Articles: general-anesthesia.
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Anaesthesiol Reanim · Jan 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of neuromuscular blockade by mivacurium and atracurium].
The aim of our randomized controlled study was to compare the neuromuscular characteristics of mivacurium and atracurium by evaluating the intubation conditions, intubation times, onset times and the duration of action of these two muscle relaxants using two different dosing principles. Forty-eight patients were included in this study. All patients were premedicated orally with 0.2 mg/kg diazepam. ⋯ The patients of group 3 (n = 12) were intubated with 0.46 mg/kg atracurium (2 x ED95) and the patients of group 4 (n = 12) received a priming dose of 0.046 mg/kg atracurium (20% of ED95) and an intubation dose of 0.23 mg/kg atracurium (ED95) four minutes later. The patients were intubated under normocapnic conditions and following stabilisation of the palmar skin temperature after a 90% neuromuscular block (T1) had occurred. The intubation conditions were measured semiquantitatively using an intubation score.(ABSTRACT TRUNCATED AT 250 WORDS)
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Complications related to wrong or improper perioperative positioning are preventable events. Nevertheless patients may suffer from these complications much more than from the original pathology. In a short review a focus is set on the prone and supine position. Finally remarks for prevention are added.
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New justification for the use of regional anaesthesia, either alone or in combination with general anaesthesia, has been provided with reports of some unexpected influences on outcome. A reduction in the incidence of postoperative thrombotic episodes and vascular graft occlusion is strongly suggested in patients with generalized vascular disease. Application of a variety of drugs, including local anaesthetics, opioids and adrenergic agonists, in the region of the spinal cord reduces afferent input during surgery and also the metabolic stress response. ⋯ Premedication with opioid and other analgesics may also enhance this pre-emptive effect. New general anaesthetic and analgesic drugs are available that are more suited to these combined techniques. They have shorter duration of action so that plasma concentration can be rapidly adjusted to match a variable surgical stimulus.
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Cahiers d'anesthésiologie · Jan 1995
[Capnography in pediatric anesthesia: pitfalls and applications].
Expired CO2 analysis is an important area of anaesthetic monitoring. It ranges from ventilator connection to the estimation of alveolar dead space. ⋯ Confrontation between the technical specificities of CO2 monitors and the anatomical and physiological distinctive characteristics of the paediatric patient is mainly responsible for the interpretation difficulties encountered. Nevertheless capnography remains fundamental for paediatric ventilation monitoring.