Anesthesia and analgesia
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Anesthesia and analgesia · May 1981
Exposure to nitrous oxide and neurologic disease among dental professionals.
Questionnaires, mailed to approximately 30,000 dentists and an equal number of dental assistants requesting information regarding professional exposure to anesthetics and health problems, showed an increased incidence of neurologic complaints in dental professionals who worked with nitrous oxide. The most striking differences were noted in individuals reporting symptoms of numbness, tingling, and/or muscle weakness. ⋯ For dental assistants heavily exposed to nitrous oxide, a 3-fold increase in these same complaints was noted. In view of recent evidence that nitrous oxide abuse may lead to polyneuropathy, the results suggest that occupational exposure to nitrous oxide by both dentists and dental assistants may be associated with similar neuropathy.
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Anesthesia and analgesia · May 1981
Comparative StudyClinical evaluation of high-frequency positive-pressure ventilation (HFPPV) in patients scheduled for open-chest surgery.
Comparisons were made in 10 patients scheduled for thoracotomy between a prototype of a low-compressive system (Bronchovent Special) for volume-controlled, high-frequency positive-pressure ventilation (HFPPV; fixed frequency of 60/min; fixed relative insufflation time of 22%), and a conventional respirator (SV-900) for intermittent positive-pressure, volume-controlled ventilation at a frequency of 20/min, after induction of anesthesia, but before surgery. With both ventilator systems intratracheal, intrapleural, systolic, diastolic, and mean arterial systemic and central venous pressures were measured at normoventilation (normocarbia). Mean intratracheal pressure and mean intrapleural pressure were significantly lower with volume-controlled HFPPV (1.3 +/- 0.5 and -4.0 +/- 2.1 (SD) cm H2O, respectively) than with conventional volume-controlled ventilation with SV-900 (2.1 +/- 1.2 and -3.0 +/- 1.5 cm H2O, respectively). ⋯ After compression the lung was readily re-expanded with the aid of a brief period of positive end-expiratory pressure (PEEP). Thus, even relatively low intrapulmonary pressures during volume-controlled HFPPV without PEEP are adequate to keep the open-chest lung expanded during intrathoracic surgery. This creates optimal conditions for the surgeons.
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Anesthesia and analgesia · May 1981
Fentanyl-air-oxygen anesthesia for ligation of patent ductus arteriosus in preterm infants.
In 10 premature infants (1123 +/- 263 g), fentanyl citrate (30 to 50 microgram/kg) was used in conjunction with pancuronium (0.1 mg/kg) as the sole anesthetic for transthoracic ligation of patent ductus arteriosus. Ventilation was controlled with air and oxygen in concentrations sufficient to maintain transcutaneous PO2 between 50 and 70 torr. Circulatory stability was easily maintained throughout the procedure. "Stiff chest" was avoided by the use of muscle relaxants, and the infants were awake within 1 hour after the procedure.