Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
[Effects of pressure support ventilation (PSV) or PSV+PEEP on the respiratory function during general anesthesia under spontaneous ventilation].
This study was performed to examine the hypothesis that PSV with PEEP compared to spontaneous breathing with a circle anesthesia system may have beneficial effects on gas exchange and work of breathing during inhalational anesthesia. Nine patients (age; 58 +/- 20 yr) scheduled to receive general anesthesia for orthopedic (n = 3) or ENT (n = 6) surgery were randomly assigned in a triple cross-over manner to breathe with a standard anesthesia circle system, 5 cmH2O PSV, and 5 cm H2O PSV above 5 cmH2O PEEP. General anesthesia was induced with thiamylal (5 mg.kg-1) and succinylcholine (1 mg.kg-1), followed by tracheal intubation. ⋯ PaCO2 was lower during PSV+PEEP, but the difference was not significant. This level of PSV or PSV with PEEP may have little beneficial effects on gas exchange in our study condition. The mean WOBp was smaller in the PSV with PEEP group but the difference was not statistically significant.
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Randomized Controlled Trial Comparative Study Clinical Trial
[The effect of different anesthetic procedures on hormone levels in women. Studies during an in vitro fertilization-embryo transfer (IVF-ET) program].
Different anaesthetic procedures that were used during an in vitro fertilisation and embryo transfer (IVF-ET) program have been analysed in order to determine their influence on plasma levels of estradiol, progesterone, prolactin, and beta-endorphin and results of IVF-ET. METHODS. Fifty-four patients awaiting transvaginal oocyte aspiration were randomised into three groups: (1) anaesthesia with ketamine as an induction agent and analgesic (n = 20); (2) general intubation anaesthesia using thiopentone for induction and enflurane for maintenance (n = 18); and (3) no anaesthesia (n = 16). ⋯ CONCLUSIONS. The increased prolactin and beta-endorphin plasma levels associated with ketamine and general anaesthesia reflect a significant alteration of the observed hormone levels. When anaesthesia is indicated, we try to avoid general intubation anaesthesia in favor of ketamine.
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Anesthesia and analgesia · Nov 1994
Plasma inorganic fluoride and intracircuit degradation product concentrations in long-duration, low-flow sevoflurane anesthesia.
Plasma inorganic fluoride (F-) concentrations in long-duration, low-flow sevoflurane anesthesia were studied to assess effects on renal and hepatic function. The intracircuit concentration of degradation product generated by reaction between sevoflurane and CO2 absorbant was also determined. Ten patients undergoing prolonged surgery of 10 h or longer received sevoflurane anesthesia at 1 L/min. ⋯ Its individual maximum concentrations were 13.6-35.1 ppm (24.3 +/- 2.4 ppm). Postanesthesia clinical laboratory tests showed no renal impairment and only mild hepatic dysfunction that was not associated with anesthesia. Hyperfluorinemia and minute quantities of compound A were detected following long-duration, low-flow sevoflurane anesthesia.
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Case Reports
EEG-controlled "overdosage" of anesthetics in a patient with a history of intra-anesthetic awareness.
In spite of the ever-growing pharmacologic arsenal available for induction and maintenance of anesthesia, to our knowledge no treatment regimen exists that will provide full protection against intraoperative awareness. To date, no single monitoring technique is able to detect awareness or predict recall. Although the frequency of these complications is rare, the occurrence of any such event can be very distressful for the patient. Based on our clinical experience with a patient with a history of recall and a marked resistance to benzodiazepines, we present electroencephalogram-based anesthetic management as a technique to address this difficult problem.