Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative morbidity is similar in patients anesthetized with epidural and general anesthesia for radical prostatectomy.
To compare the effect of epidural and general anesthesia on the postoperative course and complication rate in patients undergoing radical prostatectomy. ⋯ Intraoperative anesthetic technique was not associated with a different postoperative complication rate in patients undergoing RRP. The very low incidence of complications and the uniform postoperative analgesic regimen may have contributed to the similarity between groups.
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Review Comparative Study
Anesthesia for microlaryngeal surgery: the case for subglottic jet ventilation.
Although the techniques for surgery on the endolarynx using suspension and the operating microscope have been fully developed, the safest, and least obtrusive anesthetic technique has yet to be manifested, as evidenced by more than 200 references to anesthesia for microlaryngoscopy in the world literature. This study reviews the physiology, physics, and problems of each anesthetic technique. In light of this review, animal and human studies are reported demonstrating the utility and safety of subglottic ventilation when provided with proper monitoring using an automatic ventilator. ⋯ There was no difference in the flammability of Silastic, rubber or PVC when struck by these lasers in this study. For these reasons, subglottic ventilation using a fluoroplastic, monitored, self-centering, subglottic, jet ventilation tube driven by an automatic ventilator with a shutdown feature, in the event of excessive pressure buildup, is proposed for anesthetizing healthy patients undergoing suspension microlaryngoscopy, and who have no airway obstructing lesion. A large tube with inflatable cuff is indicated when a supraglottic lesion may obstruct the airway.
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We have assessed the effect of lengthening the expiratory limb of an Ayre's T-piece from 0.5 to 10 m for ventilation with a Nuffield series 200 ventilator and Newton valve, as this equipment is potentially suitable for infants and young children during anaesthesia for magnetic resonance imaging (MRI). We used lung models with compliances and resistances representative of the respiratory system with intubated trachea of a neonate, infant and child weighing 15-20 kg. The effects on ventilation were small, being greatest with the largest lung model where the longer T-piece resulted in a reduction in tidal volume from 261 to 236 ml and an increase in intrinsic and extrinsic positive end-expiratory pressure from 0.20 to 0.32 kPa and from 0.14 to 0.25 kPa, respectively. Such changes are unlikely to be clinically important and can be obviated by using the ventilator with the standard valve in children weighing 15-20 kg.