Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Anesthesia, Inhalation”

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 937 records · Page 52Linked to original sources
PubMed1993

[Reevaluation of spinal anesthesia in elderly people--an evaluation of circulatory changes].

Appropriate methods of anesthesia for the elderly people are being discussed as the ratio of elderly people in our society increases. During spinal anesthesia, hypotension was frequently observed in patients with hypertension, arteriosclerosis, coronary deficiency, and so on. It is also difficult to pass the needle between degenerated vertebrae. However, general inhaled anesthesia accompanies the respiratory complications and consciousness derangement after surgical operations more frequently than after spinal anesthesia. In this study, circulatory conditions during spinal anesthesia in elderly people (30-91 years old) were analyzed in 109 cases of spinal anesthesia. Hypotension occurred about 10 minutes and 40-60 minutes after injection of anesthetics and was frequent in patients of high aged group, but tachycardia was not observed among them. In addition, their blood pressure in the recovery room could not recover to the level before anesthesia. It is thought that hypotension during spinal anesthesia was induced by the vascular dilatation caused by sympathetic nerve block and the deficiency of reflective venous constriction in upper extremities and abdominal organs. Tachycardia may also produce hypotension. However, the reflexive vasoconstriction and tachycardia are thought to be poor on account of arteriosclerosis and down regulation of beta-receptor in elderly people. Therefore, during spinal anesthesia in the elderly people, the catecholamine released by the surgical stimulation could not increase blood pressure effectively. To prevent hypotension during spinal anesthesia in elderly people, it is advisable to employ the treatment for upregulation of beta-receptor before anesthesia and the administration of alpha . beta-receptor, epinephrine and dopamine for control of blood pressure during spinal anesthesia.

Aged↗
PubMed1998

NitroG-L-arginine methyl ester decreases minimum alveolar concentration of isoflurane and reduces brain nitric oxide synthase activity in rats.

BACKGROUND: Nitric Oxide (NO), an endogenous messenger produced by the enzyme nitric oxide synthase (NOS), is recently introduced to be involved in inhalational anesthesia. We have previously reported that a specific NOS inhibitor, nitroG-L-arginine methyl ester (L-NAME), reduces the value of minimum alveolar concentration (MAC) for isoflurane anesthesia in rabbits. The purpose of this study is to evaluate the effects of the NOS inhibitor, L-NAME, on isoflurane MAC and NOS activity in rats. METHODS: Adult Wistar rats receiving isoflurane inhalation were randomly divided into two groups, with eight rats in each group. In the study group, L-NAME 30 mg/kg was given 60 min before the inhalation of isoflurane. Normal saline was given to the control group instead. The data of MAC, blood pressure (BP), and heart rate (HR) were recorded. The vital signs, such as EtCO2, PaO2, and temperature, were maintained within normal ranges. The activity of NOS in cerebellum was assessed by measuring the conversion of L-[3H] arginine to L-[3H] citrulline. All data were presented as mean +/- SD. Statistical analysis was performed using Student's t-test, where P < 0.05 was considered significant. RESULTS: In the presence of L-NAME (30 mg/kg), the MAC for isoflurane was markedly reduced from 1.6 +/- 0.20% (study group) to 1.0 +/- 0.09% (control group) (P < 0.05). The activity of cNOS in cerebellum was 220.09 +/- 23.64 (pmol/mg protein/30 min) in the control group, and in contrast a sharp reduction as low as to 115.40 +/- 24.85 (pmol/mg protein/30 min) was seen in the study group. CONCLUSIONS: The involvement of NO in the mechanism of isoflurane anesthesia can be demonstrated by the fact that the NOS inhibitor, L-NAME reduces the level of MAC and the cerebral NOS activity in rats.

Anesthetics, Inhalation↗
PubMed2001

Anesthesia and critical care of thymectomy for myasthenia gravis.

Myasthenia gravis is an autoimmune disease resulting from the production of antibodies against the ACh receptors of the neuromuscular synapse. The thymus gland is involved in the autosensitization process, and the disease frequently is associated with thymic morphologic abnormalities. There is a consensus that all adults with generalized MG should have a thymectomy. This recommendation has been propagated by the safety of the procedure and excellent outcome. Removal of as much thymic tissue as possible (anterior mediastinal exenteration) by transsternal approach is the logical goal of thymectomy in the treatment of MG. Transcervical approach and VATS, however, are less invasive and have been used in patients who have MG unaccompanied by thymoma. Optimization of the condition of the myasthenic patients can markedly decrease the risk of surgery and improve the outcome. Two techniques have been recommended for general anesthesia in the myasthenic patient. Because of the unpredictable response to succinylcholine and the marked sensitivity to nondepolarizing muscle relaxants, some anesthesiologists avoid muscle relaxants and depend on deep inhalational anesthesia, such as halothane, isoflurane, or sevoflurane, for tracheal intubation and maintenance of anesthesia. Others, however, use a balanced technique of anesthesia that includes the use of carefully titrated muscle relaxants. The most important preoperative factor predicting the need for postoperative mechanical ventilation is the severity of bulbar involvement (Ossermann group 3 and 4), usually indicated by significant dysphagia and dysarthria associated with borderline respiratory dysfunction. Thymectomy benefits nearly 96% of patients: 46% develop complete remission, 50% are asymptomatic or improve on therapy, and 4% remain the same. The time from diagnosis to surgery is shorter than 8 months, and mild or moderate myasthenic symptoms are the main prognostic factors that predict the best outcome after thymectomy.

Anesthesia↗
PubMed1995

Inhaled nitric oxide improves oxygenation in piglets with meconium aspiration.

We hypothesized that nitric oxide (NO) inhalation in a model of meconium aspiration in newborn piglets would decrease pulmonary vascular resistance. Seven neonatal piglets were obtained at less than 48 hr of age and instrumented under fentanyl anesthesia. Inhaled NO (40 parts per million) was administered during normoxia and again after hypoxia was induced by reducing FiO2 to 0.13. During normoxia NO inhalation caused a fall in pulmonary artery pressure from a mean of 3.15 (SD 0.8) kPa to 2.84 (SD 0.7) kPa (P < 0.01). Hypoxia (mean arterial O2 saturation 35%) increased PA pressures to a mean of 5.4 (SD 1.6) kPa and NO administration during hypoxia decreased PA pressures to 3.6 (SD 1.2) kPa (P < 0.001). In order to determine the effects of NO in a model of meconium aspiration, 6 to 7 mL/kg of 20% human meconium in normal saline was instilled into the trachea. This procedure induced hypoxemia (mean SaO2 43.4%, SD 19), respiratory acidosis, (mean PaCO2 12.1 kPa, SD 0.5; mean pH 7.04, SD 0.03), and pulmonary arterial hypertension (mean pulmonary artery pressure 6.0 kPa, SD 1.3) despite ventilation with 90% oxygen. Inhaled NO was then administered in concentrations of 5, 10, 20, 30, 40, 60, and 80 parts per million in random order according to a Latin square design.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1999

Spinal anesthesia for cesarean section: isobaric versus hyperbaric solution.

BACKGROUND: The present study was undertaken to compare the outcomes of hyperbaric versus isobaric spinal anesthesia in Cesarean delivery. METHODS: The anesthetic solution was administered in sitting position as this posture is commonly used in this clinical setting. Except for the baricity of the anesthetic solution, identical technique was employed for every parturient in the study. Following administration of anesthetic solution the parturient immediately resumed horizontal supine position. The solutions used were 2.0 mL of 0.5% tetracaine in 5% dextrose (hyperbaric) for Group H (n = 30) and in cerebrospinal fluid (isobaric) for Group I (n = 30). RESULTS: Both hyperbaric and isobaric tetracaine given in sitting position provided adequate analgesic levels. However, hyperbaric tetracaine solution produced a slightly higher median peak level of wilder range, and caused a higher incidence of hemodynamic changes and subjective sensation of "feeling sick" than isobaric tetracaine. Additionally, the duration of surgical anesthesia was shorter and the sacral block was longer for hyperbaric tetracaine solution than for isobaric tetracaine solution at same dose and concentration. Only one mother in Group H needed supplemental inhalation anesthesia for a subsequent hysterectomy due to uncontrollable bleeding. There were no complications, including postpuncture headache in either group. CONCLUSIONS: Our results indicated that numerous variables must be taken into consideration in predicting the outcome of a spinal anesthesia. Alternation in the technique and individual patient factor may individually or collectively produce different results.

Adolescent↗
PubMed2006

Combined spinal-epidural anesthesia in a dog.

OBJECTIVE: To report use of combined spinal epidural anesthesia for tail resection and surgical exploration of the pelvic canal and the perineal-pararectal area in a dog. ANIMAL: A 4-month-old, 13 kg male Collie dog. METHODS: Under inhalant anesthesia, an epidural catheter was threaded through a Tuohy needle at L5-L6. Then using a Whitacre spinal needle bupivacaine and fentanyl were administered in the subarachnoid space at L6-L7 level. Fifteen minutes later, morphine was administered epidurally. Bupivacaine and morphine were administered epidurally 4 hours after the subarachnoid injection. RESULTS: No cardiorespiratory response to surgical stimulation was observed. Postoperative analgesia was satisfactory, and the catheter was removed 30 hours later. No complications or neurologic sequelae occurred before discharge or were noted 10 days later. CONCLUSION: Combined spinal-epidural anesthesia provided excellent intraoperative anesthesia and perioperative analgesia in a dog undergoing surgery involving the pelvic canal. CLINICAL RELEVANCE: Combined spinal-epidural anesthesia can be performed in dogs, and its use should be considered in major surgeries caudal to the diaphragm, as the epidural catheter allows cranial extension of the block, providing excellent intraoperative anesthesia and perioperative analgesia.

Analgesia, Epidural↗
PubMed1979

Decreased tear production associated with general anesthesia in the dog.

Schirmer I tear tests were done on 20 dogs before and during general anesthesia. Atropine sulfate reduced tear production from a mean base-line value of 20.35 +/- 3.33 mm/minute to 14.10 +/- 6.13 mm/minute, 10 minutes after its subcutaneous administration. The combination of subcutaneous atropine, intravenous thiamylal sodium, and inhalation anesthesia reduced tear production to a mean value of 0.53 +/- 1.12 mm/minute at 60 minutes after induction.

Anesthesia, General↗
PubMed2006

Effect of postoperative experiences on willingness to pay to avoid postoperative pain, nausea, and vomiting.

BACKGROUND: The authors assessed the willingness to pay (WTP) for "perfect" prophylactic antiemetics and analgesics in patients who were scheduled to undergo surgery during general anesthesia. Furthermore, they determined whether postoperative experiences of pain and nausea and vomiting (PONV) changed patients' WTP. METHODS: Data were collected alongside a randomized clinical trial that investigated the incidence of PONV in patients anesthetized with either inhalation anesthesia or total intravenous anesthesia. A subset of 808 consecutive patients participating in the trial completed WTP questionnaires 1 day before and 2 weeks after surgery. The outcome measure was the maximum amount of money that patients were willing to pay for "perfect" antiemetics and analgesics. Preoperative WTP and individual WTP changes after surgery were analyzed in relation to baseline characteristics and postoperative pain and PONV experiences. RESULTS: Prevention of postoperative pain was valued higher than prevention of PONV. The median preoperative WTP for analgesics was US dollar 35 (interquartile range, dolalr 7-69) vs. US dollar 17 (interquartile range, dollar 7-69) for antiemetics. Individual WTP changes for antiemetics were not related to PONV experience, whereas severe postoperative pain (numerical rating score > or = 8) was associated with an increase in the WTP for analgesics. CONCLUSIONS: Severe postoperative pain experiences increased patients' WTP for analgesics, but PONV did not increase WTP for antiemetics. The elicited WTP values were lower than those reported in previous studies, which is possibly related to differences in market culture or patients' attitudes toward postoperative pain, nausea, and vomiting.

Adult↗
PubMed2002

Prevention and treatment of malignant hyperthermia in certified training hospitals in Japan: a questionnaire.

PURPOSE: To assess the preparedness of hospitals in Japan for cases of malignant hyperthermia (MH). METHOD: A survey was sent to 884 training hospitals certified by the Japan Society of Anesthesiologists (JSA) in June and July 2000. Useful answers were received from 431 (48.8%) institutions. RESULTS: For general anesthesia, inhalation anesthetics were widely used in 283 (65.7%) hospitals, and succinylcholine was the most commonly used muscle relaxant, which was used in 270 hospitals (62.5%). For patient monitoring, 422 (97.9%) hospitals used a pulse oximeter for all general anesthesia cases. A capnogram was used in 152 (35.3%) hospitals, and continuous body temperature was measured in 128 (29.7%). Two hundred and eighty-eight (66.8%) hospitals had more than six vials of dantrolene prepared for use, whereas 13 (3.0%) had none. CONCLUSION: The results of the survey revealed that some hospitals had inadequate monitoring methods and a lack of prepared dantrolene for cases of MH under general anesthesia. We recommend that essential monitors be deployed and adequate preparations of dantrolene be maintained for effective early diagnosis and treatment of MH.

Journal Article↗
PubMed1982

Evidence for acute cellular changes in human hepatocytes during anesthesia with halogenated agents: an electron microscopic study.

Liver biopsy specimens of 24 patients who had elective laparotomies were studied by electron microscopy for evidence of anesthesia-related toxic changes. All patients were initially anesthetized with nitrous oxide, barbiturate, and narcotic until the laparotomy incision was completed and an initial preanesthesia liver biopsy specimen was taken. Patients were then give, in randomized fashion, maintenance inhalational anesthesia for the duration of the procedure with halothane, fluroxene, or enflurane. Control patients were continued on nitrous oxide, barbiturate, and narcotic. After approximately 60 minutes a second postanesthesia liver biopsy specimen was taken. For each patient, the preanethesia and postanesthesia liver biopsy specimens were compared, in blinded fashion, for evidence of morphologic changes resulting from anesthesia. Ultrastructural changes consistent with hepatic toxicity were present in more than 25% of the cells examined in the postanesthesia specimens in all of the seven patients given halothane, five of the six patients given fluroxene, and one of the five patients given enflurane. None of the six nitrous oxide-barbiturate-narcotic control patients showed toxic changes in postanesthesia specimens. The most prominent toxic change was dilatation of endoplasmic reticulum. Accumulation of intracellular inclusions occurred in some cells, and a small percentage of cells also showed lipid accumulation and mitochondrial swelling. Evidence suggested that exposure to halogenated anesthetics is related to acute toxic subcellular changes in hepatocytes.

Adolescent↗
PubMed1998

Local/regional anesthesia for thyroidectomy: evaluation as an outpatient procedure.

BACKGROUND: The purpose of this paper was to review my evolving experience with local/regional anesthesia in an outpatient setting. METHODS: Two hundred three consecutive patients during a 9-year period who chose to undergo thyroid operation under regional/local anesthesia were reviewed. Early discharge was offered to patients who were observed for 6 hours without neck swelling and who had no surgical reasons for delaying discharge. RESULTS: In group A there were 2 patients who were given inhalation anesthesia during operation compared with none in groups B and C. The average length of stay in group A was 0.49 days, 0.55 days in group B, and 0.24 days in group C. Eighty-five percent of the patients whose operation began before 1300 hours were discharged within 6 hours versus only 50% of those operated on later in the day. Forty-seven percent of patients in group A, 65% of group B, and 77% of patients in group C were discharged within 6 hours of operation. On the basis of previous experience with general anesthesia, discharge time is not significantly influenced by the type of anesthesia chosen. There were no readmissions to the hospital, but 2 episodes of postoperative bleeding required reoperation. Survey showed that 95% of patients rated the level of pain equivalent or less severe than dental procedures under local anesthesia, and all patients would choose local again. CONCLUSIONS: These data suggest that thyroidectomy can be performed with the patient under local/regional anesthesia, with low morbidity and high patient satisfaction. Most patients can be discharged within 6 to 8 hours, and these discharges were not associated with readmissions.

Adult↗
PubMed1990

Does continuous positive airway pressure compensate for loss of glottic function during tracheal intubation?

Adult patients with acute lung injury (ALI) exhibit increased PaO2 when receiving continuous positive airway pressure (CPAP). Some have increased PaO2 after extubation. To determine the role a competent glottis played in improving gas exchange, we anesthetized seven rabbits and inserted central venous and carotid artery catheters. After recovery from anesthesia, ALI was induced with oleic acid (0.08 ml/kg). Twenty-four hours later, the animals were sedated and placed in a sling. The pHa and blood gas tensions were measured. The animals were placed supine and were given inhalation anesthesia to facilitate tracheal intubation. A polyethylene catheter was placed slightly distal to the tracheal tube outlet to measure tracheal pressure (PT). Intubated rabbits were repositioned in the sling and were given either zero end-expiratory pressure (ZEEP) or 5 cm H2O CPAP, alternately. After the animals had breathed room air for 60 min, pHa and blood gas tensions were again measured, and PT was recorded. Animals were extubated, but the PT catheter was left in place. Data were collected again 60 min later, the catheter was removed, and the animals were returned to their cages. Forty-eight hours after onset of ALI, the protocol was repeated.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

[Increase in bispectral index induced by antihyperalgesic dose of ketamine].

We report two cases of sudden increase in Bispectral Index (BIS) after the injection of low-dose ketamine for the prevention of postoperative hyperalgesia. The two patients were anaesthetised with a continuous infusion of remifentanil associated with propofol for one and isoflurane for the other. Changes in BIS occurred while the two patients were in a stable phase of surgery (beginning of parietal closure and suture of an anastomosis) and had a stable target concentration of anaesthetic agents. No others signs of awakening were observed. The BIS value returned progressively to 40-50 despite no increase in target concentration. None of the patients complained of intra-operative recall.

Aged↗
PubMedDate not supplied

Anesthesia in sheep with propofol or with xylazine-ketamine followed by halothane.

OBJECTIVE: This study evaluates the clinical usefulness and anesthetic effect of propofol, and compares these effects with those of xylazine-ketamine-halothane anesthesia in sheep. STUDY DESIGN: Prospective, randomized, clinical trial. ANIMALS OR SAMPLE POPULATION: Fourteen healthy adult male sheep. METHODS: Sheep were randomly assigned to two different drug regimens: (1) Bolus injection of propofol (3 mg/kg, intravenously [i.v.]) followed by continuous intravenous infusion and (2) xylazine (0.11 mg/kg, i.v.) and ketamine (2.2 mg/kg, i.v.) for induction followed by halothane anesthesia. Heart rate, respiratory rate, and arterial blood pressures were monitored during anesthesia. Venous blood samples were collected for blood gas analysis. Quality of induction and recovery were also recorded. RESULTS: The average dose of propofol used to induce and maintain anesthesia was 6.63 +/- 2.06 mg/kg and 29.3 +/- 11.7 mg/kg/hr (0.49 +/- 0.20 mg/kg/min), respectively. The duration of propofol anesthesia was 45.3 +/- 13.2 minutes and recovery to standing occurred in 14.7 +/- 5.7 minutes. Sheep receiving xylazine-ketamine-halothane were anesthetized for 35.9 +/- 4.0 minutes and recovery to standing occurred within 28.5 +/- 7.5 minutes. Sheep anesthetized with propofol had a significantly higher heart rate, diastolic blood pressure and Pvo2, and a lower Pvco2 at 30 minutes and lower BE at 15 and 30 minutes than sheep anesthetized with xylazine-ketamine-halothane. CONCLUSIONS: Propofol anesthesia was characterized by a smooth induction, effective surgical anesthesia and rapid recovery which was comparable to anesthesia with xylazine-ketamine-halothane. CLINICAL RELEVANCE: Propofol may be indicated in situations when it is desirable to maintain anesthesia with an intravenous infusion followed by a rapid recovery in healthy sheep.

Anesthesia, Inhalation↗