Articles: general-anesthesia.
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Comparative Study
Combined epidural and general anesthesia in aortic surgery.
The perioperative course of 144 consecutive patients undergoing aortic reconstructive surgery was studied to assess the potential benefit of employing a combined epidural and light general anesthesia technique. A group of 67 patients had general anesthesia alone (GA), while in the group of 77 remaining patients, a combined epidural and general anesthesia (Epi-GA) was employed. The two groups were similar in regards to age, medical risk factors, preoperative assessment of cardiac and pulmonary function, and type of surgical reconstruction. ⋯ More patients in the GA group required a prolonged ventilatory support (P less than 0.05) and a high parenteral narcotic administration (P less than 0.025) during the first 48 hours. While the mortality rate was similar for the two groups (3.0% for GA group vs 5.2% for Epi-GA group), there was a higher percent of postoperative pulmonary complications observed in the GA group (7.6%) compared to the Epi-GA group (2.6%). By facilitating early extubation and a decreased need for systemic narcotics in the early postoperative period, Epi-GA may be beneficial in the high risk pulmonary patient undergoing aortic reconstruction.
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Case Reports
Respiratory tract infection and anaesthesia. Haemophilus influenzae pneumonia that developed under anaesthesia.
A 2-year-old boy with symptoms of a minor upper respiratory tract infection developed Haemophilus influenzae pneumonia that presented as hypoxaemia under anaesthesia for minor emergency surgery. The patient required 72 hours of mechanical ventilation in an intensive care unit after the anaesthetic and thereafter made an uneventful recovery. The value of pre-operative chest radiology and the possible contributory effect of anaesthesia are discussed.
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Anesteziol Reanimatol · Jul 1990
[Moradol (butorphanol tartrate) as the analgesic component of current combination general anesthesia].
A technique is described for the use of moradol as an agent ensuring analgesia in modern combined general anesthesia during abdominal and thoracic surgery, cardiac surgery, cardiopulmonary bypass included, and diagnostic manipulations. Moradol was particularly effective for long-term surgery. ⋯ Agonist opioid activity of moradol was maximum 10 min after its intravenous administration, therefore a 5 to 10 min exposition upon moradol injection prior to hypnotic drug administration is suggested. Bolus drug dose (150 mg/kg) for induction to anesthesia was an adequate protection against pain impulsation in surgical trauma in the course of 3-4 hours of surgical intervention.
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Psychother Psychosom Med Psychol · Jul 1990
[Preoperative anxiety--anxiety about the operation, anxiety about anesthesia, anxiety about pain?].
Questioning for the content of presurgical anxiety a situative examination of different contents of anxiety was performed combined with a correlational analysis of problem relevant personality traits (Freiburger Personality Inventory, FPI; Eigenschaftswörterliste, EWL). Preoperatively the anxiety in young patients is higher than it is in old ones, women anticipating thoracotomy name the highest anxiety scores. Generally the anxiety before important surgery is higher than before operations, which are calculated as being not so impressive; women show higher anxiety than men. ⋯ The informations about anxiety are related to content of anxiety, rarely to other variables, which were examined together with. The information is correlated to the personality traits, esp. to extraversion-introversion and emotional lability/stability, both are similarly correlated with pain, but not to postoperative complications. The idea that preoperative anxiety may reactively induce postoperative complications cannot be supported by the results.