Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bispectral analysis of the electroencephalogram correlates with patient movement to skin incision during propofol/nitrous oxide anesthesia.
Bispectral analysis is a signal-processing technique that determines the harmonic and phase relations among the various frequencies in the electroencephalogram. Our purpose was to compare the accuracy of a bispectral descriptor, the bispectral index, with that of three power spectral variables (95% spectral edge, median frequency, and relative delta power) in predicting patient movement in response to skin incision during propofol-nitrous oxide anesthesia. ⋯ The bispectral index of the electroencephalogram is a more accurate predictor of patient movement in response to skin incision during propofol-nitrous oxide anesthesia than are standard power spectrum parameters or plasma propofol concentrations.
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Outcome is presented for 465 knee arthroscopies performed under general anesthesia in a public teaching hospital day surgery unit. The unanticipated hospital admission rate on the day of surgery was 1.07%. There were 11 (2.37%) major complications in the combined perioperative and postdischarge periods (up to 4 weeks postdischarge). ⋯ At early follow-up, 4.7% and 2.5% of patients had presented to hospital accident and emergency departments and local family doctors, respectively, usually for minor problems. Ninety-nine percent of all patients were happy with the ambulatory surgery service. With careful patient assessment and selection, day-case knee arthroscopy in a teaching hospital can provide satisfactory outcome.
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Comparative Study
Thermoregulatory and anesthetic-induced alterations in the differences among femoral, radial, and oscillometric blood pressures.
A decrease in radial artery blood pressure relative to central arterial blood pressure is commonly associated with the rewarming phase of cardiopulmonary bypass. Decreased hand vascular resistance has been suggested as a possible mechanism. Although decreased blood viscosity due to hemodilution may contribute to decreased hand vascular resistance, thermoregulatory vascular responses to core hyperthermia also may be important. ⋯ Thermoregulatory and anesthetic-induced alterations in upper-extremity blood flow substantially influence the relations among femoral artery, radial artery, and oscillometric blood pressure measurements.