Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
The effects of different anesthetic regimens on fibrinolysis and the development of postoperative arterial thrombosis. Perioperative Ischemia Randomized Anesthesia Trial Study Group.
The purpose of this clinical trial was to compare the effects of different anesthetic and analgesic regimens on hemostatic function and postoperative arterial thrombotic complications. ⋯ Impaired fibrinolysis may be related causally to postoperative arterial thrombosis. Because RA combined with epidural fentanyl analgesia appears to prevent postoperative inhibition of fibrinolysis, this form of perioperative management may decrease the risk of arterial thrombotic complications in patients undergoing lower extremity revascularization.
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To evaluate the efficacy of general anesthesia during epileptic surgery. ⋯ General anesthesia is a safe and effective method for epileptic surgery, with local anesthesia providing additional sedation for isolated cases. Appropriate treatment requires an understanding of the pharmacokinetics and pharmacodynamics of the drugs used, as well as knowledge of the condition and the anticonvulsive medications used.
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Randomized Controlled Trial Clinical Trial
[Recovery of psychomotor and cognitive functions following anesthesia. Propofol/alfentanil and thiopental/isoflurane/ alfentanil].
Recent changes in the medical system have resulted in a significant increase of ambulatory surgical procedures. Therefore, a safe and short postoperative recovery period and, especially, the full recovery of complex psychological function after general anaesthesia have become increasingly important. In the present study we investigated the recovery of psychomotor and cognitive function after general anaesthesia with propofol/alfentanil and thiopentone/isoflurane/alfentanil. ⋯ Also in the digit span, the scores were significantly lower 30 min after recovery from the anaesthetic. Here again the propofol group tended to be a little better than the isoflurane group 30 min, 60 min and 240 min after anaesthesia. In the Munich Verbal Learning Test both groups had lower scores 30 min and 60 min, the isoflurane group also 240 min, after recovery...
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Experiences of awareness and recall during general anesthesia can be most distressing for patients. To obtain relevant information, the authors systematically interviewed patients in whom awareness during surgery had occurred, and questioned them about their experiences. ⋯ Details recalled from the period of awareness correspond with data from the literature. The anesthesiologist's role in discussing, and dealing with, traumatic experiences related to anesthesia may be of great importance. The hand-written anesthetic record is of limited value in retrospectively explaining why awareness and recall have occurred.
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The case notes and anaesthetic charts of 44 patients with dystrophic epidermolysis bullosa were reviewed retrospectively. A total of 390 general anaesthetics were performed for 469 surgical procedures over a 10-year period. Procedures included repair of syndactyly, dilatation of oesophageal strictures, extraction of teeth, excision of skin tumours and other procedures related to dystrophic epidermolysis bullosa. ⋯ Previous reports have suggested problems with the use of suxamethonium, nondepolarising muscle relaxants and thiopentone. These agents were all used in many of our patients without any adverse effects. There was one intra-operative death in a 35-year-old woman having an oesophageal dilatation which was complicated by oesophageal rupture.