Articles: general-anesthesia.
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We have studied the automatic administration of alfentanil during alfentanil-nitrous oxide anaesthesia in 11 patients using a closed-loop feedback control system based on EEG analysis. We chose a median EEG frequency of 2-4 Hz as the EEG set point. ⋯ The average effective therapeutic infusion of alfentanil was 0.140 (0.032) mg min-1. We conclude that EEG feedback control may be useful in assessing and defining the dose requirements of alfentanil.
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Comparative Study
[Utilization of laryngeal masks. Preliminary study. 21 cases. Department of Anesthesia-Resuscitation, Yaounde, Cameroon].
The authors present a preliminary and retrospective study about the utilization of laryngeal mask. 21 patients underwent surgery concerning short or mid term intervention. A positioning of a laryngeal mask was easy with 83 p.c. of success. ⋯ Not at all replacing endotracheal intubation, the laryngeal mask is in peculiar situations an other possibility of protection of respiratory tract, and of ventilation be spontaneous manual or mechanical. The advantages of laryngeal mask versus facial one are obvious.
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Case Reports
Anesthetic management of a patient with hereditary fructose intolerance and phenylketonuria.
This is a report of a five-year-old girl with phenylketonuria (PKU) and hereditary fructose intolerance (HFI) who underwent elective strabismus surgery. PKU and HFI are two inborn errors of metabolism which have an autosomal recessive mode of inheritance. This case report describes the anesthetic features of a patient with PKU and HFI, each defect requiring specific anesthetic management.
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Comparative Study
An alternative method of increasing PCO2 using apnoea and continuous positive airway pressure.
We have examined the use of continuous positive airway pressure (CPAP) and apnoeic oxygenation for restoration of spontaneous breathing at the end of anaesthesia after controlled ventilation. We studied 45 adult patients without a history of acute or chronic respiratory disturbances. Anaesthesia was induced with thiopentone or propofol and maintained with nitrous oxide and enflurane in oxygen. ⋯ All patients were well oxygenated (PO2 mean 43.5 kPa, range 21-76 kPa) when spontaneous ventilation started. The pH was close to 7.28 in most cases (mean 7.28, range 7.21-7.32), and PCO2 varied in the range 6.6-9.9 kPa (mean 7.9 kPa). It is concluded that the method is safe with regard to oxygenation and acid-base balance.
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The pharmacokinetic and pharmacodynamic properties of propofol indicate that this may be an appropriate agent for induction and maintenance of anesthesia in obese patients. This study was designed to assess the rates of recovery and the pharmacokinetics of propofol infusions in morbidly obese patients. ⋯ Results from this study confirm the absence of propofol accumulation in morbidly obese patients when the current dosing scheme is used. Dosing schemes expressed in mg.kg-1 are the same as those in normal patients.