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 397 records · Page 22Linked to original sources
PubMed1989

AANA Journal course: new technologies in anesthesia: update for nurse anesthetists--monitoring depth of anesthesia using a reliable esophageal method. (continuing education credit)

Until recently, there had been no simple, accurate, and reliable technique for monitoring depth of anesthesia, but now a monitoring system that measures lower esophageal contractility (LEC) is available. The system consists of a monitor and a disposable esophageal stethoscope equipped with provoking and measuring balloons. Since the brain stem directly controls the motor function of the esophagus, LEC was postulated to reflect the anesthetic state of the patient. Multiple-center clinical studies have shown that LEC correlates significantly with administered levels of intravenous and inhalation anesthetic agents and patient responses to surgical stimulation. Monitoring LEC permits the clinician to administer the dose of drug needed without the complications associated with "too deep" or "too light" anesthesia.

Anesthesia, General↗
PubMed1985

Serum levels of cortisol in man during etomidate, fentanyl and air anesthesia, compared with neurolept anesthesia.

The effects of etomidate and fentanyl given as a mixture in continuous infusion and of a classical neuroleptanalgesia, with droperidol and fentanyl, on the serum cortisol levels were compared during and after anesthesia in sixteen patients who were to undergo major abdominal surgery. The results showed that the postoperative increase of serum cortisol levels which occurred in the neurolept group was absent in the group receiving etomidate and fentanyl infusion. During etomidate-fentanyl anesthesia there was a more significant decrease of serum cortisol and no rise in serum cortisol levels in response to synthetic ACTH injection. Etomidate and fentanyl, given as a continuous infusion during major abdominal surgery, block the adrenal mechanism to secrete endogenous cortisol in response to stress or after the administration of adreno-corticotrope hormone.

Adrenocorticotropic Hormone↗
PubMed1987

Appropriate selection of anesthesia personnel for office dental anesthesia.

The requirement for pain and anxiety control for dental patients has been estimated as high as 50 per cent of the population. Supporting this statement is the estimation that 35 million Americans avoid routine dental care until they are in severe pain. This amounts to 15 per cent of the American population and represents a significant public health problem. There is a long tradition of anesthesia provided in the dental office. This article will focus on the personnel who may provide services to dental patients requiring anesthesia.

Anesthesia, Dental↗
PubMed1986

[High-dose piritramide basal anesthesia in experimental anesthesia and surgery].

On the basis of investigations of three groups of dogs (7 in each) the effects of high dosage piritramide anesthesia were analyzed. Using a standardized technique no significant changes in hemodynamics and microcirculation were found during 4 h. So variations in the "steady-state" must be attributed to additional medication or therapeutic intervention. High dosage piritramide anesthesia has been applied in more than 250 animal experiments.

Anesthesia↗
PubMedDate not supplied

[Regional anesthesia by conduction anesthesia and reflexotherapy technics in the acute readaptation period following antiorthostatic hypokinesia].

After 7-day head-down tilt at --8 degrees six healthy male test subjects were exposed to leg anesthesia achieved by peridural anesthesia (3 subjects) and electroauriculoacuanalgesia (3 subjects), with circulation parameters being monitored. The anesthetic effect was not accompanied by significant changes in hemodynamics or homeostasis.

Acupuncture Therapy↗
PubMed1995

[Sedation and anesthesia in dogs and cats with cardiovascular diseases. I. Anesthesia plan considering risk assessment, hemodynamic effects of drugs and monitoring].

The purpose of this study was to review the effects of sedatives and anesthetics in 137 dogs and 13 cats with congenital or acquired heart disease which were referred for diagnostic, therapeutic, and surgical interventions: correction of patent ductus arteriosus (PDA-ligation, 28%), cardiac catheterization with angiogram and angioplasty (22%), pacemaker implantation (18%), exploratory lateral thoracotomy (8.7%), correction of right aortic arch (ring anomaly, 3.3%), correction of subvalvular aortic stenosis (2.7%), correction of PDA with coil in patients with mitral regurgitation and congestive heart failure (2%), pericardectomy and removal of heart-base tumors (2%), palliative surgery for ventricular septal defect (VSD, 0.7%), and sick patients with deleterious cardiac arrhythmias (0.7%). The anesthetic plan considered the risks of anesthesia based upon preoperative patient assessment, classification scheme for functional phases of heart failure, and anesthetic drug effects of the cardiovascular system. The effects of sedatives and anesthetic drugs on determinants of cardiac output are described. The most commonly used drugs for premedication, induction, and maintenance of anesthesia were midazolam-oxymorphone (20%), thiopental or etomidate (30%), and isoflurane (64%). Prompt therapy was given to control arrhythmias and provide organ perfusion, pain relief, muscle relaxation and renal diuresis, using lidocaine, dopamine, fentanyl, atracurium, and furosemide in 17.3% 14.7%, 12%, 10%, and 8.7% of animals, respectively. Methods of routine and advanced patient monitoring are described.

Anesthesia↗
PubMed1995

[Sedation and anesthesia in dogs and cats with cardiovascular disease. II. Anesthesia planning with respect to pathophysiology, heart arrhythmia].

The purpose of this study was to review the incidence of cardiac arrhythmias in 137 anesthetized dogs and 13 anesthetized cats with congenital or acquired heart disease that were referred for correction of following procedures: patent ductus arteriosus (PDA-ligation, 28%), cardiac catheterization with angiogram and angioplasty (22%), pacemaker implantation (18%), exploratory lateral thoracotomy (8.7%), correction of right aortic arch (ring anomaly, 3.3%), correction of subvalvular aortic stenosis (2.7%), correction of PDA with coil in patients with mitral regurgitation and congestive heart failure (2%), pericardectomy and removal of heart base tumor (2%), and palliative surgery for ventricular septal defect (VSD, 0.7%). The anesthetic plan considered the risks of anesthesia based upon the pathophysiology of cardiac lesions and the anesthetic drug effects on the cardiovascular system. Recommendations are made for dogs with decreased cardiac contractility, cardiac disease with volume overload, cardiac disease with pressure overload, and pericardial tamponade. The percentages of animals and their associated cardiac arrhythmias after premedication and during and after anesthesia were: sinus bradycardia (15.3%), sinus tachycardia (3.3%), atrial flutter (0.7%), atrial fibrillation (0.7%), premature ventricular contraction (14%), and ventricular tachycardia (1.3%). Prompt therapy was given to a percentage of animals in order to control arrhythmia and support cardiovascular system, by using atropine or glycopyrrolate (14%), lidocaine (17.3%), and dopamine (14.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1996

Glucose monitoring of patients with diabetes mellitus receiving general anesthesia: a study of the practices of anesthesia providers in a large community hospital.

Surgical stress causes hyperglycemia with potential complications (e.g., impaired granulocytic function and delayed wound healing) particularly when glucose levels exceed 250 mg/dL. Standards of care for patients with diabetes undergoing surgery may vary by geographic locale, type of surgical procedure, and type of diabetes. We explored whether anesthesia providers monitor glucose levels in patients with diabetes. Records of 100 patients with diabetes who underwent surgery under general anesthesia (length of procedure: range, 1.9-11.8 hours) were reviewed. Demographic information, glucose levels, frequency of glucose monitoring, and treatment used for diabetes management preoperatively, intraoperatively, and postoperatively were recorded. There were 46 males and 54 females, aged 62 +/- 13 years (55% currently treated with insulin). Of the study cohort, 89% had preoperative, 23% had intraoperative, and 54% had postoperative glucose monitoring performed. As expected, postoperative glucose concentrations were significantly higher than preoperative glucose levels (mean difference, 99 mg/dL, P < .01). The mean postoperative glucose level was 262 +/- 89 mg/dL with 30 of the 54 monitored patients having a postoperative glucose level greater than 250 mg/dL. Individuals treated with insulin and those who underwent major surgery were more likely to have glucose levels monitored. These results suggest that better strategies for monitoring glucose levels during the surgical period are needed.

Aged↗
PubMed1998

[CSE vs. augmented epidural anesthesia for cesarean section. Spinal and epidural anesthesia with bupivacaine 0.5% "isobar" require augmentation].

UNLABELLED: Incomplete anaesthesia is a major clinical problem both in single spinal and in single epidural anaesthesia. The clinical efficacy of epidural anaesthesia with augmentation (aEA) and combined epidural and spinal anesthesia (CSE) for cesarean section was investigated in a prospective randomized study on 45 patients. METHODS: Anaesthesia extending up to Th5 was aimed for. Depending on the patient's height, epidural anaesthesia was administered with a dose of 18-22 ml 0.5% bupivacaine and spinal anaesthesia with a dose of 11-15 mg 0.5% bupivacaine. Augmentation was carried out in all cases in epidural anaesthesia, initially with 7.5 ml 1% Lidocaine with epinephrine 1:400,000, raised by 1.5 ml per missing segment. The epidural reinjection in CSE was carried out as necessary with 9.5-15 ml 1% lidocaine with epinephrine, depending on the height and difference from the segment Th5. RESULTS: The extension of anaesthesia achieved in epidural anaesthesia after an initial dose of 101.8 mg bupivacaine and augmenting dose of 99 mg lidocaine reached the segment Th5. The primary spinal anaesthesia dose up to 15 mg corresponding to height led to a segmental extension to a maximum of Th3 under CSE. Augmentation was necessary in 13 patients; in 5 cases because of inadequate extent of anaesthesia and 8 cases because of pain resulting from premature reversion. The augmenting dose required was 13.9 ml. Readiness for operation was attained after 19.8 min (aEA) and after 10.5 min (CSE). No patient required analgesics before delivery. The additional analgesic requirement during operation was 63.6% (aEA) and 39.1% (CSE). Taking into account pain in the area of surgery, the requirement of analgesics was 50% (aEA) vs. 17.4% (CSE). Antiemetics were required in 18.2 (aEA) and in 65.2% (CSE). The systolic blood pressure fell by 17.7% (aEA) and in 30.3% (CSE). The minimum systolic pressure was observed after 13.4 min in aEA, and after 9.5 min in CSE. The APGAR score and the umbilical pH did not show any differences. General anaesthesia was not required in any case.

Adult↗
PubMed1995

[Inhalation anesthesia and intravenous anesthesia from the medical and economic viewpoint].

The unique pharmacokinetic properties of propofol gave rise to a widespread use of the technique of total intravenous anaesthesia. These properties of propofol are reviewed and compared to those of barbiturates and benzodiazepines. Based on this comparison and with respect to their respective intra- and postoperative effects, a cost-benefit analysis of both inhalational- and intravenous anaesthesia is presented. The choice of an anaesthetic technique must not only be made with regard to medical implications; economical aspects have also to be taken into account without challenge to the quality of care. A consequent use of low-flow techniques and a market oriented purchase of drugs and disposables may allow cost savings in anesthesia.

Anesthesia, General↗
PubMed1993

[N2O-supplemented intravenous anesthesia versus inhalation anesthesia. A comparative study of the sympathoadrenergic reaction and postoperative vigilance].

The aim of the present study was a comparison of the intraoperative sympathoadrenergic response and the postoperative vigilance of a propofol/alfentanil anaesthesia to a conventional isoflurane anaesthesia. 25 patients were admitted to the study undergoing septorhino surgery. Patients with continuous intravenous anaesthesia with propofol/alfentanil combined with nitrous oxide showed better haemodynamic conditions without an increase of blood pressure and catecholamines under laryngoscopy, intubation and surgical stimulation. In contrast to that the patients with isoflurane anesthesia showed a significant increase in haemodynamic parameters and capillary bloodflow. The measured plasma adrenalin levels showed wide intraindividual fluctuation but no significant difference between the groups. The suppression of plasma noradrenaline was more pronounced under intravenous anaesthesia. Recovery was significantly faster and vigilance significantly better in the patients undergoing intravenous anaesthesia. After 30 min patients with i.v. anaesthesia fulfilled all the conditions to be transferred to the regular ward; the other group needed more than one hour. It can be concluded that continuous i.v. anaesthesia with propofol/alfentanil is superior in suppressing the stress response to invasive stimuli and provides faster recovery and better postoperative analgesia.

Adult↗
PubMed1992

[Regional anesthesia in emergency cesarean section. Quality of epidural and spinal anesthesia].

From 1987 to 1989, 97.8% of non-elective caesarean sections at Innherred general hospital were performed under regional anaesthesia (N = 271). A retrospective analysis showed that the mean time from giving the anaesthetic until start of surgery was 28.1 min. with epidural anaesthesia and 12.7 min. with spinal anaesthesia. Mean time was 25.9 and 9.3 min. respectively in cases of suspected asphyxia. In eight women primary anesthesia was unsuccessful; six received further spinal anaesthesia and two general anaesthesia. Regional anaesthesia is considered safe for the purpose, but in cases of serious asphyxia there is some controversy as to whether spinal or general anaesthesia is to be preferred.

Anesthesia, Epidural↗
PubMed2005

The changing pattern of anesthesia, 1954-2004: a review based on the content of the Canadian Journal of Anesthesia in its first half-century.

PURPOSE: In order to review changes and progress in anesthesiology in the second half of the 20th century, and to recognize the first half-century of the Journal's existence. SOURCE: The content of the Journal from its inauguration in 1954 through 2004 was reviewed. RESULTS: Although the data base is that of the Canadian Journal, many of the contributions were from other countries, and for this reason the findings will have relevance both in Canada and elsewhere. The review suggests that anesthesiology evolved in two phases in this period: from 1954 to 1978 and from 1979 to 2004. The first was characterized by the introduction of new drugs and adaptation to new surgical techniques; the second, by a greater emphasis on clinical excellence, outcome, quality patient care both in the operating room and elsewhere in the hospital, and research. CONCLUSIONS: Although profound advances in knowledge, techniques, and relationships, have shaped the pattern and practice of anesthesiology in this half-century, the basic concerns of anesthesiologists relating to the practice of anesthesia and to their patients remained unchanged. At the same time, the many advances that have shaped anesthesiology in this half-century have extended the understanding of the phenomenon of anesthesia and enhanced the quality of patient care, which gives rise to the hope that anesthesiologists will continue to fully achieve these twin goals in the next half-century.

Anesthesiology↗
PubMed2005

Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis.

BACKGROUND: It remains unclear whether application of local anesthesia (LA) interferes with clinical efficacy of extracorporeal shock wave therapy (ESWT) for chronic plantar fasciitis. AIMS: To evaluate the effect of local anesthesia on the clinical outcome after repetitive low-energy ESWT for chronic plantar fasciitis. METHODS: Eighty-six patients with chronic plantar fasciitis were randomly assigned to receive either low-energy ESWT without LA, given weekly for three weeks (Group I, n=45; 3 x 2000 pulses, total energy flux density per shock 0.09 mJ/mm2) or identical ESWT with LA (Group II, n=41). Primary outcome measure was: Reduction of pain from baseline to month 3 post-treatment in a pain numeric rating scale [0-10 points] during first steps in the morning, evaluated by an independent blinded observer. Calculations were based on intention-to-treat. RESULTS: No difference was found between the groups at baseline. At 3 months, the average pain score was 2.2+/-2.0 points for patients of Group I, and 4.1+/-1.5 points for patients of Group II. The mean between-group difference was 1.9 points (95% CI: [1.1-2.7 points]; P<.001). Significantly more patients of Group I achieved 50% reduction of pain compared to Group II (67% vs 29%, P<.001). CONCLUSION: ESWT as applied should be done without LA in patients suffering from chronic heel pain. LA applied prior treatment reduced the efficiency of low-energy ESWT.

Adult↗
PubMed2002

Intraoperative awareness and the depth of anesthesia in children: a perspective from pediatric anesthesia.

The bispectral index (BIS) monitoring, using electroencephalographically-derived method, has shown some promise to measure 'depth of anesthesia' for various anesthetics. A large fraction of the literature that has investigated BIS monitoring demonstrates that BIS correlates well with clinically important endpoints and many clinical utility trials have been undertaken in adults to prove its effectiveness to improve perioperative patient care. As the use of the technology grows, other potential applications have been investigated; BIS as a monitor in pediatric anesthesia and BIS as a monitor to measure the depth of sleep may serve as examples. If the two are proved useful, these successes may bring clinicians another application of this technology: BIS to monitor unconsciousness state of babies to prevent sudden infant death syndrome or apparent life threatening event.

Journal Article↗
PubMed2002

Nurse anesthesia students' perceptions of the anesthesia patient simulator: a qualitative study.

The purpose of this study was to describe the perceptions of nurse anesthesia students (NAS) who used a MedSim simulator (MedSim USA, Inc, Ft Lauderdale, Fla) as part of their educational training. A convenience sample of 12 NAS in their first year of clinical training was researched. The researcher analyzed data qualitatively from observations made during 4 different sessions. Session 1 introduced the students to the simulator. Session 2 involved each student performing an anesthetic induction. A minor incident such as hypotension, hypertension, bradycardia or tachycardia occurred in session 3, and a major incident such as cardiac ischemia, anaphylaxis, bronchospasm, or malignant hyperthermia occurred in session 4. Data collection involved observation by the primary investigator, journal entries by the anesthesia students, and focus group interviews with the students. Results of the study indicate that, although students experience feelings of apprehension, uneasiness, or fear during the sessions, they felt it was very educational. Disadvantages include the lack of reality, lack of knowledge on handling crisis events, possibility of fixation errors, and the presence of anxiety. Advantages include improved critical thinking and decision-making skills, increased confidence, and improved clinical preparation. Results can be used to assist instructors in improving the students' learning experiences and to teach more effectively.

Attitude↗