Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
Augmented thermic effect of amino acids under general anaesthesia: a mechanism useful for prevention of anaesthesia-induced hypothermia.
1. Intravenous infusion of amino acids stimulates energy expenditure and heat accumulation in normal man. To find out whether such stimulation also occurs during general anaesthesia, thermogenesis was measured in 21 patients before, during and after anaesthesia and surgery. 2. ⋯ The difference, 21 W, illustrates the thermogenic action of the amino acids. This value may be compared with that of 4 W, observed in unanaesthetized individuals subjected to 30 min of identical amino acid infusions. 4. At awakening after the anaesthesia, the oxygen consumption rose to 71 +/- 21% above the pre-anaesthesia level in the amino acid-treated patients, who, without shivering, rapidly returned to normothermia, whereas in the control patients the oxygen uptake remained slightly below the pre-anaesthesia level, despite sustained hypothermia and vigorous shivering.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Surgical stimulation induces changes in brain electrical activity during isoflurane/nitrous oxide anesthesia. A topographic electroencephalographic analysis.
The aim of this study was to investigate topographic changes in electroencephalographic (EEG) power and frequency induced by abdominal surgery during anesthesia with 0.6% or 1.2% isoflurane in 66% nitrous oxide. ⋯ The current data demonstrate graded EEG responses induced by abdominal surgery during anesthesia with 0.6% or 1.2% isoflurane in 66% nitrous oxide. Spatial heterogeneities in absolute spectral power densities were reflected by color changes in the EEG maps. The topographic EEG analysis indicates that these changes were most dominant at frontal areas. The increases in delta and decreases in alpha activities may be related to intraoperative "paradoxical" electrophysiologic arousal phenomena.
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Comparative Study
The influence of anesthetic technique on perioperative complications after carotid endarterectomy.
This study evaluated the influence of anesthetic techniques on perioperative complications after carotid endarterectomy. ⋯ We conclude that cervical block anesthesia is safer and results in a more efficient use of hospital resources than general anesthesia in the treatment of patients undergoing carotid endarterectomy.
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Pneumocephalus occurs in a variety of clinical settings and has important anesthetic implications, particularly if N2O is used. One common cause of pneumocephalus is a craniotomy or craniectomy, and therefore, patients undergoing these neurosurgical procedures may be at increased risk for the development of tension pneumocephalus if N2O is used during a subsequent anesthetic. However, because the rate at which a postoperative pneumocephalus resolves has not been well defined, the duration of this risk period is unknown. ⋯ These data indicate that all patients have pneumocephalus immediately after a supratentorial craniotomy. Although the incidence and size of pneumocephali decrease over time, a significant number of patients have an intracranial air collection large enough to put them at risk for complication if N2O is used during a second anesthetic in the first 3 weeks after the first procedure. This information should be considered in the evaluation of the patient and in the selection of anesthetic agents.