Articles: general-anesthesia.
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Acta Anaesthesiol Scand · May 1995
Anaesthesia for microvascular surgery in children. A combination of general anaesthesia and axillary plexus block.
Nowadays, microvascular reconstructions are performed with high success rate even in small children. The combination of general anaesthesia and axillary plexus block was used in this prospective study in order to achieve optimal surgical conditions in these challenging operations. Fifteen children under eight years of age (1-8 years) were anaesthetised with a standardised anaesthesia method using a combination of general anaesthesia and axillary plexus block for microvascular toe-to-hand transfer. ⋯ One 1-year-old child developed a moderate hyperthermia of 39.1 degrees C. According to this study axillary plexus block can be combined with general anaesthesia in prolonged microvascular operations. When the effect of general anaesthesia ceased, the plexus block effectively increased peripheral circulation in the operated hand.
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Certified Registered Nurse Anesthetists (CRNA) have an ethical obligation to assure the safety of the anesthetized patient. Maintenance of orotracheal tube intra-cuff pressure (IcP) in a range preventing aspiration and avoiding tracheal ischemia is one way to enhance patient safety. Currently, no standardized method of cuff inflation and IcP maintenance is used in anesthesia practice. ⋯ Elapsed time for the IcP increase ranged from 2 to 52 minutes (mean = 12.34, median = 8 minutes). During anesthesia with 50% to 70% N2O, IcP will increase from initial safe levels to ischemia producing levels. Devices and approaches designed to limit N2O induced IcP increase have been described, however only direct IcP monitoring has been shown to assure safe initial and ongoing IcP.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1995
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial[Behavior of intraocular pressure in anesthesia with isoflurane in comparison with propofol/alfentanil].
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1995
Review[Allergic and pseudo-allergic reactions in anesthesia. II: Symptoms, diagnosis, therapy, prevention].
In this article we present the symptomatic features and discuss relevant diagnostic and therapeutic aspects of anaphylactoid reactions. In addition we give practical advice as to how to avoid and manage allergic or pseudoallergic reactions during anaesthesia. ⋯ Preventive measures like careful premedication, calm atmosphere, slow injection of drugs, the use of diluted solutions, and the use of drugs with a low potential for anaphylactoid reactions are important. Substances like inhalation anaesthetics, propofol, etomidate, ketamine, midazolam, fentanyl, alfentanil and bupivacain without epinephrine should be used.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1995
Review[Current status of ambulatory pediatric anesthesia].
Anaesthesia in paediatric outpatients represents a multi-facetted challenge for the anaesthesiologist. Certain steps have to be taken to allow preoperative examination of the patient on an outpatient basis. Preoperative screening should identify patients whom it is preferable to treat as inpatients. ⋯ Prophylactic administration of antiemetic agents must be considered for special operations. Patients should also be discharged according to standardised guidelines. In this way, the risks involved in anaesthesia and surgery should not be higher for outpatients than they are for inpatients.