Articles: general-anesthesia.
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Historical Article
'The smart of the knife'--early anaesthesia in the services.
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Anasth Intensivther Notfallmed · Jun 1985
[Suppression of the adrenal cortex by infusion of etomidate in general anesthesia].
The effects of anaesthesia with fentanyl and prolonged etomidate infusion (0.8 mg/kg/h) on the peroperative and postoperative change in blood concentrations of aldosterone, cortisol, dehydroepiandrosterone, ACTH, epinephrine, norepinephrine, dopamine, glucose, lactate and free fatty acids (FFA) were investigated in connection with major abdominal surgery. During surgery and anaesthesia with prolonged etomidate infusion no significant alterations in plasma catecholamine concentrations were observed. ⋯ Despite this endogenous ACTH stimulus, aldosterone (121.8 +/- 19.4 pg/ml----58.4 +/- 10.4 pg/ml) and cortisol (12.3 +/- 2.84 micrograms/dl----5.79 +/- 1.2 micrograms/dl) and dehydroepiandrosterone (2.28 +/- 1.09 ng/ml----1.27 +/- 0.25 ng/ml) levels were markedly depressed in every patient during the perioperative period. Twenty-four hours after surgery the basal steroid values were within or above normal limits.
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Acta Anaesthesiol Belg · Jun 1985
Randomized Controlled Trial Comparative Study Clinical TrialHormonal response in thoracic surgery. Effects of high-dose fentanyl anesthesia, compared to halothane anesthesia.
Thirty two patients undergoing cardiac thoracic surgery were randomly assigned into two groups: Patients of the first group received high dose fentanyl (50 micrograms/kg) at the induction and patients of the second group received halothane for the maintenance of anesthesia. All patients received N2O:O2 and pancuronium for muscle relaxation. Surgical stress, as evaluated by changes in blood pressure, heart rate, plasma cortisol and glucose levels, appeared in the halothane group but not in the fentanyl group. ⋯ Nevertheless two of these patients presented hypoventilation requiring intubation and naloxone administration. High dose fentanyl anesthesia may prove to be very useful in non cardiac thoracic surgery as it protects the patient from the stress of the operation and assures prolonged postoperative analgesia. When this technique is used one must always anticipate postoperative mechanical ventilation.
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Anesthesia and analgesia · May 1985
Clinical Trial Controlled Clinical TrialAtracurium infusion requirements in children during halothane, isoflurane, and narcotic anesthesia.
We were interested in determining the dose-response relationship of atracurium in children (2-10 yr) during nitrous oxide-isoflurane anesthesia (1%) and the atracurium infusion rate required to maintain about 95% neuromuscular blockade during nitrous oxide-halothane (0.8%), nitrous oxide-isoflurane (1%), or nitrous oxide-narcotic anesthesia. Neuromuscular blockade was monitored by recording the electromyographic activity of the adductor pollicis muscle resulting from supramaximal stimulation at the ulnar nerve at 2 Hz for 2 sec at 10-sec intervals. To estimate dose-response relationships, three groups of five children received 80, 100, 150 micrograms/kg atracurium, respectively. ⋯ At equipotent concentrations, halothane and isoflurane augment atracurium neuromuscular block to the same extent, compared to narcotic anesthesia. Atracurium steady-state infusion requirements averaged 6.3 +/- 0.6 micrograms . kg-1 . min-1 during halothane or isoflurane anesthesia; the requirements during balanced anesthesia were 9.3 +/- 0.8 micrograms . kg-1 . min-1 (P less than 0.05). There was no evidence of cumulation during prolonged atracurium infusion.