Articles: general-anesthesia.
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Br J Obstet Gynaecol · Sep 1986
Maternal stress response associated with caesarean delivery under general and epidural anaesthesia.
The maternal stress response to caesarean delivery with either general or epidural anaesthesia was investigated. Patients given a general anaesthetic showed statistically significant increases in blood pressure, heart rate, and levels of plasma catecholamines, cortisol and glucose. Epidural anaesthesia, to at least the T6 dermatome, obtunded these responses. The significance of these findings to the choice of method of anaesthesia is discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of wakefulness with two anaesthetic regimens. Total i.v. v. balanced anaesthesia.
Fifty-five patients were assigned randomly to receive either a total i.v. anaesthetic based on a two-stage infusion of etomidate plus increments of fentanyl or a regimen based on inhaled nitrous oxide with i.v. fentanyl increments. Using the isolated forearm technique, 44% of the nitrous oxide group were found to be wakeful at some time during surgery, whereas only 7% of the etomidate group were wakeful. There was one case of awareness in the nitrous oxide group.
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Two alternative anesthetic techniques for use during carotid endarterectomy were studied in a series of 424 procedures. A total of 248 were performed in patients under general anesthesia and 176 patients received regional block anesthesia. Perioperative instability of blood pressure was noted in 108 patients. ⋯ The 1 month operative mortality for the entire carotid series was 1.2% (5/424). There were three stroke-related deaths. In addition, two nonfatal major strokes and two minor strokes occurred in patients who received general anesthesia vs one nonfatal major stroke in a patient who received regional block anesthesia.