Articles: general-anesthesia.
-
Arch Ophthalmol Chic · Mar 1985
Intraoperative adjustment of eye muscle surgery. Correction based on eye position during general anesthesia.
During general anesthesia, the eye position of patients with strabismus, measured by Krimsky's test at 1 m, 30 minutes after induction, has a linear correlation with the eye position measured clinically preoperatively. A similar study was performed on 77 patients; however, Hirschberg's test was used for simplicity and was performed as soon as the patient was in a surgical plane of anesthesia. We confirmed that there was a linear correlation. ⋯ We did approximately 1 mm more or less surgery than we had planned on each eye muscle. This significantly improved the final results in anomalous cases. Patients with anomalous tests who did not have such adjustments had significantly poorer results.
-
Radionuclide cardiography with 99mTc-labeled erythrocytes was carried out in three different studies comprising 20 female patients without heart or lung diseases. Left ventricular ejection fraction (LVEF) and other hemodynamic variables were measured immediately before and during induction of anesthesia (thiopental, N2O/O2, succinylcholine, laryngoscopy + oral intubation, halothane). In study 1, serial measurements of LVEF, left ventricular volume, and derived variables were obtained by gamma camera in seven patients using 3-min sampling periods. ⋯ This decrease was accompanied by an increase in end-systolic volume and a decrease in the ratio: systolic cuff pressure/end systolic volume, whereas end-diastolic volume and cardiac index remained unchanged. In the nuclear stethoscope studies, LVEF decreased both after thiopental and after intubation, in study 2 from 0.68 to 0.38 and from 0.53 to 0.41, respectively; in study 3 from 0.69 to 0.53 and from 0.57 to 0.44, respectively. Our observation, in healthy, female individuals, provide an impetus for further noninvasive radionuclide studies during anesthesia in patients with cardiovascular disease.
-
A 40 year old man, who was suspected on clinical evidence (fever, severe muscle pains, dark urine following general anesthesia 8 years ago) of being susceptible to malignant hyperthermia, was scheduled for traumatologic surgery. Dantrolene-Sodium 4 mg/kg orally was given prophylactically the day before surgery; as a premedication the patient received morphine and triflupromazine intramuscularly. ⋯ The remainder of the postoperative course was uneventful. The patient was discharged 9 days later.
-
We report about hypertensive crises, cardial arrhythmia and respiratory complications in 47 patients undergoing thermocoagulation of the gasserian ganglion. Therapeutic proposals are discussed.
-
The correlation between end-tidal partial pressure of CO2 (PETCO2) and arterial (PaCO2) was determined for spontaneously breathing ponies under halothane or isoflurane anesthesia. The PETCO2 was useful as a trend indicator of PaCO2 during the first 60 minutes of halothane or isoflurane anesthesia when PaCO2 values were less than 60 to 70 mm of Hg. Halothane anesthesia lasting greater than 90 minutes was associated with PaCO2 values in excess of 60 to 70 mm of Hg, a large arterial- to end-tidal PCO2 difference (PaCO2-PETCO2) and a significant increase in alveolar dead space. ⋯ Arterial blood gas analysis is therefore recommended during halothane anesthesia when the PETCO2 is greater than 60 to 70 mm of Hg. A decrease in alveolar capillary perfusion relative to alveolar ventilation is the most likely cause for the increase in alveolar dead space during halothane anesthesia. Based on these findings, isoflurane may be superior to halothane for prolonged anesthesia of spontaneously breathing horses.