Articles: general-anesthesia.
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Anesthesia and analgesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialRenal and hepatic function in surgical patients after low-flow sevoflurane or isoflurane anesthesia.
The safety of low-flow sevoflurane anesthesia, which produces higher concentrations of toxic compounds, has been questioned. One hundred surgical patients received sevoflurane or isoflurane anesthesia at a total flow rate of 1 L/min. End-tidal CO2 concentrations and inspired and end-tidal anesthetic concentrations were monitored during anesthesia. ⋯ In both groups, total bilirubin, direct bilirubin, aspartate aminotransferase, and alanine aminotransferase were increased postoperatively. There was no difference between groups. Low concentrations of Compound A were present in low-flow sevoflurane anesthesia, but no significant differences in clinical laboratory values were observed between low-flow sevoflurane and isoflurane anesthesia.
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Mental status changes were assessed and compared in 172 general surgical and orthopedic patients and 190 nonsurgical patients, all aged 55 and over, during a 10-month period. Assessments included a structured psychosocial questionnaire and standardized tests of cognition, affect, and function. The relationship of surgery, type of surgery, age, gender, and postoperative delirium to long-term postoperative decline was evaluated. ⋯ Hierarchical multiple regression analyses assessed the unique contributions of demographic and surgical variables to cognitive, affective, and functional change. None of the independent variables tested made a significant contribution to changes from baseline to long-term follow-up. The findings may be due to the physical and psychological health of this sample, and replication of this work in more impaired populations may be productive.
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Animal studies show that airway receptors responsible for eliciting respiratory protective reflexes are not uniformly distributed in the airways. Based on this information, it is possible that the protective reflex responses to airway irritation in humans may vary, depending on the site of stimulation. The purpose of this study is to examine whether the protective reflex responses evoked from the larynx are different from those evoked from the lower airways and to see how change in depth of anesthesia modifies the protective reflex responses evoked from individual sites. ⋯ The respiratory reflex responses evoked by injection of water vary, depending on the site of stimulation. The incidence of various reflex responses was not affected by the changing depth of anesthesia. The sensitivity to airway irritation seems to be greater at the larynx and trachea than at the more peripheral airways.
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Mivacurium is a potent, short-acting, nondepolarizing relaxant of the benzylisoquinoline series. In adults endotracheal intubation can be performed after a 2 x ED95 dose of 0.15-0.2 mg/kg within 2-2.5 minutes. In infants onset time and clinical duration of mivacurium are significantly shorter than in adults. ⋯ The properties of mivacurium described above are related to patients with normal pseudocholinesterase activity. Particularly patients with atypical pseudocholinesterase show a marked increase in clinical duration. Side-effects due to significant histamine release with flush, tachycardia and hypotension are seldom observed if mivacurium is injected slowly over a period of more than 30 seconds and bolus injections of more than 2 x ED95 or 3 x ED95 are avoided.
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Ann Fr Anesth Reanim · Jan 1996
Comparative Study[Changes in intraocular pressure during anesthesia with intratracheal intubation or laryngeal mask].
To compare the effects of the laryngeal mask airway (LMA), and the tracheal tube (TT) insertion on intra-ocular pressure (IOP) in eye surgery. ⋯ LMA insertion does not elicit significant haemodynamic or IOP changes. Conversely, the TT increases HR, MAP and IOP. These changes can be deleterious in case of emergency surgery for perforating eye injuries. The LMA can be recommended as an alternative to TT in eye surgery, provided security rules are followed, because of the risk of displacement of LMA during surgery.