Anesthetic measures in management of pain associated with malignancy.
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Analgesia↗
Biomedical subjects
T Ferrer-Brechner
Publications and source records attributed to T Ferrer-Brechner.
Limbic neuronal firing rates in man during administration of nitrous oxide--oxygen or sodium thiopental.
Electroencephalographic activity and extracellular discharges from neurons in deep temporal lobe structures were recorded from fine wire microelectrodes chronically implanted in seven psychomotor epileptic patients for diagnostic localization of seizure foci. In four patients, inhalation of 80 per cent nitrous oxide resulted in loss of consciousness without change in firing rates of temporal lobe neurons (n = 22). In all seven patients, thiopental (400 or 200 mg, iv) decreased limbic neuronal firing rates (n = 38) until the return of wakefulness. In only three of these patients, however, did the firing rates of the neurons (n = 19) decrease significantly (P less than .05). Thiopental suppression of unit activity was not related to systemic hypoxia. This study demonstrates that anesthetic induction with nitrous oxide-oxygen does not significantly affect the firing of neurons in various regions of the human limbic system, which may explain the incidence of patient awareness reported when nitrous oxide-oxygen is administered alone. Thiopental depresses the firing of limbic neurons, and this may account in part for the temporary confusion and amnesia often manifested by patients recovering from the effects of thiopental.
Adolescent↗
Anesthetic considerations for cerebral computer tomography.
Cerebral computer tomography is a recently introduced neuroradiologic procedure involving tomographic x-rays of horizontal brain sections. Although most adults undergo the procedure without anesthesia, children and uncooperative adults must be given general anesthesia for absolute immobility. Of 84 procedures under general anesthesia, 10 employed ketamine, 6 used oral chloral hydrate; 60, endotracheal anesthesia enflurane or halothane; 7 used combinations of various sedatives. One was performed with local anesthesia standby. Ketamine and heavy sedation were found to be totally unsatisfactory because of airway problems and unpredicatability of motion, which produced image artifacts. General endotracheal anesthesia with either halothane or enflurane in N2O-O2 was found most satisfactory because of better control of airway and prevention of motion.
Adult↗