Articles: general-anesthesia.
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We evaluated the significance of patient's position in the measurement of gastric contents at the induction of anesthesia (n = 18). After the induction of general anesthesia with tracheal intubation, a nasogastric tube (16F) was inserted into the stomach. ⋯ The existence of the gastric content which can not be aspirated with supine position was confirmed. We conclude that it is necessary to place the patient on bilateral decubitus positions besides supine to evaluate the volume of the gastric content correctly.
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of tracheal extubation in patients deeply anesthetized with desflurane or isoflurane.
A randomized, single-blind study design was used to compare desflurane with isoflurane in 31 adults undergoing intraocular surgery to determine whether the lower blood:gas partition coefficient of desflurane would result in a more rapid emergence after endotracheal extubation of deeply anesthetized patients. A standardized general anesthetic technique was used, consisting of sufentanil, 0.25 microgram/kg, and propofol, 1.5 mg/kg, followed by either isoflurane (n = 15) or desflurane (n = 16) in an air/oxygen mixture. After the operation and reversal of residual neuromuscular block, spontaneous ventilation was reestablished and the patients' tracheas were extubated at equianesthetic concentrations of desflurane and isoflurane (i.e., approximately 1.4 times the minimum alveolar anesthetic concentration [MAC]). ⋯ Use of desflurane (versus isoflurane) was not associated with an increased incidence of coughing or airway irritation during the emergence period. However, use of desflurane did not significantly reduce the duration of the postanesthesia care unit (PACU) stay or alter later recovery events compared to isoflurane. In conclusion, the more rapid emergence would favor the use of desflurane when tracheal extubation during deep anesthesia is required.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 1994
Review[Perioperative EEG monitoring: studies of the electrophysiological arousal mechanism].
Electroencephalogram recordings have been advocated for assessment of changes in cerebral function during anaesthesia. Controversy exists on the specificity of EEG parameters indicating depth of anaesthesia, because cortical electrical activity is modulated not only by drugs but also by a variety of exogenous and endogenous stimuli. In clinical practice, EEG measures often fail to accurately predict anaesthetic depth since the effects of nociceptive stimulation on the EEG are still not well defined. ⋯ The occurrence of slow EEG wave patterns may be related to functional blockade of the ascending activating system of the brain stem. In contrast, slowing of the EEG is comparable to EEG changes seen with increasing concentrations of anaesthetics. This indicates the difficulty to discriminate arousal phenomena from drug effects using EEG monitoring alone.(ABSTRACT TRUNCATED AT 250 WORDS)