Articles: general-anesthesia.
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To understand the cellular and molecular basis of the anaesthetic state, it is important to remember that, in the intact CNS, synapses operate within elaborate nerve networks. From the data presented above, it is evident that block of impulse conduction in presynaptic fibres does not explain the effects of most anesthetics on synaptic activity. This is not surprising since some anaesthetics, the barbiturates in particular, may both depress excitation and enhance inhibition. ⋯ The overall effect of an anaesthetic agent depends on summation of events occurring at the many individual synapses and neurones that make up the network. The effects of anaesthetics on different neuronal pathways may therefore depend on the nature of the receptors and ion channels of the cells that comprise the network. The anaesthetic state may be the result of all these actions, but the characteristics of the state may differ somewhat from agent to agent.
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Clinical Trial
Pupillary assessment of sensory block level during combined epidural/general anesthesia.
Currently, no reliable method exists to determine the level of sensory block during combined epidural/general anesthesia. However, the pupil dilates markedly in response to noxious electrical stimulation during general anesthesia. Presumably, sensory block produced by epidural anesthesia decreases or obliterates this autonomic response. Accordingly, we tested the hypothesis that pupillary dilation in response to noxious stimulation would predict the level of sensory block achieved during combined epidural/general anesthesia. ⋯ We conclude that dilation of the pupil in response to electrical stimulation is an accurate test of the sensory block level during combined epidural/general anesthesia.
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Randomized Controlled Trial Clinical Trial
Prostaglandin E1 as a hypotensive drug during general anesthesia for total hip replacement.
To determine the effect of intravenous administration of prostaglandin E1 (PGE1) in inducing controlled hypotension during general anesthesia. ⋯ These data suggest that PGE1 can be used safely to induce hypotension, thereby reducing blood loss during total hip replacement with general anesthesia.
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Randomized Controlled Trial Clinical Trial
The laryngeal lift: a method to facilitate endotracheal intubation.
To assess the efficacy of the "laryngeal lift" maneuver in improving laryngoscopic visualization to facilitate endotracheal intubation. ⋯ The laryngeal lift should be part of the anesthesiologists' armamentarium in helping the laryngoscopist who is faced with Grades II, III, IV, and V laryngoscopic views to enhance visualization of the larynx and thus facilitate endotracheal intubation.