Articles: general-anesthesia.
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Eighty patients undergoing elective thoracotomy were studied to assess the possibility of predicting arterial oxygenation (PaO2) during one-lung anaesthesia (OLA). The first 50 patients were studied retrospectively. The method of multiple linear regression was used to construct a predictive equation for PaO2 during OLA. ⋯ Four of 30 patients had a predicted PaO2 at ten minutes of OLA < 150 mmHg. Of these, 2/4 subsequently required abandonment of OLA for pulse oximetric saturation < 85%. We conclude that although it is not possible to predict an individual patient's PaO2 during OLA with a high degree of accuracy, it is possible, before the initiation of OLA, to identify those patients whose arterial oxygenation is likely to decrease to low levels during OLA.
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The laryngeal mask airway (LMA) provides a patent airway when placed 'blindly' into the hypopharynx. At the laryngeal side it is supposed to form a seal surrounding the laryngeal inlet with the epiglottis lying outside the mask aperture. This study is designed to assess the prelaryngeal position of the mask by the fibreoptic technique. ⋯ For patients who are at risk of regurgitation of gastric contents, use of the LMA is absolutely contraindicated. Relative contraindications are local pathology of the pharynx and situations with low pulmonary compliance and/or high airway resistance (massive obesity, asthma, etc.), especially during controlled ventilation. Further studies are necessary to establish definite indications for the application of the LMA.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Pediatric surgery. A comparison of spinal anesthesia and general anesthesia].
Forty patients aged 2 to 5 years who were admitted for paediatric operations were randomly assigned to have either spinal or general anaesthesia. Spinal anaesthesia was achieved with isobaric bupivacaine 0.5% at a dose of 0.5 mg/kg. General anaesthesia was induced with thiopentone 2-5 mg/kg and continued with low-dose fentanyl (1-2 micrograms/kg, oxygen/nitrous oxide/isoflurane (30/70/0.1-0.5%), vecuronium normoventilating the patients. ⋯ Vomiting (2), sore throat (4) and micturition difficulties (2) were the adverse events associated with general anaesthesia. Three patients were restless after spinal anaesthesia. It can be concluded that spinal anaesthesia is a suitable anaesthetic technique for paediatric surgery.
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Case Reports
General anaesthesia and the hypereosinophilic syndrome: severe postoperative complications in two patients.
Two patients with markedly increased eosinophil counts developed severe postoperative complications after general anaesthesia. One patient suffered life-threatening Adult Respiratory Distress Syndrome (ARDS), while the other presented with a coagulopathy and less severe respiratory problems. ⋯ These cases suggest that, in patients with marked eosinophilia requiring general anaesthesia, perioperative steroid cover is advisable. This may reduce or prevent serious lung damage and other complications.