Articles: general-anesthesia.
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This investigation evaluated the hemodynamic effects of orally administered dexmedetomidine in chronically instrumented dogs in the conscious state, during enflurane anesthesia, and after emergence. Four experimental groups (n = 9 each) were completed. In groups 1 and 2, dexmedetomidine (10 or 20 micrograms/kg, respectively) was administered orally, and hemodynamics, arterial blood gas tensions, and plasma norepinephrine concentrations were monitored for 6 h. ⋯ Peak effects occurred within 30 min and lasted approximately 3 h. No reduction in coronary blood flow velocity, decrease in regional contractile function, or respiratory depression was observed. Administration of dexmedetomidine before enflurane anesthesia also was associated with a reduction in heart rate and rate-pressure product, and dexmedetomidine prevented the increase in heart rate (146 +/- 9 vs. 60 +/- 7 beats per min) and arterial pressure (117 +/- 7 vs. 98 +/- 7 mmHg) during emergence from anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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Single lung transplantation was performed in several steps: laparotomy to prepare an omentopexy, followed by pneumonectomy and implantation of a pulmonary graft, both by postero-lateral thoracotomy. The patients suffered from lymphangiomyomatosis (1), panacinar emphysema (2) and idiopathic pulmonary fibrosis (1). Immunosuppressive treatment was started before surgery. ⋯ Except in one patient with preoperative pulmonary hypertension, the increase in pulmonary vascular resistances remained moderate after clamping of the pulmonary artery. Sufficient oxygen delivery, with more than 50% venous oxygen saturation, was maintained at this time by the infusion of dopamine and dobutamine. Two other specific problems were encountered in the emphysematous patients: severe hypotension following the start of artificial ventilation and after placing the patient in lateral position; thoracic asymetry with overdistension of the emphysematous lung, and mediastinal shift.(ABSTRACT TRUNCATED AT 250 WORDS)
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Nitrous oxide-oxygen sedation in dental treatment has been used to a limited extent at the dental schools in Oslo and Bergen since the middle of the 1970-ies. Anesthetists were responsible for the sedation until 1983. Since then two dentists at the pedodontic departments, one in Oslo and one in Bergen, have been licensed for the use of nitrous oxide. ⋯ The acceptance and cooperation from the patients were better with low concentrations of nitrous oxide than at higher levels. The side effects/complications were few and mild (4.1%). This study shows that nitrous oxide-oxygen sedation in dental treatment is excellent and safe for many patients that cannot be treated conventionally.
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Akush Ginekol (Mosk) · Jan 1991
Comparative Study[Changes in various indicators of secondary hemostasis in physiological labor and cesarean section in relation to the type of general anesthesia].
Combined ketamine++ anesthesia and combined neuroleptic anesthesia were examined for impact in cesarean section. This revealed that the former anesthesia caused moderate hypercoagulative changes in the hemostatic system and a drastic increase in fibrinolysis at the end of the operative intervention. Early in the postoperative period, general combined neuroleptic anesthesia induced a profound hypercoagulation and inhibited fibrinolysis that preserved, which might result in thrombophilic events.
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Neuromuscul. Disord. · Jan 1991
Case ReportsFatal rhabdomyolysis complicating general anaesthesia in a child with Becker muscular dystrophy.
A 6-yr-old boy who presented with brown urine due to myoglobinuria and who was otherwise virtually asymptomatic was diagnosed as having Becker muscular dystrophy on the basis of a greatly elevated creatine kinase, muscle biopsy, dystrophin analysis, and a deletion of exons 3-7 in the dystrophin gene. Fifteen months later, during a general anaesthetic for dental treatment, he had a cardiac arrest associated with acute rhabdomyolysis, hyperkalaemia and hypocalcaemia. He died 4 days later. This case is reported to highlight this rare but potentially fatal complication of anaesthesia in muscular dystrophy, and to discuss possible ways of preventing such a catastrophe.