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 523 records · Page 29Linked to original sources
PubMed2003

[Effects of sevoflurane anesthesia on the immune response and biochemical parameters in mice. Comparison between single exposure and repeated anesthesia].

OBJECTIVE: Given that anesthesia and surgery are known by their immunomodulatory effects, we aimed to compare the immune response after 1 or 3 anesthetic exposures to sevoflurane in a murine model without surgery. MATERIAL AND METHODS: Young adult male mice, non-controlled for body conformation, were exposed 1 (group S1) or 3 times (group S3) to 3% sevoflurane in oxygen (1.2 maximum alveolar concentration) for 40 minutes. Untreated animals were used as controls. Three days after in vivo exposure to sevoflurane, the cellular composition of peripheral blood and of the spleen were studied. We also studied the in vivo response to exogenous (sheep red blood cells: SRBC) and endogenous antigens (heat shock proteins: HSP 65 and HSP 70) as well as biomarkers of toxicity. RESULTS: The number of leukocytes in peripheral blood decreased in S3 animals, and the number of lymphocytes decreased in both groups. B cells in spleen decreased only in the S1 group, but an increased in vivo response to SRBC was seen in both S1 and S3 mice in comparison with the control animals. Re-exposure to sevoflurane led to a decrease in immunoglobulin G response only to HSP 70. Plasma markers of liver and kidney function did not change after anesthetic exposure. CONCLUSION: Changes in leukocyte populations in peripheral blood and in antibody-producing capacity occur after either a single exposure or repeated exposures to sevoflurane. However no changes occur in biomarkers of toxicity.

Anesthetics, Inhalation↗
PubMed1991

Report of the National Commission on Nurse Anesthesia Education. American Association of Nurse Anesthetists Medicare pass-through reimbursement for nurse anesthesia education programs.

Medicare pass-through dollars for paramedical education are one way hospitals can still get reimbursed on the basis of their costs under the prospective payment system. To qualify, a hospital must demonstrate that it has some involvement in the operation of the nurse anesthesia program. Establishment of a cost center for school-related expenses can help maximize reimbursement.

Accounting↗
PubMed1990

AANA Journal course: new technologies in anesthesia: update for nurse anesthetists--mass spectrometry in anesthesia.

Despite the development of mass spectrometry in the early 1900's, it has only in this decade been introduced into the clinical anesthesia arena. The mass spectrometer's ability to make simultaneous measurements of specific gases distinguish it from currently available monitoring apparatus. This article will review the basic principle of operation of the mass spectrometer. The cost of implementation of mass spectrometry, clinical applications and potential pitfalls associated with its use will also be discussed.

Education, Nursing, Continuing↗
PubMed1990

AANA Journal course: new technologies in anesthesia: update for nurse anesthetists--the computer-generated anesthesia record.

This lesson will introduce the anesthetist to computerized anesthesia record keepers, their history, development and current technology. It will identify some of the outstanding advantages and disadvantages of computerized record keepers from both clinical and legal standpoints. Computerized record keepers may not assume charting duties during all anesthetics administered in the United States but they do offer many advantages, especially during difficult cases. As their development continues, they may relieve the anesthetist of some repetitive and distracting tasks while providing clinically useful information and analysis.

Education, Nursing, Continuing↗
PubMed1998

[Remifentanil-propofol anesthesia in vertebral disc operations: a comparison with desflurane-N2O inhalation anesthesia. Effect on hemodynamics and recovery].

OBJECTIVE: To ascertain whether there is a difference between total intravenous anaesthesia with propofol (P) and remifentanil (R) and inhalational anaesthesia with desflurane (D) and nitrous oxide (N) with regard to haemodynamic reactions, recovery profile and postoperative analgesic demand in patients scheduled for elective microsurgical vertebral disc resection. METHODS: 50 patients (ASA I-II, 18-65 years) were randomly assigned to receive total intravenous anaesthesia with propofol and remifentanil or inhalational anaesthesia with desflurane and nitrous oxide. After standardised induction of anaesthesia in both groups (1 microgram.kg-1 remifentanil, 1.5 mg.kg-1 propofol 0.1 mg.kg-1 cisatracurium), anaesthesia was maintained in the D/N group with desflurane in 50% N2O. The patients of the P/R group received a constant infusion of 2 mg.kg-1.h-1 propofol and a constant infusion of 0.5 microgram.kg-1.min-1 remifentanil, which was reduced after 15 min by 50%. The administration of desflurane and the infusion of the anaesthetics were adjusted to maintain a surgical depth of anaesthesia. At the end of surgery the anaesthetics were discontinued and early emergence from anaesthesia was assessed by measuring time to spontaneous ventilation (VT > 4 ml/kg), tracheal extubation, opening of the eyes and stating correct name and data of birth. The frequency of analgesics and total demand for analgesics were determined using patient-controlled analgesia and recorded for 2 h postoperatively. In addition the pain level of the patients was measured on a visual analogue scale and the incidence of postoperative shivering, nausea and vomiting was noted. RESULTS: Patients anaesthetised with desflurane responded to tracheal intubation and skin incision with increasing blood pressure and showed higher heart rates than patients anaesthetised with propofol and remifentanil, but there were no other haemodynamic differences between the groups in response to surgical stimuli. There were significantly shorter times to spontaneous ventilation (3.2 vs. 6.3 min), extubation (3.8 vs. 9.5 min), eye opening (3.0 vs. 11.5 min) and giving name and date of birth (4.8 vs. 14.3 min) in patients anaesthetised with remifentanil and propofol than in those receiving desflurane and nitrous oxide. In addition, patients anaesthetised with remifentanil and propofol had a greater incidence of postoperative shivering. There were no significant differences between the two groups in the patients' pain scores, analgesic demand and incidence of nausea and vomiting. CONCLUSION: Patients anaesthetised with propofol and remifentanil have significantly shorter emergence times than patients anaesthetised with desflurane and nitrous oxide. The low incidence of postoperative pain after microsurgical vertebral disc resections requires no large-scale analgesic therapy, even after total intravenous anaesthesia including remifentanil.

Adult↗
PubMed1996

[Perioperative monitoring of the course of anesthesia, the postanesthesia visit and inquiry of patient satisfaction. A prospective study of parameters in process and outcome quality in anesthesia].

PURPOSE: This study is an investigation into the results of reporting on incidents during and after anaesthesia, to reveal any possible associations between intra-procedural and final outcome. The study contributes to the quality assurance project of the German Society of Anaesthesiology and Intensive Care (DGAI). We adjusted and tabulated our data for preoperative risk and for different methods of anaesthesia. This nation-wide DGAI project was launched to compare clinical institutions in accordance with German social legislation. METHOD: DGAI recommends standardised documentation of parameters representing quality of process (QP) defined by a 63-items list, during every anaesthesia course. Additionally, quality of outcome parameters (QO) defined by a 64-items list should be assessed by an anaesthetist during a standardised postoperative ward round by means of spot checks. A questionnaire covering subjective complaints (SC) and patient satisfaction, is optional. The combination of these tools was evaluated during a 5-month period in every patient (n = 282) on a traumatological surgery ward. RESULTS: QP and QO showed a significant association (p < 0.0001). The incidence of both parameters increases according to risk factors like age and ASA physical status. This was not significant in respect of the type of anaesthesia (p = 0.20). Whereas perioperative QP parameters were less frequent in regional versus general anaesthesia (p < 0.0001), there was no postoperative difference in QO as seen by the anaesthetist (p = 0.20). However, postoperative SC were less frequent with regional anaesthesia (p < 0.0001). The association of QO and SC was mot significant (p = 0.24). There was comparable preoperative morbidity (p = 0.74) for both anaesthetic procedures. 96.5% of all patients expressed overall satisfaction. Despite this fact, nausea (25%), vomiting (29%), thurst (29%) and particularly wound pain (33%) were frequent. CONCLUSIONS: Quality parameters assessed by anaesthetists and patients are independent in respect to their frequency. For this purpose, anaesthesiological quality assurance must focus on both the anaesthetist and the patient. As clinical consequence, we suggest establishing an interdisciplinary post-anaesthesia service. Acceptance by, and collaboration between, the surgical disciplines are indispensable especially for a successful application of effective pain and antiemetic therapy.

Adult↗