Articles: general-anesthesia.
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We studied the protective effect of prostaglandin E1 (PGE1)-induced hypotensive anesthesia on gastric mucosa in 30 elective surgical patients. Three groups, each composed of 10 patients, received PGE1, nitroglycerin or none during general anesthesia. ⋯ In the PGE1 group the viscosity and pH increased significantly and rapidly (P less than 0.05) as compared with the other groups. This suggests that PGE1 offers prophylactic effect against postoperative acute gastric mucosal lesion (AGML).
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Comparative Study
The effect of two intraoperative heat-conserving methods on orthopedic patients receiving regional and general anesthesia.
Postoperative hypothermia is a serious complication of surgery. The best way to prevent postoperative hypothermia is to prevent perioperative heat loss. The purpose of this study was to compare the efficacy of Thermadrape (O. ⋯ Hospital decisions regarding choice of perioperative heat conservation interventions will be guided by the cost of the intervention as well as efficacy. If overall hospital cost of cotton blankets is greater than that associated with Thermadrape covering, a decision to use Thermadrape covering may be warranted. Important factors for consideration in future research are presented and discussed.
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During carotid endarterectomy (CEA), phenylephrine infusions are commonly used to induce hypertension during carotid clamping in an attempt to increase collateral cerebral blood flow and prevent cerebral ischemia. Although this practice appears to increase the incidence of intraoperative myocardial ischemia during CEA when general anesthesia is employed, whether the limited use of phenylephrine infusions in specific instances of cerebral ischemia, as shown on an electro-encephalogram, results in low perioperative rates of both myocardial infarction (MI) and cerebral infarction remains unclear. We studied 171 CEAs done under general anesthesia performed with selective shunting based on the identification of cerebral ischemia by a two-channel computerized electroencephalographic monitor. ⋯ Two non-Q wave MIs (1.2%) occurred, both nonfatal. There were two cerebral infarctions (1.2%) and three deaths not related to MI (1.8%). Based on these findings, in order to decrease the incidence of both MI and cerebral infarction after general anesthesia for CEA, we recommend the restrictive use of phenylephrine-induced hypertension for specific instances of slowly or poorly reversible cerebral ischemia, as shown on the electroencephalogram.