Articles: general-anesthesia.
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Ann R Coll Surg Engl · Nov 1991
Application of the laryngeal mask airway to thyroid surgery and the preservation of the recurrent laryngeal nerve.
We report our experience of using the laryngeal mask airway (LMA) in 13 consecutive patients undergoing thyroid surgery and discuss the advantages and limitations of the technique. We also describe a method, based on the use of the LMA, for identifying and preserving the recurrent laryngeal nerve during thyroid surgery.
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Anesteziol Reanimatol · Nov 1991
[General anesthesia in patients with abdominal trauma in a district hospital].
The paper reviews three techniques of anesthesia used in 113 patients with abdominal trauma and thoracoabdominal wounds. In 42 patients N2O-ether (halothane)-O2 anesthesia was used. In 40 patients thalamonal-hydroxybutyric analgesia was used. ⋯ In six patients trauma was incompatible with life. From the point of view of their effect on the cardiovascular system two techniques of anesthesia seem to be most advisable: thalamonal-hydroxybutyric general anesthesia and general anesthesia with ketamine. Postoperative lethality was 6 patients (5.6%).
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Randomized Controlled Trial Clinical Trial
Efficacy of therapeutic suggestions for improved postoperative recovery presented during general anesthesia.
There have been claims that the postoperative course of patients may be improved by presentation during general anesthesia of therapeutic suggestions which predict a rapid and comfortable postoperative recovery. This study evaluated the effectiveness of such therapeutic suggestions under double-blind and randomized conditions. A tape recording predicting a smooth recovery during a short postoperative stay without pain, nausea, or vomiting was played during anesthesia to about half the patients (N = 109), while the remaining, control patients were played a blank tape instead (N = 100). ⋯ There were no meaningful, significant differences in postoperative recovery of patients receiving therapeutic suggestions and controls. These negative results were not likely to be due to insensitivity of the assessments of recovery, as they showed meaningful interrelations among themselves and numerous differences in recovery following different types of surgery. Widespread utilization of therapeutic suggestions as a routine operating room procedure seems premature in the absence of adequate replication of previously published positive studies.
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Anesthesia and analgesia · Nov 1991
Randomized Controlled Trial Comparative Study Clinical TrialEfficacy of esmolol versus alfentanil as a supplement to propofol-nitrous oxide anesthesia.
In 97 outpatients undergoing ambulatory arthroscopic procedures, we compared esmolol with alfentanil when used to supplement propofol-N2O-atracurium anesthesia according to a randomized, double-blind protocol. After an initial intravenous dose of 16 micrograms/kg alfentanil, or 2 mg/kg of esmolol, a variable-rate infusion of alfentanil or esmolol was administered to maintain a stable heart rate. After induction of anesthesia with 2.5 mg/kg of propofol, mean arterial pressure decreased to a larger extent in the alfentanil-treated patients. ⋯ There were no significant differences in the incidences of nausea and vomiting between the two groups. The authors conclude that esmolol may be used in place of alfentanil to supplement propofol-N2O-atracurium anesthesia in outpatients undergoing arthroscopic procedures. However, hemodynamic responses to tracheal intubation were larger with esmolol, and avoidance of alfentanil did not decrease the incidence of postoperative nausea and vomiting in this outpatient population.