Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
Cognitive and functional competence after anaesthesia in patients aged over 60: controlled trial of general and regional anaesthesia for elective hip or knee replacement.
To determine the influence of general or regional anaesthesia on long term mental function in elderly patients. ⋯ Cognitive and functional competence in elderly patients was not detectably impaired after either general or regional anaesthesia when attention was paid to the known perioperative influences on mental function.
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One hundred percent carbon dioxide was administered accidentally to a child aged 21 months during anaesthesia; this was caused by unauthorized filling of an oxygen cylinder with carbon dioxide. Cardiac arrest ensued, but was detected and treated promptly and no neurological deficit was detectable following recovery. The case demonstrates a typical preventable anaesthetic mishap and emphasizes the importance of monitoring oxygen supply and delivery.
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Neuropsychological and neurophysiological investigations indicate that a 30-40 Hz oscillatory brain mechanism is necessary for the adequate uptake and processing of elementary successive sensory events. An oscillatory component of that particular frequency range can be observed in the mid-latency auditory evoked potential (MLAEP). It is suppressed under non-specific anesthetic agents (agents not acting on specific structures of the brain or receptors). ⋯ By Fast-Fourier Transform-analysis corresponding power spectra were calculated to analyze energy portions of the AEP frequency components. In the awake state AEP showed an oscillatory component between 20- and 100-ms post-stimulus latency. Corresponding power spectra indicated a dominant 30-40 Hz frequency.(ABSTRACT TRUNCATED AT 250 WORDS)
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Swedish health care registries were used to identify women who had surgery during pregnancy and their offspring. Among the 2,252 infants born to women who had first trimester operations during 1973-1981, six had definite diagnoses of neural tube defects (expected number, 2.5). Scrutiny of the records showed that 572 operations occurred during gestational weeks 4-5, the period of neural tube formation, and that the mothers of five of the six infants with neural tube defects had an operation during that period (expected number of neural tube defects, 0.6) although one of the offspring probably had Meckel's syndrome. The relationship between neural tube defects and operation during pregnancy is discussed including the possibility that the association may be random.
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Randomized Controlled Trial Clinical Trial
Potency of propofol for loss of consciousness after a single dose.
A dose-response curve for loss of consciousness after administration of propofol was obtained using 56 unselected, premedicated patients presenting for surgery. Propofol was given in doses according to the calculated lean tissue mass (LTM) of the patient. ⋯ Using probit analysis, the ED50 for propofol was found to be 1.34 mg/kg of LTM and the ED95 was found to be 2.56 mg/kg of LTM. Comparison with previously published data for thiopentone showed propofol to be approximately twice as potent as thiopentone at ED50 and the slope of its dose-response curve to be shallower than that of thiopentone.