Articles: surgery.
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To reduce the doses of intravenous anesthetics (ketamine, diazepam, droperidol, and vecuronium) used in total intravenous anesthesia (TIVA), epidural administration of a ϰ-stimulating opioid, eptazocine, was combined with TIVA in 115 patients. Surgical procedures were uneventful under TIVA plus epidural eptazocine; significant depression of EEG and somatosensory-evoked potentials during anesthesia were observed without delay in recovery. ⋯ Therefore, epidural eptazocine may make it possible to use lower doses of anesthesia in TIVA, thus reducing the adverse effects associated with TIVA such as hypertension during surgery, intraoperative awareness, postanesthetic respiratory depression, delayed recovery from anesthesia, and neurological signs after anesthesia. This may be due to the ϰ-stimulating action of epidural eptazocine on the spinal cord and its σ-blocking action, as well as its lack of μ-action on the brain.
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Journal of anesthesia · Dec 1995
Inhibitory effect of prostaglandin E1 on gastric secretion during general anesthesia in humans.
The present study was undertaken to clarify the effects of prostaglandin E1 (PGE1) on gastric secretion during general anesthesia. Thirty-three patients, 16 with (PGE1 group) and 17 without (control group) PGE1 administration, scheduled for selective surgery were studied during general anesthesia with nitrous oxide (67%) and enflurane (1%-2% inspired). PGE1 was administered at a rate of 50-200 ng·kg(-1)·min(-1) when hypotensive medication was required. ⋯ The pH of gastric juice increased significantly, and the acidity and pepsin activity decreased after the beginning of the administration of PGE1, and these changes were observed even 1h after discontinuation. There was significant differences in the pH, acidity, and pepsin activity between the two groups after administration of PGE1. The results indicate that PGE1 inhibits gastric secretion at doses that produce a sufficient hypotensive effect under general anesthesia.
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Plast. Reconstr. Surg. · Dec 1995
Case ReportsAesthetic restoration of the severely disfigured face in burn victims: a comprehensive strategy.
Although highly specialized burn centers have significantly reduced mortality rates following extensive total body surface area burns, survivors are often left with grotesque facial disfigurement. The strategy of modern facial restoration emphasizes enhancement of aesthetic appearance as significantly as mitigation of functional impairment. Criteria for success are (1) an undistracted "normal" look at conversational distance, (2) facial balance and symmetry, (3) distinct aesthetic units fused by inconspicuous scars, (4) "doughy" skin texture appropriate for corrective makeup, and (5) dynamic facial expression. ⋯ In all cases, facial integrity has been aesthetically restored and, in most instances, with makeup, is near normal in social settings at conversational distances. Facial animation is retained and color matches are excellent. One flap was lost early in the series.
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Comparative Study Clinical Trial Controlled Clinical Trial
Value of sedative premedication in female sterilization via minilaparotomy: a prospective study of two local anaesthesia regimen.
A prospective study of two local anaesthesia regimen for female sterilization is presented. A total of 1,077 female clients were sterilized via minilaparotomy under local anaesthesia (ML/LA) as outpatients. The clients underwent pre-operative screening and received pre-operative and continuing counselling. ⋯ D. 4.5) minutes. Clients who were pre-medicated with pethidine were more likely to have multiple post-operative complaints, especially dizziness, faintness, headache, nausea and vomiting. This study found no significant difference in the clinical performance of female sterilization by minilaparotomy, duration of operation, length of incision, amount of local anaesthesia required or perception of pain between clients who were premedicated with intramuscular pethidine and those who were not.
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Eur J Anaesthesiol Suppl · Sep 1995
Comparative Study Clinical Trial Controlled Clinical TrialIntubation conditions and time-course of action of low-dose rocuronium bromide in day-case dental surgery.
A relatively small dose of rocuronium (0.45 mg kg-1) was compared with equipotent doses of atracurium (0.35 mg kg-1) and vecuronium (0.075 mg kg-1) for ease of intubation at 60 s. All patients could be intubated but the proportion with excellent or good conditions was much greater with rocuronium. Mean clinical duration of effect of this dose was 22.2 min. There was no correlation between intubating conditions and the degree of block of the adductor policis.