Articles: general-anesthesia.
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Sickle cell disease (SCD) is associated with many pathological and functional abnormalities affecting all organ systems. Renal manifestations of SCD may result in end-stage renal disease (ESRD), which can be treated by chronic haemodialysis or renal transplantation. Renal transplantation was successfully performed in a 25-yr-old male with sickle cell beta-thalassaemia and nephrotic syndrome. We present a case report of this patient, a discussion of the renal complications associated with SCD and the perioperative management of a patient with SCD undergoing renal transplantation.
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Journal of anesthesia · Oct 1990
Characteristic changes between core and peripheral surface temperature related with postanesthetic shivering following surgical operations.
The relationship between changes in the core and the surface temperature and postanesthetic shivering was studied in 100 patients who underwent general anesthesia. Patients were classified into four groups by the patterns of change in the core and peripheral surface temperature. Type II and type IV groups of patients showed a decrease in surface temperature during the major operation such as gastrectomy and radical mastectomy. ⋯ However, in patients in type I and III, the rate of shivering was low. Evaluation of the difference between core and peripheral surface temperature may be important to manage body temperature at a steady level during the operation. The monitoring of body temperature difference between core and peripheral surface during the operation may be useful for predicting to occurrence of postanesthetic shivering.
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Acta Anaesthesiol Scand · Oct 1990
Anaesthesia in malignant hyperthermia-susceptible patients without dantrolene prophylaxis: a report of 30 cases.
The intra- and postoperative course of 30 anaesthetics in 24 MH-carriers verified by in vitro contracture tests is reported. None of the patients received dantrolene prophylactically and only agents known to be nontriggers were used for anaesthesia. Neither MH-related changes in perioperative heart rates, body temperatures, and CK levels nor any other symptoms of MH were observed. We conclude that the prophylactic use of dantrolene is not necessary in patients suspected to be prone to MH if triggering agents are avoided and the patients are closely monitored.
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J Cardiothorac Anesth · Oct 1990
Comparative StudyCombined epidural and general anesthesia for abdominal aortic surgery.
The hypothesis that combined epidural and light general anesthesia for infrarenal abdominal aortic surgery is associated with a more stable intraoperative course and less postoperative morbidity than general anesthesia alone was tested. The authors compared intraoperative hemodynamic variables and postoperative morbidity between a group with combined epidural and general anesthesia (n = 30) and a group with general anesthesia (n = 19). Patients who had combined epidural and general anesthesia were given epidural bupivacaine intraoperatively and epidural morphine postoperatively. ⋯ In addition, vasodilator therapy was required less frequently in the group with combined epidural and general anesthesia (P = 0.002). Duration of intensive care unit stay was shorter in the combined epidural and general anesthesia group (2.7 days v 3.8 days, P = 0.003). These data indicate that for infrarenal abdominal aortic surgery, combined epidural and general anesthesia is associated with more stable intraoperative hemodynamics and significantly less postoperative morbidity than general anesthesia alone.
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Anasth Intensivther Notfallmed · Oct 1990
[The effect of positive end expiratory pressure on the blood flow velocity in the basal cerebral arteries during general anesthesia].
The effects of incremental positive end-expiratory pressure (PEEP) on middle cerebral artery (MCA) blood flow velocity and pulsatility index were studied in 20 patients scheduled for minor elective surgery. Transcranial Doppler sonography (TCD) was used to measure systolic (Vsyst) and mean flow velocity (Vmean) and the pulsatility index (PI). Heart rate (HR), mean arterial blood pressure (MAP), end-tidal CO2(PetCO2) and TCD parameters were recorded at control (PEEP = O) and following PEEP of 5 cm H2O, 10 cm H2O and 15 cm H2O for a period of 5 minutes for each PEEP level. ⋯ PI increased stepwise in response to each PEEP level. MAP decreased with PEEP 10 and 15 while HR and PetCO2 remained constant over time. These data suggest that PEEP-induced decreases in MCA blood flow velocity may represent decreases in CBF due to impairment of the intracranial venous flow if the diameter of the insonated vascular segment remains constant.