Anesthesia and analgesia
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Anesthesia and analgesia · Sep 1977
Crystalloid hemodilution, hypothermia, and halothane blood solubility during cardiopulmonary bypass.
Sequential determinations of halothane blood solubility were determined in 8 patients undergoing cardiac surgical procedures with cardiopulmonary bypass (CPB), hypothermia, and crystalloid hemodilution. The mean temperature-corrected blood/gas partition coefficient (B/G) at the end of surgery (2.4) was lower than preceding induction (2.7). The greatest mean B/G (2.9) occurred after induction of anesthesia. ⋯ For halothane, the increased blood solubility due to hypothermia was initially antagonized by the crystalloid hemodilution. This antagonism would also be anticipated for methoxyflurane, enflurane, and isoflurane. For N2O and diethyl ether, the increased blood solubility due to hypothermia would be unopposed by simultaneous crystalloid hemodilution.
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Anesthesia and analgesia · Sep 1977
Circulatory response to laryngoscopy and tracheal intubation with or without prior oropharyngeal viscous lidocaine.
Oropharyngeal topical anesthesia with viscous lidocaine (25 ml of 2% as a "mouthwash and gargle" 10 min before laryngoscopy) attenuated the pressor but not heart rate (HR) response during laryngoscopy and tracheal intubation. Compared with control patients, mean arterial pressure (MAP) increased less in response to tracheal intubation (23 +/- 5 torr versus 39 +/- 4 torr, p less than 0.05) and returned toward awake levels sooner in patients receiving viscous lidocaine. ⋯ Arterial lidocaine concentrations were less than 0.5 microgram/ml after oropharyngeal anesthesia. Prior topical anesthesia of the oropharynx with viscous lidocaine should be considered when pressor responses during tracheal intubation would be particularly likely or hazardous.
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Anesthesia and analgesia · Sep 1977
Case ReportsProbable amniotic fluid embolism during curettage for a missed abortion: a case report.
Diagnosis of amniotic fluid embolism is difficult in a patient under general anesthesia and may initially resemble several other conditions. Successful treatment requires maintenance of adequate cardiac output and oxygenation and prompt heparin treatment of the disseminated intravascular coagulation. The presented case exemplifies another group of patients who are ar risk for amniotic fluid embolism.