Articles: general-anesthesia.
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Arterial Po2 and Pco2 were measured at half-hourly intervals in eleven patients anaesthetized for lower limb vascular surgery with a combination of nitrous oxide 67% and halothane 0.3-0.5% in oxygen, and an extradural injection of bupivacaine. Values for the alveolar-arterial oxygen tension difference, physiological deadspace and deadspace-tidal volume ratio were calculated. Although both the alveolar-arterial oxygen tension difference and physiological deadspace were large, spontaneous ventilation was adequate to maintain both Po2 and Pco2 of arterial blood at acceptable values. Over the course of 2 hr following the extradural injection there were no significant changes in any measured value.
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Comparative Study
[Effect of ethrane on the circulatory parameters of geriatric patients (author's transl)].
The cardiovascular effects of enflurane in geriatric patients have been compared with the effects of this anaesthetic agent in a group of young patients. The degree of cardiovascular depression in geriatric patients was much greater than in the young patients despite the smaller inspired concentration of enflurane necessary to produce a similar depth of anaesthesia. In comparison with halothane and neuroleptanaesthesia, enflurane produced the greatest decrease in cardiac output. The mean arterial pressure, however, was quite well maintained due to a simultaneous increase in total peripheral resistance.
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Ten intact anaesthetized dogs breathing room air spontaneously (Group A) were compared with ten artificially ventilated dogs (Group B). All were given a bolus of ketamine 2 mg/kg followed by a 20-min infusion of ketamine 0.1 mg/kg/min. In Group A, coronary sinus blood flow, measured with a thermodilution flowmeter, increased by 90% while coronary vascular resistance decreased by 28% and coronary sinus oxygen content decreased by 27%. ⋯ A dose of 8 mg/kg produced increases in cardiac output, heart rate and arterial pressure of 21%, 44% and 24%, respectively, while coronary blood flow increased 47%. We conclude that, in healthy dogs, ketamine produces an increase in heart rate and cardiac work. A significant increase in coronary blood flow appears to be insufficient to meet the metabolic demands of the myocardium, as the coronary sinus oxygen content decreased.
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Enflurane was administered to 100 unselected patients undergoing various oral surgical procedures. The anesthetic provided smooth induction, maintenance, and rapid recovery. ⋯ Postanesthesia incidences of nausea, vomiting, and excitement were minimal. Our experience suggests that enflurane may be the preferred anesthetic agent both for minor dental procedures in outpatients as well as for major oral surgical procedures in hospitalized patients.