Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
Epidural vs general anaesthesia and leg blood flow in patients with occlusive atherosclerotic disease.
Total leg blood flow (plethysmography), skin blood flow (laser-Doppler flowmetry), and haemodynamic stability (MAP, HR, RPP) were studied in vascular (ABI less than 1.0; n = 31) and in non-vascular (ABI greater than 1.0; n = 24) surgical patients during epidural or fentanyl-supplemented general anaesthesia. During epidural anaesthesia significant increases in total leg blood flow were observed in vascular (from 1.9 +/- 0.2 to about 3 ml/100 ml tissue/min) as well as in non-vascular (from 2.5 +/- 0.6 to about 7 ml/100 ml tissue/min) patients and leg blood flow remained high in the postanaesthetic period. During general anaesthesia total leg blood did not increase, either in vascular or in non-vascular patients, and in the postanaesthetic period blood flow values even lower than the initial ones were observed. ⋯ In vascular patients no critical redistribution of blood flow within the limb was observed irrespective of the type of anaesthesia. Good haemodynamic stability could only be maintained in the epidural group. It is concluded that epidural anaesthesia seems to offer considerable advantages over general anaesthesia for high-risk vascular patients during arterial reconstructions since better haemodynamic stability and higher leg blood flow can be achieved.
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A case of postoperative coma associated with diabetes insipidus and hypothermia is presented. Some recommendations are offered for the future management of similar cases.
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Arterial oxygen saturation was measured by pulse oximetry in 105 children (aged 2 weeks-14 years) during recovery from general anaesthesia. Oxygen saturation was monitored continuously from the time that anaesthesia ended in the operating theatre until the children were fit to leave the recovery ward. All children breathed room air during transfer to the recovery area; 81 children continued to breathe room air in the recovery ward while the remainder received supplementary oxygen. ⋯ The administration of 100% oxygen at the end of anaesthesia had no effect on the incidence of early hypoxaemia which was greatest in children whose trachea had been intubated. Late hypoxaemia was associated most commonly with crying and breath-holding and was reduced significantly by supplemental oxygen. The oxygen saturation of children on return to the ward was significantly lower than the pre-operative value (p less than 0.001).
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Randomized Controlled Trial Clinical Trial
Postoperative recovery after general anaesthesia with and without retrobulbar block in retinal detachment surgery.
This study was to determine whether general anaesthesia plus retrobulbar block would be a better anaesthetic technique than general anaesthesia alone in retinal detachment surgery. Twenty-eight patients were allocated randomly to either general anaesthesia with retrobulbar block or general anaesthesia alone. The anaesthetist involved was blinded as to whether a retrobulbar block was performed or not. ⋯ Those who received general anaesthesia plus block recovered significantly more rapidly than those receiving general anaesthesia alone. The time to opening of eyes on command (p less than 0.05), telling the correct date of birth (p less than 0.01), reaching a full recovery score (p less than 0.005) and performing a simple motor task (p less than 0.025) was shorter in patients with general anaesthesia plus block. Thus general anaesthesia plus retrobulbar block was superior to general anaesthesia alone in terms of pain and recovery after operation.