Articles: general-anesthesia.
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Oxygen saturation and cardiovascular changes during fibreoptic intubation under general anaesthesia.
Sixty patients who required fibreoptic nasotracheal intubation were studied. Arterial oxygen saturation, arterial blood pressure and heart rate were monitored continuously during fibreoptic intubation under deep halothane anaesthesia. ⋯ Almost one third of the patients (18 out of 60) suffered a decrease in arterial oxygen saturation below 90% during the intubation sequence and in five patients the saturation fell below 80%. The episodes of desaturation were not related to the induction-intubation time or to the grade of laryngeal visibility at direct laryngoscopy.
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Case Reports
[The relation between upper respiratory tract infection and mild hypoxemia during general anesthesia in children].
Anesthesiologists often face the problem of a child with symptoms of an acute upper respiratory infection (URI) presenting for surgery. Anesthesia in the presence of uncomplicated URI may not be contraindicated. ⋯ Patients with symptoms of URI showed a significantly high incidence of decreased SpO2 to below 95% for 5 minutes. Our results suggest that, with URI symptoms even uncomplicated, symptomatic patients have increased risks for the development of mild hypoxemia during anesthesia.
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Randomized Controlled Trial Clinical Trial
Accelographic train-of-four at near-threshold currents.
The authors evaluated train-of-four (TOF) fade, as quantified by accelography, in response to neurostimulation at currents ranging from 10 to 60 mA. This was done to determine the range of currents over which measurements of fade remain consistent. In 31 patients (ASA Physical Status 1,2, and 3), anesthesia was induced with fentanyl, midazolam, and thiopental and was maintained with isoflurane and 66% nitrous oxide in oxygen. ⋯ This inconsistency was eliminated by testing at greater than or equal to 10 mA above threshold. TOF ratios obtained at 10 mA above T4 threshold correlated highly with those at 60 mA (Spearman r value = 0.94). The authors conclude that the TOF ratio is consistent over a wide range of stimulating currents and that testing with submaximal currents can be performed reliably at greater than or equal to 10 mA above the T4 threshold.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia progress · Jan 1992
Comparative StudySupplemental oxygen after outpatient oral and maxillofacial surgery.
Arterial oxygen saturation (SpO2) was monitored postoperatively with pulse oximetry in 72 dental patients. Intravenous general anesthesia was employed in 57 patients. All of these patients received supplemental oxygen intraoperatively, and of these, 29 received supplemental oxygen postoperatively. ⋯ Patients with a smoking history had more episodes of desaturation than did nonsmokers in the group that received general anesthesia and breathed room air postoperatively. The total amount of methohexital administered had no significant effect on the number of patients with desaturation episodes. These observations emphasize the need for postoperative oxygen for patients who undergo general anesthesia for outpatient oral and maxillofacial surgery.
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Randomized Controlled Trial Clinical Trial
[The effect of halothane, alfentanil and propofol on blood flow velocity, blood vessel cross section and blood volume flow in the middle cerebral artery].
Transcranial Doppler sonography (TCD) has gained in relevance for noninvasive monitoring of the cerebral circulation during the perioperative period. As long as the diameters of the investigated vessels remain unknown, however, flow velocities alone are not really informative. Exact vessel diameter determination in humans under the influence of different anesthetic drugs has not yet been performed due to ethical and methodological restrictions. ⋯ LAR remained unaltered after alfentanil administration. The site of action of some anesthetic agents on cerebral vessels does not seem to be restricted to cerebral arterioles: at least for halothane, a vasodilating effect on large cerebral arteries could be demonstrated. This should be kept in mind when transcranial Doppler is applied during the perioperative period.