Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
Influence of extradural and general anaesthesia on natural killer cell activity and lymphocyte subpopulations in patients undergoing hysterectomy.
The effect of hysterectomy was studied on natural killer (NK) cell activity, the distribution of lymphocyte subpopulations, and the endocrine stress response in 16 patients allocated to receive extradural analgesia S5-T4 (group I) or neuroleptanaesthesia (NLA) (group II). In group II a significant decrease in NK cell activity was found after operation for at least 3 days, while surgery during extradural analgesia did not induce significant changes. ⋯ Compared with group II, extradural analgesia significantly reduced the cortisol and noradrenaline response to surgery, while the adrenaline response in both groups was abolished. The results suggest that the decrease in NK cell activity and alterations in lymphocyte subsets induced by surgery and general anaesthesia can be prevented to a certain degree by extradural analgesia.
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Br Med J (Clin Res Ed) · Mar 1988
Randomized Controlled Trial Clinical TrialDoes halothane anaesthesia decrease the metabolic and endocrine stress responses of newborn infants undergoing operation?
Concern about the side effects of various anaesthetic agents in newborn infants has led to the widespread use of anaesthesia with unsupplemented nitrous oxide and oxygen with muscle relaxants in such patients. To investigate the efficacy of such a regimen 36 neonates undergoing operations were randomised to two groups: one group received anaesthesia with nitrous oxide and curare alone and the other was additionally given halothane. Concentrations of metabolites and hormones were measured before and at the end of operation and at six, 12, and 24 hours after operation and the values compared between the two groups. ⋯ Changes in blood concentrations of glucose and total ketone bodies and plasma concentrations of non-esterified fatty acids were also decreased in neonates receiving halothane anaesthesia. Neonates given anaesthesia with unsupplemented nitrous oxide showed significantly greater increases in the urinary ratio of 3-methylhistidine to creatinine concentration and their clinical condition was also more unstable during and after operation. Unless specifically contraindicated potent anaesthesia with halothane or other anaesthetic agents should be given to all neonates undergoing surgical operations as it decreases their stress responses and improves their clinical stability during and after operation.
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Clinical Trial Controlled Clinical Trial
Serum myoglobin following tourniquet release under anaesthesia.
Serum myoglobin concentrations were studied in 34 patients during tendon and nerve reconstruction operations that required the application of a pneumatic limb tourniquet. Seventeen patients received general anaesthesia without the use of suxamethonium, while the remaining 17 were given suxamethonium as part of the anaesthetic technique. Tourniquet times of up to 2.5 h were associated with negligible myoglobin release, but the use of suxamethonium administration resulted in a rise of serum myoglobin in some subjects, reaching a maximum of 300 micrograms litre-1 20-40 min after induction. ⋯ Three of the four patients who required a re-application of the tourniquet (after a short reperfusion time) had rises of serum myoglobin up to 120 micrograms litre-1 following the second deflation. Pneumatic tourniquets appear to cause no detectable ischaemic damage for up to 2.5 h, with or without prior use of suxamethonium. Re-application after only a short period of reperfusion may be inadvisable.