Articles: general-anesthesia.
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Anesthesia and analgesia · Dec 1995
Decreases in anesthesia-controlled time cannot permit one additional surgical operation to be reliably scheduled during the workday.
We tested whether anesthesiologists can decrease operating room (OR) costs by working more quickly. Anesthesia-controlled time (ACT) was defined as the sum of 1) the time starting when the patient enters an OR until preparation or surgical positioning can begin plus 2) the time starting when the dressing is finished and ending when the patient leaves the OR. Case time was defined as the time starting when one patient undergoing an operation leaves an OR and ending when the next patient undergoing the same operation leaves the OR. ⋯ Statistical analysis of measured OR times showed that ACt would have to be decreased by more than 100% to permit one additional scheduled, short (30-min) operation to be performed in an OR during an 8-h workday after a prior series of cases, each lasting more than 45 min. Anesthesiologists alone cannot reasonably decrease case times sufficiently to permit one extra case to be reliably scheduled during a workday. Methods to decrease ACT (e.g., using preoperative intravenous catheter teams, procedure rooms, and/or shorter acting drugs) may simply increase costs.
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Clinical Trial Controlled Clinical Trial
Gastric regurgitation during general anaesthesia in different positions with the laryngeal mask airway.
Ninety patients, divided into three groups of 30, were investigated to determine the incidence of gastric regurgitation during general anaesthesia administered via the laryngeal mask airway in the supine, Trendelenburg and lithotomy positions. Fifteen minutes before induction of anaesthesia each patient swallowed a 75 mg methylene blue capsule. At the end of surgery, the LMA and the oropharynx were inspected for bluish discoloration which was considered to be a sign of gastric regurgitation. No blue dye was detected in the supine group but it was observed in one patient in each of the other two groups.
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J Osaka Univ Dent Sch · Dec 1995
The incidence of arrhythmias during induction of general anesthesia.
In this study, our induction methods of endotracheal anesthesia was evaluated with reference to electrocardiogram, hemodynamic status and arterial blood gas analysis on 153 patients. From the beginning of induction, electrocardiogram was recorded continuously to the completion of intubation. The blood pressure and heart rate were also measured. ⋯ As a result of careful and gentle induction techniques, the incidence of arrhythmias during intubation was very low. However, an elevation of PaCO2 was not avoidable, even in smooth and successful intubation. In conclusion, the importance of more adequate ventilation coupled with skillful intubation in a shorter period to avoid hypercapnia and arrhythmias is appreciated again in the endotracheal anesthesia for the maxillofacial surgical patients with anatomical airway problems.
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Preschool children depend on their parents for support and guidance in dealing with new or stressful situations. When requested, the parents should be allowed to support their children during ambulatory surgical procedures, especially during the induction of anesthesia. With proper understanding on our part, and with proper preparation and counseling, the parents can become our allies and help to smooth the experience for the child, for the staff, and for themselves. Future efforts should be directed at studying the effects of different methods of preoperative preparation and counselling on the parents' attitude and cooperation during induction.