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 379 records · Page 21Linked to original sources
PubMed1993

A comparison of injectable local anesthesia and electronic dental anesthesia in restorative dentistry.

This study compares patient satisfaction and subjective pain levels with either electronic dental anesthesia (EDA) or injectable local anesthesia (LA) during the placement of direct restorations. Twenty-five patients (mean age 41 years), who each required two similar restorations in vital teeth, were selected. One restoration was placed using EDA and the other using LA. Preoperatively, all participants completed the Corah Dental Anxiety Scale, and postoperatively they completed a satisfaction questionnaire. Fifteen (60%) patients preferred EDA to LA, and 7 (28%) had no preference. Asked to rate their feelings on the prospect of having a filling placed with either EDA or LA (scale 1 to 5, very anxious to very relaxed), the patients rated LA as 3.0 and EDA as 3.6 (mean scores). Some pain or discomfort was felt by 12 patients with EDA and 14 patients with LA. On a scale of discomfort (1 to 5, very slight to very severe), the mean score was 1.0 for EDA and 1.2 for LA.

Adult↗
PubMed1993

[Relation between fingertip temperature pattern and epidural puncture site during epidural anesthesia combined with general anesthesia].

We are employing fingertip temperature monitoring to estimate the spread of epidural anesthesia in patients who received combined epidural and general anesthesia. In this study we examined the relation between fingertip temperature pattern and epidural puncture site. One hundred patients scheduled for elective digestive tract surgery were studied. They were divided into three groups according to the epidural puncture sites as follow; Group 1, T7-9 (n = 26); group 2, T9-12 (n = 48); and group 3, T12-L5 (n = 26). Fingertip temperature was determined by Anritsu thermocouples. These probes were attached to the thumb and the big toe (hand and foot fingertip). The changes of these temperatures were classified to four types. In type 1, the hand fingertip temperatures were elevated after administration of the local anesthetics. In type 2, both hand and foot fingertip temperatures were elevated. In type 3, the foot fingertip temperature was elevated. In type 4, the hand and foot fingertip temperatures were unchanged. In group 1, we found 10 cases of type 1, 13 cases of type 2 and 3 cases of type 3. In group 2; 15, 22, 11 cases respectively. In group 3; 1, 16 cases respectively and 1 case in type 4. In group 1 and 2, the type 1 temperature pattern was observed more than in group 3 (P < 0.01). And in group 3, the type 3 temperature pattern was observed more than in group 1 and 2 (P < 0.01). We found no intergroup difference in type 2 pattern. But there were some exceptions.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1996

[Intraoperative acute myocardial infarction during total gastrectomy under general anesthesia combined with thoracic epidural anesthesia].

A 61-year-old, 54-kg man with gastric cancer was scheduled for total gastrectomy under general anesthesia combined with thoracic epidural anesthesia. Approximately 20 minutes after the start of the operation, the patient developed sudden hypotension and ventricular fibrillation. The cardiac rhythm returned to normal after 38 minutes of cardiopulmonary resuscitation. The operation was discontinued and the patient was transferred to an intensive care unit. A 12-lead electrocardiogram (ECG) revealed complete right bundle branch block and elevation of the ST-segment from leads II, III, aVF, V1, and V2 which indicated an inferior myocardial infarction. Laboratory data showed elevated levels of enzymes such as glutamic oxaloacetic transaminase (495 IU.l-1), lactic dehydrogenase (1781 IU.l-1), and creatine kinase-MB (112 IU.l-1). The mildly elevated levels of the enzymes decreased around 10 hours after the termination of the operation, but they increased markedly again without any change in ECG on the second postoperative day. Elevation in serum myoglobin and glutamic pyruvic transaminase and decline in arterial ketone body ratio were also detected. Furthermore, renal failure developed with increase in blood urea nitrogen and creatinine. Because of hepatic failure and renal failure which might have been caused by rhabdomyolysis, the patient needed inotropic support with dopamine, dobutamine, and epinephrine to maintain the circulation. The patient died of reinfarction of the 20th postoperative day despite intensive care such as intraaortic balloon pumping, hemodiafiltration, and continuous intravenous infusion of prostaglandin E1.

Acute Kidney Injury↗
PubMed1998

[A comparison of the incidence of postoperative nausea and vomiting after propofol-fentanyl anesthesia and that after nitrous oxide-isoflurane anesthesia].

We compared the incidence of postoperative nausea and vomiting after total intravenous propofol-fentanyl anesthesia (TIVA group) and that after thiamylal-nitrous oxide-isoflurane anesthesia (GOI group) in 60 ASA physical I and II patients for elective abdominal simple total hysterectomy. When the patients returned to the ward, the incidence of nausea was lower in TIVA group than in GOI group (P < 0.05), but no difference was found in the incidence of vomiting between the two groups. There were no differences in the incidence of nausea and vomiting 6 hours after the operation and on the next morning between the two groups. Postoperative pain scores were similar between the two groups, while total postoperative evaluation scores (nausea, vomiting, pain, fever, and sleep disturbance) were lower in TIVA group (P < 0.05). We conclude that TIVA with propofol-fentanyl reduced the incidence of nausea and improved total evaluation scores in the immediate postoperative period.

Adult↗
PubMed1975

Anesthesia and the golgi apparatus: enzyme activity changes in a golgi-rich fraction of rat liver after a short ether anesthesia.

Activity changes of enzymes in isolated rat liver Golgi preparations at different times (1-48 h) after a short ether anesthesia are reported. Activity of galactosyl-transferase showed a slight gradual increase but thiamine pyrophosphatase decreased sharply, and after 24 h increased to above control level. Arylsulphatase-A remained largely unchanged, and B was significantly decreased. Acid phosphatase activity did remain at the control level, but alkali phosphatase showed a gradual and highly significant increase. Five other enzymes representing probable contaminations from other subcellular organelles, have also been assayed. Correlation is sought between the enzyme activity changes and some other metabolic effects of anesthesia.

Acid Phosphatase↗
PubMed2006

Combined "periprostatic and periapical" local anesthesia is not superior to "periprostatic" anesthesia alone in reducing pain during Tru-Cut prostate biopsy.

OBJECTIVES: To evaluate, in a prospective study, the benefit of adding local periapical prostatic anesthesia to routine periprostatic infiltration to the prostate-seminal vesicle junction in a randomized fashion. Transrectal ultrasound-guided biopsy is the reference standard in the diagnosis of prostate cancer. Although well tolerated by most patients, it can be associated with discomfort. METHODS: A total of 120 consecutive evaluable patients with an elevated total prostate-specific antigen (tPSA) level, increased tPSA velocity, and/or abnormal digital rectal examination findings were enrolled. The patients were randomized into two groups. Group 1 received periprostatic infiltration of 6 mL 1% lidocaine. Group 2 received periprostatic and apical infiltration: 4 mL 1% lidocaine at the prostate-seminal vesicle junction and 2-mL infiltration at the prostatic apex 15 minutes before transrectal ultrasound-guided biopsy. Pain was assessed using a 10-point modified visual analog scale. RESULTS: The mean patient age was 63.7 +/- 1.2 years and 64.2 +/- 1.1 years, the mean tPSA level was 12.1 +/- 1.5 ng/mL and 13.6 +/- 2.7 ng/mL, the mean biopsy duration was 6.2 +/- 2.5 minutes and 6.1 +/- 2.2 minutes, and the mean visual analog scale pain score was 1.26 +/- 0.1 and 1.23 +/- 0.1 for groups 1 and 2, respectively. No statistically significant difference was observed with respect to age, tPSA level, mean biopsy duration, or pain score between the two groups. CONCLUSIONS: Periprostatic lidocaine infiltration provides local anesthesia that results in improved visual analog scale pain scores. Additional apical infiltration did not improve patient discomfort further. However, comparative evidence has indicated that increasing the time elapsed between the anesthetic infiltration and the biopsy procedure may further improve pain control.

Aged↗
PubMed1994

Alkalinization of local anesthesia with sodium bicarbonate--preferred method of local anesthesia.

Effective anesthetic techniques include local anesthetic infiltration with or without sedation and general anesthesia. Local anesthesia is a safe and effective anesthetic technique, that when performed properly is applicable to many outpatient urologic procedures. We have found that the pain usually associated with intradermal injection of lidocaine is attenuated by the addition of sodium bicarbonate.

Anesthesia, Local↗
PubMed1997

Compliance with gloving in anesthesia: an observational study of gloving practice at induction of general anesthesia.

STUDY OBJECTIVE: To gather direct observational data on anesthesiologists' compliance with universal precautions' gloving standards during induction of general anesthesia. DESIGN: Prospective, observational study. SETTING: Operating theaters of an Israeli government teaching hospital. SUBJECTS: Over a four-month period, all "first case of the day" general anesthetics were observed to determine if the anesthesiologist directly administering patient care wore gloves during the period of anesthetic induction. All anesthesia department members were observed and none was aware of the ongoing study. MEASUREMENTS AND MAIN RESULTS: Resident anesthesiologists were found to be more compliant with gloving policy than their attendings (61.8% vs. 33.7%, p < 0.0001). However, the lower compliance among the attendings was entirely attributable to the most senior staff members (over age 55 years) whose compliance rate was 11.5% versus 55.6% for attending staff below age 55 years (p < 0.0001). Departmental compliance as a whole was 49.6%. Compliance in pediatric cases averaged 10% and was equally poor among all department staff. CONCLUSIONS: Although glove use remains inconsistent, in less than one and one half years since institution of a departmental gloving policy, a substantial degree of compliance was achieved. Nevertheless, further efforts are still needed to improve compliance with universal precautions. In this study, glove use was particularly deficient in pediatric cases and among senior staff aged 55 years and older. Pinpointing specific areas of greatest deficiency may prove useful in guiding additional efforts to improve compliance with universal precautions.

Age Factors↗
PubMed2002

[Risk predictors, scoring systems and prognostic models in anesthesia and intensive care. Part I: anesthesia].

Risk predictors and scoring systems are commonly used in medicine to provide a reliable and objective estimation of disease prognoses, probability of adverse events and outcome. Furthermore, they were designed to classify severity of illness or the course of diagnostic and therapeutic interventions and to perform a risk stratification for scientific studies in a standardized way. In quality management and cost control, scoring systems and predictors are used for risk adjustment and evaluation of care performance. The aim of this review article was to describe common risk indices and scoring systems in anesthesia (part I) and intensive care (part II), and to point out their possible benefits and limitations. Different scoring systems and classifications are available to stratify perioperative risk and adverse events in anesthesia. Especially in cardiac surgery, an increasing interest in risk-adjusted outcome studies led to the modeling and validation of different prognostic systems for postoperative morbidity, mortality and length of stay. Furthermore, there are scoring-systems for special events, such as difficult laryngoscopy or postoperative nausea and vomiting (PONV). Risk check lists and risk indices are superior to the ASA classification of physical status in providing more exact results and the possibility of statistic risk calculation. Nevertheless, they are not frequently used in clinical routine. Because of its simplicity and easy handling the ASA classification has worldwide popularity and recent studies demonstrated at least equal prognostic performance.

Anesthesia↗
PubMed2003

Relative value to surgical patients and anesthesia providers of selected anesthesia related outcomes.

BACKGROUND: Anesthesia side effects are almost inevitable in most situations. In order to optimize the anesthetic experience from the patient's viewpoint, it makes intuitive sense to attempt to avoid the side effects that the patient fears the most. METHODS: We obtained rankings and quantitative estimates of the relative importance of nine experiences that commonly occur after anesthesia and surgery from 109 patients prior to their surgery and from 30 anesthesiologists. RESULTS: Pain was the most important thing to avoid, and subjects allocated a median of 25 dollars of an imaginary 100 dollars to avoiding it. Next came vomiting (20 dollars), nausea (10 dollars), urinary retention (5 dollars) , myalgia (2 dollars) and pruritus (2 dollars) . Avoiding blood transfusion, an awake anesthetic technique or postoperative somnolence was not given value by the group as a whole. Anesthesiologists valued perioperative experiences in the same way as patients. CONCLUSIONS: Our results are comparable with those of previous studies in the area, and suggest that patients can prioritize the perioperative experiences they wish to avoid during their perioperative care. Such data, if obtained in the appropriate fashion, would enable anesthetic techniques to be compared using decision analysis.

Adolescent↗
PubMed2005

Airway reflexes return more rapidly after desflurane anesthesia than after sevoflurane anesthesia.

Patients given a more soluble inhaled anesthetic usually take longer to awaken from anesthesia than do patients given a less soluble anesthetic. In the present study, we tested whether such a delay in awakening was also associated with a delay in restoration of protective airway reflexes. Patients were randomly assigned to receive desflurane (n = 31) or sevoflurane (n = 33) via a laryngeal mask airway. Demographics did not differ between groups. The average minimum alveolar anesthetic concentration fraction for both groups was 0.62, and the mean (+/-sd) minimum alveolar anesthetic concentration hours was 1.00 +/- 0.68 for desflurane versus 0.95 +/- 0.57 for sevoflurane, although more patients given sevoflurane also received regional anesthesia (17 for sevoflurane and 8 for desflurane). The time from stopping anesthetic administration to appropriate response to command was longer after sevoflurane (5.5 +/- 3.1 versus 3.4 +/- 1.9 min; P < 0.01). In addition, the time from first response to command to ability to swallow 20 mL of water without coughing or drooling was longer after sevoflurane. At 2 min after responding to command, all patients given desflurane were able to swallow without coughing or drooling, whereas 55% of patients given sevoflurane coughed and/or drooled (P < 0.001). At 6 min after responding to command, 18% of patients given sevoflurane still could not swallow without coughing or drooling (P < 0.05). We conclude that desflurane allows an earlier return of protective airway reflexes.

Adult↗
PubMed2004

Intramuscular anesthesia of bonito and Pacific mackerel with ketamine and medetomidine and reversal of anesthesia with atipamezole.

OBJECTIVE: To determine anesthetic effects of ketamine and medetomidine in bonitos and mackerels and whether anesthesia could be reversed with atipamezole. DESIGN: Clinical trial. ANIMALS: 43 bonitos (Sarda chiliensis) and 47 Pacific mackerels (Scomber japonica). PROCEDURE: 28 bonitos were given doses of ketamine ranging from 1 to 8 mg/kg (0.5 to 3.6 mg/lb), i.m., and doses of medetomidine ranging from 0.2 to 1.6 mg/kg (0.1 to 0.7 mg/lb), i.m. (ratio of ketamine to medetomidine, 2.5:1 to 20:1). Doses of atipamezole equal to 1 or 5 times the dose of medetomidine were used. The remaining 15 bonitos were used to determine the anesthetic effects of ketamine at a dose of 4 mg/kg (1.8 mg/lb) and medetomidine at a dose of 0.4 mg/kg (0.2 mg/lb). The mackerels were given ketamine at doses ranging from 11 to 533 mg/kg (5 to 242 mg/lb) and medetomidine at doses ranging from 0.3 to 9.1 mg/kg (0.1 to 4.1 mg/lb; ratio of ketamine to medetomidine, 3:1 to 800:1). Doses of atipamezole equal to 5 times the dose of medetomidine were used. RESULTS: I.m. administration of ketamine at a dose of 4 mg/kg and medetomidine at a dose of 0.4 mg/kg in bonitos and ketamine at a dose of 53 to 228 mg/kg (24 to 104 mg/lb) and medetomidine at a dose of 0.6 to 4.2 mg/kg (0.3 to 1.9 mg/lb) in mackerels was safe and effective. For both species, administration of atipamezole at a dose 5 times the dose of medetomidine reversed the anesthetic effects. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a combination of ketamine and medetomidine can safely be used for anesthesia of bonitos and mackerels and that anesthetic effects can be reversed with atipamezole.

Adrenergic alpha-Agonists↗
PubMed1976

[Combined anesthesia with propionylpromazine (Combelen) and methadone (Polamivet). A sure simple method of anesthesia in gastrointestinal surgery in dogs].

In more than 400 cases of gastrointestinal surgery on mongrel dogs, a combination anesthesia of a neuroplegic agent--propionyl promazine (Combelen) and methadone (Polamivet), an analgesic--was administered without additional intubation or ventilation. This type of anesthesia is simple to apply and practically without risk; the conditions for the operation are therefore excellent. No monitoring personnel is required, no intra- or post-operative incidents have occurred. Thus this method may be recommended as safe and simple for experimental abdominal surgery in dogs.

Anesthesia, Intravenous↗
PubMedDate not supplied

[Prevention of hemodynamic disorders during anesthesia in middle-aged and elderly patients with essential hypertension. Components of anesthesia. II].

Hemodynamic parameters were evaluated during various stages of anesthesia in two groups of patients aged 60-85 years with mild essential hypertension. In group 1, routine preoperative treatment with hypotensive drugs was carried out and in group 2 differentiated preoperative treatment with calcium antagonists was carried out with consideration for a hemodynamic type. Group I patients were operated on under traditional neuroleptic analgesia (NLA), group 2 under NLA with 40% lower drug doses than in group 1 and with addition of calcium antagonists. To patients with hypo- and eukinetic hemodynamics, nifedipine was injected (bolus injection) in a dose of 14.2 micrograms/kg before induction and then was infused in a dose of 6.0-14.2 micrograms/kg/min. Patients with hyperkinetic hemodynamics were injected verapamil in a dose of 70-140 micrograms/kg (bolus injection) and then the same dose every hour of the operation. Differentiated use of calcium antagonists during anesthesia helped transform the hyper- and hypokinetic types of hemodynamics into a more rational eukinetic type, which was associated with a decrease of MVO2. Calcium antagonists, exerting analgesic, automatic stabilizing, and antihypoxic effects, prevented the hyperdynamic reactions complicating NLA in 30% cases and precluded complications of concomitant ischemic diseases, which were observed in 40% of group 1 patients.

Adjuvants, Anesthesia↗
PubMed2003

[Remifentanil and eye surgery. A randomized, clinical comparison of propofol/remifentanil anesthesia and propofol/fentanyl/alfentanil anesthesia].

INTRODUCTION: The aim of this study was to investigate how many patients, after anesthesia with either propofol/remifentanil or propofol/fentanyl/alfentanil, within 20 minutes from the end of surgery could be transferred directly to the general ward. The number of undesired preoperative incidents, the anesthetists', the surgeons', and the patients' evaluations of the anesthesia were registered. An evaluation of the economic consequences of the two methods was also intended. MATERIAL AND METHODS: The study was clinically controlled, randomised, and partly blinded. A total of 80 patients undergoing eye surgery were recruited. The patients were scored 10, 15, and 20 minutes after the end of surgery according to a modified Aldrete score. With sufficient awakening score, the patients were transferred to the general ward. RESULTS: Thirty-six patients in each group underwent the examination. In the propofol/remifentanil-group 31 (86%) could be transferred to the general ward compared to 15 (42%) in the proponol/fentanyl/alfentanil-group. In the propofol/remifentanil-group there were less reactions to the start of surgery, more episodes with preoperative hypotension and postoperative shivering. Otherwise there were no differences between the groups. It was estimated that the additional expenses for medcine were by far outweighed by the lower costs postoperatively. DISCUSSION: With a propofol/remifentanil-anesthesia, the patients had a predictably short awakening time, so they could be transferred directly to the general ward. This may, especially in ambulatory surgery, mean cost savings and perhaps higher patient satisfaction.

Adolescent↗
PubMed2006

Unplanned intubation during anesthesia: review of 31 cases from the Thai Anesthesia Incidents Study (THAI study).

OBJECTIVES: To examine the causes, outcomes, and contributing factors associated with patients requiring unplanned emergency intubation for adverse respiratory events. METERIAL AND METHOD: Appropriate unplanned intubation incidents were extracted from the Thai Anesthesia Incidents Study (THAI Study) database conducted between February 1, 2003, and January 31, 2004, and analyzed using descriptive statistics. RESULTS: Thirty-one incidents of unplanned intubation were recorded, 21 of which were due to respiratory problems particularly after bronchoscopy with and without surgery of the upper airway. Six of the 21 cases (28.6%) were children under 10 years of age who suffered from papilloma of the larynx. Sixteen cases of the 31 cases (52%) of the unplanned intubations were due to inadequate ventilation; 13 cases (41%) due to laryngeal edema; 11 cases (36%) due to sedative agents. The other events were the result of unstable hemodynamics, severe metabolic acidosis, muscle relaxants, and intrapulmonary lesions. Eighteen cases of unplanned intubations (18/31) (58%) occurred in the Post-Anesthesia Care Unit, 5 cases (16%) in a ward, and 4 (13%) in the operating room. The reported contributing factors included inadequate experience, lack of supervision and the patient's condition. CONCLUSION: Major incidents of unplanned intubation occurred after bronchoscopy. Common contributing factors related to inadequate ventilation, airway obstruction, sedative agents and unstable hemodynamics. Quality assurance, additional training, and improved supervision tended to minimize the incidents.

Adolescent↗
PubMed1990

[Differentiation of brain stem anesthesia from high spinal anesthesia using auditory brain stem response].

A 67-year old woman having intractable chronic postherpetic neuralgia at the neck to forearm for two years was treated with subarachnoid block. Initially, bolus of 1% lidocaine 8 ml, with methylprednisolone acetate 20 mg was injected intrathecally at 6th cervical intervertebral space. The auditory brain stem response (ABR) during high spinal block with intact consciousness was not depressed in its wave height. ABR recorded showed prolongation of latency of 3 and 5 waves and prolongation of 1-3 phase to phase interval without prolongation of 3-5 phase to phase interval. Intrathecal nerve block was then performed with 1% lidocaine 15 ml and methylprednisolone acetate 20 mg, because she complained awareness and shocking sensation with controlled respiration during the first block. She assured that she felt nothing during the second block. The ABR recorded during the second block showed near complete suppression in its height of all waves and prolongation of all wave latencies. During recovery period, 1-3 and 3-5 phase to phase interval prolongation was recorded. One can differentiate brain stem anesthesia from other state that induces unconsciousness after block which is capable of inducing accidental brain stem anesthesia. These two blocks improved activity of daily living of the patient and severity of her pain decreased to 1/5 to 1/10.

Aged↗