British journal of anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Early recovery after remifentanil-pronounced compared with propofol-pronounced total intravenous anaesthesia for short painful procedures.
We compared recovery from high-dose propofol/low-dose remifentanil ('propofol-pronounced') compared with high-dose remifentanil/low-dose propofol ('remifentanil-pronounced') anaesthesia. ⋯ In patients having short painful surgery, less propofol does not give faster recovery as long as the same anaesthetic level (as indicated by BIS and clinical signs) is maintained by more remifentanil. However, recovery times were less variable following remifentanil-pronounced anaesthesia suggesting a more predictable recovery.
-
Case Reports
Postoperative pseudoepileptic seizures in a known epileptic: complications in recovery.
A 47-yr-old woman underwent general anaesthesia for a squint correction. She had previously suffered a cerebral venous thrombosis, presenting as grand mal seizures during recovery from general anaesthesia for minor surgery. Subsequently, she was affected by Jacksonian limb seizures and petit mal epilepsy and had required long-term rehabilitation, and anticonvulsant and anticoagulant therapy. ⋯ Whilst observing the seizure pattern and excluding the differential diagnoses, evidence emerged that psychological factors had played a large part in her clinical picture. Her differential diagnosis had recently been amended to include 'pseudoseizures'. A firm, supportive approach caused the 'convulsions' to cease within a few hours.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Recovery of elderly patients from two or more hours of desflurane or sevoflurane anaesthesia.
The solubility of desflurane compared with sevoflurane suggests more rapid recovery from desflurane anaesthesia. This could be important after prolonged anaesthesia and fast recovery may be advantageous in the elderly where slow recovery of mental function is a concern. We compared emergence from desflurane vs sevoflurane in elderly patients undergoing two or more hours of anaesthesia. ⋯ Early but not intermediate recovery times of elderly patients undergoing a wide range of surgical procedures requiring two or more hours of anaesthesia is significantly (P