Articles: general-anesthesia.
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J. Oral Maxillofac. Surg. · Nov 1984
Case ReportsBenzocaine-induced methemoglobinemia during general anesthesia.
A case is reported in which a patient developed cyanosis under general anesthesia due to methemoglobinemia. The cause of the methemoglobinemia was benzocaine applied topically to the pharynx and trachea. ⋯ If possible, determination of arterial blood gases should be made to obtain the methemoglobin concentration. Finally, all medical and dental personnel using benzocaine should be aware of the recommended dose and the possible complications of overdosage.
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Sixty-seven patients undergoing general anaesthesia for exodontia as outpatients were studied in order to measure the levels of oxygen saturation. Both the anaesthesia and extractions were performed by fourth year dental undergraduates working under direct supervision. Falls in oxygen saturation in excess of 5% were found in three groups of patients receiving 20%, 25%, and 30% oxygen in the inspired mixture.
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Efficacy of neostigmine (0.04 mg/kg of body weight) and edrophonium (1 mg/kg), as antagonists for pancuronium neuromuscular blockade in halothane-anesthetized ponies, was evaluated. Neostigmine and edrophonium were satisfactory antagonists, with edrophonium having a significantly (P less than 0.01) more rapid onset of action than did neostigmine. Muscarinic activity of neostigmine and edrophonium was also evaluated. ⋯ Blood pressure increased within 1 to 2 minutes of antagonist administration. Heart rate decreased after edrophonium injection, but this occurred after blood pressure increase. Heart rate increased or did not change after neostigmine administration.
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Heat loss during anesthesia and operation and subsequent hypothermia will increase the postoperative oxygen demand and may endanger patients with restricted cardiopulmonary reserves. Forty patients scheduled for intra-abdominal aortic surgery and 40 patients scheduled for peripheral vascular surgery on the lower limbs were investigated using a warming blanket, humidified heated inspired anesthetic gases at 37-40 degrees C, or both these methods together. A fourth group of patients received no active warming. ⋯ The combination of humidified and heated inspired gases and a warming blanket gave significantly better heat preservation after 40 min (P less than 0.05). Patients undergoing peripheral vascular surgery had similar but smaller drops in temperature with the different types of warming procedures employed. The differences in temperature between the intra-abdominal and extra-abdominal operations were statistically significant after 3 h (P less than 0.05).