Articles: general-anesthesia.
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Ann Fr Anesth Reanim · Jan 1988
[Development of anesthetic technics for resection-anastomosis of the trachea].
A series is reported of 109 patients, 45 +/- 18 yr old, undergoing tracheal sleeve resection. 101 patients had iatrogenic tracheal stenosis, 5 tracheal cylindroma, 2 tracheal cancer and 1 tracheal trauma. 84 patients underwent preoperative laser coagulation to increase the airway internal diameter. Anaesthesia for the sleeve resection was induced by thiopentone, and maintained by an opiate, nitrous oxide and, if necessary, a volatile anesthetic. Patients were intubated, after having been given a muscle relaxant, with either a normal length and diameter tube with a low pressure cuff, or a narrow (internal diameter less than 6 mm) 50 cm long tube with or without a low pressure cuff. ⋯ Preoperative photocoagulation reduced the risk of induction and intubation; the choice of endotracheal tube no longer depended on the tracheal diameter, but on the method of ventilation chosen. However, HFJV has tended to be phased out, except for the surgery of lesions close to the carena; it has been replaced by intermittent positive pressure ventilation via long tubes. Because laser photocoagulation can completely cure small stenoses, these patients requiring surgery were those with long stenoses which were difficult to treat.(ABSTRACT TRUNCATED AT 250 WORDS)
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Intraocular surgery is performed under local or general anesthesia. The indications for these procedures are often dependent on local circumstances. On the one hand, the optimal conditions for operations under general anesthesia, on the other, the negligible stress of local anesthesia, especially for the elderly, are emphasized. To clarify this question, perioperative anxiety behavior and postoperative pain were investigated in geriatric patients undergoing ophthalmic surgery. ⋯ The scores of state and trait anxiety behavior are comparable to a normal geriatric population, even if normal data cannot always be applied to clinical situations.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ann Fr Anesth Reanim · Jan 1988
[Respiratory obstruction during anesthesia in children with malignant mediastinal lymphoma].
In children with a malignant mediastinal lymphoma, acute respiratory occlusion can be a life-threatening complication during general anaesthesia. 26 cases have been reported since 1973, with five deaths. There were 23 boys for 3 girls, aged between 13 months and 18 years. The hazards of anaesthesia in these children are described. ⋯ General anaesthesia, carried out with the patient half-sitting, should be aimed at maintaining spontaneous breathing, and therefore muscle relaxants should be avoided. The anaesthetist should also be prepared to change the patient rapidly to a lateral or prone position; a rigid bronchoscope should always be at hand. Preoperative awareness of the risk of respiratory occlusion in these patients is essential so that the correct anaesthetic technique can be chosen and the postoperative course prepared.