Articles: general-anesthesia.
-
J Cardiothorac Anesth · Oct 1989
Anesthetic management of abdominal aortic surgery: a retrospective review of perioperative complications.
The incidence of perioperative complications was retrospectively reviewed in 103 patients who underwent replacement of the abdominal aorta from 1981 to 1987. Eighty-nine of the patients had associated systemic diseases, with hypertension being the most frequent (63%). Ischemic heart disease and cerebrovascular disease had an incidence of 12% and 13%, respectively. ⋯ Deterioration in renal function occurred in 6 patients, but with no difference between groups. There were three perioperative deaths (2.9%), with two of them resulting from cerebrovascular accidents in patients with a history of cerebrovascular disease. The overall morbidity and mortality were independent of the anesthetic technique.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of the neuromuscular block induced by mivacurium, suxamethonium or atracurium during nitrous oxide-fentanyl anaesthesia.
We compared the neuromuscular and cardiovascular changes following administration of mivacurium 0.15, 0.20 and 0.25 mg kg-1, suxamethonium 1.0 mg kg-1 or atracurium 0.5 mg kg-1 i.v. in 41 (ASA physical status I or II) patients during nitrous oxide-fentanyl anaesthesia. Mean onset times for total ablation of twitch response for mivacurium 0.15, 0.20 and 0.25 mg kg-1, were 2.5, 2.4 and 2.7 min, respectively, similar to that for atracurium (2.5 min), but longer than for suxamethonium (1.1 min) (P less than 0.05). ⋯ Following neostigmine 0.045 mg kg-1, mean times for twitch tension to recover from 10% to 90% of control were similar for mivacurium (9.7 min) and atracurium (10.5 min). Transient decreases in mean arterial pressure (greater than 20%) were observed in seven of 15 patients who received the two higher doses of mivacurium.
-
Minerva anestesiologica · Oct 1989
Comparative Study[Anesthesia for shoulder surgery. Comparison of anesthesiologic problems and technics].
We evaluated the ability of general, regional (interscalene block) and balanced anaesthesia (interscalene block supplemented by general anaesthesia) to manage the problems of shoulder surgery. Our results show that general anaesthesia is not adequate. ⋯ The positions of patient and surgeons cause the main disadvantages of anaesthesia with interscalene block alone, ad the control of airway of sedated patients is difficult and performing general anaesthesia in case of insufficient analgesia may be troublesome. Balanced anaesthesia, as compared to regional block alone, allows a safer control of respiration and an easier control of surgical analgesia.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[The effect of sufentanil in high doses on hemodynamics and electroencephalography activity in coronary patients].
Sufentanil, a synthetic opioid that is 5-10 times as potent as fentanyl, has been suggested by some authors to prevent hypertensive responses to noxious stimuli in patients undergoing coronary artery bypass surgery much better than fentanyl, while in other studies it has failed to maintain cardiovascular stability during surgical stimulation. This study was designed to investigate the cardiovascular and electroencephalographic effects of high-dose sufentanil/O2/pancuronium anesthesia in patients undergoing coronary artery bypass surgery. METHODS. ⋯ Cardiac and stroke volume indexes stayed significantly lower than the awake values, whereas heart rate remained essentially unchanged during the course of the study. There were no statistically significant differences between the groups during all measurements. In the EEG, sufentanil anesthesia was characterized by a decrease in the number of higher frequency waves and an increase in lower frequency (delta) waves, which did not change during sternotomy in 17 of the 20 patients.