Articles: adult.
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Journal of anesthesia · Mar 1996
Does increasing end-tidal carbon dioxide during laparoscopic cholecystectomy matter?
To examine the adverse effects of peritoneal carbon dioxide (CO2) insufflation during laparoscopic cholecystectomy, both hemodynamic and respiratory alterations were continously monitored in 17 adult patients using noninvasive Doppler ultrasonography and a continuous spirometric monitoring device. During the surgery, which was performed under inhalational general anesthesia, intraabdominal pressure was maintained automatically at 10mmHg by a CO2 insufflator, and a constant minute ventilation, initially set to 30-33 mmHg of end-tidal CO2 (ETCO2), was maintained. ⋯ The stress of 10mmHg pneumoperitoneum was a major cause of hemodynamic changes during laparoscopic cholecystectomy. Some clinical strategies such as deliberate intraabdominal insufflation at the initial phase might be required to minimize these hemodynamic changes.
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Journal of anesthesia · Dec 1995
Interactions of nicardipine to inhalation anesthetics sevoflurane and isoflurane.
The hemodynamic effects and pharmacokinetics of nicardipine under general anesthesia were compared between two different volatile anesthetics, sevoflurane and isoflurane. Sixteen adult neurosurgery patients were divided into sevoflurane and isoflurane groups. Anesthesia was maintained with either sevoflurane or isoflurane (0.5-1.5%) and nitrous oxide in oxygen. ⋯ The sevoflurane group had a significantly longer elimination half-life, a larger area under the plasma concentration curve, and smaller clearance of nicardipine compared to the isoflurane group. In summary, the effects of nicardipine on blood pressure and heart rate were significantly longer under isoflurane anesthesia than under sevoflurane anesthesia. However, the etabolism and excretion of nicardipine were significantly delayed under sevoflurane anesthesia.
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Postoperative pain therapy often appears to be inadequate in children. The present study was a retrospective investigation of the administration of analgesics given to 133 children and adults following surgery for funnel chest between 1983 and 1994. ⋯ Children received smaller quantities of narcotics than adults when postoperative analgesia was performed with PRN administration. PCA led to delivery of larger quantities of narcotic drugs than PRN medication in children.
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Journal of anesthesia · Mar 1995
Prophylactic hemostatic drugs do not reduce hemorrhage: Thromboelastographic study during upper abdominal surgery.
Although a number of hemostatic drugs are currently used during surgery to reduce hemorrhage, their effects on bleeding are still controversial. Furthermore, few studies have been made on their prophylactic effects. The purpose of this study was to clarify the effects of hemostatic drugs on bleeding. ⋯ No significant difference in blood loss was observed between the groups. Our findings, therefore, suggest that these two hemostatic drugs do not have prophylactic effects on intraoperative bleeding. Further studies are, however, necessary before applying these results to all surgical patients.
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Bull. World Health Organ. · Jan 1995
Use of body mass index of adults in assessing individual and community nutritional status.
Adult malnutrition is much more widespread than is commonly recognized. Described in this article is the use of body mass index (BMI = weight in kg/(height in metres)2) as a measure of adult nutritional status, both of individuals and of communities. ⋯ Included is a tabular presentation that permits rapid assessment of both thinness or underweight (BMI values < 16, 17 and 18.5) and overweight (BMI > 25, 30 and 40). Examples of the use of BMI in both clinical and public health practice are also given.