Zhongheng

    2016-01-01

    Congenital pulmonary agenesis is a rare condition with high mortality. Mechanical ventilation in these patients is challenging and there has no such case been reported in the literature. We reported a 61-year-old female with lung agenesis who presented to our hospital with pneumonia and pelvic mass. In the past, she had undergone repairing of atrial septal defect and mitral valve forming surgery at 6-year-old. Thereafter she had remained asymptomatic until this time of hospital admission. The patient underwent operation for the pelvic mass with one-lung ventilation (OLV) under general anesthesia. We highlighted the use of protective ventilation (PV) strategy during OLV.

  1. Rehabilitation of severely mutilated teeth under general anesthesia in an emotionally immature child.

    Science.gov (United States)

    Navit, S; Katiyar, A; Samadi, F; Jaiswal, J N

    2010-01-01

    Dental caries is the single most common chronic childhood disease. In rampant caries, there is early pulp involvement and gross destruction of the maxillary anterior teeth as well as posterior teeth. This leads to decreased masticatory efficiency, difficulty in speech, compromised esthetics, development of abnormal tongue habits and subsequent malocclusion and psychological problems. The restoration of severely decayed primary incisors is often a procedure that presents a special challenge to dentists, particularly in an uncooperative child. This case report documents the restoration of severely mutilated deciduous teeth in an emotionally immature patient under general anesthesia.

  2. Should patients receive general anesthesia prior to extubation at the end of life?.

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    Truog, Robert D; Brock, Dan W; White, Douglas B

    2012-02-01

    Billings has proposed that any potentially conscious and imminently dying patient who is undergoing withdrawal of ventilator support should be offered general anesthesia to fully protect against suffering. Here we examine whether his proposal is compatible with the doctrine of double effect, a philosophical construct that is generally in accord with the legal requirements for palliative care in the United States. We review the essential elements of the doctrine of double effect, and emphasize the importance of pre-medicating patients before ventilator withdrawal (anticipatory dosing) and of titrating medications to the needs of the patient. The doctrine of double effect requires physicians to balance the risk of the patient suffering against the risk of hastening the patient's deathwhen titrating the medications used to provide comfort. We argue that the values and preferences of the patient should determine how these risks are balanced. We therefore agree with Billings that general anesthesia may be indicated for patients who prefer to minimize the risk of suffering while accepting a greater risk of having their death hastened. This approach would not be appropriate, however, for patients who place a higher value upon avoiding the risk of hastening death, even when this involves a greater risk of potential suffering.

  3. Positive end-expiratory pressure and variable ventilation in lung-healthy rats under general anesthesia.

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    Luciana M Camilo

    Full Text Available OBJECTIVES: Variable ventilation (VV seems to improve respiratory function in acute lung injury and may be combined with positive end-expiratory pressure (PEEP in order to protect the lungs even in healthy subjects. We hypothesized that VV in combination with moderate levels of PEEP reduce the deterioration of pulmonary function related to general anesthesia. Hence, we aimed at evaluating the alveolar stability and lung protection of the combination of VV at different PEEP levels. DESIGN: Randomized experimental study. SETTING: Animal research facility. SUBJECTS: Forty-nine male Wistar rats (200-270 g. INTERVENTIONS: Animals were ventilated during 2 hours with protective low tidal volume (VT in volume control ventilation (VCV or VV and PEEP adjusted at the level of minimum respiratory system elastance (Ers, obtained during a decremental PEEP trial subsequent to a recruitment maneuver, and 2 cmH2O above or below of this level. MEASUREMENTS AND MAIN RESULTS: Ers, gas exchange and hemodynamic variables were measured. Cytokines were determined in lung homogenate and plasma samples and left lung was used for histologic analysis and diffuse alveolar damage scoring. A progressive time-dependent increase in Ers was observed independent on ventilatory mode or PEEP level. Despite of that, the rate of increase of Ers and lung tissue IL-1 beta concentration were significantly lower in VV than in VCV at the level of the PEEP of minimum Ers. A significant increase in lung tissue cytokines (IL-6, IL-1 beta, CINC-1 and TNF-alpha as well as a ventral to dorsal and cranial to caudal reduction in aeration was observed in all ventilated rats with no significant differences among groups. CONCLUSIONS: VV combined with PEEP adjusted at the level of the PEEP of minimal Ers seemed to better prevent anesthesia-induced atelectasis and might improve lung protection throughout general anesthesia.

  4. A clinical evaluation of comprehensive dental treatment for children under general anesthesia.

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    Su, H L; Chen, P S

    1992-12-01

    The purpose of this study is to evaluate the comprehensive dental treatment for children under general anesthesia. From 1989 to 1991, 57 children with mean age of 3 years 2 months were treated, followed up with a minimal of 1 year. This procedure allows the dentition to be restored in one visit. Further care including preventive options and behavior shaping was provided on a 3-6 months recall schedule. The reasons for general anesthesia are that these children were either unable to accept treatment because of handicaps, extreme fear or young age. Their mean number of decayed tooth was 15 (Standard Deviation, SD = 5) and nearly three quarters of the children were under 6 years old. The most frequent treatment procedures were the extraction of teeth, composite resin restoration and Ni-Cr crown restoration. The Ni-Cr crown (1.7% failure rate) was more successful than the amalgam and composite resin restoration (9.7% failure rate). Pedo-strip crown had the highest failure rate (22%) for anterior teeth restoration. Nineteen children needed retreatment with conventional behavior guide. Six children had new caries and required further treatment. Thirty eight children returned for regular recall during the minimal 1 year follow-up period.

  5. Dextromethorphan Reduces Postoperative Pain of Post Partum Tubal Ligation under General Anesthesia

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    N. Manochehrian

    2009-04-01

    Full Text Available Introduction & Objective: Postoperative pain has harmful effects in many systems. Dextromethorphan reduces postoperative pain in post partum tubal ligation under general anesthesia. Materials & Methods: In this research 40 patients with ASA class I and II in double blind randomized clinical trial were studied in two groups. 90 minutes before surgery the patients received 90 mg dextromethorphan or placebo (oral. The patients induced general anesthesia with thiopental (5mg/kg, fentanyl 1.5 g/kg and succinylcholin(1-1.5 mg/kg and maintenance with halothane and N2O 50%. Patients were observed studied for analgesic requirement, nausea, vomiting, urinary retention and respiratory depression in recovery and 2,4,8 and 24 hours after surgery. Results: There was no significant difference in age, education, . . . Pain in recovery, 2 and 4 hours after surgery in dextromethorphan was less than placebo group. The analgesic requirement (pethidine in dextromethophan was less than placebo group.Conclusion: Administration of 90 mg dextromethorphan 90 minutes before the surgery under GA reduces pain in recovery time , 2 and 4 hours after the surgery.

  6. Laparoscopic cholecystectomy under spinal-epidural anesthesia vs. general anaesthesia: a prospective randomised study

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    Erdem, Vuslat Muslu; Uzman, Sinan; Yildirim, Dogan; Avaroglu, Huseyin; Ferahman, Sina; Sunamak, Oguzhan

    2017-01-01

    Purpose Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. Methods Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups. Results Anesthesia procedures and surgeries for all patients were successfully completed. After the organization of pneumoperitoneum in CSEA group, 3 patients suffered from shoulder pain (12.5%) and 4 patients suffered from abdominal discomfort (16.6%). All these complaints were recovered with IV fentanyl administration. Only 1 patient developed hypotension which is recovered with fluid replacement and no need to use vasopressor treatment. Postoperative shoulder pain was significantly less observed in CSEA group (25% vs. 60%). Incidence of postoperative nausea and vomiting (PONV) was less observed in CSEA group but not statistically significant (4.2% vs. 20%). In the group of CSEA, 3 patients suffered from urinary retention (12.5%) and 2 patients suffered from spinal headache (8.3%). All postoperative pain parameters except 6th hour, were less observed in CSEA group, less VAS scores and less need to analgesic treatment in CSEA group comparing with GA group. Conclusion CSEA can be used safely for laparoscopic cholecystectomies. Less postoperative surgical field pain, shoulder pain and PONV are the advantages of CSEA compared to GA.

  7. Regional versus General Anesthesia for Percutaneous Nephrolithotomy: A Meta-Analysis.

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    Henglong Hu

    Full Text Available To compare the effectiveness and safety of regional anesthesia (RA and general anesthesia (GA for percutaneous nephrolithotomy (PNL.PubMed, EMBASE, The Cochrane Library, and the Web of Knowledge databases were systematically searched to identify relevant studies. After literature screening and data extraction, a meta-analysis was performed using the RevMan 5.3 software.Eight randomized controlled trials (RCTs and six non-randomized controlled trials (nRCTs involving 2270 patients were included. Patients receiving RA were associated with shorter operative time (-6.22 min; 95%CI, -9.70 to -2.75; p = 0.0005, lower visual analgesic score on the first and third postoperative day (WMD, -2.62; 95%CI, -3.04 to -2.19; p < 0.00001 WMD, -0.38; 95%CI, -0.58 to -0.18; p = 0.0002, less analgesic requirements (WMD, -59.40 mg; 95%CI, -78.39 to -40.40; p<0.00001, shorter hospitalization (WMD, -0.36d; 95%CI, -0.66 to -0.05; p = 0.02, less blood transfusion (RR, 0.61; 95%CI, 0.41 to 0.93; p = 0.02, fewer modified Clavion-Dindo Grade II (RR, 0.56; 95%CI, 0.37 to 0.83; p = 0.005, Grade III or above postoperative complications (RR, 0.51; 95%CI, 0.33 to 0.77; p = 0.001, and potential benefits of less fever (RR, 0.79; 95%CI, 0.61 to 1.02; p = 0.07, nausea or vomiting (RR, 0.54; 95%CI, 0.20 to 1.46; p = 0.23, whereas more intraoperative hypotension (RR, 3.13; 95%CI, 1.76 to 5.59; p = 0.0001 when compared with patients receiving GA. When nRCTs were excluded, most of the results were stable but the significant differences were no longer detectable in blood transfusion, Grade II and more severe complications. No significant difference in the total postoperative complications and stone-free rate were found.Current evidence suggests that both RA and GA can provide safe and effective anesthesia for PNL in carefully evaluated and selected patients. Each anesthesia technique has its own advantages but some aspects still remain unclear and need to be explored in future studies.

  8. Alveolar recruiting maneuver in dogs under general anesthesia: effects on alveolar ventilation, gas exchange, and respiratory mechanics.

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    Staffieri, F; De Monte, V; De Marzo, C; Scrascia, F; Crovace, A

    2010-06-01

    The aim of this study was to evaluate the effects of a recruiting maneuver (RM) on lung aeration, gas exchange, and respiratory mechanics during general anesthesia in mechanically ventilated dogs. A thoracic computed tomography (CT) scan, an arterial blood sample, and measurement of respiratory mechanics were performed 10 min before (baseline) and both 5 and 30 min after a vital capacity RM in 10 dogs under general anesthesia. The RM was performed by inflating the lung at 40 cm H(2)O for 20 s. Lung aeration was estimated by analyzing the radiographic attenuation of the CT images. Lung aeration and gas exchange improved significantly 5 min after the RM compared to baseline and returned to values similar to baseline by 30 min. Static lung compliance was not significantly affected by the RM. An RM induces a temporary improvement in lung function in healthy dogs under general anesthesia.

  9. Comparison of recovery profiles of propofol AND sevoflurane anesthesia with bispectral index monitoring (BIS in general anesthesia

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    Mukesh Somvanshi

    2015-03-01

    Method: Fifty ASA physical status I-II patients of either sex, aged between 18 and 60 years were randomly divided into two groups to receive either propofol infusion (group P, n=25 or sevoflurane (group S, n=25. Cardiovascular parameters, SpO2 and bispectral index (BIS scores were recorded. Time to eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9 and the incidence of complications were noted. Results: Early recovery times [eye opening, hand squeezing and achieve modified Aldrete's Score and #8805; 9] were significantly longer in group P (P 0.05. The incidence of post-operative nausea and vomiting was significantly higher in group S. Conclusions: The present study which adjusted propofol infusion rate and sevoflurane concentration according to BIS scores revealed that maintenance of anesthesia with sevoflurane is associated with faster recovery than anesthesia with propofol. Propofol resulted in a significantly lower incidence of postoperative nausea and vomiting. [Natl J Med Res 2015; 5(1.000: 52-56

  10. Fear of going under general anesthesia: A cross-sectional study

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    M E Ruhaiyem

    2016-01-01

    Results: Among 450 questionnaires that were disturbed, 400 questionnaires were collected and analyzed. Eighty-eight percent experienced preoperative fear. The top three causes of their fears were fear of postoperative pain (77.3%, fear of intraoperative awareness (73.7%, and fear of being sleepy postoperatively (69.5%. Patients are less fearful of drains and needles in the operative theater (48%, of revealing personal issues under general anesthesia (55.2%, and of not waking up after surgery (56.4%. Age and gender were significant predictors of the overall fear among preanesthetic patients. Females are 5 times more likely to experience fear before surgery (P = 0.0009. Patients aged more than 40 years old are also at 75% higher risk of being afraid (P = 0.008. Conclusion: The majority of the patients going for surgery experienced a fear of anesthesia. Mostly females, especially those over 40, were at a higher risk of being afraid. Fear can bring anxiety which, in turn, might affect the patient′s surgery.

  11. Dental trauma related to general anesthesia: should the anesthesiologist perform a preanesthetic dental evaluation?

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    Idrees, Saeed Riad; Fujimura, Kazuma; Bessho, Kazuhisa

    2014-06-01

    Perioperative dental damage is one of the most common anesthesia-related adverse events and is responsible for the greatest number of malpractice claims against anesthesiologists; therefore, several dental considerations are warranted. A thorough evaluation may necessitate a dentist's help, requires that anesthesiologists receive more formal training regarding oral and dental anatomy, and enables performing the treatments necessary to minimize the risks of dental injuries. Nevertheless, this preanesthetic assessment is frequently overlooked by surgeons and anesthesiologists. The present study aimed to investigate, for both dentists and anesthesiologists, how often and under what circumstances dental trauma occurs during general anesthesia as well as isolate possible anatomical, dental, and anesthesiological risk factors, based on which suggestions for preventive measures could be made. Anesthesiologists must perform a thorough preoperative oral evaluation to help identify the dentition at risk; the evaluation should include the patient's dental history, oral/dental examination, and a specific discussion with the patient about any existing dentures or crowns. The dental examination should especially include an assessment of the patient's upper incisors--the teeth most likely to be injured during the perioperative period--for pre-existing damage. Preoperative notes should record any damages or missing teeth. In addition, anesthesiologists must take adequate intraprocedure precautions to prevent/minimize iatrogenic dental injury.

  12. Comparative outcomes of peripheral nerve blocks versus general anesthesia for hip fractures in geriatric Chinese patients

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    Liu JL

    2014-05-01

    Full Text Available Jun Le Liu,1,* Xiao Lin Wang,1,* Mao Wei Gong,1,* Hai Xing Mai,2 Shu Jun Pei,1 Wei Xiu Yuan,1 Hong Zhang11Anesthesia and Operation Center, Chinese People’s Liberation Army General Hospital and Medical School of Chinese People’s Liberation Army, Beijing, People’s Republic of China; 2Department of Urology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China*These authors contributed equally to this workBackground: Geriatric patients undergoing hemiarthroplasty for hip fractures have unacceptably high rates of postoperative complications and mortality. Whether anesthesia type can affect the outcomes has still been inconclusive.Objectives: We compared general anesthesia (GA and peripheral nerve blocks (PNBs on postoperative complications and mortality in elderly patients with femoral neck fractures (FNF undergoing hemiarthroplasty.Materials and methods: This retrospective study involved data collection from an electronic database. Two hundred and seventeen patients underwent hemiarthroplasty for FNF between January 2008 and December 2012 at the Chinese People’s Liberation Army General Hospital. Data on mortality within in-hospital, 30-day, and 1-year, complications, comorbidities, blood loss and transfusion, operative time, postoperative hospital length of stay, intensive care unit admission, and hospital charge were collected and analyzed. Univariate and multivariate Cox regression analyses of all variables were used for 30-day and 1-year mortality.Results: Seventy-two patients receiving GA and 145 receiving PNBs were eventually submitted and analyzed. Mortality was 6.9%, 14.7%, and 23.5% at in-hospital, 30-day, and 1-year, respectively postoperatively, while mortality and cardiovascular complications did not differ between the two anesthetic techniques. Preoperative comorbidities and intraoperative parameters were not statistically different except that patients receiving GA were more likely

  13. Evaluation of "no touch" extubation technique on airway-related complications during emergence from general anesthesia

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    Saad A Sheta

    2011-01-01

    Full Text Available Background and Objectives: Awake "no touch" extubation requires performing extubations only when the patient spontaneously wakes up without any kind of stimulation during emergence from general anesthesia. The aim of this study was to evaluate absolutely awake extubation "no touch" technique in adult patients, scheduled for elective nasal and paranasal sinus surgeries under general anesthesia as regard to emergence airway complications. Methods: A total of 60 adult patients were randomly allocated into one of two equal groups according to the method of extubation: Group I: Standard fully awake, Group II: Absolutely "no touch" awake extubation (absolutely no stimulation "no touch" was allowed until patients were able to open their eyes. The incidence of laryngospasm and its grade according to a four-point scale was reported. Occurrence of airway events (excessive secretions, breath-holding, coughing, hoarseness, biting, as well as the number and severity of any desaturation episodes, oozing from the wound, and postoperative sore throat were also recorded. The heart rate (HR, systolic (SBP and diastolic (DBP blood pressure measured at the end of surgery served as baseline values, and subsequent measurements were taken within 30 minutes after the end of surgery. Results: There was absolutely no case of laryngeal spasm or episode of desaturation among patients who were extubated with the "no touch" technique. On the other hand, there were 3 cases of laryngeal spasm in standard fully awake group. Severity of coughing, excessive secretions and breath holding, hoarseness, biting, and occurrence of non-purposeful movements of the limbs were significantly less in the absolutely "no touch" awake technique. The changes in HR, SBP, and DBP during emergence extubation were significantly less in "no touch" technique group. However, oozing from the wound was significantly higher with standard fully awake extubation. However, there were no significant

  14. Dexmedetomidine for awake intubation and an opioid-free general anesthesia in a superobese patient with suspected difficult intubation

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    Gaszynski T

    2014-07-01

    Full Text Available Tomasz Gaszynski,1 Ewelina Gaszynska,2 Tomasz Szewczyk31Department of Anesthesiology and Intensive Therapy, 2Department of Hygiene and Health Promotion, 3Department of Gastroenterology, Oncology, and General Surgery, Barlicki University Hospital, Medical University of Lodz, PolandAbstract: Super-obese patients (body mass index [BMI] >50 kg/m2 are at a particularly high risk of anesthesia-related complications during postoperative period, eg, critical respiratory events including respiratory arrest, and over-sedation leading to problems with maintaining airway open, hypoxia and hypercapnia. In this paper authors present a case of a 39-year-old super-obese (BMI 62.3 kg/m2 female patient who was admitted for surgical treatment of obesity. Preanesthesia evaluation revealed hypertension and type 2 diabetes mellitus (DM as comorbidities as well as potential for a difficult intubation– neck circumference of 46 cm, reduced neck mobility and DM type 2. Patient was intubated using "awake intubation" method using topical anesthesia and dexmedetomidine infusion. General anesthesia was maintained with sevoflurane and dexmedetomidine infusion instead of opioid administration in "opioid-free anesthesia method".Keywords: morbid obesity, non-opioid anesthesia, dexmedetomidine

  15. Continuous measurement of transcutaneous oxygen tension of neonates under general anesthesia.

    Science.gov (United States)

    Welle, P; Hayden, W; Miller, T

    1980-06-01

    Neonates present unique challenges to the anesthesiologist because of their susceptibility to oxygen toxicity and because clinical assessment of the degree of an infant's hypoxia is more difficult than in the adult. Equipment is now available for the continuous noninvasive measurement of transcutaneous oxygen tension. We used this equipment to monitor nine different neonates undergoing ten surgical procedures requiring general anesthesia. We found that certain of the infants were above and below what we considered to be a safe range for the transcutaneous oxygen tension for a significant portion of the surgery. Additionally, the manipulations of the surgeon and anesthesiologists were seen to cause sudden and large fluctuations in the transcutaneous oxygen tension. By providing the anesthesiologist with continuous and immediate data on the cardiorespiratory status of the infant, transcutaneous oxygen monitoring makes itself a valuable addition to the equipment used in the intraoperative monitoring of the neonate.

  16. Near-death experience in a boy undergoing uneventful elective surgery under general anesthesia.

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    Lopez, Ursula; Forster, Alain; Annoni, Jean-Marie; Habre, Walid; Iselin-Chaves, Irène A

    2006-01-01

    Near-death experience (NDE) is a complex subjective experience, which may include affective elements such as a sense of peacefulness, paranormal components such as a sensation of floating out of the body, and a perception of being in a dark tunnel and seeing a brilliant light. It is usually reported to occur in association with a wide range of life-threatening situations, as for instance, cardiopulmonary resuscitation. We report on an episode of NDE that occurred in a 12-year-old boy who underwent a general anesthesia for an elective uncomplicated surgery. To our knowledge, this is the first case of NDE in a child that has been reported in this context.

  17. [Difficult airway management for general anesthesia in two patients with Kartagener syndrome].

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    Andoh, Taiki; Momota, Yoshihiro; Murata, Kenji; Kotani, Junichiro

    2010-05-01

    Two patients with Kartagener syndrome were managed under general anesthesia by nasal intubation for sagital split ramus osteotomy. Many episodes of expectoration were encountered in the former patient's perioperative period and the expectoration discharge was inadequate by postoperative nausea, leading to trouble in airway management. In the second patient, tube collapse was caused after intubation by serious nasal cavity strangulation, and re-intubation was necessary. Expectoration is seen resulting from decreased ciliary function with bronchiectasis during anesthetic management of patients with Kartagener syndrome. It is important to prevent lung complications by nausea prevention and pain killing in the postoperative period, in addition to proper suctioning in the perioperative period. Furthermore, there is nasal cavity narrowing by chronic sinusitis. When performing nasal intubation, the difficult airway management is required.

  18. Hemoptysis during general anesthesia in a diabetic patient with healed tuberculosis: a case report

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    Chung, Mee Young; Jeong, Hyeon-Do; Kim, Seul-Gi

    2017-01-01

    Hemoptysis is a common complication of pulmonary tuberculosis. Most of the cases of hemoptysis originate from hypertrophied bronchial arteries. Also, diabetes induces pulmonary vascular abnormalities such as endothelial dysfunction, inflammatory infiltration and pulmonary vascular remodeling. A 27-year-old male, with diabetes and a history of tuberculosis, underwent the procedure of pars plana vitrectomy under general anesthesia. After an uneventful intra-operative period, he had hemoptysis prior to extubation. Emergency fiberoptic bronchscopy showed blood plugs and spotted fresh blood at the right upper lobar bronchus. After successful embolization of the bronchial artery, the patient made a recovery and was discharged without experiencing any complication. Predisposing factors of hemoptysis in this case are presumed to be tuberculosis and diabetes. The bleeding might had been caused by the rupture of a weakened artery within the cavity in the right upper lobe, through expansion of the lung during manual ventilation by positive pressure. PMID:28184273

  19. Effect of Mild Hypercapnia on Lung Oxygenation in Sitting Position During Shoulder Arthroscopy Under General Anesthesia

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    Kwak, Hyun Jeong; Lee, Ji Yeon; Lee, Jong Wha; Kim, Hong Soon; Hur, Ho Jin; Kim, Ji Young

    2017-01-01

    Background Mild hypercapnia is permitted during surgeries in sitting position under general anesthesia to maintain cerebral regional oxygen saturation (rSO2). However, since hypoventilation may cause gas exchange impairment, we evaluated effects of mild hypercapnia on lung oxygenation during shoulder arthroscopy in sitting position. Material/Methods Forty patients were randomly allocated to a normocapnia group (ETCO2 35 mmHg, n=20) or a hypercapnia group (45 mmHg, n=20). The mean arterial pressure (MAP), heart rate (HR), and rSO2 were measured 5 min after intubation in supine position (T0), and at 2, 4, 6, 8, 10, 20, 30, 40, 50, and 60 min of remaining in sitting position (T1–10). Arterial blood gas was analyzed at T0 and T5. The oxygenation index (PaO2/FiO2) and dead-space ventilation ratio (Vd/Vt) were calculated. Results There were no differences in PaO2/FiO2 at T0 and T5 between the 2 groups. At T5, the Vd/Vt was higher in the normocapnia group than in the hypercapnia group (p=0.04). The Vd/Vt at T5 increased from T0 in the normocapnia group. The incidence of cerebral desaturation in the hypercapnia group (0/20) was lower than in the normocapnia group (5/20) (p=0.047). Among rSO2, MAP, and HR, only changes in rSO2 over time between the 2 groups differed significantly (p=0.048). Conclusions Mild hypercapnia did not decrease lung oxygenation in sitting position, probably due to attenuation of the increase in dead-space ventilation ratio. Since hypercapnia maintained rSO2 without changes in oxygenation index and hemodynamic parameters, mild hypercapnia should be maintained during shoulder arthroscopy in sitting position under general anesthesia. PMID:28202896

  20. Effect of Oral Midazolam Premedication on Children’s Co-operation Before General Anesthesia in Pediatric Dentistry

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    Nasser Kaviani

    2014-09-01

    Full Text Available Statement of the Problem: Premedication is expedient in reducing the psychological trauma from recalling the unpleasant pre-anesthetic phases, hence, inducing a trouble-free anesthesia. Purpose: This study aimed to determine the effectiveness of oral midazolam in co-operation of the subjects before general anesthesia and in recalling the pre-anesthetic phases, performed on children candidate for dental treatment under general anesthesia. Materials and Method: In this prospective clinical trial study, 62 healthy non-cooperative children, candidate for dental treatment under general anesthesia, were randomly divided into study and control groups. The children received 20ml orange juice, 20 minutes before starting the anesthesia. The juice of the test group contained 0.5mg/kg of midazolam and that of the control group included no medication. The induction and the maintenance process of anesthesia were similar in both groups. The manner of subjects when separated from parents, their cooperation during intravenous catheterization, and recalling the pre-anesthetic events were recorded. Data were analyzed by adopting chi-square and Mann-Whitney tests. Results: Most of the children in the test group had a comfortable separation from parents, restful IV catheterization and 90% of the subjects did not recall the pre-anesthetic events. Conclusion: Under the circumstances of this study, it could be concluded that 0.5mg/kg oral midazolam premedication is effective for comfortable separation of children from parents and restful IV catheterization and also forgetting the pre-anesthetic events.

  1. Premedication with clonidine versus fentanyl for intraoperative hemodynamic stability and recovery outcome during laparoscopic cholecystectomy under general anesthesia

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    Gupta, Kumkum; Lakhanpal, Mahima; Prashant K.Gupta; Krishan, Atul; Rastogi, Bhawna; Tiwari, Vaibhav

    2013-01-01

    Background: Laparoscopic cholecystectomy under general anesthesia induced intraoperative hemodynamic responses which should be attenuated by appropriate premedication. The present study was aimed to compare the clinical efficacy of clonidine and fentanyl premedication during laparoscopic cholecystectomy for attenuation of hemodynamic responses with postoperative recovery outcome. Subjects and Methods: In this prospective randomized double blind study 64 adult consented patients of either sex ...

  2. [A Case of General Anesthesia for a Cardiac Transplanted Patient Undergoing Inguinal Hernia Repair under Laparoscopic Surgery].

    Science.gov (United States)

    Inoue, Mitsuko; Hayashi, Yasue; Fujita, Yuki; Shimizu, Motoko; Hotta, Arisa; Nakamoto, Ai; Yoshikawa, Noriko; Ohira, Naoko; Tatekawa, Shigeki

    2016-04-01

    A 52-year-old man was scheduled for the repair of inguinal hernia recurrence. When he was 48 years of age, he received a heart transplantation due to severe heart failure resulting from ischemic heart disease. When he was 50 years old, he suffered from inguinal hernia, and it was repaired under spinal anesthesia. During this surgery, he experienced pain because of the inadequate effect of anesthesia, but his blood pressure and heart rate were stable. We suspected that this was because of denervation of the heart. On hernia repair for inguinal hernia recurrence, general anesthesia was chosen, induced with midazolam, rocuronium, and fentanyl and maintained with sevoflurane, rocuronium, fentanyl, and remifentanil. The blood pressure was mostly stable during anesthesia, but we noted an increase in the heart rate when the trachea was intubated and extubated and when surgical incision started. This phenomenon may indicate reinnervation of the transplanted heart. We could safely manage anesthesia without invasive monitoring because the transplanted heart functioned favorably and surgery was minimally invasive.

  3. Relationship between pre-anesthetic and intra-anesthetic airway resistance in patients undergoing general anesthesia: A prospective observational study

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    Ikeda, Takamitsu; Uchida, Kanji; Yamauchi, Yasuhiro; Nagase, Takahide; Oba, Koji; Yamada, Yoshitsugu

    2017-01-01

    Surgery patients in Japan undergo routine spirometry testing prior to general anesthesia. The use of a flow sensor during general anesthesia has recently become common. However, it is not certain whether the information derived from flow-volume curves is being adequately used for mechanical ventilation management during general anesthesia. So far, there have been no attempts to calculate airway resistance using flow-volume curves. Therefore, we performed a prospective, observational study to investigate the relationship between pre-anesthetic and intra-anesthetic airway resistance in patients scheduled for surgery under general anesthesia. We calculated pre-anesthetic and intra-anesthetic airway resistance in each patient, based on the slopes of flow-volume curves obtained prior to and during general anesthesia. We also calculated endotracheal tube resistance to correct the intra-anesthetic airway resistance values calculated. A total of 526 patients were included in the study, and 98 patients had a forced expiratory volume in the first second/forced vital capacity ratio of mechanical ventilation (p = 0.48). Pre-anesthetic and intra-anesthetic airway resistance values were closer to each other in patients without airflow obstruction, with a mean difference < 1.0 cmH2O L-1s-1, than in those with airflow obstruction, although these respiratory parameters were significantly different (p < 0.001). Intra-anesthetic airway resistance was not related to the FEV1/FVC ratio, regardless of the degree to which the FEV1/FVC ratio reflected pre-anesthetic airway resistance. As compared with patients with airflow obstruction, the mean difference between pre-anesthetic and intra-anesthetic airway resistance was small in patients without airflow obstruction. PMID:28212451

  4. Anestesia geral versus raquianestesia para colecistectomia videolaparoscópica Anestesia general versus raquianestesia para colecistectomía videolaparoscópica General anesthesia versus spinal anesthesia for laparoscopic cholecystectomy

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    Luiz Eduardo Imbelloni

    2010-06-01

    posibilidad de realizar la colecistectomía laparoscópica bajo raquianestesia, comparándolo con la anestesia general. MÉTODO: Entre julio del 2007 y septiembre del 2008, 68 pacientes con síntomas de cálculo en la vesícula se incluyeron en el estudio. Pacientes estado físico ASA I y II, fueron aleatoriamente separados para ser operados de colecistectomía laparoscópica con neumoperitoneo con baja presión de CO2 bajo anestesia general (n = 33 o raquianestesia (n = 35. La anestesia general fue realizada con propofol, fentanil, rocuronio, sevoflurano e intubación traqueal. La raquianestesia fue realizada con 15 mg de bupivacaína hiperbárica con 20 µg fentanil hasta que el nivel sensitivo alcanzase T3· Los parámetros intraoperatorios, como el dolor postoperatorio, complicaciones, recuperación, satisfacción del paciente y coste, fueron comparados entre los grupos. RESULTADOS: Todos los procedimientos quirúrgicos se completaron con el método de elección y apenas un paciente fue convertido de la raquianestesia para la anestesia general. El dolor fue significativamente menor em 2, 4 y 6 horas después del procedimiento bajo raquianestesia, comparado con el grupo que recibió anestesia general. El coste de la raquianestesia fue significativamente menor. Todos los pacientes fueron liberados después de 24 horas. En la evaluación del postoperatorio, todos los pacientes quedaron satisfechos con la raquianestesia y recomendarían ese procedimiento. CONCLUSIONES: La colecistectomía laparoscópica con neumoperitoneo en baja presión de CO2 puede ser realizada con seguridad bajo raquianestesia. La raquianestesia estuvo asociada con un mínimo de dolor en el postoperatorio, mejor recuperación y un menor coste que la anestesia general.BACKGROUND AND OBJECTIVES: Laparoscopic cholecystectomy is the treatment of choice for cholelithiasis. The objective of this study was to compare the possibility of performing laparoscopic cholecystectomy under spinal anesthesia versus

  5. Regional anesthesia as compared to general anesthesia for surgery in geriatric patients with hip fracture: Does it decrease morbidity, mortality and healthcare costs? Results of a single-centered study

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    Le-Wendling, Linda; Bihorac, Azra; Baslanti, Tezcan Ozrazgat; Lucas, Stephen; Sadasivan, Kalia; Heyman, James; Wendling, Adam; Heyman, H. James; Boezaart, Andre

    2013-01-01

    Introduction Hip fracture in geriatric patients has a substantial economic impact and represents a major cause of morbidity and mortality in this population. At our institution, a regional anesthesia program was instituted for patients undergoing surgery for hip fracture. This retrospective cohort review examines the effects of regional anesthesia (from mainly after July 2007) versus general anesthesia (mainly prior to July 2007) on morbidity, mortality and hospitalization costs. Methods This retrospective cohort study involved data collection from electronic and paper charts of 308 patients who underwent surgery for hip fracture from September 2006 to December 2008. Data on postoperative morbidity, in-patient mortality, and cost of hospitalization (as estimated from data on hospital charges) were collected and analyzed. Seventy-three patients received regional anesthesia and 235 patients received general anesthesia. During July 2007, approximately halfway through the study period, a regional anesthesia and analgesia program was introduced. Results The average cost of hospitalization in patients who receive surgery for hip fracture was no different between patients who receive regional or general anesthesia ($16,789 + 631 v. $16,815 + 643, respectively, p = 0.9557). Delay in surgery and intensive care unit admission resulted in significantly higher hospitalization costs. Age, male gender, African-American race and intensive care unit admission were associated with increased in-hospital mortality. In-hospital mortality and rates of readmission are not statistically different between the two anesthesia groups. Conclusions There is no difference in postoperative morbidity, rates of re-hospitalization, in-patient mortality or hospitalization costs in geriatric patients undergoing regional or general anesthesia for repair of hip fracture. Delay in surgery beyond 3 days and intensive care unit admission both increase cost of hospitalization. PMID:22758782

  6. Effect of Low-Dose (Single-Dose Magnesium Sulfate on Postoperative Analgesia in Hysterectomy Patients Receiving Balanced General Anesthesia

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    Arman Taheri

    2015-01-01

    Full Text Available Background and Aim. Aparallel, randomized, double blinded, placebo-controlled trial study was designed to assess the efficacy of single low dose of intravenous magnesium sulfate on post-total abdominal hysterectomy (TAH pain relief under balanced general anesthesia. Subject and Methods. Forty women undergoing TAH surgery were assigned to two magnesium sulfate (N=20 and normal saline (N=20 groups randomly. The magnesium group received magnesium sulfate 50 mg·kg−1 in 100 mL of normal saline solution i.v as single-dose, just 15 minutes before induction of anesthesia whereas patients in control group received 100 mL of 0.9% sodium chloride solution at the same time. The same balanced general anesthesia was induced for two groups. Pethidine consumption was recorded over 24 hours precisely as postoperative analgesic. Pain score was evaluated with Numeric Rating Scale (NRS at 0, 6, 12, and 24 hours after the surgeries. Results. Postoperative pain score was lower in magnesium group at 6, 12, and 24 hours after the operations significantly (P<0.05. Pethidine requirement was significantly lower in magnesium group throughout 24 hours after the surgeries (P=0.0001. Conclusion. Single dose of magnesium sulfate during balanced general anesthesia could be considered as effective and safe method to reduce postoperative pain and opioid consumption after TAH.

  7. Cerebral oxygenation and processed EEG response to clamping and shunting during carotid endarterectomy under general anesthesia.

    Science.gov (United States)

    Perez, William; Dukatz, Christopher; El-Dalati, Sami; Duncan, James; Abdel-Rasoul, Mahmoud; Springer, Andrew; Go, Michael R; Dzwonczyk, Roger

    2015-12-01

    Clamping and shunting during carotid endarterectomy (CEA) surgery causes changes in cerebral blood flow. The purpose of this study was to assess and compare, side by side, the cerebral oxygenation (rSO2) and processed electroencephalogram (EEG) response bilaterally to carotid artery clamping and shunting in patients undergoing CEA under general anesthesia. With institutional approval and written informed consent, patients undergoing CEA under general anesthesia and routine carotid artery shunting were recorded bilaterally, simultaneously and continuously with an rSO2 and processed EEG monitor. The response of the monitors during carotid artery clamping and shunting were assessed and compared between monitors and bilaterally within each monitor. Sixty-nine patients were included in the study. At clamping the surgical-side and contralateral-side rSO2 dropped significantly below the baseline incision value (-17.6 and -9.4% respectively). After shunting, the contralateral-side rSO2 returned to baseline while the surgical-side rSO2 remained significantly below baseline (-9.0%) until the shunt was removed following surgery. At clamping the surgical-side and contralateral-side processed EEG also dropped below baseline (-19.9 and -20.6% respectively). However, following shunt activation, the processed EEG returned bilaterally to baseline. During the course of this research, we found the rSO2 monitor to be clinically more robust (4.4% failure rate) than the processed EEG monitor (20.0% failure rate). There was no correlation between the rSO2 or processed EEG changes that occurred immediately after clamping and the degree of surgical side stenosis measured pre-operatively. Both rSO2 and processed EEG respond to clamping and shunting during CEA. Cerebral oximetry discriminates between the surgical and contralateral side during surgery. The rSO2 monitor is more reliable in the real-world clinical setting. Future studies should focus on developing algorithms based on these

  8. Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods: Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0.75% pure bupivacaine (8-12 mg) was applied to patients in Group Ⅰ (n= 30). Patients in Group Ⅱ (n=30) received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results: The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ. Obturator nerve reflex was observed in 15 (50.0%) patients in Group Ⅰ, but none (0%) in Group Ⅱ (P<0.01). Conclusion: Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.

  9. Oral health-related quality of life in pediatric patients under general anesthesia

    Science.gov (United States)

    Li, Lanlan; Wang, Hongwei; Han, Xueping

    2017-01-01

    Abstract Our goal was to evaluate how dental treatments under general anesthesia (GA) affect the quality of life by a prospective pair-matched design. Pediatric patients, who had received dental treatments under GA, were enrolled and were asked to complete the Early Childhood Oral Health Impact Scale (ECOHIS) before the treatment and 1 month after the treatment. To shield the observed impacts, a pair-matched control group was performed. Patients in the control group were also required to complete the ECOHIS at these different points in time. In both groups, the items of troubled sleep and oral/dental pain scored highest, whereas avoiding smiling or laughing and avoiding talking scored lowest before the treatment. The total mean score in the 2 groups was 13.1 and 13.7, respectively, and there was no significant statistical difference (P > 0.05). However, the total mean score was 1.9 in the experimental group after the treatment and smaller compared with the control group (1.9 vs. 4.7, P < 0.001). The majority of the items in both groups had an apparent effect size and the total mean effect in the experimental group was greater than that in the control group (85.5% vs. 65.7%, P < 0.001). Therefore, dental treatment under GA could provide better quality of life restoration compared with treatment over multiple visits. PMID:28079793

  10. Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants

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    Windram, Jonathan; Grosse-Wortmann, Lars; Shariat, Masoud; Greer, Mary-Louise; Yoo, Shi-Joon [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Crawford, Mark W. [Hospital for Sick Children, Department of Anesthesia, Toronto (Canada)

    2012-02-15

    MRI in small children generally necessitates the use of general anesthesia. We describe our initial results with a new technique that we name the feed-and-sleep method, whereby an infant can undergo a cardiac MRI without the need for general anesthesia or sedation. The infant is fasted for 4 h prior to the scan and is then fed by his mother prior to the scan. He is then swaddled with 1 to 2 infant sheets before being placed in a vacuum-bag immobilizer. As air is removed from the bag, the immobilizer becomes a rigid cradle that fits the infant's body. We prioritize the sequences according to the purpose of the study and in the order of clinical importance. Between January 2010 and January 2011 a total of 20 infants with the median age 14.5 days (minimum 2 days, maximum 155 days) underwent CMR studies via this method. All were performed successfully with no distress to the infant. The median scan time was 46.5 min (minimum 20, maximum 66). All had complex congenital heart defects and all planned sequences were acquired with sufficient quality to allow accurate diagnosis and to plan appropriate surgery. Using this technique, infants younger than 6 months can complete a cardiovascular MRI without the need for sedation or general anesthesia. We advocate the incorporation of this safe and reliable technique into routine clinical practice. (orig.)

  11. COMPARISON OF ONDANSETRON IN TWO DIFFERENT DOSES IN THE REDUCTION OF POST ANESTHETIC SHIVERING AFTER GENERAL ANESTHESIA

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    Umar Qadir

    2015-03-01

    Full Text Available GOALS OF STUDY: Ondansetron, a specific 5 - HT 3 antagonist, conventionally used as an antiemetic may also affect perioperative thermoregulation and Post Anesthetic Shivering (PAS. Therefore, we decided to compare the effect of Ondansetron in 2 different doses (4mg and 8 mg given just before the induction of general anesthesia on the incidence of PAS. METHODS: A double blind, placebo - controlled study was adopted to study 90 patients divided into 3 equal groups receiving general anesthesia for elective general surgeries. Groups – A, B and C received Ondansetron 4 mg, 8mg and Normal Saline 4 ml I/V respectively immediately before anesthetic induction. Core and peripheral temperatures were documented every 10 minutes from baseline to recovery from anaesthesia. After recovery from anaesthesia the occurrence of shivering was documented. Data was entered in excel and statistically important tests were done. P <0.05 was considered as significant. RESULTS: The incidence of PAS was 60% in the Group - C compared with 16.7% in Group - B , and 36.7% in Group - A. PAS was significantly low in the group receiving 8 mg ondansetron. CONCLUSIONS: Ondansetron 8 mg when compared with Ondansetron 4 mg given before the induction of anesthesia, reduces the incidence of PAS in adults significantly, without affecting the core – to - peripheral redistribution of temperature. The incidence of shivering was highest in the control group (60% with an intermediate incidence in the group receiving 4mg Ondansetron (36.7% and a lowest incidence in the group receiving 8mg Ondansetron (16.7%. CONTEXT: Different observations suggest that the serotonergic system has a role in the control of postanesthetic shivering. Ondansetron is a specific 5 - HT 3 antagonist that may affect perioperative thermoregulation and PAS. Therefore, we decided to compare the effect of Ondansetron, in 2 different doses (4mg and 8 mg given just before the induction of general anesthesia, on the

  12. Breath isoprene concentrations in persons undergoing general anesthesia and in healthy volunteers.

    Science.gov (United States)

    Hornuss, Cyrill; Zagler, Armin; Dolch, Michael E; Wiepcke, Dirk; Praun, Siegfried; Boulesteix, Anne-Laure; Weis, Florian; Apfel, Christian C; Schelling, Gustav

    2012-12-01

    Human breath contains an abundance of volatile organic compounds (VOCs). Analysis of breath VOC may be used for diagnosis of various diseases or for on-line monitoring in anesthesia and intensive care. However, VOC concentrations largely depend on the breath sampling method and have a large inter-individual variability. For the development of breath tests, the influence of breath sampling methods and study subject characteristics on VOC concentrations has to be known. Therefore, we investigated the VOC isoprene in 62 study subjects during anesthesia and 16 spontaneously breathing healthy volunteers to determine (a) the influence of artificial and spontaneous ventilation and (b) the influence of study subject characteristics on breath isoprene concentrations. We used ion molecule reaction mass spectrometry for high-resolution breath-by-breath analysis of isoprene. We found that persons during anesthesia had significantly increased inspiratory and end-expiratory isoprene breath concentrations. Measured isoprene concentrations (median [first quartile-third quartile]) were in the anesthesia group: 54 [40-79] ppb (inspiratory) and 224 [171-309] ppb (end-expiratory), volunteer group: 14 [11-17] ppb (inspiratory) and 174 [124-202] ppb (end-expiratory). Higher end-tidal CO(2) concentrations in ventilated subjects were associated with higher expiratory isoprene levels. Furthermore, inspiratory and end-expiratory isoprene concentrations were correlated during anesthesia (r = 0.603, p < 0.001). Multivariate analysis showed that men had significantly higher end-expiratory isoprene concentrations than women. Rebreathing of isoprene from the anesthesia machine possibly accounts for the observed increase in isoprene in the anesthesia group.

  13. Capturing Pain in the Cortex during General Anesthesia: Near Infrared Spectroscopy Measures in Patients Undergoing Catheter Ablation of Arrhythmias.

    Directory of Open Access Journals (Sweden)

    Barry D Kussman

    Full Text Available The predictability of pain makes surgery an ideal model for the study of pain and the development of strategies for analgesia and reduction of perioperative pain. As functional near-infrared spectroscopy reproduces the known functional magnetic resonance imaging activations in response to a painful stimulus, we evaluated the feasibility of functional near-infrared spectroscopy to measure cortical responses to noxious stimulation during general anesthesia. A multichannel continuous wave near-infrared imager was used to measure somatosensory and frontal cortical activation in patients undergoing catheter ablation of arrhythmias under general anesthesia. Anesthetic technique was standardized and intraoperative NIRS signals recorded continuously with markers placed in the data set for the timing and duration of each cardiac ablation event. Frontal cortical signals only were suitable for analysis in five of eight patients studied (mean age 14 ± 1 years, weight 66.7 ± 17.6 kg, 2 males. Thirty ablative lesions were recorded for the five patients. Radiofrequency or cryoablation was temporally associated with a hemodynamic response function in the frontal cortex characterized by a significant decrease in oxyhemoglobin concentration (paired t-test, p<0.05 with the nadir occurring in the period 4 to 6 seconds after application of the ablative lesion. Cortical signals produced by catheter ablation of arrhythmias in patients under general anesthesia mirrored those seen with noxious stimulation in awake, healthy volunteers, during sedation for colonoscopy, and functional Magnetic Resonance Imaging activations in response to pain. This study demonstrates the feasibility and potential utility of functional near-infrared spectroscopy as an objective measure of cortical activation under general anesthesia.

  14. Dexmedetomidine for awake intubation and an opioid-free general anesthesia in a superobese patient with suspected difficult intubation

    OpenAIRE

    Gaszynski T; Gaszynska E; Szewczyk T

    2014-01-01

    Tomasz Gaszynski,1 Ewelina Gaszynska,2 Tomasz Szewczyk31Department of Anesthesiology and Intensive Therapy, 2Department of Hygiene and Health Promotion, 3Department of Gastroenterology, Oncology, and General Surgery, Barlicki University Hospital, Medical University of Lodz, PolandAbstract: Super-obese patients (body mass index [BMI] >50 kg/m2) are at a particularly high risk of anesthesia-related complications during postoperative period, eg, critical respiratory events including respi...

  15. Evaluation of efficacy of restorative dental treatment provided under general anesthesia at hospitalized pediatric dental patients of Isfahan

    OpenAIRE

    Eshghi, Alireza; Samani, Mahdi Jafarzadeh; Najafi, Naghme Feyzi; Hajiahmadi, Maryam

    2012-01-01

    Background: General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. Materials and Methods: In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan's hospitalized dentistry center were examined. The examination was performed on dental ...

  16. A combination therapy of ethanol injection and radiofrequency ablation under general anesthesia for the treatment of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kazutaka Kurokohchi; Tomohiko Taminato; Shigeki Kuriyama; Seishiro Watanabe; Hirohito Yoneyama; Akihiro Deguchi; Tsutomu Masaki; Takashi Himoto; Hisaaki Miyoshi; Hamdy Saad Mohammad; Akira Kitanaka

    2008-01-01

    AIM: To summarize the effects of laparoscopic ethanol injection and radiofrequency ablation (L-EI-RFA), thora-coscopic (T-EI-RFA) and open-surgery assisted EI-RFA (O-EI-RFA) under general anesthesia for the treatment of hepatocellular carcinoma (HCC).METHODS: Time-lag performance of RFA after ethanol injection (Time-lag PEI-RFA) was performed in all cases. The volume of coagulated necrosis and the applied energy for total and per unit volume coagulated necrosis were examined in the groups treated under general (group G) or local anesthesia (group L).RESULTS: The results showed that the total applied energy and the applied energy per unit volume of whole and marginal, coagulated necrosis were significantly larger in group G than those in the group L, resulting in a larger volume of coagulated necrosis in the group G. The rate of local tumor recurrence within one year was extremely low in group G.CONCLUSION: These results suggest that EI-RFA, under general anesthesia, may be effective for the treatment of HCC because a larger quantity of ethanol and energy could be applied during treatment under pain-free condition for the patients.

  17. Hemodynamic Effect of 2% Lidocaine with 1:80,000 Epinephrine Infiltration in Maxillofacial Surgeries under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Baratollah Shaban

    2013-12-01

    Full Text Available Introduction: Epinephrine-containing lidocaine is the most used anestheic drug in dentistry. The aim of this study was to investigate the hemodynamic changes following local infiltration of 2% lidocaine with 1:80,000 epinephrine in subjects undergoing orthognatic surgery under general anesthesia. Methods: Twenty five patients without any systemic disease participated. After general anesthesia, two cartridges of 2% lidocaine + 1:80,000 epinephrine were infiltrated around the surgery site. Systolic (SBP and diastolic (DBP blood pressure, mean arterial blood pressure (MAP, heart rate (HR, and blood sugar (BS were measured in three stages: before the injection (M1, at the end of injection (M2, and 10 min after injection (M3. Results: No significant difference observed in SBP, DBP, and MAP at the end of injection and 10 min later. HR was increased significantly after injection and remained significantly higher than baseline after 10 min. BS increased slightly at the end of injection and continued to increase after 10 min. However, changes in BS were not significant. Conclusion: Using two cartridges of epinephrine-containing lidocaine have slight systemic changes in healthy subjects; as a result, this dosage could be used in patients with cardiovascular complications undergoing general anesthesia.

  18. A Four-Year Monocentric Study of the Complications of Third Molars Extractions under General Anesthesia: About 2112 Patients

    Directory of Open Access Journals (Sweden)

    A. Guerrouani

    2013-01-01

    Full Text Available Introduction. The aim of this study was to assess the complications resulting from third molar extraction under general anesthesia. Material and Methods. The retrospective study included all patients who underwent impacted third molars extraction from January 2008 until December 2011. 7659 third molars were extracted for 2112 patients. Postoperative complications were retrieved from medical files. Results. No complications were related to general anesthesia. The most frequent postoperative complication was infection (7.15%. Lingual nerve injuries affected 1.8% of the patients. All of them were transient and were not related to tooth section. Inferior alveolar nerve injuries were reported in 0.4% of the cases. 95.8% of these patients were admitted for one-day ambulatory care, and only two patients were readmitted after discharge from hospital. Discussion. This surgical technique offers comfort for both surgeons and patients. Risks are only linked to the surgical procedure as we observed no complication resulting from general anesthesia. One-day hospitalization offers a good balance between comfort, security, and cost. The incidence of complications is in agreement with the literature data, especially regarding pain, edema, and infectious and nervous complications. It is of utmost importance to discuss indications with patients, and to provide them with clear information.

  19. Hemodynamic Effect of 2% Lidocaine with 1:80,000 Epinephrine Infiltration in Maxillofacial Surgeries under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Baratollah Shaban

    2013-01-01

    Full Text Available Introduction: Epinephrine-containing lidocaine is the most used anestheic drug in dentistry. The aim of this study was to investigate the hemodynamic changes following local infiltration of 2%lidocaine with 1:80,000 epinephrine in subjects undergoing orthognatic surgery under general anesthesia. Methods: Twenty five patients without any systemic disease participated. After general anesthesia, two cartridges of 2% lidocaine + 1:80,000 epinephrine were infiltrated around the surgery site. Systolic (SBP and diastolic (DBP blood pressure, mean arterial blood pressure (MAP, heart rate (HR, and blood sugar (BS were measured in three stages: before the injection (M1, at the end of injection (M2, and 10 min after injection (M3. Results: No significant difference observed in SBP, DBP, and MAP at the end of injection and 10 min later. HR was increased significantly after injection and remained significantly higher than baseline after 10 min. BS increased slightly at the end of injection and continued to increase after 10 min. However, changes in BS were not significant. Conclusion: Using two cartridges of epinephrine-containing lidocaine have slight systemic changes in healthy subjects; as a result, this dosage could be used in patients with cardiovascular complications undergoing general anesthesia.

  20. Exposure to general anesthesia and risk of alzheimer's disease: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Seitz Dallas P

    2011-12-01

    Full Text Available Abstract Background Alzheimer's disease (AD is common among older adults and leads to significant disability. Volatile anesthetic gases administered during general anesthesia (GA have been hypothesized to be a risk factor for the development of AD. The objective of this study is to systematically review the association between exposure to GA and risk of AD. Methods We searched electronic databases including MEDLINE, Embase, and Google scholar for observational studies examining the association between exposure to GA and risk of AD. We examined study quality using a modified version of the Newcastle-Ottawa risk of bias assessment for observational studies. We used standard meta-analytic techniques to estimate pooled odds ratios (OR and 95% confidence intervals (CI. Subgroup and sensitivity analyses were undertaken to evaluate the robustness of the findings. Results A total of 15 case-control studies were included in the review. No cohort studies were identified that met inclusion criteria. There was variation in the methodological quality of included studies. There was no significant association between any exposure to GA and risk of AD (pooled OR: 1.05; 95% CI: 0.93 - 1.19, Z = 0.80, p = 0.43. There was also no significant association between GA and risk of AD in several subgroup and sensitivity analyses. Conclusions A history of exposure to GA is not associated with an increased risk of AD although there are few high-quality studies in this area. Prospective cohort studies with long-term follow-up or randomized controlled trials are required to further understand the association between GA and AD.

  1. A Comparative Study between Intramuscular Midazolam and Oral Clonidine As A Premedication For General Anesthesia

    Directory of Open Access Journals (Sweden)

    Jignasa J Patel

    2015-12-01

    Full Text Available Background: Most anesthesiologists agree on the need for efficient pre-medication. The pattern of desired effects of a pre-medication is however, complex and includes relief of anxiety, sedation and relaxation of the patient. The present study was undertaken to compare the effects of Midazolam and clonidine as premedication. Methodology: A comparative study between midazolam and clonidine as a premedication for general anesthesia was conducted. Patients were divided in two groups: Group I: Inj. Midazolam 0.07 mg/kg i.m. before surgery; Group II Tab.Clonidine 4 and micro;g/kg oral, 2 hours before surgery. Pulse rate, blood pressure, state of excitement, apprehension and sedation were noted at the time of giving premedication. Results: Majority of cases in both the groups were in the age group of 16-30 years (56%. Gender wise distribution shows 40% cases were males and 60% were females. The sedation score, apprehension score and excitement score in both the groups before and after induction was statistically significant. There is no significant difference in dose requirement of pentothal for induction between midazolam and clonidine group. The amnesia score shows that midazolam produces more potent and perfect amnesia as compared to clonidine. Amnesia score in both the groups was statistically significant Conclusion: It was concluded from the present study that midazolam was superior to clonidine in its sedative and anxiolytic effects, had a potent amnesia and does not attenuate hemodynamic response to laryngoscopy and intubation and does not prolong recovery time. [Natl J Med Res 2015; 5(4.000: 312-315

  2. Adverse reactions to suxamethonium and other muscle relaxants under general anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Vervloet, D.; Nizankowska, E.; Arnaud, A.; Senft, M.; Alazia, M.; Charpin, J.

    1983-06-01

    The mechanisms of anaphylactic reactions to muscle relaxants under general anesthesia are not completely understood. Extending an earlier study, we report 41 cases of anaphylactic shock investigated by intradermal skin tests with muscle relaxants (suxamethonium, pancuronium, gallamine, nortoxiferine), in vitro leukocyte histamine release, and Prausnitz-Kuestner tests. Intradermal tests were significantly positive at concentrations ranging from 10 to 10(5) times less than those in controls. Reproducibility tested for suxamethonium at a 1-year interval in five patients was good. Histamine release induced by muscle relaxants in Tris-albumin-Ca++-Mg++ buffer showed positive results in 8/25 instances and was inhibited by antigen excess in seven cases. Addition of 50% deuterium oxide (D2O) caused significant increase of histamine release in positive cases and induced release in all five negative cases studied. Muscle relaxant-induced histamine release was inhibited by in vitro anti-IgE leukocyte desensitization. The mean maximal histamine release dropped from 58.2% +/- 9.7 to 5.8% +/- 2 (p less than 0.01). Similarly, leukocyte desensitization also inhibited histamine release induced by anti-IgE but not by formyl-L-methionyl-L-leucyl-L-phenylalanine or poly-L-arginine. Prausnitz-Kuestner tests were positive in five out of 21 cases studied and became negative after heat inactivation. These results confirm the usefulness of intradermal skin tests in diagnosis of patients' reaction to muscle relaxants and suggest an IgE-mediated rather than an idiosyncratic mechanism.

  3. [A case of a pediatric patient with tuberous sclerosis (Bourneville-Pringle disease) and frequent epileptic seizure for intensive dental treatment under general anesthesia].

    Science.gov (United States)

    Mimura, Shinichiro; Kikura, Mutsuhito; Itagaki, Taiga; Inokuma, Mie; Iwamoto, Tatsuaki; Kawakubo, Atsushi; Hirano, Kazuhiro; Sato, Shigehito

    2006-04-01

    Tuberous sclerosis (Bourneville-Pringle disease) is a rare disease with a triad of mental retardation, epilepsy, and facial spot. Management of the patients with tuberous sclerosis under general anesthesia has been previously reported. However, there are few case reports about management under general anesthesia of a pediatric patient with tuberous sclerosis with frequent epileptic seizure. Here, we report a case of a pediatric patient with tuberous sclerosis and frequent epileptic seizure who underwent intensive dental treatment under general anesthesia with careful management of epilepsy. The patient was discharged on the day of surgery without any complications. In this case report, we discussed the appropriate assessment of the complications of tuberous sclerosis; such as, of central nervous, circulatory, respiratory, endocrine, and urinary systems including the management of general anesthesia.

  4. Effect of esmolol infusion on myocardial oxygen consumption during extubation and quality of recovery in elderly patients undergoing general anesthesia: randomized, double blinded, clinical trial

    Directory of Open Access Journals (Sweden)

    Sherif A. ELokda

    2015-04-01

    Conclusions: Esmolol is a safe, effective and well-tolerated drug that can be used in elderly patients undergoing general anesthesia to reduce the myocardial oxygen consumption and improve the quality of recovery.

  5. High Thoracic Epidural Analgesia as an Adjunct to General Anesthesia is Associated with Better Outcome in Low-to-Moderate Risk Cardiac Surgery Patients

    DEFF Research Database (Denmark)

    Stenger, Michael; Fabrin, Anja; Schmidt, Henrik;

    2013-01-01

    The purpose of this study was to evaluate the addition of high thoracic epidural analgesia (HTEA) to general anesthesia in cardiac surgery patients to enhance the fast-track and improvement in outcome.......The purpose of this study was to evaluate the addition of high thoracic epidural analgesia (HTEA) to general anesthesia in cardiac surgery patients to enhance the fast-track and improvement in outcome....

  6. Validation of continuous noninvasive arterial blood pressure measurements during general anesthesia

    NARCIS (Netherlands)

    Kalmar, A.F.; Vos, Jaap Jan; Weening, M.; Mooyaart, E.A.; Poterman, Marieke; Struys, Michel; Scheeren, Thomas

    2012-01-01

    Background:  Continuous invasive arterial blood pressure (IBP) monitoring remains the accepted gold standard for blood pressure monitoring because of its high accuracy. Several disadvantages of this method motivate the use of noninvasive intermittent blood pressure (NIBP) in most anesthesia cases de

  7. [A Case of Postoperative Paraplegia Caused by Idiopathic Spinal Cord Infarction following Hepatectomy under Both General and Epidural Anesthesia].

    Science.gov (United States)

    Koga, Yukari; Hiraki, Teruyuki; Ushijima, Kazuo

    2015-04-01

    A 73-year-old woman (height : 155 cm, weight : 55 kg) was scheduled to undergo a laparotomic hepatectomy and radiofrequency ablation for hepatocellular carcinoma. Her medical history did not include any relevant conditions such as cardiovascular or neurological disorders. A thoracic epidural catheter was introduced at T8-9 before the induction of anesthesia with intravenous propofol. General anesthesia was maintained with the inhalation of oxygen, air, and desflurane, and the continuous infusion of remifentanil. Several intraoperative episodes of mild hypotension occurred, each of which was successfully treated with intravenous ephedrine, but otherwise her anesthetic course was uneventful, and she recovered from the anesthesia smoothly. Her postoperative pain was well controlled with continuous epidural infusion of levobupivacaine and fentanyl, and she could walk by herself on postoperative day (POD) 1. However, she suffered weakness in her lower extremities on POD2 and subsequently fell into complete paraplegia with sensory loss below the T4 level on POD3. A magnetic resonance imaging scan taken on POD4 showed an idiopathic spinal cord infarction (SCI) involving levels T1 through T4, although no epidural abnormalities, e.g., hematomas, were detected. Immediate treatment with methylprednisolone, ozagrel, and edaravone failed to resolve her symptoms. We suggest that it is of great importance to consider SCI as a differential diagnosis as soon as possible in cases of unanticipated postoperative paraplegia.

  8. Evaluation of clinical and paraclinical effects of intraosseous vs intravenous administration of propofol on general anesthesia in rabbits

    Directory of Open Access Journals (Sweden)

    Ramin Mazaheri-Khameneh

    2012-06-01

    Full Text Available This prospective study aimed to compare the intraosseous (IO and intravenous (IV effects of propofol on selected blood parameters and physiological variables during general anesthesia in rabbits. Thirty New Zealand White rabbits were studied. Six rabbits received IV propofol (group 1 and another 6 rabbits, were injected propofol intraosseously (Group 2 for 30 minutes (experimental groups. Rabbits of the third and fourth groups received IV and IO normal saline at the same volume given to the experimental groups, respectively. In the fifth group IO cannulation was performed but neither propofol nor normal saline were administered. Blood profiles were assayed before induction and after recovery of anesthesia. Heart and respiratory rates, rectal temperature, saturation of peripheral oxygen and mean arterial blood pressure were recorded. Heart rate increased significantly 1 to 5 minutes after induction of anesthesia in experimental groups (P < 0.05. Although mean arterial blood pressure decreased significantly from baseline, values remained above 60 mm Hg (P < 0.05. Respiratory rate decreased significantly in experimental groups, but remained higher in group 2 (P < 0.05. The lymphocyte count decreased significantly in group 1 (P < 0.05. The concentration of alkaline phosphatase in all rabbits, aspartate aminotransferase and gamma- glutamyl transferase in the first group and gamma-glutamyl transferase in the third group increased significantly (P < 0.05. Total bilirubin decreased significantly in group 2 (P < 0.05. All measured values remained within normal limits. Based on the least significant physiological, hematological and biochemical effects, the IO injection of propofol appears to be safe and suitable method of anesthesia in rabbits with limited vascular access.

  9. Cognitive function correlations with apolipoprotein Eε4 single nucleotide polymorphism in 1 000 elderly patients following general anesthesia A randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    Yingmin Cai; Haitao Hu; Rongliang Xue; Pengbin Liu; Gaifeng Feng; Weijiang Dong; Bin Yu; Minggang Zhao

    2009-01-01

    BACKGROUND: Cognitive dysfunction occurs in elderly patients following general anesthesia, and this might be associated with genetics. Studies have shown that theε4 allele gene is closely associated with senile dementia.OBJECTIVE: To compare and analyze the correlations between cognitive dysfunction and single nucleotide polymorphism of apolipoprotein E (ApoE) following inhaJation or intravenous anesthesia.DESIGN, TIME AND SETTING: A randomized, controlled study was performed. The patients were recruited from the Department of Anesthesia, Second Affiliated Hospital, Medical College, Xi'an Jiaotong University, China between May 2005 and December 2008. Genetic analyses were conducted at the Departments of Neuroanatomy and Forensic Medicine, Medical College, Xi'an Jiaotong University, China.PARTICIPANTS: A total of 1 000 patients of ASA Ⅰ-Ⅱ grade, without genetic connection, were enrolled in this study, comprising 520 males and 480 females, aged (70.1±4.6) years and weighing (57.3±7.5) kg. No patients suffered from cognitive dysfunction.METHODS: The patients were equally and randomly divided into intravenous anesthesia and gas anesthesia groups. Total intravenous anesthesia and inhaled anesthesia were used. Genomic DNA from whole blood was extracted. The ApoE gene was amplified by PCR. Restriction fragment length polymorphism of ApoE gene was analyzed. Cognitive function was evaluated by Mini-Mental State Examination (MMSE). Patients scoring 0.05).CONCLUSION: Results demonstrated a correlation between cognitive dysfunction and ApoE single nucleotide polymorphism in elderly patients after gas anesthesia. However, no relationship between cognitive dysfunction and ApoE single nucleotide polymorphism was determined in elderly patients following intravenous anesthesia. Therefore, elderly patients, especially those expressing the ApoEε4 gene, should be cautiously exposed to gas anesthesia.

  10. SPINAL ANESTHESIA A BETTER AND EFFECTIVE ALTERNATIVE TO GENERAL ANEASTHESIA IN SPINE SURGERIES: A PROSPECTIVE OPEN LABEL SINGLE ARM STUDY

    Directory of Open Access Journals (Sweden)

    Kumar Babu

    2014-11-01

    Full Text Available : INTRODUCTION: In all practical purposes various thoraco lumbar and lumbar surgeries like discectomy, laminectomy and spinal fusion procedures are usually performed under general anesthesia (GA. Our aim of this study is to assess whether spinal anesthesia is a better and effective alternative to general anesthesia in terms of economic advantage and functional recovery with both intra and post-operative heamodynamic stability. METHODS: In our study hundred patients with age group 25-45 yrs within the ASA criteria of class I-III were enrolled. All patients were randomly selected based on age, sex, ASS criteria, duration of surgery, heart rate (HR, mean arterial pressure (MAP, blood loss, previous history of risk factors and co morbidities. The severity of postoperative pain based on visual analogue scale (VAS and use of analgesics post operatively, were recorded. RESULTS: There were 41 males and 59 females. The mean age of the patient was 39.28±9.27 yrs. Six patients had hypertension, 11 with diabetes. Patients with ASA Grade I and II and III were 60, 34 and 6 respectively. There were no episodes of air way compromises, 2 patients had spinal aneasthesia failures, no incidence of post dural puncture headache, 3 patients had mean blood pressure fluctuations among them, one patient had post-operative paraperesis due to hematoma treated by immediate decompression, and 13 patients had usage of propofol sedation in terms of comfort. The duration of surgery (range was 77.25±22.44 min (40-120 Severity of postoperative pain after four hours of surgery on VAS was 3.24±0.46. Twenty two patients (22% required analgesics. Two patients had post-operative vomiting. CONCLUSIONS: In our study we have considered that spinal anesthesia for advantages such as less blood loss, intra operative blood pressure and heart rate changes, postoperative pain, quick functional recovery and lower incidence of pulmonary complications. Additionally, during spinal anesthesia

  11. The influence of general anesthesia and surgery on cognition in old age: A twin study

    DEFF Research Database (Denmark)

    Dokkedal, Unni; Hansen, Tom G.; Rasmussen, Lars S;

    Introduction: There is a pronounced variation in level of cognitive function and rate of cognitive decline in late life. Results from smaller human and animal studies suggest that exposure to anesthesia may be a risk factor for cognitive impairment. Using a twin design, the objective of the present...... study was to examine whether exposure to anesthesia and surgery is associated with level of cognitive function in middle and old age. Materials and Methods: The study is based on two population-based surveys comprising 8,503 Danish twins aged 45–102 years at study intake during 1995–2001. Through...... linkage to the Danish National Patient Register, we obtained information on surgeries performed in hospitals in Denmark from 1977 and until study intake. Four exposure groups were defined based on type of surgery (major, minor, knee and hip replacement, other). A cognitive test battery consisting of five...

  12. [Biologically active substances in patients with hypervolemic congenital heart defects undergoing general multicomponent anesthesia].

    Science.gov (United States)

    Gerasimov, N M; Guliamov, D S; Karimova, T Z; Belova, O A; Ivanova, L S; Nam, L N

    1994-01-01

    In 95 patients with hypervolemic congenital heart diseases (42 with interventricular and interatrial septal defects, and 53 with patent ductus arteriosus) mixed venous blood levels of serotonin, histamine, adrenalin, noradrenaline, total 11-hydroxycorticosteroids were studied using spectrofluorimetry, cyclic adenosine- and guanosine-monophosphate (cAMP and cGMP), prostaglandins E+A and F2 alpha and their interaction were assessed using radioimmunoassay and correlation analysis, respectively. Before surgical treatment the patients showed higher (than in the control) concentrations of histamine, adrenalin, noradrenaline, cAMP, and cGMP, prostaglandins E+A. During anesthesia including fentanyl, morphine, diazepam, N2O:O2 in patients with heart valve defects cGMP level was increased and in patients with patent ductus arteriosus cAMP level was increased during analogous anesthesia with morphine replaced by halothane.

  13. 全麻对剖宫产胎儿影响的临床研究%Clinical study of the influence of general anesthesia on cesarean delivery fetus

    Institute of Scientific and Technical Information of China (English)

    李莉; 苏利

    2014-01-01

    Objective To compare the influence of general anesthesia and combined spinal-epidural anesthesia on neonatal Apgar score. Methods A total of 65 cases of single pregnancy to full term undergone cesarean section were taken as study subjects. There were 32 cases in the general anesthesia group received general anesthesia due to intraspinal anesthesia taboo, and the other 33 cases in the combined spinal-epidural anesthesia group received combined spinal-epidural anesthesia. The fetal childbirth time, birth weight, and apgar score at 1 min and 5 min were recorded. Results Apgar score at 1 min of general anesthesia group and combined spinal-epidural anesthesia group were (9.5±0.8) points and (9.8±0.6) points respectively, and there was no significant difference between the two groups (P>0.05). Apgar scores at 5 min were all 10 points in the two groups. Conclusion General anesthesia and combined spinal-epidural anesthesia have no obviously variant influences on fetus.%目的:比较剖宫产施行全身麻醉(全麻)和腰硬联合麻醉对新生儿Apgar评分的影响。方法选择足月单胎妊娠行择期剖宫产的产妇65例,椎管内麻醉禁忌而需使用全麻的剖宫产为全麻组32例,其余33例行腰硬联合麻醉作为腰硬联合麻醉组。记录胎儿娩出时间,新生儿体重和1、5 min的Apgar评分。结果全麻组和腰硬联合麻醉组新生儿1 min的Apgar评分分别为(9.5±0.8)分、(9.8±0.6)分,两组差异无统计学意义(P>0.05)。5 min Apgar评分均为10分。结论全麻和硬联合麻醉对胎儿的影响没有明显差异。

  14. Malignant ventricular dysrhythmias in a patient with isovaleric acidemia receiving general and local anesthesia for suction lipectomy.

    Science.gov (United States)

    Weinberg, G L; Laurito, C E; Geldner, P; Pygon, B H; Burton, B K

    1997-12-01

    We report the occurrence of severe ventricular arrhythmias in a patient with isovaleric acidemia during general anesthesia for suction lipectomy. The timing of events and character of the ECG changes are most consistent with bupivacaine toxicity after subcutaneous injection of tumescence solution containing this local anesthetic. The patient had previously documented carnitine deficiency, a condition which, we speculate, may lower the threshold for bupivacaine induced cardiotoxicity. We review clinical considerations in isovaleric acidemia and conclude that the use of bupivacaine in these patients probably should be avoided.

  15. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

    Directory of Open Access Journals (Sweden)

    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  16. A COMPARATIVE STUDY OF RECOVERY TIME AFTER GENERAL ANESTHESIA AND SUBARCHNOID BLOCK FOR INGUINAL HERNIORRAPHY IN PACU

    Directory of Open Access Journals (Sweden)

    Dipalisingh

    2014-06-01

    Full Text Available BACKGROUND: Inguinal herniorraphy is commonly performed on an outpatient basis under nerve blocks, local, spinal or general anesthesia (GA. We have selected inguinal herniorraphy under general anesthesia and spinal anesthesia (SA. OBJECTIVE: To compare the recovery time, postoperative pain and patient satisfaction in the Post Anesthetic Care Unit (PACU. METHODS: A prospective, single blinded, controlled study involved total 60 patients belonging to American Society of Anesthesiologists (ASA I/II scheduled for elective repair of unilateral inguinal hernia. Randomization was done using computer generated random numbers. GA group received intravenous (IV propofol (2mg/kg, butorphanol (40μg/kg and skeletal muscle relaxation was achieved with vecuronium bromide (0.1 mg/kg. Patient was maintained with nitrous oxide and oxygen (66:33 and sevoflurane. SA group received 2ml of 0.5% of hyperbaric bupivacaine intrathecal in lateral decubitus position with 0.04mg/kg midazolam injection IV for sedation. Modified Aldrete scoring system, Visual Analogue Scale (VAS and modified Bromage score were employed to assess recovery time. When pain score was more than 5, rescue analgesia was given with IV injection ketorolac 30mg. All data were analyzed statistically. RESULTS: Patients in GA group (136.23 ±17.82 minutes showed a statistically significant (p< 0.05 recovery time to get shifted from PACU compared with patients in the SA group (176.00 ± 11.92 minutes. But patients in the SA group had significantly less VAS score pain (1.30±1.76 vs. 3.23±2.88, less number of patient received rescue analgesia (16.7% vs. 50% and satisfaction was higher than GA group. CONCLUSIONS: We conclude that GA group resulted in faster recovery time from PACU but SA group had less post-operative pain and better satisfied

  17. Contrast of Relief Effect of Tramadol and Dexmedetomidine on Shivering after General Anesthesia%Medical Recapitulate

    Institute of Scientific and Technical Information of China (English)

    王怡

    2016-01-01

    目的:比较曲马多与右美托咪定缓解全身麻醉术后寒战的临床效果。方法选取于2013年1月至2014年1月来辽宁省肿瘤医院行择期腹部手术后发生寒战的患者100例,依据随机数字表法分为右美托咪啶组(35例)、曲马多组(35例)、生理盐水组(30例)。右美托咪啶组给予右美托咪啶0.5μg/kg,曲马多组给予曲马多1 mg/kg,生理盐水组给予0.9%NaCl注射液0.05 mg/kg。观察对比三组患者的临床效果及术后寒战情况。结果右美托咪定组、曲马多组全身麻醉腹部手术患者给药后5、10 min寒战评分均较给药前呈下降趋势,右美托咪定组下降速度更快;生理盐水组给药后5、10 min寒战评分均较给药前无变化[右美托咪定组:(0.60±0.11)分、(0.22±0.03)分比(3.82±0.11)分;曲马多组:(2.01±0.41)分、(2.23±0.21)分比(3.91±0.12)分;生理盐水组:(3.71±0.13)分、(3.72±0.22)分比(3.74±0.13)分],三组寒战评分组间、时点间、组间・时点间交互效应比较差异有统计学意义( P<0.05)。右美托咪啶组给药后10 min 的镇静评分均高于曲马多、生理盐水两组[(2.89±0.23)分比(1.97±0.35)分、(1.74±0.28)分,P<0.05],差异有统计学意义;右美托咪啶组用药后恶心呕吐、心动过缓不良反应发生率为5.71%(2/35),低于曲马多组的22.86%(8/35),差异有统计学意义(P<0.05)。结论与曲马多相比,全身麻醉中静脉注射右美托咪定可有效减少术后寒战、恶心、呕吐等并发症发生,临床效果好,具有良好的临床价值。%Objective To compare the clinical effect of tramadol and dexmedetomidine for the relief of shivering after general anesthesia.Methods From Jan.2013 to Jan.2004 100 patients with postoperative shivering after elective

  18. Comparison of the pro-postoperative analgesia of intraoperative dexmedetomidine with and without loading dose following general anesthesia

    Science.gov (United States)

    Fan, Wei; Yang, Haikou; Sun, Yong; Zhang, Jun; Li, Guangming; Zheng, Ying; Liu, Yi

    2017-01-01

    Abstract Intraoperative dexemdetomidine (DEX) with or without loading dose is well-established to improve postoperative pain control in patient-controlled analgesia (PCA). This study was designed to compare the pro-analgesia effect between the 2 in patients received general anesthesia. Seventy patients shceduced abdominal surgery under general anesthesia were randomly assigned into 3 groups which were maintained using propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/dexmedetomidine with (PRDw) or without (PRDo) a loading dose of dexmedetomidine before induction. PRDw/o patients displayed a greater Romsay sedation score measured immediately after surgery. When compared with PRR patients, those from the PRDw/o group had an increased time to first request of postoperative morphine and decreased 24 hours total morphine consumption. No significant difference was observed between patients from the PRDw and PRDo groups with respect to these parameters. The present study suggests that the administration of a DEX loading dose does not affect the pro-analgesic effect of intraoperative use of DEX on morphine-based PCA. PMID:28207529

  19. Maternal and neonatal effects of nalbuphine given immediately before induction of general anesthesia for elective cesarean section

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    Sabry M Amin

    2011-01-01

    Full Text Available Background: Although nalbuphine was studied extensively in labour analgesia and was proved to be acceptable analgesics during delivery, its use as premedication before induction of general anesthesia for cesarean section is not studied. The aim of this study was to evaluate the effect of nalbuphine given before induction of general anesthesia for cesarean section on quality of general anesthesia, maternal stress response, and neonatal outcome. Methods: Sixty full term pregnant women scheduled for elective cesarean section, randomly classified into two equal groups, group N received nalbuphine 0.2 mg/kg diluted in 10 ml of normal saline (n=30, and group C placebo (n=30 received 10 ml of normal saline 1 min before the induction of general anesthesia. Maternal heart rate and blood pressure were measured before, after induction, during surgery, and after recovery. Neonates were assisted by using APGAR0 scores, time to sustained respiration, and umbilical cord blood gas analysis. Result: Maternal heart rate showed significant increase in control group than nalbuphine group after intubation (88.2±4.47 versus 80.1±4.23, P<0.0001 and during surgery till delivery of baby (90.8±2.39 versus 82.6±2.60, P<0.0001 and no significant changes between both groups after delivery. MABP increased in control group than nalbuphine group after intubation (100.55±6.29 versus 88.75±6.09, P<0.0001 and during surgery till delivery of baby (98.50±2.01 versus 90.50±2.01, P<0.0001 and no significant changes between both groups after delivery. APGAR score was significantly low at one minute in nalbuphine group than control group (6.75±2.3, 8.5±0.74, respectively, P=0.0002 (27% of nalbuphine group APGAR score ranged between 4-6, while 7% in control group APGAR score ranged between 4-6 at one minute. All neonates at five minutes showed APGAR score ranged between 9-10. Time to sustained respiration was significantly longer in nalbuphine group than control group (81.8

  20. General anesthesia in tetanus patient undergoing emergency surgery: A challenge for anesthesiologist.

    Science.gov (United States)

    Mahajan, Reena; Kumar, Amit; Singh, Shiv Kumar

    2014-01-01

    Tetanus is an acute often fatal disease produced by gram positive obligate anaerobic bacterium Clostridium tetani. Tetanolysin damages local tissue and provides optimal conditions for bacterial multiplication. It is therefore important to perform a wide debridement of any wound suspected of being a portal of entry for the bacteria. Little evidence exists to recommend specific anesthetic protocols. We encountered a child scheduled for fracture both bone forearm with developing tetanus. Initial management done with intravenous (i.v) diazepam, phenobarbitone, and metronidazole. After premedication with midazolam and fentanyl, induction was done by propofol 60 mg, vecuronium 2.5 mg, ventilated with O2+ N2O 50:50 with sevoflurane 2% and tracheal intubation was done with 5.5 ID cuffed PVC endotracheal tube. Anesthesia was maintained with sevoflurane 2% and vecuronium intermittently when required. Intraop vitals were stable. On completion of surgery, reversal given and patient was extubated uneventfully and shifted to recovery room. Little evidence exists to recommend specific anesthetic technique for tetanus patient posted for surgery. When present, obvious wounds should be surgically debrided. Ideally patients considered for surgery should undergo anesthesia and surgery before severe autonomic dysfunction develops. Most anesthetic managements are based on limited evidence. However, we used sevoflurane and vecuronium successfully, further study is needed to establish their efficacy and safety. Major challenges lie in the control of muscle rigidity and spasm, autonomic disturbances and prevention of complications.

  1. Impact of general versus epidural anesthesia on early post-operative cognitive dysfunction following hip and knee surgery

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    Mandal Sripurna

    2011-01-01

    Full Text Available Background : Post-operative cognitive dysfunction is the subtle cerebral complication temporally seen following surgery. The aim of this study was to compare the influence of either general anesthesia (GA or epidural anesthesia (EA on the early post-operative neurocognitive outcome in elderly (>59 years subjects undergoing hip and knee surgery. Methods : A total of 60 patients were recruited in a prospective, randomized, parallel-group study, comparable by age and sex. They were enrolled and randomized to receive either EA (n = 30 or GA (n = 30. All of them were screened using the Mini Mental State Examination (MMSE, with components of the Kolkata Cognitive Screening Battery. The operated patients were re-evaluated 1 week after surgery using the same scale. The data collected were analyzed to assess statistical significance. Results : We observed no statistical difference in cognitive behavior in either group pre-operatively, which were comparable with respect to age, sex and type of surgery. Grossly, a significant difference was seen between the two groups with respect to the perioperative changes in verbal fluency for categories and MMSE scores. However, these differences were not significant after the application of the Bonferroni correction for multiple analyses, except the significant differences observed only in the MMSE scores. Conclusions : We observed a difference in cognitive outcome with GA compared with EA. Certain aspects of the cognition were affected to a greater extent in this group of patients undergoing hip and knee surgery.

  2. Tamsulosin-induced severe hypotension during general anesthesia: a case report

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    Khan Fauzia

    2010-11-01

    Full Text Available Abstract Introduction Tamsulosin, a selective α1-adrenergic receptor (α1-AR antagonist, is a widely prescribed first-line agent for benign prostatic hypertrophy (BPH. Its interaction with anesthetic agents has not been described. Case presentation We report the case of 54-year-old Asian man undergoing elective left thyroid lobectomy. The only medication the patient was taking was tamsulosin 0.4 mg for the past year for BPH. He developed persistent hypotension during the maintenance phase of anesthesia while receiving oxygen, nitrous oxide and 1% isoflurane. The hypotension could have been attributable to a possible interaction between inhalational anesthetic and tamsulosin. Conclusion Vigilance for unexpected hypotension is important in surgical patients who are treated with selective α1-AR blockers. If hypotension occurs, vasopressors that act directly on adrenergic receptors could be more effective.

  3. 不同麻醉方法用于剖宫产术的成本分析%Cost of continuous epidural anesthesia and general anesthesia for caesarean section

    Institute of Scientific and Technical Information of China (English)

    许敏; 魏昕; 柴小青; 潘建辉

    2014-01-01

    目的:比较分析剖宫产中应用椎管内麻醉或全身麻醉的成本消耗,为医疗成本运作和医疗政策制定提供临床参考数据。方法回顾我院择期行子宫下段剖宫产术的患者(212例),按其接受的麻醉方法分为椎管内麻醉组(连续硬膜外麻醉,SA组,106例)及全身麻醉组(喉罩下全麻,GA组,106例),对麻醉的直接成本进行了评估。从麻醉数据库中统计麻醉中使用的药品及耗材,根据麻醉相关时间及麻醉人员薪酬计算人员成本,并计算相关比例。结果剖宫产中应用全身麻醉直接麻醉成本及非人员麻醉成本均高于连续硬膜外麻醉(P<0.05),人员成本则是连续硬膜外麻醉高于全身麻醉(P<0.05),全身麻醉的药品及耗材成本明显高于连续硬膜外麻醉(P<0.05),连续硬膜外麻醉的诱导时间及持续时间较长(P<0.05),两组患者术后住院天数差异无统计学意义(P>0.05)。结论椎管内麻醉的直接成本较低,但是人员成本相对较高。麻醉方法的选择并不影响患者术后住院天数。%Objective To analyze the costs of continuous epidural anesthesia and general anesthesia for caesarean section and pro-vide clinical reference data for health behaviors and health policy makers.Methods The clinical data of 212 patients (aged 22~35 years) who received elective cesarean section surgery from to July to December in 2012 in our hospital were retrospectively analysed.The patients were divided into the spinal anesthesia group(continuous epidural anesthesia,SA group,n=106)and the general anesthesia group(LMA un-der general anesthesia,GA group,n=106 )according to their method of anesthesia.Direct costs were measured on detailed data of the re-sources used during anaesthetic procedures from the anesthesia record.Costs related to anaesthetic staff work were calculated based on per ca-pita remuneration and duration of

  4. Comparison of palanosetron with ondansetron for postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia

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    Jyoti Bhalla

    2015-01-01

    Full Text Available Background: Post-operative nausea and vomiting (PONV is a ′big little′ problem especially after laparoscopic surgeries. Palanosetron is a new potent 5 hydroxy tryptamine 3 antagonists. In this randomized double blind clinical study we compared the effects of i.v. ondansetron and palanosetron administered at the end of surgery in preventing post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia. Materials and Methods: A total of 100 subjects between 18-60 years with Apfel score ≥2, were randomly assigned into one of the two groups, containing 50 patients each. Group A received ondansetron 4 mg i.v. and Group B received palanosetron 0.07 5mg i.v. both as bolus before induction. The incidence of nausea, retching and vomiting, incidence of total PONV, requirement of rescue antiemetics and adverse effects were evaluated during the first 24 h following end of surgery. Results: The incidence of nausea was significantly lower in patients who had received palanosetron (16% as compared to ondansetron (24%. Need of rescue antiemetics was significantly higher in patients receiving ondansetron (32% as compared to palanosetron (16%. The incidence of total PONV was also significantly lower in group receiving palanosetron (20% as compared to ondansetron (50%. Among the side effects, headache was noted significantly higher with ondansetron (20% as compared to palanosetron (6%. Conclusion: Palanosetron has got better anti-nausea effect, less need of rescue antiemetics, favourable side effect profile and a decrease in the incidence of total PONV as compared to ondansetron in 24 h post operative period in patients undergoing laproscopic cholecystectomy under general anesthesia.

  5. Comparative evaluation of propofol in nanoemulsion with solutol and soy lecithin for general anesthesia

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    José Carlos Rittes

    2016-06-01

    Full Text Available ABSTRACT INTRODUCTION: The vehicle for propofol in 1 and 2% solutions is soybean oil emulsion 10%, which may cause pain on injection, instability of the solution and bacterial contamination. Formulations have been proposed aiming to change the vehicle and reduce these adverse reactions. OBJECTIVES: To compare the incidence of pain caused by the injection of propofol, with a hypothesis of reduction associated with nanoemulsion and the occurrence of local and systemic adverse effects with both formulations. METHOD: After approval by the CEP, patients undergoing gynecological procedures were included in this prospective study: control (n = 25 and nanoemulsion (n = 25 groups. Heart rate, noninvasive blood pressure and peripheral oxygen saturation were monitored. Demographics and physical condition were analyzed; surgical time and total volume used of propofol; local or systemic adverse effects; changes in variables monitored. A value of p < 0.05 was considered significant. RESULTS: There was no difference between groups regarding demographic data, surgical times, total volume of propofol used, arm withdrawal, pain during injection and variables monitored. There was a statistically significant difference in pain intensity at the time of induction of anesthesia, with less pain intensity in the nanoemulsion group. CONCLUSIONS: Both lipid and nanoemulsion formulations of propofol elicited pain on intravenous injection; however, the nanoemulsion solution elicited a less intense pain. Lipid and nanoemulsion propofol formulations showed neither hemodynamic changes nor adverse effects of clinical relevance.

  6. A PHASE 1 DOSE OPTIMIZATION STUDY OF ABP-700 WITH OPIATES AND/OR MIDAZOLAM PRE-MEDICATION IN HEALTHY ADULT VOLUNTEERS TARGETING INDUCTION OF GENERAL ANESTHESIA

    NARCIS (Netherlands)

    Meier, Sascha; Absalom, Anthony; Sweeney, Steven; Campagna, Jason; Marota, John; Struys, Michel

    2016-01-01

    INTRODUCTION: ABP-700 is a novel, second-generation metabolically labile etomidate analogue in development for procedural sedation and general anesthesia . Pre-clinical and Phase I studies show minimal hemodynamic and respiratory depression, no adrenocortical suppression, and rapid emergence from se

  7. Comparison of the effects of intravenous premedication: Midazolam, Ketamine, and combination of both on reducing anxiety in pediatric patients before general anesthesia

    Science.gov (United States)

    Sajedi, Parvin; Habibi, Bashir

    2015-01-01

    Objective: In some medical circumstances, pediatric patients may need premedication for transferring to the operating room. In these situations, using intravenous premedication is preferred. We assessed the efficacy and safety of intravenous midazolam, intravenous ketamine, and combination of both to reduce the anxiety and improve behavior in children undergoing general anesthesia. Methods: In a double-blind randomized clinical trial, 90 pediatric patients aged 6 months to 6 years with American Society of Anesthesiologist grade I or II were enrolled. Before anesthesia, children were randomly divided into three groups to receive intravenous midazolam 0.1 mg/kg, or intravenous ketamine 1 mg/kg, or combination of half doses of both. Behavior types and sedation scores were recorded before premedication, after premedication, before anesthesia, and after anesthesia in the postanesthesia care unit. Anesthesia time, recovery duration, blood pressure, and heart rate were also recorded. For comparing distribution of behavior types and sedation scores among three groups, we used Kruskal–Wallis test, and for comparing mean and standard deviation of blood pressure and heart rates, we used analysis of variance. Findings: After premedication, children's behavior was significantly better in the combination group (P ketamine as premedication produced more deep sedation and more desirable behavior in children compared with each midazolam 0.1 mg/kg or ketamine 1 mg/kg. PMID:26645024

  8. 硬膜外麻醉和全身麻醉对高龄患者腹部术后谵妄的影响%Assessment on Deliration of Old Age Patients after Operation with General Anesthesia and Epidural Anesthesia

    Institute of Scientific and Technical Information of China (English)

    吴莉; 郭春燕; 薛明明

    2013-01-01

    Objective To compare the influence of general anesthesia and epidural anesthesia on the operative deliration of old age patients. Methods All 120 patients undergoing major abdominal surgery in our hospital from 2010.1 -2012.1 were selected and divided into two groups:general anesthesia group(60 cases) and epidural anesthesia group(60 cases). During and after operations,the levels of ECG,MV,MAP,HR,SpO2 ,PEtCO2 and deliration in two groups were observed. Results During and after operations, the levels of ECG, HR, MV, SpO2, PEtCO2 in two groups have no significance differences ( P > 0.05), but MAP has significance difference( P <6.01). The delirium formation rate of general anesthesia group(56.0% ) is higher than epidural anesthesia group(26.0% ) after operations(P < 0.05 ). Conclusion The delirium formation rate of general anesthesia is higher than epidural anesthesia group;therefore,we should select appropriate anesthetic techniques to reduce the incidence of postoperative delirium.%目的 探讨硬膜外麻醉和全身麻醉对高龄患者腹部术后谵妄的影响差异.方法 选择2010年1月-2012年1月进行腹部手术的患者120例,随机分为两组,硬膜外麻醉组60例,其中男性33例,女性27例,手术时采用硬膜外麻醉法.全身麻醉组60例,其中男性31例,女性29例,手术时采用全身麻醉法.观察术中ECG、MV、MAP、HR、SPO2、PEtCO2,并观察术后1~3d的谵妄发生率,比较二者差异.结果 结果显示,术中全身麻醉组MAP显著升高,硬膜外麻醉组无明显变化或略低,两组比较差异有统计学意义(P<0.05),其余指标差异无统计学意义(P>0.05).全身麻醉组术后谵妄发病率为56.0%,高于硬膜外麻醉组(26.0%),差异具有统计学意义(P<0.05).结论 全身麻醉对于高龄患者术后谵妄的影响较大,硬膜外麻醉影响较小,因此应该选取适宜的麻醉方法以降低术后谵妄的发病率.

  9. Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies.

    Science.gov (United States)

    Hicks, C Gray; Jones, James E; Saxen, Mark A; Maupome, Gerardo; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.

  10. Intrathecal morphine plus general anesthesia in cardiac surgery: effects on pulmonary function, postoperative analgesia, and plasma morphine concentration

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    Luciana Moraes dos Santos

    2009-04-01

    Full Text Available OBJECTIVES: To evaluate the effects of intrathecal morphine on pulmonary function, analgesia, and morphine plasma concentrations after cardiac surgery. INTRODUCTION: Lung dysfunction increases morbidity and mortality after cardiac surgery. Regional analgesia may improve pulmonary outcomes by reducing pain, but the occurrence of this benefit remains controversial. METHODS: Forty-two patients were randomized for general anesthesia (control group n=22 or 400 µg of intrathecal morphine followed by general anesthesia (morphine group n=20. Postoperative analgesia was accomplished with an intravenous, patient-controlled morphine pump. Blood gas measurements, forced vital capacity (FVC, forced expiratory volume (FEV, and FVC/FEV ratio were obtained preoperatively, as well as on the first and second postoperative days. Pain at rest, profound inspiration, amount of coughing, morphine solicitation, consumption, and plasma morphine concentration were evaluated for 36 hours postoperatively. Statistical analyses were performed using the repeated measures ANOVA or Mann-Whiney tests (*p<0.05. RESULTS: Both groups experienced reduced FVC postoperatively (3.24 L to 1.38 L in control group; 2.72 L to 1.18 L in morphine group, with no significant decreases observed between groups. The two groups also exhibited similar results for FEV1 (p=0.085, FEV1/FVC (p=0.68 and PaO2/FiO2 ratio (p=0.08. The morphine group reported less pain intensity (evaluated using a visual numeric scale, especially when coughing (18 hours postoperatively: control group= 4.73 and morphine group= 1.80, p=0.001. Cumulative morphine consumption was reduced after 18 hours in the morphine group (control group= 20.14 and morphine group= 14.20 mg, p=0.037. The plasma morphine concentration was also reduced in the morphine group 24 hours after surgery (control group= 15.87 ng.mL-1 and morphine group= 4.08 ng.mL-1, p=0.029. CONCLUSIONS: Intrathecal morphine administration did not significantly alter

  11. Effects of intracerebroventricular NMDA and non-NMDA receptor agonists or antagonists on general anesthesia of propofol in mice

    Institute of Scientific and Technical Information of China (English)

    XU Aijun; DUAN Shiming; TIAN Yuke

    2007-01-01

    The efiects of intracerebroventricular(icv)agonists and antagonists of N-methyl-D-aspartate(NMDA)and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors on the general anesthesia of propofol were studied.A tohal of 144 Kunming mice,male and female with body mass of(22±3)g,were used.Part One of the Experiment:a total of 104 Kunming mice,male and female,were randomly divided into 13 groups.Intracerebroventricular artificial cerebral fluid (aCSF)or different doses of NMDA,AMPA,MK-801 or NBOX was iniected immediately after intravenously administered propofol 25 mg/kg and the recovery time following the loss of righting reflex (LORR)was recorded.Part Two of the Experiment:a total of 40 Kunming female mice were divided randomly into 5 groups and iniected with icv aCSF or NMDA.AMPA.MK-801 or NBQX after intraperitoneally administered propofol 50 mg/kg.The pain threshold of the mice was then investigated by hot-plate test(HPPT).NMDA(0.05 or 0.075μg,icv)or AMPA(0.05 μg,icv)exhibited no effects on the LORR,but NMDA(0.1 μg,icv)or AMPA(0.075 or 0.1 μg,icv)prolonged the LORR significantly compared with the aCSF group(P<0.05,P<0.01).The LORR of the 2 μg MK-801 group had no changes,while those of the 4 or 8 μg MK-801 groups were prolonged significantly.The LORR of the 0.5,2 or 4 μg NBQX groups were all prolonged significantly.NMDA 0.05 μg or AMPA 0.05 μg decreased the pain threshold slightly but did not differ in effect compared with the aCSF group;2 μg MK-801 or 0.5 μg NBQX both increased the pain threshold significantly.Our results indicate that propofol produces general anesthesia partly through an interaction with brain NMDA and AMPA receptors in mice.

  12. A Prospective, Multicenter, Single-Blind Study Assessing Indices of SNAP II Versus BIS VISTA on Surgical Patients Undergoing General Anesthesia

    Science.gov (United States)

    Bergese, Sergio D; Puente, Erika G; Marcus, R-Jay L; Krohn, Randall J; Docsa, Steven; Soto, Roy G; Candiotti, Keith A

    2017-01-01

    Background Traditionally, anesthesiologists have relied on nonspecific subjective and objective physical signs to assess patients’ comfort level and depth of anesthesia. Commercial development of electrical monitors, which use low- and high-frequency electroencephalogram (EEG) signals, have been developed to enhance the assessment of patients’ level of consciousness. Multiple studies have shown that monitoring patients’ consciousness levels can help in reducing drug consumption, anesthesia-related adverse events, and recovery time. This clinical study will provide information by simultaneously comparing the performance of the SNAP II (a single-channel EEG device) and the bispectral index (BIS) VISTA (a dual-channel EEG device) by assessing their efficacy in monitoring different anesthetic states in patients undergoing general anesthesia. Objective The primary objective of this study is to establish the range of index values for the SNAP II corresponding to each anesthetic state (preinduction, loss of response, maintenance, first purposeful response, and extubation). The secondary objectives will assess the range of index values for BIS VISTA corresponding to each anesthetic state compared to published BIS VISTA range information, and estimate the area under the curve, sensitivity, and specificity for both devices. Methods This is a multicenter, prospective, double-arm, parallel assignment, single-blind study involving patients undergoing elective surgery that requires general anesthesia. The study will include 40 patients and will be conducted at the following sites: The Ohio State University Medical Center (Columbus, OH); Northwestern University Prentice Women's Hospital (Chicago, IL); and University of Miami Jackson Memorial Hospital (Miami, FL). The study will assess the predictive value of SNAP II versus BIS VISTA indices at various anesthetic states in patients undergoing general anesthesia (preinduction, loss of response, maintenance, first purposeful

  13. What does pain signify? A hypothesis concerning pain, the immune system and unconscious pain experience under general anesthesia.

    Science.gov (United States)

    Neuman, Yair

    2004-01-01

    In this paper, I present a case-study that initiates a discussion about the meaning of pain. The case-study concerns a person who was under deep sedation during colonoscopy. The person did not experience pain from a first-person perspective, although pain was evident to the medical team from a second-person perspective. The divergence of pain perspectives raises an interesting quandary. If the body communicates pain while pain consciousness is blocked by the sedation procedure, our conclusion should be that the intersubjective aspect of pain precedes the "subjective," first-person experience of pain. This conclusion is not consistent with the common representational conception of pain that places the intrasubjective point of view prior to the intersubjective point of view. The solution I offer to this quandary is the quasi-paradoxical idea that pain can be experienced unconsciously through the immune system. Following this suggestion, I hypothesize that post-traumatic stress disorders following general anesthesia may result from this unconscious pain experience. If this idea is scientifically grounded, then physicians should: (1) consider ways of blocking the unconscious pain experience produced by the immune system without interfering with the immune response, and (2) study pain as a complex cognitive and unconscious system by drawing an analogy with the immune system, which follows similar logic.

  14. [Torsade de pointes (TdP) observed during general anesthesia for cerebral aneurysm clipping in a patient with QT prolongation].

    Science.gov (United States)

    Tajiri, Osamu; Ito, Hiroyuki; Yago, Yasuko; Masumori, Yasushi

    2011-09-01

    A 55-year-old woman underwent emergency cerebral aneurysm clipping for subarachnoid hemorrhage (SAH). Her past and family history was unremarkable. Preoperative blood examinations were within normal ranges except for a slight decrease in serum potassium level. ECG showed a prolonged QTc interval (0.54 sec). General anesthesia was induced with propofol, fentanyl and vecuronium, and maintained with 1-1.5% sevoflurane, 50% nitrous oxide in oxygen and intermitted doses of fentanyl. About three hours after starting the operation, bigeminal pulse appeared followed by torsade de pointes. This arrhythmia returned to sinus rhythm by continuous infusion of lidocaine, and operation was performed completely. At the end of the operation, prolonged QT interval (QTc 0.71 sec) was noted. Her postoperative course was unremarkable and she was discharged on postoperative day 44. QT prolongation is a frequently seen ECG abnormality in a patient with SAH. In anesthetic management in this situation, it is important to monitor QT interval closely as well as to use anesthetics that would not exacerbate QT interval prolongation.

  15. Paravertebral blocks provide superior same-day recovery over general anesthesia for patients undergoing inguinal hernia repair.

    Science.gov (United States)

    Hadzic, Admir; Kerimoglu, Beklen; Loreio, Dan; Karaca, Pelin Emine; Claudio, Richard E; Yufa, Marina; Wedderburn, Ray; Santos, Alan C; Thys, Daniel M

    2006-04-01

    Inguinal herniorrhaphy is commonly performed on an outpatient basis under nerve blocks or local or general anesthesia (GA). Our hypothesis is that use of paravertebral blocks (PVB) as the sole anesthetic technique will result in shorter time to achieve home readiness and improved same-day recovery over a 'fast-track' GA. Fifty patients were randomly assigned to receive either PVB or GA under standardized protocols (PVB = 0.75% ropivacaine, followed by propofol sedation; GA = dolasetron 12.5 mg, propofol induction, rocuronium, endotracheal intubation; desflurane; bupivacaine 0.25% for field block). Eligibility for postanesthetic care unit (PACU) bypass and data on time-to-postoperative pain, ambulation, home readiness, and incidence of adverse events were collected. More patients in the PVB group (71%) met the criteria to bypass the postanesthetic care unit compared with patients in the GA group (8%; P local anesthetic (P = 0.005). Patients in the PVB group were able to ambulate earlier (102 +/- 55 minutes) than those in the GA group (213 +/- 108 minutes; P inguinal herniorrhaphy, PVB resulted in faster time to home readiness and was associated with fewer adverse events and better analgesia before discharge than GA.

  16. Combined general-epidural anesthesia with continuous postoperative epidural analgesia preserves sigmoid colon perfusion in elective infrarenal aortic aneurysm repair

    Directory of Open Access Journals (Sweden)

    Venetiana Panaretou

    2012-01-01

    Full Text Available Background: In elective open infrarenal aortic aneurysm repair the use of epidural anesthesia and analgesia may preserve splanchnic perfusion. The aim of this study was to investigate the effects of epidural anesthesia on gut perfusion with gastrointestinal tonometry in patients undergoing aortic reconstructive surgery. Methods: Thirty patients, scheduled to undergo an elective infrarenal abdominal aortic reconstructive procedure were randomized in two groups: the epidural anesthesia group (Group A, n=16 and the control group (Group B, n=14. After induction of anesthesia, a transanally inserted sigmoid tonometer was placed for the measurement of sigmoid and gastric intramucosal CO 2 levels and the calculation of regional-arterial CO 2 difference (ΔPCO 2 . Additional measurements included mean arterial pressure (MAP, cardiac output (CO, systemic vascular resistance (SVR, and arterial lactate levels. Results: There were no significant intra- and inter-group differences for MAP, CO, SVR, and arterial lactate levels. Sigmoid pH and PCO 2 increased in both the groups, but this increase was significantly higher in Group B, 20 min after aortic clamping and 10 min after aortic declamping. Conclusions: Patients receiving epidural anesthesia during abdominal aortic reconstruction appear to have less severe disturbances of sigmoid perfusion compared with patients not receiving epidural anesthesia. Further studies are needed to verify these results.

  17. Relatively light general anesthesia is more effective than fluid expansion in reducing the severity of epinephrine-induced hypotension during functional endoscopic sinus surgery

    Institute of Scientific and Technical Information of China (English)

    LI Wei-yan; ZHOU Zhi-qiang; JI Jun-feng; LI Ze-qing; YANG Jian-jun; SHANG Ruo-jing

    2007-01-01

    Background Epinephrine infiltration of the nasal mucosa causes hypotension during functional endoscopic sinus surgery (FESS) under general anesthesia. A prospective randomized-controlled study was designed to determine whether relatively light general anesthesia is superior to fluid expansion in reducing epinephrine-induced hypotension during FESS.Methods Ninety patients undergoing elective FESS under general anesthesia were randomly assigned to three groups with 30 patients in each. Each patient received local infiltration with adrenaline-containing (5 μg/ml) lidocaine (1%,4 ml) under different conditions. For Group Ⅰ, anesthesia was maintained with propofol 2 μg/ml and rimifentanil 2 ng/ml by TCI. Group Ⅱ (control group) and Group Ⅲ received propofol 4 μg/ml and rimifentanil 4 ng/ml, respectively. In Groups Ⅰ and Ⅱ, fluid expansion was performed with hetastarch 5 mi/kg within 20 minutes; hetastarch 10 ml/kg was used in Group Ⅲ. Mean arterial pressure (MAP) and heart rate (HR) were recorded at 30-second-intervals for 5 minutes after the beginning of local infiltration. Simultaneously, the lowest and the highest MAP were recorded to calculate the mean maximum increase or decrease percent in MAP for all patients in each group. Data analysis was performed by χ2 test,one-way analysis of variance, or one-way analysis of covariance.Results Hemodynamic changes, particularly a decrease in MAP accompanied by an increase in HR at 1.5 minutes(P<0.05), were observed in all groups. The mean maximum decrease in MAP below baseline was 14% in Group Ⅰ, 24% in Group Ⅲ and 26% in Group Ⅱ. There were statistically significant differences between Group Ⅰ and Groups Ⅱ and Ⅲ(P<0.05). The mean maximum increase in MAP above baseline was 9% in Group Ⅰ, 6% in Group Ⅲ and 2% in Group Ⅱ.Conclusion Relatively light general anesthesia can reduce the severity of epinephrine-induced hypotension more effectively than fluid expansion during FESS under general

  18. [Intravenous Sedation and Repeated "the Same Day General Anesthesia" for a School-age Boy with Dandy-Walker Syndrome and Dentinogenesis].

    Science.gov (United States)

    Hitosugi, Takashi; Tsukamoto, Masanori; Fujiwara, Shigeki; Yokoyama, Takeshi

    2016-03-01

    Dandy-Walker syndrome (DWS) is characterized by perfect or partial defect of the cerebellum vermis and cystic dilatation of the posterior fossa communicating with the fourth ventricle. Common clinical signs are mental retardation, cerebellar ataxia, and those of increased intracranial pressure (ICP). Associated congenital anomalies are craniofacial, cardiac, renal, and skeletal abnormalities. We experienced a case of intravenous sedation and six times of "the same day" general anesthesia for a school-aged boy (10-13 years old) with DWS and hypodentinogenesis. The patient underwent an examination and dental treatments. We had to pay attention to airway management tracheal tube selection and control of ICP. In addition, we should prevent tooth injuries through mishaps during tracheal intubations, since all-tooth-hypoplasia with fragile dental crowns was strongly suggested in this case. Detailed postoperative care is also required for general anesthesia afflicted with DWS.

  19. [Ultra-fast opiate detoxification under general anesthesia: preliminary results of the Liege protocol].

    Science.gov (United States)

    Pinto, E; Reggers, J; Delhez, M; Fuchs, S; Venneman, I; Lamy, M; Ansseau, M

    2001-08-01

    Many studies support the hypothesis of a substantial benefit in inducing an Opiate Receptor Blockade through a Rapid Opiate Detoxification under general Anaesthesia (RODA) in opiate dependent patients. However, prospective studies and long term evaluation of the technique are lacking. In order to evaluate long-term abstinence rates after a RODA among a sample of opiate addicts, a study was started in March 1999 at the University of Liège. To date, 45 patients were evaluated (mean age: 29 +/- 5 years) with a mean opiate dependence duration of 8 +/- 4 years. Most of them were both heroin and methadone dependent; 42.2% of them were included while 31.1% did not complete the whole inclusion procedure and 26.7% were excluded. None experienced severe withdrawal symptoms. At six months, abstinence rate was 67% and 46% at one year. These preliminary results suggest the interest of the procedure in carefully selected patients.

  20. The comparison of anesthesia effect of lung surgery through video-assisted thoracic surgery: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Jing-Dong Ke

    2015-01-01

    Conclusion: These results indicated that epidural anesthesia can save operating time and postoperative hospital stay time. But epidural anesthesia and general anesthesia have the same effect on complications.

  1. Study on the anesthetic effect of combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children

    Institute of Scientific and Technical Information of China (English)

    Jing Liu

    2016-01-01

    Objective:To analyze the anesthetic effect of combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children.Methods:A total of118 cases of children with inguinal hernia who received laparoscopic surgery in our hospital from August 2012 to August 2014 were enrolled as research subjects and randomly divided into observation group 59 cases and control group 59 cases. Control group received conventional tracheal intubation intravenous general anesthesia, observation group received combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing, and then differences in respiratory and circulatory indicators, awareness-related indicators, G-6PD, PFK and inflammatory factor levels and oxidative stress levels between two groups were compared.Results:HR and MAP values of observation group at T1 and T2 were lower than those of control group, and SpO2 value was higher than that of control group; intraoperative Ppeak, Pplat, Raw, D(A-a)O2 and RI levels of observation group were lower than those of control group, and levels of Cdyn and OI were higher than those of control group; intraoperative G-6PD, PFK, CRP and IL-6 levels of observation group were lower than those of control group, and IL-10 level was higher than that of control group; intraoperative NO, SOD and GSH levels of observation group were higher than those of control group, and levels of ET-1, CAT and blood glucose were lower than those of control group.Conclusion:Combined intravenous-inhalation general anesthesia under nasopharyngeal airway-mask spontaneous breathing for laparoscopic inguinal hernia surgery in children can effectively stabilize respiratory and circulatory level, reduce intraoperative systemic inflammation and oxidative stress state and contribute to early postoperative rehabilitation.

  2. Perioperative respiratory adverse events in children with active upper respiratory tract infection who received general anesthesia through an orotracheal tube and inhalation agents

    OpenAIRE

    Kim, So Yeon; Kim, Jeong Min; Lee, Jae Hoon; Kang, Young Ran; Jeong, Seung Ho; Koo, Bon-Nyeo

    2013-01-01

    Background Active upper respiratory tract infection (URI), orotracheal intubation and use of inhalation anesthetics are known risk factors for perioperative respiratory adverse events (RAE). This study investigated the risk factors of perioperative RAE in children with these risk factors. Methods The records of 159 children who underwent general anesthesia with an orotracheal tube and inhalation were reviewed. These patients also had at least one of the following URI symptoms on the day of su...

  3. Comparative evaluation of oral gabapentin versus clonidine as premedication on preoperative sedation and laryngoscopic stress response attenuation for the patients undergoing general anesthesia

    OpenAIRE

    Saikat Majumdar; Anjan Das; Haripada Das; Sambhunath Bandyopadhyay; Bimal Kumar Hajra; Dipankar Mukherjee

    2015-01-01

    Background: Laryngoscopy and endotracheal intubation (L and I) is associated with rise in blood pressure (BP), heart rate (HR), leading to adverse cardiological outcome especially in susceptible individuals. To compare the BP, HR during L and I as well as to evaluate the preoperative sedation status between oral clonidine (Group C) and oral gabapentine (Group G) as premedication for the patients undergoing major surgery under general anesthesia (GA). Materials and Methods: From April 2008...

  4. Lidocaine-prilocaine cream reduces catheter-related bladder discomfort in male patients during the general anesthesia recovery period: A prospective, randomized, case-control STROBE study.

    Science.gov (United States)

    Mu, Li; Geng, Li-Cheng; Xu, Hui; Luo, Man; Geng, Jing-Miao; Li, Li

    2017-04-01

    Urethral catheterization is a predictor of agitation during the general anesthesia recovery period. The aim of this study was to determine the effect of intraurethral 5% lidocaine and 25 mg/g prilocaine cream in reducing catheter-related bladder discomfort (CRBD) in male patients during the general anesthesia recovery period. Adult male patients undergoing elective operations that required urinary catheterization under general anesthesia were enrolled and assigned randomly to 2 groups. In the lidocaine-prilocaine cream group (n = 72), approximately 5 g of topical cream was spread in the preputial sac, the glans, the meatus, and on the urinary catheter surface before urinary catheterization. In the control group (n = 74), the urinary catheter was lubricated with lidocaine gel. The incidence and severity of CRBD were assessed 15, 30, 45, and 60 minutes postoperatively. We found that the incidence of CRBD in the lidocaine-prilocaine cream group was significantly lower than in the control group. Multivariate logistic regression analysis showed that lidocaine-prilocaine cream applications reduced moderate or severe CRBD. Thirty minutes postoperation was the most frequent time point for the incidence of CRBD. Application of lidocaine-prilocaine cream on the surface of the urinary catheter is an efficient and safe method to reduce the incidence and severity of CRBD.

  5. Anesthesia of the geriatric equine

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    Doherty TJ

    2012-08-01

    Full Text Available Reza Seddighi, Thomas J DohertyDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, Veterinary Medical Center, University of Tennessee, Knoxville, TN, USAAbstract: Advancements in veterinary medicine have resulted in an increased number of geriatric horses being presented for medical or surgical procedures that require general anesthesia. Due to the physiological changes associated with aging and the likelihood of concurrent disease conditions, the geriatric equine is at an increased risk during anesthesia. The main physiological changes associated with aging, and their impact on anesthesia, are discussed in this review.Keywords: geriatric, equine, anesthesia

  6. Fully Automated Anesthesia, Analgesia and Fluid Management

    Science.gov (United States)

    2016-09-05

    General Anesthetic Drug Overdose; Adverse Effect of Intravenous Anesthetics, Sequela; Complication of Anesthesia; Drug Delivery System Malfunction; Hemodynamic Instability; Underdosing of Other General Anesthetics

  7. High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound

    Science.gov (United States)

    Schumann, Roman; Natov, Nikola S; Rocuts-Martinez, Klifford A; Finkelman, Matthew D; Phan, Tom V; Hegde, Sanjay R; Knapp, Robert M

    2016-01-01

    AIM To examine whether high-flow nasal oxygen (HFNO) availability influences the use of general anesthesia (GA) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) and associated outcomes. METHODS In this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras (era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era (era 2). The primary outcome was the percent utilization of GA vs deep sedation in each period. Secondary outcomes included oxygen saturation nadir during sedation between periods, as well as procedure duration, and anesthesia-only time between periods and for GA vs sedation cases respectively. RESULTS During the study period 238 ERCP or EUS cases were identified for analysis. Statistical testing was employed and a P sedation was significantly higher in era 2 compared to era 3 (P sedation (P ≤ 0.007) as was the anesthesia-only time (P ≤ 0.001). CONCLUSION High-flow nasal oxygen availability was associated with decreased GA utilization and improved oxygenation for ERCP and EUS during sedation. PMID:28058020

  8. [Condition of patients after surgical wisdom tooth extraction under general anesthesia with different premedication variants--a prospective study based on a post-anesthesia questionnaire].

    Science.gov (United States)

    Markus, H; Schwarz, A

    2001-01-01

    Evaluation of the modified "postanaesthesiological questionnaire" pointed to a subtle influencing of the condition of patients who had undergone 3rd molar surgery in general anaesthesia by using different premedication variants: "Atropine, Pethidine and Midazolam" (group A) and "Atropine, Midazolam and S-Ketamin" (group B). The combination in group B seems to be more suitable. On the one hand, a lower incidence of unwanted side-effects was found and, on the other hand, remarkable positive effects were observed. Of particular significance with this combination was also the more effective suppression of postoperative pain. The Propofol-supplemented general anaesthesia prepared in this way and administered using a nasal intubation technique found the full approval of the patients. Postoperative pain therapy was effective and also inexpensive, costing just 8.20 DM per patient, according to current prices calculated by Magdeburg University Hospital.

  9. Comparing the preventive effect of 2 percent Topical Lidocaine and Intravenous Atropine on oculocardiac reflex in Ophthalmological Surgeries under General Anesthesia

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    Parvin Sajedi

    2013-01-01

    Full Text Available Background: The current study aimed to determine preventive effect of 2 percent topical xylocaine on oculocardiac reflex in ophthalmological surgeries except strabismus, including retinal detachment and vitrectomy with scleral buckling under general anesthesia. Methods: A randomized controlled clinical trial was carried out on 150 patients aged 18-90 years undergoing ophthalmological surgeries under general anesthesia. Samples randomly divided into the experimental group (received four drops of 2 percent topical xylocaine instilled in desired eye and control group (received 0.5 mg atropine sulfate injection. Systolic, diastolic and mean arterial blood pressure of patients and baseline heart rate were recorded. They were compared regarding the incidence of bradycardia, heart rate less than 60 beats/minute, hypotension and blood pressure less than 90 mm/Hg. Data were analyzed by Statistical Package for the Social Sciences software version 20 using Chi-square and ANOVA. Results: The difference between two groups was not statistically significant regarding demographic and basic variables. The incidence of bradycardia in both groups was respectively (90.7 percent vs. 17.3 percent, heart rate less than 60 beats/minute (40 percent vs. 13.3 percent, hypotension (76 percent vs. 32 percent and blood pressure less than 90 mmHg was (28 percent vs. 8 percent. Accordingly, the differences between both groups were statistically significant (P > 0.001. Conclusions: The preventive impact of topical xylocaine upon oculocardiac reflex in ophthalmological surgeries such as retinal detachment and vitrectomy with scleral buckling under general anesthesia was less effective than that of atropine injection. Therefore, to avoid this reflex in high-risk patients, injecting atropine would be safer.

  10. Accuracy of Neutrophil Gelatinase-Associated Lipocalin in Detecting Acute Kidney Injury after Urogenital Robotic Assisted Laparoscopic Surgery under General Anesthesia

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    Orsolya MIHÁLY

    2012-06-01

    Full Text Available The aim of this study was to demonstrate the accuracy of NGAL in detecting acute kidney injury (AKI after urogenital robotic surgery in general anesthesia. Methods: A prospective longitudinal observational study, which included patients scheduled for elective robotic surgery under general anesthesia. The serum and urine NGAL at induction, 6 hours and 12 hours were determined. Serum creatinine was measured preoperatively and daily 4 days postoperatively. AKI was defined as the absolute growth of serum creatinine by 0.3 mg/dl over baseline within 48 hours postoperatively. Results: 24 patients were enrolled in the study. AKI occurred in 38% of patients. Serum NGAL increased significantly at 6 hours and 12h, compared to baseline, with a higher increase in the group of patents without AKI. There were no significant results for urine NGAL. A link was observed between the values of serum NGAL, with associated significance p<0.0001. The correlations between urine NGAL were not significant. The predictive value of NGAL, analyzed by cross-tabulation, OR was 3 for baseline value and 5.33 for the values measured at 6 hours and 12 hours, but with no statistical significance. Conclusions: The modifications of the NGAL levels, measured at 6 hours and 12 hours from the induction of anesthesia, were significant with more importance at 6 hours and in patients without AKI. Serum NGAL had no predictive value for AKI, but the risk to develop AKI was 3 times higher for baseline determination and 5 times at 6 and 12 hours.

  11. Triple Therapy with Scopolamine, Ondansetron and Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Moderate to High Risk Patients Undergoing Craniotomy Under General Anesthesia: A Pilot Study

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    Sergio Daniel Bergese

    2015-06-01

    Full Text Available Introduction: Postoperative nausea and vomiting is one of the most common complaints from patients and clinicians after a surgical procedure. According to the current Society of Ambulatory Anesthesia Consensus Guidelines, the general incidence of vomiting and nausea is around 30% and 50% respectively; and up to 80% in high risk patients. In previous studies, the reported incidence of PONV at 24 hours after craniotomy was 43%-70%. The transdermal scopolamine delivery system contains a 1.5 mg drug reservoir, which is designed to deliver a continuous slow release of scopolamine through intact skin during the first 72 hours of patch application. Therefore, we designed this single arm, non-randomized, pilot study to assess the efficacy and safety of triple therapy with scopolamine, ondansetron and dexamethasone to prevent PONV.Materials and methods: In the preoperative area, subjects received an active TDS 1.5 mg that was applied to a hairless patch of skin in the mastoid area approximately 2 hours prior to the operation. Immediately after anesthesia induction, all patients received a single 4 mg dose of ondansetron IV and a single 10 mg dose of dexamethasone IV. Patients that experienced nausea and/or vomiting received ondansetron 4 mg IV as the initial rescue medication. Results: A total of 36 subjects were analyzed. The overall incidence of PONV during the first 24 hours after neurological surgery was 33% (n=12. The incidence of nausea and emesis during the first 24 hours after surgery was recorded as 33% (n=12 and 16% (n=6 respectively. Conclusion: Our data also showed that this triple therapy regimen may be an efficient alternative regimen for PONV prophylaxis in patients undergoing neurological surgery with general anesthesia. Further studies using regimens affecting different receptor pathways should be performed to better prove the efficacy in preventing PONV or delayed PONV.

  12. General Anesthesia Combined With Epidural Anesthesia on Elderly Patients With Single Lung Ventilation Intrapulmonary Shunt and Arterial Oxygenation%全麻复合硬膜外麻醉对老年患者单肺通气肺内分流及动脉氧合的影响

    Institute of Scientific and Technical Information of China (English)

    王福杰; 周英娟

    2016-01-01

    Objective Discuss on general anesthesia combined with epidural anesthesia on elderly patients with single lung ventilation pulmonary artery shunt and oxygenation.Methods Randomly selected from May 2013 to December 2015 in our hospital 60 elderly patients with clinical data,depending on the anesthesia,60 patients were divided into two groups, ]one group for the general anesthesia. Group 2 to 1.0% lidocaine anesthesia combined with epidural anesthesia group,30 cases in each. Compared the two groups before the single-lung ventilation lung,single lung ventilation 10 min,20 min,30 min, 40 min of arterial blood gases and arterial oxygenation.Results Arterial oxygen pressure and flow and ventilation points when comparing the two groups,had declined. Epidural anesthesia group decreased more efective than general anesthesia group,compared to the diference was statisticaly significant(P<0.05).Conclusion Anesthesia combined with epidural anesthesia in elderly patients with reduced single-lung ventilation pulmonary shunt,reduced arterial oxygen tension.%目的:探讨全麻复合硬膜外麻醉对老年患者单肺通气肺内分流及动脉氧合的影响。方法随机选择我院2013年5月~2015年12月我院收治的60例行开胸手术的老年患者临床资料,根据不同麻醉方式把60例患者分成2组,1组为全麻组,2组为全麻复合1.0%利多卡因硬膜外麻醉组,每组各30例。比较2组单肺肺通气前、单肺通气10 min、20 min、30 min、40 min的动脉血气及动脉氧合。结果两组单肺通气时动脉氧分压与分流量与通气前对比,均有所下降,全麻复合组下降效果优于单纯全麻组,对比差异有统计学意义(P<0.05)。结论全麻复合硬膜外麻醉减少老年患者单肺通气肺内分流,降低动脉血氧分压。

  13. 全麻下俯卧位脊柱手术护士与麻醉师的护理配合体会%Nursing cooperation experience of nurse and anesthesiologist in spinal operation at prone position under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    纪阴心

    2014-01-01

    本文总结了全身麻醉下俯卧位脊柱手术护士与麻醉师的护理配合体会,包括麻醉前、麻醉中及麻醉后护理配合。认为巡回护士协助麻醉师妥善的固定气管插管和维护全麻肌松后的呼吸循环神经系统至关重要,减少了因手术体位的改变所致的并发症的发生,保证了麻醉平稳,手术顺利进行。%In this paper,the author has summarized the nursing cooperation experience of nurse with anesthesiologist in spinal operation at prone position under general anesthesia,including before anesthesia,during anesthesia and after anesthesia nursing cooperation.We think that it is very important of the itinerate nurse assisting the anesthesiologist to properly secure endotracheal intubation and maintaining respiration,circulation and nerve systems after muscle relaxation under general anesthesia,which can reduce the complications caused by posture change of operation,and ensure the stable anesthesia and operation smoothly.

  14. Using General Anesthesia plus Muscle Relaxant in a Patient with Spinal Muscular Atrophy Type IV: A Case Report.

    Science.gov (United States)

    Liu, Xiu-Fen; Wang, Dong-Xin; Ma, Daqing

    2011-01-01

    Spinal muscular atrophy (SMA) is a rare genetic disease characterized by degeneration of spinal cord motor neurons, which results in hypotonia and muscle weakness. Patients with type IV SMA often have onset of weakness from adulthood. Anesthetic management is often difficult in these patients as a result of muscle weakness and hypersensitivity to neuromuscular blocking agents as shown by (Lunn and Wang; 2008, Simic; 2008, and Cifuentes-Diaz et al.; 2002). Herein we report a case of anesthetic management of a patient with SMA type IV for mammectomy and review some other cases of SMA patients receiving different kinds of anesthesia.

  15. Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery

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    Hedenstierna Göran

    2011-05-01

    Full Text Available Abstract Background Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery. Methods The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO" trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH2O with recruitment maneuvers (the lung-protective strategy or mechanical ventilation with the level of PEEP at maximum 2 cmH2O without recruitment maneuvers (the conventional strategy. The primary endpoint is any post-operative pulmonary complication. Discussion The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications. Trial registration ISRCTN: ISRCTN70332574

  16. Effects of dexmedetomidine on depth of anesthesia and sore throat after general anesthesia%右美托咪定对全麻麻醉深度和术后咽喉痛的影响

    Institute of Scientific and Technical Information of China (English)

    张辉; 邵东华; 吴进; 张维; 王华

    2015-01-01

    目的:探讨右美托咪定对麻醉深度及对全麻术后咽喉痛的影响。方法:选择择期行甲状腺肿瘤切除术患者40例,随机分为右美托咪定组和对照组,每组20例;在全麻下手术开始后10 min,右美托咪定组给予右美托咪定0.6μg/kg 泵注10 min,继以0.2μg·kg -1·h -1维持泵注;对照组以相同方式输注生理盐水。监测并记录两组患者用药前即刻(T0)、用药后5 min(T1)、10 min(T2)、15 min(T3)、20 min(T4)、25 min(T5)、30 min(T6)的 Narcotrend 指数(NTI)、平均动脉压(MAP)、心率。比较两组患者在麻醉恢复室拔管时间、苏醒时间、镇痛药总用量及术后24 h 咽喉痛发生率。结果:与对照组相比,右美托咪定组心率在 T1~T6时间点明显降低(P <0.05),NTI 在 T3~T6时间点明显降低(P <0.05),T1~T6时间点 MAP 差异无统计学意义(P >0.05);两组患者拔管时间及苏醒时间差异无统计学意义(P >0.05);右美托咪定组术中镇痛药总用量和术后24 h 咽喉痛发生率明显低于对照组(P <0.05)。结论:全麻患者术中静脉输注小剂量右美托咪定可增加麻醉镇静深度,并可有效预防全麻术后咽喉痛的发生。%Objective:To explore the effects of dexmedetomidine on depth of anesthesia and sore throat after general anesthesia.Methods:Forty ASA Ⅰ/Ⅱ patients undergoing thyroidectomy operation were ran-domly assigned into two groups:dexmedetomidine group (n =20)and control group (n =20).Ten minutes after the start of the operation,under general anesthesia,patients in the dexmedetomidine group received intravenous injection of dexmedetomidine 0.6 μg/kg for 10 min and followed by 0.2 μg·kg -1 ·h -1 for maintenance.Saline was applied in the same way in the control group.Monitored and recorded the NTI, MAP,heart rate before(T0)and 5 min(T1),10 min(T2),15 min(T3),20 min(T4),25 min

  17. 认知行为干预对全麻后导尿病人疼痛耐受力的影响%Effect of Cognitive Behavioral Intervention on Pain Tolerance of Patients with Urinary Catheter after General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    刘永宁; 金嵩; 王晓庆

    2016-01-01

    目的:通过术前认知干预缓解患者因手术麻醉后留置导尿引起的疼痛及麻醉恢复期躁动。方法对150例全麻后导尿的手术患者随机分成认知干预组和对照组,对照组常规麻醉诱导后导尿,干预组术前给予麻醉后导尿的认知辅导,对全麻恢复期尿管刺激疼痛强度及躁动情况比较。结果两组患者术后现有疼痛强度评定P<0.05有统计学意义;术后麻醉恢复躁动差异显著P<0.01。结论通过建立全麻手术患者对麻醉后导尿的认知及认知评价,可以提高手术患者术后及麻醉恢复期对尿管刺激疼痛的耐受力,减少术后躁动。%Objective to releive urinary catheter pains and dysphoria at anesthesia recovery period after operation general anesthesia of patients through preoperative cognitive intervention.Methods 150 patients with urinary catheter after general anesthesia were randomly divided into cognitive intervention and control group. Control group was treated with catheterization of routine anesthesia induction, and intervention group with preoperative cognition instruction of urinary catheterization after anesthesia. Compare catheter stimulation pain intensity and dysphoria during recovery period of general anesthesia.Results postoperative pain intensity assessment of two groups showedP<0.05 with statistical significance; postoperative anesthesia recovery dysphoria showed significant difference P<0.01.Conclusion: establishing patients’ cognition and evaluation for catheterization after general anesthesia can improve catheter stimulation pain tolerance after surgery during anesthesia recovery period, and reduce postoperative dysphoria.

  18. Comparative Study of the Effect of Intravenous Paracetamol and Tramadol in Relieving of Postoperative Pain after General Anesthesia in Nephrectomy Patients

    Science.gov (United States)

    Manne, Venkata Sesha Sai Krishna; Gondi, Srinivasa Rao

    2017-01-01

    Aim: The aim of this study was to compare the effect of intravenous paracetamol and tramadol in relieving of postoperative pain after general anesthesia for nephrectomy in prospective donor patients for kidney transplantation. Materials and Methods: A randomized study was conducted on 100 adult patients scheduled for nephrectomy aged from 35 to 55 years of both sexes and divided into two groups and were administered intravenous paracetamol and tramadol for postoperative pain relief and assessed with visual analog scale score and variations in vital parameters to assess extent of pain relief. Results: After statistical interpretation of collected data, the observations were extrapolated. There was a statistically significant difference in the pain intensity scores obtained between the paracetamol and tramadol groups. Conclusion: On the basis of the present study, it is concluded that tramadol due to its lesser onset of action time was superior to paracetamol in providing acute postoperative pain relief.

  19. Effects of general anesthesia on stress response and inflammatory cytokines in elderly patients undergoing abdominal surgery under the guidance of Narcotrend

    Institute of Scientific and Technical Information of China (English)

    Da-Yong Lin; Yan-Xin Liu; Qian Li

    2016-01-01

    Objective:To investigate the effect of general anesthesia on stress response and inflammatory cytokines in elderly patients undergoing abdominal surgery under the guidance of Narcotrend. Methods:A total of 150 elderly patients with abdominal surgery in our hospital from January 2015 to December 2015 were randomly divided into three groups: D0, D2 and E2 group, each 50 cases. With different depth of anesthesia, the stress response indexes COR, ACTH, CRP and ET-1, the inflammatory factors IL-6 and TNF-α before anesthesia, postoperative 1 h and postoperative 1 d were compared.Results:The differences of Cor, ACTH, CRP and ET-1 in the three groups D0, D2 and E2 were all statistically significant (P<0.05); the differences of Cor, ACTH and CRP at each time point were also statistically significant (P<0.05), Cor in D0 and D2 group were significantly increased postoperative 1 h and 1 d (P<0.05), ACTH in D0, D2 and E2 group were significantly increased postoperative 1 h and 1 d (P<0.05), CRP in D0 group was significantly increased postoperative 1 h and 1 d (P<0.05); The increase amplitude of Cor in D0 and D2 group at each time point was higher than in E2 group (P<0.05), the increase amplitude of ACTH in D2 group at each time point was lower than in D0 and E2 group (P<0.05), the increase amplitude of CRP in D0 group at each time point was higher than in D2 and E2 group (P<0.05), ET-1 in D0 and D2 group had no changes at each time point, while the decrease amplitude of ET-1 in E2 group at each time point was significantly higher than in D0 and D2 group (P<0.05). The differences of IL-6 and TNF-α in the three groups D0, D2 and E2 were all statistically significant (P<0.05); the differences of IL-6 and TNF-α at each time point were also statistically significant (P<0.05), IL-6 and TNF-α in D0 group were significantly increased postoperative 1 h and 1 d (P < 0.05); the increase amplitude of IL-6 and TNF-α in D0 group at each time point was higher than in D2 and E2 group (P<0

  20. Relationship Between Respiratory Dynamics and Body Mass Index in Patients Undergoing General Anesthesia with Laryngeal Mask Airway (LMA) and Comparison Between Lithotomy and Supine Positions.

    Science.gov (United States)

    Zhao, Xiao; Huang, Shiwei; Wang, Zhaomin; Chen, Lianhua; Li, Shitong

    2016-08-01

    BACKGROUND This study aimed to compare respiratory dynamics in patients undergoing general anesthesia with a laryngeal mask airway (LMA) in lithotomy and supine positions and to validate the impact of operational position on effectiveness of LMA ventilation. MATERIAL AND METHODS A total of 90 patients (age range, 18-65 years) who underwent general anesthesia were selected and divided into supine position (SP group) and lithotomy position groups (LP group). Vital signs and respiratory dynamic parameters of the 2 groups were measured at different time points and after implantation of an LMA. The arterial blood gas was monitored at 15 min after induction. The intraoperative changes of hemodynamic indexes and postoperative adverse reactions of LMA were recorded. The possible correlation between body mass index (BMI) and respiratory dynamic indexes was analyzed. RESULTS With prolonged duration of the operation, the inspiratory plateau pressure (Pplat), inspiratory resistance (RI), and work of breathing (WOB) gradually increased, while chest-lung compliance (Compl) and partial pressure of carbon dioxide in end-expiratory gas (PetCO2) gradually decreased (all P value <0.05). The mean airway pressure (Pmean), Pplat, and expiratory resistance (Re) in the LP group were significantly higher than in the SP group (P<0.05), while the peak inspiratory flow (FImax), peak expiratory flow (FEmax), WOB, and Compl in the LP group were significantly lower than in the SP group (P<0.05). BMI was positively correlated with peak airway pressure (PIP/Ppeak), Pplat, and airway resistance (Raw) and was negatively correlated with Compl; the differences among patients in lithotomy position were more remarkable (P<0.05). CONCLUSIONS The inspiratory plateau pressure and airway resistance increased with prolonged duration of the operation, accompanied by decreased chest-lung compliance. Peak airway pressure and airway resistance were positively correlated with BMI, and chest-lung compliance was

  1. 浅谈全麻苏醒期躁动的原因及护理体会%Causes and nursing experience of analepsia restlessness under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    孙少梅

    2012-01-01

    目的 调查全身麻醉苏醒期躁动发生的原因及护理体会.方法 对331例全麻患者进行观察,调查苏醒期躁动的发生原因及护理方法.结果 术后疼痛占45.3%,气管导管、尿管刺激占23.6%,心理因素占8.1%,其他原因所致(如缺氧、药物作用、反复吸痰、体位不适等)占5.4%.通过术前访视、选择适当的导尿时间、正确安置手术体位、适时拔除气管导管、术后充分镇痛等患者安全度过苏醒期.结论 针对不同的原因进行护理,可减少躁动对患者所造成的伤害,保障患者的安全.%Objective To investigate the causes and nursing experience of analepsia restlessness under general anesthesia. Methods A total of 331 general anesthesia patients were observed to summarize the causes and nursing experience of analepsia restlessness. Results Postoperative pain accounted for 45. 3% , tracheal catheter, stimulation of catheter 23. 6% , psychological factor 8. 1% ,and other reasons such as hypoxia, drug effects, repeated sputum suction, postural discomfort accounted for 5.4%. Patients survived from analepsia through preoperative visit, proper catheteri-zation, proper placement of operation posture, timely removal of the catheter, and adequate postoperative analgesia. Conclusion Nursing based on different causes can reduce the injury led by restlessness to patients and ensure the safety of patients.

  2. Evaluation of Differences between PaCO2 and ETCO2 by Age as Measured during General Anesthesia with Patients in a Supine Position

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    Kenichi Satoh

    2015-01-01

    Full Text Available Objective. The aim of this study was to evaluate the arterial to end-tidal partial pressure gradient of carbon dioxide according to age in the supine position during general anesthesia. Methods. From January 2001 to December 2013, we evaluated 596 patients aged ≥16 years who underwent general anesthesia in the supine position. The anesthetic charts of these 596 patients, all classified as American Society of Anesthesiologists physical status I or II, were retrospectively reviewed to investigate the accuracy of PaCO2 and ETCO2. Results. The a-ETCO2 was 3.0 ± 2.1 mmHg for patients aged 16 to <65 years and 4.1±3.1 mmHg for patients ≥65 years. The a-ETCO2 was 2.4±3.1 mmHg for patients aged 16 to 25 years, 3.1±2.2 mmHg for patients aged 26 to 35 years, 3.0±2.2 mmHg for patients aged 36 to 45 years, 3.4±2.0 mmHg for patients aged 46 to 55 years, 3.2±2.0 mmHg for patients aged 56 to 64 years, 4.3±3.2 mmHg for patients aged 65 to 74 years, and 3.7±2.8 mmHg for patients aged 75 to 84 years. Conclusion. The arterial to end-tidal partial pressure gradient of carbon dioxide tended to increase with increasing age.

  3. A COMPARATIVE STUDY OF PEDIATRIC CARDIAC CATHETERIZATION PROCEDURE UNDER GENERAL ANESTHESIA WITH OR WITHOUT FEMORAL NERVE BLOCK

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    Jigisha

    2016-02-01

    Full Text Available OBJECTIVE Anesthetic management for interventional cardiac procedures/cardiac catheterization in pediatric patients is challenging. Cardiac anomalies vary from simple to complex congenital cardiac anomalies, shunts may be present at multiple levels and patients may be profoundly cyanotic, may be with ventricular dysfunction. They usually require sedation and analgesia to maintain steady stable state. In adults, such type of procedures can be well managed with local anesthesia. METHODS Fifty patients were included in the study. They were randomly divided into two groups- Group A (n=25 patients received femoral N. block along with IV sedation and analgesia while group B (n=25 patients received only IV sedation and analgesia. Both groups were compared for hemodynamics, pain score and requirement of IV anesthetic agents and any complications if come up. RESULTS Group A patients required IV ketamine 3.24mg/kg (±0.31SD as compared to 5.58mg/kg (±1.6SD in group B, which suggests significantly reduced requirement of IV anesthetic agents in group where femoral nerve block has been given. Hemodynamic parameters remained stable and comparable (no statistically significant variation Pain score was less in group A patients than group B. CONCLUSION It has been observed that Group A patients required less dosages of IV anesthetic agents, with stable hemodynamics and less pain score and sedation score as compared to group B patients.

  4. Spinal and epidural anesthesia

    Science.gov (United States)

    ... you epidural or spinal anesthesia is called an anesthesiologist. First, the area of your back where the ... Chan VWS. Spinal, epidural, and caudal anesthesia. In: Miller RD, ed. Miller's Anesthesia . 8th ed. Philadelphia, PA: ...

  5. Obesity and Anesthesia

    Science.gov (United States)

    ... Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery Obesity and Anesthesia More than one-third of Americans ... Sleep Apnea, a chronic medical problem common with obesity, can present with serious breathing problems before, during, ...

  6. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ... 6620 | E-mail: info@sambahq.org Copyright | 2016 Society for Ambulatory Anesthesia Home | Search | Terms | Privacy Policy | ...

  7. Pre-emptive analgesia using intravenous fentanyl plus low-dose ketamine for radical prostatectomy under general anesthesia does not produce short-term or long-term reductions in pain or analgesic use.

    NARCIS (Netherlands)

    Katz, J.; Schmid, R.L.; Snijdelaar, D.G.; Coderre, T.J.; McCartney, C.J.; Wowk, A.

    2004-01-01

    The aim of the study was to evaluate post-operative pain and analgesic use after pre-operative or post-incisional i.v. fentanyl plus low dose i.v. ketamine vs. a standard treatment receiving i.v. fentanyl but not ketamine. Men undergoing radical prostatectomy under general anesthesia were randomly a

  8. Transverse myelitis following spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Jha Sanjeev

    2006-01-01

    Full Text Available Spinal anesthesia is widely used during surgical procedures. It is generally safe and the frequency of severe, permanent neurological complications associated with it has been reported to be extremely low. We report a patient, who developed paraplegia following spinal anesthesia. A 29-year-old male was referred with acute, flaccid, sensory motor paraplegia, with bladder and bowel involvement. He developed this immediately after an operation for inguinal hernia under spinal anesthesia. Spinal magnetic resonance imaging revealed hemorrhagic myelitis in the conus at D12. He was referred after he did not respond to intravenous methylprednisolone for 10 days. This case brings up the difficulty encountered in determination of the interspace used for spinal anesthesia and the potential for traumatic injury to the spinal cord. It also demonstrates the tragic outcome after a clinician violates some important, standard and established guidelines.

  9. A comparison of desflurane and sevoflurane in the recovery of cognitive function after general anesthesia in elderly patients

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    Pandurang Kondiba Jadhav

    2015-11-01

    Full Text Available Background: The postoperative cognitive dysfunction (POCD or psychomotor function disorder is known to be associated with the anesthetic agents, as well as the physiological changes resulting from the anesthesia. The known risk factors are old age, preexisting cerebral cardiac or vascular disease, alcohol abuse, intra and post-operative complications. Methods: 50 patients above 65 years of age falling into ASA Grade 1, 2, or 3 were catagrzed into 2 groups, one (Group A wherein sevoflurane was given as the anesthetic agent and the other (Group B where desflurane was administered. All had undergone physical and regular blood examination. MMSE score was taken for all patients for cognitive recognition before surgery and 1, 3, and 6 hours after surgery. Results: Of the 50 patients, the MMSE score was above 27 for all before surgery, while, post-surgery it was below 27 after I hour in 100% of the cases. After 3 hours, in Group A, the mean MMSE was above 27 while it was still below 27 in Group B while it was above 27 in both the Groups after 6 hours post-surgery. There was only 1 cases of POCD after 6 hours in Group A and none in Group B. The recovery time was faster in Group B as compared to Group A. Conclusions: Desflurane was marginally a better anesthetic agent in terms or recovery to sevoflurane and sevoflurane was slightly better than the former when it came to cognitive recognition Therefore, we conclude that both the drugs are equally good anesthetic agents. [Int J Res Med Sci 2015; 3(11.000: 3278-3282

  10. A short period of fasting before surgery conserves basal metabolism and suppresses catabolism according to indirect calorimetry performed under general anesthesia.

    Science.gov (United States)

    Yoshimura, Shinichiro; Fujita, Yoshihito; Hirate, Hiroyuki; Kusama, Nobuyoshi; Azami, Takafumi; Sobue, Kazuya

    2015-06-01

    It is recommended that the period of fasting before elective surgery should be shortened to facilitate a rapid recovery by preventing catabolism. We examined the effects of a short period of fasting on metabolism by performing indirect calorimetry (IC) under general anesthesia. A prospective observational study involving 26 consecutive patients who underwent elective surgery and whose metabolism was evaluated using IC during anesthesia was conducted. The patients were divided into two groups, those who fasted for 10 h (group L). Oxygen consumption, the volume of carbon dioxide emissions (VCO2), the respiratory quotient (RQ), resting energy expenditure (REE), and basal energy expenditure (BEE) were compared. The REE, VCO2, and RQ of group L (17.7 ± 2.3 kcal/kg/day, 118.5 ± 20.8 ml/min, and 0.71 ± 0.12, respectively) were significantly lower than those of group S (19.7 ± 2.3 kcal/kg/day, 143.6 ± 30.9 ml/min, and 0.81 ± 0.09, respectively) (P < 0.05). In group L, the relationship between REE and BEE was weaker (r(2) = 0.501) and the BEE-REE slope was less steep (REE = 0.419BEE + 509.477) than those seen in group S (r(2) = 0.749 and REE = 1.113BEE - 376.111, respectively). Our findings suggest that a short period of fasting (<8 h) before surgery is more strongly associated with the conservation of basal metabolism.

  11. 脑电监测SD大鼠异氟醚全身麻醉模型的建立及脑电分析%The Establishment of SD Rats with Dynamic EEG Monitoring Model Under General Anesthesia with Isoflurane

    Institute of Scientific and Technical Information of China (English)

    杨海帆; 董海龙; 张昊鹏; 徐晨; 郭超

    2011-01-01

    目的:建立脑电监测SD大鼠异氟醚全身麻醉模型并分析脑电监测结果.方法:随机选取SD大鼠20只,先行脑电电极置入术,术后使用密闭吸入麻醉动物行为学观察圆筒,观察异氟醚引起的麻醉诱导、维持、觉醒状态并记录诱导、觉醒时间.将记录的行为学结果对照典型脑电图波形改变判断麻醉深度.结果:实验SD大鼠均检测出脑电图,通过对照行为学观察发现动态脑电监测结果同异氟醚麻醉过程进展一致.在麻醉过程中SD大鼠出现典型的全身麻醉脑电循环.结论:动态脑电监测和SD大鼠行为学观察可以准确反应全身麻醉深度.%Objective: To creative a dynamic EEG monitoring SD rats under isoflurane-induced general anesthesia of making animal models and analysis the result of EEG was monitoring. Methods: EEG electrodes were implanted in 20 SD randomly selected rats, and then observed their behavior from the sealed animal observation cylinder. The subtle presentations and precise time of ioflurane-in-duced anesthesia, maintenance, and wakefulness in general anesthesia were respectively recorded. The degree of anesthesia can be judged by comparing the record with the typical EEG waveforms. Results: The EEG waveforms could be detected form SD rats in the experiment. By using the comparison behavior method, the results of dynamic EEG monitoring were observed the same result of the process of isoflurane anesthesia. SD rats showed the typical anesthesia EEG cycle during the anesthesia. Conclusion: Through the comparison of the animal behavior observation of SD rats with dynamic EEG monitoring results, the dynamic EEG monitoring could accurately reflect the general anesthesia degree.

  12. Atelectasia pulmonar em cães durante anestesia geral Pulmonary atelectasis in dogs during general anesthesia

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    Patrícia Cristina Ferro Lopes

    2010-02-01

    Full Text Available A pressão intrapleural normalmente é menor que a pressão intrapulmonar. Consequentemente , os pulmões tendem ao colapso e se retraem, afastando-se da parede torácica. No início do século XX, Pasteur descreveu a atelectasia pulmonar, que ocorre com frequência durante a indução anestésica, persiste no período pós-operatório e pode contribuir de maneira significativa para a morbidade e o aumento nos gastos com medicamentos. Em medicina veterinária, no entanto, a atelectasia não é frequentemente diagnosticada, apesar de que isso não implica afirmar que tal afecção não ocorra, visto que existem relatos do desenvolvimento desse quadro em cães e em outras espécies. No contexto da anestesia geral, essa complicação pulmonar pode ser encontrada em animais que respiram 80 a 100% de oxigênio. A partir dessas informações, torna-se necessário que o profissional da anestesiologia veterinária obtenha conhecimentos complementares sobre o tema. Com este trabalho, objetivou-se descrever alguns dos mecanismos da atelectasia e seus pontos relevantes, de modo a familiarizar os profissionais quanto aos pormenores dessa importante, e nem sempre bem compreendida, alteração fisiológica respiratória.Pleural pressure is usually lower than pulmonary pressure. Therefore, the lungs tend to collapse and increase its distance from thoracic walls. At the beginning of 20th century, Pasteur described the pulmonary atelectasis, which develops during induction of anesthesia and persists to the postoperative period. It can contribute significantly to morbidity and to increase the medical expenses. In veterinary medicine, pulmonary atelectasis is not frequently diagnosed, which doesn't rule out the occurrence of this disease, since there are reports of atelectsasis in dogs. This pulmonary complication can be found in animals that breathe 80% to 100% oxygen in anesthetic procedures. Based on this information, the veterinary anesthesiologist is required

  13. Anesthesia for outpatient female sterilization.

    Science.gov (United States)

    Fishburne, J I

    1983-04-01

    This issue of the Bulletin deals with the principles of anesthesia for outpatient female sterilization with emphasis on techniques for laparoscopy and minilaparotomy. General anesthesia techniques provide analgesia, amnesia, and muscle relaxation and are particularly useful for managing the anxious patient. Disadvantages include increased expense, need for specialized equipment, and highly trained personnel, and delayed recovery. Complications, though relatively rare, can be life-threatening and include aspiration of stomach contents, hypoxia, hypercarbia, hypotension, hypertension, cardiac arrhythmias, cardiorespiratory arrest, and death. There is no single preferred technique of general anesthesia, athough most anesthetists employ methods that allow rapid recovery of faculties, enabling the patient to be discharged soon after surgery. To accomplish this end, light anesthesia with sodium thiopental induction and nitrous oxide maintenance is often used. Short duration muscle relaxation with an agent such as succinylcholine supplements this technique. Other techniques include light anesthesia with inhalational anesthetic agents and the use of intravenous ketamine. Local anesthesia augmented by systemic and/or inhalational analgesia is supplanting general anesthesia techniques for laparoscopy in many locales. This approach is also particularly well-suited for minilaparotomy in developing countries, where it has achieved its greatest popularity. The local technique carries with it reduced morbidity and mortality but may not entirely relieve discomfort. The primary danger of local anesthesia is respiratory depression due to excessive narcosis and sedation. The operator must be alert to the action of the drugs and should always use the minimal effective dose. Although toxicity due to overdosage with local anesthetic drugs is occasionally experienced, allergic reactions to the amide-linkage drugs such as lidocaine or bupivacaine are exceedingly rare. For outpatient

  14. [Anesthesia for cesarean section in patients with fetal anomaly].

    Science.gov (United States)

    Nakano, S; Tashiro, C; Nishimura, M; Ueyama, H; Uchiyama, A; Kubota, A; Suehara, N

    1991-05-01

    Twenty-two cases of Cesarean section due to fetal anomaly diagnosed prenatally were reviewed in terms of the anesthetic managements. In 6 cases, diazepam 0.3 mg.kg-1, which provides fetal anesthesia for surgery scheduled immediately after birth, was administered intravenously to the mothers with/without fentanyl (2 general anesthesia and 4 regional anesthesia). The diagnosis of their fetuses was congenital diaphragmatic hernia, congenital cystic adenomatoid malformation of the lung, gastroschisis or omphalocele. No fetal anesthesia was performed in the other 16 cases (15 spinal anesthesia and 1 general anesthesia). Seven of their fetuses were diagnosed as hydrops. Since the general condition of the diseased newborn is known to be deteriorated after receiving various stress and aerophagia, fetal anesthesia in Cesarean delivery has the advantage of stress reduction and prevention of aerophagia. When the newborn is considered to need immediate neonatal resuscitation or intensive care including surgery, fetal anesthesia may be a choice of anesthetic technique.

  15. [Application of Non-intubated Anesthesia in VATS].

    Science.gov (United States)

    Dai, Xiaotan; Song, Pingping; Zhang, Baijiang

    2016-05-20

    Tracheal intubation general anesthesia technique is widely used in video-assisted thoracic surgery (VATS) because it can improve the safety of VATS, but the complications of tracheal intubation can not be avoided. How to develop a "minimally invasive" surgery (including micro anesthesia) has become a hot topic in the field of minimally invasive surgery. Along with the progress of the anesthesia management technology and the risk management in the operation, the technology of non-intubated anesthesia was successfully applied to VATS, namely using local anesthesia to maintain patients intraoperative independent ventilation and intraoperative only mild sedation or fully conscious state of implementation of thoracoscope surgery, therefore is also called awake VATS. The anesthesia method not only reduces the anesthesia injury of tracheal intubation, but also conforms to the idea of rapid rehabilitation surgery. Based on non-intubated anesthesia in VATS in the brief history of development, the anesthesia selection, operation advantages and risks are reviewed in this paper.

  16. Anesthesia for fetoscopic intervention

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    Jamil S Anwari

    2014-01-01

    Full Text Available This is the first case report on anesthesia for fetoscopy performed in Saudi Arabia. Epidural anesthesia was given to the mother in her late second trimester for the fetoscopic intervention. The anesthesia related issues such as physiological and anatomical changes in pregnancy, tocolytic medications and their interactions with anesthesia, anesthetizing/sedating the primary patient are discussed.

  17. Topical anesthesia

    Directory of Open Access Journals (Sweden)

    Mritunjay Kumar

    2015-01-01

    Full Text Available Topical anesthetics are being widely used in numerous medical and surgical sub-specialties such as anesthesia, ophthalmology, otorhinolaryngology, dentistry, urology, and aesthetic surgery. They cause superficial loss of pain sensation after direct application. Their delivery and effectiveness can be enhanced by using free bases; by increasing the drug concentration, lowering the melting point; by using physical and chemical permeation enhancers and lipid delivery vesicles. Various topical anesthetic agents available for use are eutectic mixture of local anesthetics, ELA-max, lidocaine, epinephrine, tetracaine, bupivanor, 4% tetracaine, benzocaine, proparacaine, Betacaine-LA, topicaine, lidoderm, S-caine patch™ and local anesthetic peel. While using them, careful attention must be paid to their pharmacology, area and duration of application, age and weight of the patients and possible side-effects.

  18. Discussion on Different Postures of Post-anesthesia Nursing Care for General Surgery%普外科麻醉术后不同护理体位的探讨

    Institute of Scientific and Technical Information of China (English)

    刘晓红; 贺锦花

    2009-01-01

    Objective To discuss and choose an reasonable posture for post-anesthesia patients suf-fered general surgical operation. Methods every 120 postoperative patients with general anesthesia(the patients were awake and get normal vital sign), epidural anesthesia or cervical anesthesia were randomly divided into control group and experiment group. Semi-reclining position were adopted after being taken horizontal position for 6 hours in the control group, and the semi-reclining position were directly taken in the experiment group after operation and the comparison was made between the two groups. Results Vital signs of all patients were smooth, and there was no statistic difference in the incidence rate of headache, dizziness and vomiting between two groups (P>0.05), but the malaise feeling was severe in control group (P0.05);而体位不适感对照组明显高于实验组(P<0.01).结论 普外科患者麻醉术后直接选择半卧位或低半卧位可以提高舒适感,有利于患者的恢复.

  19. Curative Effect and Safety Analysis of Intravenous Introduction Dexmedetomidine Assist General Anesthesia%静脉注射右美托咪定辅助全身麻醉的疗效及安全性分析

    Institute of Scientific and Technical Information of China (English)

    严明; 周薇; 李祖阁; 李靖

    2014-01-01

    Objective:To investigate the analysis of intravenous introduction dexmedetomidine clinical efficacy and safety of general anesthesia.Methods:60 patients were randomly divided into two groups of 30 cases each.Control group to give intravenous saline auxiliary anesthesia,the observation group was given intravenous introduction dexmedetomidine assist general anesthesia,comparing two drug sedative effects and adverse reactions.Results:Two groups of patients before anesthesia Ramsay score compared with no significant difference (P>0.05);Ramsay scale observation group patients were significantly higher than that of control group,significant difference (P0.05);给药5min和10min后,观察组患者Ramsay评分均显著高于对照组,差异有统计学意义(P<0.05);观察组寒颤及苏醒期躁动的发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:静脉注射右美托咪定辅助全身麻醉效果显著,不良反应少,安全可靠,值得在临床上应用和推广。

  20. Distinguishing between pre- and post-incision under general anesthesia by spectral and recurrence analysis of EEG data

    OpenAIRE

    Fedotenkova, Mariia; Hutt, Axel; beim Graben, Peter; Sleigh, James W.

    2015-01-01

    International audience; Nowadays, surgical operations are impossible to imagine without general anaesthesia, which involves loss of consciousness, immobility, amnesia and analgesia. Understanding mechanisms underlying each of these effects guarantees well-controlled medical treatment.Our work focuses on analgesia effect of general anaesthesia, more specifically, on patients reaction on nociception stimuli. The study was conducted on dataset consisting of 230 EEG signals: pre- and post-incisio...

  1. Effects of preoperative psychological state on the results of general anesthesia%术前心理状态对全麻效果的影响

    Institute of Scientific and Technical Information of China (English)

    冯晋潞; 乔阳

    2007-01-01

    Objective To study the effects of preoperative psychological state on calm time、recovery time and the level of pain about female tumer patients with general anesthesia.Methods We selected 105 female tumer patients whose ages were from 39 years to 66 years.They were divided into two groups according to SAS grade.We observed the calm time,recovery time and the VAS about the two groups.Results The calm time and reeovery time in disquieting group was significant longer than that of the normal group.There was a significant difference between group A and group B(P<0.01).Otherwise the grade of VAS after operation was significant greater than that of the normal group.Conclusion The disquieting preoperative psychological state would effect the results of general anesthesia.The anesthetist should pay attention to the visiting patients before operation.%目的 研究术前心理状态对妇科肿瘤切除术患者全麻镇静时间、苏醒时间和术后疼痛的影响.方法 选择年龄在39~66岁,行择期妇科肿瘤切除术的患者105例,按照Zuang焦虑自评量表(SAS)对患者进行焦虑状态自评的分数,将105例患者分为对照组(A组)和焦虑组(B组)两组.观察上述两组全麻镇静时间、苏醒时间和术后视觉模拟(VAS)评分情况.结果 焦虑组全麻镇静时间、苏醒时间均明显长于对照组(P<0.01),焦虑组的术后VAS评分也明显大于正常组(P<0.01).结论 术前患者的焦虑心理状态对全麻效果有一定的影响,麻醉医师应重视术前访视患者.

  2. 全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响%Effects of general anesthesia and epidural anesthesia on the short-term cognitive function in the elderly patients after orthopedics surgery

    Institute of Scientific and Technical Information of China (English)

    夏燕飞; 黄浩; 周嘉莉; 罗妙妙

    2012-01-01

    Objective To study the influence of general anesthesia and epidural anesthesia on postoperative short-term cognitive function in the elderly patients undergoing orthopedics surgery.Methods 120 patients with hip joint displacement or internal fixation after femur fracture and American Society of Anesthesiology Ⅰ and Ⅱ were randomly divided into general anesthesia and epidural anesthesia groups(n=60 for each group).Artery blood pressure(ABP)and heart rate were recorded before operation,pre-operation after anesthesia,during 30 min operation,during main operation and at operation end.Cognitive function was detected by mini-mental state(MMS)before induction of anesthesia and 6 h,12 h,24 h and 72 h after anesthesia.Results There were no differences in ABP and heart rate during operation between the two groups(P>0.05).The scores of MMS in general anesthesia group at 6 h(26.5±0.5),12 h(25.4±0.7)and 24 h(27.4±0.3)were decreased as compared with pre-induction of anesthesia(29.5 ± 0.3)(P< 0.05),while no difference was found at 72 h(29.3±0.3).The scores of MMS in epidural anesthesia group at 6 h(26.6±0.4)and 12 h(25.6±0.8)were lower(P<0.05),while had no difference at 24 h(29.1±0.4)and 72 h (29.5±0.4)(P>0.05)as compared with pre-induction of anesthesia(29.4±0.4).At 24 h after anesthesia,the MMS scores were higher in epidural anesthesia group(29.1±0.4)than in general anesthesia group(27.4±0.3)(P<0.01).Conclusions General anesthesia may contribute to more obvious influences on cognitive function than epidural anaesthesias within 12h after operation in the elderly patients undergoing orthopedics surgery.%目的 观察全身麻醉和硬膜外麻醉对老年骨科患者术后短期认知功能的影响. 方法 选择全髋关节置换或股骨骨折切复内固定手术患者120例,美国麻醉医师协会(ASA)病情分级Ⅰ、Ⅱ级,数字抽签随机分为全身麻醉组和硬膜外麻醉组各60例.记录术前、麻醉后手术前、手术30 min、主

  3. Comparison of risk of tumor invasion and metastasis under paravertebral block combined with general anesthesia versus general anesthesia in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope:plasma VEGF and M%椎旁神经阻滞联合全麻与全麻下胸腔镜肺癌根治术病人肿瘤侵袭和转移风险的比较:VEGF和MMP-9血浓度

    Institute of Scientific and Technical Information of China (English)

    陈冀衡; 范志毅; 张云霄; 金云玉; 李萍

    2015-01-01

    Objective To compare the risk of tumor invasion and metastasis under paravertebral block (PVB) combined with general anesthesia versus general anesthesia in the patients undergoing radical resection for lung cancer performed via video-assisted thoracoscope in terms of plasma concentrations of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9).Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 30-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective radical resection for lung cancer performed via video-assisted thoracoscope,were randomly divided into 2 groups (n =20 each) using a random number table:general anesthesia group (group G) and PVB combined with general anesthesia (group PG).PVB of T4-7 was performed successfully with local injection of 0.375% ropivacaine 5 ml before induction of anesthesia.Double-lumen endotracheal tube was placed after induction of anesthesia,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 1%-2%),and intravenous infusion of remifentanil 0.2-0.3 μg · kg-1 · min-1,and intermittent intravenous boluses of atracurium.Before anesthesia and at 24 h after surgery,the venous blood samples were collected for measurement of plasma concentrations of VEGF and MMP-9.Results The plasma VEGF and MMP-9 concentrations were significantly lower after surgery in group PG than in group G.Conclusion PVB combined with general anesthesia significantly decreases the risk of tumor invasion and metastasis in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope in comparison to general anesthesia.%目的 采用血管内皮生长因子(VEGF)和基质金属蛋白酶-9(MMP-9)血浓度,比较椎旁神经阻滞联合全麻与全麻下胸腔镜肺癌根治术病人肿瘤侵袭和转移风险.方法 择期行胸腔镜肺癌根治术病人40例,年龄30 ~ 64岁,性别不限,BMI 18

  4. Airway management under general anesthesia during operation for oral and maxillofacial injuries%品腔颌面创伤手术麻醉气道管理

    Institute of Scientific and Technical Information of China (English)

    刘可斌; 李向京

    2009-01-01

    Establishment and maintenance of fluent re-spiratory tract is important in management of general anesthe-sia in surgery for oral and maxillofacial injuries. Patients with oral and maxillofaeial injuries are likely to have obstruction of respiratory tract, especially patients with coma, massive hem-orrhage, foreign bodies in respiratory tract and wallowing tongue base. Studies showed that the mortality caused by re-spiratory problems is higher than that caused by injury itself in patients with oral and maxiUofacial injuries. Along with the in-novation of anesthesia, in-depth understanding of difficult re-spiratory tract and development of new anesthetic or instru-ment, more and more methods can be attained for management of the respiratory tract in surgery for oral and maxillofacial in-juries. The pivot of maintenance of fluent respiratory tract is taking effective steps to avoid lack of oxygen in pre-operation period. It is also important to use all kinds of intubation meth-ods and technologies skillfully.%维持气道通畅是口腔颌面创伤麻醉处理的重要课题.观察显示口腔颌面部外伤容易并发呼吸道梗阻,尤其是合并颅脑外伤者、昏迷状态、颌面部大出血、各种异物、舌根后坠等.相关报道合并颅脑外伤昏迷时,呼吸道问题引起的死亡,往往高于创伤本身.随着麻醉学技术的进步和对困难气道的深入认识以及麻醉药品器械的研制,解决问题的手段也日益增多.但每种解决办法都有自身特点,即适应证或禁忌证,尚需深入研究.颌面创伤气道的安全性关键在于围术期如何避免缺氧,有防范策略;其次是如何熟练应用各种插管方法.

  5. The Influence of Oral Ginger before Operation on Nausea and Vomiting after Cataract Surgery under General Anesthesia: A double-blind placebo-controlled randomized clinical trial

    Science.gov (United States)

    Seidi, Jamal; Ebnerasooli, Shahrokh; Shahsawari, Sirous; Nzarian, Simin

    2017-01-01

    Background According to Iranian traditional medicine, using safe ginger may contribute to taking less chemical medicines and result in fewer side effects. Objective To determine the influence of using ginger before operation on nausea and vomiting, after cataract surgery under general anesthesia. Methods This study was a double-blind placebo-controlled randomized clinical trial conducted at Kurdistan University of Medical Sciences in 2015. 122 candidates of cataract surgery were randomly allocated in three groups. The first group received a ginger capsule in a single 1 g dose, the second received two separate doses of ginger capsule each containing 500 mg and the third group received placebo capsule before operation. The patients were examined and studied for the level of nausea and occurrence of vomiting for 6 hours after the operation. The intensity of nausea was scored from zero to ten, based upon Visual Analog Scale. SPSS version 20 was used to analyze the data. We used Chi square and Kruskal-Wallis test for the analyses of outcomes. Results The frequency and intensity of nausea and the frequency of vomiting after operation among those who had taken the ginger capsule in 2 separate 500 mg doses was less than the other 2 groups. This difference was significant (pKurdistan University of Medical Sciences, Sanandaj, Iran. PMID:28243400

  6. Influencing factors for restlessness during anesthesia recovery period after gynecologic laparoscopic surgery under general anesthesia%妇科全麻腹腔镜手术患者术后麻醉恢复期躁动的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    孙明

    2012-01-01

    目的 分析妇科全麻腹腔镜手术患者术后全麻苏醒期躁动(EA)的影响因素.方法 回顾性分析268例行妇科全麻腹腔镜手术患者的临床资料.结果 年龄大、高血压病史、糖尿病病史、诱导后放置导尿管、术前血小板计数高是妇科全麻腹腔镜手术患者术后EA的危险因素,术后镇痛、SPO2高是保护因素.结论 医务人员应针对EA发生的危险因素进行相应干预措施,防止EA的发生.%Objective To explore the influencing factors of emergence agitation (EA) in patients after gynecologic laparoscopic surgery under general anesthesia. Methods The clinical data of 268 patients undergoing gynecologic laparoscopic surgery under general anesthesia were retrospectively reviewed. Results Advanced age, hypertension history, diabetes history, catheter placement after induction, preoperative high platelet count were dangerous factors of EA after general anesthesia laparoscopic surgery. Postoperative analgesia and high level of SP2 were protective factors. Conclusion Medical personnel should take related intervention measures aiming directly at dangerous factors to prevent the occurrence of EA.

  7. Comparison between general and spinal anesthesia in inguinal hernia repair in Clinical University Hospital "St. Naum Ohridski" - Skopje

    OpenAIRE

    2015-01-01

    Most often recommended treatment for inguinal hernia diagnosed patients is surgery. Generally, the surgical treatment includes several components: opening the subcutaneous fat by incision of the abdominal wall, mobilization of cord structures, dissection of weakened tissue and closure of inguinal canal with application of sterile synthetic mesh patch used to repair and decrease the tension in the weakened area of the abdominal wall after mobilization of hernia. Usually, the patient is given g...

  8. 盐酸右美托咪定辅助全麻镇静镇痛的疗效及安全性分析%Curative Effect and Safety Analysis on Sedation and Analgesia of Dexmedetomidine Assist General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    马志军; 臧颖卓

    2015-01-01

    Objective To observe the effect of sedation and analgesia of intravenous introduction dexmedetomidine.Methods Accordiing to society of Anesthesiologists(ASA)classification, 84 patients gradeⅠ-Ⅱ were randomly divided into two groups, 42 cases each. Observation group was given intravenous introduction dexmedetomidine assist general anesthesia,while control group was given intravenous saline auxiliary anesthesia, and then determine Ramsay score, the mean arterial pressure(MAP) and heart rate (HR) of before anesthesia, and at 5min,10 min after medication separately,comparing the effect of sedation and analgesia of the two drugs.Results Before anesthesia, Ramsay score compared with the two groups, was no significant difference (P>0.05);Ramsay scale of observation group patients were significantly higher than that of control group,there was significant difference (P0.05);给药10min和20min后,观察组患者Ramsay评分显著高于对照组(P<0.05),观察组心率和平均动脉压较对照组降低(P<0.05)。结论静脉注射右美托咪定辅助全麻镇静镇痛疗效显著,值得在临床上应用和推广。

  9. Phrenic nerve blocage with spinal anesthesia for laparoscopic Nissen fundoplication

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2015-06-01

    Full Text Available In this case, we describe a patient having laparoscopic Nissen fundoplication (LNF under spinal anesthesia with phrenic nerve blockade. It’s emphasized that in this type of operations, spinal anesthesia may be an alternative method rather the general anesthesia and the resulting shoulder pain in laparoscopic surgery performed under spinal anesthesia can be prevented by phrenic nerve blockade. J Clin Exp Invest 2015; 6 (2: 186-188

  10. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    OpenAIRE

    Tapar, Hakan; SÜREN, Mustafa; Kaya, Ziya; Arıcı, Semih; Karaman, Serkan; Kahveci, Mürsel

    2012-01-01

    Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to...

  11. Spinal morphine anesthesia and urinary retention.

    Science.gov (United States)

    Mahan, K T; Wang, J

    1993-11-01

    Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented.

  12. Inguinal hernioraphy under local anesthesia in the elderly patients

    Directory of Open Access Journals (Sweden)

    Nurettin Kahramansoy

    2012-12-01

    Full Text Available Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years and theyounger. Anesthesia methods, additional anesthesia requirementand complications were compared.Results: Of totally 177 patients, 30.5% were elderly.Operation type, anesthesia method and score of operationalrisk differed between groups. The percentage of comorbidity (55.6% in the elderly was significantly high (p<0.001. Among elderly, the frequency of co morbidity wasslightly higher in patients who had local anesthesia comparedto spinal and general anesthesia. Patients in youngand middle ages preferred to be operated less under localanesthesia (34.1% compared to elderly (70.4%. Therewas one case (2.6% converted to general anesthesiaas an additional anesthesia in the elderly group. Postoperativecomplications were slight more frequent in elderly.These cases were five in number (31.3% and were operatedunder spinal or general anesthesia (p=0.002.Conclusions: The frequency of co morbidity and riskscore of operation (ASA category rise in the elderly.However, inguinal hernioraphy can be performed underlocal anesthesia without complication and conversion togeneral anesthesia.Key words: Inguinal hernia; aged; comorbidity; local anesthesia

  13. 盐酸戊乙奎醚在复合全身麻醉中的应用价值研究%The Research of the Value for the Application of Penehyclidine Hydrochloride in General Anesthesia/

    Institute of Scientific and Technical Information of China (English)

    吴千海; 陈宏; 王蕾

    2013-01-01

      目的:探讨盐酸戊乙奎醚在全身麻醉中的应用价值.方法:61例患者均选自2008-2011年本院麻醉科开展全麻手术者,将患者随机分为观察组32例和对照组29例,对照组采用阿托品麻醉,观察组采用盐酸戊乙奎醚麻醉.观察静卧10 min后,注药后1、3、5、10和20 min心率(HR)和平均动脉压(MAP)变化.运用视觉模拟评分法(visual analogue scale,VAS)测定口干程度并记录给药前、给药后20 min、术后1 h和苏醒后口干程度.结果:观察组患者麻醉3 min起各时间段的HR均较对照组麻醉后低(P<0.05);观察组患者麻醉5 min后的MAP均较对照组麻醉后低(P<0.05).观察组患者的VAS评价结果明显优于对照组,差异具有统计学意义(P<0.05).结论:盐酸戊乙奎醚能有效、快速地减轻抗胆碱药的心血管副作用,有利于患者平稳进入麻醉,在麻醉后恢复过程中也能大大降低过多分泌物对拔管的影响.%Objective:To investigate the application of penehyclidine hydrochloride be used in general anesthesia.Method:61 patients who carried out of anesthesia general anesthesia from 2008 to 2011 in our hospital were chosen,and they were randomly divided into treatment group(29 cases)and control group(32 cases).The treatment group was taken with atropine anesthesia,and the observation group was treated with hydrochloric acid penehyclidine anesthesia.The changes of heart rate(HR)and mean arterial pressure(MAP)1,3,5,10 and 20 min after injection 10 min of repose were observed. The use of visual analogue scales(visual analogue scale,VAS)for the determination of the extent of dry mouth and recorded the extent of dry mouth 20 min after taking drugs,1 h after surgery and after waking.Result:The HR after taking anesthesia for 3 min was lower compared with the use of atropine(P<0.05). The MAP anesthesia after 5 min in the observation group was lower compared with the control group after anesthesia (P<0.05).The VAS evaluation

  14. Anesthesia and the developing brain

    DEFF Research Database (Denmark)

    Davidson, Andrew J; Becke, Karin; de Graaff, Jurgen

    2015-01-01

    It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large...

  15. Reduction in pulmonary complications in high risk patients undergoing surgery for total hip replacement under general anesthesia by preoperative intensive inspiratory muscle training:A randomized controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    Bingqiang Ma; Hongguang Bao

    2009-01-01

    Objective: To evaluate the effects of preoperative inspiratory muscle training (IMT) on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia. Methods: Thirty two high-risk paticnts undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical trial, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment (CT). The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization. Results: Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis (P = 0.25). Median duration of postoperative hospitalization was 13 days (range, 10~17 days) in the IMT group versus 16 days (range, 11~23 days) in the CT group (Mann-Whitney U statistics, Z =-2.22, P = 0.03). Mean postoperative inspiratory pressure was 5% higher in the IMT group. Conclusion: Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.

  16. Evaluation of Combined General Epidural Anesthesia in 62 Cases of Gynecological Laparoscopic Operation Anesthesia%硬膜外复合全麻在62例妇科腹腔镜手术中的麻醉效果评价

    Institute of Scientific and Technical Information of China (English)

    李英杰

    2014-01-01

    Objective To study anaesthesia effect of the combined general epidural anesthesia in gynecological laparoscopic operation. Methods From 2010 October to 2014 April, 102 cases in our hospital for gynecological laparoscopic operation were divided randomly into the control group (40 cases) and observation group (62 cases). The control group were used conventional general anesthesia, the observation group were treated by general anesthesia combined with epidural anesthesia, comparing and analyzing hemodynamic changes in patients in the two group, postoperative the recovery time and the excellent and good rate of uterine relaxation degree. Results The two groups were observed before and after induction, mean arterial pressure and heart rate fiuctuation, recovery time and uterine relaxation rate in patients in observation was significantly better than the control group, P<0.05, the difference was statistically significant. Conclusion Through general epidural anesthesia in gynecological laparoscopic operation, intraoperative mean arterial pressure and heart rate are stable, uterine relaxation degree is good, and have faster postoperative recovery.%目的:研究硬膜外复合全麻在妇科腹腔镜手术中…的麻醉效果。方法选取2010年10月~2014年4月于本院进行妇科腹腔镜手术治疗的102例患者,分为对照组40例和观察组62例,对照组患者采用普通全麻进行麻醉,观察组患者采用硬膜外复合全麻进行麻醉,观察两组患者术中…血流动力学变化,术后苏醒时间及子宫松弛度优良率,对比并分析两组患者的麻醉效果。结果两组比较,观察组患者诱导前后的平…均动脉压和心率波动较小,苏醒时间和子宫松弛良好率明…显优于对照组,P <0.05,差异具有统计学意义。结论硬膜外复合全麻在妇科腹腔镜手术中…的麻醉效果较好,术中…平…均动脉压和心率均较平…稳,子宫松弛度良好,术后苏醒快。

  17. Stabilizing membrane domains antagonizes anesthesia

    CERN Document Server

    Machta, Benjamin B; Nouri, Mariam; McCarthy, Nicola L C; Gray, Erin M; Miller, Ann L; Brooks, Nicholas J; Veatch, Sarah L

    2016-01-01

    Diverse molecules induce general anesthesia with potency strongly correlated both with their hydrophobicity and their effects on certain ion channels. We recently observed that several anesthetics inhibit heterogeneity in plasma membrane derived vesicles by lowering the critical temperature ($T_c$) for phase separation. Here we exploit conditions that stabilize membrane heterogeneity to test the correlation between the anesthetic potency of n-alcohols and effects on $T_c$. First we show that hexadecanol acts oppositely to anesthetics on membrane mixing and antagonizes ethanol induced anesthesia in a tadpole behavioral assay. Second, we show that two previously described `intoxication reversers' raise $T_c$ in vesicles and counter ethanol's effects in vesicles, mimicking the findings of previous electrophysiological measurements. Third, we find that hydrostatic pressure, long known to reverse anesthesia, also raises $T_c$ in vesicles with a magnitude that counters the effect of an anesthetic at relevant concen...

  18. Observe the curative effect of Seven sevofl urane inhalation anesthesia for elderly patients in general anesthesia surgery%七氟烷吸入麻醉用于老年患者全身麻醉手术中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张会娟

    2015-01-01

    目的:探讨七氟烷吸入麻醉用于老年患者全身麻醉手术中的疗效。方法将我院收治手术治疗老年患者116例随机平均分为观察组与对照组,各58例。对照组给予异氟烷吸入麻醉,观察组给予七氟烷吸入麻醉。对两组麻醉前后的心率、血压及认知功能进行测定。结果两组行插管与手术后血压对比,差异有统计学意义(P<0.05),观察组患者拔管后认知恢复时间显著短于对照组,差异有统计学意义(P<0.05)。结论对老年手术治疗患者采用七氟烷吸入麻醉能够取得显著的疗效,并且患者认知功能恢复时间短、安全性高,值得临床推广。%ObjectiveTo explore the sevoflurane inhalation anesthesia used in elderly patients with the clinical effect of general anesthesia.MethodsWill be our hospital surgical treatment of elderly patients with 116 cases randomly divided into observation group and control group,58 cases were treated isoflurane inhalation anesthesia,bservation group of 58 cases give sevoflurane inhalation anesthesia.The two groups before and after anesthesia heart rate,blood pressure and cognitive function were measured.ResultsThe two groups in signifi cant difference compared with that of blood pressure after surgery(P<0.05),intubation observation groups during after pull out urinous catheter cognitive recovery time was significantly shorter than the control group(P<0.05). Conclusions Surgical treatment for the elderly patients with sevofl urane inhalation anesthesia can obtain signifi cant clinical effect,and cognitive function in patients with recovery period,high safety,worth clinical promotion.

  19. The Effectiveness of Intravenous Dexmedetomidine on Perioperative Hemodynamics, Analgesic Requirement, and Side Effects Profile in Patients Undergoing Laparoscopic Surgery Under General Anesthesia

    Science.gov (United States)

    Panchgar, Vinayak; Shetti, Akshaya N.; Sunitha, H. B.; Dhulkhed, Vithal K.; Nadkarni, A. V.

    2017-01-01

    Background: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively. Dexmedetomidine is one of the α2 agonist drugs which acts at both supraspinal and spinal level and modulate the transmission of nociceptive signals in the central nervous system. The basic effect of dexmedetomidine on the cardiovascular system is to decrease the heart rate and systemic vascular resistance with additional feature of opioid sparing effect. This drug has become an ideal adjuvant during general anesthesia, especially when stress is expected. Hence, the drug was studied in laparoscopic surgeries. Aims and Objectives: (a) To study the effect of dexmedetomidine on hemodynamic parameters during perioperative period in patients undergoing laparoscopic surgery. (b) To study the postoperative sedation score and analgesic requirement. (c) To study the side effect profile of dexmedetomidine. Settings and Design: Randomized double blind controlled trial. Subjects and Methods: After obtaining the Institutional Ethical Clearance, the study was conducted. Forty patients of American Society of Anesthesiologists Class I and II were enrolled in this randomized study. The patients were randomly divided into two groups; group normal saline (NS) and group dexmedetomidine. Patient received either NS or dexmedetomidine in group NS and group dexmedetomidine, respectively, depending upon the allocation. The infusion rate was adjusted according to; loading dose (1 μg/kg) over 10 min and maintenance dose (0.5 μg/kg/h) and

  20. 日间门诊全麻下拔牙的临床应用及评价%Tooth Extraction Under General Anesthesia in Outpatient Department: A Retrospective Study with 18 Cases

    Institute of Scientific and Technical Information of China (English)

    张智勇; 张晓; 王德蕙; 高巍; 陈全; 刘文曙; 姜霞

    2012-01-01

    目的:回顾性分析日间门诊全麻下拔牙的病例资料,总结日间门诊全麻下拔牙的麻醉特点、诊疗规范、手术特点和安全性.方法:收集日间门诊全麻下拔牙病例,总结选择全麻的原因、拔除牙位、离院评价得分,分析日间门诊全麻下拔牙的麻醉特点、手术特点.根据术中情况和术后复查分析该方法的安全性.结果:共收集18个病例,男11例,女7例,年龄7~50岁.选择全麻的原因包括:无法配合手术的儿童、智障、癫痫、咽部敏感、局麻药物过敏和有紧张晕厥病史.拔除牙位主要是阻生智齿和埋伏多生牙,均采用气管内插管静吸复合麻醉.所有病例手术顺利并安全离院,离院标准评分均在13分以上.结论:严格遵从诊疗规范的情况下,日间门诊全麻下拔牙对因各种原因无法配合局麻下手术的患者是一种安全有效的治疗方法.%Objective: To evaluate the indication and security of tooth extraction under general anesthesia in outpatient department. Methods: The patients accepted tooth extractions under general anesthesia in outpatient department were included in this study. The following information were recorded and summed, including: the reason for choosing general anesthesia, the position of the teeth removed and the score of postanesthetic discharge scoring system. Results: 18 cases were collected in this study. There were 11 male and 7 females, and the range of the age was from 7 to 50 years. The reasons for choosing general anesthesia including: children cannot corporate, falling sickness, mentally challenged, pharynx sensitivity, allergenic to local anesthesia drug and patients have swoon history because of overmuch nervous in dentistry treatment. The major positions of the teeth extracted were impacted teeth and supernumerary teeth. All patients accepted endotracheal intubation intravenous -inhalation combined anesthesia. All the operations were performed successfully and all

  1. Exploration of clinical application of exercise cardiac contractility monitor in artificial abortion with general anesthesia%运动心力监测仪在全麻人流手术中的临床应用探讨

    Institute of Scientific and Technical Information of China (English)

    李玮; 刘德顺; 袁蔚; 漆洪波

    2012-01-01

    Objective To monitor the cardiac reserve in artificial abortion with general anesthesia with exercise cardiac contractility monitor. Methods One hundred and seventy-nine pregnant women aged 20-40 years with 8. 0 ± 1. 9 gestational weeks were recruited, and they all accepted artificial abortion with general anesthesia. The heart rate ( HR ), the ratio of the amplitude of the first heart sound to the second heart sound ( S1/S2 ) and the ratio of diastolic phase duration to systolic phase duration ( D/S ) were measured before general anesthesia, after anesthesia and in operation. Results HR in operation was lower than that before anesthesia( 82.36 ± 12. 29/min vs 85. 12 ± 15.54/min,t=2. 19, P<0. 05 ). Compared with that after anesthesia, the HR in operation decreased ( 82.36 ±12.29 /min vs 90.52 ± 10. 86/min, t =6.66, P <0.05 ). S1/S2 decreased and D/S increased, and the differences were significant ( t value was 2. 62 and 5. 37, respectively, both P < 0. 05 ). Conclusion Cardiac function is up-regulated after general anesthesia and down-regulated in operation in women of artificial abortion. The exercise cardiac contractility monitor may measure cardiac reserve during artificial abortion with general anesthesia and provide safe data for predicting safety of women.%目的 运用运动心力监测仪监测全麻人流手术中心脏储备变化.方法 选择179名20~40岁孕8.0±1.9周的早孕妇女为研究对象,均进行全麻无痛人流手术,测量及计算无痛人流麻醉前,麻醉后及手术中心率、第一心音幅值与第二心音幅值的比值(S1/S2),舒张期与收缩期时限比值(D/S).结果 术中心率较麻醉前降低(82.36±12.29次/min vs 85.12±15.54次/min,t=2.19,P<0.05);术中与麻醉后比较心率降低(82.36±12.29次/min vs 90.52±10.86次/min,t=6.66,P<0.05),S1/S2降低、D/S升高,差异有统计学意义(t分别为2.62、5.37,均P<0.05).结论 无痛人流手术麻醉后应激使心脏功能上调,术中心脏功能下

  2. Application of oxycodone hydrochloride in the induction of general anesthesia%羟考酮在全身麻醉诱导中的临床应用

    Institute of Scientific and Technical Information of China (English)

    朱文智; 王东信

    2016-01-01

    目的:探讨羟考酮行全麻诱导的有效性与安全性。方法择期行结直肠癌手术患者60例,年龄35~75岁,随机分为两组,每组30例。F 组静脉注射芬太尼2μg/kg、丙泊酚2 mg/kg与顺式阿曲库铵0.15 mg/kg 行全麻诱导;O 组静脉注射羟考酮0.2 mg/kg、丙泊酚2 mg/kg 与顺式阿曲库铵0.15 mg/kg 行全麻诱导。记录诱导前(T0)、插管前1 min(T1)、插管后即刻(T2)、插管后1 min(T3)、5 min(T4)的 MAP 和 HR;记录手术时间、苏醒时间、拔管时间及不良反应情况。结果与T0时比较,T1时两组 MAP 均明显降低,T2时明显升高(P <0.05),且 T1时 F 组明显低于 O 组(P<0.05);T1时 F 组 HR 明显减慢(P <0.05);T2、T3时两组 HR 均明显增快(P <0.05)。插管期间两组 HR 差异无统计学意义。两组手术时间、苏醒时间、拔管时间差异无统计学意义。F 组咳嗽发生率明显高于 O 组(P <0.05)。结论羟考酮可以安全有效地用于临床全身麻醉气管插管的诱导。%Objective To explore the clinical effect and safety of oxycodone hydrochloride in the induction of genenral anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 35-75 years,sched-uled for colorectal surgery,undergoing general aneasthesia were randomly divided into two groups with 30 cases in each group:fentanyl group (group F)and oxycodone hydrochloride group (group O).Fentanyl 2 μg/kg+propofol 2 mg/kg+cisatracurium 0.1 5 mg/kg (group F)or oxycodone 0.2 mg/kg+propofol 2 mg/kg + cisatracurium 0.1 5 mg/kg (group O)was administered intravenously for general anesthesia induction.MAP and HR were monitored and recorded before the induction (T0 ),1 min before intubation (T1 ),at the time of intubation (T2 ),1 min after intubation (T3 )and 5 min after intubation (T4 ).Side-effect incidence of each group,operation time,wakening time,extuba-tion time and visual analogue scale (VAS)were recorded.Results Compared with group F,MAP in group O were lower than that of group F at

  3. Current clinical evidence on the effect of general anesthesia on neurodevelopment in children: an updated systematic review with meta-regression.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available BACKGROUND: Several epidemiological studies have been conducted to address the later effect of anesthesia on neurodevelopment in children. However, the results are still inconclusive. METHODS: We here conducted a systematic review and meta-analysis to summarize the currently available clinical and epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children by searching PubMed, EMBASE, and Web of Science database (from January-1 2000 to February-1, 2013. The evaluation of neurodevelopment includes language and learning disabilities, cognition, behavioral development, and academic performance. Both retrospective and prospective studies were included. Data were abstracted from seven eligible studies. We estimated the synthesized hazard ratios (HR and 95% confidence interval (CI according to inter-study heterogeneity. RESULTS: The pooled HR for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.25 (95% CI, 1.13-1.38, P<0.001; random-effects model in children undergoing the first anesthesia before the age of 4-year. Then we analyzed the factors for this association using meta-regression method. It showed that it was the number of times of exposure (HR = 1.75, 95% CI 1.31-2.33; P<0.001 rather than the time at exposure before 4-year (HR = 1.08, 95% CI 0.87-1.34 for the effect of per 1-year early exposure; P = 0.47 is a risk factor for neurodevelopmental impairment. CONCLUSION: The current clinical evidence suggests modestly elevated risk of adverse neurodevelopmental outcomes in children who were exposed to anesthesia/surgery during early childhood, especially for those with multiple times of exposure. Due to limitation of retrospective studies, prospective investigations are needed to determine whether anesthesia/surgery is causative.

  4. Clinical study of OSAHS surgery under general anesthesia without muscle relaxants%无肌松药全身麻醉用于鼾症手术的临床研究

    Institute of Scientific and Technical Information of China (English)

    张玉琴; 孟凡民; 王红国; 王高宏; 栾秀坤

    2013-01-01

    目的 尝试在鼾症(OSAHS)手术全身麻醉维持中免用肌松药的可行性,探讨其临床价值.方法 选择ASA Ⅰ~Ⅱ级悬雍垂腭咽成形术(UPPP)鼾症患者180例,随机分为A、B、C三组(每组n=60),均以瑞芬太尼、丙泊酚及氯化琥珀胆碱静脉快诱导,经鼻明视或盲探气管插管,A组以瑞芬太尼、丙泊酚维持麻醉,B、C组分别在A组基础上加用阿曲库铵、维库溴铵维持麻醉.观察记录三组患者各时点循环和呼吸功能指标及术中肌松程度、体动次数、麻醉苏醒时间、拔管时间、不良反应及并发症等.结果 三组气管插管成功率100%,麻醉维持平稳,无体动反应,均顺利完成手术;A组拔管前后清醒彻底,呼吸功能和肌力正常,无麻醉并发症发生,B、C组清醒后有不同程度肌松药残余,须使用新斯的明拮抗,拔管后分泌物增多、出血、心动过缓、低氧血症、舌后坠、喉痉挛、呼吸道梗阻、支气管痉挛发生率明显高于A组(P<0.01).结论 瑞芬太尼-丙泊酚无肌松药全凭静脉麻醉维持用于鼾症手术安全有效,可明显缩短麻醉恢复时间,提高麻醉恢复质量,降低麻醉恢复期风险,减少并发症发生.%Objective To invertigate the feasibilityand clinical efficacy of OSAHS surgery under general anesthesia without muscle relaxants. Methods Totally 180 ASA Ⅰ or Ⅱ OSAHS cases underwent UPPP surgery were randomly divided into 3groups(n =60) , general anesthesia was induced with Remifentanil, Propofol and Succinylcholine, and maintained with Propofol and Remifentanil at group A. Group B, C added atracurium, vecuronium to maintain anesthesia, on the basis of group A. Observed and recorded the three groups of patients at each time point circulatory and respiratory function parameters and the number of intraoperative muscle relaxants degree of body movement, anesthesia time, time to extubation, adverse reactions and complications. Results All patients of the

  5. 178名儿童口腔医生对笑气镇静及全麻的认知调查%Investigation of the cognition of 178 pediatric dentists about nitrous oxide sedation and general anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈静涛; 周志斐; 邬礼政; 王小竞

    2013-01-01

    目的:了解儿童口腔医生对笑气镇静及全麻的认知情况.方法:2012-06对参加第七次全国儿童口腔医学会议的178名医生进行笑气镇静及全麻认知情况问卷调查,并对相关因素进行分析.结果:178名医生中有25人(14%)独立开展过笑气镇静;42人(23.6%)在麻醉医生的合作下开展过全麻技术;38人(21.3%)接受过不同程度的笑气镇静专科培训.医师工作所在省市GDP位于全国前10位的92名医生中有30人(32.6%)在麻醉医师合作下开展全麻技术,位于10位以后的86名医生中仅有12人(13.9%)开展过全麻技术.笑气镇静和全麻的优点,85人(47.8%)选择了避免患儿产生心理阴影;笑气镇静和全麻的缺点,选择医疗费用高,操作难度大,会出现麻醉意外分别为33.7%,29.2%,27.5%;175名(98.3%)医生在以后的工作中会建议病人使用笑气镇静或全麻.结论:目前国内开展笑气镇静及全麻技术的程度较低,可能与国内经济教育发展水平相对不高有关.%AIM: To investigate the general cognition situation of chinese pediatric dentists about the use of nitrous oxide (NO) sedation and general anesthesia. METHODS: In June, 2012 during the 7 th National Congress of Pediatric Dentistry a questionnaire was delivered to delegates on the acceptance level of NO sedation and general anesthesia and effective replies with a sample size of 178 were received. Then the related factors based on the questionnaires were further assessed. RESULTS: 25 out of the 178 investigated pediatric dentists(14% ) had carried out NO sedation independently and 42 (23. 6% ) had taken general anesthesia by anesthesiologists in the treating procedure. 38 (21. 3% ) had received professional training in the field of NO sedation. 30 out of the 92 (32. 6% ) from the provinces or cities ranking top 10 of GDP in China had carried out general anesthesia with the cooperation of anesthesiologists while those from the other

  6. Analysis of delay cause to wake up after general anesthesia in elderly patients%老年患者全身麻醉后苏醒延迟病因分析

    Institute of Scientific and Technical Information of China (English)

    文平山

    2014-01-01

    目的:探究老年患者全身麻醉后苏醒延迟的病因及护理措施。方法选取我院2011年1月至2014年1月间发生全麻后苏醒延迟的老年患者40例,并对苏醒延迟的原因及护理措施开展回顾性分析。结果40例老年患者均安全度过全麻恢复阶段,未出现任何严重的并发疾病。全麻后苏醒延迟的主要原因是麻醉用药代谢缓慢,其次还有肝肾功能减退、药物分布容积下降及术前睡眠时长较短,术后体温偏低等。结论40例老年病患全麻后苏醒延迟的病因较复杂,需及时查明原因,并采取有效的处理手段,避免并发疾病的出现。%Objective: To explore the causes of delay recovery after general anesthesia in aged patients and nursing measure. Methods: Select the hospital from January 2011 to January 2014 I woke up after a delay of 40 cases senile patients undergoing general anesthesia, wake up and retrospective analysis of causes and nursing measures of the delay. Results:In 40 senile patients have survived during the recovery phase, without any serious concurrent il ness. Recovery after delayed mainly due to anesthesia general anesthesia drug metabolism is slow, fol owed by liver and kidney dysfunction, the decline in volume of drug distribution and preoperative sleep time shorter, postoperative low body temperature. Conclusion: 40 cases of elderly patients after general anesthesia wake delay causes more complex, needs identified, and effective means of treatment, appeared to avoid concurrent disease.

  7. General Electropharmaceutical Anesthesia (Point Electroanesthesia).

    Science.gov (United States)

    1980-07-01

    anestesia high9 OFreuny low U.~~of ASUA elN11.1.11CATItOWDOWNGeeRADINGe *~~~~~f DITIBTOur ultimT o bjoeciermistettleinaonfdugad thppodctoe o...surgery. Local infection seems to be less frequent after EA. In order to explain this difference (statis- tically significant : p < 0.001) one should

  8. [Automated anesthesia record system].

    Science.gov (United States)

    Zhu, Tao; Liu, Jin

    2005-12-01

    Based on Client/Server architecture, a software of automated anesthesia record system running under Windows operation system and networks has been developed and programmed with Microsoft Visual C++ 6.0, Visual Basic 6.0 and SQL Server. The system can deal with patient's information throughout the anesthesia. It can collect and integrate the data from several kinds of medical equipment such as monitor, infusion pump and anesthesia machine automatically and real-time. After that, the system presents the anesthesia sheets automatically. The record system makes the anesthesia record more accurate and integral and can raise the anesthesiologist's working efficiency.

  9. Application of general anesthesia with sevoflurane inhalation anesthesia combined with sacral block in children with indirect inguinal hernia in single hole laparoscopic operation%七氟醚吸入全麻加骶管阻滞在小儿单孔腹腔镜疝气手术中的应用

    Institute of Scientific and Technical Information of China (English)

    覃兴龙; 黄春柳

    2014-01-01

    Objective To observe the clinical application effect of general anesthesia with sevoflurane inhalation anesthesia combined with sacral block in children with indirect inguinal hernia in single hole laparoscopic operation,and early postoperative recovery and analgesic effect.Methods 60 cases of children with indirect inguinal hernia operation,were randomly divided into the observation group and the control group (n=30).The observation group was given mask inhalation of sevoflurane anesthesia induction after insertion of endotracheal tube,the caudal block combined with sevoflurane inhalation anesthesia maintain,control group was treated with sevoflurane inhalation combined with intravenous anesthesia maintenance.The two groups were observed in heart rate,blood pressure and pulse oximetry,recovery time and room crying in pain score and 30 mins score.Results The incision of skin in two groups showed good effect of anesthesia,vital signs were stable during the time of analepsia; observation group (5.8 ± 3.6) min and control group (15.6 ± 8.5) min,showing statistical significant difference (P < 0.001),with a better analgesic =effect in the room.Conclusion Sevoflurane inhalation anesthesia combined with sacral block is conducive to children's anesthesia management and postoperative rapid recovery in children with indirect inguinal hernia of single hole laparoscopic operation,and can provide good effect of postoperative analgesia.%目的 观察七氟醚吸入全麻加骶管阻滞在小儿腹股沟斜疝单孔腹腔镜手术麻醉中的临床应用,及其术后早期苏醒及镇痛效果.方法 选择腹股沟斜疝手术患儿60例,随机数字表法分为观察组和对照组(n=30).观察组面罩吸入七氟醚麻醉诱导后插入气管导管,采用骶管阻滞加七氟醚吸入全麻维持,对照组采用七氟醚吸入复合静脉全麻维持.观察两组患儿术中心率、血压及脉搏血氧饱和度、苏醒时间以及出室时哭闹评分及术后30 min

  10. Anesthesia Approach in Endovascular Aortic Reconstruction

    Directory of Open Access Journals (Sweden)

    Ayşin Alagöl

    2013-03-01

    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  11. Study on effect of combined intravenous and inhalation general anesthesia or combined spinal epidural anesthesia in laparoscopic opera-tion for inguinal hernia%腹股沟疝患者采用腹腔镜手术治疗中静吸复合全身麻醉与腰硬联合麻醉的对比研究

    Institute of Scientific and Technical Information of China (English)

    钱建学; 须挺

    2015-01-01

    Objective To compare the effect of combined intravenous and inhalation general anesthesia and combined spinal epidural an-esthesia applied in laparoscopic operation for treatment of patients with inguinal hernia. Methods Eighty patients with inguinal hernia were trea-ted with laparoscopic operation,the application of combined spinal and epidural anesthesia in 40 patients as observation group,and application of combined intravenous and inhalation general anesthesia in 40 cases as control group,and the effect of anesthesia in these two groups had been com-pared. Results The Ramsay scores of patients with grade I in observation group were significantly lower than those of control group,and Ramsay scores in patients with grades II ~ IV in observation group were significantly higher than those of control group,and the difference was statistically significant( P < 0. 05). The onset time of anesthesia and awake time in patients of observation group were lower than those of patients in control group,and the difference was statistically significant( P < 0. 05). Conclusion Epidural anesthesia is good in laparoscopic operation for patients with inguinal hernia,with short onset time and shorter awake time,hence it is worthy for clinical application.%目的:对比静吸复合全身麻醉和腰硬联合麻醉在腹股沟疝腹腔镜手术治疗的麻醉效果。方法选取需进行腹腔镜手术治疗的腹股沟疝患者80例,其中应用腰硬联合麻醉患者40例作为观察组,应用静吸复合全身麻醉40例作为对照组,观察两组麻醉效果。结果①观察组患者 Ramsay 评分为 I 级患者明显少于对照组,而 II ~ IV 级患者明显多于对照组,差异有统计学意义( P <0.05);②观察组患者麻醉起效时间、清醒时间明显低于对照组,差异有统计学意义( P <0.05)。结论硬联合麻醉对腹腔镜手术腹股沟疝患者麻醉效果好,起效时间短,术后清醒快,值得在临床上推广应用。

  12. Practice characteristics among dental anesthesia providers in the United States.

    Science.gov (United States)

    Boynes, Sean G; Moore, Paul A; Tan, Peter M; Zovko, Jayme

    2010-01-01

    General descriptions or "snapshots" of sedation/general anesthesia practices during dental care are very limited in reviewed literature. The objective of this study was to determine commonalities in dental sedation/anesthesia practices, as well as to accumulate subjective information pertaining to sedation/anesthesia care within the dental profession. This questionnaire-based survey was completed by participating anesthesia providers in the United States. A standardized questionnaire was sent via facsimile, or was delivered by mail, to 1500 anesthesia providers from a randomized list using an online database. Data from the returned questionnaires were entered onto an Excel spreadsheet and were imported into a JMP Statistical Discovery Software program for analyses. Quantitative evaluations were confined to summation of variables, an estimation of means, and a valid percent for identified variables. A total of 717 questionnaires were entered for data analysis (N=717). Data from this study demonstrate the wide variation that exists in sedation/anesthesia care and those providing its administration during dental treatment in the United States. The demographics of this randomized population show anesthesia providers involved in all disciplines of the dental profession, as well as significant variation in the types of modalities used for sedation/anesthesia care. Data from this study reveal wide variation in sedation/anesthesia care during dental treatment. These distinctions include representation of sedation/anesthesia providers across all disciplines of the dental profession, as well as variations in the techniques used for sedation/anesthesia care.

  13. SURVEY ON CLINICAL STUDY OF COMPOUND ACUPUNCTURE ANESTHESIA IN RESENT 10 YEARS IN CHINA

    Institute of Scientific and Technical Information of China (English)

    秦必光; 胡北喜; 等

    2002-01-01

    In the present paper,the authors make a review on the progresses of acupuncture anesthesia(AA) from (1)historical development,(2)research on acupuncture combined with local anesthesia;(3)research on acupuncture combined with epidural anesthesia;and (4)research on acupuncture combined with general anesthesia.Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definits analyesic effect and many advantages,and should be investigated further.

  14. Effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. A randomized, placebo controlled pilot study

    Directory of Open Access Journals (Sweden)

    Jusset Teresa García-Navia

    2016-01-01

    Full Text Available Background and goal of study: there is evidence that perioperative intravenous ketamine and lidocaine reduce postoperative pain, postoperative opioids consumption, shortens hospital stay and accelerates intestinal function recovery. However, it has not been studied the beneficial effects in the intraoperative period. The aim of this study was to evaluate the effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. Materials and methods: we performed a single-centre, prospective, randomized, double-blinded, placebo-controlled study. We included 33 patients (11 in the ketamine group, 11 in the lidocaine group and 11 in the placebo group. Postoperative analgesia was accomplished by patient-controlled morphine. Patients were randomly assigned to receive either a 1.5 mg/kg of 2% lidocaine, 0.5 mg/kg of 5% ketamine or 0.9% saline bolus. The primary outcome was the opioids consumption during surgery. The secondary outcomes included: emergence time, pain scores, opioids consumption within 24 h after surgery and side effects. Results: decreased intraoperative opioids requirements were noted in the experimental groups (ketamine: 402.3 } 106.3 and lidocaine: 397.7 } 107.5, compared with saline: 561.4 } 97.1; p = 0.001. We found a positive correlation between intraoperative opioids consumption and emergence time (r = 0.864, p < 0.001. There was no significant difference between the groups in VAS pain scores at rest within the first 24 postoperative hours. Total morphine consumption within 24 h after surgery did not differ significantly among the groups (placebo: 27.54 } 11.75; ketamine: 30.95 } 7.88; lidocaine 34.77 } 10.25; p = 0.26. Postoperative nausea and vomiting were more common in placebo group (it was observed in 3 subjects in ketamine group, in 5 subjects in lidocaine group and in 9 subjects in placebo group; p = 0

  15. Effect observation of Solidago decurrens gargle treating halitosis of patients with general anesthesia%一枝黄花含漱液防治全麻术后口臭的效果观察

    Institute of Scientific and Technical Information of China (English)

    张孝云; 陆静波; 戴金花

    2013-01-01

    Objective To explore the effects of Solidago decurrens gargle to reduce halitosis of patients with general anesthesia,and improve the life quality.Methods Using random sampling method,80 cases of general anesthesia patients with laparoscopic cholecystectomy were randomly divided into two groups with 40 cases in each.The observation group adopted Solidago decurrens gargle for oral care,the control group adopted 0.9% of saline for regular oral care.Two groups were compared with the incidence of halitosis.Results The incidence of halitosis in the observation group was significantly lower than that in the control group (P < 0.05).Conclusions Solidago decurrens gargle can obviously reduce the occurrence of halitosis after general anesthesia.%目的 探讨一枝黄花含漱液行口腔护理减少全麻术后患者发生口臭的可行性,提高患者的生活质量.方法 采用随机抽样法将80例全麻下行腹腔镜胆囊切除术患者分成两组,每组40例.观察组采用一枝黄花含漱液进行口腔护理;对照组采用0.9%生理盐水进行常规口腔护理.比较两组患者口臭发生情况.结果 观察组的口臭发生率明显低于对照组(P<0.05).结论 一枝黄花含漱液行口腔护理可明显降低全麻术后患者口臭的发生.

  16. 不同全身麻醉下麻黄碱升压效应的比较%Comparison of pressor responses to ephedrine during general anesthesia with different drugs

    Institute of Scientific and Technical Information of China (English)

    夏江燕; 孙永瀛; 袁静; 陆新建; 汤文浩; 尹宁

    2013-01-01

    目的 比较不同全身麻醉下麻黄碱的升压效应.方法 择期胃肠道肿瘤切除术患者60例,年龄20 ~ 64岁,体重45 ~ 90 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其分为3组(n=20),Ⅰ组:右美托咪定-瑞芬太尼-七氟醚复合麻醉;Ⅱ组:异丙酚-瑞芬太尼-七氟醚复合麻醉;Ⅲ组:右美托咪定-异丙酚-瑞芬太尼-七氟醚复合麻醉.麻醉中SBP降至90 mm Hg左右时静脉注射麻黄碱0.1mg/kg,给药后10 min内每分钟测定血压,记录麻黄碱升高SBP、DBP和MAP的起效时间(TSBP、TDBP、TMAP)及其最大幅度(△SBP、△DBP、△MAP).结果 与Ⅱ组比较,Ⅰ组和Ⅲ组TSBP、TDBP、TMAP缩短,△SBP、△DBP、△MAP增大(P<0.05).结论与异丙酚-瑞芬太尼-七氟醚复合麻醉相比,右美托咪定-瑞芬太尼-七氟醚复合麻醉和右美托咪定-异丙酚-瑞芬太尼-七氟醚复合麻醉下麻黄碱升压效应增强.%Objective To compare the pressor responses to ephedrine during general anesthesia with different drugs.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective gastrointestinal tumor resection under general anesthesia,aged 20-64 yr,weighing 45-90 kg,were included in this study.The patients were randomized to receive dexmedetomidine + remifentanil + sevoflurane (group Ⅰ,n =20),propofol + remifentanil + sevoflurane (group Ⅱ,n =20),or dexmedetomidine + propofol + remifentanil + sevoflurane (group Ⅲ,n =20) to maintain the depth of anesthesia.Ephedrine 0.1 mg/kg was injected intravenously when the systolic blood pressure (SBP) was decreased to about 90 mm Hg during anesthesia.Blood pressure was monitored and recorded at 1-min intervals for 10 min after the injection.The onset time (TSBP,TDBP,TMAP) for ephedrine to raise the SBP,diastolic blood pressure (DBP) and mean arterial pressure (MAP) and the maximal amplitude (△SBP,△DBP,△MAP) were also recorded.Results Compared with Ⅱ group,TSBP,TDBP and TMAP were significantly

  17. Mortality in anesthesia: a systematic review

    Directory of Open Access Journals (Sweden)

    Leandro Gobbo Braz

    2009-01-01

    Full Text Available This systematic review of the Brazilian and worldwide literature aims to evaluate the incidence and causes of perioperative and anesthesia-related mortality. Studies were identified by searching the Medline and Scielo databases, followed by a manual search for relevant articles. Our review includes studies published between 1954 and 2007. Each publication was reviewed to identify author(s, study period, data source, perioperative mortality rates, and anesthesia-related mortality rates. Thirty-three trials were assessed. Brazilian and worldwide studies demonstrated a similar decline in anesthesia-related mortality rates, which amounted to fewer than 1 death per 10,000 anesthetics in the past two decades. Perioperative mortality rates also decreased during this period, with fewer than 20 deaths per 10,000 anesthetics in developed countries. Brazilian studies showed higher perioperative mortality rates, from 19 to 51 deaths per 10,000 anesthetics. The majority of perioperative deaths occurred in neonates, children under one year, elderly patients, males, patients of ASA III physical status or poorer, emergency surgeries, during general anesthesia, and cardiac surgery followed by thoracic, vascular, gastroenterologic, pediatric and orthopedic surgeries. The main causes of anesthesia-related mortality were problems with airway management and cardiocirculatory events related to anesthesia and drug administration. Our systematic review of the literature shows that perioperative mortality rates are higher in Brazil than in developed countries, while anesthesia-related mortality rates are similar in Brazil and in developed countries. Most cases of anesthesia-related mortality are associated with cardiocirculatory and airway events. These data may be useful in developing strategies to prevent anesthesia-related deaths.

  18. 腹腔镜下胆囊切除术全麻复苏期甲状腺危象的护理体会%Nursing experience of laparoscopic cholecystectomy under general anesthesia recovery period of thyroid crisis

    Institute of Scientific and Technical Information of China (English)

    高家芝

    2014-01-01

    目的:探讨非甲亢手术全麻复苏期发生甲状腺危象病人的护理方法。方法:回顾性分析救治的1例腹腔镜下胆囊切除术全麻复苏期发生甲状腺危象病人的护理资料。结果:护理方法有效,术后3小时病情逐渐好转,1周后出院。结论:非甲亢手术病人全麻复苏期发生甲状腺危象,及时发现,及时有效的救治与护理,可有效提高患者生存率,降低死亡率。%Objective:To explore the nursing methods of patients with hyperthyroidism thyroid crisis occurred in non operation anesthesia recovery period.Methods:To review the nursing data of patients with thyroid crisis operation under general anesthesia recovery period resection in 1 case of laparoscopic treatment of gal bladder analysis.Result:The ef ective nursing method,3 hours after the operation condition improved gradual y,1 week later discharge from hospital.Conclusion:Non hyperthyroidism operation patients during general anesthesia recovery period of thyroid crisis occurred,the timely disG covery,timely and ef ective treatment and nursing,can ef ectively improve the survival rate of patients,reduce the mortality rate.

  19. 右美托咪定与曲马多预防全麻妇科腔镜手术后寒战的比较%Comparison of dexmedetomidine and tramadol on shivering following general anesthesia for gynecologic laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    焦妮妮; 刘静

    2015-01-01

    目的:比较右美托咪定与曲马多对全身麻醉下妇科腔镜手术后寒战的影响。方法150例择期全麻手术患者,以数字表法随机分为右旋美托咪啶组、曲马多组和等容生理盐水组3组,每组50例。在全麻成功后手术结束前30 min分别静脉滴注右旋美托咪啶1.0μg/kg,曲马多1.0 mg/kg和等容生理盐水,观察术后1 h内寒战发生率、镇静评分。结果右旋美托咪啶、曲马多两组寒战发生率无差异但均显著低于生理盐水组(P<0.05);右旋美托咪啶组过度镇静率显著低于曲马多组(P<0.05)。结论右美托咪定和曲马多均可预防全麻后寒战,但前者过度镇静发生率低于后者。%Objective To compare dexmedetomidine with tramadol on shivering following general anesthesia for gynecological laparoscopic surgery. Methods One hundred and fifty patients undergoing elective gynecologic surgery under general anesthesia were randomly divided into dexmedetomidine group,tramadol group and normal saline group (n=50). All patients respectively received different drugs by intravenous drip from anesthesia success to 30 min before the end of operation (dexmedetomidine group,dexmedetomidine 1.0 μg/kg;tramadol group,tramadol 1.0 mg/kg;normal saline group,equal volume of normal saline).The prevalence of shivering and sedation score within 1 h after surgery in each group were recorded. Results The shivering rate in dexmedetomidine group and tramadol group were significautly lower than that in normal saline group(P<0.05). The excessive sedation rate in dexmedetomidine group was significantly lower than that in tramadol group(P<0.05). Conclusions Both dexmedetomidine and tramadol can prevent shivering following general anesthesia,but dexmedetomidine provides less excessive sedation than tramadol.

  20. Airway Complications during and after General Anesthesia: A Comparison, Systematic Review and Meta-Analysis of Using Flexible Laryngeal Mask Airways and Endotracheal Tubes.

    Directory of Open Access Journals (Sweden)

    Rui Xu

    Full Text Available Flexible laryngeal mask airways (FLMAs have been widely used in thyroidectomy as well as cleft palate, nasal, upper chest, head and neck oncoplastic surgeries. This systematic review aims to compare the incidence of airway complications that occur during and after general anesthesia when using the FLMA and endotracheal intubation (ETT. We performed a quantitative meta-analysis of the results of randomized trials.A comprehensive search of the PubMed, Embase and Cochrane Library databases was conducted using the key words "flexible laryngeal mask airway" and "endotracheal intubation". Only prospective randomized controlled trials (RCTs that compared the FLMA and ETT were included. The relative risks (RRs and the corresponding 95% confidence intervals (95% CIs were calculated using a quality effects model in MetaXL 1.3 software to analyze the outcome data.Ten RCTs were included in this meta-analysis. There were no significant differences between the FLMA and ETT groups in the incidence of difficulty in positioning the airway [RR = 1.75, 95% CI = (0.70-4.40]; the occurrence of sore throat at one hour and 24 hours postoperative [RR = 0.90, 95% CI = (0.13-6.18 and RR = 0.95, 95% CI = (0.81-1.13, respectively]; laryngospasms [RR = 0.58, 95% CI = (0.27-1.23]; airway displacement [RR = 2.88, 95% CI = (0.58-14.33]; aspiration [RR = 0.76, 95% CI = (0.06-8.88]; or laryngotracheal soiling [RR = 0.34, 95% CI = (0.10-1.06]. Patients treated with the FLMA had a lower incidence of hoarseness [RR = 0.31, 95% CI = (0.15-0.62]; coughing [RR = 0.28, 95% CI = (0.15-0.51] during recovery in the postanesthesia care unit (PACU; and oxygen desaturation [RR = 0.43, 95% CI = (0.26-0.72] than did patients treated with ETT. However, the incidence of partial upper airway obstruction in FLMA patients was significantly greater than it was for ETT patients [RR = 4.01, 95% CI = (1.44-11.18].This systematic review showed that the FLMA has some advantages over ETT because it

  1. 地佐辛对小儿耳鼻喉手术全身麻醉苏醒期躁动的影响%Effect of Dezocine General Anesthesia in Pediatric ENT Surgery Restlessness

    Institute of Scientific and Technical Information of China (English)

    曾春红

    2015-01-01

    目的:探讨地佐辛对减轻小儿耳鼻喉手术全身麻醉苏醒期躁动的作用。方法:选取我院收治的行全身麻醉耳鼻喉手术的小儿患者作为研究对象,并随机分为对照组和观察组,所有患者术前接受相同的治疗,使用东莨菪碱、芬太尼、异丙酚和罗库溴铵诱导麻醉,微量泵入异丙酚、瑞芬太尼维持麻醉。手术结束前观察组静脉滴注地佐辛,对照组滴注生理盐水。结果:两组小儿患者手术时间、麻醉时间及拔管时间差异无统计学意义(P>0.05),拔管后15min时,观察组患者的平均动脉压(79.0±6.9) mmHg和心率(98.0±15.5)次/min均低于对照组的平均动脉压(94.2±8.3)mmHg和心率(115.1±17.2)次/min,差异有统计学意义(P<0.05);观察组小儿患者躁动情况控制率显著(80.0%)高于对照组(26.7%),且观察组平均躁得分(0.67±0.11)低于对照组(1.96±0.46),差异有统计学意义(P<0.05)。结论:地佐辛对减轻小儿耳鼻喉手术全身麻醉苏醒期躁动效果显著。%Objective: To investigate the Dezocine pediatric ENT surgery to relieve restlessness general anesthesia role. Methods:Our hospital ENT surgery under general anesthesia in pediatric patients for the study and randomly divided into control group and observation group,all patients received the same treatment,the use of scopolamine,fontanel,protocol and rocuronium-induced anesthesia,micro-pump protocol remifentanil anesthesia was maintained.Before the end of surgery,intravenous Dezocine observation group and control group with normal saline infusion.Results:The two groups of pediatric patients operative time,anesthesia time and estuation time was no significant difference (P>0.05),15min after estuation,observe the group of patients with mean arterial pressure (79.0±6.9)mmHg and heart rate (98.0±15.5)times / min were lower than the control group, mean arterial pressure (94.2±8.3)mmHg and heart rate (115.1±17.2)times

  2. Observation of different plasma concentration of remifentanil combined with sevoflurane in inhalation general anesthesia induction%不同靶浓度的瑞芬太尼用于七氟醚吸入诱导的对比观察

    Institute of Scientific and Technical Information of China (English)

    幸芳; 周东民; 曹丽艳

    2014-01-01

    Objective This experiment was trying to compare the hemodynamic effect of patients with general anesthesia induction of sevoflurane combined with different remifentanil plasma concentration under monitoring of bispectral index(BIS).And to figure out the proper dosage of remifentanil for general anesthesia induction. Methods Sixty patients waiting for the selective operation with general anesthesia were separated randomly into 3 groups according to target plasma concentration of remifentanil:3ng/ml(D1)、4ng/ml(D2)and 5ng/ml(D3), (n=20each).All of 3 groups combined with sevoflurane for the general anesthesia induction.and took tracheal intubation after Cisatracurium Besilate injection when BIS came to 60.To record the mean blood pressure(MAP),heart rate(HR) at the time points of before anesthesia induction(T1), before intubation(T2),intubation time(T3),3min after intubation(T4) and to record the time of consciousness lost. Results Compared with the time points of before anesthesia induction(T1), the mean blood pressure (MAP)and heart rate(HR) of all the 3 groups at the time points of before anesthesia induction(T1) was lower.and particularly evident in D3(P<0.05).The MAP and HR of D1 group’s patients at the time points of intubation time(T3) were markedly faster than that at the time points of before anesthesia induction(T1), before intubation(T2)(P<0.05).There was no significant difference in the consciousness lost time of all the 3 groups. Conclusion Target-controlled infusion(TCI) of remifentanil at target plasma concentration of 4ng/ml is the proper dosage for the general anesthesia induction combined with sevoflurane,which can get a more stable hemodynamic effect.%目的:在脑电双频指数(BIS)的监测下,比较不同血浆靶浓度的瑞芬太尼复合七氟醚麻醉诱导对血流动力学的影响,探讨瑞芬太尼合适的麻醉诱导剂量。方法择期全麻手术患者60例,按瑞芬太尼靶浓度不同随机分为3组:3 ng/ml(D1

  3. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

    Full Text Available Introduction: Elective upper and lower GI endoscopy is usually performed in children on an outpatient basis with the child under sedation or general anesthesia (GA. The objective of this study was to describe Anesthesia related complications in   children undergoing elective GI endoscopy.   Materials and Methods: The study design was descriptive on 1388 patients undergoing elective GI endoscopy in Sheikh Hospital from 2009 to 2013. All patient received propofol or standard inhalational anesthesia. We examined patients’ demographic data  ,  location of GI endoscopy ,  perioperative vital singe ,  recovery time , respiratory and cardiac complications , post operative nausea and vomiting , agitation , diagnosis and outcome   Results: Pediatric patients aged 2 to 17 years. 29 % of elective GI endoscopy was upper GI endoscopy and 70.3 % was lower GI endoscopy and 0.7 was both of them. 47.7 % of Pediatric patients were female and 52.3 % was male. We haven’t significant or fatal anesthesia related respiratory and cardiac complications (no apnea, no cardiac arrest. 8 patients (0.5% have transient bradicardia in post operative care Unit. 83 patients (5.9% have post operative nausea and vomiting controlled by medication.  6 patients (0.4% have post operative agitation controlled by medication.   Conclusions: General anesthesia and deep sedation in children undergoing elective GI endoscopy haven’t significant or fatal anesthesia related complications. We suggest Anesthesia for infants, young children, children with neurologic impairment, and some anxious older children undergoing elective GI endoscopy. Keyword: Anesthesia, Complication, Endoscopy, Pediatric.

  4. Efficacy of general anesthesia with SLIPA laryngeal mask airway with tumescent anesthesia in patients abdominal liposuction%SLIPA喉罩下全麻联合局部肿胀麻醉用于脂肪抽吸术的效果观察

    Institute of Scientific and Technical Information of China (English)

    唐华明; 任羿; 陈志兵

    2015-01-01

    Objective To evaluate the efficacy of general anesthesia with SLIPA laryngeal mask airway with tumescent anesthesia in patients abdominal liposuction. Methods 160 ASAⅠ-Ⅱpatients of fe⁃males,aged 20-35years,weighing 56-78 kg,abdominal liposuction under general anesthesia,were randomly divided into 2 groups (n=80 each).Group Ⅰ received combined intravenous-inhalational anesthesia with endotracheal tube.Group Ⅱ received combined intravenous-inhalational anesthesia with SLIPA laryngeal mask airway then undergoing abdominal liposuction with tumescent anesthesia. HR was maintained at 50-100bpm,MAP was maintained at the preoperative baseline level (increase or decrease amplitude <20% of the baseline level) during operation and in postanesthesia care unit (PACIU) and vasoactive drugs (atropine,esmolol,efedrina or urapidil) were given when necessary.The patients received patient-controlled intravenous analgesia with sufentanil (background infusion 1.5 ml/h, bolus dose2 ml,lockout interval 15 min) after operation and VAS score was maintained at≤2.The re⁃quirement for vasoactive drugs during operation and in PACU,PACU stay length,and consumption of analgesics and occurrence of nausea and vomiting within 24h after operation were recorded. Results Compared with groupⅠ,the requirement for all vasoactive drugs during operation and in PACU was significantly reduced,PACU stay length was significantly shortened,and the consumption of analge⁃sics and incidence of nausea and vomiting were significantly reduced in groupⅡ(P<0.05). Conclu⁃sion general anesthesia with SLIPA laryngeal mask airway with tumescent anesthesia provides better efficacy with fewer complications and less consumption of postoperative analgesics than general an⁃esthesia with endotracheal tube in patients abdominal liposuction.%目的:评价SLIPA喉罩下全麻联合局部肿胀麻醉用于脂肪抽吸术的效果。方法:择期行腰腹脂肪抽吸术的患者80例,女性,年龄20

  5. 单次肌松药全身麻醉下进行神经外科手术的可行性%The feasibility of neurosurgery under general anesthesia with a single dose of muscle relaxant

    Institute of Scientific and Technical Information of China (English)

    李玉兰; 刘映龙; 徐成明; 吕兴华; 万占海

    2012-01-01

    Objective To evaluate the feasibility of neurosurgery under general anesthesia with single dose of muscle re -laxant. Methods 60 patients with ASA I - II scheduled for neurosurgery were randomly divided into Atracurium (group A) and Succinylcholine (group S), each group had 30 cases. After anesthesia induction and intubation with a single use of Atracuri -um or Succinylcholine, anesthesia was maintained with Propofol and Remifentanil at BIS level. The duration of neuromus -cular blocking, the anesthetics consumption, the presence of unwanted patient movement, the airway pressure, the extuba -tion delay and the rate of residual neuromuscular blockade of two groups were recorded. The surgical conditions were scaled by surgeons after operation. Results No patients' movement was observed during operation, there were 2 patients of control group had cough. The recovery time of muscle tone in group A was longer than group S (P 0.05). Conclusion The feasibility of neurosurgery under general anesthesia with a single dose of muscle relaxant is affirmed, but airway stimulation is not allowed in this condition.%目的 探究单次肌松药全身麻醉下进行神经外科手术的可行性.方法 选取我院ASA Ⅰ~Ⅱ级全身麻醉下进行神经外科手术患者60例,随机分为阿曲库铵组(A组)和琥珀酰胆碱组(S组),每组各30例.麻醉诱导后停用肌松药,全程仅用得普利麻、瑞芬太尼静脉泵注维持电脑双频指数(BIS)麻醉.观察两组麻醉药用量、肌松恢复时间、术中体动次数、气道压、拔管时间、残余肌松发生率、拔管时间及外科麻醉评分.结果 两组患者均无术中体动,S组2例发生呛咳;A组肌松恢复时间较S组长(P0.05).结论单次肌松药全身麻醉下进行神经外科手术是基本可行的,但在这种麻醉状态下不宜进行气管内操作.

  6. [Anesthesia in ophthalmology (author's transl)].

    Science.gov (United States)

    Gemperlé, M

    1977-02-01

    General anesthesia in ophthalmological surgery has become a great fashion. However there are still many problems especially in intraocular surgery. The eye with normal intraocular pressure generally needs no special technique. Most of the usual anesthesia produce a slight hypotonia with the exception of Succinylcholine, whose effect is contrary. Unfortunately this is not the case in eyes with pathologically increased intraocular pressure as in the different forms of glaucoma. Eye surgeons and anesthesists therefore look for solutions to this problem which in principle consist in the application of medicaments, which not seldom are rather agressive. The controlled hypotension by ganglion blockers, the curarisation in the state of being awake, the rapid perfusion of solutions with high osmotique effect (isolated or associated) represent such measures. The one has the disadvantage to be applied during so-called subvigile anesthesias where the security that the patient is asleep is rather doubtful; the other has the disadvantage that it requires a rapid perfusion of solutions with highly osmotic effect. It goes without saying that these conditions represent risks especially if one considers that the candidates for this type of intervention very often are senile persons with prearious cardiovascular equilibrium, with insufficient renal function and with insufficient arterial cerebral circulation. These are some of the problems which are to be discussed.

  7. Study for the comfortable conditions and influencing factors for patients with general anesthesia%全麻手术患者围麻醉期舒适状况及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    张健; 谭君梅; 彭文涛

    2015-01-01

    Objective To study the peri‐operative comfortable conditions and influencing factors for patients with general anesthesia .Method By convenience sampling method ,peri‐anesthesia comfort questionnaire(PCQ) designed by American care experts E .Kline was used for survey and measuring the perianesthesia comfortable conditions a‐mong 160 patients in provincial three class general hospitals .Result The anesthesia comfort score range was 65 .00~144 .00 among 160 patients .The average score and standard deviation was(110 .09 ± 17 .67) .The three score rank in 24 entries in turn are:(1)I was able to visualize a successful recovery .(2)My anesthetist and operating room nur‐ses took good care of me .(3)My care helped me feel confident .named after scoring last three in turn are:(1)My IV site was painful .(2)My anxiety was high .(3)I was cold .There was significant differences in comfort between pa‐tients without work and retired patients (P<0 .05) .There was significant difference in comfort between the patient with primary education and patients educated in University(P<0 .05) .Conclusion The peri‐anesthesia comfort for patients undergoing general anesthesia was the high degree of comfort .Cold ,anxiety ,pain is an important factor af‐fecting patient comfort .Academic qualifications and working conditions also have a significant impact on patient comfort conditions .Clinical staff should be highly concerned about the anesthesia surgery patients peri‐anesthesia cold ,anxiety ,physical pain and discomfort ,Depending on the implementation of the different demographic charac‐teristics of care ,thereby improving patients undergoing general anesthesia peri‐anesthesia comfort .%目的:了解全麻手术患者围麻醉期的舒适状况及影响因素。方法采用便利抽样方法,用美国护理专家E .Kline研发的围麻醉期舒适度调查问卷( Perianesthesia Comfort Questionnaire PCQ )对本院160例全麻择期手术患者围麻醉期舒

  8. Smartphones in the Operating Room: Distraction or Diagnostic Aid? A Case of Newly Diagnosed Wolff-Parkinson White in a Pediatric Patient Having Bronchoscopy Under General Anesthesia.

    Science.gov (United States)

    Esenther, Brandon; Ko, Riva

    2015-08-01

    A 4-year-old boy presented for elective bronchoscopy after years of pharmacologically unresponsive reactive airway disease that limited physical activity. After mask induction with nitrous oxide and sevoflurane, the patient was noted to be intermittently in a hemodynamically stable tachyarrhythmia. The anesthesia machine, though equipped with electrocardiogram (ECG) recording capabilities, malfunctioned during the case and was not able to print a rhythm strip. As a substitute, a smartphone picture and video were recorded. In the recovery room, initial 12-lead ECG showed sinus tachycardia. Shortly after, a presumptive diagnosis of Wolff-Parkinson White was given upon review of the smartphone recordings by the pediatric cardiologist on service. Twelve lead ECG was repeated which showed intermittent Wolff-Parkinson White. This case highlights 2 points. First, any prolonged or sustained pediatric dysrhythmia revealed during anesthesia warrants further investigation and should not be assumed secondary to an anesthetic drug. Second, ubiquitous smartphones are an excellent tool for capturing data that the monitor is unable to capture.

  9. Influence of different operative positions on postoperative p ulmonary infection in general anesthesia%不同手术体位对全身麻醉术后肺部感染的影响

    Institute of Scientific and Technical Information of China (English)

    方海燕; 万福红; 梁宁

    2015-01-01

    目的:研究麻醉机通气系统病原微生物定植特点,探讨不同手术体位对全身麻醉术后肺部感染的影响。方法选择2013年10月至2014年10月在该院择期实施全身麻醉插管手术患者70例,根据手术方式分为俯卧位组(A组)和仰卧位组(B组),各35例,分别于麻醉前、麻醉4 h、麻醉结束时对麻醉机吸气端、呼气端、储气囊口进行采样,随后接种至血液培养基中培养,分离纯化后再用微生物生化鉴定系统进行鉴定。术后对患者进行5d随访,观察肺部感染发生情况。结果(1)麻醉机通气系统内部环路的细菌检出率为21.43%(45/210),其中呼气端、吸气端、储气囊口的细菌检出率分别为45.71%(32/70)、17.14%(12/70)、1.43%(1/70),检出菌大多为条件致病菌。(2)麻醉4 h和麻醉结束时,两组患者麻醉机吸气端、呼气端的病原菌阳性检出率比较,差异均有统计学意义(P<0.05)。(3)A组患者肺部感染发生率明显低于B组,差异有统计学意义(P<0.05)。结论术中仰卧位较俯卧位更易增加全身麻醉术后肺部感染的发生率。%Objective To study the colonization characteristics of pathogenic microorganisms in the anesthesia machine ventilation system and to investigate the influence of different operative positions on postoperative pulmonary infection in general anesthesia. Methods Totally 70 patients undergoing general intubation anesthesia in our hospital from October 2013 to October 2014 were selected as the research subjects and divided into the prone position group(group A) and supine position group(group B) according to the operation modes,35 cases in each group. The sampling was taken from the suction side,expiration side and store airbags of anesthesia machine before anesthesia,at 4 h and end of anesthesia,then inoculated at the blood culture medium for conducting culture,separation and purification. The

  10. Potential anesthesia protocols for space exploration missions.

    Science.gov (United States)

    Komorowski, Matthieu; Watkins, Sharmila D; Lebuffe, Gilles; Clark, Jonathan B

    2013-03-01

    In spaceflight beyond low Earth's orbit, medical conditions requiring surgery are of a high level of concern because of their potential impact on crew health and mission success. Whereas surgical techniques have been thoroughly studied in spaceflight analogues, the research focusing on anesthesia is limited. To provide safe anesthesia during an exploration mission will be a highly challenging task. The research objective is thus to describe specific anesthesia procedures enabling treatment of pre-identified surgical conditions. Among the medical conditions considered by the NASA Human Research Program Exploration Medical Capability element, those potentially necessitating anesthesia techniques have been identified. The most appropriate procedure for each condition is thoroughly discussed. The substantial cost of training time necessary to implement regional anesthesia is pointed out. Within general anesthetics, ketamine combines the unique advantages of preservation of cardiovascular stability, the protective airway reflexes, and spontaneous ventilation. Ketamine side effects have for decades tempered enthusiasm for its use, but recent developments in mitigation means broadened its indications. The extensive experience gathered in remote environments, with minimal equipment and occasionally by insufficiently trained care providers, confirms its high degree of safety. Two ketamine-based anesthesia protocols are described with their corresponding indications. They have been designed taking into account the physiological changes occurring in microgravity and the specific constraints of exploration missions. This investigation could not only improve surgical care during long-duration spaceflights, but may find a number of terrestrial applications in isolated or austere environments.

  11. Randomized study of phentolamine mesylate for reversal of local anesthesia.

    Science.gov (United States)

    Laviola, M; McGavin, S K; Freer, G A; Plancich, G; Woodbury, S C; Marinkovich, S; Morrison, R; Reader, A; Rutherford, R B; Yagiela, J A

    2008-07-01

    Local anesthetic solutions frequently contain vasoconstrictors to increase the depth and/or duration of anesthesia. Generally, the duration of soft-tissue anesthesia exceeds that of pulpal anesthesia. Negative consequences of soft-tissue anesthesia include accidental lip and tongue biting as well as difficulty in eating, drinking, speaking, and smiling. A double-blind, randomized, multicenter, Phase 2 study tested the hypothesis that local injection of the vasodilator phentolamine mesylate would shorten the duration of soft-tissue anesthesia following routine dental procedures. Participants (122) received one or two cartridges of local anesthetic/vasoconstrictor prior to dental treatment. Immediately after treatment, 1.8 mL of study drug (containing 0.4 mg phentolamine mesylate or placebo) was injected per cartridge of local anesthetic used. The phentolamine was well-tolerated and reduced the median duration of soft-tissue anesthesia in the lip from 155 to 70 min (p < 0.0001).

  12. Classifying depth of anesthesia using EEG features, a comparison.

    Science.gov (United States)

    Esmaeili, Vahid; Shamsollahi, Mohammad Bagher; Arefian, Noor Mohammad; Assareh, Amin

    2007-01-01

    Various EEG features have been used in depth of anesthesia (DOA) studies. The objective of this study was to find the excellent features or combination of them than can discriminate between different anesthesia states. Conducting a clinical study on 22 patients we could define 4 distinct anesthetic states: awake, moderate, general anesthesia, and isoelectric. We examined features that have been used in earlier studies using single-channel EEG signal processing method. The maximum accuracy (99.02%) achieved using approximate entropy as the feature. Some other features could well discriminate a particular state of anesthesia. We could completely classify the patterns by means of 3 features and Bayesian classifier.

  13. Local anesthesia: A feasible option for pediatric frontalis sling surgery.

    Science.gov (United States)

    William, Jerald; Abbott, Joseph; Kipioti, Athina; Reuser, Tristan

    2011-01-01

    The purpose of this study was to demonstrate the suitability of local anesthesia in the pediatric age group for oculoplastic procedures. The authors present a case of frontalis sling surgery performed under local anesthesia in a 15-year-old boy with bilateral congenital ptosis. No significant technical difficulties were encountered during the procedure. Optimal intraoperative eyelid placement was facilitated by the patient's comfort and cooperation. For some selected children, local anesthesia is a good alternative to general anesthesia to obtain the best outcome.

  14. 舒芬太尼预防全麻术后躁动和咽喉疼痛的临床观察%Clinical observation of preventive effects of sufentanil on restlessness and sore throat after surgery under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    姚猛飞; 何丽云

    2011-01-01

    Objective To observe preventive effects of intravenous injection of sufentanil by the end of surgery under general anesthesia on restless during awakening and sore throat within postoperative 24 h. Methods 122 patients who would undergo selective operation under general anesthesia were randomly divided into group A and group B( n= 61 ). Both groups received anesthesia induction with midazolam, atracurium, fentanil and propofol,then maintenance anesthesia with propofol + remifentanil + isoflurane. B group was intravenously injected with sufentanil at 0.25 - 0.5 μg/kg 30 - 40 min before the anesthetic withdrawal ,while in group A no drug was administered by the end of surgery The recovery time of spontaneous breathing, eye opening time, incidence of restless during postanaesthetic recovery and incidence of sore throat within postoperative 24 h were recorded in the two groups. Results The recovery time of spontaneous breathing and eye opening time were not significantly different between the two groups( P > 0.05 ). However, the incidences of restless and sore throat in group B were significantly lower than those in group A( P < 0.05 ). Conclusion Low - dose sufentanil administration before awakening from general anesthesia can not only prevent restless during postanaesthetic recovery, but also prevent sore throat within postoperative 24 h.%目的 观察术毕前静脉注射舒芬太尼预防全麻术后苏醒期躁动和术后24 h咽喉疼痛的效果.方法 随机将122例需要全麻的择期手术患者分为A组和B组,每组61例,两组均以咪唑安定、阿曲库铵、芬太尼、丙泊酚诱导,丙泊酚+瑞芬太尼+异氟醚维持麻醉.B组于手术结束麻醉停药前30~40 min给予舒芬太尼0.25~0.5 μg/kg;A组手术结束前不给药.分别纪录两组患者的自主呼吸恢复时间、呼之睁眼时间及苏醒期患者的躁动发生率、术后24 h咽喉疼痛发生率.结果 两组患者手术结束后,自主呼吸恢复时间、呼

  15. Countermeasure and Clinical Analysis of Intraoperative Awareness of Patients Undergoing General Anesthesia%全身麻醉患者发生术中知晓的临床特征和对策

    Institute of Scientific and Technical Information of China (English)

    刘珍珍; 夏中元; 姚瑶; 杜立

    2012-01-01

    Objective:To analyze the Incidence, risk factors and characteristics intraoperative awareness of patients undergoing general anesthesia and explore the prevention and control measures. Methods:28 cases of intraoperative awareness undergoing general anesthesia were analyzed retrospectively in our hospital from 2005 to 2010.Results:The incidence of intraoperative awareness was 0.07%; The characteristics of the group of patients:①The prevalence was greater in men than in women;②More common in anesthesia in less than lh of the "short operation";③Awareness during intravenous anesthesia was higher than that of other ways, but also case of all did not use benzodiazepine drugs; ④It was higher in the patients with long-term drinking and using diazepam for a long time, and intraoperative monitoring of brain function is not implemented; ⑤Postoperative period were with serious psychological and mental disorders, But the treatment was obviously effective. Conclusion:Awareness of patients undergoing general anesthesia during surgery in patients can cause severe psychological and mental disorders; We should strengthen the preoperative evaluation and prevention of high-risk patients such as men, short operation and long-term using diazepam for a long time ,and especially preventive use of benzodiazepines drugs.BIS monitoring should be implemented; Pay attention to the return visit and timely psychological and drug treatment.%目的:分析全身麻醉患者发生术中知晓的发生率、高危因素及特征,探讨其防治措施.方法:回顾性分析我院2005年-2010年全身麻醉患者中发生术中知晓的28例病例.结果:全身麻醉患者术中知晓的发生率为0.07%;该组病例特征为:①男性的发生率大于女性;②多见于麻醉手术时间小于1h的"短小手术";③麻醉方式主要表现在静脉复合麻醉中,但均未使用苯二氮卓类药;④长期口服"安眠药"和长期饮酒的患者发生率高,且术中未实施脑功能监

  16. [Anesthesia for ambulatory patients].

    Science.gov (United States)

    Landauer, B

    1975-11-13

    The specific problems of outpatient anesthesia are discussed with respect to the patient's condition, the anesthesist's qualification and pharmacological properties of anesthetics used. Methohexitone seems to be the best choice for induction. Problems may arise from the use of Propanidid, Ketamin and Diazepam. Nitrousoxide and Enflurane are a suitable completion. Endotracheal intubation, if needed, is facilitated by Suxamethonium, which is rapidly eliminated. Practical aspects of timing, premedication, induction, maintenance and ending of anesthesia are pointed out. After 1-2 hours the patient can be allowed to leave the hospital accompanied by a responsible person. Driving a car is not recommended before 24 hours have elapsed since anesthesia.

  17. 七氟烷和丙泊酚麻醉下阻塞性黄疸患者术后恢复的比较%The difference on anesthesia recovery period in obstructive jaundice patients under general anesthesia with sevoflurane of intravenous propofol

    Institute of Scientific and Technical Information of China (English)

    李廷坤; 卢锡华; 吕帅国; 章云飞; 王根生; 冯艳平

    2008-01-01

    Objective To investigate the effect of general anesthesia with sevoflurane or intravenous propofol on anesthesia recovery period in obstructive jaundice patients. Methods Thirty ASA Ⅰ or Ⅱ and Child A obstructive jaundice patients were randomly divided into two equal groups (n=15 each). The patients in group S received inhalation anesthesia with sevoflurane and those in group P intravenous anesthesia with propofol during operation for obstructive jaundice. The patients were premedicated with intramuscular phenobarbital 100mg and atropine 0.5mg, anesthesia was induced with midazolam 0.05mg/kg, atracurium 0.5mg/kg, propofol 1.5-2.5mg/kg and fentanyl 4μg/kg. Maintained with TCI of propofol (target plasmaconcentration was set at 3.5mg/L) or sevoflurane inhalation (end-tidal sevoflurane concentration was 2%-3%) and intermittent i. v. boluses of fentanyl. EGG, HR, MAP, SpO and end-tidal sevoflurane concentration were continuously monitored during operation. Duration of anesthesia, the volume of infusion and fentanyl were recorded, awaking time, extubation and regained consciousness after operation were recorded. Results There were no significant differences between the two groups in average age, sex, body-weight, duration of anesthesia, the parameters of MAP and HR (P>0.05). The awaking time was (7.9±1.5) minutes in group S and (26.1±8.8) minutes in group P. The extubation time was (8.5±2.5) minutes in group S and (27.8±11.2) minutes in group P. The regained consciousness time was (13.1±4.4) minutes in group S and (33.7±12.5) minutes in group P. The incidence of lethargy, fidget were higher in group P than those in group S. Conclusion Both sevoflurane and propofol can provide satisfactory anesthesia for the operation of obstructive jaundice, but the recovery of influence caused by sevoflurane is faster and more steady than that caused by propofol.%目的 比较阻塞性黄疽患者在七氟烷和丙泊酚麻醉后恢复的差异.方法 择期

  18. Local anesthesia for endovascular abdominal aortic aneurysm repair

    NARCIS (Netherlands)

    Verhoeven, ELG; Cina, CS; Tielliu, IFJ; Zeebregts, CJ; Prins, TR; Eindhoven, GB; Span, MM; Kapma, MR; van den Dungen, JJAM

    2005-01-01

    Objectives: This study reports the results of a prospective continuous cohort of patients treated for endovascular aneurysm repair (EVAR) with a unified anesthetic strategy based on the use of local anesthesia (LA) in all patients, while reserving regional (RA) or general anesthesia (GA) only for th

  19. The risk factors for delirium in older orthopedic surgery patients in post-anesthesia care unit after general anesthesia%麻醉后恢复室老年骨科全麻患者谵妄的危险因素

    Institute of Scientific and Technical Information of China (English)

    杨许丽; 刘玥; 郑旭; 孙玉娥; 王杨; 李新梅; 江澜; 王江; 王玲

    2014-01-01

    Objective To investigate the risk factors for delirium incidence in older orthopedic surgery patients in postanesthesia care unit (PACU) following general anesthesia.Methods Sixty-seven cases of elderly patients exposed to orthopedics surgery with general anesthesia were enrolled in the PACU.Delirium was evaluated with the intensive care delirium screening checklist (ICDSC) after extubation for 5 min.We also recorded relevant data for statistical analysis such as intraoperative fluid intake and output,positive reaction for catheterization as well as patient's age,sex,weight,body height and education time.Results Postoperative delirium was observed in 19 patients (5 males and 14 females),accounting for 28.34%.The average age in delirium group(group Z) was (77±7),while non-delirium group (group NZ) was (72±6).Furthermore,the average education time in group Z was(4.6±2.4),which was much lower compared with (6.5±3:1) group NZ,and exhibited statistically significant differences between the two groups (P<0.05).We also revealed that age may serve as a potential risk factor for delirium via logistic regression analysis for variables observed statistically significant in comparisons between groups (P=0.005,OR=1.231).Conclusions Age may increase the risk of delirium in older orthopedic patients in PACU following general anesthesia.%目的 探讨麻醉后恢复室(post-anesthesia care unit,PACU)老年骨科全麻患者谵妄发生的危险因素. 方法 观察67例接受骨科手术入PACU的老年全麻患者,拔管后5 min采用重症监护谵妄筛查检查表(the intensive care delirium screening checklist,ICDSC)评估谵妄.记录术中出入量,是否有尿管反应,患者的年龄、性别、体重、身高、受教育年限等一般资料,进行统计分析. 结果 19例患者(男5例,女14例)发生术后谵妄,占28.34%.谵妄组(Z组)平均年龄(77±7)岁,高于无谵妄组(NZ组)(72±6)岁;谵妄组(Z组)患者平均受教育年限(4.6±2.4)

  20. Anesthesia & Down Syndrome

    Science.gov (United States)

    ... tests used to verify existence and severity of valvular heart disease. Unfortunately, not all adults with Down syndrome will ... exams without sedation or anesthesia. Suspected existence of valvular heart disease must be communicated to the anesthesiologist prior to ...

  1. Anesthesia-Related Maternal Mortality in the United States : 1979-2002

    NARCIS (Netherlands)

    Hawkins, Joy L.; Chang, Jeani; Palmer, Susan K.; Gibbs, Charles P.; Callaghan, William M.

    2011-01-01

    OBJECTIVE: To examine 12 years of anesthesia-related maternal deaths from 1991 to 2002 and compare them with data from 1979 to 1990, to estimate trends in anesthesia-related maternal mortality over time, and to compare the risks of general and regional anesthesia during cesarean delivery. METHODS: T

  2. SEVOFLURANE VERSUS HALOTHANE FOR GENERAL ANESTHESIA IN PEDIATRIC PATIENTS – A COMPARATIVE STUDY OF INDUCTION TIME, INTUBATION TIME AND EMERGENCE TIME

    Directory of Open Access Journals (Sweden)

    Santosh K

    2014-03-01

    , diastolic blood pressures, and SpO2. The depth of anesthesia was assessed clinically by evaluation of changes in heart rate, and blood pressure during surgery and these were maintained within 20% of baseline values. RESULTS: Induction time was significantly shorter with Gr S[mean(SD 136.0(19.343secs] than with Gr H [mean (SD 156.09(10.651 secs] (P=0.0001. Intubation time was significantly shorter with Gr S [mean (SD 242.400(9.940 secs] than with Gr H[mean(SD 265.769(12.039 secs] (P<0.0001. Time to emergence was significantly shorter in Gr S [mean(SD 217.667(22.831secs] than with Gr H[mean(SD 450.5(18.407 secs] (P<0.0001. CONCLUSIONS: We found that sevoflurane is an excellent agent for inhalational induction of anesthesia in pediatric patients. It facilitates a rapid induction of anesthesia, found to be 20 seconds faster than halothane in our study. Emergence time is relatively shorter with sevoflurane as compared to halothane

  3. Guardian喉罩用于中度肥胖手术患者的全麻通气效果%Efficacy of Guardian laryngeal mask airway on ventilation in patients moderate obese undergoing surgery under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    黄翠凤; 尤新民; 蔡玉红; 程志军; 季惠

    2014-01-01

    Objective: To assess the efficacy of Guardian laryngeal mask airway(GLMA)on ventilation in patients moderate obese patients undergoing surgery under general anesthesia. Methods:Eighty ASA I orⅡpatients of aged 18-65 years weigh-ing 65-100 kg(BMI 35-0.05)。G组气道密封压为(32±5) cmH2O。纤支镜证实GLAM位置好。结论:GLAM气道密封性可靠,通气效果好,心血管功能稳定,拔除后不良反应发生少,可安全有效地用于中度肥胖患者外科手术的全麻通气。

  4. Presbycusis: reversible with anesthesia drugs?

    Science.gov (United States)

    Kocher, Carl A

    2009-02-01

    Age-related hearing impairment, or presbycusis, is a degenerative condition not currently treatable by medication. It is therefore significant that the author, as a patient, experienced a reversal of high-frequency hearing loss during a 2-day period following abdominal surgery with general anesthesia. This report documents the surgery and the subsequent restoration of hearing, which was bilateral and is estimated to have exceeded 50dB at 4kHz. A possible role is noted for anesthetic agents such as lidocaine, propofol, or fentanyl. This experience may hold a clue for research toward the development of medical treatments for presbycusis.

  5. 全麻鼻内镜术后应用普米克令舒雾化吸入的护理%The Nursing of General Anesthesia Nasal Endoscopic Surgery Patients with Inhaling Pulmicort

    Institute of Scientific and Technical Information of China (English)

    邬燕平; 刘伟

    2011-01-01

    Objective:Observation of ultrasonic atomizer inhaled Pulmicort respules adjuvant therapy nasal endoscopy surgery patients complicating odynophagia and cracked curative effect and nursing. Methods: Select 68 cases of general anesthesia nasal endosciouc surgery patients do application of ultrasonic atomizer inhaled Pulmicort respules adjuvant therapy,and corresponding nursing.Results:68 patients had the odynophagia,cracked alleviate time is 2d 24 example,3d 36 cases,4d 6 cases,5d 2 cases.60 case excellence, 8 cases effectively, invalid to 0.Conclusion:ultrasonic atomizer inhaled Pulmicort respules to improve general anesthesia nasal endoscopic surgery patients odynophagia, cracked complications have clinical significance.%目的:观察超卢雾化吸入普米克令舒辅助治疗全麻鼻内镜手术后患者并发吞咽痛及声音嘶哑的疗效与护理.方法:选取68例全麻行鼻内镜手术患者应用超声雾化吸入普米克令舒进行辅助治疗,并采取相应的护珲措施.结果:68例患者术后吞咽痛、声音嘶哑缓解时间为2d24例,3d 36例,4d 6例,5d 2例.60例显效,8例有效,无效为0.结论:超声雾化吸入普米克令舒对改善全麻鼻内镜术后患者吞咽痛、声音嘶哑并发症具有临床意义.

  6. Airway management of infants with cleft lip under general anesthesia during operation%婴幼儿唇裂手术麻醉呼吸道管理

    Institute of Scientific and Technical Information of China (English)

    王淼

    2009-01-01

    Cleft lip is one of the common diseases in Oral and Maxillofacial Surgery, and children with cleft lip should be treated by cleft lip repair, mostly operation in infan-cy. The management of airway plays an important role in safety of surgery. Pay attention to the prevention of preoperative re-spiratory infection, intraoperative hypoxia and airway edema, postoperative respiratory depression and respiratory complica-tions such as laryngeal spasm, We can effectively prevent the occurrence of accidents and complications in anesthesia and improve surgical safety.%唇裂是口腔颌面外科的常见病之一,主要在婴儿期采用唇裂修补术来进行治疗.呼吸道的管理对手术安全具有非常重要的作用.注意术前预防呼吸道感染、术中防止缺氧及气道水肿、术后防止呼吸抑制及喉痉挛等呼吸道并发症,可以有效预防麻醉意外及并发症的发生,提高手术安全性.

  7. 全麻机械通气SLIPA喉罩漏气相关因素分析%Factors associated with gas leakage in use of streamlined liner of the pharynx airway with la-ryngeal mask airway under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    张庆兵; 韩苗华; 周懿; 封丽丽; 刘佳; 刘毅

    2014-01-01

    Objective:To verify the factors associated with gas leakage in applying of streamlined liner of the pharyngeal airway ( SLIPA) with classic la-ryngeal mask airway (LMA) to mechanically ventilated patients in general anesthesia.Methods:260 patients undergone minor surgery with general anes-thesia were included and recorded regarding the gender, ages, body mass index, Mallampati classification, neck circumference, thyromental distance (TMD),mandibular length,width of mouth opening and status of teeth before anesthesia.Selection of the LMA size was complied to the width of thyroid cartilage of patients,and determination of LMA leakage was based on the operator′s experience and tidal volume monitoring.χ2 test was used to analyze the difference concerning the parameters described previously between the leakage group and the non-leakage group.Results:SLIPA LMAs were successfully applied in 254 patients,whereas LMA leakage was found in 17 cases.Higher incidence of the gas leakage was seen patients with shorter TMD (35% vs. 5%) and without teeth (29% vs.3% )when the two groups were compared (P<0.05).Conclusion:SLIPA LMA can be safely used in mechanically ventilated patients under general anesthesia,yet higher incidences of gas leakage may be involved in those with short TMD or without teeth.%目的:筛选全麻机械通气使用SLIPA喉罩时发生漏气的相关因素。方法:选取短小全麻手术260例,记录患者性别、年龄、体质量指数、Mallampati分级、颈围、甲颏距、下颌骨水平长度、张口度以及牙齿情况。根据甲状软骨宽度选取合适型号的喉罩。操作者根据临床经验和潮气量监测判断喉罩是否漏气。采用卡方检验比较喉罩漏气和未漏气两组患者间各项指标的差异。结果:260例患者成功置入SLIPA喉罩,其中17例出现喉罩漏气。与喉罩未漏气患者相比,喉罩漏气患者短颏甲距(35%vs.5%)和无牙(29%vs.3

  8. Combined spinal–epidural anesthesia for an elderly patient with proportionate dwarfism for laparotomy

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-01-01

    Full Text Available Anesthesia in a dwarf patient may be challenging as various anatomical anomalies make both general and regional anesthesia difficult. These patients may have atlantoaxial instability, potential for airway obstruction, and associated respiratory problems that may pose problems for general anesthesia. Spinal stenosis, osteophytes, short pedicles, or a small epidural space could complicate regional anesthesia in dwarfs which could lead to difficulties in locating the epidural space and increase the risk of dural puncture. Spinal stenosis may impair cerebrospinal fluid flow such that identification of dural puncture is difficult. This elderly dwarf patient had history of bronchial asthma with restriction of neck extension, managed successfully using combined spinal–epidural anesthesia.

  9. 喉罩联合无肌松全麻在小儿眼科手术中的应用%The application of LMA combined with general anesthesia without muscle relaxants in the pediatric department of ophthalmology operation

    Institute of Scientific and Technical Information of China (English)

    贺伟忠; 杨义; 范小丽; 李萌

    2014-01-01

    目的:研究无肌松全麻联合喉罩置入对小儿眼科手术围术期应激反应的影响。方法选择全身麻醉下小儿眼科手术患者90例,随机分为A、B两组,每组各45例。 A组使用肌松药插入气管导管,B组采用无肌松药全麻并置入喉罩。对比手术中各时间点的平均动脉压(MAP)、心率(P)、心率收缩压乘积(RPP)、血氧饱和度(SpO2)。观察两组拔管期呛咳、躁动等拔管反应,并记录拔管(喉罩)时间、麻醉药总量。结果A组麻醉诱导及拔管期血流动力学波动高于B组;A组严重呛咳、躁动例数高于B组;A组拔管时间长于B组;A组麻醉药物总量多于B组。结论喉罩联合无肌松全麻应用于小儿眼科手术安全可靠,相较气管插管围术期应激反应更低。%Objective To study without muscle relaxants combined general effect of laryngeal mask insertion on the pe-diatric department of ophthalmology operation perioperative stress responses. Methods Ninety patients with pediatric eye surgery were randomly divided into group A and group B, 45 cases in each group. Group A treated with muscle re-laxants insert the tracheal tube, group B treated with without anesthesia and muscle relaxants into the LMA. Contrast surgery mean arterial pressure at each time point (MAP), heart rate (P), rate pressure product (RPP), oxygen saturation (SpO2). Extubation were observed choking, restlessness, etc. extubation reaction, record extubation (LMA) time, total quantity of using drug. Results A induction of anesthesia and extubation hemodynamic fluctuations was higher than that of group B; Severe cough, agitation of group A were higher than that in B group; The extubation time was longer than that of group B; Drug amount was higher than that of group B. Conclusion LMA Joint no muscle relaxant used in pe-diatric anesthesia eye surgery is safe and reliable, with lower stress response.

  10. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding...

  11. The Biochemical Impact of Surgery and Anesthesia

    NARCIS (Netherlands)

    J.W. Hol (Jaap Willem)

    2014-01-01

    markdownabstract__Abstract__ General anesthesia has been considered by some medical historians as one of the most important contributions to modern medicine second to perhaps the concept of antiseptic medicine and hygiene. The first historical mention of a deep unnatural sleep so that surgery can t

  12. Risk management in anesthesia.

    Science.gov (United States)

    Cabrini, L; Levati, A

    2009-11-01

    Anesthesia is considered a leading discipline in the field of patient safety. Nevertheless, complications still occur and can be devastating. A substantial portion of anesthesia-related adverse events are preventable since risk factors can be detected and eliminated. Risk management (RM) in anesthesia includes preventive and remedial measures to minimize patient anesthesia-related morbidity and mortality. RM involves all aspects of anesthesia care. Classically, the following four steps are needed to prevent critical incidents or to learn from them: (1) detection of problems, (2) assessment, (3) implementation of solutions, and (4) verification of effectiveness. Problems and solutions can be identified into the fields of structures, processes and personnel. Authoritative agencies like the World Health Organization, the World Federation of Societies of Anesthesiologists, the Section and Board of Anesthesiology of the European Union of Medical Specialties and the Italian Scientific Society of Anesthesiologists (Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva SIAARTI) have proposed initiatives addressing safety in the operating room. The central role of a well-trained, constantly present anesthesiologist and the usefulness of checklists have been highlighted. Cost cutting and production pressure in medical care are potential threats to safety. A shared knowledge of the best standards of care and of the potential consequences of unscrupulous actions could make the daily management of conflicting interests easier. A correctly applied RM can be a powerful, highly beneficial aid to our practice.

  13. The efficacy of dexmedetomidine hydrochloride on prevention of agitation and sore throat after surgery with general anesthesia%右美托咪定预防全麻术后躁动和咽喉疼痛的作用

    Institute of Scientific and Technical Information of China (English)

    刘晶; 廖信芳; 胡祖荣; 贾杰; 黄希照; 邓恋

    2012-01-01

    目的 探讨右美托咪定(Dex)对患者全麻术后躁动和咽喉疼痛的预防作用.方法 将200例择期腹腔镜妇科手术患者分为观察组和对照组,每组100例,两组均以咪达唑仑、维库溴铵、舒芬太尼、丙泊酚诱导,丙泊酚、瑞芬太尼和七氟醚维持麻醉.手术结束前30 min观察组用Dex 0.6 μg/kg 10 min泵入,对照组相同量生理盐水10 min泵入.观察记录两组患者的自主呼吸恢复时间、呼之睁眼时间、拔管时间及苏醒期患者的躁动评级、身体舒适度评分(BCS)、术后24 h咽喉疼痛评级.结果 两组患者手术结束后,自主呼吸恢复时间、呼之睁眼时间及拔管时间差异无统计学意义(P>0.05),而躁动和咽喉痛发生率观察组比对照组明显降低(P<0.05),观察组BCS明显高于对照组(P<0.05).结论 Dex可有效预防全麻术后躁动和咽喉疼痛的发生.%Objective To study preventive efficacy of dexmedetomidine on agitation and sore throat after surgery with general anesthesia. Methods Two hundred patients with selective celoscopic gynecological operation were randomized two groups (n = 100) : Group A and B. Midazolam, vecuronium bromide, sufentanil and propofol were applied for anesthesia induction, as propofol, remifentanil and sevoflurane were applied for maintenance of anesthesia in the both groups. However, intravenous dexmedetomidine (0. 6 μg/kg) was given to the participants in Group A 30 min before the end of the operation, whereas the substituted physiological saline was given in Group B. The recovery time of spontaneous breathing, eye opening time, extubation time, agitation grading, body comfort score (BCS) and sore throat grade within the 24 h after operation were recorded. Results There was no significant difference in recovery time of spontaneous breathing, eye opening time or extubation time between the two groups ( P > 0. 05 ) . However, there was significant reduction of incidences of agitation and sore throat

  14. Tramadol with Flurbiprofen Axetil reduces recovery restlessness after general anesthesia%曲马朵联合氟比洛芬酯预防全麻苏醒期躁动

    Institute of Scientific and Technical Information of China (English)

    谢阳; 方志源

    2011-01-01

    Objective To observe the effect of t lurbiproten Axetu and Tramadol on treating the recovery restlessness after general anesthesia. Methods Sixty patients of LC surgery were divided into 3 groups randomly, each with 20 cases. Group A was given Flurbiprofen (1 mg/kg) before induction of anesthesia, Group B was given Tramadol (2 mg/kg) 20 minutes before finishing the surge and Group C was given Flurbiprofen (1 mg/kg) before induction of anesthesia, then was given Tramadol (2 mg/kg) 20 minutes before finishing the surge. Agitation score, the time from withdrawal to recovery and side effects were observed. Results Emergence agitation score at each time point: Group A>Group B>Group C with P0. 05. Conclusion Flurbiprofen Axetil with Tramadol can degrade the level of recovery restlessness after general anesthesia with less side reactions.%目的 观察曲马朵联合氟比洛芬酯用于预防全麻手术苏醒期躁动的效果及安全性.方法 择期腹腔镜胆囊切除手术60例,随机分为3组,每组20例.A组:于麻醉诱导开始前给予氟比洛芬酯注射液1 mg/kg;B组:于手术停止前20 min给予曲马朵注射液2 mg/kg;C组:于麻醉诱导开始前给予氟比洛芬酯注射液1mg/kg,手术停止前20 min给予曲马朵注射液2 mg/kg.观察:每组患者拔管即刻(0min),拔管后5min,10 min,15 min的躁动评分;从停药到患者清醒的时间;是否发生呼吸抑制、恶心呕吐、皮肤瘙痒等不良反应.结果 各时间点躁动分级:A组明显高于B组和C组,B组明显高于C组(P<0.01).B、C组各有1例恶心、呕吐发生,3组无呼吸抑制、凝血功能异常、瘙痒等不良反应,3组之间差异无显著性意义.结论 术中应用曲马朵联合氟比洛芬酯对预防全麻苏醒期躁动具有良好的效果,并能降低不良反应发生率.

  15. Awake caudal anesthesia for inguinal hernia operations: successful use in low birth weight neonates.

    Science.gov (United States)

    Geze, S; Imamoğlu, M; Cekic, B

    2011-09-01

    Neonates with inguinal hernia face a relatively high risk of incarcerated hernia and bowel obstruction and this therefore requires surgical treatment. Complications following general anesthesia even for minor surgery are more common in low birth weight neonates than in term neonates. Caudal epidural anesthesia without adjunct general anesthesia has been recommended for neonates to reduce the risk of postoperative complications. The successful application of awake caudal anesthesia with levobupivacaine for inguinal hernia repair in 15 low birth weight neonates is reported. Single dose caudal epidural anesthesia was administered for inguinal hernia surgery to avoid complications associated with general anesthesia. Caudal block was performed with 2.5 mg/kg body weight (BW) levobupivacaine. Caudal anesthesia can be recommended as an effective technique for avoiding postoperative anesthetic complications in low birth weight neonates.

  16. 鼻内镜手术无肌松药全身麻醉可行性探讨%Application of general anesthesia without muscle relaxant in nasal endoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    杨戈雄; 袁杰; 高爽; 李滔; 滕煜; 马军令

    2014-01-01

    Objective To investigate the effect and feasibility of anesthesia without muscle relaxant in nasal endoscopic opera-tion.Methods 120 patients with ASAⅠ-Ⅱundergoing nasal endoscopic operation were randomly divided into normal muscle relaxant use group ( group Ⅰ) and intubation without muscle relaxant maintenance group ( groupⅡ) , 60 cases in each.GroupⅠwas treated with vecuronium 0.08-0.1 mg/kg induced, in patients with body movement or per 40min intravenous infusion of 0.05 mg/kg maintai-ning muscle relaxation;group Ⅱtracheal intubation after complex full airway surface anesthesia but without muscle relaxants mainte-nance during operation.Blood pressure ( MAP) , heart rate ( HR) , pulse oxygen saturation ( SpO2 ) , end tidal carbon dioxide partial pressure ( PetCO2 ) were recorded in each time point in the two groups before anesthesia ( T0 ) , 2 min after anesthesia induction ( T1 ) , 2 min after endotracheal intubation ( T2 ) , 2 min after the start of operation ( T3 ) , 20 min after the start of operation ( T4 ) , and 5 min after extubation ( T5) .The body movement frequency intraoperation , recovery time from anesthesia and extubation time, adverse reac-tions and complications and intraoperative additional infusion dosage of remifentanil and propofol were compared between the two groups.Results In both groups, T0 ~T4 each observation point,HR, MAP, SpO2 and PetCO2 changes were not significantly different (P>0.05).Breathing the air after 5 min(T5), SPO2 in group Ⅱwere higher than those in groupⅠ, PetCO2 in groupⅡlower than that in groupⅠ, there were significant differences between the two groups (P<0.05).In groupⅡ,anesthesia recovery time and ex-tubation time were significantly shorter than those in group Ⅰ( P <0.01).There were no adverse reaction and complication. Conclusions The effect of nasal endoscopic surgery under tracheal intubation general anesthesia without muscle relaxant is reliable, safe and feasible.%目的:探讨在无肌

  17. Current options in local anesthesia for groin hernia repairs.

    Science.gov (United States)

    Kulacoglu, Hakan; Alptekin, Alp

    2011-01-01

    Inguinal hernia repair is one of the most common procedures in general surgery. All anesthetic methods can be used in inguinal hernia repairs. Local anesthesia for groin hernia repair had been introduced at the very beginning of the last century, and gained popularity following the success reports from the Shouldice Hospital, and the Lichtenstein Hernia Institute. Today, local anesthesia is routinely used in specialized hernia clinics, whereas its use is still not a common practice in general hospitals, in spite of its proven advantages and recommendations by current hernia repair guidelines. In this review, the technical options for local anaesthesia in groin hernia repairs, commonly used local anaesthetics and their doses, potential complications related to the technique are evaluated. A comparison of local, general and regional anesthesia methods is also presented. Local anaesthesia technique has a short learning curve requiring simple training. It is easy to learn and apply, and its use is in open anterior repairs a nice way for health care economics. Local anesthesia has been shown to have certain advantages over general and regional anesthesia in inguinal hernia repairs. It is more economic and requires a shorter time in the operating room and shorter stay in the institution. It causes less postoperative pain, requires less analgesic consumption; avoids nausea, vomiting, and urinary retention. Patients can mobilize and take oral liquids and solid foods much earlier. Most importantly, local anesthesia is the most suitable type of anesthesia in elder, fragile patients and patients with ASA II-IV scores.

  18. A comparison of the end-expired concentrations of sevoflurane at the same anesthesia depth among patients with different ages undergoing general anesthesia%不同年龄患者在同一麻醉深度下呼气末七氟烷浓度的比较

    Institute of Scientific and Technical Information of China (English)

    张旭东; 张可贤; 陈一丁; 于涛; 唐育民

    2013-01-01

    Objective:To investigate the difference of the end-expired concentrations of sevoflurane in patients with different ages undergoing general surgery with remifentanil .Methods: One hundred and twenty-five ASAⅠ-Ⅱpatients undergoing general surgery were allocated into 5 groups ( 25 cases in each group ) , group 1:1-4 yrs;group 2:5-18 yrs;group 3:19-40 yrs;group 4:41-65 yrs;and group 5:66-86 yrs.After inducing ,anesthesia was maintained with sevoflurane and remifentanil ( 0.1 μg · kg -1 · min-1 ) .The concentration of sevoflurane was adjusted to maintain Narcotrend index (NI) at 64.BP,HR and expired concentration of sevoflurane were measured and recorded at these three time points:before anesthesia , the time when NI maintaining 64 and 85.Results:There were no recovering delay ,respiration dysfunction or intraoperative awareness in each group .The values of end-expired concentration of sevoflurane among the 5 groups had significant differences ( P <0.05 ) .At the same anesthesia depth, the value of end-expired concentration of sevoflurane in group 3 was lowest among the 5 groups.Conclusion:The end-expired concentrations of sevoflurane in different ages at the same anesthesia depth undergoing general surgery with remifentanil were significantly different (P<0.05).And the end-expired concentration of sevoflurane should be adjusted according to the age of the patient for the proper depth of sevoflurane anesthesia .%目的:观察不同年龄的全麻普通外科手术患者复合雷米芬太尼麻醉在同一麻醉深度下呼气末七氟烷浓度的区别。方法:125例行腹部手术的患者, ASA分级Ⅰ~Ⅱ,按年龄分为5组:组1为1~4岁,组2为5~18岁,组3为19~40岁,组4为41~65岁,组5为66~86岁,每组25例。静脉诱导后雷米芬太尼维持输注速度为0.1μg · kg -1· min-1和吸入七氟烷维持麻醉,调节七氟烷浓度使Narcotrend指数( Narcotrend index,NI)值稳定在64水平。手术结束后

  19. Percutaneous Nephrolithotomy under Spinal Anesthesia with Marcaine

    Directory of Open Access Journals (Sweden)

    S.M.R. Rabani

    2010-01-01

    Full Text Available Introduction & Objective: The efficacy of Percutaneous Nephrolithotomy (PCNL in the treatment of renal stones has been proven in its indications. The main method of anesthesia in this procedure is general anesthesia. We used spinal anesthesia (SA as an alternative method of anesthesia with many benefits. This study was intended to show the possibility of SA as a more comfortable method of anesthesia for the surgeon , the anesthesiologist and the patient via more cooperation of the patient during changing the position and prevention of some complications mostly in upper extremities and neck. Materials & Methods: In a prospective clinical trial study, a total of 112 patients underwent PCNL under SA with marcaine , from Nov 2004 till Feb 2009. Their mean age was 36 years (22-48, at first the syringe was stained by epinephrine and then 2 -3.5 ml marcaine was used for SA and addition of analgesics , sedatives or both., if needed. The rest of the procedure was done as routine.Results: Stone clearance was achieved in 82% of the patients and the rest were managed by ESWL. The mean operation time was 126 minutes (90-220, 36% of the patients needed sedation, analgesia, or both, specially those with bigger stones. 6% of the patients had upper pole stones .Blood transfusion was needed only in one patient. No significant complication was observed in this study.Conclusion: PCNL under SA afforded the surgeon and the anesthesiologist the opportunity of more patient cooperation during position changes and precludes some morbidities that may happen under general anesthesia because the patient is awake and able to portend.

  20. Dexmedetomidine: Expanding role in anesthesia

    Directory of Open Access Journals (Sweden)

    Jyotsna S Paranjpe

    2013-01-01

    Full Text Available The potential uses of dexmedetomidine (DEX, a highly selective α2 - adrenoceptor agonist are very diverse. DEX appears to mimic many of the actions of mythical ′ideal′ sedative/analgesic agent. Although not orally active, DEX shows good bioavailability when administered via various other routes like intranasal, buccal, IM than intra-venous. DEX has similar pharmacokinetics in all age groups. Its side effects are predictable and easily treatable, hence it has found place as a part of fast-tracking anesthesia regimens in children. DEX is the sedative of choice for peri-operative use in high risk patients, since it is cardioprotective, neuroprotective and renoprotective. Premedication with DEX obtunds the autonomic pressor responses due to laryngoscopy and endotracheal intubation when used as an adjuvant to general anesthesia. DEX in high doses offers another approach to managing morbidly obese patients and patients with a compromised airway; without causing any cardio-respiratory depression. It is near ideal hypotensive agent used for controlled hypotension. Its value as a primary sedative and analgesic is becoming more accepted and evident in critically ill patients; in adult and paediatric intensive care units. Besides use in locoregional anesthesia, it is also used as an opioid substitute, for treatment of substance withdrawal, as an anti-shivering agent, for treatment of delirium and as an end of life medication. Availability of an antidote (Atipamezole with similar elimination half life is taking the drug into new frontiers. However, use of DEX is contraindicated in patients with hepatic failure, hypovolemic shock, advanced heart block or ventricular dysfunction.

  1. Accuracy of spectral entropy as an electroencephalographic measure of level of sedation during general anesthesia%熵指数监测全麻患者镇静水平的准确性

    Institute of Scientific and Technical Information of China (English)

    张宏; 毕素萍; 贾宝森

    2008-01-01

    Objective To evaluate the accuracy of spectral entropy including response entropy(RE)and state entropy(SE)as a new electroencephalographic measure of depth of sedation during general anesthesia.Methods Twenty ASA Ⅰ or Ⅱ patients aged 20-55 yr undergoing elective abdominal surgery were studied.Anesthesia Was induced with intravenous propofol,fentanyl and vecuronium.After tracheal intubation anesthesia was maintained with sevoflurane inhalation and intermittent iv boluses of fentanyl and vecuronium.BP,HR,SpO2,spectral entropy(Datex-Ohmeda)and BIS(Aspect Medical)were monitored during anesthesia.Loss of eyelash reflex and unresponsiveness to verbal stimulus and mild prodding and shaking were considered to be signs of loss of consciousness(LOC).The time of regaining consciousness Was defined as the time when patients started responding to verbal commands.RE,SE and BIS were recorded before anesthesia(baseline),10 min before LOC,immediately after LOC,immediately after tracbeal intubation,1 h after skin incision,10 min before regaining consciousness immediately after consciousness was regained and 10 min after extubation.Results There were sisnificant changes in RE,SE and BIS during the transition from consciousness to LOC.The RE,SE and BIS values for LOC were 76,73 and 68 with sensitivity of 94%,95%and 92%and specificity of 92%,94%and 91%respectively.The accuracy of RE.SE and BIS in predicting LOC was 93%,95%and 94%respectively.The RE,SE and BIS values for regaining consciousness were 82,75 and 70 with sensitivity of 95%,95%and 91%and specificity of 93%,96%and 93%respectively.The accuracy in predicting regaining of consciousness was 98%,96%and 97%respectively.Conclusion Entropy index Can accurately monitor level of sedation during general anesthesia.%目的 评价反应熵和状态熵监测全麻患者镇静水平的准确性.方法 择期行腹部手术患者20例,ASAⅠ或Ⅱ级,入室后监测反应熵(RE)、状态熵(SE)及脑电双频谱指数(BIS),静脉注射

  2. A comparison of side effects and cost for spinal andgeneral anesthesia in geriatric patients

    OpenAIRE

    E. Nasiri; R.Nemat; F. Sohail Arshadi; R.A.Mohammadpour

    2006-01-01

    AbstractBackground and purpose: There is still debate regarding advantages and disadvantages of regional versus general anesthesia techniques. Some studies suggested that regional anesthesia technique probably reduces postoperative morbidity and mortality.In this retrospective historical cohort study, we compared the cost-effectiveness for spinal and general anesthesia in elderly patients.Materials and methods : A total of 120 medical records of elderly participants whom underwent general or ...

  3. Risk factors of postoperative respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia%全身麻醉患者术后呼吸道感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李宁; 张义龙; 赵国军; 宋有鑫; 任磊; 李建玲

    2016-01-01

    目的 探讨气管插管全身麻醉下行腰椎手术患者术后发生呼吸道感染的原因,为其临床预防治疗提供参考依据.方法 连续收集2012年9月-2014年9月住院拟行气管插管全身麻醉下腰椎后路切开减压内固定椎间融合术的患者300例作为研究对象,记录其基本信息及相关病史,分析术后呼吸道感染的原因,采用SPSS 17.0软件进行数据统计分析,对危险因素应用logistic回归模型分析.结果 300例患者中发生呼吸道感染34例,发生率11.33%;多因素分析结果 表明,年龄、吸烟史、既往有呼吸系统慢性感染、糖尿病、无口腔护理等因素与术后呼吸道感染有关(P<0.05).结论 气管插管全身麻醉下行腰椎手术患者,如为高龄、吸烟者,既往有慢性呼吸道感染及糖尿病史,术后发生呼吸道感染危险明显增高;术前规范进行口腔护理可以降低术后发生呼吸道感染的风险.%OBJECTIVE To explore the causes for respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia in order to guide the clinical prevention and treatment .METHODS The continuous clinical data of 300 patients who needed lumbar vertebra surgery under general anesthesia from Sep .2012 to Sep . 2014 were collected and their general information and the relative medical history were recorded ,then the patients who had respiratory tract infections postoperatively were recorded and analyzed .The software SPSS 17 .0 was used for statistical analysis and the risk factors were analyzed by logistic regression model .RESULTS Of 300 pa-tients with complete data ,respiratory tract infections occurred in 34 cases with the incidence rate of 11 .33% .The multivariate analysis indicated that age ,smoking history ,history of chronic respiratory tract infections or diabetes mellitus ,and absence of oral care were correlated with postoperative respiratory tract infections .CONCLUSION The risk of getting respiratory

  4. Risk factor analysis of postoperative respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia%腰椎手术患者全麻术后呼吸道感染的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李宁; 张义龙; 赵国军; 宋有鑫; 任磊; 李建玲

    2016-01-01

    目的:探讨气管置管全身麻醉下行腰椎手术患者术后发生呼吸道感染的相关因素,为其临床预防治疗提供参考依据。方法收集2012年9月-2014年9月在医院住院拟行气管置管全身麻醉下腰椎后路切开减压内固定椎间融合术的患者303例作为研究对象,记录其基本信息及相关病史,分析术后呼吸道感染的相关因素,研究数据采用SPSS 17.0软件进行统计处理。结果300例患者中发生呼吸道感染34例,感染率为11.33%;多因素分析结果显示,年龄、吸烟史、既往有呼吸系统慢性感染、糖尿病、无口腔护理等因素与术后呼吸道感染有关,差异有统计学意义(P<0.05)。结论气管置管全身麻醉下行腰椎手术患者,如为高龄、吸烟者,既往有慢性呼吸道感染及糖尿病史,术后发生呼吸道感染危险因素明显增高;术前进行规范口腔护理可以降低术后发生呼吸道感染的风险。%OBJECTIVE To explore the related factors for respiratory tract infections in patients undergoing lumbar vertebra surgery under general anesthesia in order to guide the clinical prevention and treatment .METHODS The consecutive clinical data of 300 patients who needed lumbar vertebra surgery under general anesthesia from Sep . 2012 to Sep .2014 were collected and the general information and the relative medical history were recorded .The related factors for postoperative respiratory tract infection were analyzed .The data were statistically analyzed by software SPSS 17 .0 .RESULTS Of 300 patients with complete data ,respiratory tract infection occurred in 34 cases with the incidence rate of 11 .33% .The multivariate analysis indicated that age ,smoking history ,history of chro-nic respiratory tract infection or diabetes mellitus ,and oral care were correlated with postoperative respiratory tract infections ,with significant difference (P<0 .05) .CONCLUSION The risk factors of

  5. Comparison of the Effects of General Anesthesia and Epidural Combined Anesthesia on Postoperative Early Cognitive Function in Elderly Patients with Postoperative Epidural Analgesia%全身麻醉与硬膜外复合麻醉继以术后硬膜外镇痛对老年患者非心脏手术后早期认知功能的影响比较

    Institute of Scientific and Technical Information of China (English)

    隋金玲; 邓蓉蓉

    2015-01-01

    Objective To probe into the effect of general anesthesia and epidural combined anesthesia on postoperative early cognitive function in elderly patients with postoperative epidural analgesia. Methods 115 patients who accepted heart operation treatments in our hospital from January, 2011 to December, 2014 and these patients were randomly divided into the control group and the observation group.In the observation group of 60 patients were received general anesthesia and epidural combined anesthesia and postoperative epidural analgesia while in the control group of 55 patients were received general anesthesia and intravenous analgesia after surgery. Then, the postoperative neurological and mental function and other indicators of two groups of patients were observed and the early postoperative cognitive function of patients was comparative analyzed.Results The incidence of cognitive dysfunction seven days after surgery in the observation group and control group was 51.67% (31/60) and 49.09% (27/55).Conclusion After non cardiac surgery, the elderly patient wil have some early cognitive dysfunction due to surgical operation and education, while the effect of epidural anesthesia and epidural anesthesia on early cognitive function in elderly patients is not obvious.%目的:探讨全身麻醉与硬膜外复合麻醉继以术后硬膜外镇痛对老年患者非心脏手术后早期认知功能的影响。方法选择2011年01月~2014年12月在我院进行非心脏手术的老年患者115例分为对照组和观察组,观察组60例患者接受全身麻醉与硬膜外复合麻醉和术后硬膜外镇痛,对照组55例患者仅接受全身麻醉和术后静脉镇痛。观察两组患者术后神经及精神功能等各项指标,就患者术后早期认知功能情况作对比分析。结果观察组和对照组患者在术后七天的认知功能障碍发生率为51.67%(31/60)、49.09%(27/55)。结论在进行非心脏手术后,老年患者会因外科手

  6. 全麻/控制性降压手术对海马神经元凋亡的影响%Effect of surgical operation with general anesthesia/controlled hypotension on neuronal apoptosis in hippocampus

    Institute of Scientific and Technical Information of China (English)

    王改梅; 刘喆; 沈颖洁; 方剑乔

    2013-01-01

    目的:观察全麻/控制性降压手术对海马神经元损伤的影响及其可能的机制.方法:选用12只6~8月龄雄性健康比格犬,随机分为全麻组(A组,n=6)和控压组(C组,n=6).全麻组采用丙泊酚注射及异氟醚吸入麻醉,控压组在麻醉基础上联合硝普钠行控制性降压,达到目的血压(基础平均动脉压的40%)后维持60 min(2组动物均在相应期间行剖腹探查术),术毕使血压回升至基础水平72 h后取脑.采用免疫组织化学法检测海马CA1和CA3区白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)以及凋亡相关蛋白(Bcl-2、Bax和活化型caspase-3)的表达;TUNEL法检测海马神经元凋亡情况.结果:(1)控压组动物海马CA1和CA3区IL-1β和TNF-α阳性细胞率均较全麻组升高(P<0.01);(2)控压组CA1和CA3区Bcl-2/Bax阳性细胞比值均较全麻组降低(P<0.05);与此相应,控压组海马各区caspase-3阳性细胞率均显著高于全麻组(P<0.01);(3)全麻组与控压组CA1和CA3区存在凋亡细胞,但控压组各区细胞凋亡指数均较全麻组显著升高(P<0.01).结论:全麻/控制性降压下的手术可诱导海马不同区域促炎细胞因子表达,降低Bcl-2/Bax比值,促进caspase-3的表达,进而导致海马神经元的凋亡.这种术后海马神经元损伤可能与全麻/控压手术诱导的海马炎症反应有关.%AIM: To observe the influence and the possible mechanism of surgical operation with general anesthesia/controlled hypotension on neuronal injury in hippocampus. METHODS: Twelve healthy male Beagle dogs aged 6 ~ 8 months were randomly divided into general anesthesia group ( group A, n = 6) and controlled hypotension group (group C, n = 6). The dogs in group A were anesthetized with propofol injection and isoflurane inhalation. The dogs in group C were combined with intravenous infusion of sodium nitroprusside to induce hypotension based on the anesthesia, and the target mean arterial pressure (MAP) was

  7. Effect of dexmedetomidine on blood lfow dynamics in elderly patients undergoing general anesthesia%右美托咪啶对全麻老年患者血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    徐永生

    2016-01-01

    目的:探讨右美托咪啶用于全麻老年高血压患者对心钠素(ANP)、内皮素(ET)及血流动力学的影响,分析右美托咪啶在全麻老年高血压患者的应用效果。方法随机选择2015年4月至2016年1月哈尔滨市第五医院拟行气管插管全麻的开腹手术老年原发性高血压患者40例。所选患者随机分为两组,即右美托咪啶组(D组)和对照组(C组),每组20例。分别于麻醉前(即基础值)(Tl)、插管前(T2)、插管后(T3)、手术开始切皮时(T4)、手术30min(T5)、手术结束拔管时(T6),六个时点抽取静脉血,采用放免法测定血浆中ET、ANP的含量。所有患者围术期连续监测心电图(ECG)、心率(HR)、血氧饱和度(SPO2)、收缩压(SBP)、舒张压(DBP)、尿量并对这些指标定时记录。结果在SBP、DBP、HR中显示D组与C组比较,除T1以外T2-T6均有差异(P<0.05)。在监测血浆内皮素和心钠素的浓度中发现,D组与C组间比较除麻醉前以外,T2-T6各个时间点比较有显著差异(P<0.05)。结论右美托咪啶用于全麻老年高血压患者能有效减少手术过程中ET、ANP的释放和保持围手术期血流动力学稳。%Objective To evaluate the Dexmedetomidine Injection used for general anesthesia in the elderly patients with high blood pressure and blood flow to ET, ANP dynamics influence, so as to analyze the Dexmedetomidine Injection in the elderly patients with high blood pressure of general application effect, to provide reference for clinical medication.Methods Random selection in April 2015 to January 2016 he fifth hospital of Harbin plans to do tracheal intubation of general anesthesia open surgery patients with essential hypertension 40 cases, The selected patients were randomly divided into two groups, and Each group of 20 cases. Dexmedetomidine(D group) and the control group(group C). Difference in anesthesia

  8. The Develoment of Anesthesia.

    Science.gov (United States)

    Davis, Audrey B.

    1982-01-01

    Until the eighteenth century, doctors were reluctant to use chemicals to alleviate pain because they accepted the religious/moral beliefs of their day, claiming that pain was beneficial for the body. Traces technical developments in the control of pain, discussing relationships of anesthesia to social, cultural, and scientific factors and…

  9. Local anesthesia: a review.

    Science.gov (United States)

    Malamed, S F; Sykes, P; Kubota, Y; Matsuura, H; Lipp, M

    1992-01-01

    Local anesthetics are the most widely administered drugs in dentistry. Significant advances have been made in past decades that have greatly increased both the safety and the efficacy of these important drugs. This paper reviews the history of local anesthesia, pharmacokinetics and clinical implications, techniques, complications, and future directions in the quest for more effective pain control in dentistry.

  10. Effect of general anesthesia for children on their intelligence and sensory integration capability%儿童行全身麻醉手术对其智力和感觉统合能力的影响

    Institute of Scientific and Technical Information of China (English)

    朱明; 王璐

    2015-01-01

    Objective To study the effect of general anesthesia on children's intelligence and sensory integra-tion capability. Methods Children aged 7~9 who had gone through general anesthesia during the age from 1 to 3 but not for cardiac surgery or neurosurgery were selected as the experimental group (n=72). Children aged 7~9 who re-ceived no general anesthesia during the age from 1 to 3 were selected as the control group (n=72) based on the 1:1 principle correspondent with sex, age, and education, education levels, occupation of their parents of the experimental group. The Wechsler Intelligence Scale and Children Sensory Integration Capability Development Rating were used to assess the children's intelligence and capability of sensory integration. Results The two groups of children showed no statistically significant difference in the total index of intelligence and cognitive ability (P>0.05). In terms of the in-ternal structure of intelligence, the proportion of patients in the experimental group who were with difference between perceptual reasoning index and processing speed index was 16.7%(12/72), and that in the control group was 1.4%(1/72). Proportion of patients in the experimental group who were with difference between working memory and the verbal comprehension index was 20.8%(15/72), and that of the control group was 2.8%(2/72). Both the above com-parisons showed statistically significant differences (P0.05)。在智力内部结构方面,实验组儿童的言语理解-加工速度指数存在差异者为16.7%(12/72),而对照组为1.4%(1/72),实验组的知觉推理-加工速度指数差异者为20.8%,(15/72),对照组为2.8%(2/72),两组指数比较差异均具有统计学意义(P<0.05);实验组儿童前庭功能失衡发生率为25.0%(18/72),明显高于对照组儿童的1.4%(1/72),差异具有统计学意义(P<0.05)。结论总体来看,儿童在1~3岁期间进行全麻手术后对其后期的智力、感觉统合能力无显著影响,

  11. 全麻下头面部手术患者眼保护方法的对比研究%Eye-protection for operative patients with craniofacial surgery undergoing general anesthesia.

    Institute of Scientific and Technical Information of China (English)

    谭云燕; 宁传艺; 刘丽清; 韦江平

    2012-01-01

    Objective:To compare and assess the efficacy of eye ointment under general anesthesia eye -protection care, aim to find out the more effective measure for clinical nursing. Methods:200 general anesthesia patients were randomly divided into chlortetracycline group and tetracycline group. After the 1th ,3rd, 5th days of postoperative, we observed the clinical outcome including the availability of eye irritation, photophobia, tearing the cornea, conjunctivitis symptoms, and trichiasis, conjunctival hyperemia, corneal ulcers, vision loss and other concurrent disease and the complaints. Results:Observation outcome indicates that chlortetracycline group with 2 complications,tetracycline group had no ocular complications,no significant difference between groups( P >0. 05 ). Chlortetracycline group had photophobia, tearing and foreign body sensation with tingling in 15 cases,there was only 1 case of tetracycline group with tearing and photophobia,and 3 cases with foreign body sensation, was statistically significant in the results. Conclusions:There is no difference in the effective of eye - protection in chlortetracycline ointment and tetracycline ointment in general anesthesia patients. And the tetracycline ointment can reduce the uncomfortable symptoms more than the chlortetracycline ointment.%目的:对患者分别用金霉素软膏和四环素软膏进行眼保护护理比较,旨在寻求有效保护全麻患者眼睛的方法.方法:分别对我院需行全麻下头面部手术患者(200例)随机分成金霉素和四环素两组各100例,按照术中眼保护护理方法分别进行护理,在术后第1,3,5 d对两组患者的眼部表现及患者主诉,包括有无眼部刺痛、畏光、流泪等角膜、结膜炎症状,以及倒睫、结膜充血、角膜溃疡、视力减退等并发症及不适主诉进行比较.结果:金霉素组出现并发症2例,分别为角膜溃疡和视力减退,四环素组无眼部并发症,组间比较无统计学意义(P>0.05);金

  12. Research of Temperature Protection Strategy of Precaution Hypothermia in Infant Patients after General Anesthesia%防范婴幼儿患者全身麻醉后低体温的体温保护策略研究

    Institute of Scientific and Technical Information of China (English)

    李涵霖; 朱素洁; 熊金敏; 陈琛; 宣燕

    2016-01-01

    目的:分析行外科手术的婴幼儿患者全身麻醉后低体温发生率,探讨综合保温措施应用于婴幼儿患者以防范全麻后低体温的效果。方法择期全麻下行腹部手术的婴幼儿患者60例,随机分为对照组和综合保温组,每组30例。所有的患儿均给予常规保温措施:棉被或敷料覆盖肢体、室温控制在24~26℃。综合保温组除常规保温措施外,还将患儿的双上肢,双大腿下1/3至足部及肩颈部用棉垫包裹,术前将电热加热毯铺于床上(温度设定为38.5℃)的体温保护措施。对照组除实施常规保温措施外,不另外实施其他保温措施。记录两组患儿的鼻咽温变化及低体温的发生情况。如患者出现低体温(体温<36.5℃),则采用其他保温措施。结果综合保温措施组低体温的发生率较对照组低(P<0.05),两组患儿术中最低体温及不同时间点的体温变化没有统计学差异(P>0.05)。结论为维持患儿的正常体温,提高全身麻醉后患儿的安全性,除常规保温措施外,还应采用综合保温措施以维持患儿体温。%Objective To analysis the incidence of low body temperature of infant patients after general anesthesia during surgical operation, and to discuss the effect of comprehensive heat preservation measures applied to infants to prevent hypothermia after general anesthesia. Methods A total of 60 infant patients scheduled for elective surgery were randomized divided into comprehensive heat preservation measures group and control group, with 30 cases in each group. During the surgery, all the patients were covered with quilts, and room temperature control in 24~26℃. In comprehensive heat preservation measures group, patients' upper limbs' 1/3 of lower limbs, feet, shoulder and neck were covered with cotton pads, and electric blankets were used to cover the bed which allowed patients to lie on with the temperature being set

  13. Ablação curativa da fibrilação atrial: comparação entre sedação profunda e anestesia geral Curative ablation of atrial fibrillation: comparison between deep sedation and general anesthesia

    Directory of Open Access Journals (Sweden)

    Elizabeth Bessadas Penna Firme

    2012-12-01

    Full Text Available OBJETIVO: Comparar sedação profunda com anestesia geral para ablação curativa de fibrilação atrial. MÉTODOS: Estudo prospectivo, aleatório, com 32 pacientes, idades entre 18 e 65 anos, ASA 2 e 3, IMC d" 30kg/m², distribuídos em dois grupos: sedação profunda (G1 e anestesia geral (G2. Todos receberam midazolan (0,5mg/kg venoso. O G1 recebeu propofol (1mg/kg e máscara facial de O2, seguido da infusão contínua de propofol (25-50mg/kg/min e remifentanil (0,01-0,05µg/kg/min. O G2 recebeu propofol (2mg/kg e máscara laríngea com tubo de drenagem, seguido da infusão contínua de propofol (60-100mg/kg/min e remifentanil (0,06-0,1µg/kg/min. Foram comparados: frequência cardíaca, pressão arterial invasiva, complicações, recidiva (desfecho em três meses e gasometrias. RESULTADOS: Os pacientes do G1 apresentaram gasometrias arteriais com níveis de PaCO2 maiores e pH menores (p=0,001 e maior incidência de tosse. Ocorreu diminuição da PAM e FC no G2. Exceto a tosse, as complicações e recidivas foram semelhantes em ambos os grupos. CONCLUSÃO: Ambas as técnicas podem ser utilizadas para a ablação curativa da fibrilação atrial. A anestesia geral proporcionou menores alterações respiratórias e maior imobilidade do paciente.OBJECTIVE: To compare deep sedation with general anesthesia for curative ablation of atrial fibrillation. METHODS: We conducted a prospective, randomized study with 32 patients, aged between 18 and 65 years, ASA 2 and 3, BMI d" 30kg/m2, divided into two groups: deep sedation (G1 and general anesthesia (G2. All patients received intravenous midazolam (0.5 mg / kg. G1 received propofol (1mg/kg and O2 by facemask, followed by continuous infusion of propofol (25-50mg/kg/min and remifentanil (0.01-0.05 mg / kg / min. G2 received propofol (2mg/kg and laryngeal mask with built-in drain tube, followed by continuous infusion of propofol (60-100mg/kg/min and remifentanil (0.06 to 0.1g/kg/min. We compared heart rate

  14. Screening of postoperative delirium in elderly diabetic patients after general anesthesia%老年糖尿病患者全麻术后谵妄筛查的研究

    Institute of Scientific and Technical Information of China (English)

    钱彦; 吴红英; 吴悦; 徐文斌; 卢伟良

    2014-01-01

    Objective To investigate the incidence of postoperative delirium in elderly diabetic patients after general anesthesia. Methods The incidence of postoperative delirium in 140 elderly diabetic patients after general anesthesia was screened with Intensive Care Delirium Screening Scale (ICDSC). With DSM- IV as the gold standard for diagnosis of delirium, the validity of ICDSC was evaluated. Results The incidence of delirium was 23.8%in 140 postoperative elderly patients with dia-betes. The sensitivity, specificity, positive predictive value and negative predictive value of ICDSC in diagnosis of delirium were 0.935, 0.889, 0.725 and 0.978, respectively; and the kappa consistency coefficient was 0.750. Conclusion The incidence of postoperative delirium in elderly patients with diabetes is relatively high, and ICDSC can be used effectively in screening of deliri-um for postoperative patients.%目的:探讨老年糖尿病患者全麻术后谵妄发生率和谵妄筛查量表的筛查效度。方法以DSM- IV诊断作为金标准,调查140例老年糖尿病患者术后谵妄发生率,评价重症监护谵妄筛查量表(ICDSC)的筛查效果。结果老年糖尿病患者全麻术后谵妄发生率为23.8%;ICDSC筛查敏感度0.935,特异度0.889,阳性预测值0.725,阴性预测值0.978,一致性Kappa系数为0.750。结论老年糖尿病患者全麻术后谵妄应引起高度关注,可使用有效筛查工具ICDSC进行常规筛查,提前预防和干预,减少术后并发症,降低病死率。

  15. 腹部手术硬全联合麻醉术后谵妄的影响因素%The Inlfuencing Factors of Postoperative Delirium in Continuous Epidural Block Combined with General Anesthesia with Tracheal Intubation on Abdominal Operation

    Institute of Scientific and Technical Information of China (English)

    曾晓燕; 李正芬

    2013-01-01

    目的:分析腹部手术硬全联合麻醉患者术后谵妄的影响因素。方法:采用病例对照研究方法,选择腹部手术硬全联合麻醉患者,根据患者术后3天内是否发生谵妄分为病例组和对照组,以单因素分析联合多因素分析方法研究患者术后发生谵妄的影响因素。结果:患者术后谵妄发生率4.95%,患者均在术后24 h内发病;高龄、手术时间>2h、术后疼痛评分>2分、肺部慢性疾病史、饮酒史是患者术后发生谵妄的危险因素。结论:对高龄、既往患有肺部慢性疾病、手术时间长的患者,术后密切监测电解质、血气,防治肺部感染的发生,以降低患者术后谵妄的发生率。%Objective:To analysis the influencing factors of postoperative delirium in continuous epidural block combined with general anesthesia with tracheal intubation on abdominal operation. Methods:The case control study were used, continuous epidural block combined with general anesthesia with tracheal intubation on abdominal operation patients were selected, was divided into case group and control group according to the delirium of patients after 3 days, study the influence factors of postoperative delirium in patients by single factor analysis and multiple factor analysis.Results:The incidence rate of delirium was 4.95%in patients, the patients were onset within 24h;senility, operation time≥2h, postoperative pain score>2, chronic lung disease, drinking history were risk factors of postoperative delirium for patients.Conclusion:In the light of elderly patients, who suffered from chronic lung disease, long operation time of patients, postoperative close monitoring of electrolytes, blood gas analysis, prevention and treatment of pulmonary infection, to reduce the incidence of postoperative delirium in elderly patients .

  16. 氟马西尼用于脑瘫患儿全麻催醒的临床研究%CLINICAL STUDY ON FLUMAZENIL USING FOR ANALEPSIA OF CHILDREN WITH CEREBRAL PALSY AFTER GENERAL ANESTHESIA

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    张科; 叶章文; 余学英; 齐磊

    2011-01-01

    目的 探讨氟马西尼用于脑瘫患儿全麻术后催醒的有效性和安全性.方法 40例行脑瘫手术的患儿,随机分为氟马西尼组(I组)和生理盐水组(II组).前者在手术结束后经留置针注射氟马西尼0.006mg/kg,60s内清醒程度未达到要求再追加半量.II组注射相同剂量的生理盐水.观察记录注射药物后5min患儿清醒率、注射药物时和注射药物后5min患儿的脑电双频指数(bispectral index,BIS)值以及清醒后30min内躁动和恶心、呕吐发生率.结果 氟马西尼组注射药物后5min清醒率及BIS值均高于生理盐水组(P<0.05),2组患儿的躁动和恶心、呕吐发生率差异无统计学意义(P>0.05).结论 氟马西尼可以安全有效的用于脑瘫患儿的全麻术后催醒.%Objective To determine the analeptic effectiveness and safety of flumazenil in child patients with cerebral palsy for recovery from general anesthesia. Methods Forty operated child patients with cerebral palsy were randomly divided into two groups ( n = 20 each ) . The patients in group I received flumazenil (0. 006mg/kg, intravenous injection) after surgery, and patients in group II received normal saline. When patients could not be awakened in 60 seconds, they were given a half of the first dose once more. The alertness score and the bispectral index (BIS) value in 5min before and after the injection were assessed, and adverse reactions such as nausea ,vomiting and psychomotor agitation of all patients were also recorded. Results The alertness rate and BIS value were significantly higher in group I than those in group II. However, there were no significant difference in nausea, vomiting and psychomotor agitation found between two groups. Conclusion Flumazenil can be effectively and safely used for analepsia of children with cerebral palsy after general anesthesia.

  17. Application Analysis of Comprehensive Nursing Intervention in General Anesthesia Operation Patients During Recovery Period%综合护理干预在全麻手术患者苏醒期的应用分析

    Institute of Scientific and Technical Information of China (English)

    徐冬霞; 邵正霞

    2015-01-01

    Objective To discuss the application method and effect of comprehensive nursing intervention in general anesthesia operation patients during recovery period.Methods500 cases of general anesthesia operation patients in recovery period were selected and randomly divided into treatment group and control group with 250 cases each. The former received regular nursing combined with comprehensive nursing intervention while the latter received regular nursing.Results The incidence of restlessness of treatment group was lower than control group (P<0.05) and the severity was also slighter (P<0.05). At discharge, the physiological, psychological, social and environmental scores in the treatment group were higher than those in the control group (P<0.05).Conclusion Comprehensive nursing intervention can reduce the incidence of restlessness and alleviate the severity, which is favorable for improving the overall life quality.%目的:探讨综合护理干预在全麻手术患者苏醒期的应用方法与效果。方法选择全麻手术进入苏醒期患者500例,随机分为治疗组与对照组各250例,治疗组在苏醒期给予常规护理联合综合护理干预,对照组在苏醒期给予常规护理。结果治疗组的躁动发生例数少于对照组(P<0.05),且发生程度轻于对照组(P<0.05)。出院时进行调查,治疗组的生理、心理、社会与环境领域得分都高于对照组(P<0.05)。结论综合护理干预在全麻手术患者苏醒期的应用能减少躁动的发生,减轻躁动发生程度,有利于患者总体生活质量的改善。

  18. 连续无创血压监测系统在全身麻醉中的应用%Efficacy of a continuous non -invasive arterial pressure monitor system during general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李晶; 周婷; 田丽平; 徐世元; 张鸿飞

    2016-01-01

    目的:评价TL_300 tensymeter系统(TL_300)所测的连续无创血压(NIBP)在全身麻醉中的有效性及安全性。方法选择全身麻醉下行择期仰卧位手术的成年患者20例,ASAⅠ~Ⅲ级。麻醉诱导后无菌操作下左侧桡动脉穿刺置入动脉导管进行连续有创血压( IBP)监测,右侧手臂连接TL_300进行NIBP监测,稳定5 min后,同时测量IBP和NIBP,间隔3 min分别记录IBP监测及相应时点NIBP监测的收缩压、舒张压和平均压。术后监测与两种血压监测相关的并发症如肢体缺血、坏死、感觉异常。结果 NIBP监测与IBP监测所测收缩压、舒张压和平均压差值分别为(-0.086±9.59)、(3.203±7.11)、(2.60±6.76) mmHg,两种血压监测方法的收缩压、舒张压和平均压的决定系数分别为0.711、0.565和0.729,P值均小于0.001。所有患者均未发生肢体缺血、坏死、感觉异常。结论与IBP监测相比,NIBP监测在全身麻醉成年手术患者中,可提供连续、无创、准确、安全的血压监测。%Objective To investigate the accuracy, precision and safety of continuous non-invasive blood pres-sure( NIBP) monitoring delivered by TL_300 tensymeter system.Methods Twenty ASA classification of Ⅰ-Ⅲadult patients undergoing elective surgeries in a supine position under general anesthesia were included in the study.A catheter was placed into the left radial artery under local anesthesia before induction, with the TL_300 tensymeter system connected to the right arm.Continuous invasive blood pressure ( IBP) monitoring was derived from the invasive artery catheter while the NIBP was from TL_300 tensymeter system.Systolic, diastolic and mean arterial pressure were recorded every 3 mi-nutes simultaneously for both IBP and NIBP from 5 min after monitoring to the end of surgery.Complications associated with both pressure monitors including limb ischemia, necrosis and paresthesia were recorded

  19. 不同药物治疗小儿麻醉苏醒期躁动的疗效分析%Analysis of the effect of different drugs on emergence agitation in children after general anesthesia

    Institute of Scientific and Technical Information of China (English)

    宁丽; 杜健儿

    2016-01-01

    目的:观察氯胺酮、芬太尼与丙泊酚静脉注射对小儿外科手术麻醉后苏醒期躁动(emergency agitation ,EA )的治疗效果。方法:选择全麻后出现苏醒期躁动的患儿90例,美国麻醉医师协会(ASA )Ⅰ~Ⅱ级,随机分为3组:氯胺酮组(K组)、芬太尼组(F组)和丙泊酚组(P组),每组30例。3组分别给予静脉注射氯胺酮1 mg/kg、芬太尼1μg/kg和丙泊酚1 mg/kg。各组患儿分别在用药前后采用麻醉苏醒期躁动量化评分表(PA ED )评分、东安大略儿童医院疼痛评分量表(C H EO Ps )评分和Ramsay镇静评分评价治疗效果,同时记录各组用药后血氧饱和度(SpO2)<90%、需要手控呼吸以及再次躁动的患儿数。结果:与用药前比较,用药后3组患儿的PAED评分和CHEOPs疼痛评分均显著下降(P<0.05),Ramsay镇静评分均显著升高。K组PAED评分低于F组和P组(P<0.05),CHEOPs评分低于P组(P<0.05),Ramsay镇静评分高于F组和P组;K组用药后发生呼吸抑制和再次躁动的患儿数均少于F组和P组。结论:1 mg/kg氯胺酮能有效治疗患儿全身麻醉后苏醒期躁动的发生,且不良反应发生率小于芬太尼和丙泊酚。%Objective:To observe the effects of ketamine ,fentanyl and propofol intravenous injection on emergency agitation (EA) in children after anesthesia in pediatric surgery .Methods: Ninety children who suffered from emergence agitation (ASA Ⅰ-Ⅱ) after general anesthesia were selected .They aged 2-7 years old ,weighed 12-31 kg ,and the gender was not limited .They were randomly divided into 3 groups:ketamine group (group K) ,fentanyl group (group F) and propofol group (group P) ,with 30 cases in each group .Intravenous injection of ketamine 1 mg/kg ,fentanyl 1 μg/kg and propofol 1 mg/kg in 3 groups were given to three groups respectively .The degree of EA was evaluated using the Pediatric Anesthesia

  20. The Application of Remifentanil-Propofol in Obstetric General Anesthesia of High Risk Pregnancy Cesarean Section%高危妊娠剖宫产全身麻醉中瑞芬太尼和异丙酚的应用

    Institute of Scientific and Technical Information of China (English)

    蔡昀夏; 曾葵; 黄蔚; 陈筱静

    2011-01-01

    Ob|ective:To study the effect of remifentanil-propofol on neonatus and mothers with high risk pregnancy in obstetric general anesthesia. Methods:46 women with high risk pregnancy who had cesarean section were divided into group I (epidural anesthesia, n = 24) and group Ⅱ (general anesthesia with remifentanil and propofol, n=22). The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate(HR) were observed five times: before, at the beginning of (after the tracheal cannu-la) and 20 minutes in the operation, fetal delivery and at the end of the operation . Apgar scores at 1, 5, 10 minutes after baby delivery, the frequency of the the newborns'tracheal cannula,pH, PaCO2 and PaO2 of umbilical artery, the operation time, blood loss, and the time of baby delivery from the beginning of the operation were compared between the two groups. Results:There were no significant differences in HR, DBP, operative duration .blood loss,the time of baby delivery, Apgar scores of the newborns,the frequency of the the newborns'tracheal cannula,umbilical arterial blood gas (P > 0. 05). The SBP in group I was markedly lower than that in group Ⅱ at the beginning of operation (after the tracheal cannula) ( P < 0. 05). The incidences of left heart failure andhy of mothers during anesthesia and operation in group I were higher than those in group Ⅱ(P<0.05)). Conclusions:Remifentanil-propofol in anesthesia of High-risk pregnancy is a safe, stable, quick palinesthesia. And there is no obviously side effects on the neonates if the drug-taken time and dosage are well controlled.%目的:应用瑞芬太尼和异丙酚对高危妊娠患者剖宫产施行全身麻醉,观察其对新生儿和母体的影响.方法:高危妊娠施行剖宫产患者46例,分成Ⅰ组(硬膜外麻醉)及Ⅱ组(瑞芬太尼和异丙酚全身麻醉).记录术前、手术开始时(即气管插管后时刻)、胎儿娩出时、术中20分钟时及术毕母体的收缩压(SBP)、舒张

  1. The role of dexmedetomidinein immune function of patients with breast cancer via sevoflurane inhalation general anesthesia during perioperative radical mastectomy%右美托咪定对七氟烷全麻乳腺癌根治术围术期免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    徐勇民; 傅艳师; 郑艳萍; 陈琳; 杨新明; 周艳; 陈俊; 王万平

    2016-01-01

    Objects To evaluate the immune protective effect of dexmedetomidine on breast cancer dur-ing perioperative radical mastectomy via sevoflurane inhalation general anesthesia. To explore reasonable anesthet-ic strategyfor breast cancer radical mastectomy. Methods Patients were divided into two groups. Patients in ex-perimental group receivedgeneral anesthesia with dexmedetomidine and sevoflurane. Control group means general anesthesia with sevoflurane only. In both groups, the level of cortisol, IL-6, IL-8 and of TNF-αin serum were measured at 5 time points , 30 minutes before anesthesia , after cutting skin , after surgery , 24 h after surgery and 72 h after surgery. Results The amount of anesthetic used to induce general anesthesia in the experimen-talgroup were lower than that of the control group.There is no obvious difference of cortisol , IL-6, IL-8 and of TNF-αin serumat the time of 30 min before anesthesia between two groups.Concentrations ofseveral markersin-creasedafter anesthesia, of which experimentalgroup were lower than that of the control group. Conclusions Dexmedetomidine could be immunoprotective for patient with breast cancer during perioperative radical mastecto-my via sevoflurane inhalationgeneralanesthesia. This study recommends usingmultiple anestheticdrugs to anes-thetize patients of breast cancer when performing radical mastectomy.%目的:评价右美托咪定对七氟烷吸入全麻乳腺癌根治围术期免疫保护作用,探讨乳腺癌根治术合理麻醉用药。方法:比较右美托咪定联合七氟烷全麻(实验)组和单纯七氟烷全麻(对照)组,在麻醉前30 min、切皮后、术毕、术后24 h,术后72 h不同时点血清皮质醇(cor)、IL-6、IL-8、TNF-α浓度。结果:实验组麻醉剂用量较对照组降低。麻醉前30 min各指标浓度没有差异,麻醉后各指标浓度均上升,每个时间点实验组浓度均低于对照组。结论:右美托咪定对七氟烷全麻乳腺

  2. Comparação da anestesia geral e bloqueio do plexo cervical superficial em tireoidectomias parciais Comparison between general anesthesia and superficial cervical plexus block in partial thyroidectomies

    Directory of Open Access Journals (Sweden)

    Rui Celso Martins Mamede

    2008-02-01

    Full Text Available Tireoidectomia sob efeito de bloqueio do plexo cervical superficial (BPCS tem sofrido resistência. OBJETIVO: Comparar variáveis cirúrgicas e anestésicas, custos do tratamento e grau de satisfação de pacientes submetidos à hemitireoidectomia sob efeito de anestesia geral e BPCS. CASUÍSTICA E MÉTODOS: Foram 21 pacientes submetidos à anestesia geral (AG e outro tanto ao BPCS. Após sedação, no grupo com BPCS, usou-se marcaína com vasoconstritor, e quando necessário, lidocaína a 2% com vasoconstritor. Sedação intra-operatória com diazepam endovenoso e metoprolol para controle da PA e FC eram administradas quando necessário. Usou-se anestesia geral (AG segundo padronização do serviço. RESULTADOS: Foram significantes (pThyroidectomy under the effect of superficial cervical plexus block (SCPB has met resistance. AIM: to compare variables in patients submitted to hemithyroidectomy under the effect of general anesthesia (GA and SCPB. CASE REPORT AND METHODS: GA was used in 21 patients, and SCPB was used in another 21 patients. Following sedation, marcaine 0.5% with vasoconstrictor was used in the SCPB group. Intraoperative sedation with diazepam and metoprolol to control arterial pressure and cardiac frequency was given as needed. GA followed the standard method in the unit. RESULTS: We found significant results (p<0.05, Student’s t-test for surgery time (GA - 111.4 min; SCPB - 125.5 min, anesthesia time (GA - 154.1 min; SCPB - 488.6 min, time in the surgery room (GA - 15 min; SCPB - 1 min, treatment costs (GA - R$203.2; SCPB - R$87.4, presence of bradycardia (GA - 0; SCPB - 23.8% and laryngotracheal injury (GA - 51; SCPB - 0 %. We also found the following non-significant results: hospitalization time (GA - 17.3; SCPB - 15.1 hours; bleeding volume (GA - 41,9 g; SCPB - 47.6 g, size of the operative specimen (GA - 52.1 cm3; SCPB - 93.69 cm3 and patient satisfaction level (GA - 3.8; SCPB - 3.9. CONCLUSION: Although the incidence of

  3. Comparison of the streamlined pharynx airway liner with the conventional laryngeal mask airway for airway management during general anesthesia%SLIPA~(TM)喉罩与普通喉罩用于全麻气道管理的比较

    Institute of Scientific and Technical Information of China (English)

    徐建设; 陈辉; 傅卫军; 唐靖

    2010-01-01

    Objective To compare the performance of the streamlined pharynx airway liner (SLIPA~(TM)) with the conventional laryngeal mask airway(LMA) for airway management in minor surgery under general anesthesia. Methods Sixty fasted adult patients with ASA status Ⅰ~Ⅱ were randomly designed to establish SLIPA~(TM) airway (SLIPA~(TM) group) or LMA airway(LMA group) for airway management during anesthesia. Article airway handling, pharynx sealing, ventilation maintenance and adverse reactions with SLIPA~(TM) group and LMA group were assessed. Results SLIPA~(TM) had comparable total rate of successful insertion and airway placement difficulty to LMA(P>0.05). Maximum seal pressure was (22±5) cm H_20 and (24±6) cm H_2O in SLIPA~(TM) group and LMA group (P>0.05), respectively. A leak was noticed in 20% and 16.7% of patiemts in LMA group when patients' lungs were ventilated using intermittent positive pressure ventilation mode after airway mask placment and during surgery, and 3.3% and 0 in SLIPA~(TM) group (P0.05).通气道插入后SLIPA~(TM)组1例患者(3.3%)、LMA组6例患者(20%)需进一步调整位置方可行间歇正压通气;术中lJMA组5例患者(16.7%)需重新调整方可维持间歇正压通气,SLIPA~(TM)组均顺利完成手术全程间歇正压通气(P<0.05).2种喉罩通气道喉损伤的发生率差异无统计学意义.结论 SLIPA~(TM)喉罩的临床性能与LMA相似,是一种可替代LMA的通气道.SLIPA~(TM)喉罩操作简便,对咽喉损伤较小,维持间歇正压通气较LMA更为稳定.

  4. 护理干预对全麻下腹腔镜胆囊切除术中胃积气的影响%Nursing interventions of accumulated stomach gas produced in laparoscopiccholecystectomy with general ;anesthesia

    Institute of Scientific and Technical Information of China (English)

    徐燕

    2014-01-01

    目的:探讨全麻下腹腔镜胆囊切除术中胃积气的护理干预措施。方法选取自2012年2月至2014年4月行腹腔镜胆囊切除术患者150例,按照手术先后顺序分为干预组和对照组,对照组采用常规护理方法,干预组在常规护理基础上进行心理护理、麻醉诱导时预给氧及按压腹部等护理干预,以减少术中胃积气的发生。观察两组患者术中胃积气的情况。结果干预组胃积气程度显著小于对照组,两组比较有显著差异(P<0.05)。结论适当的护理干预措施可以减少腹腔镜胆囊切除术中胃积气的发生,使手术视野能充分暴露,保证手术的顺利完成。%Objective To explore the care interventions of accumulated stomach gas produced in laparoscopiccholecystectomy with general anesthesia .Methods 150 laparoscopiccholecystectomy cases from February 2012 to April 2014 were selected .According to the order of surgeries , those cases were divided into two groups, the intervention and control groups . The control group adopted conventional methods , while the intervention group applied self-psychological care , pre-oxygenation during induction of anesthesia and nursing interventions , such as pressing the abdomen besides the conventional methods , in order to reduce the incidence of accumulated stomach gas produced during the surgeries .The volumes of accumulated stomach gas were recorded in both groups .Results It was found that accumulated stomach gas in the intervention group was significantly less than the control group (P<0.05).Conclusions Appropriate care interventions can reduce the incidence of accumulated stomachgas produced during laparoscopic cholecystectomy , which will lead to fullyoperative field exposure and then ensure the completion of the surgeries .

  5. 硫酸镁对全麻术后疼痛和并发症影响的Meta分析%Effects of Magnesium Sulfate on Postoperative Pain and Complications after General Anesthesia: A Meta-Analysis

    Institute of Scientific and Technical Information of China (English)

    尹秀茹; 裴凌

    2012-01-01

    Objective To systematically evaluate the effects of magnesium sulfate on postoperative pain and complications after general anesthesia. Methods A literature search was conducted in following databases as The Cochrane Library, Embase, PubMed, EBSCO, Springer, Ovid, CNKI and CBM from the date of establishment to September 2011 to identify randomized controlled trials (RCTs) about intravenous infusion of magnesium sulfate during general anesthesia. All included RCTs were assessed and the data were extracted according to the standard of Cochrane systematic review. The homogenous studies were pooled using RevMan 5.1 software. Results A total of 11 RCTs involving 905 patients were included. The results of meta-analyses showed that compared with the control group, intravenous infusion of magnesium sulfate during general anesthesia significantly reduced the visual analog scale (VAS) scores at the time-points of 2, 4, 6, 8,16, and 24 hours, respectively, after surgery, the postoperative 24 hours morphine requirements, and the incidents of postoperative nausea and vomiting (RR=0.61, 95%CI 0.40 to 0.91, P=0.02) and chilling (RR=0.29, 95%CI 0.14 to 0.59, P=0.000 7). Although the incidents of bradycardia (RR=1.93, 95%CI 1.05 to 3.53, P=0.03) increased, there were no adverse events or significant differences in the incidents of hypotension and serum concentration changes of magnesium. Conclusion Intravenous infusion of magnesium sulfate during general anesthesia may obviously decrease the pain intensity, and the incidents of nausea and vomiting and chilling after surgery, without increasing cardiovascular adverse events and risk of hypermagnesemia. The results still need to be confirmed by more high-quality and large-sample RCTs.%目的 系统评价硫酸镁对全麻术后疼痛和并发症的影响.方法 计算机检索Cochrane图书馆、EMbase、PubMed、EBSCO、Springer、Ovid、CNKI、CBM等数据库,收集从建库至2011年9月间关于全身麻醉中静脉应用硫酸

  6. 丁丙诺啡、曲马多用于雷米芬太尼全麻苏醒过渡期镇痛%Analgesic effect of buprenorphine comparied with tramadol on emergence after remifentanil-based general anesthesia

    Institute of Scientific and Technical Information of China (English)

    杨金凤; 常业恬; 周志国

    2005-01-01

    目的对照观察丁丙诺啡、曲马多用于雷米芬太尼全麻苏醒过渡期镇痛的安全性和有效性.方法120例全麻开胸手术患者分为三组,术毕关胸时停静脉麻醉,同时A组静脉给予丁丙诺啡3μg/Kg,B组曲马多2 mg/Kg,C组注射用水2 mL.观察三组患者用药前(t1)、用药后10′(t2)、30′(t3)、拔管时(t4)、拔管后5′(t5)、10′(t6)各时点血流动力学、血氧饱和度、呼末CO2分压、躁动评分(RS)、Ramsay镇静评分、术后身体舒适评分(BCS)、苏醒时间、PCA按压次数、剂量及不良反应.结果A、B两组较C组在苏醒期血流动力学更稳定;给药后10′开始A、B两组RS明显低于C组(P<0.01).给药后30′开始RSS A、B两组明显高于C组(P<0.01),且拔管时开始A组明显高于B组(P<0.01);BCS A、B两组明显高于C组(P<0.01);B组出汗明显多于A组或C组(p<0.05);PCA按压次数及用药量C组>B组>A组(P<0.01,P<0.05).结论丁丙诺啡、曲马多均可安全有效应用于雷米芬太尼全麻苏醒过渡期镇痛,其中丁丙诺啡效果更好,副作用更少.%[Objective] To observe the analgesic effect of buprenorphine comparied with tramadol on emergence.after remifentanil-based general anesthesia. [Methods] 120 patients undergoing elective thoracotomy under general anesthesia were randomly divided into 3 equal groups(group A, B, C), stoped general anesthesia when starting to shut off thorax and injected buprenorphine 3 μg/kg at group A, tramadol 2 mg/kg at group B, 0.9%NS 2 mL at group C.At three groups the HR, MAP, SPO2, PETCO2, RS, RSS at every time point(t1~t6) and BCS, the waken time, PCA bolus times, PCA dosage, side reactions were observed. [Results] There were more steadily hemodynamics at group A、B than group C; Since 10' after drugs given RS of group A、B were apparently lower than group C (P <0.01).Since 30' after drugs given RSS of group A、B were obviously higher than group C (P <0.01), and there were

  7. 右美托咪定在胆囊微创手术老年患者中的全麻维持效果研究%Effect of dexmedetomidine on elderly patients underwent laparoscopic cholecystectomy under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李峥

    2015-01-01

    Objective To investigate the effect of dexmedetomidine on elderly patients underwent laparoscopic cholecystectomy under general anesthesia. Methods One hundrad patients underwent laparoscopic cholecystectomy in Central Hospital of Nanyang from January 2011 to December 2013 were selected and randomly divided into control group (propofol combined with remifentanil)and the study group(dexmedetomidine combined with remifentanil),with 50 pa-tients in each group. The control group was not treated with any preoperative medication,while study group was treated with loading dose of 0. 5 μg/ kg dexmedetomidine intravenously completed within 10 minutes. Induction of anesthesia were same in both groups. Maintenance of anesthesia in control group treated with propofol 2. 0 ~ 3. 0 μg/ ml + 4. 5 ~ 5. 5 ng/ ml TCI, Maintenance of anesthesia in study group treated with dexmedetomidine 0. 25 μg/(kg·h) + remifentanil 4. 5 ~ 5. 5 ng/ ml (TCI). HR,SBP,DBP,BIS values,and Steward awakening scores and OAA/ S rating were recorded at different time points. Results No significant difference was found between BIS value of two groups at different time points. Compared with control group,HR at different time in study group were significantly lower,SBP,DBP were significantly decreased (P ﹤ 0. 05). There was no significant difference in Steward awakening score and modified OAA/ S score at recovery and ex-tubation time between the two groups. Conclusions Compared with propofol given in minimally invasive laparoscopic gall-bladder surgery in elderly patients maintain anesthesia effect,dexmedetomidine is more secure,more efficient and more sta-ble hemodynamics. Therefore,it is worthy of clinical application.%目的:探讨右美托咪定在腹腔镜胆囊微创手术老年患者中全麻维持效果。方法2011年1月至2013年12月在南阳市中心医院行腹腔镜胆囊切除术的患者共100例,随机分为对照组(丙泊酚+瑞芬太尼麻醉)和研究组(右美托咪定

  8. Effect of dexmedetomidine on tracheal extubation response in patients undergoing thyroid surgery after general anesthesia%右美托咪定对甲状腺手术患者全身麻醉拔管反应的影响

    Institute of Scientific and Technical Information of China (English)

    马立靖; 马璨; 任宪凤; 林长赋

    2012-01-01

    目的 观察右美托咪定对甲状腺手术患者全身麻醉拔管反应的影响.方法 择期全凭静脉麻醉下行甲状腺手术患者42例,ASA分级Ⅰ~Ⅱ级,按随机数字表法将患者分为两组:右美托咪定组和对照组,每组21例.两组麻醉诱导和维持相同,右美托咪定组于麻醉诱导前15 min静脉泵注右美托咪定0.6μg/kg( 10 min泵注完毕),术中继之以0.4μg/(kg·h)持续泵注;对照组以同样方式泵注等量0.9%氯化钠.记录患者收缩压、舒张压和心率变化,手术时间,苏醒时间,拔管时间,定向力恢复时间,恢复至Aldrete改良评分≥9分时间,苏醒时耐管评分,苏醒期躁动率及不良反应.结果 两组患者手术时间、苏醒时间、拔管时间、定向力恢复时间和恢复至Aldrete改良评分≥9分时间比较差异无统计学意义(P>0.05).右美托咪定组拔管即刻及拔管后1、3、5 min时收缩压、舒张压、心率低于同时点对照组(P< 0.05或<0.01).右美托咪定组患者苏醒时耐管评分优良率[95.2%(20/21)]明显高于对照组[28.6% (6/21)] (P< 0.05),苏醒期躁动率(0)明显低于对照组[28.6%(6/21) ](P< 0.05).两组苏醒期均无不良反应发生.结论 麻醉诱导前静脉泵注右美托咪定0.6μg/kg( 10 min泵注完毕),术中继之以0.4μg/(kg·h)持续泵注可有效降低甲状腺手术患者拔管期的心血管反应,增强患者气管导管耐受性,降低患者苏醒期躁动率,有利于患者平稳舒适苏醒.%Objective To investigate the effect of dexmedetomidine on tracheal extubation response in patients undergoing thyroid surgery after general anesthesia.Methods Forty-two patients who ASA classification Ⅰ - Ⅱ,were performed thyroid surgery under total intravenous anesthesia.They were divided into dexmedetomidine group and control group by random number table with 21 cases each.Both groups patients anesthesia induction and maintenance with the same methods,dexmedetomidine group

  9. [Clinical utility of thoracoscopy under local anesthesia].

    Science.gov (United States)

    Ishii, Yoshiki

    2007-07-01

    Thoracoscopy has been recently established as an indispensable technique for diagnosis and treatment of respiratory diseases. Although, thoracoscopy is usually applied under general anesthesia by a surgeon, it can also be applied by a chest physician under local anesthesia if the target is limited to pleural diseases. The main objective of medical thoracoscopy under local anesthesia is to establish a diagnosis of pleural effusions by means of observation and biopsy in the thoracic cavity. Our main target diseases are the pleuritis carcinomatosa, malignant mesothelioma and tuberculous pleuritis. These 3 diseases are the diseases with which medical thoracoscopy is most useful because they can be reliably diagnosed by biopsies and because early diagnosis and early treatment are essential. In case of the pneumothorax, treatment with bulla looping or cauterization may be possible, but we do not treat pneumothorax with medical thoracoscopy because it is impossible to approach and find air leaks of lesions located in or near blind spots such as the apex or mediastinal part In case of acute emphysema, it is important to release adhesions and perform effective drainage using thoracoscopy as soon as possible since deposition of fibrin tends to form quickly compartments that make drainage difficult. Scince medical thoracoscopy under local anesthesia is rapid, easy, safe, and well-tolerated procedure with an excellent diagnostic yield, it is recommended as a diagnostic procedure for cases with pleural diseases.

  10. Outpatient varicocelectomy performed under local anesthesia

    Institute of Scientific and Technical Information of China (English)

    Geng-Long Hsu; Pei-Ying Ling; Cheng-Hsing Hsieh; Chii-Jye Wang; Cheng-Wen Chen; Hsien-Sheng Wen; Hsiu-Mei Huang; E. Ferdinand Einhorn; Guo-Fang Tseng

    2005-01-01

    Aim: To report a series of varicocelectomy performed under pure local anesthesia. Methods: From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale (VAS)was used to assess whether the pain level was acceptable. Results: The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % (567/575) of men could go back to work by the end of the first post-operative week and only 8 (1.4 %) men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of (18.5 ± 11.3) mm that was regarded as tolerable. Conclusion: This study has shown varicocelectomy under local anesthesia to be possible,simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.

  11. Anesthesia for thoracoscopic surgery

    OpenAIRE

    Conacher I

    2007-01-01

    Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therape...

  12. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  13. 异病酚静脉全麻下复合氯胺酮或曲马多行纳屈酮快速阿片脱毒的效果比较%The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

    Institute of Scientific and Technical Information of China (English)

    黄位耀; 肖晓山; 刘瑛; 廖秀清; 周代伟; 戴航

    2002-01-01

    Objective To release the heroin addicts' sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia. Method 160 volunteers were divided at random into two groups:Group A were performed under the combined anesthesia with propofol, midazolam and ketamine,Group B were performed under the combined anesthesia with propofol with midazolam and tramadol. The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirst, sleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much difference between group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days. Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious. The tramadol is better than others.

  14. Application of OPLER laryngeal mask in elderly patients undergoing general anesthesia operation%欧普乐喉罩在老年患者全麻手术中的应用分析

    Institute of Scientific and Technical Information of China (English)

    苗秀娟

    2014-01-01

    Objective To assess the application of OPLER laryngeal mask in elderly patients undergoing general an -esthesia.Methods Seventy-two ASASⅡ-Ⅲpatients aged 70-83 years (40 men and 32 women) requiring abdomi-nal surgery under general anesthesia were randomly divided into two groups , according to their treatment of tracheal intu-bation (group B, n=32) and laryngeal mask (group H, n=40).All patients were intravenously administrated with 1.5 mg/kg propofol, 4 μg/kg fentanyl, and 0.6 mg/kg rocuronium bromide for anesthesia induction .Then, the heart rate (HR), pulse oxygen saturation (SpO2), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure ( MAP) were measured before/after anesthesia induction , and when intubation and extubation were per-formed.Also, the airway pressure (Ppeak), end-tidal carbon dioxide (ETCO2) and the number of patients complai-ning postoperative throat pain were recorded .Results No significant differences were found as to blood pressure and heart rate in both groups before and after anesthetic induction (P>0.05).However, significant differences were seen during intubation and before and after extubation (P<0.01).Both groups were able to complete operation , with 12 ca-ses of postoperative throat pain in group B and simply 2 cases of throat discomfort in group H .Conclusion The applica-tion of laryngeal mask in elderly patients for general anesthesia is safe and can significantly reduce the rates of cardiovas -cular adverse reaction , with less complications .%目的:探讨欧普乐喉罩在老年患者全麻手术中的应用效果。方法 ASA Ⅱ-Ⅲ级、拟在全麻下实施腹部手术的患者共72例,随机分为气管插管全麻组( B组,32例)和喉罩全麻组( H组,40例)。2组均静脉给予丙泊酚1.5 mg· kg-1、芬太尼4μg· kg-1、罗库溴铵0.6 mg· kg-1进行麻醉诱导,B组气管插管,H组置入OPLAC-LMA喉罩,观察2组患者在麻醉诱导前后、插

  15. Safe Anesthesia For Every Tot

    DEFF Research Database (Denmark)

    Weiss, Markus; Vutskits, Laszlo; Hansen, Tom G

    2015-01-01

    PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus...... on the safe conduct of pediatric anesthesia. This initiative aims to provide guidance on markers of quality anesthesia care. The introduction and implementation of national regulations of 'who, where, when and how' are required and will result in an improved perioperative outcome in vulnerable children....... The improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps...

  16. A comparison of between hyomental distance ratios, ratio of height to thyromental, modified Mallamapati classification test and upper lip bite test in predicting difficult laryngoscopy of patients undergoing general anesthesia

    Directory of Open Access Journals (Sweden)

    Azim Honarmand

    2014-01-01

    Full Text Available Background: Failed intubation is imperative source of anesthetic interrelated patient′s mortality. The aim of this present study was to compare the ability to predict difficult visualization of the larynx from the following pre-operative airway predictive indices, in isolation and combination: Modified Mallampati test (MMT, the ratio of height to thyromental distance (RHTMD, hyomental distance ratios (HMDR, and the upper-lip-bite test (ULBT. Materials and Methods: We collected data on 525 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all four factors before surgery. A skilled anesthesiologist, not imparted of the noted pre-operative airway assessment, did the laryngoscopy and rating (as per Cormack and Lehane′s classification. Sensitivity, specificity, and positive predictive value for every airway predictor in isolation and in combination were established. Results: The most sensitive of the single tests was ULBT with a sensitivity of 90.2%. The hyomental distance extreme of head extension was the least sensitive of the single tests with a sensitivity of 56.9. The HMDR had sensitivity 86.3%. The ULBT had the highest negative predictive value: And the area under a receiver-operating characteristic curve (AUC of ROC curve among single predictors. The AUC of ROC curve for ULBT, HMDR and RHTMD was significantly more than for MMT (P 0.05. Conclusion: The HMDR is comparable with RHTMD and ULBT for prediction of difficult laryngoscopy in the general population, but was significantly more than for MMT.

  17. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  18. Anesthesia for Adults Having Eye Surgery

    Science.gov (United States)

    ... Condiciones Chinese Conditions Anesthesia for Adults Having Eye Surgery En Español What kinds of anesthesia are available for adults having eye surgery? A “general”, “local”, or “topical” anesthesia is necessary ...

  19. The influence of various anesthesia techniques on postoperative recovery and discharge criteria among geriatric patients

    Directory of Open Access Journals (Sweden)

    Dilsen Ornek

    2010-01-01

    Full Text Available OBJECTIVE: We aim to compare selective spinal anesthesia and general anesthesia with regard to postoperative recovery and fast-track eligibility in day surgeries. MATERIALS AND METHOD: Sixty geriatric outpatient cases, with ASA II-III physical status and requiring shortduration transurethral intervention, were enrolled in the study. The cases were split into 2 groups: as general anesthesia (Group GA and selective spinal anesthesia (Group SSA. Group GA (n = 30 received propofol 2 mg kg-1 (until loss of eyelash reflex, remifentanil induction 0.5-1 µg kg-1, and laryngeal mask. Maintenance was achieved by 4-6% desflurane in 60% N2O and 40% O2 along with remifentanil infusion at 0.05 µg /kg-1 /min-1. Drugs were discontinued after the withdrawal of the ureteroscope, and extubation was carried out with 100% O2. Group SSA (n = 30 received 0.5% spinal anesthesia via L4-5 space by 0.5% hyperbaric bupivacaine 5 mg. Anesthesia preparation time, time to surgical anesthesia level, postoperative fast-tracking, and time to White-Song recovery score of 12, were noted. In the operating room, we evaluated hemodynamics, nausea/vomiting, surgeon and patient satisfaction with anesthesia, perioperative midazolam-fentanyl administration, postoperative pain, and discharge time. RESULTS: Anesthesia preparation time, length of surgery, anesthesia-related time in the operating room, time to sit, and time to walk were significantly low in Group GA (p < 0.05, whereas time to fast-track eligibility, length of stay in the PACU, discharge time, and other parameters were similar in both of the groups. CONCLUSION: While anesthesia preparation time, length of surgery, start time of surgery, time to sit, and time to walk were shorter in the General Anesthesia group, time to fast-track eligibility, phase 1 recovery time, and discharge time were similar among patients subjected to selective spinal anesthesia.

  20. Sleep Apnea and Total Joint Arthroplasty under Various Types of Anesthesia

    Science.gov (United States)

    Memtsoudis, Stavros G.; Stundner, Ottokar; Rasul, Rehana; Sun, Xuming; Chiu, Ya-Lin; Fleischut, Peter; Danninger, Thomas; Mazumdar, Madhu

    2014-01-01

    Background and Objectives The presence of sleep apnea (SA) among surgical patients has been associated with significantly increased risk of perioperative complications. Although regional anesthesia has been suggested as a means to reduce complication rates among SA patients undergoing surgery, no data are available to support this association. We studied the association of the type of anesthesia and perioperative outcomes in patients with SA undergoing joint arthroplasty. Methods Drawing on a large administrative database (Premier Inc), we analyzed data from approximately 400 hospitals in the United States. Patients with a diagnosis of SA who underwent primary hip or knee arthroplasty between 2006 and 2010 were identified. Perioperative outcomes were compared between patients receiving general, neuraxial, or combined neuraxial-general anesthesia. Results We identified 40,316 entries for unique patients with a diagnosis for SA undergoing primary hip or knee arthroplasty. Of those, 30,024 (74%) had anesthesia-type information available. Approximately 11% of cases were performed under neuraxial, 15% under combined neuraxial and general, and 74% under general anesthesia. Patients undergoing their procedure under neuraxial anesthesia had significantly lower rates of major complications than did patients who received combined neuraxial and general or general anesthesia (16.0%, 17.2%, and 18.1%, respectively; P = 0.0177). Adjusted risk of major complications for those undergoing surgery under neuraxial or combined neuraxial-general anesthesia compared with general anesthesia was also lower (odds ratio, 0.83 [95% confidence interval, 0.74–0.93; P = 0.001] vs odds ratio, 0.90 [95% confidence interval, 0.82–0.99; P = 0.03]). Conclusions Barring contraindications, neuraxial anesthesia may convey benefits in the perioperative outcome of SA patients undergoing joint arthroplasty. Further research is needed to enhance an understanding of the mechanisms by which neuraxial

  1. Application of remifentanil combined with propofol of general anesthesia for cesarean section%丙泊酚联合瑞芬太尼在剖宫产全身麻醉中的应用

    Institute of Scientific and Technical Information of China (English)

    屈军; 刘晖; 刘锦

    2011-01-01

    目的 探讨丙泊酚联合瑞芬太尼在全身麻醉下剖宫产术中的应用价值.方法 选择足月单胎剖宫产术不适宜常规椎管内麻醉的孕妇151例,分为观察组(n=76)和对照组(n=75),观察组给予异丙酚1.5 mg·kg-1、瑞芬太尼1.0μg·kg-1、阿曲库胺0.8 mg·kg-1,缓慢静脉推注,术中以瑞芬太尼和丙泊酚靶控泵入维持;对照组给予丙泊酚1.5 mg·kg-1、芬太尼1.0~2.0μg·kg-1、阿曲库胺0.8 mg·kg-1,缓慢静脉推注,术中以丙泊酚靶控泵入和间断静脉推注芬太尼维持;2组均面罩给氧3 min后气管插管,比较2组产妇术中心率和平均动脉压(MAP)的变化及2组新生儿Apgar评分.结果 观察组诱导时、诱导后3 min、胎儿娩出时、胎儿娩出后5 min产妇MAP与术前比较,差别无统计学意义(P>0.05);对照组胎儿娩出时、胎儿娩出后5 min产妇MAP低于术前(P<0.05).观察组诱导时、胎儿娩出时产妇心率较术前加快(P<0.05),诱导后3 min、胎儿娩出后5 min产妇心率与术前比较,差别无统计学意义(P>0.05);对照组诱导时、胎儿娩出时、胎儿娩出后5 min产妇心率较术前加快(P<0.05).对照组在胎儿娩出时和胎儿娩出后5 min产妇的MAP明显低于观察组(P<0.05);对照组在诱导时、胎儿娩出时和胎儿娩出后5 min,产妇的心率明显快于观察组(P<0.05).观察组新生儿出生5 min时Apgar评分高于对照组(P<0.05).结论 对于存在椎管内麻醉禁忌证的产妇,应用丙泊酚联合瑞芬太尼实施全身麻醉,对产妇的循环功能影响较小,同时对新生儿Apgar评分无明显影响.%Objective To discuss the application of remifentanil combined with propofol of general anesthesia for cesarean section. Methods One hundred and fifty-one expectant mother with full-term single tire cesarean section not suitable for conventional spinal canal anesthesia were divided into observation group ( n = 76 ) and control group (n = 75). The observation

  2. Effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. A randomized, placebo controlled pilot study.

    Science.gov (United States)

    García-Navia, Jusset Teresa; Tornero López, Javier; Egea-Guerrero, Juan José; Vilches Arenas, Angel; Vázquez Gutiérrez, Tiburcio

    2016-01-01

    Introducción y objetivos del estudio: existe evidencia de que la administracion perioperatoria de ketamina y lidocaina intravenosa reduce el dolor y el consumo de opioides postoperatorio, acorta la estancia hospitalaria y acelera la recuperacion de la funcion intestinal. Sin embargo, no se han estudiado los efectos beneficiosos en el periodo intraoperatorio. El objetivo de este estudio fue evaluar el efecto de una unica dosis de lidocaina y ketamina sobre el consumo intraoperatorio de opioides en pacientes sometidas a cirugia ginecologica electiva bajo anestesia general. Material y métodos: estudio prospectivo, aleatorizado, doble ciego, controlado con placebo en un solo centro. Se incluyeron 33 pacientes (11 en el grupo ketamina, 11 en el grupo lidocaina y 11 en el grupo placebo). Para la analgesia postoperatoria se utilizo una bomba PCA (Analgesia Controlada por el Paciente ) de morfina. Los pacientes fueron asignados al azar a uno de los tres grupos de estudio: 1,5 mg/kg de lidocaina al 2%, 0,5 mg/kg de ketamina al 5% o solucion salina 0.9%. La variable principal del estudio fue el consumo de opioides durante la cirugia. Las variables secundarias fueron: tiempo de educcion de la anestesia, intensidad del dolor, consumo de opioides en las 24 horas posteriores a la cirugia y efectos adversos. Resultados: se observo una disminucion del consumo intraoperatorio de opioides en los grupos ketamina (402,3 } 106,3) y lidocaina (397,7 } 107,5) frente al grupo placebo (561,4 } 97,1); p = 0,001. Se encontro una correlacion positiva entre el consumo intraoperatorio de opioides y el tiempo de despertar (r = 0,864, p.

  3. 采用七氟烷或丙泊酚/瑞芬太尼全身麻醉行妇科手术临床研究%Clinical study of sevoflurane or propofol/remifentanil general anesthesia undergoing gynecological surgery

    Institute of Scientific and Technical Information of China (English)

    吴迪

    2014-01-01

    Objective To study the effect of sevoflurane or propofol/remifentanil general anesthesia undergoing gynecological surgery.Methods A total of 80 patients scheduled for selected gynecological surgery were divided into sevoflurane group or propofol/remifentanil group by random digits table method and 40 cases in each group.The induction of anesthesia was conducted with midazolam,propofol,sulfentanil,and rocuronium.After tracheal intubation,anesthesia was maintained with sevoflurane in sevoflurane group,and with propofol/remifentanyl target-controlled infusion in propofol/remifentanil group.Bispectral index was monitored in each group,and which was maintained 40-60.Blood pressure and heart rate was observed.At the end of operation,all anesthetics were discontinued,and the time of consciousness recovery,tracheal extubation,orientation was recorded.The incidence of agitation,nausea and vomiting within 24 h after surgery and the use of rescue drugs such as epinephrine,atropine or urapidil was recorded.Results No statistically significant difference was observed with respect to the time of consciousness recovery,tracheal extubation,orientation between two groups (P > 0.05).The use of atropine and epinephrine in sevoflurane group was lower than that in propofol/remifentanil group [7.5%(3/40) vs.22.5%(9/40),20.0%(8/40) vs.32.5%(13/40)],and there was significant difference(P < 0.05),and the use of urapidil in sevoflurane group was higher than that in pmpofol/remifentanil group [22.5% (9/40) vs.2.5% (1/40)],and there was significant difference (P < 0.01).There was no statistically significant differences with respect to the incidence of agitation,nausea and vomiting within 24 h after surgery between two groups (P >0.05).Conclusion Propofol/remifcntanil and sevoflurane both provide satisfactory anesthesia for gynecological surgery.%目的 观察七氟烷吸入麻醉或丙泊酚/瑞芬太尼全凭静脉麻醉行妇科手术的临床麻醉效果.方法 80例

  4. Delayed emergence after anesthesia.

    Science.gov (United States)

    Tzabazis, Alexander; Miller, Christopher; Dobrow, Marc F; Zheng, Karl; Brock-Utne, John G

    2015-06-01

    In most instances, delayed emergence from anesthesia is attributed to residual anesthetic or analgesic medications. However, delayed emergence can be secondary to unusual causes and present diagnostic dilemmas. Data from clinical studies is scarce and most available published material is comprised of case reports. In this review, we summarize and discuss less common and difficult to diagnose reasons for delayed emergence and present cases from our own experience or reference published case reports/case series. The goal is to draw attention to less common reasons for delayed emergence, identify patient populations that are potentially at risk and to help anesthesiologists identifying a possible cause why their patient is slow to wake up.

  5. Nurse anesthesia and multiculturalism.

    Science.gov (United States)

    Horton, B J; Waugaman, W R

    1996-01-01

    Program directors from 90 accredited nurse anesthesia programs in the United States and Puerto Rico were surveyed concerning multicultural issues. This article summarizes the identified needs of clients and student nurse anesthetists from culturally diverse backgrounds. Noteworthy findings include the perception that clients were more disadvantaged than students because of differences in socioeconomic status; the fact that about half of the programs provided students with instruction on cultural differences; and the observation that specific units of instruction within courses were the most frequent way of giving instruction in this subject area.

  6. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I

    2007-01-01

    Full Text Available Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therapeutic for thoracotomy. Perioperative management needs to reflect the concern for these complex, and complicating, processes to the morbidity of thoracoscopic surgery.

  7. Anesthesia and pulmonary hypertension.

    Science.gov (United States)

    McGlothlin, Dana; Ivascu, Natalia; Heerdt, Paul M

    2012-01-01

    Anesthesia and surgery are associated with significantly increased morbidity and mortality in patients with pulmonary hypertension due mainly to right ventricular failure, arrhythmias, postoperative hypoxemia, and myocardial ischemia. Preoperative risk assessment and successful management of patients with pulmonary hypertension undergoing cardiac surgery involve an understanding of the pathophysiology of the disease, screening of patients at-risk for pulmonary arterial hypertension, analysis of preoperative and operative risk factors, thorough multidisciplinary planning, careful intraoperative management, and early recognition and treatment of postoperative complications. This article will cover each of these aspects with particular focus on the anesthetic approach for non-cardiothoracic surgeries.

  8. Anesthesia for geriatric patients.

    Science.gov (United States)

    Deiner, S; Silverstein, J H

    2011-02-01

    The number of elderly surgical patients will be increasing in Italy. Slowly, anesthesiologists are developing the expertise to care for these patients. The information available to apply to these cases is now the topic of a number of anesthesia textbooks dedicated to the elderly. In this article, we review some of the more recent findings and provide some tips to help guide the care of elderly patients. It is hoped that practitioners will use this information to improve the care of these patients and conduct additional research to further improve care in the future.

  9. [Anesthesia and bodybuilding].

    Science.gov (United States)

    Hokema, Frank; Pietsch, Uta-Carolin; Führer, Dagmar; Kaisers, Udo

    2008-05-01

    A strong tendency toward body enhancement and body forming in western industrial societies makes it more likely for each anesthesiologist to get involved in the care of bodybuilders. These patients quite frequently consume androgenic anabolic steroids, human growth hormone and other drugs or substances which are believed to accelerate muscle gain. Cardiovascular, hepatic, psychiatric, hormonal and infectious side effects or complications are common and rarely monitored by health care professionals. The anesthesia risk is not exactly known but seems to be determined mainly by cardiovascular events like myocardial ischemia and dysrhythmias.

  10. [Evaluation of muscle relaxant requirement for hospital anesthesia].

    Science.gov (United States)

    Shchegolev, A V; Levshankov, A I; Bogomolov, B N; Pereloma, V I; Dumnov, A G

    2013-03-01

    The rationale for cost-effectiveness of modern muscle relaxants (MR) administration in general anesthesia was evaluated. New MRs are more expensive than traditionally used pipecuronium and succinylcholine. However, the old MRs are often required as a block reversion with anticholinesterase medicines at the end of surgery, the longer artificial lung ventilation and observation in patients during recovery in intensive care unit. It was found that the district military hospital had done an annual average of about 900 general anesthesia assisted with artificial ventilation and muscle relaxation. About 2% of all anesthesias accrue to short-term anesthesia, the 27% to medium-term and 71% to long-term. 81% of the medium-term anesthesia accrue small hospitals. According to cost/effectiveness the most optimal muscle relaxants administration scheme for short-term (up to 30 min) anesthesia was mivacurium, for the operation of medium duration (30-120 min)--rocuronium, for long-term (120 min)--pipecuronium. An electronic form of annual report, which allows to obtain the necessary data for calculation of annual muscle relaxants demand and costs both in hospital and in the whole of the armed forces quickly, was developed.

  11. Narcotrend用于全麻手术期间麻醉深度监测的临床评价%The application of Narcotrend in the monitoring of general anesthesia

    Institute of Scientific and Technical Information of China (English)

    徐忠厚; 郑立东; 李家宽

    2014-01-01

    Objective:To evaluate the accuracy and practicability of Narcotrend ( NT ) in the monitoring of general anesthesia. Methods:Forty patients with grade Ⅰ-IIASA were randomly divided into the observation group and control group ( 20 cases each group). The drug in observation group was adjusted according to the anesthetic depth detected by NT,the drug in control group was adjusted according to the clinical experience. The levels of MAP,ECG and HR were observed,the drug use and awakening time were recorded. Results:The differences of MAP and HR on the time-point of skin incision ( T4 ) , operating ( T5 ) , end of surgery ( T6 ) and going out the operation room(T7) between observation group and control group were statistically significant(P0. 05). The awakening and extubation time in observation group were shorter than those in control group(P0.05);观察组的苏醒时间和拔管时间均短于对照组(P<0.05);观察组无一例发生术中知晓,对照组有1例发生术中知晓。结论:NT能较好地反映全麻手术患者镇静深度变化,有助于判断全麻深度,指导个体化麻醉用药,提高麻醉质量。

  12. Anesthesia Technique In A Patient With Langerhans Cell Histiocytosis For Diagnostic Biopsy

    Directory of Open Access Journals (Sweden)

    Abdi S

    2005-07-01

    Full Text Available Histiocytosis under general anesthesia. In these patients, depend on organs involvement and dysfunction, anesthesia technique and specific drugs should be selected.of langerhans cells consist of a range of clinical manifestations, including bone eosimophilic granuloma, Hand-Schuller-Chiristian syndrome and Letterer-Siwe disease. Definitive diagnosis is based on biopsy of involved tissues. This report describes anesthesia technique in a 2 years old girl for diagnostic biopsy

  13. 无肌松药全身麻醉下进行骨科手术的临床对照试验%Controlled clinical trials of orthopedic surgery under general anesthesia without muscle relaxants

    Institute of Scientific and Technical Information of China (English)

    徐成明; 李玉兰; 刘映龙; 吕兴华; 万占海

    2012-01-01

    目的 比较使用和不使用神经肌肉阻滞药全身麻醉下进行部分骨科手术的优缺点.方法 76例ASAⅠ或Ⅱ级骨科手术患者,随机分为试验组(T组)、对照组(C组)各38例.使用琥珀酰胆碱诱导后,T组只用丙泊酚、瑞芬太尼维持麻醉,C组按常规使用阿曲库铵.术中维持脑电双频指数(BIS值)在30~60之间,记录两组患者麻醉前,诱导后,切皮时,术后30、60 min和拔管后的BIS值和四个成串刺激比(T4/T1,TOFr),比较两组丙泊酚和瑞芬太尼用量、睁眼时间、拔管时间、术后20 min警觉与镇静评分(OAA/S)及不良反应,术后请外科医师评价肌松效果.结果 两组患者瑞芬太尼用量、外科肌松评价、术中体动次数、血管活性药使用次数无显著差异;T组插管后各时点TOFr均显著高于C组(P < 0.01),丙泊酚用量多于C组(P < 0.05),睁眼时间、拔管时间明显短于C组(P < 0.05),拔管后BIS值显著高于C组(P < 0.05),术后20 min OAA/S评分明显低于C 组(P < 0.05).结论 无肌松药全身麻醉下进行骨科手术比使用者呼吸恢复早,拔管快,清醒程度好,具有显著优势.%Objective To compare the efficacy of general anesthesia with and without muscle relaxant on orthopedic surgery. Methods 76 ASA I or II adults underwent elective orthopedic surgery were randomly divided into 2 groups: trial group (group T) and control group (group C), with 38 cases in each group. General anesthesia was induced with Midazolam, Fentanyl, Propofol and Succinylcholine, and maintained with Propofol and Remifentanil at BIS level 30 to 60. After induction, Atracurium was used in group C but not in group T. BIS and TOFr at baseline, after induction, at skin incision, 30 min and 60 min after skin incision and at extubation were recorded. The dosage of Propofol and Remifentanil, eye-opening time, extubation time and OAA/S scale 20 min after extubation and possible adverse reaction were compared. The muscle relaxation

  14. 抗NMDA受体脑炎患者卵巢囊肿剔除术的麻醉处理%Anesthetic management for ovarian cystectomy in patients with anti-N-methyl-D-aspartate receptor encephalitis undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈雯; 桑诺尔; 罗爱伦; 黄宇光

    2014-01-01

    Objective Anti-N-methyl-D-Aspartate (NMDA) receptor encephalitis is a rare disease,recently described as autoimmune disorder of paraneoplastic limbic encephalitis,which is related to the NMDA receptor antibodies and frequently develops in young women with ovarian teratoma.The disease is usually accompanied by symptoms of psychosis and abnormal behaviors,autonomic nervous system dysfunction,central hypoventilation,and hyperthermia.During induction and maintenance of general anesthesia,we should be aware of adverse reactions such as cardiovascular events,hyperthermia and respiratory insufficiency.In order to maintain vital signs stable,pharmacological agents including vasopressors,β-blockers,antihypertensives,and anticholinergics should be prepared before the surgery.Invasive monitoring for blood pressure can be set if necessary.This study described the method for anesthetic management of 3 patients with anti-NMDA receptor encephalitis undergoing resection of ovarian teratoma under general anesthesia.Preoperative treatment included antipsychotic,anti-infective and immune therapy.General anesthesia was induced with propofol,rocuronium,fentanyl and midazolam to facilitate tracheal intubation and was maintained with inhalation of sevoflurane (mixed with oxygen and air) and intermittent iv boluses of fentanyl and rocuronium during the surgery.All the drugs mentioned above had no interaction or had slight indirect action on anti-NMDA receptors to avoid NMDA-related adverse reactions.In conclusion,the adequate preparation for the surgery should be done in this kind of patients,we should avoid using anesthetics having NMDA receptor antagonism (such as ketamine,N2O,methadone,dextromethorphan,phencyclidine) or other anesthetics acting indirectly (such as pentobarbital) on the NMDA receptors during anesthetic management in the patients with anti-NMDA receptor encephalitis.%目的 抗NMDA受体脑炎是一种与抗NMDA受体抗体相关的、自身免疫性副肿瘤边缘叶

  15. Distribution of pathogens causing postoperative infections in acute intracerebral hemorrhage patients undergoing general anesthesia%急性脑出血全麻患者术后感染病原菌分析

    Institute of Scientific and Technical Information of China (English)

    陈洁; 王光磊; 王云; 张智卿; 白延仓

    2016-01-01

    OBJECTIVE To analyze the pathogen distribution and its effect on recognition function in acute intrace‐rebral hemorrhage patients with general anesthesia ,so as to provide reference for clinical treatment .METHODS A total of 170 cases of patients got infections after general anesthesia operation for the acute intracerebral hemorrhage in our hospital from Sep .2012 to Sep .2014 were enrolled as infected group .Another 170 cases of healthy subjects at the same period in our hospital were taken as control group .And another 170 cases of uninfected patients after general anesthesia operation for acute intracerebral hemorrhage were taken as uninfected group .The changes of recognition function , serum fibroblast growth factor and inflammatory factors were compared in these three groups .RESULTS A total of 170 strains of pathogens were isolated from the 170 cases of patients ,including 77 (45 .3% ) strains of gram‐positive bacteria ,mainly Staphylococcus aureus 18 (10 .6% ) strains , Staphylococcus saprophyticus 12(7 .1% ) strains ,and Enterococcus f aecalis 11(6 .5% ) strains .There were 93 (54 .7% ) strains of gram‐negative bacteria ,including Pseudomonas aeruginosa 18 (10 .6% ) strains , Enterobacter aerogenes 17 (10 .0% ) strains ,and Neisseria meningitides 16(9 .4% ) strains .The MMSE scores of infected patients were de‐creased obviously ,and catalase and superoxide dismutase in serum were lower than control group and uninfected group obviously ,but MDA ,IL2 ,IL10 and TNF‐α were increased significantly compared with control and unin‐fected groups (P<0 .05) .CONCLUSION There is big chance for acute intracerebral hemorrhage patients got infec‐ted ,and which could influence the cognition function of patients .%目的:研究急性脑出血全麻患者术后感染病原菌分布及对患者认知功能的影响,为临床治疗提供参考。方法选取医院2012年9月-2014年9月诊治的170例急性脑出血全麻术后感

  16. Colorectal Surgery in Patients with General Anesthesia the Incidence of Muscle Relaxant Residual after Extubation and its Countermeasures%结直肠手术患者全麻拔管后肌松残余发生率及其应对措施

    Institute of Scientific and Technical Information of China (English)

    陈晓峰; 刘学连; 王淑荣; 魏玲; 马显亮; 史学梅

    2015-01-01

    Objective To study the patients with colorectal surgery the incidence of muscle relaxant residual after general anesthesia and its countermeasures.Methods Our hospital 100 cases of colorectal patients under general anesthesia to collate data analysis colorectal surgery, using neuromuscular monitoring and assessment of the patient monitoring NMB incidence of residual NMB and analyzing the prevention of postoperative residual NMB measures to patients.Results Postoperatively in patients with colorectal surgery anesthesia with objective evaluation method of the incidence of muscle relaxant residual after extubation was 63%, the residual group with the muscle relaxant residual muscle relaxant in patients' body quality, age, type of nondepolarizing agent has more significant difference (P<0.05); should pay attention to during the process of surgery anesthesia management, maximum limit reduce the incidence of postoperative muscle relaxant residual, prevent the occurrence of complications.Conclusion Patients with colorectal surgery anesthesia significantly higher incidence of postoperative residual of muscle relaxant, so pay attention to the patients in the process of surgery anesthesia management, strengthen the monitoring.%目的:探讨结直肠手术患者全麻拔管后肌松残余的发生率及其应对措施。方法将我院100例全身麻醉结直肠手术患者资料进行整理分析,同时使用肌松监测仪监测肌松及评估患者肌松残余的发生率,并分析预防患者出现术后肌松残余的措施。结果结直肠手术全麻患者术后用客观评估法拔管后肌松残余的发生率为63%,肌松残余组与非肌松残余组在患者体质量、年龄、肌松剂类型方面比较有显著差别(P<0.05);手术过程中要注意麻醉管理,最大限度降低术后肌松残余发生率,防止并发症的发生。结论结直肠手术全麻患者术后肌松残余的发生率明显升高,所以要注意患者手术过

  17. Anesthesia and cor triatriatum

    Directory of Open Access Journals (Sweden)

    Federica Scavonetto

    2014-01-01

    Full Text Available Aims and Objectives: Cor triatriatum sinistrum (CTS and cor triatriatum dextrum (CTD are rare congenital anomalies characterized by the presence of a perforated septum which divides the respective atrium into a proximal and distal chamber. This report reviews the perioperative course of patients with uncorrected cor triatriatum (CT undergoing procedures requiring anesthesia. In addition, we performed a literature search that examines the experience of others regarding the peri-operative course of patients with CT. Materials and Methods: A computerized search of a medical record database was conducted to identify patients with a clinical diagnosis of uncorrected CTD and CTS undergoing surgical procedures. Descriptive statistics were used. Results: We identified 12 adult patients with asymptomatic CTS (n = 7 and CTD (n = 5 who underwent 23 anesthetics. There were no perioperative complications which could be attributed directly to the anatomy of CT. Conclusions: Our observation and review of the literature suggest that patients with asymptomatic CT typically tolerate anesthesia and surgical procedures well.

  18. Influence of general anesthesia combined with epidural block on gas exchang during one-lung ventilation in patients undergoing thoracic surgery%硬膜外阻滞复合全麻对单肺通气期间气体交换的影响

    Institute of Scientific and Technical Information of China (English)

    赵念峰; 杨建香; 刘功俭

    2008-01-01

    Objective To evaluate the effects of general anesthesia combined with throacic epidural block on pulmonary gas ex-change during one-lung ventilation in patients undergoing thoracic surgery. Methods Eighty patients of ASA Ⅰ-Ⅱ undergoing electivethroacic surgery were randomly divided into two Groups (n = 40 ) receiving combined genera] anesthesia with throacic epidural block(group A ) or general anesthesia (group B ). MAP, HR, SpO2, PETCO2, VT, Paw were monitored at both bronps. Arterial andmixed vein blood gas were analyzed and Qs/Qt ,A-aDO2,Vd/Vt were calculated in both groups at 20 rain ( T1 ) before one-lung ventila-tion and 30 min( T2 ), 60 min( T3 ), as well as 120 min ( T4 ) after one-lung ventilation. Results In both groups, Paw and Qs/Qt in-creased while PaO2 decreased significantly at T2-4, ( P0.05);与B组相比,A组T2-4时的Qs/Qt增加(P0.05).结论 单肺通气期间硬膜外阻滞复合全麻对肺换气功能有影响,使Qs/Qt增加,PaO2下降,A-aDO2增大;对肺泡通气功能指标Vd/Vt影响甚微.

  19. 右旋美托咪啶对患者镇静效应和血流动力学的影响%Effect of dexmedetomidine on depth of sedation and hemodynamics in patients undergoing general anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈华永; 李丽; 张敬

    2015-01-01

    目的 探讨脑电双频指数(BIS)监测下右旋美托咪啶(Dex)对患者的镇静效应及血流动力学的影响.方法 选取潍坊医学院附属益都中心医院自2011年9月至2013年8月择期行全麻手术的胶质瘤患者80例,分为Dex组(45例)和对照组(35例).Dex组患者术前静脉注射0.4μg/kg Dex,5 min内注射完毕后以每小时0.4 μg/kg维持静脉滴注30 min;对照组患者以同样的方式注射等量生理盐水.2组患者的其他麻醉诱导、麻醉维持用药相同.记录2组患者注射Dex前(T0)、注射后即刻(T1)及静脉滴注后10 min(T2)、20 min(T3)和30 min(T4)的BIS值、心率(HR)、收缩压(SBP)、舒张压(DBP),并对患者进行警觉/镇静评分(OAA/S)、Ramesay镇静评分.结果 与对照组比较,Dex组患者T1、T2、T3和T4时的BIS和OAA/S评分较低、Ramsay评分较高,差异均有统计学意义(P<0.05).与对照组比较,Dex组患者T1、T2、T3、T4时的HR较慢、T1、T2时的SBP较高,差异有统计学意义(P<0.05).2组患者T3、T4时的SBP及T1、T2、T3、T4时的DBP比较差异均无统计学意义(P>0.05).结论 静脉注射Dex可使清醒患者产生明显的镇静效应,加深麻醉手术患者的麻醉深度,引起HR减慢.%Objective To discuss the effect ofdexmedetomidine (Dex) on depth of sedation and hemodynamics in patients undergoing general anesthesia with monitor of bispectral index.Methods Eighty patients with gliomas,admitted to our hospital from September 2011 to August 2013 and accepted surgery under general anaesthesia,were randomly divided into Dex group and control group (n=45).Patients from the Dex group received intravenous injection of 0.4 μg/kg before operation;and 5 min after that,Dex at a loading dose of 0.4 μg/kg was given for 30 min;and 0.9% normal saline was given to the control group.The bispectral index (BIS),heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),observer assessment of alertness/sedation (OAA/S) scores

  20. Estudo comparativo entre anestesia peridural torácica e anestesia geral em mastectomia oncológica Estudio comparativo entre la anestesia epidural torácica y la anestesia general en mastectomia oncológica Comparative study between thoracic epidural block and general anesthesia for oncologic mastectomy

    Directory of Open Access Journals (Sweden)

    Sérgio D. Belzarena

    2008-12-01

    esthetic breast surgeries but reports of its use in mastectomies with axillary exploration are very rare. The present study compared this technique with general anesthesia in oncologic surgeries of the breasts. METHODS: Forty patients were divided in two groups. The epidural group (n = 20 underwent epidural thoracic block with bupivacaine and fentanyl associated with sedation with midazolam. The other group (n = 20 underwent conventional general anesthesia with propofol, atracurium, and fentanyl, and maintenance with O2 and isoflurane. Duration of the surgery, the need for intraoperative complementation of anesthesia or sedation, and intraoperative hemodynamic parameters were recorded. In the postoperative period, length of time until discharge from the recovery room and from the hospital, severity of pain, analgesic consumption, adverse effects, and satisfaction with the anesthetic techniques were recorded. RESULTS: Both groups were similar and differences in the duration of the surgery were not observed. Complementary sedation was necessary in 100% of the patients who underwent epidural block and complementary sedation with infiltration of local anesthetic in the axilla in 15% of the patients in this group. The rate of hypertension was more frequent in the group of patients who underwent general anesthesia, while hypotension was more frequent in the epidural group. Pruritus was observed in 55% of the patients in the epidural group. Nausea (30% and vomiting (45% were more frequent in the general anesthesia group. The quality of postoperative analgesia was better in the epidural group, which also presented lower consumption of analgesics; the length hospitalization in this group was also lower. CONCLUSIONS: Epidural block has some advantages when compared with general anesthesia and can be considered an anesthesia option in oncologic mastectomies with axillary lymph node dissection.

  1. Dexmedetomidine Improvement of Postoperative Delirium Following Gynaecologic Surgery in Elderly Female Pa-tients with General Anesthesia%右美托咪定减少全麻下老年女性患者妇科手术术后谵妄的临床观察

    Institute of Scientific and Technical Information of China (English)

    何鞠颖; 曹蓉; 彰宁

    2014-01-01

    Objective To investigate the results of dexmedetomidine improvement of postoperative delirium following gynaecologic surgery in elderly female patients by general anesthesia. Methods 60 cases of elderly female patients with gynaeco-logic surgery were performed general anesthesia. All cases were randomized into normal dexmedetomidine group ( group A, n=30) and saline group (group B, n=30). The saline and Dexmedetomidine (4μg/ml) was infused with 3μg/(kg·h) for 10 min, then persistently infused with 0. 3μg/( kg·h) to the end of operation in group A and group B, respectively. The following varia-bles were analyzed, including the duration of anesthesia, the recovery time of the autonomous respiration( >10bpm), the extuba-tion time, the richmond agitation-sedation scale(RASS) in extubation, the comfort score after extubation 15min and the CAM Chi-nese reversion after 48 hours of operation. Results There was no significant difference in the duration of anesthesia. The recovery time of the autonomous respiration, the extubation time, the RASS in extubation, the comfort score after extubation 15min were ob-viously different between two groups(all P0.05),停药后自主呼吸恢复时间、拔管时间、拔管时镇静-躁动评分、拔管后15min舒适度评分、术后48小时CAM. CR评分情况均差异有统计学意义(P<0.05)。结论术中静脉持续微量泵入右美托咪定能够有效的减少老年女性患者妇科手术术后谵妄的发生,并且减低全麻苏醒期躁动发生率,提高患者的满意度。

  2. Effect of general anesthesia on voice

    Directory of Open Access Journals (Sweden)

    Balegh Hamdy

    2016-07-01

    Conclusion: Traumatic manifestations of the laryngeal structures that occur during intubation are the most common causes of postoperative dysphonia, with a tendency toward a regressive course of the resulting dysphonia. As such, it is important to establish an early diagnosis and adopt preventive measures.

  3. Anesthesia for the patient with dementia

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    With a growing aging population, more patients suffering from dementia are expected to undergo surgery, thus being exposed to either general or regional anesthesia. This calls for specific attention ranging from the legal aspects of obtaining informed consent in demented patients to deciding...... on the use of premedication, choice of anesthetics, and management of postoperative pain. This review reflects on both general considerations concerning geriatric patients but also on the specific features of perioperatively used drugs and anesthetics that might have an impact on patients with Alzheimer...

  4. Intranasal sufentanil/midazolam versus ketamine/midazolam for analgesia/sedation in the pediatric population prior to undergoing multiple dental extractions under general anesthesia: a prospective, double-blind, randomized comparison.

    Science.gov (United States)

    Roelofse, J A; Shipton, E A; de la Harpe, C J; Blignaut, R J

    2004-01-01

    This article details a double-blind, randomized study evaluating the efficacy and safety of intranasal sufentanil and intranasal midazolam (S/M) when compared with intranasal ketamine and intranasal midazolam (K/M) for sedation and analgesia in pediatric patients undergoing dental surgery. Fifty healthy ASA status 1 children aged 5-7 years, weighing 15-20 kg, and having 6 or more teeth extracted, were randomly allocated to 2 groups of 25 patients each (n = 50). In the S/M group, 25 children received intranasal sufentanil 20 microg, and intranasal midazolam 0.3 mg/kg 20 minutes before the induction of anesthesia. In the K/M group, 25 children received intranasal ketamine 5 mg/kg and intranasal midazolam 0.3 mg/kg 20 minutes before the induction of anesthesia. Sevoflurane in nitrous oxide and oxygen was used for induction and maintenance of anesthesia. This study demonstrated the safety and efficacy of both methods with ease of administration, combined with a rapid onset of action. Both groups were equally sedated. A smooth mask induction of anesthesia was experienced in the majority of children. Effective postoperative analgesia for multiple dental extractions was provided. The intranasal administration of drugs for sedation and analgesia has some promising features in preschool children undergoing multiple dental extractions.

  5. Inhibitory effect of pentobarbital anesthesia on venous stasis induced arteriolar vasoconstriction in the dog hindleg

    DEFF Research Database (Denmark)

    Bülow, J; Henriksen, O; Amtorp, Ole

    1984-01-01

    venous stasis. In another experimental series the effect of general pentobarbital anesthesia on the vasoconstrictor activity in response to venous stasis locally in subcutaneous and muscle tissue in the hind limb was examined in 6 dogs. It was found that during the first 2-3 h of anesthesia...... the vasoconstrictor response was present in both tissues although the response in muscle tissue exhibited a great variation between the dogs during this period. However, after 4-5 h of anesthesia the response was abolished in both tissues. During neurolept anesthesia with fentanyl/N2O the same vasoconstrictor...... response was demonstrated in the hindleg 1 h and 5 h after induction of the anesthesia. It is concluded that pentobarbital anesthesia abolishes the arteriolar constriction induced by venous stasis. The mechanism may be blockade of the local sympathetic vasoconstrictor fibres or interference with myogenic...

  6. Laparoscopic cholecystectomy under continuous spinal anesthesia in a patient with Steinert's disease

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    Mariana Correia

    2016-04-01

    Full Text Available ABSTRACT Steinert's disease is an intrinsic disorder of the muscle with multisystem manifestations. Myotonia may affect any muscle group, is elicited by several factors and drugs used in general anesthesia like hypnotics, sedatives and opioids. Although some authors recommend the use of regional anesthesia or combined anesthesia with low doses of opioids, the safest anesthetic technique still has to be established. We performed a continuous spinal anesthesia in a patient with Steinert's disease undergoing laparoscopic cholecystectomy using 10 mg of bupivacaine 0.5% and provided ventilatory support in the perioperative period. Continuous spinal anesthesia was safely used in Steinert's disease patients but is not described for laparoscopic cholecystectomy. We reported a continuous spinal anesthesia as an appropriate technique for laparoscopic cholecystectomy and particularly valuable in Steinert's disease patients.

  7. 氟比洛芬酯在Supreme喉罩全麻剖宫产术中的应用%Superiority about flurbiprofen axetil used for SupremeTM LMA general anesthesia of cesarean section

    Institute of Scientific and Technical Information of China (English)

    连建烽; 姚伟瑜

    2014-01-01

    scores of three group were similar.VAS score of group C was lower than that of the other two groups,and VAS score of group B was lower than that of group A.Determination of CRP in group A was higer than that in group B and C (P<0.05),and the difference between group B and C had no statistical significance.Conclusion Flurbiprofen axetil used for cesarean section anes-thesia makes the anesthesia induction more stable.It also can significantly reduce the dosage of opioid and postoperative inflam-matory reaction.It has obvious advantages comparing with single use of opioids for cesarean section general anesthesia.

  8. 蛛网膜下腔麻醉和全身麻醉对高龄患者髋关节术后谵妄的影响研究%The influence of subarachnoid and general anesthesia on delirium in the elderly patients' hip surgery

    Institute of Scientific and Technical Information of China (English)

    吉元松; 张旭; 张德山; 李龙

    2016-01-01

    目的 比较蛛网膜下腔麻醉和全身麻醉两种麻醉方式对接受髋关节置换手术老年患者的术后谵妄及认知功能的影响.方法 选择2014年1月至2015年12月期间,在我院接受治疗髋关节置换手术的老年患者150例,将入组患者随机分为蛛网膜下腔麻醉组(74例)与全身麻醉组(76例)两组,比较两种麻醉方式对患者术后谵妄及认知功能的影响.结果 对比全身麻醉组,蛛网膜下腔麻醉组术后谵妄的发生率并没有显著提高(P>0.05),但比较两组简易精神状态检查(MMSE)评分,蛛网膜下腔麻醉组明显高于全身麻醉组(P<0.05).结论 蛛网膜下腔麻醉可能会对减少术后谵妄和认知功能障碍有一定作用,值得在老年髋关节置换手术中推广.%Objective To find the difference in delirium rate and cognitive damage between subarachnoid and general anesthesia for the elder patients who underwent hip replacement surgery.Methods From January 2014 to December 2015,we chose 150 elderly patients who underwent hip replacement surgery in our hospital,the patients were randomly divided into subarachnoid anesthesia group (74 cases) and general anesthesia group (76 cases),and compared the different postoperative delirium rate and cognitive disorder of two groups.Results The incidence of postoperative delirium of two groups was not increased significantly (P > 0.05),but the score of Mini-mental state examination (MMSE) in subarachnoid anesthesia group was significantly higher than that in the general (P<0.05).Conclusion The subarachnoid anesthesia certainly could reduce the postoperative delirium and cognitive disorder.

  9. The observation of complications in elderly patients recovering from general anesthesia under different administration patterns%不同给药模式对老年全麻患者术后苏醒期并发症的观察

    Institute of Scientific and Technical Information of China (English)

    莫洪; 吴雪峰; 彭磊

    2012-01-01

    间均有统计学意义(P0.05).结论在老年患者全麻术中采用七氟烷复合瑞芬维持,手术后期采用静安(丙泊酚MCT)复合瑞芬维持,同时充分、快速排除七氟烷的情况下,患者的拔管时间、清醒时间、离室时间均较全凭静脉麻醉明显缩短,且术后谵妄躁动的发生率与全凭静脉麻醉的发生率相似,无术中知晓的发生.surgery. Method abdominal surgery 40 patients, aged 65-76 years old, weighing 56-78kg, ASA I ~Ⅱ grade,14 females and 26 males. Al patients were receiving general anesthesia for the first time without serious major organ dysfunction, no long-term alcoholism, drug abuse, mental history and history of diabetes. Al the operations carried on more than 4 hours. Randomly divided into experimental and control group,20 cases in each group. No premedication and al the catheter tube placement were completed before induction of anesthesia . The two groups are administrated with Jing (propofol MCT)1mg/kg IV, then folowed by fentanyl 4ug/kg, atracurium 0.5mg/kg when the patients were sleepy. finaly ,1mg/kg propofolMCT before intubation . Make sure the tube is in the trachea, then began the mechanical ventilation. The control group was maintained with total intravenous anesthesia: continuous infusion of propofol MCT(3-6mg/kg.h) and remifentanil (0.3-0.8ug/kg.min), intermittent infusion of atracurium 10mg/kg each time; the experimental group was maintained with low concentrations sevoflurane within a closed system, and keep the exhaled gas in a concentration around 1.5MAC. The concentration of PetCO2was maintained at 40mmhg, continuous infusion of remifentanil (0.3-0.8ug/kg.min) and intermittent infusion of atracurium 10mg/kg each time. If there are changes in depth of anesthesia, adjust the dose of propofol and remifentanil in the control group ; maintain the inhaled concentration of sevoflurane in the experimental group the same, only regulate the dose of remifentanil. Appropriate add fentanyl 0.1mg each time for

  10. Evaluation of anesthesia applications in interventional neuroradiology cases

    Directory of Open Access Journals (Sweden)

    Ziya Kaya

    2012-12-01

    Full Text Available Objectives: In this study, we aimed to evaluate anesthesiaapplications of the patients underwent invasive interventionalneuroradiology applications.Materials and methods: Between June 2004 and October2004, 152 emergency or elective adult patients whowere undergone general anesthesia were evaluated retrospectively.Information about the patients was taken fromradiology, anesthesia notes and university’s informationsystem. Patients were evaluated in terms of age, gender,American Society of Anesthesiologists score, indicationof application, the existence of concomitant diseases, anesthesiatechnique, anesthetic medications and the possibilityof whether patient were in intensive care unit.Results: Of all, 55.3% of the patients (n=84 were femaleand 44,7% (n=68 were male. General anesthesia wasapplied in all cases and propofol was preferred mostly ininduction and sevoflurane was preferred in maintenance.Surgically, 81,6% of the patients was elective and 18,4%was emergency patients. Diagnoses of patients were asfollow: Cerebral aneurysm 63,8%, arteriovenous malformation19,7%, thrombolytic therapy 8%, tumor embolization5,3% and carotid stenting 3,2%. Totally 58 patientswere taken into intensive care unit and 6 of these died.Conclusions: In order to provide a safe and efficient patientcare, we think that permanent anesthesia equipmentis necessary together with good physical conditions of theoperation room, proficiency of neuroradiologist, the closerelationship between the patient and anesthetist and agood knowledge of underlying neuropathology. J Clin ExpInvest 2012; 3(4: 493-499Key words: Interventional radiology, general anesthesia,cerebral aneurysm, arterio-venous malformations.

  11. Laparoscopic hernioplasty with epidural anesthesia; a report of 20 patients

    Directory of Open Access Journals (Sweden)

    Talebpour M

    2007-06-01

    Full Text Available Background: The incidence of inguinal hernia is 15 cases per 1,000 populations. The most common surgical methods of hernia repair are conventional open hernioplasty and laparoscopic hernioplasty. The advantages of laparoscopic hernioplasty are that the regional anatomy is observable, and bilateral herniorrhaphy can be performed at the same time. Since laparoscopic hernia is usually performed under general anesthesia, to shorten the length of hospital stay and to prevent complications, in this study, we evaluated the use of epidural anesthesia during hernioplasty. Methods: This study included 20 male patients treated by a single surgeon. We recorded the PCO2 levels before, during and after surgery, as well as the pain and intra-abdominal pressure. Results: Only one patient required conversion to general anesthesia. Three patients had hernia on the left side only, 14 patients on the right only and three patients had bilateral hernia. The PCO2 levels did not change (P=0.789. Fifty percent of patients had no postoperative pain. The median time to return to work or normal physical activity was 7 days. Conclusion: Laparoscopic inguinal herniorrhaphy is a feasible alternative to open surgical hernia repair. Employing epidural anesthesia prevents the complications of general anesthesia. This method achieves a shorter hospital stay and time to return to normal activity, as well as reduction in pain. Controlled trials comparing laparoscopic and tension-free open herniorrhaphy are needed to further assess the relative benefits of this procedure.

  12. Prevention of thromboembolism following elective hip surgery. The value of regional anesthesia and graded compression stockings

    DEFF Research Database (Denmark)

    Wille-Jørgensen, P; Christensen, S W; Bjerg-Nielsen, A

    1989-01-01

    Ninety-eight patients scheduled for elective hip arthroplasty receiving either general or regional anesthesia and graded compression stockings as the only thromboprophylactic treatment were screened for postoperative deep-venous thrombosis with 99mTc-plasmin scintimetry. The diagnosis of deep......-venous thrombosis was established by phlebography and the diagnosis of pulmonary embolism by pulmonary perfusion and ventilation scintigraphy. Of 65 patients surgically treated under general anesthesia, 20 (31%) developed deep-venous thrombosis and six developed pulmonary embolism. Of 33 patients surgically treated...... using regional anesthesia, three (9%) developed deep-venous thrombosis and one developed a pulmonary embolus. The number of patients developing deep-venous thrombosis was significantly lower in the group receiving regional anesthesia compared with the group receiving general anesthesia. The results...

  13. Serial bronchoscopic lung lavage in pulmonary alveolar proteinosis under local anesthesia

    Directory of Open Access Journals (Sweden)

    K Rennis Davis

    2015-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare disease, characterized by alveolar accumulation of surfactant composed of proteins and lipids due to defective surfactant clearance by alveolar macrophages. Mainstay of treatment is whole lung lavage, which requires general anesthesia. Herein, we report a case of primary PAP, successfully treated with serial bronchoscopic lung lavages under local anesthesia.

  14. The effects of anesthesia method on throat pain after elective rhinoplasty

    Directory of Open Access Journals (Sweden)

    Hedayatollah Elyassi

    2011-01-01

    Conclusions: Method of anesthesia had no independent role in predicting throat pain. Although larynx of subjects undergoing general anesthesia is manipulated by tracheal intubation, sedation has its specific risks for promoting throat pain after surgery. Therefore, neither CS nor GA is superior in terms of throat pain.

  15. Outcomes of ventilation with laryngeal mask in patients undergoing radical mastectomy under general anesthesia%喉罩通气在全麻下乳腺癌根治术的应用效果

    Institute of Scientific and Technical Information of China (English)

    余小玉; 徐汝玺

    2011-01-01

    目的 探讨喉罩通气应用于全身麻醉下乳腺癌根治术的效果.方法 择期乳腺癌根治术患者40例,随机均分为喉罩(IL)组和气管插管(T)组.观察插管(罩)前后血压(BP)、心率(HR)的变化以及术后胃胀、咽喉疼痛等不良反应.结果 L组插入喉罩后BP、HR没有明显变化;T组导管插入后的BP、HR均较插入前明显升(P<0.01).气管插管组咽痛等并发症发生率及疼痛程度明显高于喉罩组.结论 喉罩通气较气管插管对患者循环功能影响较小,并发症少.%Objective Toinvestigate the outcomes of ventilation with laryngeal mask in the patients undergoing radical mastectomy under general anesthesia. Methods Fourty patients with breast cancer undergoing selective mastectomy were randomly divided into two grups with 20 cases each. The patients in group L were ventilated with laryngeal mask and those in group T were given conventional tracheal intubation as the controls. The changes of blood pressure(BP) and heart rate (HR) were recorded during laryngeal mask placement or tuble insertion. The adverse responses to the procedures after operation were compared between two groups. Results BP and HR were not significantly changed after laryngeal mask placement compared to those before, which in group T were remarkably increased after intubation and higher than those in group L(P<0. 01). The incidence of sore throat after surgery was more and severer in group T than that in group L. Conclusion Ventilated with laryngeal mask is better than conventioal intubation in keeping circulation function stable and reducing sore throat.

  16. Effects of propofol and sevoflurane for induction in general anesthesia on QT interval1%丙泊酚和七氟醚全麻诱导对心电图QT间期的影响

    Institute of Scientific and Technical Information of China (English)

    庄上英; 欧阳葆怡; 黄焕森; 庄小雪梁荣丰

    2014-01-01

    目的::观测丙泊酚静脉诱导、七氟醚吸入诱导、丙泊酚与七氟醚静吸复合诱导对QT间期的影响。方法:选择2013年1月至2014年1月在广州医科大学附属第一医院择期气管插管全麻下行手术治疗的中青年患者45例为研究对象,根据数字表法随机将患者分为3组:单纯丙泊酚静脉诱导组( P 组)、单纯七氟醚吸入诱导组( S组)和丙泊酚七氟醚静吸复合诱导组( PS组),每组各15例。分别于诱导前和诱导后行心电图检查,记录心率、血压、QT间期变化,计算QTc-F。结果:与诱导前相比,P组、S组和PS组诱导后的QTc-F显著延长(P0.05)。结论:3种诱导方法均有使QT间期延长的趋势,均需谨慎用于术前QT间期延长的患者。%Objective:To observe the effects of propofol intravenous induction, sevoflurane inhalation induction,and propofol intravenous induction combined with sevoflurane inhalation induction on QT interval. Methods: Forty-five young patients, who underwent elective operation with endotracheally intubated general anesthesia in the First Affiliated Hospital of Guangzhou Medical University between January 2013 and January 2014, were included and randomized into single propofol intravenous induction group ( Group P ) , single sevoflurane inhalation induction group ( Group S) ,and propofol intravenous induction combined with sevoflurane inhalation induction group (Group PS),with 15 cases in each group.Electrocardiography was taken before and after induction. The changes in heart rate, blood pressure, and QT interval were recorded, and the QTc-F was calculated.Results:Compared with the pre-induction, the QTc-F of group P, group S and group PS prolonged significantly after induction ( P0.05).Conclusion:All the three induction methods tend to prolong QT interval, which should be cautiously used for patients who have QT interval prolongation before operation.

  17. [Regional anesthesia and cancer immunology].

    Science.gov (United States)

    Igarashi, Toru; Mori, Katsuya; Inoue, Kei; Suzuki, Takeshi; Morisaki, Hiroshi

    2013-09-01

    Regional anesthesia has been widely applied as an excellent method for perioperative analgesia. Recent studies suggested that regional anesthesia is a promising approach to minimize the risk of surgical site infection and postoperative cancer recurrence, subsequently providing the benefits to the long-term outcome. In particular, it is of great interest that regional anesthesia might be able to reduce cancer recurrence. In cancer patients, innate immunity against cancer could be depressed, resulting in the predisposition to evoke metastasis. Besides, during the perioperative periods, tumor immunity is significantly depressed due to surgical pain, activation of sympathetic nervous system, inflammatory responses, and others. In this review article, we discuss the tumor immunity during the perioperative period, with focus on the alterations of tumor immunity and regional anesthesia.

  18. Anestesia peridural contínua com ropivacaína a 0,2% associada a anestesia geral para cirurgia do abdômen superior em crianças Anestesia peridural contínua con ropivacaína a 0,2% asociada a anestesia general para cirugía del abdomen superior en niños Continuous epidural anesthesia with 0.2% ropivacaine associated to general anesthesia for upper abdominal surgery in children

    Directory of Open Access Journals (Sweden)

    Jyrson Guilherme Klamt

    2003-04-01

    el grupo Propofol, sin embargo, la intensidad y duración de la sedación fueron mayores en ese grupo en relación al grupo Sufentanil. Los escores de recuperación fueron similares en los dos grupos. Después de 3 horas en la SRPA, todos los pacientes habían llegado a los criterios de transferencia para las enfermarías. Hipotensión arterial transitoria fue observada en 2 pacientes del grupo Sufentanil. CONCLUSIONES: La combinación de la anestesia peridural torácica continua con ropivacaína a 0,2% (1,5 ml.kg-1 asociada a la infusión de propofol promueve anestesia efectiva y segura para cirugías abdominales altas en niños. El ritmo de infusión de propofol y el tiempo de sedación fueron reducidos con la adición de sufentanil.BACKGROUND AND OBJECTIVES: Several anesthetic techniques have been proposed for different pediatric surgeries to promote postoperative analgesia, among other advantages. This study aimed at evaluating propofol infusion rate and postanesthetic recovery of children submitted to upper abdominal surgeries under epidural anesthesia with 0.2% ropivacaine associated to general anesthesia with propofol or propofol plus sufentanil. METHODS: Participated in this study 26 children physical status ASA I, II and III, aged 0 to 4 years, were scheduled to upper abdominal surgeries under thoracic epidural anesthesia (T7-T8 with 0.2% ropivacaine (1.5 ml.kg-1. They were randomly distributed in two groups: Propofol (propofol infusion and Sufentanil (propofol infusion plus 1 µg.kg-1 sufentanil. Propofol infusion rates were 20 and 10 mg.kg-1.h-1 for the Propofol and Sufentanil groups, respectively, adjusted to maintain blood pressure in approximately 20% of baseline values and withdrawn 10 to 15 minutes before estimated surgery completion. Postanesthetic recovery was evaluated by a modified Aldrete-Kroulik scale and sedation was evaluated by a 5 grade score. RESULTS: Techical difficulties excluded two children of each group. Infusion rate was significantly

  19. Clinical relevance in anesthesia journals

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Møller, Ann M

    2006-01-01

    The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles.......The purpose of this review is to present the latest knowledge and research on the definition and distribution of clinically relevant articles in anesthesia journals. It will also discuss the importance of the chosen methodology and outcome of articles....

  20. 电针复合药物全麻对围术期腹腔镜胆囊切除术患者血流动力学及内啡肽的影响%Effects of Acupuncture Combined General Anesthesia on Endorphin and Hemodynamics of Laparoscopic Cholecystectomy Patients in the Perioperative Phase

    Institute of Scientific and Technical Information of China (English)

    丁依红; 顾陈怿; 沈利荣; 吴凉森; 施征; 陈跃来

    2013-01-01

    Objective To observe the effects of different anesthesia ways on endorphin and hemodynamics of laparoscopic cholecystectomy patients in the perioperative phase.Methods A total of 90 laparoscopic cholecystectomy patients,29 to 80 years old,were randomly assigned to Group A (treated with electroacupuncture at acupoints combined general anesthesia),Group B (treated with electroacupuncture at non-acupoints combined general anesthesia),and Group C (treated with general anesthesia) according to American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ,30 cases in each group.All patients were induced by 3 μg/kg Fentanyl (Fen),2 mg/kg Propofol (Pro),and 0.1 mg/kg Vecuronium (Vcr).Bispectral index (BIS),being 40-65,indicated the state of general anesthesia.The anesthesia was maintained by intravenous injecting Pro,interruptedly intravenous injecting Fen and Vcr.Each patient recieved patient controlled intravenous analgesia (PCIA) after operation.On these bases,patients in Group A received electrical acupuncture at bilateral Hegu (LI4),Neiguan (PC6),Quchi (LI11),Zusanli (ST36),and Yanglingquan (GB34).Patients in Group B received electrical acupuncture at the points beside acupoints.The electroacupuncture was lasted from 15-30 min before anesthesia induction to the end of the operation in Group A and B.The heart rate (HR),mean arterial pressure (MAP),cardiac index (CI),cardiac output (CO),systemic vascular resistance index (SVRI),and acceleration index (ACI) were recorded before anesthesia induction,immediate before pneumoperitoneum,5 min after pneumoperitoneum,excision of gallbladder,and at the end of operation.The time consumption from discontinuation to spontaneously breathing recovery,analepsia,and extubation were recorded.The blood samples (3 mL each time) were collected from the peripheral vein before anesthesia induction,2 h after operation,the 1st day after operation,and the 3rd day after operation to detect the β-endorphin (β3-EP) level.The visual analogue scale (VAS

  1. Possibilities of creating meaningful encounters in anesthesia nursing

    DEFF Research Database (Denmark)

    Aagaard, Karin

    Anesthesia nursing is performed in a highly technological environment with restricted time for interaction with patients. Patients are in a vulnerable position, which can be characterized by anxiety regarding the anesthetic and surgical procedure. The bedrock of effective nursing care is to facil......Anesthesia nursing is performed in a highly technological environment with restricted time for interaction with patients. Patients are in a vulnerable position, which can be characterized by anxiety regarding the anesthetic and surgical procedure. The bedrock of effective nursing care...... of nursing. In this dissertation, focused ethnography is used to explore the interactions between patients and nurse anesthetists before general anesthesia. Moreover, it will explore the professional identity of nurse anesthetists, in relation to the situation of preparing patients for general anesthesia....... A micro-substantive theory is developed regarding the opportunities for creating meaningful encounters between patients and nurse anesthetists. The theory is based on three dominant motivations for interaction in anesthesia nursing. The context of care is not committed and responsive to the core elements...

  2. Comparative Study of Invasive Blood Pressure and Non-invasive Blood Pressure in General Anesthesia%全身麻醉患者无创血压与有创血压的对比研究

    Institute of Scientific and Technical Information of China (English)

    徐鑫; 吴廷丽; 马正良; 顾小萍

    2015-01-01

    Objective To investigate the differences of invasive blood pressure( IBP) and non-invasive blood pressure( NIBP) in general anesthesia.Methods Eighty-two patients undergoing general anesthesia were divided into four groups depending on invasive systolic blood pressure (ISBP):group A, ISBP≤90mmHg;group B,ISBP 90-120 mmHg;group C, ISBP 120-150mmHg;group D, ISBP>150mmHg.Non-invasive blood pressure and arterial blood pressure was monitored at the same time.Bilateral NIBP and IBP val-ues were compared by paired t-test and linear correlation analysis.Results There was no significant difference between bilateral NIBP of four groups.Invasive systolic blood pressure was lower than bilateral non-invasive systolic blood pressure in group A (P0.05).Arterial diastolic blood pressure was sig-nificantly lower than bilateral non-invasive diastolic blood pressure in group B and C.There was significant correlation between arterial systolic blood pressure and bilateral non-invasive systolic blood pressure (r=0.940,P<0.01).There was significant correlation be-tween arterial diastolic blood pressure and bilateral non-invasive diastolic blood pressure (r=0.925,P<0.01).Conclusion There was significant difference and correlation between arterial blood pressure and non-invasive blood pressure.Arterial blood pressure can be estimated by non-invasive blood pressure in certain blood pressure range.%目的:探讨全身麻醉患者双侧肱动脉无创血压( NIBP)与桡动脉有创动脉压( IBP)的关系。方法于全身麻醉下进行手术的患者82例,麻醉诱导前后及术中同步测量双侧无创血压及有创血压,根据有创收缩压值( ISBP)大小分为A组( ISBP≤90mmHg)、B组(90mmHg<ISBP≤120mmHg)、C组(120mmHg<ISBP≤150mmHg)和D组(ISBP>150mmHg)。对各组数值进行差异分析,并对有创血压和无创血压值做线性相关分析。结果4组患者双侧无创血压无统计学差异(P>0.05);A组有创

  3. Study on significance of application of dexmedetomidine in reducing agitation and throat pain in patients after general anesthesia%右美托咪定预防全麻术后躁动和咽喉疼痛的作用

    Institute of Scientific and Technical Information of China (English)

    钟剑平; 何绍旋

    2014-01-01

    目的:探讨右美托咪啶在预防全麻术后躁动和咽喉疼痛方面的应用价值,以提高全身麻醉的安全性。方法选取接受全麻手术治疗的患者114例,通过随机数字表法将其分为观察组和对照组各57例。两组均采用相同的药物进行全身麻醉,观察组在手术结束前半个小时静脉泵入右美托咪啶,对照组则静脉泵入相同体积的0.9%氯化钠注射液。对比两组患者恢复自主呼吸的时间和拔除气管插管时间以及术后躁动和咽喉疼痛的发生率。结果两组患者恢复自主呼吸时间、拔除气管插管时间的对比,差异无统计学意义( P ﹥0.05)。在术后躁动方面,观察组0级的有53例,躁动率为7.02%;对照组0级的有34例,躁动率为40.35%。观察组躁动率显著低于对照组( P ﹤0.05)。在术后咽喉疼痛方面,观察组0级的有46例,咽喉疼痛率为19.30%;对照组0级的有30例,咽喉疼痛率为47.37%。观察组咽喉疼痛率显著低于对照组( P ﹤0.05)。结论右美托咪啶对全麻术后躁动和咽喉疼痛具有良好的预防作用,同时不会增加呼吸抑制的风险,值得在临床上推广应用。%Objective Toexploretheapplicationvalueofdexmedetomidineinreducingagitationandthroatpainaftergeneralanesthesia, inordertoimprovethesafetyofanesthesia.Methods Atotalof114patientsunderwentgeneralanesthesiaforoperationinthishospitalwerese-lected for this study,they were divided by random number table method into observation group and control group,each with 57 cases. Patients in these two groups were used with same drug for general anesthesia,patients in observation group were given with intravenous infusion of dexmedeto-midine at half hour before the end of operation,while patients in control group were administrated with intravenous infusion of same volume of 0. 9% sodium chloride solution. The incidence rates of agitation,spontaneous breathing recovery

  4. Analysis on the Safety and Efficacy of Midazolam Sedation in General Anesthesia Operation%全麻术中应用咪达唑仑镇静的安全性及有效性临床分析

    Institute of Scientific and Technical Information of China (English)

    原皓; 邹亮; 孙莉

    2015-01-01

    目的:探讨咪达唑仑在全身麻醉手术中的镇静效果及安全性。方法选取2011年11月至2013年11月在中国医学科学院北京协和医院肿瘤医院进行全身麻醉手术的92例患者为研究对象。采用数字表随机法将患者分为丙泊酚组和咪达唑仑组,每组46例。咪达唑仑组给予咪达唑仑镇静,丙泊酚组给予丙泊酚镇静,比较两组患者镇静的安全性及有效性。结果咪达唑仑组患者Ramsay评分与丙泊酚组患者在不同时间点、组间及组间・不同时间点比较差异均有统计学意义(P<0.05);两组患者的心率在组间及组间・不同时间点的比较差异有统计学意义(P<0.05),不同时间点比较差异无统计学意义(P>0.05);平均动脉压和血氧饱和度在组间比较差异有统计学意义(P<0.05),不同时间点及组间・不同时间点比较差异无统计学意义(P>0.05);咪达唑仑组与丙泊酚组肌肉松弛药物用量比较,差异无统计学意义(P>0.05),但拔管时间、清醒时间及回答时间显著早于丙泊酚组患者(P<0.05),其恶心、寒战、嗜睡及狂躁的发生率也显著低于丙泊酚组(P<0.05)。结论咪达唑仑在全身麻醉手术中的镇静较好,不良反应少,拔管时间短、清醒时间快。%Objective To investigate the safety and efficacy of midazolam sedation in general anesthesia operation.Methods A total of 92 patients who accepted general anesthesia in Cancer Hospital of Chinese Academy of Medical Sciences from Nov.2011 to Nov.2013 were selected as research objects.All the patients were divided into midazolam group and propofol group according to random number table ,with 46 cases in each group.Patients in midazolam group were given midazolam , while patients in propofol group received propofol.The safety and efficacy of sedation of the two groups were compared .Results Ramsay scores at dif-ferent time points

  5. Comparison of Sedation With Local Anesthesia and Regional Anesthesia in Transurethral Resection of Prostate (TURP

    Directory of Open Access Journals (Sweden)

    H Aghamohammadi

    2008-12-01

    Full Text Available ABSTRACT: Introduction & Objective: Transurethral Resection of Prostate (TURP is usually performed under regional or general anesthesia. An alternative to conventional anesthesia is performing of TURP under local anesthetic infiltration with sedation. The aim of this study was to evaluate the efficacy and complication of sedoanalgesia in TURP. Material & Methods: In a prospective clinical trial from September 2006 to December 2007, 60 patients (30 in each group with prostate hypertrophy, candidate for TURP, were randomly assigned into two groups. In the first group, standard spinal anesthesia was done. In the second group, five minutes before the operation, 25 mgs of diazepam plus 25-50 mgs of pethedine was intravenously administered followed by injection of 10 ml lidocaine 2% gel in the urethra and the skin in the suprapubic area was anesthetized with 2 ml of 1% lidocaine. Using a 22 gauge nephrostomy needle, the suprapubic skin was punctured and the needle was directed toward prostate apex and 10-20ml of 1% lidocaine was injected at the serosal aspect of the rectal wall. For dorsal nerve block, 5-10ml of 1% lidocaine was injected at penopubic junction, and then a standard TURP was performed. Patients were switched to another anesthetic technique if the selected technique failed. Severity of pain was assessed by visual analogue scale. Results: The average prostate size was 25 grs (range10-50grs in the local anesthetic group (group 1 and 27.5 grs (range 10-50 grs in the spinal group (group2. In the local anesthetic group, 82.3% had no or mild pain while moderate to severe pain was reported in 16, 7% of the patients. In the group with spinal anesthesia, these were 93.1% and 6.9% respectively. Intolerable pain was observed in 23.3% and 13.8% of groups 1 and 2 respectively (p>0.05. Two patients in spinal group and 5 in local anesthetic group (3 due to severe pain and 2 for unsatisfaction required conversion to general anesthesia or receiving

  6. GESTATIONAL OBESITY AS A DETERMINANT OF GENERAL ANESTHESIA TECHNIQUE FOR CAESAREAN DELIVERY: A CASE REPORT Obesidad en la gestación como determinante de técnica anestésica general para cesárea: reporte de caso

    Directory of Open Access Journals (Sweden)

    José Ricardo Navarro-Vargas

    2009-01-01

    Full Text Available Background. The incidence of obesity has undergone a dramatic increase around the world during the last few years. Such epidemic behavior has been associated with obstetric patient’s frequent presentation of different stages of obesity when undergoing anesthetic procedure. Obesity in pregnant women involves the risk of adverse maternal and fetal outcomes. Hypertension and preeclampsia, diabetes, fetal macrosomia, caesarean delivery, difficult airway management and neuroaxial techniques are more likely to be performed in this group of patients. Materials and methods. This is a case report of a morbid obese patient scheduled for caesarean delivery and tubal ligation. Regional, spinal and epidural techniques were attempted for surgery with unsuccessful results; this entails general anesthesia for surgery. The literature on complications due to obesity during pregnancy was reviewed, emphasising relevance for the anesthesiologist. Conclusion.Obesity, especially morbid obesity in pregnant women, represents a challenge for anesthesia management. Updated knowledge of physiology and the conditions related to obesity in pregnancy is necessary; medical services must be prepared to provide optimum and safe obstetric anesthesia, analgesia and post-operation care.Antecedentes. La incidencia de obesidad ha tenido un incremento importante en los últimos años a nivel global. Este comportamiento epidémico ha llevado a la presentación cada vez más frecuente de pacientes obstétricas con diversos grados de obesidad para procedimientos anestésicos. La obesidad en la paciente gestante tiene asociación con desenlaces adversos maternos y fetales, incremento en el riesgo de hipertensión y trastornos hipertensivos, diabetes, macrosomía fetal, nacimiento por cesárea, además de dificultad para realizar técnicas neuroaxiales y para el manejo de la vía aérea. Material y métodos.Este es un reporte de caso de una paciente obesa extrema programada para ces

  7. Efeito da anestesia geral na cognição e na memória do idoso Efecto de la anestesia general en la cognición y memoria del paciente de edad avanzada Effects of general anesthesia in elderly patients’ memory and cognition

    Directory of Open Access Journals (Sweden)

    Régis Borges Aquino

    2004-10-01

    en el post operatorio de paciente com edad 60 a 80 años de ambos los sexos, sometidos a la anestesia general con duración de 3 a 7 horas.BACKGROUND AND OBJECTIVES: General anesthesia and mental function have been subject to studies and considerations, especially for the feeling that, especially in the elderly, it could induce changes in cognition and memory. This study aimed at evaluating the effects of general anesthesia in cognition and memory of elderly patients, correlating them to gender, age and anesthesia duration. METHODS: This is a cohort, controlled study with patients divided in two observation groups: a - anesthetic; b - clinical (control. Outcome variables studied were Mini-mental test, Verbal Fluency test and Numeric Remembrance test scores; general anesthesia with halothane, isoflurane, sevoflurane, thiopental, propofol, etomidate, fentanyl, alfentanil, succinylcholine, atracurium and pancuronium; intraoperative period with PaCO2 30 to 45 mmHg, hemoglobin saturation above 90% and blood pressure tolerance with up to 20% decrease as compared to baseline. Patients presenting any intra and postoperative adverse event were excluded from the study. Chi-square test was used for categorical data. Student’s t test for independent samples was used for initial comparison between groups at baseline moment (preanesthetic. Analysis of variance (ANOVA for repeated measures was used to evaluate anesthetic process effects along time. RESULTS: Groups were similar in the Mini-Mental test with increased scores along time. Both groups had virtually unchanged Verbal Fluency test scores. Both groups were very similar in Numeric Remembrance test with increased scores in both groups. CONCLUSIONS: No postoperative cognition or memory decline has been observed in patients of both genders, aged 60 to 80 years, submitted to general anesthesia lasting 3 to 7 hours.

  8. 七氟醚复合瑞芬太尼麻醉时长对全麻苏醒质量的影响%Effect of duration of combined anesthesia with sevoflurane-remifentanil on the recovery quality after general anesthesia

    Institute of Scientific and Technical Information of China (English)

    梁小丽; 郑雪; 张鸿磊; 张秋英; 朱昭琼

    2014-01-01

    目的:评价七氟醚复合瑞芬太尼麻醉持续时间对患者术后苏醒质量的影响。方法ASAⅠ~Ⅱ级择期腹腔镜胆囊手术患者97例,根据吸入麻醉时间不同分为<90 min组(n=61)与≥90 min组(n=36)。观察苏醒期呼气末七氟醚浓度、苏醒时间、血流动力学变化,比较不良反应发生情况及术后24 h患者麻醉满意度。结果两组麻醉时间分别为(70.0±13.2)min和(120.4±27.5)min(P<0.05);自主呼吸恢复、呼唤睁眼时及拔管时间差异无统计学意义(P>0.05);手术结束时、自主呼吸恢复时、呼唤睁眼时及拔管时四个时间点的血流动力学变化、呼吸末七氟醚浓度比较差异无统计学意义(P>0.05);术后患者麻醉满意度评分及不良反应发生率比较差异亦无统计学意义(P>0.05)。结论七氟醚复合瑞芬太尼麻醉用于不同时长麻醉维持,具有较好的可控性,可有效避免麻醉时间延长导致的药物蓄积、苏醒延迟和血压波动,获得满意的苏醒质量。%Objective To evaluate the effect of the sevoflurane-remifentanli anesthesia duration on the postoperative recovery quality .Methods 97 patients with ASAⅠ ~ Ⅱ ,who have undergone laparo-scopic cholecystectomy ,were assigned to group 0 .05) .Likewise ,there were no statistical significantly differences between two groups in the changes of hemodynamics ,end-tidal concentration of sevoflurane patients’ satisfaction ratings to anes-thesia and the incidence of adverse effects at the four points including end of surgery , recovery of spontaneous breathing ,eyes opening and extubation(P>0 .05) .Conclusion Combined anesthesia with sevoflurane and remifentanil can be used in anesthesia maintenance with different duration to prevent drug accumulation ,delayed recovery and fluctuation in blood pressure due to long anesthesia duration , by which satisfactory recovery quality can be also

  9. Transient Oliguria during Anesthesia in Cerebral Salt Wasting Syndrome.

    Science.gov (United States)

    Lee, Kwang Ho; Park, Jong Taek; Cho, Dong Woo; Song, Seung Woo; Lim, Hyun Kyo

    2016-09-01

    Cerebral salt wasting syndrome is a hyponatremic and hypovolemic condition caused by intracranial disorders, such as head injury, subarachnoid hemorrhage, brain tumor, and brain operations. We report a case of a 5-year-old girl that had cerebral salt wasting syndrome with marked polyuria who showed transient oliguria during general anesthesia. The patient had undergone an operation for traumatic intracranial hemorrhage three months prior and has had marked polyuria and hyponatremia since then. After induction of anesthesia for cranioplasty, the patient had oliguria during surgery and then resumed polyuria in the post-operative period.

  10. Anesthesia and postoperative delirium in older adults undergoing hip surgery

    NARCIS (Netherlands)

    Slor, C.J.; de Jonghe, J.F.M.; Vreeswijk, R.; Groot, E.; Ploeg, T.V.D.; van Gool, W.A.; Eikelenboom, P.; Snoeck, M.; Schmand, B.; Kalisvaart, K.J.

    2011-01-01

    OBJECTIVES: To examine the effects of general anesthesia on the risk of incident postoperative delirium in older adults undergoing hip surgery. DESIGN: Secondary analysis of haloperidol prophylaxis for delirium clinical trial data. Predefined risk factors for delirium were assessed prior to surgery.

  11. Propofol and sevoflurane in children with general anesthesia on hemodynamics, postoperative recovery Quality of comparative study%丙泊酚和七氟烷在患儿全身麻醉中对血流动力学、术后苏醒质量的影响对比研究

    Institute of Scientific and Technical Information of China (English)

    陈炜; 罗会红; 龙宏杰

    2016-01-01

    Objective: To evaluate the propofol and sevoflurane in children with general anesthesia applications. Methods: Our hospital 180 cases of children with inguinal hernia elective surgery were randomly divided into propofol group and sevoflurane anesthesia group, 90 cases. Continuous monitoring of children with systolic blood pressure(SBP), heart rate(HR), electrocardiogram(ECG), diastolic blood pressure(DBP), the depth of anesthesia(BIS), oxygen saturation(SpO2), PETCO2. Record children after induction of anesthesia (T1), before induction (T0), endotracheal intubation (T2), 3min (T3), when the procedure is complete (T4), when the eyes open (T5), fully awake after intubation (T6) of SBP, HR, DBP, BIS. Results: The two groups were compared in the index, systolic and diastolic blood pressure significantly decreased compared with the induced (P<0.05), sevoflurane group of children surgery extubation time and postoperative recovery time after the completion of induction of anesthesia compared with propofol group was significantly shorter(P<0.05). Conclusion:propofol and sevoflurane anesthesia can effectively lower blood pressure, heart rate stability, to maintain a considerable depth of anesthesia, sevoflurane awake but better quality.%目的:评价丙泊酚与七氟烷在患儿全身麻醉中的应用效果。方法:选择我院择期手术的180例腹股沟斜疝患儿,随机分为丙泊酚麻醉组和七氟烷麻醉组各90例。连续监测患儿收缩压(SBP)、心率(HR)、心电图(ECG)、舒张压(DBP)、麻醉深度(BIS)、血氧饱和度(SpO2)、PETCO2。记录患儿麻醉诱导后(T1)、诱导前(T0)、气管插管即刻(T2)、插管后3min(T3)、手术完成时(T4)、睁眼时(T5)、完全清醒时(T6)的SBP、HR、DBP、BIS。结果:两组患儿组内各指标相比,麻醉诱导后收缩压和舒张压与诱导前比较明显下降(P<0.05),七氟烷组患儿手术完

  12. Modified technique of iontophoretic anesthesia for myringotomy in children.

    Science.gov (United States)

    Epley, J M

    1977-06-01

    A modified technique is described for iontophoretic anesthesia in children who require myringotomy and insertion of a tube (tympanostomy). Principal modifications include the following procedures: (1) preoperative parenteral sedation; (2) relatively painless injection of lidocaine hydrochloride-epinephrine hydrochloride solution into the external auditory canal skin after iontophoresis alone to eliminate the extreme bony canal wall tenderness; (3) injection of lidocaine-epinephrine solution into an atelectatic middle ear to anesthetize the promontory for painless tube insertion; (4) substitution of a disposable ECG electrode for a metal plate electrode to eliminate the possibility of electrical burn from metal-to-skin contact. These modifications enhance the effectiveness and the safety of iontophoretic anesthesia, minimize the need for general anesthesia, and liberalize the indications for tympanostomy.

  13. Current Strategies in Anesthesia and Analgesia for Total Knee Arthroplasty.

    Science.gov (United States)

    Moucha, Calin Stefan; Weiser, Mitchell C; Levin, Emily J

    2016-02-01

    Total knee arthroplasty is associated with substantial postoperative pain that may impair mobility, reduce the ability to participate in rehabilitation, lead to chronic pain, and reduce patient satisfaction. Traditional general anesthesia with postoperative epidural and patient-controlled opioid analgesia is associated with an undesirable adverse-effect profile, including postoperative nausea and vomiting, hypotension, urinary retention, respiratory depression, delirium, and an increased infection rate. Multimodal anesthesia--incorporating elements of preemptive analgesia, neuraxial perioperative anesthesia, peripheral nerve blockade, periarticular injections, and multimodal oral opioid and nonopioid medications during the perioperative and postoperative periods--can provide superior pain control while minimizing opioid-related adverse effects, improving patient satisfaction, and reducing the risk of postoperative complications.

  14. Clinical Using of Combined Remifentanil with Mivacurium in Obstetric General Anesthesia%联合瑞芬太尼和米库氯铵在产科全麻中的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    刘丹; 王冬娜; 王靖宇; 付颖

    2014-01-01

    目的:探讨瑞芬太尼与米库氯铵联合应用于产科全麻的临床效果,评价其可行性和安全性。方法:以38例因椎管内麻醉禁忌症而行全麻剖宫产的产妇为研究对象,随机分为 A、B两组,每组各19例。 A 组:给予丙泊酚+氯胺酮+维库溴铵组合,B 组:给予丙泊酚+瑞芬太尼+米库氯铵组合。观察两组产妇麻醉前、插管后即刻、手术10、20 min 时的 HR、DBP、SBP,记录两组手术开始至胎儿娩出时间、术毕至拔管时间、产妇完全苏醒时间、Steward 评分、新生儿出生后1、5、10 min Apgar 评分、新生儿处理情况以及不良反应等。结果:A 组产妇 HR、SBP、DBP 在麻醉各个节点上有较明显的波动,各个节点之间差异均有统计学意义(P0.05)。两组胎儿娩出时间,新生儿1、5、10 min 时 Apgar 评分以及使用面罩吸氧的新生儿例数均大体相当,组间差异均无统计学意义(P>0.05)。 B 组产妇拔管时间、完全清醒时间较 A 组短,Steward 评分比 A 组高,三个指标组间比较差异均有统计学意义(P0.05). Fetal childbirth time, neonatal Apgar scores at 1min, 5min and 10min, and the cases of neonatal using oxygen masks between the two groups were roughly the same, the differences were not statistically significant (P >0.05). The extubation time, maternal awake time of Group B were shorter than those of group A, the Steward score was higher in Group B than in Group A, the three indexes between the two groups had statistically significant differences (P<0.05). Conclusion: By combining propofol, remifentanil and mivacurium in general anesthesia of obstetrics, the maternal hemodynamics is apt to maintain stable with fast recovery, small fetal/neonatal effects, good feasibility and high security, which needs to be confirmed by further clinical studies.

  15. 右美托咪啶对正颌手术全麻苏醒期的影响%Effect of dexmedetomidine on the recovery of patients after general anesthesia in orthognathic surgery

    Institute of Scientific and Technical Information of China (English)

    王晓东; 纪志农

    2013-01-01

    目的:了解右美托咪啶对正颌手术全麻苏醒期的影响.方法:40例ASA Ⅰ-Ⅱ级择期行颌面外科正颌手术患者,随机分为右美托咪啶组(D组)和生理盐水组(C组).D组患者术毕前30 rmin给予右美托咪啶0.6 μg/kg,泵注10 min后以0.4μg(kgh)持续泵入.C组患者以相同速率输注生理盐水.在患者清醒(T1),拔管(T2),拔管后20 rmin(T3)行Ramsay评分;在T2记录2组躁动率;在T3行全麻后舒适度(BCS)评分.结果:与C组相比,D组在T1、T2、T3的Ramsay评分明显增加(P<0.05);2组在T2躁动率有明显差异(P<0.05);D组BCS评分明显高于C组(P<0.05).结论:术毕前泵入右美托咪啶可明显减少正颌手术患者拔管期躁动程度,并且提高患者带管耐受性.%Objective:To study the effect of dexmedetomidine on the recovery of patients after general anesthesia in orthognathic surgery.Methods:40 patients with ASA Ⅰ-Ⅱ degree jaw deformity undergoing orthognathic surgery were randomly divided into dexmedetomidine group (D) and normal saline group (C) with 20 cases in each.In group D,dexmedetomidine was administered intravenously at 0.4 μg(kg · h) after a bolus infusion at 0.6 μg/kg for 10 min before ending operation.Nornial saline was given by the same way in group C.Ramsay sedation scores were monitored at the time of awaken(T1),immediately after extubation(T2),20 rain after extubation(T3) ;the restlessness assessment was recorded at T2 and the bruggrmann comfort scale(BCS) assessment was recorded at T3.Results:Ramsay sedation scores were higher at T4,T2 and T3 in group D than those in group C (P < 0.05) ; the restlessness in group D was less than in group C at T2 (P < 0.05) ; the BCS was significantly higher in group D than in group C.Conclusion:Dexmedetomidine given before ending operation may decrease the restlessness in patients undergoing orthognathic surgery and improve the tolerance of retaining tracheal catheter.

  16. Effects of general anesthesia with sevoflurane on learning and memory of children%吸入麻醉药七氟醚对儿童学习记忆的影响

    Institute of Scientific and Technical Information of China (English)

    朱贵芹; 朱霞; 郑闽江; 王丽华; 李加凯; 邱燕林; 杨爱兴; 张文明; 李小民

    2011-01-01

    目的 观察研究吸入麻醉药七氟醚对儿童高级神经活动学习、记忆功能的影响.方法 选择7~10岁男生择期下腹部手术33例,分为七氟醚组(20例)和对照组(13例).采用“韦氏记忆量表”进行学习记忆能力的测试,测试术前、术后1d、术后1周长时记忆、短时记忆及瞬时记忆的量表得分.结果 ①七氟醚组和对照组2组术后1d与术前、术后1周相比,短时记忆量表得分均显著下降,差异有显著性(P<0.05);②术后1周2组患儿的短时记忆量表得分均已经接近原来的水平;③术后1d短时记忆量表得分七氟醚组与对照组量表得分相近,差异没有显著性意义.结论 ①手术患儿学习记忆能力的改变,术后1d在短时记忆的分测验中有明显的下降,而对长时记忆和瞬时记忆没有明显改变;②未能提示吸入麻醉药七氟醚对儿童学习\\记忆能力的影响是一个独立的风险因素.%Objective To investigate the possible effects of general anesthesia with sevoflu-rane on learning and memory of children. Methods The ability of learning and memory was evaluated with Wechsler Memory Scale before operation, one day and seven days after operation. Thirty three boys aged 7-10 years old undergoing elective hypogastric surgery were enrolled, of which 20 cases were treated with sevoflurane and 13 were put in control group. The long - term, short - term and instantaneous memory were measured. Results ① Comparing results one day after operation to results before operation and seven days after operation, short - term memory scale scores decreased significantly in both sevoflurane and control groups one day after operation, and the difference was significant (P<0. 05); ② The short - term memory scale scores of both two groups of children were close to the original level one week after operation. ? One day after operation the short- term memory scale scores of sevoflurane group and control group were similar

  17. Impact of pre-operational teeth-brushing on oropharyngeal bacteria colonization of patients undergoing general anesthesia%术前常规刷牙对全麻患者口咽部细菌定植的影响

    Institute of Scientific and Technical Information of China (English)

    卢玉林; 章学美; 李莉; 殷婕

    2016-01-01

    目的:通过在经口气管插管全身麻醉前行常规刷牙,探讨常规刷牙对口咽部细菌定植和口腔清洁的影响。方法150例患者随机分为3组,每组50例,A组为对照组,不进行任何干预,B组用生理盐水含漱, C组采用刷牙方法。刷牙及口咽含漱在气管插管前30 min进行。采集刷牙前后口咽部标本进行细菌培养和菌落计数,并观察患者口臭及清洁度的改变情况。结果常规刷牙在减轻和消除口臭,增加口腔清洁度上有统计学差异(P0.05)。结论生理盐水口咽含漱和常规刷牙仅能清洁口腔,不能杀灭口咽常见细菌,不利于减少经口气管插管患者因气管插管动作使口咽部细菌顺延导管下移至下呼吸道的数量。建议使用口腔含漱液配合刷牙对患者进行口腔护理,减少细菌定植数量。%Objective To study the impact of pre-operational teeth-brushing on oropharyngeal bacteria coloni-zation and oropharyngeal cleaness of patients undergoing general anesthesia. Methods A total of 150 patients were ran-domly divided into three groups (n=50) . Group A was the control group without any intervention. Patients of Group B gargled with physiological saline. While Group C adopted teeth-brushing method. Teeth-brushing and gargling with phys-iological saline were both carried out 30 minutes before the orotracheal intubation. Oropharyngeal specimens before and after the interventions were collected to carry out the bacterial culture, and the changes of patients' halitosis and cleanli-ness were observed. Results There were statistical significance for conventional teeth-brushing to reduce or eliminate halitosis, and increase oral cleanness (P0. 05 ) . Conclusions Gargling with physiological saline and brushing the teeth can only clean mouth, but can't sterilize the common oropharyngeal bacteria and was not helpful for reducing the oropharyngeal bacteria shifting to the lower respiratory tract along the tube during the

  18. 参附注射液对肺叶切除术患者血流动力学及血气分析指标的影响%Effect of Shenfu Injection on Hemodynamics and Blood Gas Analysis in Patients Undergoing Lobectomy of Lung combined Epidural Block and General Anesthesia

    Institute of Scientific and Technical Information of China (English)

    李晓征; 李界平; 王强; 于海芳; 张芸

    2012-01-01

    目的:探讨参附注射液对全麻复合胸段硬膜外阻滞下行肺叶切除术患者血流动力学及血气分析指标的影响.方法:将60例拟在胸段硬膜外阻滞复合全麻下肺叶切除术病人,随机双盲法分为参附组(n=30)及对照组(n=30),参附组在麻醉诱导前静脉输注参附注射液1.5 mL/kg;对照组以同样速度输注等量的生理盐水.结果:与对照组相比,参附组的MAP、HR在诱导后5 min(T1)、手术探查时(T2)、单肺通气30 min(T3)、单肺通气60 min(T4)及关胸前冲洗胸腔时(T5)升高(P< 0.05),术中麻黄碱、阿托品的使用量及输液总量减少(P< 0.05),PaO2在T3、T4 时较对照组升高(P< 0.05),麻醉药物用量等两组比较无差异(P> 0.05).结论:参附注射液对胸段硬膜外阻滞复合全麻下肺叶切除术患者血流动力学变化具有稳定作用,可改善单肺通气期间血气分析指标.%Objective To investigate the effect of Shenfu Injection on hemodynamics and blood gas analysis in patients undergoing lobectoiny oi lung combined thoracic epidural block and general anesthesia.Methods A double blind trail was conducted on 60 patients undergoing lobectomy of lung combined thoracic epidural block and general anesthesia.The patients were randomly divided into Shenfu Injection group (n=30) and control group (n=30). In the Shenfu Injection group, 1.5 mL/kg Shenfu Injection diluted with 250 mL saline were given before anesthesia introduction. In the control group, equal saline were given at the same time. The following indexes were observed: (1) MAP,HR and CVP at the time before anesthesia introduction (TO), after anesthesia introduction for 5 minutes(T1), surgical exploration(T2),after one-lung ventilation for 30 minutes(T3), after one-lung ventilation for 60 minutes(T4), rinse chest(T5) and the end of operation(T6).(2)the dose of atropine and ephedrine, the amount of intraoperative transfusion,blood loss, urine volume and duration of surgery.(3) the

  19. Clinical study on effects of perioperative low temperature to regaining consciousness of the severe traumatic patients with general anesthesia%围术期低温对重型创伤患者全麻苏醒的临床研究

    Institute of Scientific and Technical Information of China (English)

    肖华鑫; 廖桦; 贺强龙

    2011-01-01

    Objective The explore the effects of perioperative low temperature to regaining consciousness of the severe traumatic patients with general anesthesia. Methods 60 cases of severe traumatic surgery patients, with stochastic double blind method, were divide into two groupg, 30 cases in control group adopted conventional processing,30 cases of heat preservation group took the positive low temperature preventive measures, the conditions of awakening time, shiver during consciousness time, dysphoria and hypotension were observed in the awakening period after general anesthesia. Results There was no significant difference between the body temperature at each time point of heat preservation group and that at the anesthesia beginning(P> 0.05), but when compared to that in the control group,there was significant difference (P< 0.05); in the control group, 7 cases of consciousness were found in 30 minutes after anesthesia, 16 cases found in 30 to 60 minutes, 7 cases in more than 60 minutes. While in the heat preservation group, 7 cases of consciousness were found in 30 minutes after anesthesia, 22 cases found in 30 to 60 minutes, 1case in more than 60 minutes. There was no significant difference in consciousness conditions 30 minutes after anesthesia(P> 0.05), there was significant difference in those of 30 to 60 minutes after anesthesia(P< 0.05), and there was very significant difference in those of 60 minutes after anesthesia(P < 0.01). The data of shiver after consciousness (18 cases in control, 7 in heat preservation group), dysphoria (12 in control, 3 in heat preservation group) and hypotension (17 in control, 5 in heat preservation group) after anesthesia in these two groups had very significant differences(P< 0.01). Conclusion The perioperative low temperature can make great damage to severe traumatic patients, it will improve the general anesthesia quality, reduce the complications during conscious period,and raise the survival rate of the patients to

  20. Marsupial, insectivore, and chiropteran anesthesia.

    Science.gov (United States)

    Pye, G W

    2001-01-01

    This article covers the manual restraint and anesthesia of marsupials, insectivores, and chiroptera. Marsupials commonly kept as pets in the U.S. [e.g., eastern gray kangaroos (Macropus giganteus), Bennett's wallabies (Macropus rufogriseus), and sugar gliders (Petaurus breviceps)] are covered in detail. Marsupial species kept in zoological parks [e.g., Tasmanian devils, koalas (Phascolarctos cinereus), and common wombats (Vombatus ursinus)] are covered in less detail. Of the insectivores, only the African hedgehog (Atelerix albiventris) and the European hedgehog (Erinaceus europaeus) are commonly kept as pets and, consequently, the insectivore section concentrates on discussing these two species. The section on chiropteran anesthesia is divided into two broad categories: the megachiropterans (flying foxes and fruit bats) and the microchiropterans (insectivorous bats). Most of the information on the species covered in this article is anecdotal, and this should be kept in mind when using the anesthesia protocols described.

  1. EEG entropy measures in anesthesia

    Directory of Open Access Journals (Sweden)

    Zhenhu eLiang

    2015-02-01

    Full Text Available Objective: Entropy algorithms have been widely used in analyzing EEG signals during anesthesia. However, a systematic comparison of these entropy algorithms in assessing anesthesia drugs’ effect is lacking. In this study, we compare the capability of twelve entropy indices for monitoring depth of anesthesia (DoA and detecting the burst suppression pattern (BSP, in anesthesia induced by GA-BAergic agents.Methods: Twelve indices were investigated, namely Response Entropy (RE and State entropy (SE, three wavelet entropy (WE measures (Shannon WE (SWE, Tsallis WE (TWE and Renyi WE (RWE, Hilbert-Huang spectral entropy (HHSE, approximate entropy (ApEn, sample entropy (SampEn, Fuzzy entropy, and three permutation entropy (PE measures (Shannon PE (SPE, Tsallis PE (TPE and Renyi PE (RPE. Two EEG data sets from sevoflurane-induced and isoflu-rane-induced anesthesia respectively were selected to assess the capability of each entropy index in DoA monitoring and BSP detection. To validate the effectiveness of these entropy algorithms, phar-macokinetic / pharmacodynamic (PK/PD modeling and prediction probability analysis were applied. The multifractal detrended fluctuation analysis (MDFA as a non-entropy measure was compared.Results: All the entropy and MDFA indices could track the changes in EEG pattern during different anesthesia states. Three PE measures outperformed the other entropy indices, with less baseline vari-ability, higher coefficient of determination and prediction probability, and RPE performed best; ApEn and SampEn discriminated BSP best. Additionally, these entropy measures showed an ad-vantage in computation efficiency compared with MDFA.Conclusion: Each entropy index has its advantages and disadvantages in estimating DoA. Overall, it is suggested that the RPE index was a superior measure.Significance: Investigating the advantages and disadvantages of these entropy indices could help improve current clinical indices for monitoring DoA.

  2. Spinal anesthesia for laparoscopic cholecystectomy: Thoracic vs. Lumbar Technique

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2014-01-01

    Full Text Available Aims: In our group, after a study showing that spinal anesthesia is safe when compared with general anesthesia, spinal anesthesia has been the technique of choice for this procedure. This is a prospective study with all patients undergoing LC under spinal anesthesia in our department since 2007. Settings and Design: Prospective observational. Materials and Methods: From 2007 to 2011, 369 patients with symptoms of colelithiasis, laparoscopic cholecystectomy were operated under spinal anesthesia with pneumoperitoneum and low pressure CO 2. We compared 15 mg of hyperbaric bupivacaine and lumbar puncture with 10 or 7.5 mg of hyperbaric bupivacaine thoracic puncture, all with 25 μg fentanyl until the sensory level reached T 3 . Intraoperative parameters, post-operative pain, complications, recovery, patient satisfaction, and cost were compared between both groups. Statistical Analysis Used: Means were compared by ANOVA or Kruskal-Wallis test, the percentages of the Chi-square test or Fisher′s exact test when appropriate. Time of motor and sensory block in spinal anesthesia group was compared by paired t test or Mann-Whitney test. Differences were considered significant when P ≤ 0.05, and for comparisons of mean pain visual scale, we employed the Bonferroni correction applied to be considered significant only with P ≤ 0.0125 Results: All procedures were completed under spinal anesthesia. The use of lidocaine 1% was successful in the prevention of shoulder pain in 329 (89% patients. There were significant differences in time to reach T 3 , obtaining 15 mg > 10 mg = 7.5 mg. There is a positive correlation between the dose and the incidence of hypotension. The lowest doses gave a decrease of 52.2% in the incidence of hypotension. There was a positive correlation between the dose and duration of sensory and motor block. Sensory block was almost twice the motor block at all doses. With low doses, 60% of patients went from table to stretcher

  3. When local anesthesia becomes universal: pronounced systemic effects of subcutaneous lidocaine in bullfrogs (Lithobates catesbeianus)

    DEFF Research Database (Denmark)

    Williams, catherine; Alstrup, Aage Kristian Olsen; Bertelsen, Mads

    2017-01-01

    Sodium channel blockers are commonly injected local anesthesia but are also routinely used in general immersion anesthesia for fish and amphibians. Here we report the effects of subcutaneous injection of lidocaine (5 or 50 mg kg-1) in the hind limb of bullfrogs (Lithobates catesbeianus) on reflexes......). Reflexes were regained over 4 h. Systemic sedative effects were not coupled to local anti-nociception, as a forceps pinch test at the site of injection provoked movement at the height of the systemic effect (tested at 81 ± 4 min). Amphibians are routinely subject to general anesthesia via exposure...

  4. [Hernia repair and local anesthesia. Results of a controlled randomized clinical trial].

    Science.gov (United States)

    Milone, F; Salvatore, G; Leongito, M; Milone, M

    2010-01-01

    In the past, general and spinal anesthesia were used for hernia surgery, but nowadays local anesthesia has become the method of choice for hernia repair, especially in outpatient patients. The one-day surgery is sufficient in the management of this pathology. The advantages of local anesthesia are simplicity, safety, extended postoperative analgesia, early mobilization, lack post-anesthesia effects, and low costs. From January 2004 to December 2008 we observed 297 male patients with inguinal hernia. These patients were divided, with rigorous chronological order of hospital admission, in two study groups, different for anesthetic techniques used. Our controlled randomized clinical trial examines the effectiveness of local anesthesia to reduce the time of hospitalization, without alteration of results, and particularly the degree of satisfaction of patients surgical treated for inguinal hernia.

  5. 氟比洛芬酯和帕瑞昔布预防丙泊酚复合瑞芬太尼麻醉下苏醒期躁动的临床对比%Comparision of Flurbiprofen Axetil and Parecoxib on restlessness during the stage of analepsia after general anesthesia with Propofol combined with Remifentanil

    Institute of Scientific and Technical Information of China (English)

    熊涛; 钟世雄; 廖敏

    2011-01-01

    Objective To compare the effects of Flurbiprofen Axetil and Parecoxib injected before anesthesia induction on the restlessness during the stage of analepsia after general anesthesia with propofol combined with remifentanil. Methods Totally 84 patients with undergoing cholecystectomy by laparoscopic surgery who visited the department of hepatobiliary surgery of our hospital between January 2010 and December 2010 were randomly divided into Flurbiprofen Axetil group,Parecoxib group and control group(28 cases in each group). All patients received combined anesthesia of propofol combined with remifentanil. Patients in Flurbiprofen Axetil group and Parecoxib group respectively received 50mg of Flurbiprofen Axetil and 40mg of Parecoxib injected before anesthesia induction, and patients in control group only received normal saline. Visual analogue scale, restless scale and Ramesay scale were evaluated before and at removal of airway tube,and 15min,30min and 45min after removal of airway tube. Results Visual analogue scale, restless scale and ramesay scale in Flurbiprofen Axetil group or Parecoxib group decreased significantly compared to those in control group ( P < 0. 05 or P < 0. 01). Visual analogue scale(VAS),restless scale and Ramesay scale in Parecoxib group decreased significantly compared to those in Flurbiprofen Axetil group (P < 0. 01 ). Conclusions Parecoxib injected before anesthesia induction on the restlessness during the stage of analepsia after general anesthesia with propofol combined with remifentanil can more effectively prevent restlessness during the stage of analepsia than Flurbiprofen Axetil.%目的 观察麻醉诱导前静脉注射氟比洛芬酯和帕瑞昔布预防丙泊酚复合瑞芬太尼麻醉苏醒期躁动的效果.方法 2010年1月-2010年12月重庆市綦江县中医院肝胆外科择期行腹腔镜胆囊切除术患者84例随机分为氟比洛芬酯组、帕瑞昔布组和对照组,每组28例.所有患者均以丙泊酚、瑞芬

  6. Supreme喉罩联合七氟醚、丙泊酚顺序全麻在剖宫产中的应用%The application of Supreme laryngeal make combining with sevoflurane-propofol sequence general anesthesia in the cesarean section

    Institute of Scientific and Technical Information of China (English)

    马保新; 郑辉利

    2010-01-01

    Objective To observe the application of Supreme laryngeal make combining with sevoflurane-propofol sequence general anesthesia in the Cesarean section. Methods 60 patients were randomly divided into sevoflurane-propofol sequence general combine with Supreme laryngeal mask group (group A ) and spinal-epidural anesthesia group (group B ). Group A was administrated Supreme laryngeal-mask intubation after inhalation of 6%-8% sevoflurane in 5 L/min -8 L/min oxygen, then inhalation of 2%-3% sevoflurane in 2 L/min -3 L/min till the newborn delivery, and then used propofol combine with remifentanil to replace sevoflurane till the end of the operation. Group B was performed with spinal injection of ropivacaine 9 mg-12 mg. The parturient undergone hypotension which could not recovered by fluid replacement was intravenous injection of ephedrine. Effect-acting time of anesthesia volume of blood loss, rate of low blood pressure and dosage of ephedrine, complication of anesthesia and Apgar scores at 0,5 and 10 minutes after delivery were recorded. Results The effect-acting time of anesthesia in group B (15.8±5.6) min was longer than that (5.2±1.7) min in group A(P<0.05).The rate of low blood pressure (0.00%), the rate of ephedrine to use(0.00% ) and complication of anesthesia (3.33%) in group A were all lower than those (40.00%, 33.33%, 23.33%) in group B (P<0.05). The volume of blood loss and the Apgar scores at each time points were similar( P>0.05 ). Conclusion The effect of sevoflurane to the foetus is little and intravenous anesthesia replaced sevoflurane after the newborn delivery can reduce the effect of sevoflurane to the uterine contraction.And Supreme laryngeal mask can prevent back flow and aspiration efficiently. So the Superme laryngeal mask combining with sevoflurane-propofol sequence general anesthesia is a comfortable and effective general anesthesia, which can apply in the Cesarean section safely.%目的 对Supreme喉罩联合七氟醚、丙泊酚顺序

  7. Impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function in patients with abdominal surgery%硬膜外复合全麻对腹部手术患者血液循环及免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    马海燕

    2013-01-01

    目的 探讨硬膜外复合全麻对腹部外科手术患者血流循环及免疫功能的影响.方法 将90例行腹部手术患者随机分成实验组(应用硬膜外复合全麻)和对照组(单纯应用全身麻醉),每组45例.记录并比较2组的血流动力学及免疫功能的变化情况.结果 实验组术毕时、术后12h及术后1、2d的SBP、DBP、HR、SpO2波动幅度均明显小于对照组(P<0.05);实验组术后6h及术后1、3、5、7d的CD3+、CD4+、CD4+/CD8+水平下降幅度均明显小于对照组(P<0.05).结论 硬膜外复合全麻较单纯全麻对患者的血流循环及免疫功能的影响更小,临床应用于腹部外科手术麻醉的前景良好.%Objective To investigate the impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function in patients with abdominal surgery.Methods Ninety patients with abdominal surgery were randomly divided into two groups,treatment group (n =45) and control group (n =45).The control group was given general anesthesia only,and the treatment group was given epidural anaesthesia combined with general anesthesia.The changes of hemodynamic and the immune function in both groups were observed and compared.Results The fluctuation range of SBP,DBP,HR,SpO2 in the end of operation,12 hours after operation,ld and 2ds after operation in the treatment group were significantly less than the control group (P < 0.05).The decline of CD3+,CD4+,CD4+/CD8+ 6 hours after operation,1d,3 ds,5 ds and 7 ds after operation in the treatment group were significantly less than the control group (P < 0.05).Conclusion The impact of epidural anaesthesia combined with general anesthesia on hemodynamics and immune function is significantly smaller in patients with abdominal surgery,and the epidural anaesthesia combined with general anesthesia has good prospects in abdominal surgery.

  8. 应用韦氏智力量表评估全身麻醉下牙齿治疗对儿童的影响%Children’s intelligence quotient following general anesthesia for dental care:a clini-cal observation by Chinese Wechsler young children scale of intelligence

    Institute of Scientific and Technical Information of China (English)

    夏斌; 王建红; 肖雨萌; 刘克英; 杨旭东; 葛立宏

    2016-01-01

    Objective:It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models.However,for the limitation that the animal models can-not fully mimic the dose and duration in clinical settings especially for dental general anesthesia,the cli-nical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore,we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia comparing to that before surgery.We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia compared with that before surgery.Methods:Thirty two patients,ASA Ⅰ, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology,aged 4 to 6.5 years,were enrolled in this prospective study.Patients with severe learning difficulties or communication disorders were excluded.Written and informed consent was obtained from each patients’family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version)before and 2 weeks after dental anesthesia.They were treated by experienced pediatric dentists and the sevoflurane,propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extrac-tion.The examiners and scorers for IQ had technical training in the test administration.All the patients were tested by the same examiner and with standardized guide language.Each subtest was scored accor-ding to the tool review.Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS

  9. 无肌松维持全麻用于经皮肾镜碎石术的安全性和有效性%Maintenance of general anesthesia without muscle relaxant for percutaneous nephrolithotomy

    Institute of Scientific and Technical Information of China (English)

    杨戈雄; 袁杰; 毛兰萍; 马军令; 袁超英; 高爽

    2012-01-01

    [目的]探讨无肌松维持全凭静脉麻醉用于经皮肾镜碎石术的安全性和有效性.[方法]将180例择期行经皮肾镜碎石术的患者随机分成插管后肌松维持组(Ⅰ组)及插管后无肌松维持组(Ⅱ组)各90例.Ⅰ组予维库溴铵0.08 ~ 0.1mg/kg诱导、在患者有体动时或每40 min静注0.05 mg/kg维持肌松;Ⅱ组予维库溴铵o.05 mg/kg诱导插管,术中无肌松维持.记录两组麻醉前、气管插管前、气管插管后、手术开始后20 min、拔管前、术后1h各时点血压、心率、sPO2等血流动力学指标并与基础值比较.并记录各组术毕恢复情况.[结果]各组气管插管均一次成功,术中麻醉平稳,无体动反应,均顺利完成手术.无肌松维持组术后苏醒各项指标显著短于对照组.术后意识完全清醒,无须拮抗肌松,无呼吸抑制及呕吐误吸、分泌物阻塞、呼吸道梗阻发生.[结论]无肌松维持下丙泊酚-瑞芬太尼全凭静脉麻醉可满足经皮肾镜碎石术的需要,降低麻醉风险.%[Objective] To investigate the safety and effectiveness! of percutaneous nephrolithotomy without muscle relaxantB to maintain total intravenous anesthesia. [Methods] A total of 180 patients undergoing percutaneous nephrolithotomy were randomly divided into muscle relaxants intubation maintenance group ( group I induced 90 cases) and intubation without muscle relaxants maintain group (group II, 90 cases). Group I induced with vecuronium 0.08 - 0.1 mg/kg, when patients moved or ever 40 min 0.05 mg/kg maintain muscle relaxation were given. Group II inducted with vecuronium bromide (0.05 mg/kg ) and tracheal intubated but without muscle relaxants maintenance during operation. Blood pressure, heart rate, sPO: and other hemodynamic parameters of two groups were recorded before anesthesia , before tracheal intubation and after tracheal intubation, 20 min after surgery, before extubation and 1h after operation, compared with basic value

  10. The role of regional and neuroaxial anesthesia in patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Dempsey Z

    2011-10-01

    Full Text Available Zoey Sarah Dempsey1, Simone Rowell2, Rose McRobert31Department of Anaesthesia, Southern General Hospital, Glasgow, Lanarkshire, 2Department of Anaesthesia, Western Infirmary, Glasgow, Lanarkshire, 3Department of Anaesthesia, The Ayr Hospital, Ayr, Aryshire, UKAbstract: Systemic sclerosis (SSc, previously known as progressive systemic sclerosis, is a form of scleroderma and a multisystem connective tissue disease which can impact on every aspect of anesthetic care, especially airway management. In this review we outline clinical manifestations and current medical treatment of the disease, and general principles of anesthetizing these patients. We focus on the role of regional anesthesia, including neuroaxial anesthesia, which may serve as a safe alternative to general anesthesia but can be technically challenging. We address concerns regarding abnormal responses to local anesthesia which have previously been reported in patients with SSc, and explore future developments in technology and pharmacology, which may enable regional anesthesia to be performed more successfully and with fewer complications.Keywords: systemic sclerosis, scleroderma, regional anesthesia, neuroaxial anesthesia

  11. 婴幼儿时期麻醉手术对儿童智力和感觉统合能力的远期影响%Long-term effects of early exposure to general anesthesia and surgery on children' s development of intelligence and sensory integration function

    Institute of Scientific and Technical Information of China (English)

    李纯青; 王东信; 马旭波; 朱赛楠

    2012-01-01

    [Objective]To investigate the long-term effects of early exposure to general anesthesia and surgery on children' s development of intelligence and sensory integration function.[Methods] This was a 1 ∶ 1matched case-control study.Children who lived in Beijing urban area,underwent non-cardiac/non-neurosurgical surgery under general anesthesia before 3 years of age,aged 6 to 8 years at the time of assessment were enrolled as anesthesia group.Children,who lived in the same area but did not undergo general anesthesia and surgery before 3years of age,were matched according to children's age,sex,educational level,as well as parents' educational background,occupation,socioeconomic status and enrolled in the control group.The Wechsler Intelligence Scale for Children-fourth edition( Chinese version)and the Child Sensory Integration Check List were used to evaluate the intelligence and sensory integration function of the two groups of children.Resnlts There were no significant differences between two groups with respect to full scale Intelligence Quotient( 113.6 ± 10.4 vs.114.6 ±9.9,P=0.524 ) as well as Verbal Comprehension Index( 111.0 ± 11.3 vs.112.7 ± 10.3,P=0.320),Perceptual Reasoning Index(113.4 ±12.1 vs.114.3 ±10.4,P=0.631),Working Memory Index(109.6 ± 13.6 vs.109.4 ±10.1,P=0.896),Processing Speed Index( 105.9 ± 9.7 vs.107.7 ± 10.5,P=0.199 ),General Ability Index ( 114.4 ± 11.3vs.115.3 ±11.3,P=0.852)and Cognitive Productive Index(110.1 ± 10.9 vs.110.4 ±9.2,P=0.882).In terms of intelligence structure,the incidence of clinically meaningful difference between indexes of Working Memory and Verbal Comprehension was significantly higher in the anesthesia group than in the control group(7.4% vs.0,P=0.038 ).There was no significant difference in the incidence of sensory integration dysfunction between two groups (46.9% vs.45.7%,P=0.875 ).However,among children in the anesthesia group,the incidence of vestibule balance dysfunction was significantly

  12. Placement of a gastric tube at varied preoperative moments in patients scheduled for gastrointestinal operation under general anesthesia:the effect of timing on cortisol level%术前置胃管时间对全麻胃肠道手术患者皮质醇的影响

    Institute of Scientific and Technical Information of China (English)

    袁玉萍; 尹罗庚; 贡国娟; 吴红梅

    2012-01-01

    Objective To observe the effect of preoperative placing timing of gastric tube on cortisol level of patients scheduled for gastrointestinal operation under general anesthesia. Methods Forty patients scheduled for gastrointestinal operation under general anesthesia were commensurately randomized into two groups. The gastric tube was placed in the morning on the day when patients were to receive the gastrointestinal surgery in the control group, while it was placed after induction of general anaesthesia in the observation group. Mean arterial pressure, heart rates and serum cortisol level were recorded on the operation morning, before induction of general anesthesia, 2 and 5 minutes after endotracheal intubation. Results There was significant group effect between the two groups in mean arterial pressure, heart rates and serum cortisol level at varied time points (P<0. 05 for all). Conclusion Placement of a gastric tube after induction of general anaesthesia alleviates discomfort of patients, avoids abrupt icrease in blood pressure, heart rates and serum cortisol level, and lessens stress-induced reaction.%目的 观察术前置胃管时间对全麻胃肠道手术患者皮质醇的影响.方法 将40例胃肠道手术需要置胃管的患者随机分为两组,各20例.对照组于术晨病房常规置胃管,观察组于全麻诱导后置胃管.每组分别监测术晨,麻醉诱导前,气管插管后2 min及5 min时平均动脉压、心率及血清皮质醇.结果 两组不同时段各观察指标比较,干预主效应均P<0.05.结论 将手术患者置胃管时间放在麻醉诱导后进行能减少患者的不适感,避免血压、心率及皮质醇急剧升高,减轻应激反应.

  13. 舒芬太尼联合曲马多对全麻苏醒期躁动与寒战的预防作用%Preventive Effects of Sufentanil Combined with Tramadol on Agitation and Shivering of Patients with General Anesthesia during Recovery Period

    Institute of Scientific and Technical Information of China (English)

    许先成; 冯慧; 柯昌斌

    2011-01-01

    Objective To observe the preventive effects of sufentanil combined with tramadol on agitation and shivering of patients with general anesthesia during recovery period. Methods One hundred and twenty patients underwent general anesthesia with the same way were randomly divided into sufentanil group (group S), sufentanil combined with tramadol group (group ST) ,tramadol group(group T) and control group(group C) ,n =30. The four groups were given intravenous injection with sufentanil (0. 15 μg · kg - 1 ), sufentanil ( 0. 1 μg · kg - 1 ) combined tramadol ( 1 mg· kg - 1 ), tramadol ( 2 mg·kg-1) ,equal volum of physiological saline at 30 min before operation termination,respectively. The incidence of agitation and shivering in patients were recorded during recovery from general anesthesia by a single blind method. Results Compared with group C,the incidence of agitation and shivering in the other three groups were decreased as well as the pain score. The agitation and shivering incidences in group ST were correspondingly lower than that of group S and that of group T,and the pain score in gorup ST were lower than both group S and group T. Conclusion Pretreated with low dose of sufentanil and tramadol could alleviate the post-operation pain and prevent the agitation and shivering effectively during recovery from general anesthesia, and make the anesthesia recovery more stable.%目的:观察舒芬太尼联合曲马多对全麻苏醒期躁动与寒战的预防作用.方法:全麻下择期开腹手术患者120例随机均分为:舒芬太尼组、联合组、曲马多组及对照组,各组均采用相同的麻醉方案,分别于手术结束前3min静注舒芬太尼0.15μg·kg-1、舒芬太尼0.1μg·kg-1+曲马多1mg·kg-1、曲马多2 mg·kg-1、等量0.9%氯化钠溶液.盲法记录患者苏醒期躁动与寒战情况.结果:与对照组比较,舒芬太尼组、联合组、曲马多组苏醒期躁动与寒战发生数均显著减少,疼痛评分明显降

  14. Application of muscle relaxation closed loop monitoring system in general anesthesia for elderly patients and prevention of postoperative pulmonary infections%老年全麻患者肌松闭环监测的应用观察及术后肺部感染的预防

    Institute of Scientific and Technical Information of China (English)

    刘俊; 杜建龙; 包梅芳; 吴纯西

    2013-01-01

    OBJECTIVE To observe the clinical effect and safety of the closed-loop muscle relaxation injection system used by the elderly patients during general anesthesia so as to prevent the postoperative pulmonary infections. METHODS A total of 100 elderly patients (with the general anesthesia of AS Ⅰ - Ⅱ class) who underwent upper abdominal surgery from Feb 2010 to Feb 2012 were randomly selected as the study subjects and were divided into the group A (the AEP closed-loop muscle relaxant injection system group) and the group B (traditional experience control group) , with 50 cases in each. The mean arterial pressure, heart rate, and respiratory rate of the two groups were observed, and the total muscle relaxants, induced total recovery time and postoperative adverse reactions, and pulmonary infections were recorded. RESULTS The copper rating, anaesthetists satisfaction rate, and the operation physician satisfaction rate of the group A were all higher than the group B, the difference was statistically significant(P<0. 05). There were 8 cases with pulmonary infections in the group A with the infection rate of 16. 0%, and there were 11 cases with the postoperative pulmonary infections in the group B with the infection rate of 22. 0%. CONCLUSION The closed-loop muscle relaxant injection system used by the elderly patients with general anesthesia can effectively guide the reasonable use of muscle relaxants during anesthesia and reduce the incidence of residual paralysis, thereby improving the safety of elderly patients with general anesthesia.%目的 观察闭环肌松注射系统在老年全麻患者的临床效果及安全性,以预防老年患者术后肺部感染.方法 随机选取2010年2月-2012年2月进行上腹部手术的老年全麻手术(ASA Ⅰ-Ⅱ级)患者100例为研究对象,将其分为A、B两组,每组50例,A组为AEP闭环肌松注射系统组,B组为传统经验对照组,观察两组患者平均动脉压、心率、呼吸频率等数值,记录肌松

  15. Intestinal circulation during inhalation anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Tverskoy, M.; Gelman, S.; Fowler, K.C.; Bradley, E.L.

    1985-04-01

    This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of /sub 86/Rb and 9-microns spheres labeled with /sup 141/Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001). Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO/sub 2/) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines.

  16. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2009-01-01

    There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...

  17. Preemptive analgesia effects of flurbiprofen axetil or tramadol in patients undergoing sevoflurane general anesthesia%氟比洛芬酯和曲马多超前镇痛应用于七氟醚麻醉的比较

    Institute of Scientific and Technical Information of China (English)

    王琦; 余永华; 姚尚龙

    2013-01-01

    (the flurbiprofen axetil group,20 cases) or 2 mg/kg tramadol(the tramadol group,20 cases) or 10 ml normal saline (the normal saline group,20 cases),10 min before the surgery.The heart rate (HR),mean arterial blood pressure (MAP) and pulse oxygen saturation (SpO2) before induction of anesthesia and peri-extubation,the moment of eyes opening and extubation,and the degree of postoperative agitation were recorded.Results The MAP、HR in the flurbiprofen axetil group and the tramadol group were significantly lower than that of the normal saline group peri-extubation(P<0.05 or P<0.01),SpO2 was not significantly different in all groups.The time of eye opening and extubation in the flurbiprofen axetil group [(11 ±4),(13±3) min] were significantly shorter than that of the tramadol group [(15±4),(18±5) min] (P<0.05).The emergence of postoperative agitation in the flurbiprofen axetil group(0) and the tramadol group(20%) were significantly better than that of the normal saline group(55%)(P<0.05 or P<0.01),and the visual analogue score in the flurbiprofen axetil group[(2.2±0.6),(2.1±0.8)] and the tramadol group[(3.0±1.1),(2.6±1.0)] after the operation finished 0.5 h and 2 h were significantly better than that of the normal saline group [(4.1 ±0.7),(3.9±0.6)] (P<0.05).Conclusions Applying of flurbiprofen axetil and tramadol in sevoflurane general anasthesia can provide a good effect of preemptive analgesia and prevent postoperative agitation.But tramadol would prolong the waking time of patients.

  18. Avaliação comparativa entre a anestesia geral com halotano e isoflurano sobre a pressão arterial em cães Comparartive evaluation of the general anesthesia with halothane and isoflurane on the arterial pressure in dogs

    Directory of Open Access Journals (Sweden)

    Cláudio Corrêa Natalini

    2000-06-01

    isoflurane in group II. In both groups, nitrous oxide and oxygen in a 2:1 ratio was used as diluent for the inhalant. After 15 minutes of inhalation anesthesia, arterial blood pressures were recorded with a noninvasive blood pressure monitor in 15 minutes intervals for 90 minutes. Statistical analyses showed that there was a significant difference in systolic and diastolic pressures after 45 minutes. Differences in heart rate were not significant. In dos, general anesthesia with isoflurane maintained higher arterial blood pressures than those anesthetized with halothane which produced arterial hipotension from 45 to 75 minutes of anesthesia.

  19. Anesthesia for patients with renal/hepatic disease.

    Science.gov (United States)

    Weil, Ann B

    2010-05-01

    General anesthesia may be necessary for patients with significant disease processes such as renal disease or hepatic disease. A basic understanding of the effects of general anesthetics on these organs and the anticipated problems of renal and hepatic impairment on the anesthetic process is necessary to optimize conditions for patients with renal or hepatic disease. Patient preparation, drug selection, and monitoring strategies will be discussed for patients with renal and liver disease.

  20. Complicações respiratórias em pacientes com paralisia cerebral submetidos à anestesia geral Complicaciones respiratorias en pacientes con parálisis cerebral sometidos a la anestesia general Respiratory complications in patients with cerebral palsy undergoing general anesthesia

    Directory of Open Access Journals (Sweden)

    Sérgio Silva de Mello

    2007-10-01

    álisis cerebral (PC puede representar un desafío para el anestesiólogo. Este estudio prospectivo tuvo como objetivo determinar la prevalencia y el riesgo de complicaciones respiratorias en niños con PC sometidos a anestesia general inhalatoria para tomografía computadorizada. MÉTODO: Participaron del estudio pacientes con edades entre 1 y 17 años, estado físico ASA I a III, sometidos a AGI con sevoflurano y máscara laríngea para TC en el período de junio/2002 a junio/ 2003, divididos en 3 grupos: PC tetraplégicos (PCT, Otros tipos de PC (PCO, y paciente sin PC (NPC. Los padres o responsables respondieron a un cuestionario con preguntas sobre el historial médico de los pacientes, infección de vías aéreas superiores (IVAS, asma, convulsión, no coordinación oro faríngea, reflujo gastroesofágico, etc. Datos sobre la incidencia y la gravedad de las complicaciones respiratorias fueron recolectados proscpectivamente (tos, bronco espasmo, laringo espasmo, hipoxemia, aspiración. La muestra fue calculada para una incidencia esperada de 5% en el grupo NPC, con una diferencia de 15% entre los grupos (alfa = 0,05 y beta = 0,1, utilizando los tests del Chi-cuadrado, exacto de Fisher y t de Student. RESULTADOS: Conformaron la muestra 290 pacientes divididos en los grupos de la siguiente forma: PCT - 100, PCO - 79 y NPC- 111. No hubo diferencia en la prevalencia de complicaciones respiratorias entre los grupos PCT (4%, PCO (8,9% y NPC (7,3%. Hubo una asociación entre la presencia de IVAS y la incidencia de complicaciones (riesgo relativo 10,71. CONCLUSIONES: Niños con parálisis cerebral tipo tetraplegia espástica no parecen correr riesgo aumentado de complicaciones respiratorias durante la anestesia general inhalatoria con sevoflurano y máscara laríngea. El estudio confirma IVAS como factor de riesgo para la incidencia de esas complicaciones.BACKGROUND AND OBJETIVES: Anesthesia in patients with cerebral palsy (CP poses a challenge for the anesthesiologist. The objective

  1. Anesthesia considerations in the obese gravida.

    LENUS (Irish Health Repository)

    Tan, Terry

    2011-12-01

    Obesity is associated with serious morbidity during pregnancy, and obese women also are at a high risk of developing complications during labor, leading to an increased risk for instrumental and Cesarean deliveries. The engagement of the obstetrical anesthetist in the management of this group of high-risk patients should be performed antenatally so that an appropriate management strategy can be planned in advance to prevent an adverse outcome. Good communication between all care providers is essential. The obese patient in labor should be encouraged to have a functioning epidural catheter placed early in labor. Apart from providing analgesia and alleviating physiological derangements during labor, the presence of a functioning epidural catheter can also be used to induce anesthesia quickly in the event of an emergency cesarean section, thus avoiding a general anesthesia, which has exceedingly high risks in the obese parturient. Successful management of the obese patient necessitates a comprehensive strategy that encompasses a multidisciplinary and holistic approach from all care-providers.

  2. Avaliação de alterações timpanométricas em pacientes submetidos à anestesia geral com óxido nitroso Evaluation of tympanometric alterations in patients subject to general anesthesia with nitrous oxide

    Directory of Open Access Journals (Sweden)

    Fernanda Mossumez Fernandes Teixeira

    2005-06-01

    during the anesthetic act and cause negative pressure after it is discontinued, mainly in patients with Eustachian tube dysfunction. These pressure variations may come up with clinical implications such as tympanic membrane rupture, ossicular system disarticulation, haemotympanum, barotraumas, prosthesis displacement stapaedotomy and tympanic graft lateralization after tympanoplasty, in addition to serous fluid entrance into the middle ear during the negative pressure phase. AIM: To evaluate the nitrous oxide influence on the middle ear pressure in a population without tube malfunction performing pre and postoperative tympanometry. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: A prospective study was carried out with Universitário Clementino Fraga Filho Hospital- UFRJ inpatients submitted to general anesthesia with the use of 50% nitrous oxide from April to June 2003. It was also evaluated whether the duration of surgery, associated anesthetics, presence of allergic rhinitis and nasal septal deviation could contribute to the onset of intratympanic pressure alteration. RESULTS: The sample was made up of 50 patients and in almost half of them (48%, postoperative tympanometry alterations (type C curve were found when comparing to preoperative tympanometric control (type A curve. Neither gender nor age interfered in the onset of postoperative tympanometry alterations, similarly to surgery duration. The associated volatile anesthetic type, nasal septal deviation and allergic rhinitis were not able to influence postoperative middle ear pressure. CONCLUSION: Nitrous oxide modifies intratympanic pressure during the anesthetic act and after its discontinuation.

  3. Study on appHcatlon of complex psychological intervention in patients during recovery from general anesthesia%复合心理疏导在全麻苏醒期患者中的应用研究

    Institute of Scientific and Technical Information of China (English)

    张芝颖; 王欣然; 韩斌如

    2008-01-01

    Objective To explore the mode of clinical psychological intervention of operative patients,pmbe into the value of music therapy in clinical application,and slart the new application fields.Methods 60 Datients were divided into the experiment group and the control group.Patients in the two groups accepted the pre-operative psychological intervention 1 d before the operation.Afier the operation.the complex psychological intervention was given to the patients during recovery from general anesthesia in the experiment group.While the patients in the control group were waken only by means of music.The heart rate(HR),pulse oximetry (SpO2),mean arterial pressure(MAP) and the objective indexes of Hamilton Anxiety Scale(HAMA)were assessed between the two groups.Results MAP in the experiment group and the control group were(79.80 4±7.76)mm Hg,(82.33±6.42)mm Hg(1 mm Hg=0.133 kPa),respectively,There was no statistical meaning in MAP and SpO2 between the two groups(P>0.05).HR were(80.76±13.92),(85.82±13.39) times/minute.respectively.The difference of HR had statistical meaning(P<0.05).The anxiety degree (9.78 4±2.32)in the experiment group was obviously poor than that(11.08±2.97)in the control group,and the difference had a statistical meaning(P<0.01).Conclusions The complex psychological intervention is a combination of preoperative psychological intervention,postoperative music awakening,and psychological guidance assisted under the music during the stepwise recovery of consciousness.It provides the whole process,timely,individual and pertinent help and psychological guidance,having active effect in reducing the patients' anxiety degree.%目的 探讨手术患者的临床心理干预模式,探索音乐疗法在临床应用中的价值,并开创新的应用领域.方法 60例患者分为实验组与对照组,2组患者于手术前1 d均接受术前心理干预,手术后,实验组患者在全麻苏醒期给予复合心理疏导,对照组患者术后

  4. 达克罗宁胶浆在全麻手术经口气管插管中的应用效果%Dyclonine mortar in the application of the breath tube intubation on general anesthesia surgery

    Institute of Scientific and Technical Information of China (English)

    陈平

    2015-01-01

    Objective To study the clinical effect of dyclonine mortar as a lubricant for the breath tube intubation in critical care patients .Methods According to the random number table method, 86 patients with the breath tube intubation anesthesia were divided into observation group and control group, 43 cases in each group. After anesthesia induction, patients in observation group were with 1% dyclonine mortar as a lubricant evenly 15~20 cm in front of the endotracheal tube for endotracheal intubation, and the control group were used routinely paraffin oil lubricating oil endotracheal tube . The visual analogue scale method(visual analog score, VAS)(0~10) was used for patients' cough, sore throat and hoarseness symptoms assessment; WHO mucosa reaction classification method(0 - Ⅳ degree 0 to 4 points, has been recorded in the sum of total score for the pharyngeal and laryngeal score) on patients with pharyngeal and laryngeal mucosa reaction rate.Results Postoperative cough VAS score between the two groups had no statistical difference(P>0.05); The patients' postoperative sore throat, hoarseness VAS score in observation group were less than those in the control group, and the differences were statistically significant(P0.05);术后两组患者咽痛、声嘶VAS评分观察组小于对照组,差异有统计学意义(P<0.05);术后两组患者咽喉部黏膜反应评分观察组小于对照组,差异有统计学意义(P<0.05).结论 应用达克罗宁胶浆在气管插管中作为润滑剂,能有效地减少神经冲动刺激咽喉壁,减少患者的痛苦,提高患者的依从性,且操作简单.

  5. Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane Estudo eletrocardiográfico em cães geriátricos submetidos à anestesia geral com isofluorano

    Directory of Open Access Journals (Sweden)

    Andreza Conti-Patara

    2009-04-01

    Full Text Available The purpose of this study was to clarify the degree of influence of anesthetic agents commonly used during anesthesia on the heart conduction systems of geriatric dogs, with or without the presence of electrocardiographic changes in the pre-anesthetic electrocardiogram and also to determine the possible causes of ST-segment and T-wave changes during anesthesia, by monitoring ventilation and oxygenation. 36 geriatric dogs were evaluated. In addition to electrocardiographic evaluation, the pre-anesthetic study included serum levels of urea, creatinine, total protein, albumin and electrolytes. The pre-anesthetic medication consisted of acepromazine (0.05mg kg-1 in association with meperidine (3.0mg kg-1 by IM injection. Anesthesia was induced with propofol (3.0 to 5.0mg kg-1 by IV injection and maintained with isoflurane in 100% oxygen. During the anesthesia, the animals were monitored by continued computerized electrocardiogram. Systemic blood pressure, heart rate, respiratory rate, end-tidal carbon dioxide, partial pressure of carbon dioxide in arterial blood, arterial oxygen saturation, partial pressure of arterial oxygen and oxygen saturation of hemoglobin were closely monitored. During maintenance anesthesia, normal sinus rhythm was more common (78%. ST-segment and T-wave changes during the anesthetic procedure were quite common and were related to hypoventilation. The use of isoflurane did not result in arrhythmia, being therefore a good choice for this type of animal; Electrocardiographic findings of ST-segment and T-wave changes during the maintenance anesthesia were evident in animals with hypercapnia, a disorder that should be promptly corrected with assisted or controlled ventilation to prevent complicated arrhythmias.Os objetivos deste estudo foram esclarecer a influência dos agentes anestésicos comumente utilizados durante a anestesia no sistema de condução cardíaco em cães idosos, com ou sem alterações eletrocardiográficas pr

  6. Mortality incidence in outpatient anesthesia for dentistry in Ontario.

    Science.gov (United States)

    Nkansah, P J; Haas, D A; Saso, M A

    1997-06-01

    Studies determining anesthesia mortality rates in dentistry have been published, yet a similar investigation has never been conducted in Canada. Therefore the objective of this study was to determine the incidence of mortality when general anesthesia or deep sedation was administered by qualified dentists in the province of Ontario. Mortality data were obtained from the years 1973 to 1995 inclusive. The number of general anesthetics and deep sedations administered annually by qualified in dental offices was calculated by surveying all oral and maxillofacial surgeons and dental anesthetists in Ontario in 1990 and 1995. The results provided an estimate of 2,830,000 cases from 1973 to 1995 inclusive. Over this time period there were four deaths associated with cases in which either an oral and maxillofacial surgeon or dental anesthetist administered the general anesthetic or deep sedation, yielding a mortality rate of 1.4 per 1,000,000. This mortality incidence is similar to rates already published for outpatient dentistry.

  7. 丙泊酚复合雷米芬太尼全身麻醉对剖宫产术中新生儿氧摄取率的影响%Effect of general anesthesia with propofol and remifentanil on ERO2 of neonates during Cesarean section

    Institute of Scientific and Technical Information of China (English)

    陈静; 倪燕; 何明枫

    2016-01-01

    目的 比较不同麻醉方法用于剖宫产手术中对新生儿氧摄取率(ERO2)的影响.方法 选择40例行子宫下段剖富产手术的足月产妇,有椎管内麻醉禁忌证者纳入丙泊酚复合雷米芬太尼全身麻醉组(GA组,20例),无椎管内麻醉禁忌证者纳入硬膜外麻醉组(EA组,20例).比较两组麻醉开始至胎儿娩出时间(I-D)、子宫切开至胎儿娩出时间(U-D)、新生儿娩出后的脐动静脉血气分析值、ERO2、Apgar评分和新生儿神经行为学(NBNA)评分.结果 EA组I-D长于GA组(P<0.05),两组U-D、新生儿脐动静脉血pH值、PQ、PCQ、SpQ、Hb含量及ERQ2均无统计学差异(P>0.05).GA组新生儿1-min Apgar评分低于EA组(P<0.05),两组5-rnin Apgar评分无统计学差异(P>0.05).所有新生儿24 h的NBNA评分大于35分.结论 丙泊酚复合雷米芬太尼全身麻醉用于剖宫产手术对新生儿的ERO2影响较小,但应预防新生儿一过性呼吸抑制.%Objective To compare the effect of different anesthesia methods on oxygen extraction rate(ERO2) of neonates during Cesarean section.Methods Forty full-term puerperants underwent Cesarean section were divided into two groups of GA (with contraindication for spinal puncture,20 cases) and EA (without contraindication for spinal puncture,20 cases).Group GA received general anesthesia with combined use of propofol and remifentanil and group EA received epidural anesthesia The time from the start of anesthesia to neonatal delivery(I-D) and that from uterus opening to neonatal delivery (U-D),the values of umbilical arterial and venous blood gas analysis,neonates ERO2,Apgar scores and neonatal behavioral neurological assessment (NBNA) scores were compared between two groups.Results I-D time was longer in group EA than that in group GA(P<0.05).There were no significant differences in U-D time,ERO2,and pH value,PO2,PCO2,SpO2,hemoglobin concentration of umbilical arterial and venous blood between two groups (P>0.05).The 1

  8. 小儿全身麻醉苏醒期呼吸道并发症发生的影响因素分析%Risk Factors Analysis of the Occurrence of Airway Adverse Events in Pediatric General Anesthesia Awakening Period

    Institute of Scientific and Technical Information of China (English)

    杨琰

    2014-01-01

    目的:探讨小儿全身麻醉苏醒期呼吸道并发症发生的影响因素。方法选择2011年3月至2014年3月收住复旦大学附属中山医院、择期行脐以下手术(时程>30 min)或行骨手术或泌尿手术的患儿(年龄1~8岁)共100例,美国麻醉师协会分级评定为Ⅰ~Ⅱ级,按患儿实际接受手术的先后顺序、根据随机数字表法给予患儿全麻术后不同的通气装置,分别是一定麻醉深度下拔除气管导管(ETT-A)组、一定麻醉深度下移除喉罩(LMA-A组)、清醒下拔除气管导管(ETT-W)组和清醒下拔除喉罩(LMA-W)组。观察和记录成功插管的次数,患儿苏醒时间及苏醒期呼吸道并发症的情况(有无呼吸道分泌物增多、咳嗽、喉痉挛等),并进行多因素 Logistic回归分析。结果 ETT-W组的苏醒时间较 ETT-A组、LMA-A组、LMA-W组显著减少,差异有统计学意义(P <0.05);ETT-W 组苏醒期呼吸道并发症发生率高于ETT-A组、LMA-A组和LMA-W组(P<0.05)。多因素Logistic回归分析结果显示,通气装置的选择为危害性因素,年龄及拔管(喉罩移除)时麻醉状态为保护性因素。结论选择气管导管更易引发小儿全麻苏醒期呼吸道并发症,需重视和加强手术前后的监护,积极预防和减少并发症的发生,以提高小儿围术期麻醉的安全性。%Objective To investigate the risk factors of the occurrence of airway adverse events in pedi-atric general anesthesia awakening period.Methods During Mar.2011-Mar.2014,a total of 100 children ( aged 1-8 years) , with the surgery below the umbilicus ( >30 min) or bone surgery or urological surgery, and ASA (American Society of Anesthesiologists) for Ⅰ-Ⅱ level,were included in the study,who were giv-en different anesthesia ventilation devices according to the actual surgery order and with random number table method after general anesthesia operation.They were

  9. The modifying effect of anesthetic technique on the metabolic and endocrine responses to anesthesia and surgery

    DEFF Research Database (Denmark)

    Kehlet, H

    1988-01-01

    and the widespread use of the term "stress free anesthesia" in surgery is therefore not valid. However, continuous administration of local anesthetic agents in the epidural space is the most effective technique in so far as reduction of the stress response is concerned. The clinical implication of a variable...... reduction in the stress response to surgery by different anesthetic techniques remains largely unsettled, since only few controlled studies have been published on the clinical effects of pain relief and general anesthesia. However, a vast amount of data exist from controlled studies comparing regional...... anesthesia with local anesthetics and general anesthesia. The cumulative experience from these studies have demonstrated an advantageous effect on postoperative morbidity parameters such as blood loss, postoperative thromboembolic complications, pulmonary infective complications, gastrointestinal motility...

  10. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Shah U

    2015-04-01

    Full Text Available Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA. Patient satisfaction is a complex concept that is influenced by multiple factors. A patient's viewpoint and knowledge plays an influential role in patient satisfaction with ambulatory surgery. Medical optimization and psychological preparation of the patient plays a pivotal role in the success of ambulatory surgery. Postoperative pain, nausea, and vomiting are the most important symptoms for the patient and can be addressed by multimodal drug regimens. Shared decision making, patient–provider relationship, communication, and continuity of care form the main pillars of patient satisfaction. Various psychometrically developed instruments are available to measure patient satisfaction, such as the Iowa Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, but none have been developed specifically for ambulatory surgery. The ASA has made recommendations for data collection for patient satisfaction surveys and emphasized the importance of reporting the data to the Anesthesia Quality Institute. Future research is warranted to develop a validated tool to measure patient satisfaction in ambulatory surgery. Keywords: patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives

  11. Anesthesia and analgesia for caesaren section in dog

    Directory of Open Access Journals (Sweden)

    Vasiljević Maja

    2014-01-01

    Full Text Available This work presents a case of a pregnant female dog, of English bulldog breed, three years old, which was brought to Belgrade Faculty of Veterinary Medicine because of inability for normal parturition. Cesarean section is an urgent intervention both in human and in veterinary medicine. Anesthesia of a pregnant dog should be carried out very carefully, because of all the physiological changes that appear during pregnancy, as well as the impact of anesthetics on embryos themselves. Anesthetics, analgesics and sedatives pass through blood brain barrier, but also their transport goes through placenta to embryo, so for that reason it is not possible to anesthetize only mother and to avoid anesthesia effects on the embryo. Therefore, anesthetics with short time of action which metabolize quickly and have minimal negative effect on embryos are recommended. When choosing the right analgesics and anesthetics, there should be known that female dogs in which it is necessary to do Cesarean section belong to the group of high risk patients. Pregnant female dogs are exposed to hypoventilation, hypoxia, hypercapnia, intense heart work, vomiting and regurgitation as well. Reversible anesthetics are recommended to provide shorter duration time of anesthesia, and in accordance, inhalation anesthetics doses are minimal. Application of α2- agonist in premedication, propophol in induction, as well as maintaining general inhalation anesthesia with sevofluran, along with local analgesia, proved to be the ideal combination in this case of cesarean section.

  12. Associação entre midazolam e detomidina na medicação pré-anestésica para indução da anestesia geral com cetamina em potros A combination study of midazolam and detomidine in the premedication anesthesia for the induction of general anesthesia with ketamine in foals

    Directory of Open Access Journals (Sweden)

    J.A. Marques

    2009-12-01

    Full Text Available Empregou-se a associação midazolam e detomidina para indução de anestesia com cetamina em 16 potros, machos e fêmeas, entre três e seis meses de idade, distribuídos aleatória e equitativamente em dois grupos (GI e GII. A todos os animais foram administrados midazolam, via intramuscular, na dose de 0,2mg/kg, e após 15 minutos, detomidina, via intravenosa, na dose de 0,02mg/kg. Os animais do GII receberam cetamina pela via intravenosa, dose 2,0mg/kg, três minutos após a administração de detomidina. Quinze minutos após o midazolam, ocorreram sedação e ligeira ataxia, e dois minutos após a administração da detomidina, decúbito lateral em todos os potros, com miorrelaxamento e presença dos reflexos de deglutição e miorrelaxamento, anal e oculo-palpebral. A associação midazolam/detomidina e cetamina provocou ausência dos reflexos de deglutição. Para todos os animais, o tempo de recuperação foi de 45-60 minutos, e temperatura retal e frequência respiratória permaneceram estáveis. Ocorreram bradicardia, bloqueio atrioventricular de segundo grau e aumento das pressões arteriais sistólica, diastólica e média após dois minutos da administração da detomidina. A associação midazolam/detomidina e cetamina demonstrou ser um método eficiente e seguro para a anestesia de potros hígidos.A combination of midazolam, 0.2mg/kg body weight given via intramuscular, and detomidine, 0.02mg/kg body weight given via intravenous (IV, was evaluated as a method for induction of anesthesia with ketamine, 2.0mg/kg body weight given via IV in foals. Sixteen male and female foals aging from three to six-month old were distributed into two groups. Both groups were first injected with midazolam and with detomidine 15 minutes later. Three minutes later, ketamine was injected in the foals. Sedation and light ataxia were observed 15 minutes after midazolam administration. Bradycardia, atrioventricular block, increased blood pressure, lateral

  13. [Emergencies evolving from local anesthesia].

    Science.gov (United States)

    Kaufman, E; Garfunkel, A; Findler, M; Elad, S; Zusman, S P; Malamed, S F; Galili, D

    2002-01-01

    Local anesthesia is without doubt the most frequently used drug in dentistry and in medicine. In spite of records of safety set by using these drugs, there is evidence to adverse reactions ranging from 2.5%-11%. Most of the reactions originate from the autonomic system. A recent, well-planned study indicates that adverse reactions are highly correlated to the medical status of the patient: the higher the medical risk, the greater the chance to experience an adverse reaction. This study also found that adverse reactions highly correlated to the concentration of adrenalin. Another recent study found a direct relationship between adverse reactions and the level of anxiety experienced by the patient and to the dental procedure. Most of the reactions in this study occurred either immediately at injection time and within 2 hours following the injection. Since the beginning of last century, vasoconstrictors have been added to local anesthesia solutions in order to reduce toxicity and prologue activity of the LA. However, today it is commonly agreed that this addition to local anesthesia should not be administered to cardiac patients especially those suffering from refractory dysrhythmias, angina pectoris, post myocardial infarction (6 months) and uncontrolled hypertension. Other contraindications to vasoconstrictors are endocrine disorders such as hyperthyroidism, hyperfunction of the medullary adrenal (pheochromocytoma) and uncontrolled diabetes mellitus. Cross reactivity of local anesthetic solutions can occur with MAO inhibitors, non specific beta adrenergic blockers, tricyclic antidepressants, phenothiazides and cocaine abusers. Noradrenaline added to local anesthetics as a vasoconstrictor has been described as a trigger to a great increase in blood pressure and therefore has been forbidden for use in many countries. This paper describes 4 cases of severe complications following the injections of local anesthesia of which three ended in fatality.

  14. 地佐辛复合丙泊酚静脉全麻用于宫腔镜手术的临床观察%Clinical observation on propofol combined with dezocine intravenous general anesthesia in hysteroscopes operation

    Institute of Scientific and Technical Information of China (English)

    廖小杰; 涂远艳

    2012-01-01

    目的 观察地佐辛复合丙泊酚静脉全麻对宫腔镜手术麻醉及术后镇痛的影响.方法 择期行宫腔镜术患者80例随机分为地佐辛复合丙泊酚组(B组)和单纯丙泊酚组(P组),B组患者地佐辛0.1mg/kg+丙泊酚2 mg/kg,P组丙泊酚2mg/kg+生理盐水1 ml.记录麻醉前、麻醉后5 min、扩宫颈时、停药后10 min的舒张压(DBP)、收缩压(SBP)、心率(HR)、脉搏氧饱和度(SPO2),并记录手术时间、苏醒时间、丙泊酚总用量以及麻醉效果、眩晕发生率和术毕30 min腹痛VAS评分.结果 两组患者麻醉后5 min的DBP、SBP均低于麻醉前(P<0.05),停药后10 min均恢复至术前水平;B组丙泊酚总用量显著低于P组[(158.8±12.7)mg vs(210.0±22.3)mg](P< 0.05),术中麻醉效果优于P组(P<0.05),术毕30 min疼痛VAS评分显著低于P组[(2.7±1.4)vs(6.4±2.1)](P<0.05).结论 地佐辛复合丙泊酚静脉全麻效果可靠,苏醒迅速,术后镇痛效果好,是一种安全有效的宫腔镜术麻醉方法.%Objective To evaluate the effects of propofol combined with dezocine intravenous anesthesia and postoperative analgesia in hysteroscopes operation.Methods 80 cases of hysteroscopes were randomly divided into two groups:dezocine combined with propofol group (group B,dezocine 0.1 mg/kg + propofol 2 mg/kg) and propofol group (group P,propofol 2 mg/kg physiological saline 1ml).DBP,SBP,HR and SPO2 of the patients at before induction,5 min after induction,cervical dilatation and 10 min after operation were recorded.The operating time,anesthetic recovery,propofol dosage,quality of anesthesia,rate of dizziness and visual analog scale (VAS) of 30 min after operation were also recorded.Results DBP and SBP at 5 min after induction in two groups were significantly lower than those before operation (P< 0.05).The dosage of propofol of group B was significantly less than that of group P [(158.8 ± 12.7)mg vs(210.0 ±22.3) mg] (P< 0.05),anesthetic quality of group B was

  15. Shortening Anesthesia Duration does not Affect Severity of Withdrawal Syndrome in Patients Undergoing Ultra Rapid Opioid Detoxification

    Directory of Open Access Journals (Sweden)

    Shoaleh Shami

    2010-02-01

    Full Text Available Ultra rapid opioid detoxification (UROD is one of the new methods of detoxification. This method of detoxification involves putting patients under general anesthesia and actively giving them opioid antagonists. The objective of this study was to evaluate effects of anesthesia duration in UROD on severity of withdrawal syndrome. Sixty addicted patients seeking UROD procedure assigned randomly to one of the 2hr, 4hr or 6hr anesthesia duration groups. Premedication and anesthesia procedure (induction and maintenance were the same for three groups. Detoxification was done for all patients with 50 mg oral naltroxane (prior to induction and 20 mg intravenous naloxane (8 mg/bolus and 12 mg/infusion. Blood pressure, heart rate and respiratory rate were automatically measured and recorded every 5 minutes. The severity of withdrawal syndrome was measured and recorded every one hour during anesthesia, 2hours post-anesthesia, and 12 and 24 hours following the induction of anesthesia according to the Wang Scale modified by Lomier (WSMBL. Patients aged 20-58 in three groups. Three cases experienced delirium after detoxification that lasted 24 hours in one. Severity of withdrawal syndrome in patients of groups 2, 4 and 6 hour were 8.7, 7.4 and 5.1 respectively during anesthesia and 12.3, 11.1 and 13.9 after 18 hours of anesthesia. Results of this study showed that, in standard settings, UROD is a safe method for detoxification and has low complications. The withdrawal symptoms during and after anesthesia are low. Shortening the duration of anesthesia has no affect on severity of withdrawal syndrome during and after anesthesia.

  16. [Drug dosage during balanced anesthesia in children with urinary tract diseases].

    Science.gov (United States)

    Katkovskiĭ, D G; Stepanova, N A

    1990-01-01

    To determine principles of choosing individual fentanyl and ketamin doses the data on the course of general anesthesia in 120 children were processed by regression analysis. It has been established that individual anesthetic dose titration should take into consideration the child's age, efficacy of premedication, renal function and circulatory pattern The infusion rate is determined with regard to anesthesia-induced circulatory changes. Regression analysis made it possible to work out formulas which enable individual dose titration and determination of the infusion rate.

  17. Effective dose of dexmedetomidine to induce adequate sedation in elderly patients under spinal anesthesia

    OpenAIRE

    2015-01-01

    Background During sedation with dexmedetomidine, a dose adjustment may be needed based on the invasiveness of the procedure, the patient's general condition, and their age. We aim here to determine the effective dose (ED) of dexmedetomidine to induce an adequate depth of sedation in elderly patients undergoing spinal anesthesia. Methods In this study, 47 patients aged 65 years or older, American Society of Anesthesiologists physical status I or II, undergoing spinal anesthesia were included. ...

  18. SPLIT SKIN GRAFT HARVESTING UNDER LOCAL ANESTHESIA INFILTRATION VERSUS TOPICAL LOCAL ANESTHESIA

    Directory of Open Access Journals (Sweden)

    Shahi

    2014-04-01

    Full Text Available OBJECTIVE: To compare the effectiveness of topical local anesthesia using PRILOX cream versus local anesthesia infiltration using lignocaine and adrenaline in harvesting split skin graft. METHODS: A prospective study of 58 patients requiring split skin graft was carried. One group comprising 29 patients underwent harvesting of split skin graft under topical local anesthesia using PRILOX cream while the other group had local anesthesia infiltration using lignocaine and adrenaline. RESULTS: There were no significant differences between the 2 groups in terms of operating time, per operative pain, post-operative pain and post-operative requirement of analgesia. There was significant difference in time and pain during administration of local anesthesia and patient’s acceptability/ satisfaction with method of anesthesia. CONCLUSION: Topical local anesthesia using PRILOX cream can be used effectively for harvesting of split skin graft and is good alternative to local anesthesia infiltration.

  19. 全麻下悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停低通气综合征68例%Uvulopalatopharyngoplasty under General Anesthesia in the Treatment of Obstructive Sleep Apneahypopnea Syndrome for 68 Cases

    Institute of Scientific and Technical Information of China (English)

    宋志强; 刘姣

    2011-01-01

    Objective:To investigate the clinical efficacy of nesthesia uvulopalatopharyngoplasty(UPPP)) under general anesthesia in treatment of obstructive sleep apneahypopnea syndrome(OSAHS.) Methods:From June 2004 to January 2009,68 patients of OSAHS were treated with UPPP under general anesthesia.Results:In 68 patients,the snoring significantly reduced or disappeared,the number of sleep apnea reduced obviously.The polysomnography(PSG)monitoring was done 6 month after operation and the results showed:38 cases excellent,26 cases effective and 4 case ineffective,the total effective rate was 94%.Conclusion:At present,There are many ways to treat OSAHS,but surgery is still the better method.%目的:探讨全麻下悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)治疗阻塞性睡眠呼吸暂停低通气综合征(obtructive sleep apneahypopnea syndrome,OSAHS)的临床疗效.方法:选取自2004-06~2009-01采用全麻下悬雍垂腭咽成形术(UPPP)治疗中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者68例.结果:68例患者术后打鼾症状明显减轻或消失,睡眠呼吸暂停次数明显减少,并于术后6个月进行多导睡眠(PSG)监测,其中显效38例,有效26例,无效4例,总有效率94%.结论:目前治疗OSAHS方法有很多,但手术治疗仍是一种较为肯定的治疗方法.

  20. A psychoeducational intervention reduces the need for anesthesia during radiotherapy for young childhood cancer patients

    Directory of Open Access Journals (Sweden)

    Linsenmeier Claudia

    2008-06-01

    Full Text Available Abstract Background Radiotherapy (RT has become an important treatment modality in pediatric oncology, but its delivery to young children with cancer is challenging and general anesthesia is often needed. Methods To evaluate whether a psychoeducational intervention might reduce the need for anesthesia, 223 consecutive pediatric cancer patients receiving 4141 RT fractions during 244 RT courses between February 1989 and January 2006 were studied. Whereas in 154 RT courses corresponding with 2580 RT fractions patients received no psychoeducational intervention (group A, 90 RT courses respectively 1561 RT fractions were accomplished by using psychoeducational intervention (group B. This tailored psychoeducational intervention in group B included a play program and interactive support by a trained nurse according to age to get familiar with staff, equipment and procedure of radiotherapy. Results Group A did not differ significantly from group B in age at RT, gender, diagnosis, localization of RT and positioning during RT. Whereas 33 (21.4% patients in group A got anesthesia, only 8 (8.9% patients in group B needed anesthesia. The median age of cooperating patients without anesthesia decreased from 3.2 to 2.7 years. In both uni- and multivariate analyses the psychoeducational intervention significantly and independently reduced the need for anesthesia. Conclusion We conclude that a specifically tailored psychoeducational intervention is able to reduce the need for anesthesia in children undergoing RT for cancer. This results in lower costs and increased cooperation during RT.

  1. New visible endotracheal intubation method using the endoscope system for mice inhalational anesthesia.

    Science.gov (United States)

    Konno, Kenjiro; Itano, Naoki; Ogawa, Teppei; Hatakeyama, Mika; Shioya, Kyoko; Kasai, Noriyuki

    2014-06-01

    Appropriate and effective anesthesia is critical, because it has a strong influence on laboratory animals, and its affect greatly impacts the experimental data. Inhalational anesthesia by endotracheal intubation is currently prevailing in general anesthesia and is prefered over injection anesthesia, especially for large laboratory animals, because it is a safe and easy control agent. However, it is not common for small laboratory animals, because of the high degree of technical skills required. We assessed the capability of use for mice of the endotracheal intubation by using the endoscope system "TESALA AE-C1" and inhalational anesthesia using a ventilator. Endotracheal intubation was successfully performed on all 10 C57BL/6 mice injected with M/M/B: 0.3/4/5 comprised of medetomidine, midazoram and butorphanol, at a dose of 0.3 mg/kg + 4.0 mg/kg + 5.0 mg/kg body weight/mouse, respectively. After the intubated mice were connected with the inhalational anesthesia circuit and the ventilator, vital signs were measured until 15 min after the connection. The data with M/M/B: 0.3/4/5 showed stable and normal values, which indicated that this new endotracheal intubation method was simple, reliable and safe, which mean that this anesthesia is favorable in regard to the animal's welfare.

  2. Current techniques and strategies for anesthesia in patients undergoing peripheral bypass surgery.

    Science.gov (United States)

    Bouman, E; Dortangs, E; Buhre, W; Gramke, H F

    2014-04-01

    Peripheral arterial disease is an illness with a high prevalence in Europe and North America. The disease is associated with a significant impact on quality of life. Despite advanced medical and endovascular treatments, surgery is often indicated to prevent the consequences of ischemic injury. Usually, these patients do have significant comorbidities resulting in an increased risk for anesthesia-related complications. While general anesthesia is commonly used for the majority of the patients, local and regional anesthesia (RA) offer several possible advantages such as stable cardiovascular hemodynamic perioperative course, improved postoperative pain relief and prevention of chronic postsurgical pain syndromes. This review will discuss perioperative management, available evidence regarding general anesthesia and various regional anesthetic techniques for peripheral vascular surgery, and the current advises regarding anticoagulants and RA. No definitive conclusions can be drawn from the existing literature with respect to superiority of general or neuraxial anesthesia or even RA. Maybe the profits lie in the combination of techniques, a strategy, to overcome the risks of one and use the benefits of the other technique. From circumstantial evidence, it is most likely that the experience of the anesthetic and surgical team is one of the major determinants of perioperative complications independent from the individual anesthesia technique.

  3. Articaine and lidocaine for maxillary infiltration anesthesia.

    Science.gov (United States)

    Vähätalo, K.; Antila, H.; Lehtinen, R.

    1993-01-01

    This study was undertaken to compare the anesthetic properties of articaine hydrochloride with 1:200,000 epinephrine (Ultracain DS) and lidocaine with 1:80,000 epinephrine (Xylocain-Adrenalin) for maxillary infiltration anesthesia. Twenty healthy dental student volunteers were included in this double-blind study. Each subject received 0.6 mL of each test solution at different times. Infiltration anesthesia was performed on the upper lateral incisor. The onset and duration of anesthesia were monitored using an electric pulp tester. No statistically significant differences were seen in the onset and duration of anesthesia between the articaine and lidocaine solutions. PMID:7943919

  4. Implications of National Anesthesia Workload on the Staffing of a Call Center: The Malignant Hyperthermia Consultant Hotline.

    Science.gov (United States)

    Dexter, Franklin; Rosenberg, Henry; Epstein, Richard H; Semo, Judith Jurin; Litman, Ronald S

    2015-08-01

    Recently, we analyzed data from the American Society of Anesthesiologist's (ASA) Anesthesia Quality Institute (AQI) to report the United States (U.S.) anesthesia workload by time of day and day of the week. The AQI data were reported using the Central Time zone. Times for the N = 613 calls to the Malignant Hyperthermia Association of the United States (MHAUS) Malignant Hyperthermia (MH) Hotline from August 1, 2012, through March 7, 2014, were adjusted similarly. The MH Hotline effectively provides at all times to each anesthesia group an additional board-certified anesthesiologist who has expertise in managing, diagnosing, and/or preventing MH crises. We compared the timing of calls with the MH Hotline consultants relative to times of most anesthesia workload nationally. The interval 6:30 AM to 6:30 PM Central Time on regular workdays accounted for most (P Hotline (62.5% ± 2.0% [mean ± standard error]). However, the interval accounted for significantly less than the 82.2% of anesthesia minutes and 84.5% of general anesthesia minutes during that interval nationally (both P Hotline occurred when anesthesia groups nationwide were the busiest. Weekends accounted for 15.3% ± 1.5% of MH Hotline calls, significantly greater than the rates of 5.2% of anesthesia minutes and 4.3% of general anesthesia minutes during weekends nationally (both P Hotline was used proportionately more often when anesthesia providers have fewer colleagues present and available for consultation (all P < 0.0001). These findings may be expected of other (future) national support centers for anesthesia.

  5. Transient Oliguria during Anesthesia in Cerebral Salt Wasting Syndrome

    OpenAIRE

    Lee, Kwang Ho; Park, Jong Taek; Cho, Dong Woo; Song, Seung Woo; Lim, Hyun Kyo

    2016-01-01

    Cerebral salt wasting syndrome is a hyponatremic and hypovolemic condition caused by intracranial disorders, such as head injury, subarachnoid hemorrhage, brain tumor, and brain operations. We report a case of a 5-year-old girl that had cerebral salt wasting syndrome with marked polyuria who showed transient oliguria during general anesthesia. The patient had undergone an operation for traumatic intracranial hemorrhage three months prior and has had marked polyuria and hyponatremia since then...

  6. Costs of anesthetics and other drugs in anesthesia

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.

    2012-01-01

    Full Text Available Introduction. Drugs are real and transparent costs of treatment, which are subject to constant monitoring and changes. The study was aimed at measuring and analyzing consumption of anesthetics and other drugs in anesthesia in the Clinical Centre of Serbia. Material and Methods. This paper is part of a five-year (2005-2009, academic, pharmacoeconomic retrospective-prospective study (the 4th phase. We calculated the costs of anesthetics and other drugs in all anesthetized patients at the Institute of Anesthesia and Reanimation, Clinical Center of Serbia in 2006. The data, obtained from the Clinical Centre of Serbia Database, were analyzed by descriptive statistical methods using computer program Microsoft Office Excel 2003 and the Statistical Package for the Social Sciences (SPSS for Windows. Results. The amount of money spent for the application of 33,187 general and 16,394 local anesthesia and 20,614 anesthesiology procedures was 83,322,046.36 RSD (Euros 1,054,705.4, which was 5.93% of the funds allocated for all drugs used at the Clinical Center of Serbia. Of the total fund for drugs, 57.8% was spent for anesthetics (local anesthetics 1.2% and muscle relaxants, whereas 42.2% was spent for other drugs in anesthesia. The highest amount was spent at the Emergency Center (35.8%, then at the Cardio-surgery (11.9% and the Neurosurgery (10.9% because of the large number and length of surgical interventions. Conclusion. There is no space for rationalizing the costs of anesthetics and other drugs in anesthesia.

  7. 儿童轻度上呼吸道感染应用右美托咪定全麻诱导效果影响的研究%Application of dexmedetomidine for general anesthesia induction in children with mild upper respiratory infections

    Institute of Scientific and Technical Information of China (English)

    李建玲; 苏震; 赵红莲; 张小俠; 李汝泓

    2016-01-01

    目的:探讨轻度上呼吸道感染患儿应用右美托咪定全麻诱导效果的影响,为临床儿童的全麻方法提供参考。方法选取2011年5月-2015年5月在医