Articles: general-anesthesia.
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Comparative Study
[Cognitive function of geriatric ophthalmology patients after local and general anesthesia].
Since there will be an increase in the number of geriatric patients who undergo surgery and anesthesia over the next few years, studies comparing the effects of general and local anesthesia on cognitive functioning in elderly persons are mandatory. One hundred eleven ophthalmological patients, all over the age of 64 years, were assessed preoperatively, on the first and on the fourth postoperative day using a battery of standardized cognitive tests. Of the initial sample, 47 patients undergoing local and 54 undergoing general anesthesia completed the assessment. ⋯ The performance of patients with general anesthesia decreased transiently and returned to the initial levels within 3 days. We conclude from our results that postoperative cognitive deficits may occur in geriatric patients. However, general anesthesia poses no more risk to cognitive function than local anesthesia.
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Aust N Z J Obstet Gynaecol · Aug 1993
Comparative StudyCaesarean section anaesthesia and the Apgar score.
Retrospective comparison of epidural and general anaesthesia by a multivariate analysis of 1 and 5 minute Apgar scores did not show that general anaesthesia improves operating conditions for Caesarean section or reduces fetal trauma for preterm and term infants.
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Anaesthetic residents used bag valve mask (BVM) or mouth mask (MM) ventilation, both with an O2 flow of 15 l min-1 to ventilate 30 ASA I or II anaesthetised patients for 4 min prior to endotracheal intubation. Mean nasopharyngeal O2 was higher with BVM (BVM 95% (S. D. 3%) MM 54% (S. ⋯ Gastric insufflation was detected in two MM and two BVM patients. This tended to be more severe with MM ventilation. Although MM ventilation has some important disadvantages it can be used effectively by resuscitators with little or no experience in its use.
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Anesthesia and analgesia · Aug 1993
Comparative StudyVisual and tactile assessment of neuromuscular fade.
The accuracy of visual and tactile assessment of the neuromuscular fade in response to train-of-four (TOF) and double-burst stimulation (DBS) were compared to assess their relative utility in the clinical setting. For each of 74 data sets with a mechanographic TOF ratio less than 0.70, an observer (blinded to the presence or degree of fade) performed visual and tactile assessments of fade in response to TOF, DBS3,3, and DBS3,2 stimuli at low current (20 and 30 mA) and high current (50 and 60 mA). For the range of mechanographic TOF ratios between 0.41 and 0.70, visual assessment failed to identify TOF, DBS3,3, and DBS3,2 fade in 46%, 18%, and 14% of cases at high current and in 23%, 5%, and 0% of cases at low current, respectively. ⋯ However, the degree of overestimation of the fade ratio (i.e., quantitative assessment) tended to be less when using tactile means; the difference achieved significance for TOF at low current and DBS3,3 at both low and high currents. We conclude that the differences between the visual and tactile means of assessment are relatively small compared to the differences among the TOF and DBS patterns of neurostimulation. Both subjective techniques are often inadequate in settings in which assurance of full recovery of neuromuscular function is critical.
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Anaesth Intensive Care · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia after caesarean section with intramuscular ketorolac or pethidine.
We compared, in a double-blind randomised study, intramuscular ketorolac 30 mg (n = 49) and intramuscular pethidine 75 mg (n = 51) for analgesia after elective caesarean section under general anaesthesia. Anaesthesia was induced with thiopentone and suxamethonium and maintained with atracurium, nitrous oxide and isoflurane. Intravenous fentanyl 100 micrograms was given after delivery of the neonate. ⋯ However, four patients in the ketorolac group and six patients in the pethidine group requested no further analgesia within 24 hours. Pain VAS and overall assessment of analgesia was similar between groups, although more side-effects (nausea, dizziness) were noted in the pethidine group. Ketorolac 30 mg and pethidine 75 mg provided similar but variable quality of analgesia after caesarean section.