Articles: general-anesthesia.
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Case Reports
Combined orthotopic liver transplantation and caesarean section for the Budd-Chiari syndrome.
Fulminant hepatic failure is a rare complication of pregnancy. We describe a case of Budd-Chiari syndrome that resulted in the need for combined liver transplantation and Caesarean section at 32 weeks' gestation. The anaesthetic and perioperative management are discussed.
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Case Reports
Peripartum cardiomyopathy presenting as a cardiac arrest at induction of anaesthesia for emergency caesarean section.
Peripartum cardiomyopathy is defined as the onset of acute heart failure without demonstrable cause in the last trimester of pregnancy or within the first 6 months after delivery. It occurs in about 1 in 4000 deliveries and is often unrecognized as symptoms of normal pregnancy commonly mimic those of mild heart failure. We describe a previously asymptomatic patient who presented with a cardiac arrest at induction of general anaesthesia for emergency Caesarean section and subsequently developed acute heart failure. This case is unique both in its mode of presentation and the total absence of antecedent symptoms or signs of cardiac disease.
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During surgery, the anesthesiologists adjust the concentration of inhaled anesthetics according to the change in blood pressure in order to achieve good control of anesthesia. Usually the thinking patterns of individual anesthesiologists differ from one to another. ⋯ The results showed that anesthesiologists' regulation rules were formed independently of the 3 drugs and were specific to individuals. Some trends depending on institution were observed, but no statistically significant difference was found.
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Randomized Controlled Trial Clinical Trial
Prevention of atelectasis during general anaesthesia.
Atelectasis is an important cause of impaired gas exchange during general anaesthesia; it causes pulmonary shunting. We studied the effects of gas composition on the formation of atelectasis and on gas exchange during the induction of general anaesthesia. In 12 adult patients, the lungs were ventilated with 30% oxygen in nitrogen during anaesthesia induction, and in another 12, a conventional technique was used (100% oxygen during induction and 40% oxygen in nitrogen thereafter). ⋯ In subgroup B, the shunt increased from 2.6 (5.2)% to 9.8 (5.7)% of cardiac output. These results suggest that the composition of inspired gas is important in atelectasis formation during general anaesthesia. Use of a lower oxygen concentration than is now standard practice might prevent the early formation of atelectasis.
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Minerva anestesiologica · Jun 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Hospital day-surgery: comparative evaluation of 3 general anesthesia techniques].
For the voluntary interruption of pregnancy, three anaesthetic techniques have been compared being a random assigned to three groups of 40 patients. Induction of anaesthesia was based on fentanyl 0.005 mg/kg+midazolam 0.2 mg/kg or fentanyl 0.005 mg/kg = propofol 2.5 mg/kg or ketamina 0.5 mg/kg+propofol 2.0 mg/kg. ⋯ In addition to the intraoperative conditions, quality and rapidity of some neurofunctional aspects of the recovery have been evaluated using the Steward Score and the Coin Counting Test respectively. Our data suggest fentanyl-propofol association as the safest one as regards the needs of one-day surgery.