Articles: general-anesthesia.
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Inaccuracy of oesophageal pressure for pleural pressure estimation in supine anaesthetized subjects.
Oesophageal pressure was measured, using a balloon and catheter system, at three or four positions in the oesophagus of eight supine subjects anaesthetized with 1-1.5% halothane in 67% nitrous oxide. Airway pressure and the difference between airway and oesophageal pressures were recorded during occlusion of inspiration, occlusion of expiration and occlusion of expiration followed by inspiratory occlusion. ⋯ The change in oesophageal pressure was expressed as a fraction of the change in airway pressure: the maximum fraction was obtained in each patient, and the mean of these maximum values was 82%. This suggests that changes in the difference between airway and oesophageal pressures will overestimate the change in transpulmonary pressure during artificial ventilation in supine subjects, and that lung compliance would be underestimated.
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Total intravenous anaesthesia is a feasible alternative to the use of inhalational agents and the rationale behind such a technique is presented. The various intravenous agents are discussed, particularly with regard to their suitability for this form of anaesthesia, and their physiological effects compared with those of the inhalational anaesthetics. Some of the problems associated with the use of total intravenous anaesthesia are mentioned.
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Etomidate has been studied in two groups of patients. In Group 1, 50 patients received etomidate 100 micrograms/kg/minute with fentanyl and a muscle relaxant, ventilation being with air and oxygen (50%). The technique gave a smooth, pleasant induction with all patients asleep within 2 minutes. ⋯ The cardiovascular system remained stable in all patients. Mean recovery time was 16.1 minutes (range 3-38 minutes). Twitching and restlessness were the main complications during recovery.
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Z Geburtshilfe Perinatol · Jul 1983
Comparative Study[General anesthesia or peridural anesthesia in primary cesarean section; a comparative study].
In a prospective cooperative study of gynecologists, anaesthesiologists and pediatricians we compared the effect of continuous epidural anaesthesia (23 cases) and of general anaesthesia (24 cases) on mother and newborn. All patients were delivered in the 39. to 41. week of an uncomplicated pregnancy by primary caesarean section for breech presentation or disproportion. Nearly one third of the patients with epidural anaesthesia showed an initial transitory decrease in blood pressure- up to 25%. ⋯ The neurologic examination 15 min after delivery revealed a pathologic muscle tone in three cases after general anaesthesia and in one case after epidural anaesthesia. After 7 days all children showed a normal neurobehavior. As no severe differences between the two types of anaesthesia in the effect on mother or newborn could be seen, in uncomplicated pregnancies the choice should be left to the mother.