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].
To investigate the influence of isoflurane anaesthesia versus total intravenous anaesthesia with propofol/alfentanil on intraocular pressure (IOP). ⋯ We conclude from our results that both anaesthetic techniques can be administered if increases in IOP have to be avoided.
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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.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1995
[Incidents, events and complications in the perioperative period in normal and malnurished patients--results of 23,056 patients].
Prevalence of cardiovascular risk factors in anaesthetic patients and perioperative pitfalls, events and complications (PECs) in different nutritional states were examined. The results should contribute to a current project of the German Society of Anaesthesiology and Intensive Care, established for quality assurance. ⋯ Nutritional disorder is an important epidemiological factor in anaesthesia. Particularly in younger patients without defined preoperative cardiovascular disturbance but with obesity the anaesthesist may be surprised by a remarkable incidence of relevant problems during and immediately after anaesthesia. We should consider the possible phenomenon that we are underestimating the anaesthetic challenge in young obese patients in a "healthy" cardiovascular state.