Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Anesthesia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

[Anesthesia and lumbar epidural anesthesia in an infant with third-degree burns].

Epidural route is widely used in adults for injection of drugs, but it is not so often used in pediatric patients. We present the case of a 8 month old burned infant who received anesthesia and analgesia through a lumbar epidural catheter. The insertion of epidural catheter is described. Two surgical procedures were performed under epidural anesthesia with 0.5% bupivacaine an epinephrine 1:200.000 (2.5 mg/kg). 16 hours of postoperative analgesia was obtained with epidural morphine (0.05 mg/kg). No side effects were seen. We analyze the uses of epidural anesthesia in pediatric patients, the catheter care in the burned child, the hemodynamic changes observed during anesthesia and the results of peridural morphine.

Analgesia, Epidural↗
PubMed1988

[Reaction of the sympathetic nervous system, cardiovascular parameters and endocrine stress response in disobliterating interventions of the carotid arteries. A comparison of isoflurane anesthesia and modified neurolepto-anesthesia].

In order to investigate whether the increases in mean arterial pressure (MAP) and HR during carotid endarterectomy are due to a systemic, sympathicotonic stress response and to compare two anesthetic regimens for this operation, 20 patients were randomly allocated to the following groups: (1) modified neuroleptanesthesia with midazolam, fentanyl, and vecuronium: and (2) isoflurane anesthesia with vecuronium relaxation. Premedication (pethidine, promethazine) and induction of anesthesia were similar in both groups. The plasma levels of epinephrine and norepinephrine (by HPLC/ECD), ADH, ACTH, and cortisol (by RIA), glucose, lactate, and free glycerol were determined before and after induction of anesthesia, 7 times during the operation, and 30 min after extubation. MAP and HR were measured continuously. Statistical evaluation was undertaken by analysis of variance with repeated measures on 1 factor, considering P values of less than 0.05 as significant. The endocrine parameters failed to show any remarkable increase during the entire operation period. After the end of the operation all hormones rose significantly (P less than 0.001). No correlation was found between plasma catecholamines and increases in MAP and HR. Group levels of norepinephrine and ADH were higher in the isoflurane group (P less than 0.04). It is concluded that cardiovascular reactions during carotid endarterectomy are not caused by systemic stress. Neuroleptanesthesia leads to better stress protection in the postoperative period, while isoflurane anesthesia has some advantages for the intraoperative control of arterial pressure.

Adult↗
PubMed1987

[Inhalation anesthesia or "balanced anesthesia"? A comparative perioperative study in geriatric patients].

During a prospective randomized trial, 50 geriatric patients underwent surgery for a fractured femoral neck. The perioperative circulatory and respiratory effects of anesthesia with enflurane or balanced anesthesia with enflurane and fentanyl were compared. We were particularly looking for postoperative respiratory depression after a standard dose of fentanyl given during balanced anesthesia. Method. In 25 patients anesthesia was induced with 0.2 mg/kg etomidate and 1 mg/kg succinylcholine and maintained with 0.15 mg/kg alcuronium and enflurane. Twenty-five patients received a additional dose of 5 micrograms/kg fentanyl divided into 0.1 mg/kg 2 min before endotracheal intubation and the remainder 5 min before the start of surgery. Systolic and diastolic arterial pressures, heart rate, central venous pressure, hemoglobin, hematocrit, and electrolytes were measured and arterial blood gases were analyzed. Results. There was no important difference between the two methods: during careful use of both techniques circulation remained stable. No marked postoperative respiratory depression occurred even after 5 micrograms/kg fentanyl. Conclusions. Both anesthetic procedures are suitable for hip surgery in elderly patients. In the early postoperative period geriatric patients should be observed carefully in the recovery room for at least 2 h. In some patients--especially if fentanyl is used intraoperatively--this time must be prolonged.

Aged↗
PubMed1993

Peribulbar and retrobulbar anesthesia with prilocaine: a comparison of two methods of local ocular anesthesia.

Prilocaine (Citanest) has been shown to be a satisfactory alternative to lignocaine, with certain important advantages, including superior diffusion. The latter may be especially important in peribulbar anesthesia, where the level of diffusion is a critical factor in providing a timely, high-quality block. In a prospective randomized study, we compared the effectiveness of peribulbar vs retrobulbar administration of prilocaine. Eighty-seven patients undergoing elective intraocular surgery were randomized to receive either retrobulbar or peribulbar anesthesia with prilocaine 3% with felypressin and hyaluronidase. Pain of injection, akinesia, and anesthesia were evaluated at predetermined intervals after injection. Except for the fact that lid akinesia occurred earlier in the peribulbar group, there was no difference in the quality or rate of onset of overall akinesia in the two groups. Nor were there any differences in the pain associated with injection. Both groups had excellent operative anesthesia and akinesia.

Aged↗
PubMed1993

[Anesthesia with epidural spinal cord stimulation--I). Its application to general anesthesia].

Epidural spinal cord stimulation (SCS) has been used for the relief of pain. We tried to apply SCS for general anesthesia. The subjects were 76 patients, undergoing thoracotomy (3 cases), thoraco-laparotomy (4), laparotomy (57) and others (12). A monopolar electrode was introduced to the epidural space via a Touhy needle. The conditions of the electrical stimulation were 12.5-50 Hz, 1.0 ms and 2-8 V. The voltage was adjusted to give comfortable sensation to the patients. After the electrode had been introduced, induction of anesthesia and tracheal intubation were performed with thiopental, diazepam and pancuronium or vecuronium. Anesthesia was maintained with nitrous oxide (70%-50%) and SCS. Nine patients inhaled low concentrations of enflurane in addition to nitrous oxide, and 39 patients received injection of vasodilators because of hypertension. All the patients were not awake during operation, and recovered their consciousness soon after the end of operations. SCS was continued for 17 hrs after operation. During 24 hrs after operation, 16 patients required no analgesics, 32 patients once and others twice or more. We conclude that SCS added to general anesthesia is useful to control pain, not only intraoperatively, but also postoperatively.

Adult↗
PubMed1998

Current anesthesia manpower in Belgium in relation to anesthesia work locations.

Two inquiries were conducted in 1995 and 1996 involving all anesthesiology departments in Belgium. The response rate was 57%. One aim of these surveys was to estimate the anesthesia manpower and the number of anesthesia work locations in each hospital, by hospital size and by region. In the operating theater, between 0.77 and 2.24 physicians (full time equivalents) were available per operating room. When considering also anesthesia in remote locations outside the operating theater, and the availability of fully trained physicians and trainees (efficiency estimated as 75% of a fully trained specialist), the ratio decreases to between 0.48 and 1.25, the highest ratios being found in larger hospitals (> 650 beds). When physicians currently in anesthesiology training will have graduated the mean availability of anesthesiologists per anesthesia work station will be 0.87 in Belgium, vs 0.52 in 1996.

Anesthesia Department, Hospital↗
PubMed1989

Continuous infusion of alfentanil for maintenance of anesthesia: comparison with halothane anesthesia.

This study compares anesthetic maintenance, hemodynamic stability, and speed of recovery obtained with inhalational halothane versus intravenous alfentanil anesthesia administered continuously. In two groups of patients, anesthesia was induced with sodium thiopental, maintained with 70% nitrous oxide in 30% oxygen, and either halothane (n = 10) or a continuous infusion of alfentanil (n = 10). The administration of the allocated anesthetic was adjusted according to strict predefined criteria of inadequate anesthesia. After endotracheal intubation, hemodynamics (heart rate, systolic and diastolic pressure) changed less in the alfentanil group (P less than .01). Overall hemodynamic stability was the same in both groups. In neither group was there recall of intraoperative events. Recovery was assessed by the time from cessation of nitrous oxide administration to return of spontaneous ventilation, response to simple command, extubation, orientation, and discharge from the recovery area. The time taken to respond to simple command was significantly shorter in the alfentanil group (P less than .05), but other indices of recovery were similar.

Adult↗
PubMed2006

The effects of caudal local anesthesia blockade on the Bispectral Index during general anesthesia in children.

BACKGROUND: Peripheral deafferentation induced by epidural or spinal anesthesia reduces the degree of cortical arousal in adults. This study aimed at determining if caudal blockade decreases the level of arousal, as measured by Bispectral Index (BIS) in unstimulated children, and to determine if this effect differed between age groups. METHODS: Hospital ethics committee approval and parental consent was obtained. Children (age between 24 months and 5 years) and infants (between 6 and 24 months of age) were recruited if they were scheduled for below umbilical surgery that would usually require caudal local anesthesia blockade. Before the procedure, subjects within each age group were randomized to either caudal group (1 ml.kg(-1) 0.25% bupivacaine), or control group (no caudal). In all groups, anesthesia was induced with sevoflurane and maintained at a constant endtidal concentration of 1.5% sevoflurane without N(2)O. Five minutes after induction a baseline BIS was recorded (BIS(1)). In the caudal groups, a caudal block was then performed while in the control groups no block was performed. Fifteen minutes later, the BIS was again recorded (BIS(2)). The change in BIS over this time period was the primary outcome (BIS(Delta)). After measurement, subjects in the control groups received a caudal block before the start of surgery. RESULTS: Twenty-nine infants and 18 children completed the study protocol. In children, BIS(Delta) was significantly different between the caudal group and control (-5.7 vs -0.7, P = 0.04). In infants, no significant difference was detected in BIS(Delta) between caudal and control groups. CONCLUSIONS: Caudal blockade decreased the degree of arousal, as measured by BIS, in unstimulated children aged 2-5 years. No change in arousal was detected in infants.

Analysis of Variance↗
PubMed1999

[General anesthesia vs perimedullary anesthesia].

Perimedullary anesthetic techniques (epidural or spinal anesthesia), by themselves or combined with general anesthesia offer several advantages in the postoperative period when compared with general anesthesia alone. The incidence of postoperative respiratory and cardiovascular complications is decreased. The physiologic stress reaction, with its associated hypercoagulable state and immune depression, is attenuated. Finally, the resumption of gastrointestinal function is hastened. These benefits of central neural blockade are noted most clearly when the techniques are used for several days postoperatively, most often by catheter based epidural analgesia. The use of local anesthetic agents in the analgesic mixture would appear to be important. This is likely because these substances inhibit the sympathetic nervous system and spinal reflex axes. The role of this inhibition in the advantages of perimedullary techniques is probably important. It is important to note that inhibition of the sympathatetic nervous system can be associated with indesirable consequences in certain patients. These techniques must therefore be used cautiously, and patients who benefit from them must receive careful surveillance.

Anesthesia, Epidural↗
PubMed2002

[A case of AV block (Mobitz II type) during recovery from general anesthesia combined with epidural anesthesia].

A 59-year-old female underwent total hysterectomy for cancer of the corpus uteri. Epidural catheterization was performed at T 12/L 1 interspace. Anesthesia was induced with propofol (80 mg) and vecuronium (6 mg) and maintained with nitrous oxide (66%) and sevoflurane (0.8-1.5%) in oxygen. Six ml of 1.5% lidocaine containing 1: 200,000 epinephrine was injected intermittently through the epidural catheter for epidural anesthesia. Surgery was performed uneventfully. During her recovery from anesthesia, Mobitz II heart blocks and bradycardia were observed when the discharge in the oral cavity was aspirated. The AV blocks disappeared within 2 min, but similar arrhythmia was observed when the discharge in the oral cavity was aspirated again. Stimulation of the trachea by a suction drainage reversed the arrhythmia to the normal sinus rhythm. The trachea was extubated, and arrhyththmia was no longer observed in the operating room, but when the patient vomited, the next morning, bradycardia occurred and she lost consciousness. Two weeks later, there were no abnormal findings in echocardiography, Holter ECG, master-double ECG, and scintigraphy of the heart. It is likely that in this patient stimulation of the oral cavity by suction drainage and vomiting triggered vagovagal reflex, causing the AV block.

Anesthesia Recovery Period↗
PubMed2006

[A case of general anesthesia combined with epidural anesthesia in a pregnant woman undergoing laparoscopic cholecystectomy].

We report a case of general anesthesia for laparoscopic cholecystectomy at 12 weeks of gestation. A 20-year-old woman weighing 123 kg was admitted with epigastralgia. She was diagnosed as pregnancy of 6 weeks of gestation and acute cholecystitis. Percutaneous trans-gallbladder drainage was performed to delay operation until 12 weeks of gestation. Laparoscopic cholecystectomy was performed uneventfully under general anesthesia combined with epidural anesthesia. There were no clinical signs of fetal distress during the perioperative period.

Adult↗
PubMed1988

No decisive break-through yet for general anesthesia combined with locoregional anesthesia!

Although on theoretical grounds locoregional anesthesia, because of the claimed suppression of stress response and the ease with which prolonged analgesia can be achieved, seems preferable to general anesthesia, the shortcomings and drawbacks are such that its use is restricted to well chosen indications. The hope that combination anesthesia can overcome the limitations of both techniques remain to be proven whereas the problems that can arise during the combined technique could pose a major threat to the patient.

Anesthesia, Conduction↗
PubMed1994

Local anesthesia is superior to spinal anesthesia for anorectal surgical procedures.

In this prospective study we compared local with spinal anesthesia for anorectal surgical procedures with regard to pain control, recovery time before unassisted ambulation, incidence of postoperative complications, length of hospital stay, and cost effectiveness in 80 consecutive patients. Patients were allocated in two groups: group 1 (n = 52) received local anesthesia, and group 2 (n = 28) had spinal anesthesia. There were no intraoperative complications related to the anesthetic technique, and there was no difference between groups in the number of doses of narcotics required to control postoperative pain (1.2 +/- 1.5 vs 1.8 +/- 1.7 in group 1 and 2 respectively, P > 0.05). Recovery time before unassisted ambulation was significantly longer in group 2 (139 +/- 96 minutes in group 2 vs 82 +/- 62 minutes in group 1, P < 0.05). There were 21/52 complications in group 1 in contrast to 21/28 in group 2, (P < 0.05). There was no difference between groups in the postoperative incidence of nausea, vomiting, headache, weakness, and constipation; however, the incidence of postoperative urinary retention was significantly higher in group 2 (5/52 in group 1 vs 9/28 in group 2, P < 0.05). As a result of urinary retention, more patients in group 2 required overnight hospitalization (12/52 in group 1 vs 21/28 in group 2, P < 0.05). Patients in group 2 required 36 hospital days in contrast to 21 days for patients in group 1, P < 0.05. The difference in hospital days resulted in $18,000 greater cost for patients in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The clinical use of the Ohmeda Automated Anesthesia Record Keeper integrated in the Modulus II Anesthesia System. A preliminary report.

While performing his complex array of tasks, the anesthesiologist is also responsible for maintaining an anesthetic record. Up to now, this has been done by hand. The clinical use of automated anesthesia record keeping is presently evaluated. The anesthesia records generated by the Ohmeda Automated Anesthesia Record Keeper integrated in the Modulus II Anesthesia System is compared to hand written records. The differences between the two records of identical patients are quantified as erroneous or missing data. With the criteria adapted, we found significant and clinically relevant differences which stress the importance of automated record keeping.

Anesthesiology↗
PubMed2002

Thoracoscopic sympathectomy: endobronchial anesthesia vs endotracheal anesthesia with intrathoracic CO2 insufflation.

PURPOSE: To compare clinical advantages and hemodynamic and respiratory changes during one lung-collapsed ventilation (OLCV) using a double-lumen tube (DLT) or a single-lumen tube (SLT) with intrathoracic CO(2) insufflation, in patients undergoing thoracic sympathectomy (TS) under general anesthesia. METHODS: One hundred and twenty-five patients (94 men and 31 women) undergoing TS for the treatment of palmar hyperhidrosis (PH) were randomly allocated to two groups: group A (68 patients; age, 29 +/- 6 years) in whom DLT was used, and group B (57 patients; age, 32 +/- 3 years) in whom SLT with intrathoracic CO(2) insufflation at a rate of 0.5-1 l.min(-1) and sustained intrathoracic pressure at 6 mmHg insufflation were used. Anesthesia was maintained with 1 minimum alveolar concentration (MAC) isoflurane in 50% nitrous oxide in oxygen with incremental doses of sufentanil and atracurium when required. Arterial blood gases were measured in 10 patients in group B. Hemodynamic and respiratory parameters were obtained perioperatively. RESULTS: There were no significant differences in hemodynamic and respiratory parameters between the two groups during the study phases, except for the arterial oxygen saturation (SpO(2)). The times required for anesthesia and surgery were significantly shorter in the SLT group than in the DLT group. SpO(2) during OLCV was 95 +/- 1% with DLT and 98 +/- 1% with SLT, with a significant difference. Three patients had an SpO(2) of less than 90% in the recovery room, where the chest tube position was readjusted, with no further sequelae. CONCLUSION: General anesthesia with SLT and intrathoracic CO(2) insufflation provides optimal operating conditions, adequate oxygenation, and perfect hemodynamic stability during TS.

Clinical Trial↗
PubMed2006

Interscalene block anesthesia at an ambulatory surgery center performing predominantly regional anesthesia: a prospective study of one hundred thirty-three patients undergoing shoulder surgery.

Interscalene block (ISB) of the brachial plexus is frequently used for patients undergoing ambulatory shoulder surgery. We previously reported that the incidence of postoperative complaints (neurapraxia) after an ISB was low (3% at 2 weeks), but objective neurologic assessment was not included in the study. The present study combines subjective findings with both preoperative and postoperative objective sensory and motor assessments after an ISB. We prospectively evaluated 133 patients undergoing elective ambulatory shoulder surgery. ISB anesthesia was accomplished by use of 1.5% mepivacaine alone or in combination with bupivacaine (0.5%-0.75%) via a paresthesia technique and a 23-gauge needle. All of the blocks were performed by experienced anesthesiologists. The number of passes with the needle, site of paresthesia, ease of performing the block, and success of the ISB were recorded for each patient. Neurologic assessment was performed preoperatively and up to 2 weeks postoperatively by 1 of 4 health care professionals but not by the anesthesiologists who performed the ISB and included diminished sensation, localized nerve pain, Semmes-Weinstein monofilament pressure threshold sensibility, Weber static 2-point discrimination, and grip strength changes. Patients with postoperative changes were followed up until resolution of symptoms occurred. Successful surgical anesthesia was achieved in 98% of the patients. There was 1 major perioperative complication (0.7%), a seizure that occurred within 5 minutes of the ISB. Two (1.4%) complained of transient postoperative neurapraxias. Neither patient had any changes in objective sensory and motor measurements. Hence, there was no correlation between subjective complaints and objective findings in this study. This study demonstrates that, in the hands of anesthesiologists doing predominantly regional anesthesia, there is a 1.4% incidence of neurologic complications after an ISB. ISB is a safe and effective technique for patients undergoing ambulatory shoulder surgery when an anesthesiologist experienced with regional anesthesia is involved.

Adult↗
PubMed2002

Improved anesthesia support of the forward surgical team: a proposed combination of drawover anesthesia and the life support for trauma and transport.

The Ohmeda Portable Anesthesia Complete is the apparatus available for delivery of general anesthesia in the forward surgical teams in the U.S. Army. The Life Support for Trauma and Transport is being field tested for use as a single patient critical care transport bed. An effective circuit was created which linked the currently fielded draw-over anesthesia machine with the patient ventilator (Impact 754 Eagle) mounted in the Life Support for Trauma and Transport, with bench testing indicating that the anesthesia levels were accurate and that it was a useful system for field resuscitation and surgery. Others should be able to utilize this information for the benefit of their patients in field environments, especially forward surgical teams and others working in austere health care locations.

Anesthesiology↗
PubMedDate not supplied

The influence of selected antiarrhythmic drugs on the hemodynamic parameters in rabbits during anesthesia. Part II. Thiopental anesthesia.

The aim of the study was to investigate the combined influence of thiopental and antiarrhythmic drugs: procainamide, N-acetylprocainamide, verapamil or propranolol on hemodynamic parameters in rabbits: arterial blood pressure, heart rate, cardiac output, stroke volume, peripheral vascular resistance, renal and hepatic blood flows. Propranolol used during thiopental anesthesia deepened the decrease of hepatic and renal blood flow resulting from the action of the anesthetic drug. Verapamil in a dose that did not change hepatic blood flow caused significant decrease of that parameter during thiopental anesthesia. Other hemodynamic changes observed after administration of antiarrhythmic drugs during thiopental anesthesia are essentially similar to those resulting from the action of antiarrhythmic drugs alone. The administration of procainamide or N-acetylprocainamide during thiopental anaesthesia in rabbits had no significant influence on hemodynamic changes evoked by thiopental alone. Verapamil injected to rabbits together with thiopental caused a significant decrease of blood flow in the liver, which was not observed after thiopental alone or verapamil alone. Propranolol injection together with thiopental caused a decrease of blood pressure, heart rate, cardiac output but an increase of vascular peripheral resistance, which was similar to the action of propranolol alone. Propranolol administered during thiopental anesthesia caused a significant decrease of the renal and hepatic blood flow, more marked than after the injection of that beta-blocker alone.

Anesthetics, Intravenous↗