Articles: general-anesthesia.
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A 13 year old girl who had suffered from an abortive form of malignant hyperthermia during tonsillectomy eight years before was scheduled for orthopaedic surgery. Dantrolene sodium, 3 mg/kg orally, was given prophylactically the day before surgery; preanaesthetic medication consisted of Thalamonal, a fixed combination of droperidol and fentanyl; anaesthesia was induced with methohexitone and maintained as neurolept anaesthesia with fentanyl and droperidol; tubocurarine was administered for tracheal intubation and intraoperative neuromuscular blockade. Using this anaesthetic regimen no adverse reaction was triggered.
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A series of 100 patients undergoing caesarean section was studied using ketamine 1.2 mg/kg as induction agent. Fifteen minutes prior to induction, atropine 0.25-0.5 mg and diazepam 1 mg was given intravenously as premedication. Anaesthesia was maintained with N2O:O2, FIO2 0.4. ⋯ There were no hallucinations in the recovery area. The mental condition of the mothers after the operation was acceptable. It is suggested that ketamine can be used not only on special indications but also as a routine method for induction of anaesthesia for caesarean section.
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To determine the effects of tidal volume (VT) and positive end-expiratory pressure (PEEP) on pulmonary oxygen exchange during endobronchial (one-lung) anesthesia, the authors studied the effects of VT at 8 and 16 per cent total lung capacity (TLC), at zero end-expiratory pressure (ZEEP), and at 10 cmH2O PEEP in 16 patients in the lateral position. Anesthesia was maintained with halothane and oxygen. During two-lung ventilation (FIO2 0.99), mean PaO2 and physiologic shunt (Qs/Qt) were 421 +/- 12 mmHg and 0.22 +/- 0.02, respectively. ⋯ At both levels of VT, PEEP reduced mean Qt by approximatley 10 per cent (P less than 0.01) and increased compliance (P less than 0.01). However, PEEP did not significantly affect mean Qs/Qt or mean arterial or pulmonary arterial pressures at either level of VT. There was considerable variation in PaO2 and Qs/Qt among patients.