Articles: general-anesthesia.
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Anaesthesiol Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Effect of rocuronium in sufentanil/isoflurane and sufentanil/propofol anesthesia].
It is a well-known fact that the duration of the effect of non-depolarizing neuromuscular blocking agents is influenced by other anaesthetics. Etomidate, propofol and nitrous oxide have no influence on the duration of effect of rocuronium, but a prolongation of the rocuronium effect under the influence of isoflurane has been described. In this study, we investigated the onset time, duration of effect and recovery index of rocuronium in isoflurane/N2O/sufentanil anaesthesia compared with these parameters in propofol/N2O/sufentanil anaesthesia. ⋯ Significant changes in arterial blood pressure or heart rate were not observed. The intubation conditions after 60 seconds were excellent in 34 patients (85%) and good in 6 patients (15%). It can be concluded that in comparison with anesthesia maintained by propofol/sufentanil and nitrous oxide/oxygen, the relatively low but necessary supplementation with isoflurane instead of propofol does not lead to a clinically relevant amplification of the relaxing effect of rocuronium.
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This review discusses the mechanism(s) of general anesthesia from a pharmacological viewpoint; in particular, the ability of drugs to produce many different effects is emphasised. The problems of experimental measurement of general anesthesia are discussed, and the possibilities for antagonism and potentiation of anesthesia considered. Physicochemical studies on anesthesia are described, as are the advancement of ideas beyond consideration of lipids and proteins as separate sites of action. The importance of studies on different areas of the brain is highlighted, and the review finishes with a survey of the effects of general anesthetics on synaptic transmission which emphasises the problems of extrapolation from in vitro to in vivo.
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Anesthesia and analgesia · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialTherapeutic suggestion has not effect on postoperative morphine requirements.
This study was designed to confirm the effect of therapeutic intraoperative auditory suggestion on recovery from anesthesia, to establish the effect of preoperative suggestion, and to assess implicit memory for intraoperative information using an indirect memory task. Sixty consenting unpremedicated patients scheduled for elective gynecologic surgery were randomly divided into three equal groups: Group 1 received a tape of therapeutic suggestions preoperatively, and the story of Robinson Crusoe intraoperatively; Group 2 heard the story of Peter Pan preoperatively and therapeutic suggestions intraoperatively; Group 3 heard the Crusoe story preoperatively and the Peter Pan story intraoperatively. A standardized anesthetic technique was used with fentanyl, propofol, isoflurane, and nitrous oxide. ⋯ No indirect memory for the Crusoe story could be demonstrated. This study did not confirm previous work which suggested that positive therapeutic auditory suggestions, played intraoperatively, reduced PCA morphine requirements. In contrast, a positive implicit memory effect was found for a story presented intraoperatively.
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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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Ann Fr Anesth Reanim · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Gynecologic laparoscopy with or without curare].
To assess physiological changes and operating conditions during general anaesthesia with or without neuromuscular blockade in patients undergoing gynaecologic laparoscopy. ⋯ Neuromuscular blockade influences neither most of the clinical haemodynamic and respiratory changes induced by pneumoperitoneum for gynaecologic laparoscopy not the operating conditions.