Anesthesia and analgesia
-
Anesthesia and analgesia · May 1982
Comparative StudyA model for comparison of local anesthetics in man.
Ten patients scheduled for bilateral arm surgery were given general anesthesia plus, on one side, an axillary brachial plexus block. Ten additional patients scheduled for bilateral foot surgery were similarly given general anesthesia plus an ankle block on one side. A within-patient blind comparison of postoperative analgesia between blocked and unblocked side was performed. ⋯ Postoperative analgesia recorded by a nurse observed was significantly better on the blocked side compared with the unblocked side. This difference was greater for ankle blocks. There were no differences between the analgesic measures for lidocaine and bupivacaine ankle blocks over the 6-hour study period.
-
Anesthesia and analgesia · May 1982
Intracranial hypertension during surgery for supratentorial tumor: correlation with preoperative computed tomography scans.
To test the hypothesis that preoperative head computed tomography scans could be used to predict the likelihood that a patient with a supratentorial brain tumor would develop intracranial hypertension during surgery before the cranium was opened, intraoperative intracranial pressure and blood pressure records of 60 patients undergoing craniotomy were compared with the appearance of their preoperative computed tomography scans. The scans were interpreted by a neuroradiologist who was unaware of the clinical events in each case. ⋯ When preoperative brain edema seen on computed tomography scan was taken into consideration, increases in intracranial pressure during craniotomy also correlated with simultaneous increases in blood pressure. It is concluded that patients with large amounts of preoperative brain edema surrounding supratentorial tumors should be considered at risk for developing intraoperative intracranial hypertension and may benefit from preoperative insertion of an intracranial pressure monitor before general anesthesia is induced.
-
The delivery performance of two Fortec vaporizers for isoflurane in oxygen (O2) was evaluated. Isoflurane concentration was measured at a constant O2 flow rate (from 0.75 to 15 L/min) as the vaporizer dial setting was changed over the range of 0% to 5%. At vaporizer dial settings of 2% or less the average delivered isoflurane concentration differed from dial settings by less than 0.25 vol% at all O2 flows. ⋯ Increasing the environmental temperature to 30 degrees C or decreasing it to 15 degrees C increased or decreased, respectively, vaporized output when compared with conditions at 22 degrees C. Little or no effect on vaporizer output was noted with simulated positive pressure ventilation up to a breathing circuit pressure of 25 torr. We conclude the Fortec vaporizer is as efficient in delivering isoflurane in O2 as previous reports have shown the Fluotec Mark III to be in its delivery of halothane.
-
Of 55 abstracts presented at the 1979 annual meeting of the International Anesthesia Research Society (I. A. R. ⋯ S. abstracts were filed in Science Citation Index (SCI) as cited reference and by January 1, 1981, fifty-six 1979 A. S. A. abstracts were filed.
-
Anesthesia and analgesia · May 1982
Use of 100-Hertz tetanus as an index of recovery from pancuronium-induced non-depolarizing neuromuscular blockade.
During recovery from non-depolarizing neuromuscular blockade the evoked response to train-of-four (TOF), 100-HZ tetanus (T100) and 50-HZ tetanus (T50) was measured in 10 patients. When the TOF fade ratio exceeded 0.70, tetanic tension to T50 was well sustained. ⋯ T100 stimulation appears to be too sensitive a test to residual curarization for routine clinical use. Fade on T100 may be quite apparent at a time when the use of additional neuromuscular antagonists are not indicated and may be counterproductive.