Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1983
Lack of arrhythmogenicity of isoflurane following administration of aminophylline in dogs.
Induction of halothane anesthesia after aminophylline administration may cause ventricular arrhythmias. Isoflurane may be as effective a bronchodilator as halothane. This study was designed to determine whether induction of isoflurane anesthesia after intravenous aminophylline is arrhythmogenic in dogs. ⋯ Three additional groups of six dogs were given intravenous aminophylline 10, 25, or 50 mg/kg, respectively, followed 3 min later by 1.5% isoflurane. No arrhythmias occurred after aminophylline and isoflurane at any time in any animal. In contrast to halothane, induction of isoflurane anesthesia after aminophylline is safe and does not cause cardiac arrhythmias.
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Anesthesia and analgesia · Jun 1983
Video stethoscope--a simple method for assuring continuous bilateral lung ventilation during anesthesia.
Complications of endotracheal intubation and mechanical ventilation are infrequent but important causes of intraoperative morbidity and mortality. We have developed a simple method of monitoring the ventilation of both lungs during general anesthesia and have evaluated this technique in 25 patients undergoing surgery under general anesthesia. ⋯ The patterns seen on the screen allowed easy identification of right mainstem intubation, esophageal intubation, or proper endotracheal tube placement. This preliminary study suggests that our technique is feasible and provides more information about the position of the endotracheal tube than presently used methods.
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Anesthesia and analgesia · May 1983
Effects of myocardial infarction on perioperative cardiac complications.
Of 1104 consecutive noncardiac operations on 981 patients using general anesthesia, 63 were performed on 53 patients who had had a previous myocardial infarction. Patients with a previous infarct were compared to those with no prior infarct to determine the influence of a previous infarct on perioperative cardiac complications. Two of the 53 patients with a previous myocardial infarction (3.8%) had perioperative myocardial infarction, compared to 0.4% (4/928) of patients with no prior history of myocardial infarction (P less than 0.05). ⋯ All patients with a previous myocardial infarction who developed cardiac complications underwent vascular procedures (P less than 0.005) and were over 77 years of age. The two patients who reinfarcted experienced intraoperative hypotension (P less than 0.05). Fourteen of the 53 patients with a history of a myocardial infarction (26.4%) had previous coronary artery bypass surgery; no perioperative cardiac complications occurred in these patients.
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Anesthesia and analgesia · May 1983
Comparative StudyComparison of the maternal and neonatal effects of halothane, enflurane, and isoflurane for cesarean delivery.
The maternal and neonatal effects of 50% O2-50% N2O alone and 50% O2-50% N2O combined with 0.5% halothane, 1.0% enflurane, or 0.75% isoflurane were studied in 42 healthy parturients undergoing general anesthesia for elective primary or repeat cesarean delivery at term. All patients received thiopental and succinylcholine for induction and were intubated and ventilated with a tidal volume of 10 ml/kg at a rate of 10 breaths/min. ⋯ There were no significant differences between groups in induction-to-delivery and uterine incision-to-delivery intervals, the frequency of Apgar scores less than 7 at 1 and 5 min, maternal and fetal blood-gas tensions, acid-base balance, lactate values, and early neonatal neurobehavioral scores at 2-4 h. It is concluded that analgesic concentrations of halothane, enflurane, and isoflurane can be safely added to 50% O2-50% N2O to prevent maternal awareness during general anesthesia for cesarean delivery while maintaining normal maternal and neonatal conditions.