Articles: general-anesthesia.
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Because venous air embolism (VAE) has been considered to be a major deterrent to use of the sitting position, records of 255 patients undergoing neurosurgery in the sitting position from 1975 to 1982 were reviewed to determine the nature of morbidity and mortality in relation to the surgical procedure as well as to the occurrence of VAE. Complications were classified as surgical or anesthetic during joint review by a neurosurgeon and two neuroanesthesiologists. Outcome was classified on the basis of postoperative hospital course and discharge examination. ⋯ Although there was a variety of perioperative complications in patients with and without VAE, most of the complications were related to the operative procedure, not the sitting position or VAE. The episodes of VAE did not seem to be significant factors in the perioperative morbidity and mortality in our series of patients operated upon in the sitting position. Two case reports are discussed in detail.
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Acta Anaesthesiol Scand · Jan 1986
Comparative StudyAnaesthesia for colonoscopy. An examination of the anaesthesia as an element of risk at colonoscopy.
The importance of anaesthesia as an element of risk at colonoscopy has been examined retrospectively over a 10-year period from 1975 to 1984. The colonoscopic examinations were made by surgical gastroenterologists and anaesthesiologists working in cooperation. In 1242 cases the patients received diazepam/fentanyl anaesthesia during the colonoscopy (Group I) and in 126 cases they received general anaesthesia (Group II). ⋯ The dosing in the patients in Group I averaged: diazepam as premedication 9.2 mg, intravenous diazepam 12.4 mg, intravenous fentanyl 0.14 mg, and the duration of the colonoscopy was 36.5 min. The medication and the duration of the colonoscopy did not vary significantly in the patients with perforation of the large bowel. Our conclusion is that diazepam/fentanyl anaesthesia, administered by experienced staff, is harmless, and that general anaesthesia for colonoscopy did not involve an increased risk of perforation of the large bowel.
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This chapter reviewed the mechanisms and manifestations of transient and irreversible cerebral ischemia and the current experimental approaches to attenuate ischemic neuronal injury. Patients with signs or symptoms of cerebral ischemia are likely to have abnormal cerebrovascular dynamics, with areas of cerebrum at risk, and may be at an increased risk of stroke after general or vascular surgery. ⋯ Nonetheless, the available data indicate that most perioperative strokes occur in the postoperative period and appear to be thromboembolic in nature. The existence of neither asymptomatic carotid bruits nor intraoperative hypotension appears to be associated with the occurrence of perioperative stroke.