Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
[The arterial blood gas change in anesthetized patients with apnea: disadvantage of hyperventilation before intubation].
We studied the arterial blood gas changes during 4 minute apnea period without using constant oxygen flow under anesthesia. Fifteen adult surgical patients (ASA PS 1 or 2, 21-49 years of age) were randomly divided into 3 groups by ETCO2 before the start of apnea (group I: 40 mmHg, group II: 30 mmHg, group III: 20 mmHg). In addition, each patient was monitored with pulse oximetry, ECG, blood pressure, FIO2 and ETCO2. ⋯ In conclusion, the rate of rise of PaCO2 in anesthetized patients with apnea was logarithmic and there was no correlation with pre-apnea ETCO2. The rate of SpO2 decrease was significant in hyperventilated group (III). Thus, hyperventilation applied before the endotracheal intubation is not of benefit to the oxygenation of healthy humans.
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A postal survey of 160 members of the Neurosurgical Anaesthetists' Travelling Club was conducted in 1991 to investigate the current use of the sitting position in neurosurgery. There was a 78% response rate; at least one reply was received from every neurosurgical centre in the UK. ⋯ Thus in the period 1981-1991, the number of neurosurgical centres using the sitting position routinely, decreased by more than 50%. Current techniques of ventilation and monitoring for the sitting position are discussed briefly.
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Int J Clin Monit Comput · Aug 1994
Assessment of depth of general anesthesia. Observations on processed EEG and spectral edge frequency.
The daily use of muscle relaxants and the lack of correlation between the hemodynamic behavior and stages of general anesthesia represent the main obstacles in defining the level of cortical activity depression by the anesthetic drugs. Since classical EEG is cumbersome in the operating room, and demands special knowledge, computerized methods of EEG wave analysis have more or less replaced the 'raw' display of the electrical activity of CNS. The paper describes the place of spectral edge frequency (SEF), one of the parameters obtained by processing the EEG waves, in the list of variables which could be monitored during general anesthesia. ⋯ Some data also suggested that a stable SEF on that range contributed to a higher degree of immediate postoperative analgesia after Cesarean section. The limits of SEF oblige the scientists to go on looking for other monitored parameters, to be studied in correlation with processed EEG. Further studies are needed, in order to improve the anesthesiologist's capabilities to define correctly the stage of general anesthesia.