Articles: general-anesthesia.
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Cahiers d'anesthésiologie · Oct 1989
[Frequency of hypoxic episodes during general anesthesia in children].
We measured the frequency and extent of arterial hypoxemia during pediatric general anesthesia under routine clinical conditions. The subjects were 91 children (13 newborns, 27 infants, 37 children under 6 years, 14 children under 14 years) with normal heart and lungs scheduled for extrathoracic surgery. Mask anesthesia (spontaneous/assisted ventilation) was performed in 30 cases, endotracheal anesthesia (controlled ventilation) in 61 cases. ⋯ A body weight of 10 kg appeared to constitute a threshold: in children below this weight arterial oxygen desaturation occurred significantly more frequently (p less than 0.001), and the incidence of major episodes was significantly higher (p less than 0.005). Major episodes were almost evenly distributed between induction and awakening from anesthesia, only one episode occurred during maintenance. Desaturation was more likely to occur in intubated children than in those with a mask (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Biography Historical Article
[The tragic and marvelous history of anesthesia].
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Regional-Anaesthesie · Sep 1989
Comparative Study[Mother and child stress parameters during cesarean section with general and peridural anesthesia].
This study compared maternal and fetal stress responses during cesarean section in either general anesthesia (GA) or epidural anesthesia (EA). Ten patients received GA with thiopental induction, intubation, and controlled ventilation with nitrous oxide and oxygen. After delivery, anesthesia was supplemented with fentanyl 0.2-0.3 mg. ⋯ Maternal epinephrine levels were lower under EA and below the normal range (EA 23 pg/ml, GA 77 pg/ml, P = 0.002); levels increased during GA and decreased during EA (P = 0.01). No statistical differences were seen in maternal norepinephrine (EA 206 pg/ml, GA 354 pg/ml). MAP was lower during EA (group levels EA 81 mmHg, GA 95 mmHg, P = 0.0002) and HR was higher during GA (group levels EA 89/min, GA 104/min, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Sep 1989
Randomized Controlled Trial Comparative Study Clinical TrialEffects of thoracic epidural anesthesia on systemic hemodynamic function and systemic oxygen supply-demand relationship.
The effects of thoracic epidural anesthesia (TEA) on total body oxygen supply-demand ratio are complex due to potential influences on both O2 delivery (QO2) and consumption (VO2). One hundred and five patients undergoing abdominal aortic surgery were randomly assigned to one of three groups to compare the cardiovascular and metabolic responses associated with (1) thoracic epidural anesthesia plus light general anesthesia (group TEA); (2) general anesthesia with halothane (group H); and (3) neuroleptanalgesia (group NLA). Values of cardiac index (CI) and QO2 were less intraoperatively in the TEA group than in the H or NLA groups, while VO2 values were similar. ⋯ Heart rate was slowest intraoperatively during TEA, and stroke work was less with TEA than with NLA. As cardiac filling pressure and systemic vascular resistance did not differ among the three groups, reduced adaptation of CI to tissue O2 needs during TEA was attributed to negative inotropic and chronotropic effects of the sympathetic blockade. We conclude that in patients undergoing abdominal aortic surgery, TEA has no apparent advantage over general anesthesia.
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Comparative Study
Epidural versus general anaesthesia for elective caesarean section. Effect on Apgar score and acid-base status of the newborn.
Elective Caesarean section deliveries over a 5-year period were studied to compare the effect of epidural block with general anaesthesia on the condition of the infant at birth. The Apgar score and umbilical arterial acid-base status were used as determinants of the latter. Epidural block was used in 139 (22.8%) mothers while 471 (77.2%) were performed under general anaesthesia. ⋯ The findings suggest that general anaesthesia, rather than asphyxia or aortocaval compression, is responsible for most of the depressed infants born by elective Caesarean section. This may involve over 20% of babies delivered in this manner, so greater use of epidural block for elective Caesarean section is recommended. Further investigations are required to improve results with general anaesthesia.