Articles: general-anesthesia.
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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.
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Care of patients with subarachnoid haemorrhage caused by ruptured cerebral artery aneurysm requires careful assessment of neurological function and prevention of rebleeding and ischaemia throughout the perioperative period. An understanding of the cerebral protection techniques used during periods of ischaemia or circulatory arrest will assist the provision of optimal conditions for successful surgical treatment of the aneurysm.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1995
Review[Do general anesthetics act on specific receptors?].
First of all, the meanings of the terms anaesthesia, anaesthetic and receptor are defined. Examples of anaesthetic actions in model systems are then described and compared with clinical actions of anaesthetics. When anaesthetics achieve a certain membrane concentration, they begin to influence membrane protein function in a nonspecific manner. ⋯ Rather, it is important that the drug does not show undesirable side effects when it achieves a critical membrane concentration at which lipophilic interactions occur. There are examples of specific interactions of general anaesthetics with receptors as well as examples of nonspecific effects on membranes. Whether these interactions are important for anaesthesia remains to be seen.
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We have examined the raw EEG activity and auditory evoked responses (AER) in 35 children, aged 3 days to 13 yr (median 1.5 yr), undergoing general anaesthesia for routine surgery. Binaural stimuli were presented at a frequency of 6.12 Hz and the EEG was recorded and stored using the Northwick Park auditory evoked response software. ⋯ In children less than 2 yr, regular artefact activity was superimposed on the background EEG which was at the same frequency as the instantaneous heart rate and which was often identifiable as the ECG. We conclude that the AER may be unreliable in children less than 2 yr of age, and modification of current methodology may be required if this technique is to become useful in paediatric anaesthetic practice.