Articles: general-anesthesia.
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Biography Historical Article
Horace Wells, pioneer in anesthesia and his defence of his discovery.
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Anesthesia and analgesia · Sep 1985
Randomized Controlled Trial Comparative Study Clinical TrialEtomidate versus thiopental for induction of anesthesia.
Hemodynamic changes and side effects of anesthesia induction with etomidate or thiopental were evaluated in 83 ASA class I or II patients. Patients were randomly assigned to one of 12 groups according to pretreatment drug (fentanyl, 100 micrograms, or normal saline intravenously), induction agent (etomidate, 0.4 mg/kg, or thiopental, 4 mg/kg), and maintenance anesthetic technique (isoflurane-oxygen, isoflurane-nitrous oxide-oxygen, or fentanyl-nitrous oxide-oxygen). The purpose of this experiment, of factorial design, was to evaluate the combined effects of two or more experimental variables used simultaneously and to observe interaction effects. ⋯ Patients in whom anesthesia was induced with etomidate had a greater incidence of pain on injection and myoclonus and a lesser incidence of apnea than patients in whom anesthesia was induced with thiopental. Fentanyl pretreatment significantly decreased the incidence of pain on injection and myoclonus, but it increased the incidence of apnea when anesthesia was induced with etomidate. The incidence of postoperative nausea and vomiting was similar after thiopental and etomidate and was unaffected by fentanyl pretreatment. (ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Sep 1985
Comparative Study Clinical Trial Controlled Clinical TrialComparison of morphine, meperidine, fentanyl, and sufentanil in balanced anesthesia: a double-blind study.
A double-blind study comparing four narcotic analgesics of different potencies, meperidine, morphine, fentanyl, and sufentanil, was performed on consenting patients undergoing general or orthopedic surgery under balanced anesthesia. Blood pressure, measured through an indwelling arterial catheter, was recorded continuously, as were ECG and heart rates. The narcotics, made up in equipotent concentrations, were given as indicated by hemodynamic and clinical signs. ⋯ Side effects, including histamine release accompanied by tachycardia and hypotension, were most frequent and most severe in patients who received meperidine. After extubation, marked increases in heart rate, blood pressure, and plasma norepinephrine and epinephrine occurred in some patients in each group. The incidence of postoperative respiratory depression was greatest in patients given morphine (mean dose of naloxone 8.6 micrograms/kg) and least with sufentanil (mean dose of naloxone 1.8 micrograms/kg) and fentanyl (3.2 micrograms/kg naloxone).
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Urapidil (Ebrantil) is a new antihypertensive agent exerting central and peripheral action which is recognized for the treatment of both chronic and acute hypertension. The purpose of the present study was to investigate the extent of the antihypertensive effect of urapidil in various forms of general or regional anaesthesia. To this end, a retrospective analysis was first carried out on the typical reactions of the circulatory system in 200 patients during either neuroleptanalgesia with diazepam and droperidol, or halothane, enflurane or intrathecal local anaesthesia. ⋯ Temporary blood pressure reduction to hypotensive values was observed in 2 of the 50 patients only. From the results it is concluded that urapidil is an effective and relatively safe drug for the treatment of elevated blood pressure during routine surgery. Even if it has been administered on the basis of wrong indication (e.g. hypertensive phases as a result of insufficient anaesthesia), it rarely will cause blood pressure to fall to undesired low levels after anaesthesia has been normalized.
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Foetal heart rate and tocodynamic monitoring of the uterus was performed in five pregnant patients undergoing urgent or emergency surgery unrelated to their pregnancy. All received general anaesthesia with halothane or enflurane and nitrous oxide. ⋯ Since continuous intraoperative monitoring of foetal heart rate in pregnant patients is technically feasible during peripheral surgery and during many intra-abdominal procedures, attempts should be made to monitor foetal heart rate in all anaesthetized parturients to assure that the anaesthetic is not causing foetal insult. Postoperative monitoring of uterine tone is useful in the diagnosis and treatment of postoperative premature labor.