Articles: general-anesthesia.
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Oral Surg. Oral Med. Oral Pathol. · Jan 1991
GuidelineGuidelines for intraoperative monitoring of dental patients undergoing conscious sedation, deep sedation, and general anesthesia.
The promulgation and adoption of intraoperative monitoring standards in medicine for anesthesia has resulted in early detection of untoward events during sedation and anesthesia, lowering of malpractice premiums, and an improvement in the quality of care. The American Dental Society of Anesthesiology has devised specific, detailed monitoring standards with universal applicability in the dental setting.
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Case Reports Historical Article
Postanesthetic delirium: historical perspectives.
Postanesthetic delirium is a type of postoperative emotional response occurring immediately after emergence from general anesthesia. Associated with excitement and confusion, the alternative terms emergence delirium or postanesthetic excitement are frequently used. ⋯ Reported is a case of postanesthetic delirium in a healthy young man. An historical overview of this potentially harmful condition, with specific recommendations for diagnosis and treatment, also is presented.
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Comparative Study
[Physical and pharmacokinetic properties of anesthetics and sedatives used in neuroanesthesia and resuscitation].
Pharmacokinetics of anesthetic drugs are widely influenced by their physical properties. Lipo-solubility is the most important characteristic. ⋯ The concept of effective compartment allows a best understanding of relationship between concentration, intensity and duration of action of anesthetic drugs. Constant intravenous infusion route of anesthetic drugs administration requires to be discussed.
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Recent therapeutic advances in inotropic drugs and vasipressors uses allow a reappraisal of their indications during the perioperative period. Non-catecholamines vasopressors, ephedrine and phenylephrine, are particularly suitable for treatment of abrupt peroperative arterial hypotensions as observed during induction of general and medullar anesthesias. Cardiac arrest, peroperative anaphylactoid and toxic accidents are treated with epinephrine. ⋯ Inodilators (enoximone, amrinone and milrinone) ans nex dopaminergic compound (dopexamine) are powerful vasodilators agents to be introduced with care when association of amines and current vasodilators have failed. Finally, arterial pressure has to be maintained with norepinephrine after dopamine failure. Epinephrine remains last chance.
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Ann. N. Y. Acad. Sci. · Jan 1991
ReviewRole of signal transduction in anesthetic action. Alpha 2 adrenergic agonists.
The molecular mechanism for general anesthetic action is not known. The alpha 2 adrenergic agonists represent a novel class of "anesthetic-like" agent because of their selectivity for receptor binding sites and because the transmembrane signaling systems mediating their biologic responses in non-CNS systems are known. We have begun to characterize the signal transduction pathway involved in the anesthetic-like action of the alpha 2 adrenergic agonists. ⋯ Subsequently, data using molecular biologic techniques suggested that the alpha 2 C4 isoreceptor was the probable receptor that mediated the anesthetic response. We further explored the postreceptor effector mechanism for the signal transduction pathway for alpha 2 anesthetic action and identified the participation of two other molecular components, namely, a pertussis-toxin-sensitive G protein and a 4-aminopyridine-sensitive ion channel. Whether the signal transduction pathway for alpha 2 anesthetic action mediates the further response to other non-alpha 2 anesthetic agents needs to be defined.