Anesthesia and analgesia
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Anesthesia and analgesia · Mar 1976
A comparative study of enflurane and halothane using systolic time intervals.
The effects of enflurane and halothane anesthesia on systolic time intervals were studied in 12 healthy patients. Cardiovascular measurements were made at equipotent levels of anesthesia: enflurane 1.23% end-tidal and halothane 0.65% end-tidal. ⋯ However, halothane caused significantly more myocardial depression than enflurane, as indicated by a larger preejection period (PEP) and preejection period/left ventricular ejection time (PEP/LVET) and a smaller 1/PEP2 and ejection fraction. When N2O was discontinued, both agents increased PEP and PEP/LVET and decreased 1/PEP2 and the ejection fraction.
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Anesthesia and analgesia · Mar 1976
Comparative StudyCardiovascular dynamics after large doses of fentanyl and fentanyl plus N2O in the dog.
The effects of large doses of fentanyl (0.05 to 2 mg/kg) and fentanyl plus N2O on cardiovascular dynamics were determined in 10 unpremedicated dogs breathing 100% O2. Using computer analysis of the central aortic pulsepressure curve, stroke volume (SV), cardiac output, heart rate (HR), peripheral vascular resistance (PVR), and systolic, diastolic, and mean arterial blood pressures (BP) were determined while fentanyl was being given at a rate of 0.3 to 0.44 mg/min. Fentanyl caused a dose-related decrease in HR, which was significant at 0.05 mg/kg. ⋯ Addition of N2O after fentanyl did not significantly change any parameter, although SV, cardiac output, and HR were usually increased and PVR decreased. These data demonstrate that, while large doses of fentanyl or fentanyl plus N2O do alter cardiovascular dynamics in dogs, the changes appear to be less profound than those produced by equianalgesic doses of morphine. Our findings suggest that large doses of fentanyl-O2 may be an attractive alternative to morphine-O2 anethesia in critically ill patients.
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Anesthesia and analgesia · Mar 1976
A technic of general anesthesia for blepharoplasty and rhytidectomy.
A series of 66 consecutive cases of blepharoplasty and rhytidectomy are reported, 60 of which were performed with a general anesthesia technic utilizing local anesthesia with epinephrine, in association with enflurane inhalation delivered via bilateral nasopharyngeal airways (BNPA). Six cases were not suitable candidates for the technic because of physical status or for anatomic reasons. The technic has teh advantage of providing airway control without tracheal intubation, light depth of anesthesia, compatibility with epinephrine, and highly acceptable limits of intraoperative bleeding and postoperative hematoma.
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Anesthesia for a patient with gas gangrene presents a challenge for the anesthesiologist, since it is an uncommon disease requiring emergency treatment. The authors, faced with such a challenge and finding little guidance in the literature, have proposed modalities of anesthetic management based on pathophysiology, symptomatology, and the reported experience of others. In addition to choice of anesthetic agents, problems reviewed include shock, hypovolemia, tachycardia, fever, anemia, renal dysfunction, pulmonary insufficiency, and contamination. Factors relating to anesthesia during hyperbaric-O2 therapy are also reviewed.
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Anesthesia and analgesia · Mar 1976
Circulatory changes in patients with coronary artery disease following thiamylal-succinylcholine and tracheal intubation.
Circulatory responses after thiamylal (4 mg/kg) and succinylcholine (SCh) (2 mg/kg) administration followed by direct laryngoscopy and tracheal intubation were measured in 20 patients before elective aortocoronary vein bypass graft operations. Compared with awake measurements, the mean arterial pressure (MAP) decreased 19 +/- 3 torr (mean +/- SE) and heart rate (HR) increased 9 +/- 3 bpm 1 minute after thiamylal-SCh. ⋯ Stroke volume index was decreased significantly after tracheal intubation but cardiac index was not altered. The authors conclude that thiamylal-SCh followed by tracheal intubation is an acceptable anesthetic induction sequence for patients without evidence of left ventricular heart failure who require anesthesia for elective coronary artery revascularization.