Articles: general-anesthesia.
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Successful anaesthetic management of two patients with severe epidermolysis bullosa dystrophica was accomplished with the use of ketamine-diazepam dissociative anaesthesia in one and brachial plexus block in the other. The classification and pathology of epidermolysis bullosa is considered, and the problems associated with anaesthesia in patients with this disease are discussed.
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The oxygen saturations of 152 children were studied for the first 30 minutes following general anaesthesia with a pulse oximeter. Thirty-six patients (24%) recorded oxygen saturations of less than 90% while breathing room air and in all cases this occurred during the first ten minutes. ⋯ There was no significant correlation with age, weight, procedure, time to wakening, or use of opiates. Clinical signs correlated poorly with hypoxaemia and it is recommended that all children should receive supplementary oxygen during transport to recovery wards and for at least the first ten minutes in recovery following general anaesthesia.
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An anaesthetic technique suitable for training in fibreoptic intubation is described. It uses a capped oropharyngeal airway which leaves the nose free for fibreoptic intubation and allows the airway to be maintained and ventilation to be controlled if necessary. An assessment is made of the technique after 50 fibreoptic intubations with the Olympus LF-1 fibrescope. There were no failed intubations and no serious complications.
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Propofol like thiopental and etomidate, suppresses cortical electrical activity in a dose-related manner, which leads to a 36% decrease in cerebral oxygen uptake and a 51% decrease in cerebral blood flow after an induction dose of 2 mg/kg followed by a maintenance dose of 0.2 mg/kg per min. In this study, the effects of propofol and varying paCO2 values on cerebral energy and amino acid metabolism were examined. METHODS. ⋯ Lactate/glucose index was calculated from the equation. Formula: see text. where a-vD lactate and a-vD glucose represent the arterial-cerebral venous substrate differences in mmol/l. Cerebral electrical activity was recorded by Fourier analysis of the EEG.(ABSTRACT TRUNCATED AT 250 WORDS)