Articles: surgery.
-
More than half of Cambodia's nine million people are under 17 years of age, but there are no certified paediatric surgeons. On a mission sponsored by CARE Australia and the International Federation of Surgical Colleges, Paddy A Dewan investigated the surgical care of Cambodia's children.
-
Journal of anesthesia · Dec 1995
Liver and renal functions following total intravenous anesthesia using midazolam and fentanyl-comparison with enflurane-nitrous oxide anesthesia.
Thirty patients undergoing lower abdominal surgery were studied to compare liver and renal functions in total intravenous anesthesia (TIVA) using midazolam and fentanyl with those in enflurane-nitrous oxide anesthesia (GOE). Patients were randomly divided into two groups of 15. In the TIVA group, anesthesia was induced with 0.3 mg·kg(-1) midazolam and maintained with 0.68 mg·kg(-1)·h(-1) midazolam for 15 min followed by 0.125 mg·kg(-1)·h(-1) midazolam and fentanyl. ⋯ BUN and Cr were within the normal range. There were no differences between the two groups regarding these parameters and the numbers with abnormally high levels of each parameter. In conclusion, liver and renal functions following TIVA using midazolam and fentanyl were the same as those following enflurane-nitrous oxide anesthesia.
-
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.
-
Journal of anesthesia · Dec 1995
Relationship between plasma neutrophil elastase and respiratory index of patients who had undergone cardiac surgery with cardiopulmonary bypass.
To evaluate the effects of cardiopulmonary bypass (CPB) on the release of polymorphonuclear leukocyte elastase (PMN-E) and postoperative pulmonary function, the perioperative plasma levels of PMN-E in α1-antitrypsin complex (EAC) and hydrogen peroxide concentration in the expired breath were measured in eight patients who underwent cardiac surgery with CPB, and the relationship between EAC levels and the respiratory index (RI) was studied. Although PMN, EAC, and the ratio of EAC to neutrophil (E/N) were elevated significantly after surgery, alveolar-arterial oxygen difference (A-aDO2) and respiratory index (A-aDO2/PaO2) did not change when compared with those of the preoperative period. ⋯ However, there was a significant positive correlation between E/N ratio and respiratory index (r=0.67,P<0.01). Thus excessive release of PMN-E during CPB may be implicated in the etiology of postoperative respiratory dysfunction.