Articles: general-anesthesia.
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Multichannel laser Doppler flowmeters allow continuous, simultaneous measurement of perfusion in several organs. We measured microcirculatory blood flow in the kidney, liver, skin and skeletal muscle in 10 anaesthetized rats subjected to abdominal surgery and graded haemorrhage (withdrawal of 5% total blood volume every 10 min). Mean arterial blood pressure, heart rate and haemoglobin concentrations were also measured. ⋯ We conclude that laser Doppler flowmetry is useful for continuous measurement of microcirculatory blood flow in several organs simultaneously during haemorrhagic hypovolaemia. It showed that microcirculatory blood flow in skeletal muscle is particularly sensitive to lesser degrees of blood loss during anaesthesia. Hypovolaemia-induced slow wave flowmotion occurred only in skeletal muscle, which may be linked to fluid mobilization during haemorrhage.
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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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Minerva anestesiologica · Jul 1995
Clinical Trial[Mechanical ventilation with laryngeal mask in anesthesia. Personal experience].
The aim of the study was to evaluate the following: the difficulty of inserting a laryngeal mask without the use of muscle relaxants and laryngoscopy; the incidence of possible intraoperative cardiocirculatory and respiratory alterations during the association of laryngeal mask and mechanical ventilation; local intra and postoperative complications due to their combined use. ⋯ There was no difficulty in positioning the laryngeal mask without muscle relaxants and laryngoscopy; no alterations were observed in the hemodynamic and respiratory parameters monitored; intra and postoperative local complications were frequently present in a high percentage of cases, consisting respectively in increased mucopharyngeal secretion and pharyngeal irritation and dysarthria. Whereas the former did not represent a serious clinical problem, the latter proved more troublesome for patients following surgery.
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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.