Articles: general-anesthesia.
-
Randomized Controlled Trial Clinical Trial
Effects of surgical stimulation on midlatency auditory evoked potentials during general anaesthesia with propofol/fentanyl, isoflurane/fentanyl and flunitrazepam/fentanyl.
During general anaesthesia, midlatency auditory evoked potentials are suppressed in a dose dependent manner by a number of general anaesthetics. The activating effects of surgical stimuli on midlatency auditory evoked potentials have been demonstrated during light inhalational anaesthesia, and indicate that midlatency auditory evoked potentials reflect the activity of the central nervous system and not only anaesthetic concentrations. We investigated the effect of surgical stimulation (skin incision, sternotomy) on midlatency auditory evoked potentials under high dose opioid analgesia in 30 patients undergoing elective cardiac surgery. ⋯ The latencies of the early cortical potentials were similar to those in the awake state. After skin incision as well as after sternotomy no significant changes of midlatency auditory evoked potentials could be observed in any of the experimental groups. These results indicate that activation of the auditory pathway by surgical stimuli may be blocked when analgesia is provided by high dose fentanyl.(ABSTRACT TRUNCATED AT 250 WORDS)
-
J. Allergy Clin. Immunol. · Jul 1994
Comparative StudyA cluster of anaphylactic reactions in children with spina bifida during general anesthesia: epidemiologic features, risk factors, and latex hypersensitivity.
Anaphylactic reactions (ARs) in high-risk pediatric patients undergoing general anesthesia, especially those with spina bifida, have been attributed to anesthetics, muscle relaxants, antimicrobials, ethylene oxide, and latex. ⋯ These findings demonstrate that atopy, especially symptomatic latex allergy, is associated with AR during anesthesia in patients with spina bifida. Until a standardized latex test is available, a medical history of immediate rubber contact allergy, non-white race, food allergy, or nine or more prior surgical procedures can identify patients with spina bifida at highest risk for ARs. A complete history, including rubber contact and food allergy, should be compiled on all patients with spina bifida before surgery.
-
Comparative Study
Relation between body temperature and dexmedetomidine-induced minimum alveolar concentration and respiratory changes in isoflurane-anesthetized miniature swine.
Dexmedetomidine (DEX), an alpha 2-receptor agonist, is the pharmacologically active d-isomer of medetomidine, a compound used as a sedative in veterinary medicine. Isoflurane anesthetic requirement (minimum alveolar concentration; MAC), rectal temperature, and cardiorespiratory variables were studied in chronically instrumented Yucatan miniature swine during DEX (20 micrograms/kg of body weight)-induced changes in body temperature. All studies were performed at room temperature of 22 C. ⋯ Respiratory rate and minute ventilation were significantly higher in swine with maintained temperature. The PaCO2 was lower and, accordingly, pH was higher in these swine. Blood pressure and heart rate were not affected by temperature changes.
-
Int J Obstet Anesth · Jul 1994
The incidence of herpes simplex virus labialis after cesarean delivery.
Epidural and subarachnoid opioids have been associated with the development of oral herpes simplex lesions. Because of this risk, some anesthesiologists avoid neuraxial morphine in parturients with a history of herpes simplex virus labialis. When we began using neuraxial opioids for analgesia after cesarean delivery, we did not see any increased incidence of facial lesions. ⋯ Neuraxial morphine did not increase the risk of labial lesions significantly (3.5% vs. 2.6%). Despite published data to the contrary, we found no correlation between neuraxial morphine and the risk of facial herpes virus lesions in women after cesarean delivery. We offer patients the option of neuraxial morphine for analgesia after cesarean delivery despite any history of oral herpes lesions.
-
Randomized Controlled Trial Clinical Trial
Clinical pharmacology of rocuronium (Org 9426): study of the time course of action, dose requirement, reversibility, and pharmacokinetics.
To evaluate the time course of action, dose requirement, reversibility, and pharmacokinetics of rocuronium (Org 9426) under 3 anesthetic techniques (nitrous oxide-fentanyl supplemented with propofol, halothane, or isoflurane). ⋯ Isoflurane potentiates the rocuronium-induced neuromuscular block, resulting in a longer clinical duration and lower maintenance dose requirement. This difference is not explained by differences in pharmacokinetics but is probably due to increased sensitivity of the neuromuscular junction to rocuronium during isoflurane anesthesia.