Canadian Anaesthetists' Society journal
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A study was undertaken on dogs to find the limit of carbon dioxide exchange with high frequency jet ventilation using a fluidic logic controlled oxygen jet ventilator. Fifteen dogs were ventilated through a transtracheal catheter at respiratory rates up to 600 per minute. The following were recorded: aortic, pulmonary artery, pulmonary arterial wedge, and central venous blood pressures; intratracheal pressure, electrocardiogram; inspiratory and expiratory time of the jet; arterial and central venous blood gases; intermittent cardiac output. ⋯ High frequency jet ventilation was then started at a rate of 600 per minute and decreased in increments to 100 per minute. Arterial blood gases were continuously recorded through an intra-arterial catheter connected to a mass spectrometer. The PaCO2 gradually declined to normal levels as the rate decreased.
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Out-patient surgery for infants and children offers the advantages of minimal emotional upset, less risk of infection, and fiscal economy. Many different operations can be done in the out-patient department and most children can be accepted for general anaesthesia for these operations. Preparation of the child is similar to that required for in-patient surgery. ⋯ Careful tracheal intubation should be utilized whenever indicated. Regional analgesia has many advantages over narcotic analgesics in the treatment of post-operative pain. A follow-up service should be provided.
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This discussion is based on the experience of the Phoenix Surgicenter, where over 60,000 patients have been anaesthetized since 1970. Patients accepted for out-patient surgery are ASA Status I or II, although status III patients may be included if their co-existing disability is under excellent control. Eighty-five per cent of adult patients receive general anaesthesia. ⋯ Efforts during recovery are directed towards preparing the patient for discharge in a "home ready" condition for safe handling by attending relatives. The common complications have been postoperative nausea or emesis and hypotension. The hospital transfer rate has been 0.2 per cent.