Folia medica Cracoviensia
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Folia medica Cracoviensia · Jan 2001
Arterial to end-tidal carbon dioxide difference during craniotomy in severely head-injured patients.
Clinical data suggest that cerebral blood flow (CBF) can be abnormally low within the first four to eight hours after severe head injury (SHI). An aggressive hyperventilation can additionally worsen CBF and provoke cerebral ischemia. Therefore an accurate PCO2 monitoring in SHI patients (pts) is necessary. ⋯ No relationships between P(a-et)CO2 and pts age and mean arterial pressure were found. P(a-et)CO2 was higher in normocapneic pts than in hyperventilated ones and tended to decrease with an increase in heart rate. We can conclude that during an acute craniotomy in SHI pts, PetCO2 does not reflect accurately PaCO2 and the monitoring of adequacy of ventilation should be based on repeated or continuous measurements of an arterial PCO2.
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Folia medica Cracoviensia · Jan 2001
[Presence of the trace elements from carbon dioxide absorbent containing lime using a circular apparatus during general anesthesia. ].
The aim of the study was to evaluate release of the trace elements from carbon dioxide absorbent containing soda lime during general anesthesia. We compared two suppliers Polish "Polfa" and German "Dräger". Following trace elements were evaluated: chromium, copper, zinc, cadmium, lead, nickel in soda lime. ⋯ Values of P < 0.05 were consider significant. We concluded that there were no statistically significant differences between examined groups. Thus, we can say that trace elements were not released from soda lime and concentrations of examined elements in patients' blood were not affected by general anesthesia.
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Folia medica Cracoviensia · Jan 2001
[Patient satisfaction with anesthesia as a measure of quality of anesthesia care].
Patient satisfaction with anaesthesia is very important as a expectancy satisfaction in perioperative care. It is simultaneously patient opinion about the anaesthetic care prior to and during anaesthesia, and shortly after the operation. The aim of the research was to evaluate the patient satisfaction and to determine the factors connected with satisfaction in the perioperative period Out of a total of 250 patients, 155 women (62%) and 95 men (48%) underwent general and local anaesthesia due to the operations. ⋯ The factors decreased patient satisfaction immediately after the operation were breathing difficulties, vomiting, nausea, feeling coldness and pain. The main factors evaluating the quality of anaesthetic care and patient satisfaction are specific information, proper premedication and feeling safety in the operating room. On the other hand the discomfort and insufficient analgesia decreased patient satisfaction with anaesthesia.
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Perioperative medicine is a new approaches for quicker and better preparation all patients for surgery and postoperative treatment. Perioperative medicine should fulfilled following problems: a) Preoperative assessment, b) Postoperative pain treatment, c) Postoperative intensive therapy. Anaesthesiologists are interested in above problems, except prolonged preoperative treatment, which is normally provided by other specialists. Perioperative medicine needs a new approach for training new type of anaesthesiologists well prepared for new type of responsibility.
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Folia medica Cracoviensia · Jan 2001
[Principles of qualifying children for planned surgical procedures].
Children are prone to greater preoperative stress and more frequent accidents during anaesthesia. To reduce stress--a preoperative visit, information for child and parents, premedication and parental presence during induction of anaesthesia have all been successfully used. ⋯ There is less emphasis on minimal hemoglobin level of 10 g/dl, the physician assessment of circulatory status is preferred rather than stiff laboratory values. Less stress for children means also less problems during induction and recovery as well as less need for prolonged postoperative care.